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- Certifications
- Optional Certifications
- Continued Education
- Birthing Equipment & Supplies
- Consultations & Referrals
- Client Transfer of Care
- Informed Consent
CERTIFICATIONS
HEALTHCARE PROVIDER'S CARDIOPULMONARY RESUSCITATION CERTIFICATION (CPR)
MoonDragon's primary care midwives, apprenticing midwives, birthing assistants, doulas and any other person associated with or employed by MoonDragon Birthing Services which attend births will keep current their certification in Health Care Provider's Cardiopulmonary Resuscitation (CPR). The Healthcare Provider's program covers both adult and infant CPR. This course is offered locally through Red Cross or our local hospitals for health care providers and the certifications are good for two years. The certification runs between $25-40 for the two years, depending on where and who is offering it.
MoonDragon's Healthcare Information Index
OPTIONAL CERTIFICATIONS FOR MOONDRAGON ASSOCIATES
Although we support the CPM certification as set up by the North American Registry of Midwives (NARM) and prefer to have this certification, we do feel that this is not a requirement for practicing as a primary care midwife in a homebirth setting at this time. There are many experienced, qualified, skilled midwives who choose not to follow the CPM certification route (or any other certification process) for many reasons and may prefer to be referred to as Traditional Midwives (TM), Domiciliary Midwives (DM), or Direct-Entry Midwives (DEM).
This is a long and expensive road to travel for some midwives who may have limited finances, limited access to professional educational programs, limited access to apprenticeship possibilities and a low number of birthing clients per year. We do encourage women wanting to become new midwives to approach their training and education through this route, if at all possible. However, we do acknowledge and support the many routes to becoming a qualified, educated, skilled midwife and also acknowledge that a certification or license does not necessarily a competent practitioner make... as we have seen throughout the medical profession.
This is an added, but is not a necessary certification to work with MoonDragon Birthing Services. The reason being... the course that I went through was so totally contrary to the CPR courses that I have take over the years, that I found it to be very confusing in many aspects and could or would be more of a hindrance than a help in an emergency situation. The course is actually set up for neonatal nursing teams in a hospital and the version that most midwives receive teaches about using resuscitation equipment and oxygen (which is good, if you plan on using oxygen, ambu bags and other resuscitation equipment). The full version of this course also goes into drugs and their uses and dosages as well... which most homebirth and/or non-nurse midwives do not use. They also teach their own way and rhythm of CPR (which is the confusing factor). In a time of emergency, you want a birthing team skilled in one consistent method so that they know what to do and know how to proceed without confusion or mayhem. Plus it is an expensive certification for what you actually receive from it. It seems to run about $85+ for this certification, depending on who and where it is given.
ABOUT OXYGEN USE... Many midwives do not carry oxygen, many do not want to carry oxygen, many that do carry it prefer not to use it. Oxygen is considered a "prescription drug", according to established medical practices. Misused on a newborn baby, it can become dangerous and harmful to the well-being of the baby. Hospitals have had neonatal unit employees improperly use it, harming countless babies over the years. If a midwife is to carry oxygen, she should know how to properly use it. If she chooses to have oxygen, then she should obtain the necessary education (such as the NNR or an EMT (Emergency Medical Technician course) she needs to administer it, and safely carry it.
OBTAINING OXYGEN... Unless a midwife has a supportive physician (which many do not) or a medical need, herself (such as asthma or emphysema), for the prescription... it is impossible to obtain "medical grade" oxygen. Many midwives must resort to the use of "welding grade" oxygen to refill their tanks. Although this works well most of the time, there may be problems with some unforeseen impurities being found in the "welding grade", that are filtered out of the "medical grade" oxygen supply. If a midwife must use "welding grade" oxygen, they need to be sure of the supplier and the supplier's attention to proper care and handling of their tanks and equipment. This reduces the chance of obtaining oxygen that may be less than optimal.
CARING FOR OXYGEN... Pressurized oxygen is a dangerous substance to have and care for. Care must be taken in handling the pressurized tanks and regulators. They must be secured and safely stored when in or out of use. They must be transported carefully. If the oxygen tank should happen to fall and the cylinder or regulator is broke or damaged to allow oxygen to leak out, the cylinder can become a fast moving, powerful, out-of-control missile causing severe damage to structures and may severely hurt or kill a person that may happen to have the misfortune of being in the missile's path. They must be periodically checked for damage and regulator accuracy. There must be no open flames or any chemical substance which may ignite or react with the oxygen supply. A course in chemical safety/hazardous materials and fire safety is recommended for any person using oxygen.
EDUCATION
Each birth case shall be reviewed by the primary care midwife and her attendants after each birth. Discussion, questions, answers and any suggestions or comments will be included. In the event of unexpected outcomes, the primary care midwife has the option of attending a case review with other primary care midwives in her region to discuss her client's case and obtain any helpful recommendations or suggestions about it. All cases reviewed by either method shall be kept private and respect for client confidentiality shall always be of utmost consideration.
MoonDragon's primary care midwives and birthing attendants shall continue to educate themselves regarding the care of pregnancy, birth and newborn care. They shall continue to obtain knowledge in areas in which they may need further instruction or updated instruction. Whenever possible, they need to attend organized conferences, workshops, seminars and higher educational courses which improve skill and knowledge levels. A record of educational progress shall be kept on file with MoonDragon Birthing Services and reviewed periodically for accuracy and updating.
Each MoonDragon midwife or birthing assistant shall be familiar with OSHA Guidelines and Universal Precautions for infection control. Training and/or review may be obtained either with MoonDragon Birthing Services or another health care program.
BIRTHING EQUIPMENT & SUPPLIES
CONSULTATIONS & REFERRALS
MoonDragon Birthing Services recommends that each client provide a health care provider of their own, familiar with their health history, listed with their own health insurance plan, and located in their own geographic region of residence for needed consultations or referrals, which also includes prescribed medications and diagnostic tests. We do not provide our clients with medical backup in the event of a transfer or if medical tests or procedures are required outside of our practice guidelines. This must be arranged by our clients with their primary care health providers or local medical clinic, if they become necessary. This is primarily due to our extensive travel to various geographic regions within Massachusetts and northern New England, and that we provide most of our birthing service care in client homes, thus it would be more convenient for our clients to establish their own health care network and support system. MoonDragon Associates are available for consultation with our client's health care provider(s) and health support system to assist in planning a program of optimal care for our client's continued health and well-being.
CLIENT TRANSFER OF CARE
MoonDragon Birthing Services will assist, if needed, in the event that a client chooses to transfer care from MoonDragon's service to another midwife outside of our service during her pregnancy. MoonDragon encourages communication between midwives and will assist in the transfer of client records, if requested by the client.
MoonDragon encourages clients to establish their own relationship with an Ob-Gyn or other medical service, in the event that certain tests (e.g., prenatal ultrasound or amniocentesis) may be needed for the client and/or her baby's well-being to be maintained.
MoonDragon encourages clients to establish their own relationship with a pediatric health care provider to continue care once the baby is born.
MoonDragon will provide, upon request by the client, a referral list to aid in prenatal and mothering care. This list may include, but not be limited to chiropractic and naturopathic health care providers, massage therapists, doulas, acupuncturists, Reiki therapists, mental health providers, nutritionists, breastfeeding/lactation consultants, childbirth educators and community resources (e.g., La Leche League, WIC, parenting support groups, etc.).
MoonDragon Birthing Services understands that a small percentage of clients will require care beyond the scope of midwifery and our service. Transfers to another health care provider and/or hospital may occur if any of the transfer criteria are met.
In the event a primary care midwife decides that a woman and/or baby must be transferred, the family will participate in the decision-making process and will be given a full explanation of the immediate problem and reason for the decision.
If the client and her family refuse to be transferred, the midwife must obtain a client signed document stating the problem and client refusal for her files.
If an emergency (or non-emergency) transfer is determined to be necessary and occurs, the family and midwife will decide, depending upon circumstances, whether emergency transport will be called to assist in the transfer. If at all possible, phone arrangements will be made before transfer to the nearest medical facility or a facility of the client's choice to allow the medical team to prepare for the arrival of the client. The midwife will cooperate with and assist emergency personnel as needed.
The primary midwife may accompany the family to the medical facility, and may release any necessary information, upon client approval and signed release of medical records, to the attending health care providers upon arrival. She may offer copies of medical files, but she is required to keep original files in her possession at all times. The midwife may continue to act as a client-patient liaison between the client-family members and medical and/or emergency staff, if needed.
INFORMED CONSENT
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