Thirty Years of Midwifery Education in the Rural and Diverse State of New Mexico.

The purpose of this article is to discuss the evolution of the University of New Mexico (UNM) Nurse-Midwifery Education Program, its impact on New Mexico communities, and the vision moving forward for the program in a rural and culturally diverse state. New Mexico has a rich history of community-based midwifery and the UNM Nurse-Midwifery Education Program, founded in 1991, is rooted in this tradition. Graduates are prepared to practice in rural and underserved communities, advance birth equity, and decrease perinatal health disparities. Faculty have advanced the program mission to improve the health and well-being of New Mexico families through diversifying the midwifery workforce, growing community collaboration, and engaging in research and scholarship activities aimed at promoting access to care. Program faculty recognize the critical need to address factors underpinning the rising maternal morbidity and mortality crisis, including rurality, poverty, and structural racism. These efforts have yielded positive results, with 60% of program graduates serving New Mexico communities and increasingly diverse midwifery student cohorts (70% of currently enrolled students). Efforts to support midwifery student success are bolstered through a recently awarded Health Resources and Services Administration Maternity Care Nursing Workforce Expansion grant. Through such endeavors, the program will continue to strive toward social justice and human dignity.

Clinicians Address Gestational Weight Gain and Nutrition Using the International Federation of Gynecology and Obstetrics (FIGO) Nutrition Checklist.

The negative effects of excessive gestational weight gain (GWG) and obesity during pregnancy are well documented in the literature. However, lack of time, education, comfort, and confidence among health care providers often make it difficult to provide proper nutrition and weight gain guidance for pregnant persons. In response, the International Federation of Gynecology and Obstetrics (FIGO) has developed a nutrition checklist that can standardize recommendations for GWG, facilitate discussions with pregnant persons, and aid providers with nutrition education. The checklist is an innovative tool that can help reduce complications associated with excessive GWG. This article discusses the benefits of FIGO Nutrition Checklist and its implementation at a midwifery clinic that primarily serves Native American women. By using this quick, simple, guided, time-efficient tool, clinics can be successful in facilitating important conversations and education about nutrition and GWG during pregnancy.

Incorporating an Equity Agenda into Health Professions Education and Training to Build a More Representative Workforce.

Efforts to achieve health equity goals in the United States require the recruitment, retention, and graduation of an increasingly diverse student body of aspiring health professionals. Improving access to health care providers who are culturally congruent with the populations served is a related ethical priority that has the potential to improve the health inequities faced by communities of color and others in the United States. Midwifery education program administrators and faculty have responded to this need by acknowledging that creation of a more representative midwifery workforce starts with midwifery education. The Equity Agenda Guideline, related conceptual model, and website resources were developed for the purpose of supporting health professions educators and institutions who recognize a need for change and are seeking answers about how to train and graduate more health care providers from communities that are currently underrepresented. Using a systems approach to outline the transformative multilevel changes required, these resources offer a roadmap for how to address the underlying problems of racism and other differentisms that have limited the growth and diversification of the health and helping professions. This article addresses how health education programs interested in making an impact on this complex and persistent problem can adopt or adapt the Equity Agenda Guideline, originally developed for midwifery education programs in the United States.

Postpartum Care for Women with Gestational Diabetes.

PURPOSE: To assess postpartum gestational diabetes mellitus (GDM) practice patterns of providers in a large, tertiary care hospital. A retrospective review of medical records for women with GDM receiving postpartum care in 2012 was conducted to estimate the percentage who received a postpartum visit, glucose testing, and preventive follow-up care. STUDY DESIGN AND METHODS: A sample of 97 charts was reviewed. Pearson's chi-squared tests and Fisher's exact test were used, as appropriate, to examine differences in documented care by race/ethnicity, insurance type, and type of medical provider. RESULTS: Within the system of study, 53 of 97 women (55%) with GDM had a documented postpartum visit, with disparities by race/ethnicity and insurance type, and 18 (19%) had a documented oral glucose tolerance test after 6 weeks postpartum. Most providers routinely documented interacting with patients around infant feeding, family planning, and emotional status, but fewer documented providing specific care to help patients manage future diabetes risk, with advance practice nurses significantly more likely than physicians to document some aspects of preventive care. CLINICAL IMPLICATIONS: Postpartum GDM care could be improved by educating providers on the current postpartum GDM standard of care and use of the 5 A's framework for health promotion; prompting providers to order appropriate screenings and document the 5 A's; coordinating follow-up glucose screening and behavioral management with the postpartum visit and subsequent family planning visits; notifying primary care providers and pediatricians of the GDM diagnosis to ensure continuity of care; and referring to allied healthcare providers for intensive behavior change support.

History of midwifery in New Mexico: partnership between curandera-parteras and the New Mexico Department of Health.

Curandera-parteras (traditional Hispanic midwives) have been in northern New Mexico since before its statehood. In the 1930s, the New Mexico Department of Health began a valuable relationship with the curandera-parteras through the Midwife Consultant Program. This article describes the relationship between the curandera-parteras and the New Mexico Department of Health originating in the 1920s. The amenable and effective working relationship achieved between curandera-parteras and public health during this time period helped create the positive support for midwifery that is apparent in New Mexico today.