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Masters Specialty Area
| FYI/Facts: Midwifery/Women's Health Nurse Practitioner Specialty | |
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The Nurse-Midwife
For centuries, women have turned to midwives for support and assistance in childbirth. (Midwife means "with woman.") Today's certified nurse-midwives continue to provide this personal care, which represents a bridge between traditional birth practices and modern technology.
A certified nurse-midwife (CNM) is a registered nurse who has also completed an accredited educational program in nurse-midwifery and passed an examination given by the American Midwifery Certification Board (AMCB). In California, nurse-midwives are licensed by the Board of Registered Nursing.
Despite the most advanced medical technology in the world, the United States has higher rates of infant mortality than many countries that use midwifery as their primary model of care.
In the United States, some studies have indicated that midwife-attended births have lower NICU admission rates and lower cesarian birth rates. Midwifery is increasingly perceived as an appropriate alternative to traditional obstetrical care. Consequently, the need for nurse-midwives continues to grow.
Nurse-midwives provide primary care to childbearing women in a variety of inpatient and outpatient settings including hospitals, homes, and birth centers. They provide that care from a core belief that birth is not a medical event, but a very normal physiologic process.
The Women's Health Nurse Practitioner
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.
Besides clinical care, WHNPs focus on health promotion, disease prevention, health education and counseling, and helping patients make wise health and lifestyle choices. Program graduates earn a certificate as a WHNP that enables them to be licensed as a WHNP in the State of California.
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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 Women's Health Nurse Practitioners (WHNP) and to demonstrate that nurse-midwifery practice was a safe alternative to traditional obstetrical care in the hospital environment.
Since its inception, the program has graduated hundreds of nurse-midwives while the midwifery faculty practice has attended births for more than 10,000 women. The program is dedicated to increasing service to vulnerable and underserved women and families and adheres to the philosophy of the American College of Nurse-Midwives.
This is a two-year program leading to the Master of Science degree, with certificates in nurse-midwifery and as a women's health nurse practitioner. The core curriculum includes courses in:
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.
Clinical residencies include rotations in antepartum, intrapartum, postpartum, well woman's health, newborn, and primary care. Students also complete an integration residency: a full scope clinical experience in sites that range from private midwifery practices to birth centers and tertiary care hospitals.
The Nurse Midwifery/WHNP specialty are also admits students through the UCSF MEPN program, for those who have completed their baccalaureate (bachelor's) degree in a field other than nursing. Following the first year of MEPN coursework, students then complete the two-year Master of Science specialty curriculum.
The specialty also offers a two-year program, culminating in post-master's certificates for nurse-midwifery and women's health nurse practitioners, to registered nurses who are already prepared at the Master of Science level. Certified nurse-midwives who have completed their undergraduate education may earn a Master of Science degree through a one year, 36 unit, individualized program.
To accommodate students from rural areas, on-campus coursework is clustered on one to two consecutive days per week, with some coursework offered using distance learning (on-line) technologies. Clinical rotations are provided with community practitioners. The program is accredited by the Commission on Collegiate Nursing Education (CCNE) (http://www.aacn.nche.edu/Accreditation) and the Division of Accreditation of the American College of Nurse-Midwives (http://www.acnm.org) at 8403 Colesville Rd., #1550, Silver Springs, MD 20910-6374 (Telephone: 240/485-1800).
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Amy Levi, CNM, PhD, FACNM, is the interim Program Director for the nurse-midwifery program.
Dr. Levi has extensive experience with Distance Education modalities, and will be launching the Distance Education option in the fall of 2005.
She also works with students in the antepartum and intrapartum clinical areas, and collaborates with Dr. Kennedy on research. Her current research focus is on women's decision-making in perinatal care.
Holly Kennedy, CNM, PhD, FACNM, coordinates the Nurse-Midwifery program. Her research explores specific processes of midwifery care and how those processes are related to outcomes in the health of women and their families, and midwifery practice within the context of today's health care arena.
As the coordinator of the nurse-midwifery specialty, she works closely with the clinical faculty and students to assure a rich array of courses that prepare graduates to be competent and scholarly clinicians.
She teaches students how to use research in clinical practice at the master's level, and introduction to qualitative methods for doctoral students.
Leslie Cragin, CNM, PhD, FACNM, is the Director of Nurse-Midwives of San Francisco, a faculty practice in the UCSF Department of Ob./Gyn. at San Francisco General Hospital. She conducts clinical research and is a clinical teacher for students during their intrapartum clinical coursework.
Dr. Cragin's research focuses on women from minority and vulnerable populations, and the outcomes of nurse-midwifery and other models of health care in the United States and Mexico.
Joanne Jorissen
After graduating from Brown University with a degree in international development, I worked on USAID projects as a project assistant for a couple of years. The work brought me close to issues affecting the quality of life of people in the developing world, but personally I still felt very removed from those I wanted to learn from and serve.
Through my work, I was introduced to the profession of nurse-midwifery and found that it offered a wonderful means to provide direct-care to women and their families. The profession embodied my personal conviction that health care is a basic human right, and the concept of working in partnership with women to support their empowerment resonated deeply with me. Certainly, as a nurse-midwife I would be able use my heart, hands, and intellect to effect positive change.
I entered UCSF through the MEPN track and went directly into the midwifery program after completing my RN. During my three years at UCSF, the university resources, the faculty, and my fellow students provided both the inspiration and support necessary to move forward towards the realization of my dreams.
Recently, I applied for a Fulbright and am currently on my way to Malawi where I will volunteer as a nurse-midwife and assist with curriculum development at the Kamuzu College of Nursing in Lilongwe.
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Curriculum information is available from the following web page.
Q: Do you have a distance learning program?
A: Beginning in the Fall of 2005, we will be incorporating a variety of distance learning tools into our curriculum to allow students to become nurse-midwives while residing in their home communities. Students will be able to incorporate online learning tools such as WebCT with on campus classes. Classes on campus are scheduled one day a week to enable students to commute for those days only. Clinical education will take place with preceptors close to the students' homes.
Q: What can I do to make my application "glowing"?
A: Each applicant is reviewed as a whole. Goal statement, letters of reference, extracurricular activities, language skills, activities on-the-job, research activities, work experience, professional organization activities, and GPA are ALL considered when the application is reviewed. List all of these aspects. Be sure to ask colleagues to review your goal statement. Include examples of on-the job activities. Describe any volunteer and professional activities. Make sure to ask your colleagues for "excellent" references and have them give specific reasons why they believe in your success.
Q: What does my GPA need to be for admission into the program?
A: A GPA of 3.0 is expected for admission into the School of Nursing although special circumstances can be discussed.
Q: What should I write in my goal statement?
A: You should be very clear about why you selected nurse-midwifery. Your statement should reflect how you have made this decision and your future goals.
Q: How much can I work during the program?
A: Some of our students hold part-time jobs while enrolled (typically working no more than 25% time). Working full time while in school is highly discouraged. Consult with the specialty coordinator for more information about program specifics.
Q: What if I want to study part-time?
A: Over 95% of our students study full time and complete their program in two years. The majority of specialties hold classes two days a week (Tuesday/Wednesday or Wednesday/Thursday) to allow for clinical part-time work and family obligations. "Official" part-time status is highly restricted and is available only by special arrangement. In certain circumstances, also by special arrangement, faculty will allow a student to extend a two-year program over three years.
Q: Am I responsible for finding my own preceptors?
A: No, the UCSF/SFGH nurse-midwives in their faculty practice provide the majority of clinical training for your first year. Advanced placements are located for you in year two.
Q: How do I find housing in the area? Is it expensive?
A: Many of our students find that sharing housing is a good approach to solving both the availability and cost issues. Housing in the Bay Area may be expensive, but help can be found with the campus Housing Office, the Student Affairs Office, and previous graduates can often give advice.
Q: What will help me prepare for school?
A: Rest and relaxation before school starts is helpful! A knowledge of spoken Spanish is highly recommended; many of our graduates have reported wishing they had fluent Spanish prior to entering the program. Computer skills (word processing and internet/web/email functions) are essential.
Q: What percent of the graduates pass the ACNM Board Exam?
A: Pass rate is 100%, with 99% on their first time.
Q: Can you tell me more about diversity?
A: Approximately 30% of our students are underrepresented or disadvantaged.
Q: Where do graduates work? Can they all find jobs?
A: The graduates of this program work as midwives throughout California and the United States and the world. They practice in many types of hospitals from small community settings to large tertiary hospitals, in birth centers and in home birth practices. A recent survey of the program graduates of the last 5 years indicates that 95% are employed, with over 75% caring for underserved, uninsured, Medi-Cal or minority families.
Q: What types of clinical experiences are included in the program?
A: Students attend clinical rotations beginning the first week of their first quarter all through the two years of the program. The busy midwifery program faculty practice at San Francisco General Hospital, established in 1975, provides the setting for beginning clinical rotations. Additionally, students attend outpatient clinics for antepartum and gynecology rotations at a rich variety of clinical sites throughout the Bay Area. A summer rural primary care immersion in Central California provides students opportunities to broaden primary care skills. The final quarter of the program is called the integration rotation. Students attend a full time/full scope off-site apprentice type rotation with a midwifery service in a variety of settings. All clinical placements are arranged for students by the program faculty.
Q: What are the requirements for admission to the program?
A: The program has three avenues of entry and the requirements differ slightly for each option.
Q: What qualities are you looking for in an applicant?
A: The program is philosophically dedicated to preparing midwives who will care for underserved populations of California and the United States. We seek to enroll students who share our goal and have demonstrated a commitment to the underserved through their work experiences, volunteer activities, and academic focus. We also consider the applicant's understanding of midwifery and women's health. Because rural communities are often underserved, applicants from these regions are encouraged. An ability to speak Spanish is valued because of the demographics of California and the client populations applicants will work with during their clinical experiences.
Q: I am in nursing school. Do I need labor and delivery experience before I can apply to midwifery school?
A: Experience as a labor and delivery nurse can be very helpful in developing an appreciation of the process of labor and birth. However a variety of experiences in women's health are valued and this experience is not an absolute requirement.
Q: Do students attend homebirths or work in birth centers?
A: The program does not provide opportunities to attend home births as part of our clinical rotations due to the University's inability to provide malpractice insurance for home birth. However, some students attend integration at select birth center practices. The program supports a woman's right to choice of birth setting and encourages students to learn the skills necessary for safe out of hospital birth practice.
Q: I am a nurse practitioner. Can I challenge out of any of the curriculum?
A: Yes. NP students meet with faculty to design a program which reflects the student's experience and knowledge. Past coursework, professional experiences and student goals are evaluated to determine if any coursework should be challenged. We do not expect students to repeat curriculum they have already mastered.
Q: Are there opportunities to participate in research?
A: Yes. Two of our core midwifery faculty, Dr. Leslie Cragin and Dr. Holly Kennedy, have ongoing research projects that students may work on using independent study credits. This is an excellent opportunity for students considering further doctoral study. There are many other faculty colleagues at UCSF engaged in exciting research who welcome students as research assistants.
Q: What are the strengths of your midwifery program?
A: Our program is fortunate to be an integral part of a busy committed community-based nurse-midwifery practice in a culturally diverse urban community. We enjoy a stable and collegial relationship with our fellow clinicians in the Ob/GYN Department of the UCSF School of Medicine. This affords our students excellent clinical opportunities as well as access to superb consultants and world-class speakers on obstetric complications. Our nurse-midwifery faculty members are all expert clinicians, clinical preceptors, as well as skilled classroom teachers. Just as importantly, our students have the opportunity to take their primary care and core graduate classes from the outstanding faculty in the UCSF School of Nursing. Our curriculum offers extensive coursework in primary care as well as cultural sensitivity and linguistic competency. The three program strengths consistently identified by students at graduation are 1) excellent clinical rotations and training, 2) excellent nurse-midwifery faculty and preceptors, and 3) wonderful classmates.
Q: What about our faculty practice?
A: Please go to http://www.herhealthcare.com/nmsf (website).
Q: What about student midwives, basic midwifery student scholarships, and the ACNM?
A: Please visit the ACNM website at
http://www.acnm.org/display.cfm?id=436 - or -
http://www.midwife.org/display.cfm?id=436 (alternate site).
| Quick-Links: Midwifery/Women's Health NP Specialty | ||||||||||||
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