Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Women’s Health Nurse Practitioner (WHNP) nursing programs prepare students to deliver primary healthcare to women throughout their lifespan. This nursing specialty program consists of in-depth theory, pathos-physiology, research application, pharmacological therapy, and critical thinking skills based on clinical studies. Prospective nursing students are expected to meet the requirements of the nursing program, including full-range comprehension of reproductive-gynecologic health. Prospective students should seek accredited nursing programs that meets the guidelines for women’s health nursing education established by the Association of Women’s Health, Obstetric and Neonatal Nurses and the National Organization of Nurse Practitioners of Women’s Health. Prospective nursing students should conduct the proper research to determine if the institution has obtained accreditation through the National Association of Nurse Practitioners.
Most Women’s Health Nurse Practitioner nursing programs require roughly thirty-nine credit hours and may be completed over the course of one calendar year if applied full-time. Prospective nursing students must obtain credentials through a traditional LPN program, a bridged LPN to RN program, or RN program. Any students considering a nursing specialty that previously obtained their credentials through online nursing programs should gain the necessary clinical experience by volunteering or enrolling into an internship. Without the hands-on training, most nursing graduates will find it difficult to qualify for desirable nurse jobs right out of their nursing schools.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

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As an educator, I am a clinical assistant professor at Barnes College of Nursing at the University of Missouri-St. Louis, with responsibility for developing the WHNP curriculum I have had the opportunity to design innovative clinical components that broaden our students’ experiences beyond traditional women’s health care. Currently, our nurse practitioner students, under faculty supervision, provide health education and assessment to pregnant and parenting teens in three school districts, as well as in a welfare-to-work program. We also work with a local clinic to provide traditional prenatal and family planning services, along with “house calls” to women who miss their prenatal appointments.

As a women’s health advocate, I work directly with community groups, policymakers, and organizations to address issues affecting women’s health. This has led to my appointment to the Missouri Department of Health’s Women’s Health Council, vice-chairperson of the March of Dimes-Greater Missouri Chapter, and member of the expert advisory panel for a national Cardiovascular Health for Women initiative coordinated by the Association of Women’s Health, Obstetric and Neonatal Nurses and the American Nurses Foundation. This has allowed me the opportunity to be a founding board member of two important community initiatives, the Teen Pregnancy Prevention Partnership, a diverse coalition of agencies and individuals dedicated to addressing issues affecting teen pregnancy; and the Maternal-Child and Family Health Coalition. I have also had the opportunity to work with managed care organizations and physician groups, helping them to understand the benefits of working with Whaps.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Specialties:

Most WHNPs provide primary women’s health care, which includes pre-conception health care, prenatal and postpartum care, family planning services, management of sexually transmitted diseases, well-woman care, care during perimenopause and menopause, as well as care for women experiencing episodic acute or chronic conditions. With additional education and clinical experience, WHNPS are also qualified to practice in a variety of subspecialty areas, such as infertility, cardiovascular health, oncology, geriatrics, endocrinology, urogynecology, bone health, and high-risk pregnancy, and to perform advanced technical procedures such as limited ultrasounds.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Practice Settings:

WHNPs practice in a variety of outpatient care, long-term care, and community-based settings, as well as in hospitals. Examples of WHNP practice settings include primary care clinics, physician offices, community health centers, hospitals, antepartum triage units, school and college health clinics, health departments, business and employee health settings, and nursing homes ¾ essentially everywhere that women seek health care. Additionally, opportunities abound for WHNPs as innovative business entrepreneurs.

Qualifications:

In addition to strong critical-thinking, decision-making, and communication skills, WHNPs must also possess specialized knowledge of the intricacies of how simply being a woman can affect health and disease. Nursing experience in case management and incorporating the physical, social, emotional, and spiritual aspects of life into health assessment, education, and interventions is also critical in achieving optimal women’s health. The WHNP learns to apply ethical and legal principles to complex health care situations and collaborate with women to develop health care plans that recognize the realities of their life situations. Typically, RNs entering a WHNP program are building on prior nursing experience in maternal-child or women’s health.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Throughout my nursing career, I have focused on women’s healthcare, practicing first as a staff nurse on an obstetrical unit, providing labor and delivery, postpartum, and newborn nursery care. As my career continued, I gained experience in outpatient care, specializing in prenatal care for high-risk populations, including pregnant and parenting teens, and women who are pregnant and chemically dependent. My experience also included development of professional and consumer-oriented programs focusing on maternal-child health, women’s health, and nursing practice. Some of my most valuable experience was in community health, where I provided home visits for childbearing families. All of these experiences have enhanced my WHNP practice and allow me to provide a whole-health approach to women’s health care.

I also maintain a traditional practice in a private physician’s office. In addition, my academic appointment provides me the opportunity to maintain skills in developing curricula and other education programs, as well as supporting practice in a health department and home setting.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Salary Range:

In 1999, nurse practitioners nationally earned salaries ranging between $50,000 and $70,000 across a range of specialties, with an average of $60,000. Salary ranges for WHNPs vary depending upon region and practice site. WHNP salaries typically fall into the mid range of the spectrum. However, entrepreneurial activities or specialized programs may provide the opportunity for increased earnings.

Education:

Education of the WHNP includes advanced classroom and clinical preparation beyond that of the basic professional RN. WHNPs may have been prepared through a graduate program leading to a master’s degree, or through a certificate program. The WHNP curriculum includes education in general health assessment, gynecology, obstetrics, common non-reproductive health problems, clinical therapeutics, health promotion and disease prevention, and the WHNP role.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Graduate programs leading to practice as a WHNP include a minimum of two years of post-baccalaureate education, culminating in a Master of Science degree in nursing (MSN). Several universities also offer post-master’s programs that allow MSN nurses to complete one or two years of specialty coursework in preparation for the WHNP role.

In a certificate program, RNs may complete advanced coursework and clinical education specializing in women’s health that prepares them for practice as WHNPs. Certificate courses do not culminate in a master’s degree, but do prepare participants for certification and practice as WHNP

Best Online Nurse Midwifery Programs
#1 Frontier Nursing University
Frontier Nursing University delivers exceptional nursing education to a range of students. The school tailors its community-based nurse-midwifery program to students who currently work as registered nurses, nurse practitioners, and nurse midwives. After completing the program, students graduate with a master of science in nursing with a nurse-midwifery concentration.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Frontier’s 64-credit program consists of four levels: foundations for practice (18 credits), clinical management for specialty care (25 credits), clinical bound (2 credits), and clinical practicum (4 didactic credits and 15 clinical). To finish the program, future nurses take a one-credit review course.

Students interested in obtaining a doctor of nursing practice (DNP) degree can add the 19-credit companion DNP program to their master of science in nursing curriculum.

#2 Jefferson
A partnership between Philadelphia University and Thomas Jefferson University, the Jefferson school offers an MS in midwifery, an MS in midwifery completion, and a doctor of midwifery. The nursing and midwifery courses online integrate technology and midwifery education to deliver a flexible, user-friendly program. Additionally, the Jefferson school supports peer-interaction through on-campus meetings, cohort groups, real-time web meetings, mastery sessions, and a speaker series.

Accredited by the Accreditation Commission for Midwifery Education, the 62 credit-hour MS in midwifery program prepares graduates for the American Midwifery Certification Board exam. Full-time students graduate from the program in three years, while students in the accelerated format earn the degree in two years. In both formats, degree candidates participate in clinical rotations during the final semesters of the program.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

The advanced placement option of this degree accommodates students who possess a background in midwifery or who work as nurse practitioners. These enrollees qualify for accelerated or part-time placement if they meet the eligibility criteria.

#3 Bethel University
Bethel University’s MS in nurse-midwifery program, which strives “to provide leadership in nursing education,” consists of faculty with practicing backgrounds in midwifery.

The school’s 57-credit online format includes week-long on-campus intensives. The core curriculum consists of four practicum courses and a seven-credit clinical integration class. Additionally, graduate students must complete a master’s project in midwifery using literature from the curriculum. In total, the program takes two to three years to complete.

Bethel University also administers a bridge program for registered nurses seeking a graduate midwifery degree. In this program, students take seven courses worth 21 credits to fulfill undergraduate requirements. Then, students proceed to the graduate curriculum. Bridge participants choose their enrollment status (full- or part-time) and take online courses. Students must also participate in three clinical rotations and three on-campus intensives. Once completed, bridge students graduate with a bachelor of nursing and a midwifery degree online.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

#4 Stony Brook University
Stony Brook University oversees nursing and midwifery online programs to train midwives entering the healthcare community. To apply for the program, applicants must hold a bachelor’s degree in nursing and a current nursing license. They must also submit a transcript with undergraduate coursework in health assessment and statistics. Admissions at Stony Brook prefers candidates with at least one year of nursing experience; applicants without a nursing degree must submit a clinical practice portfolio to the school for evaluation.

In the MS in nurse midwifery program, students complete 45 credits in research, pharmacology, pathophysiology, health assessment, and clinical coursework. In the clinical courses, students meet instructors and supervisors on-site to perform clinical duties.

Out-of-state students in Stony Brook’s MS in nurse midwifery program must coordinate rotations within their region. The program qualifies graduates to sit for the Certified Nurse Midwife exam and register as a certified nurse midwife by New York State Educational Department standards.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

#5 The George Washington University
GWU awards MSN and BSN degrees to students with an associate degree in nursing. In GWU’s dual-degree program, learners graduate with a bachelor’s and master’s degree in nursing in three and a half years. As one of the best online nurse-midwifery programs for students in the Washington, D.C., area, GWU requires all online students to enroll in the Virtual New Student Orientation to familiarize themselves with the school’s approach to online learning. Furthermore, students can specialize their nursing degree by selecting a concentration.

The nurse-midwifery concentration at GWU receives accreditation from the Accreditation Commission for Midwifery Education. The program is a partnership between GWU and Shenandoah University that prepares students for the national midwifery certification exam. Although most classes are delivered online, students must attend Shenandoah University for on-campus training during the last year of the program.

To enroll in GWU’s midwifery program, applicants need a current nursing license, current CPR certification, and an associate degree with a 3.0 GPA.

Nurse Midwifery Online Programs: An Overview
Online nurse midwifery programs vary by cost, admission requirements, credits, practicum hours, and residency requirements. Make sure to select a program that balances your flexibility needs with hands-on training opportunities. While program requirements may differ, you can get a better idea of what to expect from the best online nurse midwifery programs below.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Admission Requirements for an Online Nurse Midwifery Program
Designed for nurses interested in specializing their careers, online nurse midwifery programs typically require applicants to hold a bachelor’s in nursing (BSN), or a related field, from an accredited institution. Some schools offer bridge programs for registered nurses (RNs) with associate degrees. Others require a minimum GPA of 3.0 for undergraduate work and successful completion of an undergraduate statistics course. Online MSN programs require that applicants hold a current unencumbered license as an RN or require at least a year of clinical nursing experience, preferably in labor and delivery. Other common application requirements include a resume, letters of recommendation, official transcripts, and a personal statement.

How Long Does It Take to Complete an Online Nurse Midwifery Program?
Graduate-level online nurse midwifery programs typically include completing 50 credits, taking between two and three years for completion. The number of required courses, and your course load, significantly impact the time needed to finish your degree. Many schools offer both full-time and part-time options, but most recommend that students do not continue to work full time while in school. However, students can complete this master’s degree in as little as two years with full-time study.

Many nursing schools offer this program in a cohort format, meaning that you take courses and attend on-campus residencies with the same group of nurses. Cohort learning builds community and promotes networking among students. Other programs enable you to take courses at your own pace, allowing students the flexibility to work while attending school.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Example Courses for Online Nurse Midwifery Programs
Online nursing and midwifery courses differ by school, as do residency requirements and clinical rotations. Many programs offer courses relevant to all APRNs in the first year, such as anatomy and pharmacology, and require courses specific to advanced midwifery practice in the second year. All programs prepare nurse midwives for independent clinical practice caring for women. The following includes some of the sample courses within nurse midwifery programs.

Advanced Health Assessment: This course prepares APRNs to take full medical histories from patients and conduct comprehensive physical assessments. Topics include interpretation of data and test results.
Advanced Pharmacology: This course prepares APRNs to recommend and prescribe appropriate medications. Students explore typical doses, possible adverse effects, indications and contraindications, and routes of administration for acute and chronic conditions. Discussions include the legal, financial, and ethical implications of prescribing medications.
Antepartal Care: Students explore the care of women during normal and at-risk pregnancies. Nurse midwives learn to manage care in collaboration with patients and other providers to achieve desired and optimal outcomes. This course may include clinical hours or relevant pharmacology content.
Fetal Evaluation: Nurse midwife students learn to monitor the health and well-being of fetuses during pregnancy, labor, and birth. Learners examine techniques for fetal monitoring and interpretation of test results in both normal and at-risk situations.
Postpartum Care: This course explores the care and recovery of women after childbirth, in both normal deliveries and for women at risk of complications. This course may include a clinical component and relevant pharmacology.
Internship Component
Because midwifery requires hands-on skills in patient care, even online nurse midwife programs include clinical hour requirements. Those who study nursing and midwifery online may typically arrange their practicum placements at facilities near them. Some schools require on-campus skills training before beginning clinical rotations, so consider campus location when selecting a program. Practicum requirements generally include clinical hours in midwifery practice, including primary care, antepartum care, perinatal care, and postpartum care. Check with your state about licensing requirements for nurse midwives. Program faculty support and supervise nursing students throughout their clinical rotations.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Certifications and Licenses This Program Prepares For
American Midwifery Certification Board Certification: The ACMB is the national certifying body for midwives. All states license CNMs, and most require AMCB certification for licensure. Some employers also mandate that practicing midwives hold AMCB certification.
Neonatal Resuscitation Program Certification: Nurse midwives participate in the care of newborns and may need to perform resuscitation. Certification in neonatal resuscitation demonstrates competence in this critical area of patient care. Some nurse midwifery programs may require students to hold this certification before beginning clinical hours.
Electronic Fetal Monitoring Certification: A critical task performed by nurse midwives during labor and delivery is electronic fetal heart monitoring. Many healthcare providers require nurse midwives to pursue advanced training in this area.
Accredited Online Nurse Midwifery Programs
Employers, state licensing boards, and graduate schools all generally require or prefer candidates with degrees from accredited institutions. Colleges and universities may hold regional or national accreditation. Many view regional accreditation from one of the seven regional accrediting commissions as more rigorous, academic, and prestigious than national accreditation. Regionally accredited schools usually only accept degrees and transfer credits from other regionally accredited schools. The U.S. Department of Education and the Council for Higher Education Accreditation both certify independent accrediting bodies.

In addition to institutional accreditation, some programs hold specialized accreditation, which is an additional marker of program quality. Midwifery programs that prepare nurse midwives for certification and state licensure, for example, are accredited by the Accreditation Commission for Midwifery Education (ACME). All programs that grant eligibility to take the AMCB exam must hold ACME accreditation.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Job and Salary Outlook
Where Do Nurse Midwives Work?
About half of all nurse midwives report working in physicians’ practices that care for pregnant women or hospitals and outpatient birthing centers. The BLS lists physicians’ offices as employing the most nurse midwives. Midwives working in physicians’ offices see patients for routine prenatal, postnatal, and gynecological care and also attend births. Those working in hospitals and outpatient centers mainly attend births. Some nurse midwives may move into management positions; open their own independent practices; or work for universities, research centers, or government agencies.

 

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Midwives are designated primary care providers, and their care includes primary; gynecologic and family planning; preconception; pregnancy, childbirth and the postpartum period; normal newborn during the first 28 days of life; and treatment of male partners for sexually transmitted infections (ACNM, 2012c). Care settings include outpatient clinics, private offices, community and public health centers, birth centers, homes, hospitals, and more. Midwifery care also includes health promotion, disease prevision, and individualized wellness education and counseling (ACNM, 2012c). Midwives conduct physical examinations; prescribe medications including controlled substances and contraceptive methods; admit, manage and discharge patients (in hospitals and birth centers); order and interpret laboratory and diagnostic tests; and order the use of medical devices (ACNM, 2012c). A distinctive feature of midwifery care is its strong emphasis on developing a partnership with women and families and providing care with respect for their involvement and active participation in healthcare decision making.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Births attended by CNM/CMs have risen every year since 1989… In the US, the profession and practice of modern day midwifery has evolved significantly since introduced by Mary Breckinridge in 1925. Births attended by CNM/CMs have risen every year since 1989 (the first year statistics were available) (ACNM, 2013a). In 2011, 7.6% of all US hospital births and 30.2% of out-of-hospital births were attended by CNM/CMs (ACNM, 2013a). Midwifery care results in lower costs due to fewer unnecessary, invasive and expensive interventions and is associated with lower rates of cesarean birth, labor induction, and augmentation; less use of regional anesthesia; significant reduction in the incidence of third and fourth degree perineal tears; and higher rates of breastfeeding (ACNM, 2012a). Rising cesarean birth rates have been an ongoing challenge with 1 in 3 women giving birth by cesarean section in 2011 for a rate of 32.4%, (Martin, Hamilton, Ventura, Osterman, & Mathews, 2013). The continuing dramatic rise represents an ongoing “dehumanization and medicalization of birth,” despite clear evidence of the harm that occurs to both mothers and babies (Wagner, 2001). While various reasons such as changing demographics, medical legal climate, and resident training have been considered to explain the rise in Cesarean birth rates, a review of the primary cesarean section rates by states suggest a variety of medical practices may strongly influence the method of birth (Osterman, & Martin, 2013). Campaigns by the March of Dimes and the American Congress of Obstetricians and Gynecologists aimed at eliminating non-medically indicated birth before 39 weeks of …research has shown that midwifery care is of high-quality and comparable to or better than care provided by obstetrician/gynecologists. gestation have resulted in a reduction in cesarean birth at 38 weeks but an increase in cesarean birth at 39 weeks (Osterman, & Martin, 2014). The shift in practice to delay induction of labor until after 39 weeks is one area that demonstrates medicalization of birth which results in increased cesarean birth. In a recent Cochrane Review, births attended by CNM/CMs consistently demonstrated safety, less use of interventions, and fewer cesarean births (Sandall, Soltani, Gates, Shennan, & Devane, 2013). The three major midwifery organizations in the United States have joined together to promote a greater awareness and respect for normal birth. Recognizing that the use of interventions in the birth process is excessive they have published a resource for women called, “Normal, Healthy Childbirth for Women & Families: What You Need to Know.” Its purpose is to inform women in their decisions surrounding medical interventions during birth (ACNM, 2014). In general, research has shown that midwifery care is of high-quality and comparable to or better than care provided by obstetrician/gynecologists (ACNM, 2012a).Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Clinical Midwifery Practice Challenges
Challenges and barriers to CNM/CM clinical practice generally fall into one of two categories: those created by restrictive state laws and regulations and those that, although they may have a regulatory component, can be considered related to the business of midwifery. This section of the paper describes major regulatory and business midwifery challenges.

Regulatory barriers

Both the legislative authority granted to CNM/CMs to practice independently and where they practice varies considerably state to state. According to data compiled by ACNM on State Legislation and Regulatory Guidance (ACNM, n.d.), midwives that are not nurse-midwives are illegal in 10 states, 12 states have no laws or regulations about non-nurse-midwives, and 2 states prohibit CNMs from doing home births

Three major regulatory challenges exist within many states: (1) the requirement for either physician supervision or a written collaborative agreement with a physician; (2) the requirement for physician supervision of prescriptive authority even in the presence of otherwise independent practice, as well as the extent to which prescriptive authority is granted (e.g., the ability to prescribe controlled substances); and (3) legislation governing midwives and out-of-hospital birth.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Collaborative agreements. These regulatory barriers hamper access to midwifery care in several ways. Hospital credentialing and/or admitting privileges may be denied if the CNM/CM cannot find a physician willing to sign a contractual agreement. Third-party reimbursement may also be denied without a contractual agreement, even if services clearly fall within the midwife’s scope of practice. The requirement for a formal contract with a physician also creates an economic disadvantage for CNM/CMs, either because it can restrict the number of midwives “allowed” to practice with a particular physician or because it creates a potential barrier to the development of practice in a particular area (ACNM, 2013b). In many instances, because of this supervisory requirement, midwives are not considered members of a “profession” and therefore CNM/CMs are unable to open their own practices as Professional Limited Liability Corporations (PLLC). Such laws may cause midwives to leave a restrictive state and move elsewhere to work, potentially decreasing access to midwifery care in that state.

Prescriptive authority.Prescriptive authority restrictions have long been problematic for midwives. Independent practice without the ability to independently prescribe is not independent practice. For example, in Michigan prescribing is the only midwife practice area requiring physician supervision or collaboration. However, the legal interpretation of this law has evolved into the opinion that if prescribing is supervised then perforce practice must be also. This barrier prevents the creation of practices especially where there is no physician willing to partner with a midwife. Unclear prescribing practices also results in patient – and pharmacy – confusion as to the prescriber and care provider, potentially resulting in a lack of provider accountability.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Legislated barriers require legislative change. While actively working for change is not an easy process, it can be particularly difficult for CNM/CMs due to their small numbers and demanding work schedules. Partnering with APRN groups has helped to move legislative change forward. Recently, in a number of states, APRNs and midwives have worked effectively together to remove, or at least lighten, restrictions. Currently, eighteen states have no restrictive regulatory requirement for written or formal physician involvement in midwifery practice, and more are working on this type of legislation (ACNM, n.d.). There may be other opportunities to partner with APRNs or other midwives to create legislation that removes barriers for all. Collaboration with grass roots organizations, for example, can be an incredibly powerful partnership.

The passage of the Affordable Care Act has also been key in bringing attention to the need for increased access to care as well as the importance of removing APRN practice restrictions. Several events in recent years have spurred an unprecedented opportunity to address regulatory challenges. Support from the nursing profession has been described in the National Council of State Boards of Nursing (2008) Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education that defines the categories of APRNs (including CNMs). This groundbreaking document provides model regulatory language that clearly calls for autonomous and independent practice by APRNs without supervision. Another key document, the Institute of Medicine’s (2010) Future of Nursing: Leading Change, Advancing Health called for removal of barriers to APRN practice and for “the full extent of their education and training” (p.85). The passage of the Affordable Care Act has also been key in bringing attention to the need for increased access to care as well as the importance of removing APRN practice restrictions.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Midwifery and out-of-hospital birth. Between the professions of nursing and midwifery, an issue midwives uniquely face could be described as the “foot on each side of the regulatory fence.” Direct-entry midwives practice legally and are licensed separately in many states. A few states license all midwives under a Board of Midwifery, but most CNMs practice under the Board of Nursing, while a couple of states designate the Board of Medicine, and a few states issue licensing under joint regulation. ACNM considers the best model to be a separate Board of Midwifery (ACNM, 2011b). Those wishing to enter the profession of midwifery will have to thoughtfully evaluate each state’s needs and regulatory issues in considering where to practice.

Under the Affordable Care Act, Medicaid is required to reimburse for OHB services… Regulations are wide-ranging concerning out-of-hospital birth (OHB), defined as birth in free-standing birth centers or home birth. Birth center regulation exists in most states today; some are working on this legislation. States that do not regulate OHB face a considerable challenge. Under the Affordable Care Act, Medicaid is required to reimburse for OHB services; however, there is room for interpretation. Data compiled from 50 ACNM State Legislative and Regulatory Guidance sheets, reveals that a number of states actively discriminate against home birth and home birth care providers (ACNM, n.d.). A few states actively prohibit home birth care providers from practicing, whereas regulation in other states is either vague or absent entirely. Where there is no regulation, third-party reimbursement may be problematic. In addition, the frequent medical disparagement of those who choose to provide OHB services can result in erratic (at best) inter-provider communication and loss of continuity of care in the event of urgent transport to a medical facility.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Solutions to these pressing challenges include legalization, regulation, and professional recognition of all midwives… Solutions to these pressing challenges include legalization, regulation, and professional recognition of all midwives as well as all OHBs. Currently, this will require state-by-state legislative changes. The presence of safety measures such as adequate criteria for OHB candidates may be accomplished through education of providers. A “safety-net” system of seamless and respectful consultation, referral, and transfer between care providers in a timely manner also requires education and opportunities to build trusting relationships between OHB providers and in-hospital providers. A key strategy is working collaboratively with other professional and consumer groups toward solutions that enable midwives to provide care within the full scope of their practice. ACNM is politically active and has a long track record of success at the national level, both in the federal legislative arena and working with other national and international nursing, midwifery and medical organizations. ACNM lends support for state efforts as well and CNM/CMs are encouraged to take advantage of the organization’s abilities and resources if they wish to be involved in removing legislative barriers within their own states.

The landscape of healthcare delivery is constantly changing, bringing with it a unique set of challenges for today’s healthcare professionals. Although the future of our nation’s healthcare remains unclear in many ways, we do understand the undeniable value of practitioners who can meet the challenges of an evolving healthcare environment, particularly now when the demand for healthcare has never been greater. The education programs that prepare today’s practitioners are also evolving to better fit the changing shape of healthcare in the 21st century, offering students new opportunities for interdisciplinary study that will prepare them to specialize in multiple areas and serve more than one patient population group.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

A certified nurse-midwife (CNM) is a registered nurse who has also completed an accredited Master’s degree program in nurse-midwifery and passed the American Midwifery Certification Board (AMCB) examination. In California, nurse-midwives are certified by the state Board of Registered Nursing(BRN).

For centuries, midwives have provided support and assistance in childbirth. Despite the most advanced medical technology in the world, the United States has higher rates of maternal and infant mortality compared to many countries that use midwifery as their primary model of care. Studies have indicated that midwife-attended births have lower cesarean birth rates, higher breastfeeding rates and lower NICU admission rates. Midwifery is increasingly recognized as an important component of comprehensive perinatal care, and increasingly integrated into healthcare systems.

Nurse-midwives provide primary care to childbearing individuals in a variety of inpatient and outpatient settings including hospitals, homes, and birth centers. They provide care that is informed by a core belief that birth is a physiologic process and that all physiologic processes should be supported by a wellness focus, including health promotion and disease prevention.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

The Women’s Health Nurse Practitioner (WHNP) is a registered nurse who has completed advanced education with a focus on the primary health care needs of women across the life cycle, with emphasis on conditions unique to women from menarche through the remainder of their lives. Program graduates are eligible to take the National Certification Corporation’s board examination for WHNP, and to be certified as a nurse practitioner by the Board of Registered Nursing (BRN) in California.

Academic Program

In 1975, the San Francisco General Hospital Nurse-Midwifery Service was established through the UCSF School of Medicine to provide a site for the education of nurse-midwives and to demonstrate that nurse-midwifery practice was a safe alternative to traditional obstetrical care in the hospital environment. The program subsequently partnered with the School of Nursing for the Master’s degree and in 2011, moved completely to the School of Nursing. Since its inception, the program has graduated over 500 nurse-midwives. The WHNP dual certification was added in 2007.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

The program is dedicated to increasing service to vulnerable and underserved individuals and families. We adhere to the philosophy of the American College of Nurse-Midwives (ACNM, but our unique program values are captured by the program’s own Mission, Philosophy, Purpose and Objectives, which we encourage all applicants to review prior to applying.

Admissions Requirements, Deadlines and Screenings

Admission to the Nurse-Midwifery/WHNP program is highly competitive. The program adheres to admissions requirements posted for the School of Nursing MEPN, Master’s and Post-Master’s programs. Applicants may reach out to the School of Nursing Director of Outreach, Recruitment and Retention for admissions and goal statement advice, or the specialty coordinator.

The program is primarily focused on training nurse-midwives; we strongly encourage applicants to gain exposure to both nurse-midwifery practice and birth prior to application. Applicants from diverse and/or underrepresented backgrounds are strongly encouraged to apply; please contact cnm-whnp_inquiries@ucsf.edu for more information.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Note: Only those MS applications to the Nurse-Midwifery/WHNP specialty area which are fully completed by the annual priority deadline of Feb. 1st† will be reviewed for admission. Complete applications are those which include fee payment, all recommendations, transcripts, and fully completed/uploaded and locked on-line application pages. There will be no exceptions to this policy.

† In years where the first day of February falls on a weekend, the enforced deadline is the following regular workday, e.g., Monday.

In order to be considered for admission, all Nurse-Midwifery/WHNP applicants that pass an initial application screening process will be asked to attend an in-person interview early/mid-March. Our interviews are conducted in a unique “speed-dating” format in order to introduce applicants to many faculty members. More information will be provided after initial screening.

Curriculum

This is a two-year program leading to the Master of Science degree, with certificates in nurse-midwifery and as a WHNP. The core curriculum includes courses in:Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

advanced health assessment
nurse-midwifery management process
management of the antepartum, intrapartum, and postpartum periods
GYN and family planning health care
It is part of the role of nurse-midwives and WHNPs to provide family planning care. There are required competencies in abortion and family planning and optional clinical rotations in abortion care.
well-newborn care
management of complications
health promotion and disease prevention
assessment and management of common primary care signs and symptoms
clinical pharmacology
assessment and management of psychiatric symptoms
issues in professional practice
advocacy and policy
Curriculum Core and Two-Year Plan

Please note that the Nurse-Midwifery/WHNP specialty curriculum and schedule are subject to change. As indicated by the curriculum table, the combined specialty track has a rigorous academic unit load, and graduates will complete more than one thousand hours of clinical training. Depending on the quarter, students are expected to be on campus 1-2 days per week and in clinical settings 1-4 days each week.

Some program content is provided online, but all specialty courses and most general courses currently have in-person class sessions. Students in the Master of Science program also take a series of theory and research courses throughout their two-year program. This culminates in a final comprehensive scholarly paper.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Sample Two-Year Plan

Clinical Rotations​​​​

Clinical residencies include rotations in antepartum, intrapartum, postpartum, gynecology, family planning, and newborn care.

Both overnight and weekend shifts should be anticipated during intrapartum clinical rotations.
Clinical rotations are throughout the greater Bay Area and may not be accessible by public transportation, so access to a car is necessary.
The final quarter of this program is a full-scope, ten-week clinical rotation called “Integration Clinical Residency.” Many members of the class will be assigned to an integration site away from the Bay Area. This involves separation from family/community members and may have extra expense.
Many of our clinical care sites have high numbers of monolingual Spanish-speaking patients. Spanish-language skills will make a difference in your learning experience and we strongly encourage strong Spanish-language ability, especially native speakers.
The Nurse-Midwifery/WHNP specialty makes every effort to accommodate student preferences when assigning clinical placements, but requests cannot always be accommodated due to factors beyond our control, including site and preceptor availability.
Post-Master’s

Post-master’s students are invited to apply. The Nurse-Midwifery/WHNP specialty area offers a two-year post-master’s certificate program to registered nurses who are already prepared at the Master of Science level in Nursing and seeking to become a Nurse-Midwife/WHNP. The post-master’s student curriculum is determined according to each individual student’s previous preparation and experience. Post-Master’s admissions information can be found  Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

In the field of nurse-midwifery, master’s degree programs that offer dual specialization have become prevalent. One such popular option is the dual-focus Certified Nurse-Midwife (CNM)/Women’s Health Nurse Practitioner (WHNP), available through a number of institutions as a Master of Science in Nursing (MSN), Master of Science (MS), or as a post-graduate certificate program.

For many prospective nurse-midwives, completing a dual-focus advanced practice program that encompasses both nurse-midwifery and women’s health may have a host of benefits; both for their future careers and for the women they will serve. Here’s why:

Why a Dual Specialty? Understanding the Similarities and Differences between Nurse-Midwives and Women’s Health Nurse Practitioners
Although it has been fairly commonplace for practicing nurse-midwives to also pursue an APRN specialization as a women’s health nurse practitioner, it wasn’t until recently that a number of institutions began offering combined nurse-midwife/women’s health nurse practitioner programs. These graduate-level programs allow RNs to complete all courses and clinical sequences required for national certification in both APRN specializations, through one comprehensive course of study.

These programs allow graduates their choice of credentialing options, qualifying them to earn either the Certified Nurse-Midwife (CNM) credential or board certification as a Women’s Health Nurse Practitioner (WHNP-BC), or both if they so choose.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

The CNM/WHNP degree program is a natural combination program, as the scope of practice of a nurse-midwife is often closely related to that of a women’s health nurse practitioner. This combination of inter-related knowledge and skills make earning a dual specialization degree a smart choice for APRNs interested in providing comprehensive care for women throughout their lifespan:

Women’s Health Nurse Practitioner (WHNP): A women’s health nurse practitioner provides primary health care services to women, from adolescence and beyond. WHNPs specialize in gynecology, providing well-woman care and treating women with both chronic and acute illnesses.

WHNP’s provide a gender-focused approach to health concerns affecting women so as to improve women’s health outcomes, reduce health disparities, and enhance the quality and efficiency of the delivery of women’s healthcare services.

The WHNP Guidelines for Education and Practice provides a comprehensive clarification of the WHNP role to include providing specialty services related to

Infertility
Sexual health
Reproductive cancers
Menopause
They generally provide care in:

Community clinics
Hospitals
Private practices
Nurse-Midwife (NM): A nurse-midwife provides primary healthcare services, including gynecologic and family planning services, as well as preconception care, childbirth services, and care during the post-partum period. These healthcare providers are also qualified to provide care for the newborn during the first 28 days of life and for male partners as it relates to sexually transmitted infections.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Nurse-midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment of women. The scope of their services includes health promotion, disease prevention, and individualized wellness education and counseling. They provide these services in diverse settings such as:

Ambulatory care clinics
Private offices
Community and public health systems
Homes
Hospitals
Birth centers
Although both nurse-midwives and women’s health nurse practitioners are recognized as advanced practice RNs in all 50 states and are able to provide primary care to women from adolescence through menopause, there are distinct differences between these two APRN specialties:

Women’s health nurse practitioners are qualified to treat women with both chronic and acute illnesses, while the primary focus of the nurse-midwife is on well-woman care.
The major focus of nurse-midwives has long been management of the antepartum, intrapartum, and postpartum woman. Nurse-midwives attend births in any number of settings, including hospitals, birth centers, and private home births. The scope of women’s health nurse practitioners does not include care of the childbearing woman, aside from prenatal visits.
Nurse-midwives are qualified to provide care to newborns during the first 28 days of life.
Nurse-midwives also certified as WHNPs may enjoy a broader scope of practice, providing care to women during their reproductive years to include diagnosing and treating acute and chronic illnesses and injuries, thus providing them with complete and comprehensive care.

The Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP) Master’s Program
A dual focus NM/WHNP master’s program prepares students to serve as competent nurse-midwives and women’s health nurse practitioners, capable of providing family-centered clinical practice and primary care.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Students of an NM/WHNP master’s degree program can expect a rigorous academic load and more than 1,000 hours of clinical practice to meet the curriculum and experience requirements of this combined specialty track.

Admission Requirements

Students of an NM/WHNP master’s degree program must possess a current and unencumbered RN license, a Bachelor of Science in Nursing (BSN), and often:

Minimum undergraduate GPA
Minimum GRE scores
Letters of recommendation
RN experience/resume
Professional statement of purpose/admissions essay
Program Structure and Accreditation

The Accreditation Commission for Midwifery Education (ACME) accredits nurse-midwifery programs in the U.S. Students must graduate from an ACME-accredited program to qualify to sit for the Certified Nurse-Midwife Exam through the American Midwifery Certification Board.

Students of CNM/WHNP programs accredited by ACME are also qualified to sit for the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation if they choose.Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

The majority of ACME-accredited programs are designed as MSN or MS programs, although a number of programs exist to accommodate students with differing levels of education. For example:

RN-to-MSN degree programs: Often called bridge programs, these programs allow RNs with associate’s degrees to earn both their BSN and MSN degrees in one, accelerated program.
Post-graduate certificate programs: These post-graduate programs appeal to master’s prepared RNs seeking initial APRN licensure as a CNM/WHNP, or to APRNs seeking to add additional specialties to their APRN license.
Other options found throughout many NM/WHNP master’s programs include:

Part-time/Full-time: While full-time NM/WHNP programs take about two years to complete, students often have the option of completing them on a part-time basis over the course of three years.
Partially/Fully Online: A number of NM/WHNP programs offer students the option of completing part or all of their didactic requirements through online study. Web-based study is particularly useful given the select number of institutions that offer the CNM/WHNP master’s degree. Students of online programs would complete their clinical requirements at approved sites close to home.
Program Components

Because the core curriculum of a nurse-midwife program is closely related to that of a women’s health nurse practitioner program, a dual focus master’s program eliminates the need to complete these courses twice:Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

Advanced health assessment
Clinical pharmacology
Healthcare ethics
Physiology and pathophysiology
Research methods for healthcare providers
The specialty coursework of these programs includes study in:

Women’s reproductive health
Ambulatory care of women
Primary care of women
Antepartum care
Nurse-midwifery management of complications
Intrapartum and postpartum care
Care of the newborn
Clinical Requirements

Clinical practice in a dual focus CNM/WHNP master’s degree program takes place across a variety of healthcare settings in which collaborative management, medical consultation, and referrals take place. All clinical rotations are in line with the National Organization of Nurse Practitioner Faculties Competencies for NPs and the Standards for Nurse-Midwifery Practice of the American College of Nurse-Midwives. Nurse Midwifery & Women’s Health Nurse Practitioner Essay Paper

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