Review

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Clinical guidelines and flashcards from when I took midwifery boards

This past week I have finally been able to see the light at the end of the tunnel. I have one more full week of work at my current job before I have a week and a half break before the New Job.

I have started to realize that most of the patients that I see and recommend that they come back for a well-woman exam, or maybe next month for a blood pressure check, I will never see again. I won’t be able to tell the women whose abortions I provided this week that, in two weeks, they are definitely no longer pregnant.

No matter how frustrated I am with how things turned out working in NGO-ized health care, I also do know that most of the work I do here, I won’t get to do in such high volume at the New Job.

Fewer first time birth control starts. Fewer IUD insertions on women that have never had any babies (which provide a lovely challenge every time), and absolutely no more abortion care.

In preparation for my new role, I have begun to review the basics of prenatal care, pregnancy lab values, and OB emergencies. In my current role, I see women when they have just found out they are pregnant. Sometimes they want to be.

I have begun flexing my prenatal muscles again, remembering all the milestones of prenatal care, talking rustily about folic acid and weight gain recommendations.

I have lots of material to review, but the things that keep me up at night are the hand skills that don’t come in books. Will I remember how to suture? (The answer to this is definitely not). What about Leopold maneuvers? That instinct to check for the cord around a baby’s neck before easing them into the world?

I know I can review all the facts and protocols in the world, but that the hand skills will just have to come back with time and experience.

This week was unseasonably warm in Seattle, which allowed me to go on a beautiful, sunny walk with a former classmate and we talked about all the ups and downs of providing full-scope care.

As we walked and talked, I became more and more sure in the things I do remember, and look forward to learning as I expand my scope of knowledge outward and work to the full capacity of my license and ability.

I have a feeling the next few weeks will be full of bittersweet goodbyes and lots of reading and review.

Midwives, if you were jumping back into full-scope practice, what are the new guidelines and research that has been updated in the past year?

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One Response to Review

  1. lena says:

    ACOG recently issued new guidelines on diagnosis of preeclampsia…the Task Force on Hypertension in Pregnancy report is worth a read-over (it’s not available to non-members, but if you have library access through work you’d be able to read it, or send me an email and I can get you a copy). Also this is pretty new: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Emergent-Therapy-for-Acute-Onset-Severe-Hypertension-During-Pregnancy-and-the-Postpartum-Period

    I haven’t gotten to intrapartum yet, so I don’t have a ton of materials…but I’m happy to share stuff as it comes in!

    And hand skills! Leopold’s! My goodness! I’m just starting to learn this, and how to measure fundal height…I hope someday it won’t be so awkward, but sheesh. Right now, it feels so clumsy! This probably doesn’t make you feel any better, but I certainly feel a little better knowing that it’s something you just have to do consistently to keep up the skill. Once a week isn’t enough!

    Good luck! You’re going to do just awesome, I’m sure! Day by day…which is my current mantra for surviving school.

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