Education Sessions: Thursday, May 26
ES 500 Women’s Reintegration Experiences after Returning from War
The purpose of this study was to describe reintegration experiences of female US military nurses returning from deployments in the Iraq and Afghanistan wars. A qualitative, phenomenological method was used. The population included nurses from the Army, Navy, and Air Force who served during 2003-2013, including Active Duty, National Guard, and Reserve members. Samples of 32 women were recruited from veteran and professional nursing organizations. Nine themes emerged from data analysis: (1) Homecoming: A mixed reception; (2) Renegotiating roles: A family affair; (3) Painful memories of trauma; (4) Sorting it out: Getting help; (5) Needing a clinical change of scenery; (6) Petty complaints and trivial whining: No tolerance here; (7) My military unit or my civilian workplace: Support versus lack of support; (8) Family and social networks: Support versus lack of support; and (9) Reintegration: A new normal.
ES 501 After the Pap: Midwives Screening, Diagnosing, and Treating Cervical Dysplasia
A primary function of midwives is to screen for cervical dysplasia but beyond that, very few midwives participate in the diagnosis of cervical dysplasia via colposcopy. Taken a step further, even fewer midwives treat cervical dysplasia with loop electrosurgical procedure (LEEP). Midwives, known for being “with women” for a lifetime, need to apply that paradigm to care of women with cervical dysplasia. This session will cover the basics of cervical dysplasia screening, diagnosis, and treatment, with information for the midwife desiring to expand beyond the basic skill of Pap screening. Following a woman through cervical dysplasia screening, diagnosis and treatment is a rewarding extension of our scope of practice, and one we hope to encourage more midwives to take on.
ES 502 US MERA: The Midwifery Bridge Certificate and Direct Assessment Education Updates
In cooperation with the US MERA 2015 statement supporting the licensure of certified professional midwives, the North American Registry of Midwives (NARM) began offering the Midwifery Bridge Certificate to CPMs previously certified through the PEP process. This session will describe the history of the CPM certification process, the conditions set by US MERA for licensure, and the implementation of the Midwifery Bridge Certificate. In addition, US MERA called for the establishment of Direct Assessment educational programs. An update on that process will be described by the founder of the first Direct Assessment midwifery school in the United States.
ES 503 Shift the Flora: The Evidence for Probiotics as an Alternative and Complementary Treatment for Bacterial Vaginosis
ES 504 Early Pregnancy Loss: Connecting in a Large Midwifery Practice
Early spontaneous pregnancy loss is the most common complication in the first trimester, with an incidence of up to 20% of all pregnancies and causes grief equivalent to the loss of a child. Though there are various guidelines available for management of the pregnancy loss, there are no standardized social follow up guidelines to meet patient needs. Large midwifery practices especially struggle to meet women’s psychosocial needs and provide patient-centered care. We developed a solution that meets the women’s psychological and physical needs and also matched the Institute of Medicine Vital Sign Core Metrics for Health and Health Care Progress for patient engagement in care matched with patient goals. This is a low-cost model that has improved patient satisfaction, decreased patient complaints, and improved our follow-up for women in our care.
ES 505 Taking AIM at Maternal Morbidity and Mortality through Safety Bundles
In 2011, ACOG formed the Council on Patient Safety in Women’s Health Care to improve patient safety in women’s health care through multidisciplinary collaboration that drives culture change. ACNM members were included on the Council and multidisciplinary work groups that examined key priority areas and developed core and supplemental patient safety bundles. The AIM Project, as a vehicle for widely disseminating the jointly created safety bundles, is piloting the bundles in targeted states over the course of 3 years. Descriptions of the 3 newest safety bundles (Support for Intended Vaginal Birth, Reduction of Peripartum Racial Disparities, and Standards of Care for the Interconception/Postpartum Visit) will be presented. Updates from AIM leadership in the targeted state of Oklahoma will be outlined, including challenges, opportunities, and future direction for implementation at the state level. Time for Q&A will be allotted.
ES 506 Hot Topic: Zika Virus
“Zika is scarier than we thought.” These are the most recent remarks from Anne Schuchat, MD, deputy director of the Center for Disease Control and Prevention (CDC). Learn fact from fiction on this ever-evolving challenge for women and midwives. Plan to attend and hear more in-depth discussion with breaking updates on the Zika virus directly from Kim Newsome of the CDC Pregnancy and Birth Defects Task Force.
ES 507 From “Shall not” to Reproductive Justice: The History of Abortion Care and ACNM
Conversations about access, choice, training, and the understanding of what constitutes full spectrum reproductive health care have been evolving within the clinician community at the same time as these conversations have been ongoing in public and political groups. The current ACNM statement on “Reproductive Choices” supports choice and access for women, and acknowledges the need for financial support for those seeking services that meet their needs. This presentation will review the history of ACNM’s position on abortion, discuss current ACNM Position Statements and clinical documents, summarize ACNM’s advocacy activity related to reproductive health, and engage in a conversation about future activities that support women’s access to sexual and reproductive health services. To better understand the role of contemporary midwives in the provision of the full spectrum of sexual and reproductive health care services, the intersectional framework of race, access, education, class, and health, components of the broader Reproductive Justice movement started by women of color in the early ‘90s will be presented.
ES 508 Hypothyroidism in Women
Thyroid disease is a major women’s health issue with hypothyroidism disproportionately affecting more women than men. In 2008, 12.6 million adult women reported receiving treatment for thyroid disease (Soni, 2008). Hypothyroidism is more prevalent in pre-menopausal and elderly women but can impact a woman across the lifespan. Untreated hypothyroidism in women can result in amenorrhea, abnormal uterine bleeding, and infertility. If left untreated during pregnancy, hypothyroidism can result in miscarriage, premature delivery and preeclampsia. There is significant variation in symptoms associated with hypothyroidism. Common symptoms of hypothyroidism include fatigue, cold intolerance, weight gain, constipation, dry skin, myalgia, and menstrual irregularities. Many of these symptoms are often attributed to other causes. In order to address this issue among women, it is important to obtain a full health history, complete physical examination, and appropriate diagnostic tests to facilitate prompt diagnosis and treatment of hypothyroidism. It is important to evaluate and maintain thyroid function across the lifespan of a woman including during pregnancy. However, there is controversy regarding management of hypothyroidism in non-pregnant and pregnant women. Common clinical presentations, as well as current guidelines and recommendations, will be discussed during this presentation.
ES 509 An Integrative Approach to Preconception Care and Fertility Promotion
Expand your ability to provide comprehensive, holistic, and effective preconception care to include integrative approaches to promote fertility. A growing number of families are struggling to conceive and midwives are uniquely positioned to help women and families address this challenge. This session will focus on detailed preconception counseling, epigenetics of conception and pregnancy and ways to maximize fertility for families conceiving naturally as well as those undergoing IUI or more advanced fertility care like IVF using an integrative approach including nutrition, botanical medicine, and other CAM modalities. Learn how to recognize and effectively address the most common causes of infertility, including irregular cycles, PCOS and anovulation, implantation failure, and poor egg or sperm quality. This seminar is aimed toward the provider interested in integrative care for the woman/couple preparing for or struggling to achieve pregnancy.