Nurse midwifery is just one of many roles nurses who specialize in OB/GYN can choose.
As of August 2017, according to the American Midwifery Certification Board, there were more than 11,000 certified nurse midwives practicing throughout the world. They are licensed, independent healthcare providers with prescriptive authority in all 50 states, the District of Columbia, American Samoa, Guam and Puerto Rico.
Although they are well-known for assisting women in labor and delivery, nurse midwives provide many more healthcare services for women and their families.
Aiyana Davison, CNM, WHNP, RN, a certified nurse midwife and women’s health nurse practitioner, talked with Nurse.com about her own experiences, challenges she has faced when helping those who have limited access to healthcare and why she chose nurse midwifery as her career.
Davison hosts a blog called The Vagina Chronicles.
Who or what influenced you to pursue a nursing career in midwifery? Why do you find this role satisfying and fulfilling?
I knew I wanted to become a nurse midwife before I even finished nursing school. There seemed to be nothing more appealing and fulfilling than helping and supporting parents as their babies transitioned into this world. I have quite a few family members who are nurses, one of whom was my grandmother.
She knew I was becoming a nurse and that I wanted to become a nurse midwife. However, it was not until years after her passing, shortly before completing my graduate studies, when I found out she was a nurse midwife on the island of Antigua.
I also have a cousin who practiced midwifery in New York. In a way, I feel that midwifery is not only a calling for me — it’s in my blood.
The role is more satisfying than I ever anticipated. I am able to educate, bond and grow with my patients and their families. There’s a spiritual and emotional connection, which is another reason for my pursuit of midwifery. My practice as a midwife has never disappointed me.
What have you learned and what have been the challenges when caring for those women and families who have limited access to care in the U.S.?
I have learned to be patient, to get the full story of what is going on, and to meet patients and their families at a level they understand and meets their needs.
The challenges come when individuals are trying to do their best but are faced with serious life adversities, such as job and financial difficulties, insurance changes or lapses and various social issues. Understanding that these factors exist and finding ways to work around them or remove them has proven to be a worthwhile challenge for me.
I also witness great challenges when patients are dismissed or neglected in healthcare because of race, sexual preferences or identity, religious beliefs, or life morals and values. Sometimes I realize that I am left with the challenge of “picking up the pieces” and need to reassure patients they are safe and going to receive quality care.
It’s crucial to let my patients and their families know they matter and I will provide them with the best care I can offer.
What should a nurse consider before embarking on this path?
For those who are thinking about becoming midwives, I urge you to find opportunities to shadow a midwife, which will open your eyes to the work that is before you. If you are a registered nurse, it might be helpful to take some time to work on a labor and delivery unit or in a birthing center.
It’s a good idea to think about the type of practice you would like to join before entering a midwifery program. Do you wish to work in a hospital setting, birth center or in the home? Do you wish to be active in your community? By community involvement, I mean teaching classes and providing education outside of the clinic setting because office appointments often don’t allow enough time for patient education.
In-person and online courses are available to help you expand your knowledge base and are specifically designed for midwives. Some communities hold prenatal groups, postpartum groups, walks and hikes and book clubs — all designed to connect the midwives (or other healthcare providers) with their patients.
A person can follow many different avenues to becoming a midwife. While nurses can become certified nurse midwives through a master’s degree program, individuals without a nursing background also can become midwives.
Nurses can become midwives through distance learning programs, but they may require that students find their own clinical placement. Then there are in-person programs that may be better suited for those who prefer the classroom. You have options!
What makes the specialty extraordinary?
If you are considering nurse midwifery, you must think about the commitment you will make not only to women you care for but also to families that cross the lifespan. Our world is ever-changing and there’s always a need for excellent midwives to care for the many unique individuals and families in this world.
Prenatal visits can turn into annual well-woman appointments that may turn into you experiencing life events with your patients and their families.
It does not stop at “oh, you had your baby” or “here are your test results.” Many advanced practice providers continue to follow up with their patients. We also have to be aware of the individuals who have a uterus but do not identify as women. We have to be respectful of those individuals and be mindful of that when we provide our care.
As midwives, we all rely on each other. We also rely on assistance from a number of other individuals in the birth world, such as doulas, nurse practitioners, physicians, labor coaches, nurses, medical assistants, respiratory therapists and pediatricians, just to name a few. We know we are not alone in the work we do.
We also understand it’s sacred work to help individuals and their families become pregnant, remain pregnant and take care of their baby and themselves after delivery. And our duties go far beyond the birthing experience, as it includes addressing birth control, abortions, Pap smears, irregular bleeding issues, menopause and so much more. Midwifery is a lifelong commitment to women and their families.
Courses related to ‘women’s health’
60214: Support of the Childbearing Family Through Education
(2.2 contact hrs)
The nurse who cares for the laboring patient should understand what information is being taught to support a patient and her family’s wishes appropriately. This course explains the history of childbirth education, current childbirth options, the birth plan and managing pain during labor.
CE273-60: Hyperemesis Gravidarum — More than Morning Sickness
(4 contact hrs)
Although nausea and vomiting in pregnancy occur in about 70% to 85% of all pregnancies, severe symptoms can lead to complications that may endanger the life of both the expectant mother and the fetus. Hyperemesis gravidarum (HG) affects about 0.3% to 2.3% of pregnancies and is defined as severe nausea and vomiting that result in weight loss, nutritional imbalance and dehydration. This educational activity will address the etiology, assessment and management of the condition.
CE682: Importance of Nutritional Status in Pregnancy Outcomes
(1 contact hr)
The most important controllable factors in pregnancy outcome are prenatal medical care and adequate nutrition during pregnancy. The health and eating habits of the mother directly affect the fetus and the pregnancy’s outcome. In a country such as the United States where the food supply is plentiful and women should be well nourished, it is disheartening to realize that malnutrition and poor eating habits lead to maternal, fetal and neonatal complications. Not only are there short-term complications but later-in-life chronic diseases may be experienced by the baby based on the mother’s prenatal diet and its impact on the mother and the baby’s epigenetics. Learn what nutrients are necessary for a healthy pregnancy.