The EngagED Midwife

Send us a textA stomach that feels “off” can be easy to brush aside—until it shouldn't be. In this episode, Cara and Missi dig into the quiet warning signs of ovarian disease, separating the everyday from the rare but dangerous ovarian pathology. You'll learn how to read the body's cues using the BEAT mnemonic (Bloating, Early satiety, Abdominal/pelvic pain, Trouble with urination or bowels), what ultrasound reports actually mean, and why most ovarian cysts are benign even as we stay alert to red flags.We walk through the physiology of the menstrual cycle—why ovulation naturally creates a cyst each month—and how that helps explain functional cysts that disappear on their own. Then we shift to the features that raise concern: septations, solid components, irregular borders, and blood flow on Doppler. We talk openly about the limits of CA125, the absence of a reliable screening test, and why surgical biopsy still anchors a definitive diagnosis.  We unpack how opportunistic salpingectomy at the time of hysterectomy or permanent sterilization can cut risk, and how combined oral contraceptives lower lifetime risk by suppressing ovulation. We also cover who needs genetic counseling—BRCA1/2, Lynch syndrome, and other familial cancer clues—and how to build smart follow-up plans that balance reassurance with action. Most ovarian findings are benign; the key is knowing when to watch and when to act. If this conversation helps you or a patient put a name to a nagging symptom, it's done its job. 

Send us a textMidwifery is so much more than clinical care. It's about advocacy, education, research, community, and creating the future of healthcare. In this illuminating conversation with ACNM Vice President Dr. Alexis "Lexi" Dunn-Amore and CEO Dr. Michelle Monroe, we explore the heart and soul of the American College of Nurse-Midwives and why every midwife—from student to seasoned practitioner—has a place in this professional home.The conversation reveals ACNM's dramatic transformation, streamlining from 61 committees to a focused 20, with the Midwives of Color group elevated from committee to council status—signaling the organization's commitment to centering diversity and inclusion.  For those considering joining or becoming more active, the benefits extend far beyond journal access and CE opportunities. ACNM provides a supportive community where midwives find mentorship, discover new career pathways, and contribute to advancing the profession through advocacy for full practice authority and pay parity.As the 70th annual meeting approaches in Palm Springs, both leaders express excitement about bringing midwives together to celebrate, learn, and forge connections. Whether you're a student sleeping four to a hotel room or a seasoned midwife, the message is clear: your voice matters, and ACNM is stronger with your involvement.Ready to discover how you can shape the future of midwifery? Listen now and find your place in this vital professional community!#MidwivesWhoLead #MidwifeLife #ACNMEngagement #MidwiferyAdvocacy #BuildYourCommunity @acnmmidwives @lexithemidwife @mmunroecnm 

Send us a textIt's easy for healthcare providers to feel overwhelmed by medication safety during pregnancy and breastfeeding. In this episode, Cara and Missi take this complex topic and make it simple.They start by highlighting a common issue: many clinicians still use the outdated FDA risk categories (A, B, C, D, X), which were replaced in 2015 by the more detailed Pregnancy and Lactation Labeling Rule (PLLR). The hosts explain how pregnancy changes a person's body and how this affects medication, from blood volume to heart rate. They also cover specific medications to be cautious with, like ACE inhibitors and statins.  When it comes to breastfeeding, the discussion turns to lactation risk categories (L1–L5) and practical factors like timing and a baby's age as well as what's really important for nursing moms. This episode covers common clinical scenarios and provides clear guidance on safe medication options for both pregnant and breastfeeding patients while providing valuable resources for students and practicing midwives. This episode turns an intimidating topic into a manageable framework for confident prescribing.#PrescribinginPregnancy #MedicationAndMotherhood #PerinatalPharmacology #PharmForWomensHealth #NoMoreABCDX #MidwiferyMatters #JusticeForTylenol #CallTheMidwife #OurFavePharmD 

Send us a textFeeling emotionally drained, cynical about your work, or lacking professional fulfillment? You're not alone. Burnout affects healthcare providers at staggering rates, with midwives facing unique vulnerabilities due to the intensity of our profession.Drawing from personal experience and evidence-based strategies, in this episode, Cara and Missi unpack the differences between burnout, compassion fatigue, and moral distress while offering practical tools to rebuild resilience.  We explore the four pillars of resilience that sustain midwives through challenging times: connection with supportive community, establishment of healthy boundaries, development of self-compassion practices, and reconnection with purpose and joy. These foundations help counteract the emotional exhaustion and depersonalization that characterize burnout.While individual coping strategies matter, we emphasize that burnout isn't just a personal failing—it's often systemic. Midwives deserve workplaces that protect their wellbeing through adequate staffing, reasonable expectations, and supportive policies. Those in leadership positions have a responsibility to advocate for these changes.Our top ten resilience strategies provide actionable steps you can implement immediately: giving yourself permission to rest, advocating for your needs, continuing to learn, debriefing after difficult experiences, keeping visual reminders of your "why," moving your body, protecting your sleep, creating post-shift rituals, setting boundaries, and finding your people. Remember that a thriving midwife provides better care—your wellbeing matters not just for yourself, but for all the families you serve.What resilience practice will you commit to this week? Share your thoughts or questions with us on social media—we'd love to continue this important conversation.#TheEngagedMidwife #MidwifeLife #MidwivesMatter #MidwifeWellbeing #ResilientMidwife #BeatBurnout #HealthyMidwives #WorkplaceWellness #ReslienceInPractice

Send us a textThe cervical cancer screening landscape is undergoing a seismic shift, and it's time everyone knows about it. From the revolutionary PAP test that changed women's healthcare decades ago to today's primary HPV screening methods, we're witnessing a transformation that promises less invasive care with better outcomes.Did you know that high-risk HPV causes 100% of cervical cancer cases? This fundamental connection has reshaped our approach to screening. Where women once faced the prospect of 47 lifetime PAP tests, today's evidence-based guidelines recommend as few as 9 HPV tests throughout adulthood. We break down the science behind these changes and explain why primary HPV testing is proving more effective than traditional cytology alone. Cara and Missi explore the historical context that unnecessarily tied birth control access to invasive pelvic exams, and how modern approaches are finally separating these unrelated aspects of care. Beyond cervical cancer, we discuss HPV's role in head/neck, anal, and rectal cancers, making vaccination against this virus truly a cancer prevention strategy. For healthcare providers, we offer clear talking points to communicate with patients about these changes. For everyone else, this episode provides the knowledge to advocate for appropriate, evidence-based screening. The days of annual PAP tests are behind us, and understanding why represents a crucial step forward in women's healthcare. #HPVTesting #HPVAwareness #CervicalCancerPrevention #MidwivesMatter #EBP #CervicalCancerScreening #VaccinesSaveLives #Swifties #WDNCClub #WeDoNotCare #TSITP @americancancersociety @justbeingmelani @newheightshow @taylorswift @killatrav @thesummeriturnedpretty @brynne_weaver

Send us a textThe digital revolution continues to transform healthcare, and midwifery is no exception. As we launch Season 12 of The Engaged Midwife Podcast (approaching an incredible 100,000 downloads!), Missi and Cara dive into the fascinating world of artificial intelligence and its applications for midwifery students and clinicians.From study techniques to clinical decision-making, AI offers powerful tools that can streamline workflows and enhance learning—but only when used thoughtfully. We explore how tools like ChatGPT, Claude, and Gemini can help synthesize information, create customized study materials, and even assist with complex statistical analysis. However, we also examine the research suggesting that handwriting notes creates stronger neural connections than using AI-generated summaries, raising important questions about how technology shapes learning.For practicing midwives, AI has already become embedded in electronic health records and is increasingly available for generating differential diagnoses, patient education materials, and time management solutions. Yet all these applications come with important ethical considerations around data privacy, academic integrity, and environmental impact.Throughout our conversation, we emphasize the importance of critical thinking and transparency. AI works best when it augments human expertise rather than replacing it—the midwife's clinical judgment remains irreplaceable, even as technology evolves to support it. As Cara puts it, "Work smarter, not harder," but always maintain your professional knowledge and skill.#MidwiferyInnovation #AIinMidwifery #TechInBirth #SmartMidwifery #DigitalMidwife #MidwiferyEducation #WorkSmarterNotHarder @chatgpt @claudeai @microsoftcopilot @googlegemini 

Send us a textWrapping up Season 11, Cara and Missi dig deep into their fan mail bag to answer questions from listeners spanning clinical practice, education, and professional development. With their characteristic warmth and wisdom, they tackle everything from postpartum mental health screening to specialized pharmacology knowledge that you won't find in textbooks.The conversation flows through practical clinical topics, starting with the importance of comprehensive mental health screening for postpartum patients.  They share touching feedback from colleagues about creating supportive collaborative practices with physicians, highlighting how direct, respectful communication builds successful interprofessional relationships.For students and new midwives, the hosts offer a treasure trove of specialized resources. They offer insights to suturing resources, discuss scope of practice questions, and answer questions galore. Pharmacology pearls abound as they discuss innovative approaches to breakthrough bleeding, the exact formulation for All-Purpose Nipple Ointment for treating breast yeast infections, and compounded antiemetic gels for pregnancy nausea.Before previewing exciting topics for Season 12—including ovarian masses, cancer screening, osteoporosis, fertility treatments, and AI in midwifery—Cara and Missi remind listeners of the best ways to reach them with questions. Their generosity in sharing expertise and resources demonstrates why this podcast has become such a valuable companion for midwives at every career stage.Email your questions directly to missi@deliveredexamprep.com or cara@deliveredexamprep.com to become part of future episodes, and visit deliveredexamprep.com to access the resources mentioned throughout this knowledge-packed finale.

Send us a textAre you feeling exhausted, irritable, foggy-brained, or experiencing night sweats that leave you drenched? These symptoms aren't just "part of getting older" – they're signs of hormonal changes that can be effectively treated. In this eye-opening conversation, Dr. Val Schulte joins midwives Missi and Cara to demystify perimenopause and menopause with straightforward, evidence-based information that healthcare providers often miss."I can't describe how excited I am about today," says Missi at the start, acknowledging that many midwives received minimal education about menopause, especially after the Women's Health Initiative study created widespread fear around hormone therapy. Dr. Schulte, who transitioned from traditional OBGYN practice to focusing on hormone therapy and lifestyle medicine, shares how her own perimenopausal symptoms sparked her passion for helping women navigate this transition.The conversation dives deep into practical aspects of hormone testing and treatment options. Dr. Schulte explains how bioidentical progesterone can improve sleep and mood, why testosterone (often overlooked in women) dramatically affects energy and libido, and how proper estrogen therapy protects heart, brain, and bone health. She details the advantages of different delivery methods – from daily creams to pellet therapy that slowly releases hormones over months – and dispels myths about hormone risks.What makes this episode especially valuable is the real-talk about symptoms many women experience but rarely discuss: brain fog that interferes with work, anxiety that appears out of nowhere, joint pain, changes in body odor, even ridges in fingernails. Dr. Schulte connects these seemingly unrelated issues to hormonal fluctuations and offers solutions beyond the standard "here's an antidepressant" approach many providers default to.Whether you're approaching perimenopause, in the thick of menopause, or supporting someone who is, this conversation provides clarity and hope. As Missy realizes toward the end, "I do not have to feel this way for another five years." Listen now to discover how you can reclaim your energy, mood, focus, and quality of life through evidence-based hormone therapy and lifestyle approaches.#EngagEDMidwife #MidwiferyMatters #HormoneTherapy #MenopauseCare #PerimenopauseSupport #WomensHealth #MidlifeHealth #HotFlashesAndHope #ToolsInOurToolbox@menopause_society @acog_org @drjennsimmons @drrachelrubin @dlberkson @auria.care 

Send us a textWhen is the right time to prescribe antibiotics—and how do you pick the right one? In this episode, Cara and Missi are joined by a clinical pharmacist, Dr. Teresa Ash, to break down the science (and the art) of antibiotic selection in midwifery. From GBS prophylaxis to upper respiratory infections, we explore when antibiotics are essential, when they're not, and how midwives can be antimicrobial stewards without sacrificing patient safety. Smart, evidence-based, and just a little cheeky—this is the prescription for better practice. #AntibioticStewardship #MidwiferyEducation #WeHeartPenicillin #PerinatalCare #PharmacyAndMidwifery #InfectiousDiseases #MaternalHealth #SafePrescribing #AntibioticAwareness #InterprofessionalTeam 

Send us a textUltrasounds offer essential insight into maternal and fetal health—but interpreting the findings and knowing what to do next can feel overwhelming for midwifery students and new graduates. In this episode of The EngagED Midwife, Cara and Missi take a deep dive into the most common (and most confusing) ultrasound findings in OB/GYN practice. Whether it's a low-lying placenta, a thickened nuchal fold, or an unusual fetal measurement, we'll break down what it means, when to consult, and how to manage it. Practical, focused, and rooted in real clinical scenarios—this is your go-to guide for making confident, evidence-based decisions in practice. #TheEngagEDMidwife #UltrasoundInPractice #MidwiferyEducation #OBGYNultrasound #NewGradMidwife #ClinicalConfidence

Send us a textWhat happens when midwives and labor & delivery nurses sit down to get real about collaboration, communication, and mutual respect? In this episode, Cara and Missi welcome a seasoned L&D nurse to unpack what nurses really want to know about the midwifery model—and what they wish midwives better understood about the nursing role in the birthing space. With stories from the floor, candid reflections, and practical tips, this is a must-listen for anyone striving to strengthen interprofessional relationships and improve maternity care outcomes. Whether you're a nurse, midwife, student, or educator, you'll leave with new insights and renewed respect for the people standing beside you during one of life's most powerful moments: birth. #TheEngagEDMidwife #LDRNurse #MidwifeLife #NurseMidwifeCollab #BirthTeam #MaternityCare #InterprofessionalTeamwork #DreamTeam #TeamworkMakesTheDreamWork 

Send us a textThinking about when to take your midwifery boards? Cara and Missi dive into the art of timing on this episode. They cover essential exam prep strategies, discuss the importance of self-assessment, and help you determine if you're truly ready to showcase your skills. From managing test anxiety to understanding the nuances of exam readiness, Missi and Cara help you make the best decision for your journey to certification. #DeliverEDExamPrep #ReadySetTest #AsSoonAsYouAreReady #IndividualizED #GuidED #ReviewED #TSwift

Send us a textEver wondered what's really the best way to help patients care for their vagina and vulva? This week, Cara and Missi are cutting through the noise and providing you with the essential guide to keeping things healthy and comfortable. From gentle cleansing to debunking common myths, we're covering all the basics (and maybe a few things you didn't know!). Tune in for practical tips and empowering information about the vagina and vulva. #Vagina #Vulva #LoveYourV #TheCareAndKeepingOfYou #Perimenopause #Moist #SmellsGoodTastesGoodOrTingles #AmericanGirl @nglwithkylie @kykelce @americangirlbrand

Send us a textEver feel like fetal heart rate tracings are speaking a language you don't quite understand? In this episode, Missi and Cara are here to translate--they are diving deep into the world of FHR tracings, breaking down the physiology and naming those tricky patterns. They'll also share their go-to interventions and actionalble steps for non-reassuring tracings, and, of course, there will be plenty of those *asterisk* moments—because, let's face it, those little side notes are like sparklers of wisdom! Cara and Missi will also have you ready to take on certification in EFM for career advancedment and professional development--tune in for a lively discussion that will have you feeling confident and ready to interpret those squiggles like a pro. #EFM #EFMC #NCC #Certification #HiImTheProblemItsMe #Asterick #Fireworks #TalkNerdyToMe #ReviewED #deliverEDExamPrep #EFMCReviewED #DroppinAcidBase #Uteroplacental #AsEasyAsABC123 #OxygenationIsTheGoal #Sparklers #Fireworks #LikeAFirework @ncccertification @bluelaundrydesign

Send us a textIn this episode, Missi and Cara dive deep into the world of infant growth curves, normal feeding patterns, and how to identify potential concerns. Newborn feeding and growth can be a source of anxiety for many parents (and midwives). They'll empower you with the knowledge you need to understand newborns and make appropriate management decisions about their care. Tune in to gain confidence and clarity on all things newborn growth and feeding. #Newborn #Growth #FailureToThrive #Breastfeeding #PeesAndPoos 

Send us a textTo kick off season 11 of The EngagED Midwife podcast, Cara and Missi dive into the high-stakes world of umbilical cord prolapse—because sometimes, the cord just can't wait for its grand entrance. They break down risk factors, recognition, and rapid interventions with their signature blend of clinical expertise and witty banter. Tune in for a conversation that's equal parts informative and entertaining—because when the cord drops, you've got to move fast (but you can still have a sense of humor about it) #CordProlapse #RideTheBed #UmbilicalCord #Funic #Emergency #Elevated #UnderTheDrapes #AreYouOkayUnderThere

Send us a textCheers to ten incredible seasons! In this special episode, Missi and Cara are celebrating 10 seasons of bringing you engaging and informative conversations about midwifery. They share their gratitude for your continued support and exploring some of their favorite memories from the past ten seasons. Cara and Missi also are dreaming big about the future of the podcast and inviting you to be a part of it! Share your feedback, topic requests, and questions on social media or via email. We can't wait to hear from you! #EngagED #deliverEDExamPrep #TalkNerdyToMe #MidwifeLife #WeBelongToEachOther #Midwives #MidwivesMakeADifference #HappyAnniversary 

Send us a textIn this episode, Cara and Missi take a look at the high stakes surrounding marijuana, THC, and cannabis use during pregnancy, including the complex risks and potential effects on both mother and child. They also iscuss the importance of drug screening and testing, providing intervention and/or referral, and the challenging terrain of mandated reporting to child welfare services. Ethical principles that guide nurses and midwives in their duty to avoid harm to patients, ensuring that we support and protect families in the best ways possible, is reviewed as Missi and Cara provide critical insights and expert perspectives, as well as share professional guidelines and recommendations. #Marijuana #DrugScreening #DrugTesting #Bias #Racism #Pregnancy #FetalRisk #DrugUse #ChildWelfare #WhenWeKnowBetterWeDoBetter #Ethics #CodeOfEthics #TrustWomen 

Send us a textFor the first episode of 2025, Missi and Cara delve into the importance of gut health, the differences between IBS and IBD, and the management of gastrointestinal symptoms. Their conversation touched on the importance of gut health and its impact on overall well-being, while also emphasizing the importance of understanding bowel disorders to provide appropriate care and support to patients. The role of stress, sleep, and physical activity in managing symptoms was reviewed, as well as dietary changes and comprehensive medical treatment modalities.  #GutHealth #StressedOut #SecondBrain #MindBody #PrimaryCare #Irritable #Inflammatory #BristolStoolChart #HappyInTheMiddle #Diarrhea #Constipation #UlcerativeColitis #ChronsDisease #CeliacDisease

Send us a textIn episode, Cara and Missi take us on a tour around the body to see what the effects of chronic stress can be on health. From identifying types of stress, reviewing risk factors, listing signs and symptoms, and explaining long-term effects, they break it down to explain how chronic stress leads to abnormally high cortisol levels and inflammation. But, most importantly, Cara and Missi talk about how to manage stess and reduce cortisol with personal examples and advice.  #StressedOut #ChronicStress #WeCanDoHardThings #FightOrFlight #CalgonTakeMeAway 

Send us a textWhat's it like to work with midwives when you never have before? What's it like to be a new midwife in a facility that has never had one? In this episode, Missi and Cara share some advice for nurses and midwives that encounter change in their work environment. Pulling from their own experiences and many years of practice, Cara and Missi talk about curiosity, scope of practice, and unit culture in building relationships and a collaborative work environment. #MidwivesMakeADifference #Interprofessional #TeamworkMakesTheDreamWork #NursesRock #ObsAndMidwives #NurseMidwives #WeBelongToEachOther #WeCanDoHardThings 

Send us a textMissi and Cara get real in this episode, with both sharing personal stories about weight loss, taking control of their health, and the medical implications of being overweight or obese. They share guidelines for the medical management of weight, such as lifestyle changes, support/counseling, and use of surgical or medication techniquest to help people improve their health and achieve weight goals. There is no magic quick fix or one ideal power tool--we're thankful for a variety of tools to "fix" a variety of issues. That bolt doesn't need a hammer. #Obesity #WeightManagement #IResembleThat #Eating #GLP1 #GenX #Nutrition #MidwivesAsPCPs #Journey #MedicalWeightLoss 

Send us a textIn this episode, Missi and Cara are discussing birth injuries--what is common? what is rare? what are the risk factors? While we can't always anticipate which babies might have birth injuries, we can use good assessment skills, identify birth injuries, and arrange for appropriate follow up. This episode will also dive a bit into risk management and documentation for births that don't always go as smoothly as we would like. #NewbornCare #BirthInjuries 

Send us a textIn this episode, Cara and Missi talk with Dr. Christy Evers, a midwifery educator that is experienced in working with OB/GYN residents in a large community-based hospital. Christy and Missi compare and contrast the various teaching roles that they've had in working with medical students and residents. From learning the language of academia...to sharing midwifery tips and tricks...to best practices in debriefing--we hope this episode inspires more midwives to work with learners. And, of course, we hope that physicians are inspired to work with midwives. It takes a collaborative team and we love highlighting the people and places that are doing it right! This epidsode also contains BONUS content with Missi and members of the the VUMC OBGYN resident team. #AcademicMidwife #MidwifeLife #OBsAndMidwives #PracticeReady #Residency #AlphabetSoup #Interprofessional #TeamTraining 

Send us a text**Trigger: This episode covers mental health disorders and discussion of suicide.* In this episode, Missi and Cara discuss perinatal mental health, including mood and anxiety disorders. These PMADs include OCD, posttraumatic stress disorder, and bipolar disease. Cara and Missi share screening recommendations, signs and symptoms, risk factors, and basic treatment modalities. Unfortunately, suicide is the leading cause of death in the perinatal period--during pregnancy and up to 1 year after birth. The aim of this episode is to support providers in screening, assessing, diagnosing, and treating PMADs, as well as knowing when to seek expert clinical care. Resources from Postpartum Support International are also shared. #PMAD #PPD #OCD #Postpartum #MentalHealthMatters #PSI #PostpartumSupport #PerinatalMentalHealth #PerinatalCare #EPDS @postpartumsupportinternational 

Send us a textIn this episode, Cara and Missi are joined by Dr. Krsyta Ramirez Henry, a Certified Nurse-Midwife that works in a recently developed OB emergency department at a high-volume community hospital. Krysta and Missi compare and contrast the various triage presentations, protocols, and interprofessional communication that takes place in a busy triage unit. #MidwifeLife #ScopeOfPractice #InterprofessionalCare #PatientTeaching #EveryWomanDeservesAMidwife #TeamBasedCare

Send us a Text Message.This episode has Cara and Missi reminiscing about the old days of learning, in which episiotomies were more common...unfortunately! Thankful for changes in practice and a focus on improving patient outcomes and satisfaction, Missi and Cara discuss types of obstetric lacerations, the history and types of episiotomies, repair techniques, and midwifery skills to "manage" the perineum during birth. #CutItOut #Episiotomy #MidwifeTricks #Intact #Lacerations #ObstetricLacerations #OASIs #Intrapartum #Postpartum #Birth #HandsOn #HandsOff #ProtectTheVulva @midwifenell @midwifece @acog_org

In this episode, Missi and Cara review one of a midwife's least favorite things to encounter in labor and birth--shoulder dystocia. They will provide helpful information on assessing risk, identification, management, and liability reduction when you encounter this obstetric emergency. #ShoulderDystocia #HELPERR #ALSO #MidwifeLife #BePrepared #Intrapartum #Olympics #WatchWomensSports #USA @the_aafp @acog_org @jason.kelce @team_usa_olympics @stephen_nedoroscik @ilonamaher @katieledecky 

In this episode, Cara and Missi discuss the benefits of group prenatal care, as well as some history, logistics of running a program, and who may benefit the most from this type of care. They are joined by Jessica Shattuck, CNM, a group care midwife, to learn more about this experience from the provider's point of view. #group #prenatal care #Centering #WeBelongToEachOther #CenteringPregnancy #PhoneAFriend 

In this episode, Missi calls an audible and forces Cara to scramble because there are new things on the playing field! Our hosts share information about a couple of new tests available during pregnancy care to identify risk for hemolytic disease (related to Rh incompatibility) and development/progression of preeclampsia. By using these new screening tests, midwives and other providers can utilize known prevention strategies appropriately--hopefully getting a WIN for our team!  #MidwivesMakeADifference #PregnancyGamePlan #BlackMamasMatter #AnAspirinADay #pregnancygamechangers #newprenataltests #midwifelife #pregnancyjourney #winningatpregnancy #preeclampsiawareness #rhincompatibility #midwifescramble

For this episode, Cara and Missi take a little detour into personal territory while also reviewing new breast cancer screening guidelines from the United States Preventive Services Task Force. They discuss the emotional toll of abnormal screening results and share insight into patient-centered, holistic care of patients undergoing screening tests for cancer.  #WhenNormalIsNotNormal #BreastCancerScreening #MammogramsSaveLives #USPSTF #Cancer @americancancersociety @acog_org 

In this episode, Cara and Missi discuss nutrition and vitamin supplements during pregnancy. They cover what is important in a prenatal vitamin, vitamin excess, supplements to avoid, and disciss ways to get the nutrition that pregnant people and fetuses need--whether lactose-intolerant, vegan, or those with other dietary restrictions. They also dispel some of the common food concerns during pregnancy--soft cheeses and fish aren't our enemies. We just have to be wise about our intake and ensure food is prepared safely. #YouAreWhatYouEat #VitaminsForTwo #ExpectingGoodThings #Pregnant #Vitamins #Antepartum #Supplements #Vegetarian

Cara and Missi are joined for this episode by Dr. Sam Bleull to discuss the use of forceps or vacuum when needed for operative vaginal birth. While midwives may have expanded scope to use vacuum and/or forceps, they often rely on physician colleagues to step in and assist. Indications, contraindications, and sequelae are reviewed. #HelpFromBelow #Collaborate #Intrapartum #PhoneAFriend #CollaborativePractice #CanIGetAnAssist 

In this episode, Missi and Cara talk about viral illness in pregnancy and how to protect against some of the most common and most harmful respiratory infections. Influenza, COVID, and RSV are reviewed in detail (with a small shoutout to pertussis, whoop whoop!), as these infections not only impact the pregnancy and pregnant person, but may have profound impact on the newborn infant. Vaccine recommendations are provided and a great illness triage algorithm is discussed.  #Viral #Flu #COVID #RSV #VaccinesSaveLives #VaccineSuperHero #VaccinesInPregnancy #ProtectYourself #Illness #Triage #WhoopWhoop 

For this episode, Cara and Missi are joined by Certified Nurse-Midwife Linda Johnson. Linda is an experienced clinician with over 30 years of practice--she not only shares key management decisions in the care of patients with amniotic fluid embolism, but also highlights the need for clinician preparation/practice for maternal collapse and debriefing when sentinel events occur. Missi and Cara also review managment recommendations and use of the A-OK protocol for this catastrophic OB emergency. #AFE #AOK #BirthTrauma #Simulation #InterprofessionalCare

To kick off the 9th season of The EngagED Midwife, Missi and Cara describe the process that midwives can take to expand their practice beyond that of the beginning CNM/CM with core competencies for basic midwifery practice. They provide examples of expanded practice skills and review the educational preparation and maintenance of competency needed to offer these skills in your practice. #MidwifeLife #Expanded #BeyondBasic #ACNM #PatientCentered #Continuity #WeveGotSkills #ARDMS #colposcopy #FirstAssist #Ultrasound #Circumcision @acnm @asscp1 @carolyngegor 

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 #treatlocallyPowell 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.0000000000001063Qi 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 questions got the girl 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.  https://physicianguidetobreastfeeding.org/ https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdfhttps://www.amazon.com/Improved-Medihoney-Wound-Dressing-Sciences/dp/B007EBRA6Ahttps://www.motherlove.com/?gclid=CjwKCAjw4ZWkBhA4EiwAVJXwqRuMkcQNaaQ42eGxLfXlJjP0x_vNkG7G4QXmh_oOhkcVTe6yoqnF1xoCLBwQAvD_BwE