Workforce Survey of Connecticut Midwives.

INTRODUCTION: Midwives in Connecticut lack resources for current, state-specific data regarding compensation, benefits, work hours, and scope of practice. The primary purpose of this study was to provide detailed information about the work and services provided by midwives in Connecticut and how they are compensated. METHODS: Certified nurse-midwives (CNMs) licensed in Connecticut were recruited for a 53-question online survey between October 2021 and February 2022. The survey included topics such as compensation, benefits, practice patterns, and precepting. RESULTS: For full-time salaried CNMs in Connecticut, compensation was higher than the national average for midwives. A majority of CNMs in the state work 40 hours per week or less in physician-owned private practices and are preceptors. DISCUSSION: For midwives planning to negotiate contracts in Connecticut, this report provides important information to ensure fair compensation and work hours. The survey also serves as a roadmap for midwives in other states who wish to collect and disseminate similar workforce data.

"You Allowed My Body To Do What It Needed": Supporting Birthing Persons Through Conscious Empowerment.

A midwife's chance encounter with a former client demonstrates the importance of supporting birthing persons through conscious empowerment.

Midwifery Management of a Birthing Person with Cervical Edema During Labor.

During active labor, a birthing person with cervical edema often has a dysfunctional or prolonged labor and, therefore, an increased risk for cesarean birth. Midwives seeking evidence on how to manage cervical edema when they are faced with this clinical situation will note a gap in the literature regarding the management of cervical edema that this report aims to fill. This case will discuss the use of intravenous diphenhydramine (Benadryl), the application of ice to the cervix, side-lying release, epidural analgesia use, manual reduction of the cervix, and various positions to encourage reduction in cervical swelling. It is hoped these strategies will add to a midwife's clinical resources by providing ways to promote vaginal birth in the setting of cervical edema during labor.

The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): A systematic literature review.

AIM: This review evaluates the impact of complementary therapies on psychosocial factors in women undergoing IVF. BACKGROUND: According to the CDC, nearly 7% of married women in the United States face infertility. Approximately 1.5% of all infants born in the U.S. annually are conceived through assisted reproductive technologies (ART), such as IVF. Women undergoing ART report distress, anxiety, and depression related to their treatment. Stress has been cited as the top reason why women terminate treatment. Complementary therapies, such as mind-body techniques, have been associated with decreasing stress and anxiety. METHODS: CINAHL and PubMED databases were searched for studies 1) published from January 2010 to 2017, 2) written in English, 3) that examined the effect of an complementary therapy on the psychological well-being of women undergoing, or about to be undergoing a cycle of IVF. RESULTS: The search revealed 11 studies published between 2010 and 2015 from a variety of countries. The most common research design was a randomized controlled trial (n=7). The psychosocial factor most frequently measured was anxiety (n=8). The forms of complementary therapy varied, with the most common being Hatha yoga, cognitive behavioral interventions, and mind-body therapies (n=2 each). CONCLUSIONS: Utilizing complementary therapies appears to be a positive way to decrease women's anxiety, depression, distress, and stress, and to increase fertility quality of life. This review informs providers that incorporating complementary therapies into the plan of care can lead to improved psychosocial health outcomes for women undergoing IVF.

Perinatal palliative care: Integration in a United States nurse midwifery education program.

Midwifery students with perinatal palliative care education develop a skillset to provide holistic midwifery care to women and families who are experiencing stillbirth or life-limiting fetal diagnoses. This paper presents a model of perinatal palliative care in a United States midwifery education program. By utilizing evidence based practices and national programs, perinatal palliative care can be threaded through midwifery curricula to achieve international standards of practice and competencies. Most importantly, enhancing perinatal palliative care education will better prepare future midwives for when a birth outcome is not what was expected at the outset of a pregnancy.

Birth as Restorative.

A woman's past history of sexual trauma is inextricably woven into her pregnancy and birth experience. Two cases are presented by a practicing certified nurse midwife to demonstrate trauma-informed care in the childbearing setting. Providing trauma-informed care universally in the women's healthcare setting is imperative given not all women disclose their history. Empowering survivors may allow for a restorative birth, in which trust of one's own body can be regained.

Dyspareunia in a Survivor of Childhood Sexual Abuse.

Dyspareunia is a frequent chief concern encountered by midwives and other women's health care providers. There are many possible etiologies for dyspareunia, including a history of childhood sexual abuse, and approaching assessment in a holistic manner is necessary to identify the etiology. This case report presents evidence on the importance of screening a woman who presents with dyspareunia in a therapeutic manner to facilitate disclosure of sexual abuse. Best practices for screening for sexual violence, along with recommendations for providing gynecologic care to survivors, are offered. By understanding the long-term sequelae of sexual abuse and through screening all women, midwives and other women's health care providers can facilitate healing and treatment for survivors.

Incorporation of Sexual Violence in Nursing Curricula Using Trauma-Informed Care: A Case Study.

BACKGROUND: One in five women will experience sexual violence in their lifetime. As a consequence of this violence, survivors face health care concerns such as depression, anxiety, substance abuse, and gynecologic problems. Nurses are at the forefront of health care delivery to survivors of sexual violence, yet literature about nursing curricula addressing sexual violence is scant. METHOD: A holistic, single-case study from a student survivor about the impact of sexual violence, being taught from a trauma-informed care perspective, is presented. RESULTS: The powerful case study highlights the personal and professional benefits stemming from a sexual violence curriculum being taught from a trauma-informed care lens. The student survivor reports personal growth and an understanding of herself, as well as a new framework with which to care for patients who have experienced sexual violence. CONCLUSION: In preparation to deliver care to sexual violence survivors, students must be educated about the prevalence, long-term sequela, and health care needs of survivors, which can be effectively done using the model of trauma-informed care. The student's case suggests that discussing sexual violence is imperative for one's own healing and contribution to the nursing profession.