The EngagED Midwife

Send us Fan Mail

In this episode, Cara and Missi discuss nutrition and vitamin supplements during pregnancy. They cover what is important in a prenatal vitamin, vitamin excess, supplements to avoid, and disciss ways to get the nutrition that pregnant people and fetuses need--whether lactose-intolerant, vegan, or those with other dietary restrictions. They also dispel some of the common food concerns during pregnancy--soft cheeses and fish aren't our enemies. We just have to be wise about our intake and ensure food is prepared safely. #YouAreWhatYouEat #VitaminsForTwo #ExpectingGoodThings #Pregnant #Vitamins #Antepartum #Supplements #Vegetarian

Send us Fan Mail

Cara and Missi are joined for this episode by Dr. Sam Bleull to discuss the use of forceps or vacuum when needed for operative vaginal birth. While midwives may have expanded scope to use vacuum and/or forceps, they often rely on physician colleagues to step in and assist. Indications, contraindications, and sequelae are reviewed. #HelpFromBelow #Collaborate #Intrapartum #PhoneAFriend #CollaborativePractice #CanIGetAnAssist 

Send us Fan Mail

In this episode, Missi and Cara talk about viral illness in pregnancy and how to protect against some of the most common and most harmful respiratory infections. Influenza, COVID, and RSV are reviewed in detail (with a small shoutout to pertussis, whoop whoop!), as these infections not only impact the pregnancy and pregnant person, but may have profound impact on the newborn infant. Vaccine recommendations are provided and a great illness triage algorithm is discussed.  #Viral #Flu #COVID #RSV #VaccinesSaveLives #VaccineSuperHero #VaccinesInPregnancy #ProtectYourself #Illness #Triage #WhoopWhoop 

Send us Fan Mail

For this episode, Cara and Missi are joined by Certified Nurse-Midwife Linda Johnson. Linda is an experienced clinician with over 30 years of practice--she not only shares key management decisions in the care of patients with amniotic fluid embolism, but also highlights the need for clinician preparation/practice for maternal collapse and debriefing when sentinel events occur. Missi and Cara also review managment recommendations and use of the A-OK protocol for this catastrophic OB emergency. #AFE #AOK #BirthTrauma #Simulation #InterprofessionalCare

Send us Fan Mail

To kick off the 9th season of The EngagED Midwife, Missi and Cara describe the process that midwives can take to expand their practice beyond that of the beginning CNM/CM with core competencies for basic midwifery practice. They provide examples of expanded practice skills and review the educational preparation and maintenance of competency needed to offer these skills in your practice. #MidwifeLife #Expanded #BeyondBasic #ACNM #PatientCentered #Continuity #WeveGotSkills #ARDMS #colposcopy #FirstAssist #Ultrasound #Circumcision @acnm @asscp1 @carolyngegor 

Send us Fan Mail

In this episode, Cara and Missi review the implications of the 2018 ARRIVE study on patient outcomes and practice changes. They provide a midwifery-focused perspective on rapid application of research findings and how analysis of study design, analysis, and conclusions can help you to interpret the study outcomes. #arrive #induction #elective #expectant #shareddecisionmaking

Send us Fan Mail

In this episode, Cara and Missi discuss recent updates to cervical cancer screening and management of results. They give a brief history of cervical cancer screening, incidence and mortality for cervical cancer in the US, and recommendations for the frequency of screening. Then, they provide an update to screening abnormalities and how to individualize follow-up management for patients.  #cervicalcancer #screening #cancer #gynecology #womenshealth #cytology #midwivesmakeadifference #vaccinessavelives #HPV

Send us Fan Mail

In this episode, Cara and Missi review common vaginitis symptoms, evaluation, diagnosis, and treatment. They then dive deeper into complex presentations, recurrent infections, and treating mixed vaginitis. Vulvar and vaginal itching, irritation, discharge, and odor are a frequent reason for visits to a midwife or other GYN provider and this episode will build your confidence and competence in treating these issues. Resources for additional learning are provided.  #vaginitis #vulva #vagina #vaginaldischarge #selfcleaningoven #nodouching #boricacid #treatlocally

Powell A, Ghanem KG, Rogers L, et al. Clinicians' Use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis. Sex Transm Dis. 2019;46(12):810-812. doi:10.1097/OLQ.0000000000001063

Qi W, Li H, Wang C, et al. Recent Advances in Presentation, Diagnosis and Treatment for Mixed Vaginitis. Front Cell Infect Microbiol. 2021;11:759795. Published 2021 Nov 2. doi:10.3389/fcimb.2021.759795

Send us Fan Mail

In this episode, Cara and Missi dive into an overview of fibroids and adenomyosis.  Both diagnoses can be associated with abnormal uterine bleeding, pelvic pain, and pelvic fullness.  While definitive treatment is likely surgery, conservative management of these dignosis can be accomplished by the midwife or nurse practitioner.  This episide will explore symptoms, diagnosis, and treatment particularly in women who want to perserve fertility or which surgery is not a viable option. #fibroids #adenomyosis #abnormaluterinebleeding #lysteda #lupron 

Send us Fan Mail

In this episode, Cara and Missi continue a previous conversation on causes of jaundice.  ABO and Rh incompatability are predominate causes of hyperbilirubinemia in newborns.  This episode reviews the physiology of ABO and Rh and the care of women in the antepartum period as well the implications in care of the newborn. #ABO #Rh #Alloimmunization #jaundice #rhogam #newborncare #bilirubin