Saturday, February 28, 2009

To MEAC or not to MEAC

The answer is probably not to MEAC.

MEAC is the Midwifery Education Accreditation Council, and if an apprentice midwife graduates from a MEAC school, she is automatically eligible to take the NARM exam, and upon passing is a
Certified Professional Midwife. (The NARM exam is the North American Registry of Midwives certifying exam. Midwifery is legislated by state, and most -- all? -- states require a midwife to pass the NARM in order to become licensed.) If I go to a non-MEAC school, I can still take the NARM, but as a PEP (portfolio entry process) which is a time-consuming pain in the ass, from what I understand. However, I'm still pretty confused about the entire process. Like, Christine, a local apprentice who attends a non-MEAC school, told me that if the state I want to license in recognizes the non-MEAC school I choose as a "path to education," I don't need to do the PEP process. And South Carolina, which is the state I want to license in, recognizes several non-MEAC schools as paths to midwifery.

Regardless, I'm keeping really careful records of everything I do. Apparently there can be a lot of red tape in becoming a midwife if you don't attend a MEAC school.

I would love to attend a MEAC school, but most of them are residential programs, and most of them are prohibitively expensive. (There's some more red tape about getting student loans for midwifery schools.) And then there's the fact that Dustin's company increased their employees' contribution to healthcare, which translates into us being down $200 per month. We do not have an extra $200 per month to compensate, much less an extra $200 per month plus $20,000 for midwifery school.

I've always wanted to be a licensed midwife. However, I didn't plan on starting midwifery education and training until my kids were older -- I didn't think I had the time or the money. But in January I started an online CBE training course, and I managed to strike a balance between learning and studying, and spending quality time with the kids. I also met Leigh in January. She talked to me about her experience, first in midwifery school with young kids, and now as a midwife with young kids. She asked me, if midwifery is my dream, how long am I willing to put it off? And if I do put it off, what will be the personal cost?

Around this time she told me she was looking for an apprentice, and since she didn't have one, I asked if I could sit in on a prenatal or two. From there, she asked if I would attend a birth with her as her assistant, and then she offered to train me, and here I am. A currently-unlicensed South Carolina apprentice midwife. (I'm just waiting on the results of my second TB test, and also I have to register with a midwifery school, and then I can get my apprentice license.)

So back to the school issue. I'm currently leaning toward Ancient Arts Midwifery Institute, which is not a MEAC accredited school, but it is a school that South Carolina recognizes as a path to education for midwifery. (Will have to do more research. Of course.) AAMI will accept a monthly payment plan for three years, interest-free. Everyone I know in the online world -- as well as several people in real life, including Christine -- say that AAMI is an excellent education, so thorough that most students pass the NARM before even graduating! Christine is a RN, and she has told me that AAMI is as difficult as nursing school. Also, the fact that it's recognized in South Carolina is a huge bonus. If I didn't have to do the PEP process, that would be fantastic. (But I'm doing the paperwork for it so far, just in case.)

The money thing will be difficult, as always. Dustin's salary going down $3000/year really scares me. I'm trying to look the money issue in the eye and figure it out. It's math. I shouldn't let it scare me. On the other hand, when I'm apprenticing and studying, I'm not going to be taking very many doula clients, so that might will some impact on our finances. Plus I'll need books and some supplies. Eeek.

But the program is only three years. In three years, I will be able to license and become a midwife. That's pretty exciting.

Saturday, February 21, 2009

Last week was busy...

Sunday: Attended the last day of a Birthing From Within mini-class. A three part class, approximately 10h in total, of BFW pain-coping strategies, mixed in with some EFT. This last meeting was called our "Warrior Ceremony," and involved using the pain-coping techniques we'd learned in very difficult situations that I honestly hope never to replicate. Overall, I'm not a huge fan of Birthing From Within -- it's too conceptual for me, and I don't think holding ice is anything like having a contraction -- but I do think there are some good parts. I like the "labor jobs" that BFW recommends, like pulling weeds while in early labor, or baking a birthday cake for the baby. But taming tigers? Foot baths? Not my scene.

Took my week three quiz for my childbirth educator class. Got 12/15. Called Kathryn, the instructor, in a slight panic, to ensure that I'm going to pass the class. I'm putting a lot of time and effort into my childbirth educator course, and I'm having a difficult time with the quizzes. I tend to overthink the answers. Kathryn assured me that I'm fine, and tried to encourage me to do midwifery school with Aviva Institute, but as great as Aviva probably is, I don't have the thousands of dollars to start at a "great" school. I'm planning to start with the Midwife-To-Be program, and if that doesn't go well, then I'll see if we can come up with the thousands of dollars to enter another program. Christine, who is a senior-level apprentice, practically a licensed midwife, told me that AAMI, which is what she and many other students I know take for midwifery school, is harder than nursing school was for her. Great.

Monday: Got the results of my first TB test in order to become a licensed apprentice midwife in South Carolina. (I'll do the second TB test next week.)

Went with my preceptor, Leigh, to visit Client A at her home. Client A is due in March -- we have spent a good amount of time trying to determine her estimated due date -- and is having her first homebirth. During the drive I read Client A's chart, which made me feel a little carsick, but I did not tell Leigh that! At the visit we answered questions from Client A's family, who are a little nervous about homebirth. Leigh was confident and straightforward. They seemed relieved to hear the answers to their questions, which included the ever-present "What if the cord is wrapped around the neck?" I swear, that question throws more people for a loop than anything I've ever seen. Even educated people get all up in arms about a nuchal cord. Please bear in mind that babies don't actually breathe until they're born.

Leigh had me take Client A's blood pressure, which I couldn't find, and then she told me that it takes forever to learn that particular skill. (I came home and found a sphygomanometer -- aka a blood pressure cuff thingy -- on craigslist so I can practice.) I took Client A's pulse, using the math skills that Leigh has suggested I work on, to calculate her rate. I also did the baby's rate. Leigh palpated the baby in order to find where to listen with a doppler, and tried to show me where to palpate, but I had a harder time. She measured the client and did a vaginal exam. When she asked if the clients had any questions, they asked about circumcision. Leigh actually deferred to me, since I have two boys, to answer that while she did some paperwork. A little nervously, I explained that the AAP does NOT recommend routine infant circumcision. I told them that most people seem concerned with cleanliness, but it's our job as parents to teach our children to clean themselves, and my boys have never had a problem. I also talked a little about the recent studies that have shown that uncircumcised men have higher rates of HIV and AIDS, but that the study doesn't mention using condoms. I talked a little about the high school locker room scenario (my theory: don't look, don't tell!) and about how the overall circumcision rate is going down.

Hopefully they will at least give it some more consideration and not just do it automatically. If they wait 2w past birth, the baby will not need an injection of Vitamin K.

Tuesday: Dropped my mom off at the airport (she had been visiting since last Thursday), went to a meeting with Leigh and several other midwives about getting a birth center started in South Carolina. We actually met with a local businesswoman whose name I don't recall because I spent most of the meeting chasing Sydney, my 16-month-old daughter, all over Demaris' house. Sydney has certainly transitioned from cute little baby into curious toddler, and since Demaris' kids are teenagers, it wasn't the safest house for her to explore. I probably only listened to about 25% of the meeting. After the businesswoman left, everyone assured me that Sydney was fine, but I still felt kind of bad.

Spent the afternoon cleaning for my mother-in-law, who, as luck would have it, actually arrived the evening after my mom left! I had just enough time to change the sheets in our guest room and vacuum the house before it was time to go to Leigh's house for her childbirth class.

Attended Leigh's class, which included Client A and her husband and kids, (potential) Client B, another apprentice/student midwife, and me. Leigh's classes are free. She does that to provide a service and get her name out in public, since she's new to South Carolina, but I wish the people who attended the classes actually respected the classes. One couple didn't show up, one couple quit after a week, and Client A has been late twice. I think maybe it's because the classes are free. Again, I know why Leigh is doing them for free, but I'm so busy right now, I wouldn't want to put in the effort to host a childbirth class unless I was getting something tangible in return. Maybe I'm a little jaded.

Wednesday: After the older kids went to school and preschool, took Sydney to the library with my mother-in-law for story time. Fun, as usual. Came home and Sydney and my mother-in-law napped (my mil is severely jet-lagged from her x-country flight) and I did a bunch of childbirth educator class homework. I actually intended to nap also, but I got too involved in my homework. It's an online class that involves a reading lecture, supplemental websites for information, online videos, a discussion forum with mandatory essay questions, research glossary, and weekly quizzes.

I was supposed to go to a meeting of Holistic Moms Network, but I just couldn't drag myself out of the house after three straight days of running around. I promised Dustin that when I started with midwifery, I'd drop my other extra-curricular activities and just focus on midwifery and him and the kids. And that's fine. I'm busy enough, and being social enough, that I don't feel like I'm missing anything right now. I do look forward to homeschooling the kids next year, because I'll see them more. I miss them.

Thursday: Best day of my childrens' lives. I let them play hooky from school and preschool, and we took the train to Discovery Place, where they played for hours. Came home, took a brief nap, then went to Plaza Fiesta to play. Hung out with my bff Emily and her kids, and my friend Leslie and her husband and kids, and watched the kids play. Ate pizza and Mexican and ice cream.

Friday: Took my Adult/Child/Infant CPR course. I'm now officially certified. Most of the other participants were midwives, doulas, and the like, so I met some new people, which I always enjoy. Not just from a professional level; I am a very social person. Especially when it comes to birth people -- we just have a lot in common, and knowing my fellow birth people in Charlotte is a bonus. After the certification, there was a delicious potluck (I brought homemade oatmeal cocoa cookies). Then Leigh and I, along with Demaris and Christine, went to look at a building for the Carolina Community Maternity Center, which we hope to have up and running by Labor Day. (Get it? Labor Day.) The building was fantastic. I was not expecting it to be such a perfect location for a birth center. It was beautiful, with tons of windows, and it's on the second floor, which is great for privacy. Really, it's perfect. This sparked discussion of how we need to file for 501c3 status, like NOW, and get some money rolling in.

Meanwhile, Dustin took the day off from work, since his mom was in town, and he forgot to pick the kids up from school. Nice, Dustin.

Saturday: Went to a long-overdue postpartum visit with my Christmas Client. She's wonderful, and so is her baby. Breastfeeding is going great. Client is feeling great. She's very supportive of our birth center idea. Christmas Client is someone I like on a personal level, and because of her career in the alternative health field, I know I'll be running into her again. She's in the Holistic Moms Network too.