In this episode, Cara and Missi review the implications of the 2018 ARRIVE study on patient outcomes and practice changes. They provide a midwifery-focused perspective on rapid application of research findings and how analysis of study design, analysis, and conclusions can help you to interpret the study outcomes. #arrive #induction #elective #expectant #shareddecisionmaking
In this episode, Cara and Missi discuss recent updates to cervical cancer screening and management of results. They give a brief history of cervical cancer screening, incidence and mortality for cervical cancer in the US, and recommendations for the frequency of screening. Then, they provide an update to screening abnormalities and how to individualize follow-up management for patients. #cervicalcancer #screening #cancer #gynecology #womenshealth #cytology #midwivesmakeadifference #vaccinessavelives #HPV
In this episode, Cara and Missi review common vaginitis symptoms, evaluation, diagnosis, and treatment. They then dive deeper into complex presentations, recurrent infections, and treating mixed vaginitis. Vulvar and vaginal itching, irritation, discharge, and odor are a frequent reason for visits to a midwife or other GYN provider and this episode will build your confidence and competence in treating these issues. Resources for additional learning are provided. #vaginitis #vulva #vagina #vaginaldischarge #selfcleaningoven #nodouching #boricacid #treatlocally
Powell A, Ghanem KG, Rogers L, et al. Clinicians' Use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis. Sex Transm Dis. 2019;46(12):810-812. doi:10.1097/OLQ.0000000000001063
Qi W, Li H, Wang C, et al. Recent Advances in Presentation, Diagnosis and Treatment for Mixed Vaginitis. Front Cell Infect Microbiol. 2021;11:759795. Published 2021 Nov 2. doi:10.3389/fcimb.2021.759795
In this episode, Cara and Missi dive into an overview of fibroids and adenomyosis. Both diagnoses can be associated with abnormal uterine bleeding, pelvic pain, and pelvic fullness. While definitive treatment is likely surgery, conservative management of these dignosis can be accomplished by the midwife or nurse practitioner. This episide will explore symptoms, diagnosis, and treatment particularly in women who want to perserve fertility or which surgery is not a viable option. #fibroids #adenomyosis #abnormaluterinebleeding #lysteda #lupron
In this episode, Cara and Missi continue a previous conversation on causes of jaundice. ABO and Rh incompatability are predominate causes of hyperbilirubinemia in newborns. This episode reviews the physiology of ABO and Rh and the care of women in the antepartum period as well the implications in care of the newborn. #ABO #Rh #Alloimmunization #jaundice #rhogam #newborncare #bilirubin
In this episode, Cara and Missi look into the evidence surrounding obesity and induction of labor. Obesity alone is a risk for primary cesarean section. Several recents studies will be discussed shedding light on how to effectively manage patients with obesity specifically in the context of induction of labor. This review will help midwives use the correct combination of tools to help avoid unnecessary cesarean birth in this population. #intrapartum #inductionoflabor #obesity #cytotec #oxytocin #foleyballoon #CRB #physiology
In this episode, Cara and Missi introduce a topic that is important to gynecoloogy, sexual, and reproductive health--abortion. While abortion is known to be a hot topic that can spark strong opinions, the girls discuss the midwife scope of practice; highlight how midwives care for patients in options counseling, abortion care, and post-abortion care; and introduce how midwives can gain more knowledge and training in the provision of this important type of care. As an added bonus, Missi is joined for a portion of this episode by a physician colleague with specialized training in complex family planning, where they discuss the importance of health care in the post-Roe era. #abortion #reporoductivejustice #contraception #abortionishealthcare
In this episode, Cara and Missi discuss some of their favorite gifts for the midwife in your life—from the new graduate, to student, preceptor, partner, or bestie! They share ideas for making the call room comfy, for sporting your favorite advocacy, and for supporting their favorite makers and creators. This might just be one of their favorite episodes! #midwifelife #ourfavoritethings #gifts #happyholidays #holidaycheer #ourfavoritetimeoftheyear #midwifeera #vulva #stanleyasaweapon
In the episode, Cara and Missi review the uses of progestins in both contraception and hormone replacement. Progesterone is an essential hormone in the menstrual cycle and synthetic progestin has a multitude of benefits as well as side effects. This conversation will help midwives make a decision on how to chose the right progestin for the right situation. #gynecology #progesterone #progestin #hormonereplacement #contraception #androgenic #progestational #intendedeffect
In this episode, Cara and Missi push rewind on the TERMPROM study. This study, originally published in 1996, has recently bee re-examined in a an interesting secondary analysis. This episode will highlight the new insights into the data to help midwives provide evidence based care for prelabor rupture of membranes in all settings. #PROM #PPROM #prelabor #intrapartum #management
In this episode, Cara and Missi shed light and love on how to give difficult news. It's never easy to deliver news of a diagnosis, a problem, or a complications to a patient and this conversation will help provide useful tools to students and practicing midwives. This episode explores several techniques for scripting these encounters, as well as giving guidance on what information to give, how to know if patients can receive, and how to navigate difficult encounters. #difficultconversations #badnews #anticipatoryguidance #scripts #therapeuticpresence
In this episode, Cara and Missi dissect the ACOG practice guideline on antepartum fetal surveillance. Knowing when to test, what tests to use, how often to test are all important factors in competent, holistic care of the pregnant person. This episode will break down the kinds of test like NST and BPP as well as what conditions require testing and how midwives should approach the care of at risk patients.
In this episode, Cara and Missi respond to a listener query about rupture of membranes. This question got the girls thinking about all of the interventions that are done in the intrapartum and how those correlate with the pearls of midwifery. Tune in and listen to this robust conversation on everything from well timed amniotomy to position changes while interweaving information from the literature and clinical practice.
In this episode, Cara and Missi take a deep dive into all things urinary track. Moving beyond just thinking about UTI, this conversation explores incontinence, pelvic floor therapy, and how to better manage your patients with urinary complaints.
In this episode, Cara and Missi are joined by Jenna Erickson, CNM, IBCLC for an important clinical update on the 2022 mastitis guidelines from the Institute for Breastfeeding Medicine. This episode is a must listen to learn to stop the ice, treat the inflammation, feed naturally, and get down to the real causes of mastitis. Jenna give us her IBCLC take on things to do, not to do, how to care for the breast, and products that we should be recommending to our patients.
In this episode, Cara and Missi break down some common conversations between providers and patients. Have you ever wondered how other providers talk to patients? Did you ever want to hear someone else's spiel? This episode will give the practicing midwife some tips and tricks on communicating with patients and things we should always be saying.
In this episode, Cara and Missi take a look at asthma in primary care and in pregnancy. More than 22 million people in the US are diagnosed with asthma and it accounts for 14.2 million office visits annually. Asthma management including pharmacologic treatments will be reviewed as well as treatment modalities in pregnancy.
In this episode, Cara and Missi help to explain the new (read 2011) criteria for defining labor progress based on the Zhang research. Moving past the 1954 research from Friedman, the new labor curve suggests that we maintain more flexible parameters for defining labor progress than can help to decrease c-section rate. This episode also discusses the new literature on pitocin in latent and active phase, as well as pit breaks and adjunct therapies that may be effective.
In this episode, Cara and Missi discuss identification and management of obstetrical causes the acute abdomen. This conversation specifically focuses on the emergent obstetrical causes of abdominal pain. Although midwives are not surgeons, good assessment and diagnostic skills are crucial to the timely identification and management of abdominal emergencies. #abdominalpain #obstetriccauses #ectopic #PUL #torsion #uterinerupture #abdominalpregnancy
In this episode, Cara and Missi aren't talking about academic courses. Listen up to hear everything you need to know about amenorrhea. Confused about the HPA axis? Hormones giving you the run around? Tune in to hear the girls talk about why periods haven't 'come down' and how to diagnose and treat. #amenorrhea #secondaryamenorrhea #whereismyperiod #hormones #prolactin #fsh #tsh #thyroid #fertiilty #infertility
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