Education Sessions: Wednesday, May 25
ES 400 Identifying Antepartum Risk Factors for Shoulder Dystocia
10:00-11:00am - Ruidoso, East Building, Upper Level
Presented by: Pamela Hetrick, CNM; Ann Marie Konkoly, CNM, MSN
Fetal macrosomia, maternal obesity, diabetes, polyhydramios, and ultrasonographic discrepancies/margin of error can influence a patient's risk of shoulder dystocia. Learn how to identify the risk factors for shoulder dystocia, educate and counsel your patient about them, and document your discussion to avoid legal pitfalls.
ES 401 Midwifery at the Edge of Viability: Midwives, Extreme Prematurity, and Conflicts of Cultures, Ethics, and Values
10:00-11:00am - Ballroom B, West Building, Upper Level
Presented by: Mary K. Collins, CNM, JD, LLM, FACNM; Ira Kantrowitz-Gordon, CNM, PhD; Nancy Jo Reedy, CNM, MPH, FACNM; Kathleen Powderly, CNM, PhD
This session will explore the increasingly common ethical dilemmas presented by the care of extremely premature infants and the care decisions confronted by families experiencing this complication of pregnancy. Especially important is the skill set needed to deal with the conflicts that arise when the midwife cannot agree with decisions made by other care providers involved or the family. Midwives will learn about the data supporting care decisions for extremely premature infants, the legal implications of care decisions, the cultural differences impacting decision-making, support of the family during and after decisions are made, the ethical frameworks needed for ethical decision-making in this context, and midwives will work in groups on case studies utilizing ethical frameworks for decision-making.
ES 402 Health Care for the Transgender and Nonbinary Individual: Midwives-Still With Women for a Lifetime
10:00-11:00am - Pecos, East Building, Upper Level
CEUs: 0.1 - Rx: 0.2
Presented by: Patrica Detzel, CNM
About 40% of transgender and nonbinary individuals experience and report health care discrimination or substandard health care related directly to their gender identity. Another 40% of these patients report avoiding the health care system all together. Transgender and nonbinary individuals experience many challenges and obstacles in seeking health care, including primary care. This education session will provide assistance to the midwife in identifying the unique health care disparities this demographic faces and present simple solutions that will benefit both provider and patient.
ES 403 Midwifery Leadership
10:00-11:00am - La Cienega, East Building, Upper Level
Presented by: Denise Smith, CNM, PhD
The purpose of this presentation is to inspire midwives to become leaders in women's health care in the communities, health care systems, and states where we live and work. To accomplish the goal of "A Midwife for Every Woman," midwifery leadership is needed.
ES 404 New Graduate Orientation: Survival and Success in the First Year of Practice
10:00-11:00am - Ballroom A, West Building, Upper Level
Track: Midwifery Matters Business
Presented by: Elizabeth Munoz, CNM; Melissa Davis, CNM, FNP; Sharon Holley, CNM, DNP; Kathleen Danhausen, CNM; Claire Leezer, CNM
Hiring a new graduate comes with a unique set of challenges and has the potential to be a rewarding experience for all involved. Geared for practices hiring new graduates and new grads looking for a smooth transition to their first jobs, this presentation will offer solutions for common barriers during the first year of practice. Other key points include the benefits of hiring a new graduate, examples of documents used during orientation, and how to set up a system that mentors the new grad throughout the first year as a midwife.
ES 405 Strategies and Opportunities to Reduce the Rates of Cesarean Birth: Midwifery Care in Action!
10:00-11:00am - Kiva Auditorium, West Building, Upper Level
Track: Midwifery Matters Business
Presented by: Lisa Kane Low, CNM, PhD, FACNM
The focus of this presentation will be to highlight strategies to reduce and or prevent cesarean births by employing physiologic approaches to childbirth. This presentation will highlight work that has been the result of multi-stakeholder collaboration with a focus on promoting evidence-based care on maternity care units. Through the development of action steps or bundles, ACNM and other maternity care organizations have identified key steps, that when implemented, can result in reduction of cesarean birth rates. The opportunities and challenges of implementing these steps will be addressed in conjunction with identifying key opportunities to change the culture of maternity care to embrace physiologic approaches to childbirth.
ES 406 Documentation When the Going Gets Rough
12:00-1:00pm - Ruidoso, East Building, Upper Level
Track: Midwifery Matters-Business
Presented by: Katherine Page, CNM, MSN; Mamie Guidera, CNM, MSN, FACNM; Cara McGuinness, BSN, RN, SNM
Appropriately detailed and timely medical record documentation is critical for client safety and care quality, professional accountability, and reimbursement. As team-based collaborative care in obstetrics expands, midwives must understand how their documentation communicates the care provided and how it fits within the greater picture of client care as documented by other team members. This is particularly important when an adverse outcome occurs because quality of documentation could be protective with regard to litigation. In this session, an attorney and a midwife with broad experience reviewing documentation quality will discuss how it affects the midwife's risk for litigation and pearls for prevention or risk reduction. We will also discuss how tools such as debriefing, check-lists, templates, and electronic documentation records can improve consistency of documentation and affect litigation risk. Examples of documentation will be reviewed from closed claims.
ES 407 A Primer for Culturally Humble Transgender Healthcare
12:00-1:00pm - Ballroom B, West Building, Upper Level
Presented by: Dr. Nathaniel Sharon
Culturally affirming practices can improve the quality of care and care outcomes for Transgender and gender nonconforming (TGNC people). The goal of this lecture is to increase understanding of gender diverse patients and ways to create affirming and safe care environments. Participants will also learn basics of TGNC affirming family planning and midwifery care, particularly for transgender male patients who may seek midwifery services for pregnancy. Data will be reviewed on supporting patients breast and gynecological health.
ES 408 Those Magic Moments: The State-of-the-Science Regarding the Third Stage of Labor
12:00-1:00pm - Ballroom A, West Building, Upper Level
CEUs: 0.1 - Rx: 0.5
Presented by: Rebecca Safley, CNM, MSN, WHNP-BC, PhD(c)
Active management of the third stage of labor (AMTSL) is an evidence-based approach to decreasing rates of postpartum hemorrhage and maternal mortality. While AMTSL is accepted as part of the standard of care, we are beginning to recognize that exogenous oxytocin administration may have far-reaching negative sequelae for our patients. As midwives, who are both experts in physiologic birth and care providers for women who are increasingly moderate- to high-risk, how do we make sense and use of the science? In this presentation, we will discuss "those magic moments" of the third stage, the state-of-the-science, and recommendations for practice.
ES 409 Update 2016: What's New in Cervical Cancer Prevention
12:00-1:00pm - Pecos, East Building, Upper Level
Presented by: Alan Waxman, MD, MPH, Professor, Obstetrics and Gynecology, University of New Mexico
In the past decade, prevention of cervical cancer in the United States has shifted from secondary prevention, i.e. screening with the Pap smear, to a combination of screening and primary prevention with vaccination against HPV. The focus of screening has changed, with a greater emphasis now being placed on HPV testing. This presentation will discuss the rationale for relying on HPV testing in cervical screening, the scientific basis of the ASCCP guidelines for managing abnormal Pap tests, and new developments in immunization for preventing cervical cancer in 2016.
ES 410 DOR Forum II
12:00-1:00pm - Kiva Auditorium, West Building, Upper Level
Topics presented in this forum:
Economic Impact of Nurse-Midwifery Care for Childbirth: More for Less?
Presented by: Molly Altman CNM, PhD
Patient Experience of Privacy While Participating in Group Healthcare: A Phenomenographic Description
Presented by: Laurie Friedman CNM, PhD
The Role of Mediators in Reducing Antepartum Depressive Symptoms in Rural Low-Income Women Receiving a Culturally Tailored Cognitive Behavioral Intervention
Presented by: D. Elizabeth Jesse CNM, PhD
ES 411 Assessing Advantages by Using the Advantage List: Forming the Problem List Is Only Half the Job!
4:30-5:30pm - La Cienega, East Building, Upper Level
Presented by: Cecilia M. Jevitt, CNM, PhD, FACNM
Prenatal overweight and obesity and their co-morbid conditions impose risks on a healthy pregnancy. Documenting these conditions on the Problem List and providing a weight gain recommendation for pregnancy is only doing half the job. The half of the job that is most likely to help women manage a healthy prenatal weight gain is documenting their weight management advantages and using these advantages in motivational interviewing techniques. The Advantage List is a self-administered survey containing 15 behaviors proven by research to be successful in weight management, including items such as family meals and low glycemic index diets. Women mark the advantages they have used in the past and the midwife uses these as a base for prenatal weight counseling. Use of the Advantage List survey and its research base will be discussed during this session.
ES 412 HPV Cancer Prevention: The New 9 Valent HPV Vaccine, and Where We Go From Here
4:30-5:30pm - Ruidoso, East Building, Upper Level
CEUs: 0.1 - Rx: 0.5
Presented by: Carol Hayes, CNM, MN, MPH
Human Papilloma Virus (HPV) related cancers of the oropharynx, anus, and genital tract account for a tremendous number of cancers, and account for a large economic burden. Discussion will include the new vaccine that is effective against 9 strains of HPV, Gardisil-9. Vaccine effectiveness, uptake, and usage will be discussed. Presentation will include: Tips on how to make a strong recommendation for the vaccine along with how to answer questions of young women and parents. Discussion will include who should get the new vaccine based on a person's previous vaccination.
ES 413 Midwifery's Role in Reproductive Justice with Operationalizing Reproductive Justice: Implications for Midwifery
4:30-5:30pm - Ballroom A, West Building, Upper Level
Presented by: Monica R. McLemore, PhD, MPH; Evelyn Aztlan-James, CNM, PhD, WHNP
Reproductive justice represents a view of women's health that includes a broad analysis of racial, economic, cultural, and structural constraints on women's power. This evaluation of the influences on women's power and health are consistent with the midwifery goals of providing equitable, ethical, and accessible care with fully accurate and informed consent cooperatively with our patients. However, certain aspects of the reproductive justice movement, such as the ability for all women to access safe abortion, have been divisive within the midwifery community. By focusing on the similarities in goals and foundational beliefs between the reproductive justice movement and midwifery, and the reasons that the reproductive justice framework is necessary if midwifery is committed to providing care to marginalized and diverse women, this discussion hopes to present ways in which midwifery can become more focused on including learning and practice that is reproductively just.
ES 414 Navigating the Co-Sleeping Relationship in an Anti-Co-Sleeping Environment
4:30-5:30pm - Pecos, East Building, Upper Level
Presented by: Michelle Collins, CNM, PhD; James McKenna, PhD
In the recent past, there has been an intentional movement on the part of some maternal-child health stakeholders, to aggressively "warn" parents as to the "dangers" of co-sleeping. Despite sound evidence to prove the benefits of, and lack of harm, when practiced in the absence of all known hazards especially by breastfeeding mothers, and with likely over 2 million US mothers at least intermittently bedsharing with their infants, the US government NICHD has launched a nationwide educational campaign to inform the public as to the inherent "danger" of co-sleeping. This session will discuss the current climate of support (and lack thereof) for co-sleeping (in various forms) between infants and their parents. The biologic imperatives that underlie the practice and which support the co-sleeping relationship will be presented, as well as diverse lines of evidence that justifies and legitimizes co-sleeping. Finally, directives on how to best counsel clients amidst a sea of conflicting information on the topic will be presented.
ES 415 State Legislative Update
4:30-5:30pm - Kiva Auditorium, West Building, Upper Level
Track: Midwifery Matters Public Perception
Presented by: Cara Kinzelman, PhD
This session will provide an overview of important state policy developments at the legislative and regulatory levels in the past year with particular emphasis on the status of efforts related to ACNM's high priority policy goals. Whenever possible, affiliate leadership will be available to offer a first-person account of strategy and lessons learned. The session will also include a basic overview of ACNM resources available to members working on policy issues and, time permitting, conclude with an open discussion on the most effective ways to advance our policy agenda.
ES 418 The Problem that Never Goes Away: Domestic and Sexual Violence on Women's Health-Impact and Implications for Midwifery Practice
5:45-6:45pm - La Cienega, East Building, Upper Level
Presented by: Linda Locke, CNM, MPH, LSW
Domestic violence (intimate partner violence) and sexual violence are major public health concerns both in the United States and worldwide, with an estimate of 1 in 3 US women experiencing this type of violence within their lifetime. Domestic and sexual violence can have a profound impact on health, both in the short and long term, including not only the immediate trauma experienced, but they also affect the long-term health, including mental health, of survivors. Midwives will care for many women whose experience includes past or current domestic or sexual violence. Improving our knowledge of the prevalence and health impact of domestic and sexual violence, and how survivors present and interact with health care, will assist us in providing the appropriate care for these women-care which is sensitive, culturally competent, and trauma-informed.
ES 419 Protecting the Microbiome: Emerging Treatments for Vaginitis and Urinary Tract Infections
5:45-6:45pm - Ruidoso, East Building, Upper Level
CEUs: 0.1 - Rx: 0.17
Presented by: Cynthia Belew, CNM, MS, WHNP-C
Many young women receive repeated courses of antibiotics for vaginal and urinary tract infections. A growing body of evidence raises concern about the adverse impacts of antibiotics on the microbiome and the impairment of long term health, not only for the women herself but for her future offspring. Functional Medicine provides a revolutionary new approach to health and disease. By using a systems biology approach to treatment, in which we support the health of the digestive and immune systems, we can not only treat the current problem (UTI or vaginitis) but also restore homeostasis to the vaginal ecosystem and target the deeper roots of diseases, strengthening overall health and preventing future, more serious disease. A review of emerging research supporting the strategies of supplemental probiotics and biofilm disruption will be included, but the presentation will go beyond these interventions to look at dietary and lifestyle modifications that impact the microbiome and support long-term health and will touch on herbal treatment for UTIs.
ES 420 The Fellows Talk: Overcoming Adversity as a Midwife of Color
5:45-6:45pm - Ballroom A, West Building, Upper Level
Track: Midwifery Matters-Public Perception
Presented by: Heather Bradford, CNM, ARNP, FACNM; Cindy Farley, CNM, PhD, FACNM
In order to enhance diversity and inclusion in the midwifery work force and foster social justice, we need to understand the challenges that midwives from various racial and ethnic backgrounds face in becoming midwives and in practicing midwifery. Our panel of ACNM fellows from African-American and Latina cultures will share their trials and triumphs encountered during their midwifery careers. Strategies will be discussed to help grow the population of midwives of varying racial and ethnic backgrounds, as well as help midwives and midwifery students better understand how they can promote racial equality and social justice in their workplace and communities they serve.