The Atlanta Birth Center is chock full of #MidwivesMakingStrides by providing safe, out of hospital birth options. Why? “Because birth matters!”
Emory University faculty #MidwivesMakingStrides by leading in midwifery scholarship, research, teaching and clinical excellence!
L to R: Kate Woeber, Alexis Dunn, Desiree Clement
About the Emory University Nurse-Midwifery MSN Program (http://www.nursing.emory.edu/admission-and-aid/msn-programs/nurse-midwifery.html):
“Emory has been a leader in educating Nurse-Midwives for over 35 years. The focus of our program, born in 1977, is to prepare the next generation of nurse-midwives capable of leading positive change and providing the primary care needs of essentially healthy women across their lifespan, along with the care of normal newborns. Our faculty bring their diverse national and international leadership, research, and clinical experience into the classroom to advance the future of midwifery care and education.”
“We prepare students to become leaders who exemplify excellence in the care of women and families. We value holistic, family-centered care that honors the normalcy of women’s life cycle events, treating all with respect and dignity. Emory nurse-midwifery graduates are well-poised to develop and deliver evidence-based care in partnership with women, and in collaboration with an interdisciplinary team. Emory nurse-midwives strive to transform health care to improve the well-being of women and their families in local and global communities.”
Emory faculty attending the NIH/National Institute of Nursing Research in Washington, DC.
L to R: Alexis Dunn, Carrie Henry, Sara Edwards, Abby Mutic
“SUPPORTING WOMEN BECAUSE WOMEN ARE THE FOUNDATION OF HEALTHY, STRONG FAMILIES”
Check out how these midwives are making strides for women at Decatur Midwifery (http://www.decaturmidwifery.com/)!
Happy National Midwifery Week!!
Georgia Midwives are busy every day caring for Georgia’s women and families. Check out how the Kaiser Permanente CNM’s are Making Strides for Women below (https://healthy.kaiserpermanente.org/georgia)!
KAISER PERMANENTE CERTIFIED NURSE MIDWIVES
Lynette Allen-Pye, CNM; KP – Cascade Medical Center
“I’m making strides for all women by providing quality care for and to women across the life spectrum. I am supporting and assisting expectant mothers in the process of having healthy pregnancies, healthy babies and healthy outcomes and experiences.”
Staci J Cody, CNM; KP – Cumberland Medical Center
“I am making strides for women daily by listening to them and their unique stories as they pertain to them and their individual families. I deliver individualized care that is culturally competent and respectful and enables them to determine what is best for their health and make informed decisions about their healthcare.”
“I support women by meeting them where they and discussing how to get them to their best place. This includes taking into account their life’s experiences, family and religious beliefs, expectations, etc.”
Yolanda Gaines – Crawford, CNM; KP – Glen Lake Medical Center
“I’m making strides for women by providing exceptionally, culturally competent care.”
“I support women by listening and valuing their experiences and meeting them where they are to get them to the healthiest they can be.”
Catherine Salazar, CNM; KP – Crescent Centre Medical Center
“I’m making strides for all women by trying to listen to their individual, unique stories. Empowering them to make health care choices that are in line with who they are and where they come from, whether it is related to birth or with their GYN health care.”
“I support women because I believe in all women getting the best comprehensive care they deserve through their life span.”
Kelly McKune, CNM; KP – Alpharetta Medical Center
Sherennah Herring, CNM; KP – Panola Medical Center
Maureen Garcia, CNM; KP – Town Park Medical Center
Michelle Berkowitz, CNM; KP – Crescent Centre Medical Center
Join us for our quarterly ACNM Meeting!
When: Monday, May 8th at 6pm
Where: Nell Hodgson Woodruff School of Nursing- Room TBA (Free parking in Michael Street deck)
What: Education session, networking, & ACNM Meeting
Dinner & Wine will be provided!
ZIKA VIRUS UPDATE
C. Halter, CNM
- Zika virus (ZV): member of the Flavivirus family (ex. Dengue/Yellow Fever)
- Transmission : Aedes mosquito bites; mother to fetus; sexual transmission; blood transfusions; lab exposure
- Incubation period: 3-14 days
- 1 in 5 people will exhibit symptoms
- Symptoms: acute onset of fever, arthralgia, rash, non-purulent conjunctivitis
- Adverse effects: rare association with Guillain-Barre syndrome
Effects in Pregnancy
- Pregnant women may or may not develop symptoms and do not appear to suffer worse symptom manifestation.
- ZV has been found in pregnancy tissues of all three trimesters, including MAB tissue, amniotic fluid, term infants and the placenta
- Adverse outcomes: SAB/MAB; IUFD; microcephaly, neurological or eye deficiencies
- Unknown: rate of transfer from mother to fetus; viral load required for fetal defects
One study found that 1-13% of fetuses exposed to ZV in first trimester will develop microcephaly. An additional study from the 2016 Brazil outbreak suggests that 29% of all pregnancies infected with ZV regardless of trimester will develop IUGR, microcephaly or result in fetal demise.
Serum and urine tests for real-time RT-PCR, IgM and plaque reduction neutralization tests (PRNT).
No specific treatments are recommended other than supportive- fluids and acetaminophen. Aspirin and NSAID use should be avoided until Dengue and Chickungunya viruses are ruled out.
- Wear long sleeves and pants.
- Use mosquito nets or stay in air-conditioned rooms.
- Treat clothes and nets with permethrin.
- Safe to use approved insect repellants containing DEET in pregnancy.
- Do not travel to areas of ZV transmission- keep updated by checking CDC travel warnings.
- If partner or patient travels to areas of transmission and remain asymptomatic, it is considered ok to begin attempting conception 8 weeks after travel.
- If a male partner has symptoms of ZV, it is currently recommended to abstain from conception for 6 months (as of 8/3/16).
- If a female partner has symptoms of ZV, it is recommended she abstain from conception for 8 weeks.
- It is NOT recommended that asymptomatic individuals be routinely tested for ZV infection.
- To prevent sexual transmission either abstinence should be practiced or strict condom use should be encouraged for any sexual encounter or sexual activity.
PRENATAL/POSTNATAL CARE- ACOG RECOMMENDATIONS
- All pregnant women should be assessed for ZV exposure at every prenatal care visit
- Assess for symptoms
- Travel history for patient and partner(s)
- Testing: described below
- Positive ZV infected women per lab results: refer to perinatology and/or infectious disease specialist
- Serial ultrasounds every month
- After delivery: placenta and cord samples should be sent to lab for immunohistochemical staining and RT-PCR; for fetal demise, any fetal tissues should be sent in addition to placenta and cord
- Breastfeeding: no evidence of transmission through breast milk; patients may continue to breastfeed
- Reporting: All positive or equivocal laboratory samples should be reported to the Health Department.
- CDC Pregnancy Registry has been created for US ZV cases for additional surveillance.
- Additional information on infected patients will be required – including adverse outcomes
For additional questions regarding positive/equivocal lab results
Providers may call the CDC: 770-488-7100
Additional Information for Patients
Available Monday -Friday 8am-5pm in English and Spanish
MotherToBaby – 1-866-626-6847
Text questions to – 855-999-3525
Areas with Zika. Centers for Disease Control. Retrieved on August 9, 2016. http://www.cdc.gov/zika/geo/index.html
For Healthcare Providers. Centers for Disease Control. Retrieved on August 7, 2016. http://www.cdc.gov/zika/hc-providers/index.html
Practice Advisory on Zika Virus. The American College of Obstetricians and Gynecologists; Society for Maternal Fetal Medicine. August 3, 2016. http://www.acog.org/About-ACOG/News-Room/Practice-Advisories/Practice-Advisory-Interim-Guidance-for-Care-of-Obstetric-Patients-During-a-Zika-Virus-Outbreak?IsMobileSet=false
The legislative session is up and running. We have many APRN’s visiting the Capital, and for the first time in Georgia history, we have an APRN of the day program. Please contact the Affiliate if you would like to sign up to be APRN of the day.
Have you visited the Capital this legislative session? SEND US A PICTURE!
- Georgia Affiliate of ACNM will place your name in a drawing for an Amazon gift card if you take a picture of yourself participating in the legislative process and send us a copy of the photo. Email photos to firstname.lastname@example.org
House Bill 997: Preceptor Tax Program (PTIP)
- Who can receive the proposed Preceptor Tax Credit? Physicians, Advanced Practice Nurses, or Physician Assistants licensed in the state of Georgia, who receive no financial compensation from any source for the teaching of medical/osteopathic, APRN, or PA students. (this includes midwives)
- Documents are included below the house bill, talking points and the recommendations from the Primary care summit.
The American College of Nurse-Midwives (ACNM) is saddened to learn of the passing of Past-President Elizabeth Sharp, CNM, DrPH, FAAN, FACNM. Liz, as she was known to many, had a career in midwifery that spanned many decades and many functions, from clinical practice to midwifery education to establishing ethical guidelines for the profession. Her many accomplishments earned her ACNM’s Hattie Hemschemeyer Award in 1999.
Liz received her midwifery education from Yale University, graduating in 1959. She founded the Yale Young Mothers’ Program which provided special services to adolescent mothers, starting a long relationship between American midwifery and the needs of teen moms. She was an early supporter of expanding the role of midwifery to the provision of family planning. Liz was instrumental in the establishment of the midwifery service at Grady Memorial Hospital in Atlanta, GA. By the late 1970s, she started the midwifery education program at Emory University, using Grady as the primary clinical site for those students. She and Johanna Borsellega, CNM, also developed a midwifery refresher education course to convey the new policies, philosophy, and clinical skills of modern US midwifery to foreign-educated and non-practicing midwife candidates.
Liz was ACNM president from 1973 through 1975 – a period of intense debate within the College over professional identity. A period of rapid expansion in the number of midwifery education programs and midwifery graduates led to a larger workforce of better-skilled midwives who initiated moves toward independent practice. Liz led a major revision of the ACNM bylaws in 1974, only 2 years after the ACNM national office had moved to Washington, DC, further cementing the organization as an entity separate from any previous institution.
Later in her career, Liz was very involved in the development of ethical standards for midwifery through the ACNM Ethics Committee, including serving as chair. She was also active for many years with the Division of Accreditation (the official accrediting body of ACNM at that time), including acting as site visit coordinator in the early 2000s, when she brought her “considerable diplomatic skills” to bear on some tough midwifery education situations.
At this time, Liz was described by her peers and contemporaries as the epitome of “everything we can hope for in an ACNM leader.” She was an expert in fostering and navigating the interpersonal relationships necessary to establish a practice during a time when tensions were high among midwives, physicians, and nurses. Liz will be well remembered for her numerous, outstanding contributions to midwifery and ACNM.
Liz passed away Sunday, February 7, at age 82. Her family requests that any donations in her name be made to the A.C.N.M. Foundation, Inc. and/or to the Elizabeth Sharp Scholarship in the School of Nursing at Emory University.
The GA ACNM legislative goals are:
1-Expand the Preceptor Tax Incentive program to cover CNM preceptors (currently, the program only covers MDs). This would allow preceptors to decrease their tax liability if they serve as preceptors. Finding good preceptors is the bottle-neck in our system for growing new CNMs, so this is really important.
2-Expand the GA program providing student loan reimbursement for MDs who work in rural areas of GA to also cover CNMs.
3- Change the GA regulation that forbids CNMs (or any other APRN) from serving on hospital credentialing committees. These are the committees that decide who does and does not get to practice at a particular hospital. Currently, only MDs can serve on these committees in GA, and there have been examples in some parts of the state of CNMs being declined the ability to provide intrapartum care because they could not get the local physicians to accept them, primarily because they were concerned about competition for women.
4-Support more collaborative models of care between CNMs and OBs across rural and underserved parts of GA, where CNMs provide full-scope care from GYN to prenatal, intrapartum, and postpartum while OBs serve as back-up in a hospitalist model. This is the model at Athens Regional Medical Center, where preterm birth rates and low birth rate rates are half of the rest of the surrounding area.
5-Support preceptor stipends, with funds from the state, to expand the number of CNMs practicing in rural areas of GA.
Meet Eileen Thrower, our new Affiliate President. Eileen will serve from 2016-2018.
Eileen Thrower has been a nurse-midwife in clinical practice in Georgia since graduating from the midwifery program at the Nell Hodgson Woodruff School of Nursing at Emory University in 1991. She is currently working on her dissertation, conducting oral histories of Georgia’s pioneer nurse-midwives, at Georgia Baptist College of Nursing of Mercer University. Her research interests include the history of nursing and nurse-midwifery, as well as assessment of the quality of midwifery care. She has practiced full scope midwifery at a number of sites around Georgia for the past 25 years, currently working full-time at South Cobb Ob/Gyn in Austell. Eileen is a member of the Sigma Theta Tau International Honor Society, the American Association for the History of Nursing, and the Oral History Association.
Eileen has practiced full scope midwifery at a number of sites around Georgia for the past 25 years and is currently working full-time at South Cobb Ob/Gyn in Austell, GA. Eileen is a member of the Sigma Theta Tau International Honor Society, the American Association for the History of Nursing, and the Oral History Association.
Eileen and her husband have a large family which includes nine adult children and four grandchildren. When she isn’t working she enjoys camping, water skiing, crocheting, and spending time with her family.