When I was considering becoming a midwife, there was more than one path I could take.  As a doula, I had attended births where hands on skills were vital to a safe birth so I wanted to learn and feel proficient in those skills. I also knew I needed to have a much wider knowledge base to feel comfortable attending births.  I had completed all the courses required to start nursing clinicals when I attended Kansas State University, and I had worked as a Certified Nurse's Aide so I had some basic health care skills and knowledge.  That was a head start in being a midwife but it wasn't enough.  I considered going back to college to become a Certified Nurse Midwife.  That did not appeal to me at all.  First, I had (and still have) serious reservations about having to comply with hospital and insurance constraints when serving women and thier babies during pregnancy, birth, and postpartum.  Second, I had no desire to spend years of my life attending college when I could be learning and working with women right away.  Third, I wanted to focus more on hands on practice and experience to compliment the abstract knowledge I would need to serve women well.

Apprenticing to become a Certified Professional Midwife was the right path for me. I loved that I could immediately begin developing and honing skills while learning the abstract knowledge I needed to understand pregnancy, birth and postpartum. Working in a home birth practice let me see the beauty and wisdom of natural birth.  It also gave me the experience to become familiar with normal pregnancy, birth and postpartum which makes me better able to recognize when things fall outside of normal.  My apprenticeship let me experience the true continuity of midwifery care, in real world practice, which semesters and a standardized curriculum cannot replicate. My apprenticeship was one of the most challenging and fulfilling things I have ever done. My apprenticeship didn't just help me become a midwife, it helped me grow as a person.  That personal growth has served me well as a midwife.

Since Kansas does not have any credentialing for direct entry midwives, there is no test or assessment of skills to determine competency at the state level. I wanted something that showed I had met a baseline standard for midwifery care.  I wanted my clients to know that I had taken on the responsibility to learn the skills and knowledge needed to be a midwife and that I had shown competence in them. I use the knowledge and skills I learned every time I serve a client and I still hear my preceptor's voice as I use those skills.  I continue to learn and refine my current skills as well as add new skills. I am proud to have earned the national credential of CPM and I am proud to serve my clients within the framework of client centered, evidence based care that aligns with the Midwives Model of Care.
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Manhattan, Kansas is a highly mobile community.  With college students and military familes here, there is always someone leaving the area and someone who just got here.  In working with my clients, I realized that even lifelong Manhattanites sometimes need some fresh ideas of things to see and do in the area.  After doing a prenatal with a client who arrived a month ago who was still learning about the area, I realized I could help her by making a list of places to go and things to do.  

Travel guides are helpful.  Whether in book form, or online they can give you ideas that may appeal to your family.  I have found though that often they are repeating publicity information from the place itself, or rehashing what was in a travel guide from years ago.  We all appreciate hearing personal experiences and I find those more helpful.

Being married to a Soldier, my family has lived all over the place.  Once thing we realized early on is that sooner we started exploring, the sooner we started having fun.  One of my favorite ways to explore was to drive around and get lost.  Often this would be helpful when out with the hubby and realizing I'd been lost there before and knew my way around.  We loved checking out the local museums and trying to find the things to do that were off the beaten path.  

I've made my list of things to do and want to share it here.  I've been to every place on the list except two, but included them based on my friend's experiences.  I share my opinions about what age range the place is better suited for and things my family really enjoyed about it.  I hope you and your family enjoy exploring these places as much as mine did.  Please share my list and let me know your experiences and other places I should add.  Remember to check on any Covid related changes or restrictions at each place before you go. You can get the list here.

Scale and sling: At every postpartum, I will weigh baby to monitor weight.  Babies typically lose weight in the first few days after birth and I want to track this.  It is normal for a baby to lose up to 10% of birth weight.  I like to see that baby is gaining weight and is close to or back at birth weight at the two week visit. 
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Stethoscope and blood pressure cuff: I also take Mom's blood pressure at each postpartum. Blood pressure numbers can tell me how well the body is handling birth related blood loss and helps me monitor for postpartum preeclampsia.

Pulse-oximeter: I carry a pulse-oximeter to use on baby to check for critical congenital heart dieases if parents want the check completed.

Newborn heel lancet and Kansas newborn metabolic screening collection form: I use these to collect five blood drops for the state to complete the metabolic disease screening.  Parents can decide if they want ths screening completed.

My hands: I like to palpate the uterus at the first 2 or three postpartums to check how quickly it is going back to pre-pregnancy size.

Questions: I ask lots of questions.  I'll ask about nursing, Mom's sleep and appetite, how everyone is adapting to baby and many more questions.  Questions help me assess how things are going and give me the opportunity to help everyone navigate any issues that may come up.  

My most important tools:  I feel my most important tools are asking questions and listening well and trusting parental intuition. 

Postpartum is wonderful and exhausting at the same time. Rest, good support and evidence based information can all contribute to a wonderful postpartum period. My goal in the postpartum period is to work together with parents and baby to help them have the best postpartum time they possibly can have.