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A stomach that feels “off” can be easy to brush aside—until it shouldn’t be. In this episode, Cara and Missi dig into the quiet warning signs of ovarian disease, separating the everyday from the rare but dangerous ovarian pathology. You’ll learn how to read the body’s cues using the BEAT mnemonic (Bloating, Early satiety, Abdominal/pelvic pain, Trouble with urination or bowels), what ultrasound reports actually mean, and why most ovarian cysts are benign even as we stay alert to red flags.

We walk through the physiology of the menstrual cycle—why ovulation naturally creates a cyst each month—and how that helps explain functional cysts that disappear on their own. Then we shift to the features that raise concern: septations, solid components, irregular borders, and blood flow on Doppler. We talk openly about the limits of CA125, the absence of a reliable screening test, and why surgical biopsy still anchors a definitive diagnosis. 

 We unpack how opportunistic salpingectomy at the time of hysterectomy or permanent sterilization can cut risk, and how combined oral contraceptives lower lifetime risk by suppressing ovulation. We also cover who needs genetic counseling—BRCA1/2, Lynch syndrome, and other familial cancer clues—and how to build smart follow-up plans that balance reassurance with action. Most ovarian findings are benign; the key is knowing when to watch and when to act. If this conversation helps you or a patient put a name to a nagging symptom, it’s done its job. 

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Midwifery is so much more than clinical care. It's about advocacy, education, research, community, and creating the future of healthcare. In this illuminating conversation with ACNM Vice President Dr. Alexis "Lexi" Dunn-Amore and CEO Dr. Michelle Monroe, we explore the heart and soul of the American College of Nurse-Midwives and why every midwife—from student to seasoned practitioner—has a place in this professional home.

The conversation reveals ACNM's dramatic transformation, streamlining from 61 committees to a focused 20, with the Midwives of Color group elevated from committee to council status—signaling the organization's commitment to centering diversity and inclusion.  For those considering joining or becoming more active, the benefits extend far beyond journal access and CE opportunities. ACNM provides a supportive community where midwives find mentorship, discover new career pathways, and contribute to advancing the profession through advocacy for full practice authority and pay parity.

As the 70th annual meeting approaches in Palm Springs, both leaders express excitement about bringing midwives together to celebrate, learn, and forge connections. Whether you're a student sleeping four to a hotel room or a seasoned midwife, the message is clear: your voice matters, and ACNM is stronger with your involvement.

Ready to discover how you can shape the future of midwifery? Listen now and find your place in this vital professional community!

#MidwivesWhoLead #MidwifeLife #ACNMEngagement #MidwiferyAdvocacy #BuildYourCommunity @acnmmidwives @lexithemidwife @mmunroecnm 

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It’s easy for healthcare providers to feel overwhelmed by medication safety during pregnancy and breastfeeding. In this episode, Cara and Missi take this complex topic and make it simple.

They start by highlighting a common issue: many clinicians still use the outdated FDA risk categories (A, B, C, D, X), which were replaced in 2015 by the more detailed Pregnancy and Lactation Labeling Rule (PLLR). The hosts explain how pregnancy changes a person’s body and how this affects medication, from blood volume to heart rate. They also cover specific medications to be cautious with, like ACE inhibitors and statins.  When it comes to breastfeeding, the discussion turns to lactation risk categories (L1–L5) and practical factors like timing and a baby’s age as well as what's really important for nursing moms. 

This episode covers common clinical scenarios and provides clear guidance on safe medication options for both pregnant and breastfeeding patients while providing valuable resources for students and practicing midwives. This episode turns an intimidating topic into a manageable framework for confident prescribing.

#PrescribinginPregnancy #MedicationAndMotherhood #PerinatalPharmacology #PharmForWomensHealth #NoMoreABCDX #MidwiferyMatters #JusticeForTylenol #CallTheMidwife #OurFavePharmD 

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Feeling emotionally drained, cynical about your work, or lacking professional fulfillment? You're not alone. Burnout affects healthcare providers at staggering rates, with midwives facing unique vulnerabilities due to the intensity of our profession.

Drawing from personal experience and evidence-based strategies, in this episode, Cara and Missi unpack the differences between burnout, compassion fatigue, and moral distress while offering practical tools to rebuild resilience.  We explore the four pillars of resilience that sustain midwives through challenging times: connection with supportive community, establishment of healthy boundaries, development of self-compassion practices, and reconnection with purpose and joy. These foundations help counteract the emotional exhaustion and depersonalization that characterize burnout.

While individual coping strategies matter, we emphasize that burnout isn't just a personal failing—it's often systemic. Midwives deserve workplaces that protect their wellbeing through adequate staffing, reasonable expectations, and supportive policies. Those in leadership positions have a responsibility to advocate for these changes.

Our top ten resilience strategies provide actionable steps you can implement immediately: giving yourself permission to rest, advocating for your needs, continuing to learn, debriefing after difficult experiences, keeping visual reminders of your "why," moving your body, protecting your sleep, creating post-shift rituals, setting boundaries, and finding your people. Remember that a thriving midwife provides better care—your wellbeing matters not just for yourself, but for all the families you serve.

What resilience practice will you commit to this week? Share your thoughts or questions with us on social media—we'd love to continue this important conversation.

#TheEngagedMidwife #MidwifeLife #MidwivesMatter #MidwifeWellbeing #ResilientMidwife #BeatBurnout #HealthyMidwives #WorkplaceWellness #ReslienceInPractice

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The cervical cancer screening landscape is undergoing a seismic shift, and it's time everyone knows about it. From the revolutionary PAP test that changed women's healthcare decades ago to today's primary HPV screening methods, we're witnessing a transformation that promises less invasive care with better outcomes.Did you know that high-risk HPV causes 100% of cervical cancer cases? This fundamental connection has reshaped our approach to screening. Where women once faced the prospect of 47 lifetime PAP tests, today's evidence-based guidelines recommend as few as 9 HPV tests throughout adulthood. We break down the science behind these changes and explain why primary HPV testing is proving more effective than traditional cytology alone. Cara and Missi explore the historical context that unnecessarily tied birth control access to invasive pelvic exams, and how modern approaches are finally separating these unrelated aspects of care. Beyond cervical cancer, we discuss HPV's role in head/neck, anal, and rectal cancers, making vaccination against this virus truly a cancer prevention strategy. For healthcare providers, we offer clear talking points to communicate with patients about these changes. For everyone else, this episode provides the knowledge to advocate for appropriate, evidence-based screening. The days of annual PAP tests are behind us, and understanding why represents a crucial step forward in women's healthcare. #HPVTesting #HPVAwareness #CervicalCancerPrevention #MidwivesMatter #EBP #CervicalCancerScreening #VaccinesSaveLives #Swifties #WDNCClub #WeDoNotCare #TSITP @americancancersociety @justbeingmelani @newheightshow @taylorswift @killatrav @thesummeriturnedpretty @brynne_weaver

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The digital revolution continues to transform healthcare, and midwifery is no exception. As we launch Season 12 of The Engaged Midwife Podcast (approaching an incredible 100,000 downloads!), Missi and Cara dive into the fascinating world of artificial intelligence and its applications for midwifery students and clinicians.

From study techniques to clinical decision-making, AI offers powerful tools that can streamline workflows and enhance learning—but only when used thoughtfully. We explore how tools like ChatGPT, Claude, and Gemini can help synthesize information, create customized study materials, and even assist with complex statistical analysis. However, we also examine the research suggesting that handwriting notes creates stronger neural connections than using AI-generated summaries, raising important questions about how technology shapes learning.

For practicing midwives, AI has already become embedded in electronic health records and is increasingly available for generating differential diagnoses, patient education materials, and time management solutions. Yet all these applications come with important ethical considerations around data privacy, academic integrity, and environmental impact.

Throughout our conversation, we emphasize the importance of critical thinking and transparency. AI works best when it augments human expertise rather than replacing it—the midwife's clinical judgment remains irreplaceable, even as technology evolves to support it. As Cara puts it, "Work smarter, not harder," but always maintain your professional knowledge and skill.

#MidwiferyInnovation #AIinMidwifery #TechInBirth #SmartMidwifery #DigitalMidwife #MidwiferyEducation #WorkSmarterNotHarder @chatgpt @claudeai @microsoftcopilot @googlegemini 

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Wrapping up Season 11, Cara and Missi dig deep into their fan mail bag to answer questions from listeners spanning clinical practice, education, and professional development. With their characteristic warmth and wisdom, they tackle everything from postpartum mental health screening to specialized pharmacology knowledge that you won't find in textbooks.

The conversation flows through practical clinical topics, starting with the importance of comprehensive mental health screening for postpartum patients.  They share touching feedback from colleagues about creating supportive collaborative practices with physicians, highlighting how direct, respectful communication builds successful interprofessional relationships.

For students and new midwives, the hosts offer a treasure trove of specialized resources. They offer insights to suturing resources, discuss scope of practice questions, and answer questions galore. Pharmacology pearls abound as they discuss innovative approaches to breakthrough bleeding, the exact formulation for All-Purpose Nipple Ointment for treating breast yeast infections, and compounded antiemetic gels for pregnancy nausea.

Before previewing exciting topics for Season 12—including ovarian masses, cancer screening, osteoporosis, fertility treatments, and AI in midwifery—Cara and Missi remind listeners of the best ways to reach them with questions. Their generosity in sharing expertise and resources demonstrates why this podcast has become such a valuable companion for midwives at every career stage.

Email your questions directly to [email protected] or [email protected] to become part of future episodes, and visit deliveredexamprep.com to access the resources mentioned throughout this knowledge-packed finale.

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Are you feeling exhausted, irritable, foggy-brained, or experiencing night sweats that leave you drenched? These symptoms aren't just "part of getting older" – they're signs of hormonal changes that can be effectively treated. In this eye-opening conversation, Dr. Val Schulte joins midwives Missi and Cara to demystify perimenopause and menopause with straightforward, evidence-based information that healthcare providers often miss.

"I can't describe how excited I am about today," says Missi at the start, acknowledging that many midwives received minimal education about menopause, especially after the Women's Health Initiative study created widespread fear around hormone therapy. Dr. Schulte, who transitioned from traditional OBGYN practice to focusing on hormone therapy and lifestyle medicine, shares how her own perimenopausal symptoms sparked her passion for helping women navigate this transition.

The conversation dives deep into practical aspects of hormone testing and treatment options. Dr. Schulte explains how bioidentical progesterone can improve sleep and mood, why testosterone (often overlooked in women) dramatically affects energy and libido, and how proper estrogen therapy protects heart, brain, and bone health. She details the advantages of different delivery methods – from daily creams to pellet therapy that slowly releases hormones over months – and dispels myths about hormone risks.

What makes this episode especially valuable is the real-talk about symptoms many women experience but rarely discuss: brain fog that interferes with work, anxiety that appears out of nowhere, joint pain, changes in body odor, even ridges in fingernails. Dr. Schulte connects these seemingly unrelated issues to hormonal fluctuations and offers solutions beyond the standard "here's an antidepressant" approach many providers default to.

Whether you're approaching perimenopause, in the thick of menopause, or supporting someone who is, this conversation provides clarity and hope. As Missy realizes toward the end, "I do not have to feel this way for another five years." Listen now to discover how you can reclaim your energy, mood, focus, and quality of life through evidence-based hormone therapy and lifestyle approaches.

#EngagEDMidwife #MidwiferyMatters #HormoneTherapy #MenopauseCare #PerimenopauseSupport #WomensHealth #MidlifeHealth #HotFlashesAndHope #ToolsInOurToolbox

@menopause_society @acog_org @drjennsimmons @drrachelrubin @dlberkson @auria.care 

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When is the right time to prescribe antibiotics—and how do you pick the right one? In this episode, Cara and Missi are joined by a clinical pharmacist, Dr. Teresa Ash, to break down the science (and the art) of antibiotic selection in midwifery. From GBS prophylaxis to upper respiratory infections, we explore when antibiotics are essential, when they’re not, and how midwives can be antimicrobial stewards without sacrificing patient safety. Smart, evidence-based, and just a little cheeky—this is the prescription for better practice. #AntibioticStewardship #MidwiferyEducation #WeHeartPenicillin #PerinatalCare #PharmacyAndMidwifery #InfectiousDiseases #MaternalHealth #SafePrescribing #AntibioticAwareness #InterprofessionalTeam 

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Ultrasounds offer essential insight into maternal and fetal health—but interpreting the findings and knowing what to do next can feel overwhelming for midwifery students and new graduates. In this episode of The EngagED Midwife, Cara and Missi take a deep dive into the most common (and most confusing) ultrasound findings in OB/GYN practice. Whether it’s a low-lying placenta, a thickened nuchal fold, or an unusual fetal measurement, we’ll break down what it means, when to consult, and how to manage it. Practical, focused, and rooted in real clinical scenarios—this is your go-to guide for making confident, evidence-based decisions in practice. #TheEngagEDMidwife #UltrasoundInPractice #MidwiferyEducation #OBGYNultrasound #NewGradMidwife #ClinicalConfidence