The EngagED Midwife: Recent Episodes
Cara Busenhart and Missi Stec
Empowered, knowledgeable, and engaging. Cara and Missi provide insightful, relevant conversations on midwifery topics that will enhance student knowledge and improve confidence for certification. Featuring current research and evidence based practice guidelines, the EngagED midwife podcast hopes to engage practicing midwives to enhance their robust knowledge base and elevate their clinical practice.
Send us Fan Mail
“Survivor” sounds like a finish line. For many people, it feels more like a label you’re handed while you’re still trying to process what just happened. Cara and Missi get personal about cancer survivorship, using Missi’s breast cancer journey to talk about the part nobody can fully prepare you for: living in the in-between, where every new ache can trigger scanxiety and “life after” doesn’t come with a clear map.
We walk through what survivorship means clinically and emotionally, including the three phases often described in the literature and why the extended phase can feel like a muddy mess. We also unpack the real-world logistics of post-cancer care: how your team can grow from a PCP and OB-GYN to a surgical oncologist, medical oncologist, breast navigator, physical therapy, lymphatic therapy, and mental health support. If you’ve ever felt overwhelmed by appointments, paperwork, and the mental load of decision-making, you’ll feel seen.
We dig into high-interest survivorship topics for breast cancer patients and the clinicians who care for them: endocrine therapy (aromatase inhibitors like anastrozole and SERMs like tamoxifen), fatigue and brain fog, bone density loss and DEXA scans, osteoporosis treatment options such as bisphosphonates, Zometa, and Prolia, and the evolving guidance on topical vaginal estrogen for genitourinary syndrome of menopause. Cara also shares what she’s learned about lymphatics, lymphedema, compression sleeves for travel, and why protecting an arm after lymph node removal can be a forever habit.
If this conversation helps, subscribe, share it with someone who needs it, and leave a review. Send us the topics you want next, and come see us in Kansas City in October for the annual meeting.
CancerSurvivorship #BreastCancer #BoneHealth #Lymphedema #LifeAfterCancer #BodyMindSpirit #TheNewNormal
Send us Fan Mail
Sex can change fast after birth, and it can change again in perimenopause and menopause, but that doesn’t mean you’re broken. We dig into why libido, arousal, and comfort often shift when estrogen drops postpartum and later in life, and how that hormone reality shows up as vaginal dryness, painful sex (dyspareunia), and the sense that your body isn’t responding the way it used to. We also talk about the common brain-body mismatch many women experience and how mental load can shut desire down even when the relationship is solid.
We walk through the postpartum hormone landscape, including the steep fall in estrogen and progesterone after placenta delivery and how breastfeeding keeps estrogen low through prolactin and oxytocin. Then we get practical about what helps: pelvic floor physical therapy (and what to expect so it’s not a surprise), using plenty of lubricant, considering vaginal estrogen for atrophy, and expanding intimacy beyond penetration while healing happens.
From there, we transition into perimenopause and menopause, including genitourinary syndrome of menopause, irritability and sleep disruption, and why libido issues are often tied to androgens like testosterone. We cover options clinicians may consider for hypoactive sexual desire disorder, plus the overlooked impact of medications like antidepressants and blood pressure meds. We wrap with the PLISSIT model so midwives and clinicians have a clear framework to open these conversations with permission, simple education, specific suggestions, and referrals when needed.
If this helps you feel more informed or less alone, subscribe, share the episode with a friend, and leave a review so more people can find honest, evidence-informed sexual health support.
LetsTalkAboutSexBaby #SexualHealth #SexAcrossTheLifespan #PostpartumWellness #HormonalHealth #PelvicHealth #IntimacyAfterBirth #MenopauseSupport #SexualWellness
EmpoweredAging
Send us Fan Mail
A newborn arrives fast, the dates are fuzzy, and everyone in the room is sure they know how far along the pregnancy was. Then the baby tells a different story. That’s where a solid gestational age assessment and real bedside pattern recognition can change the entire plan in minutes.
We talk through the Ballard assessment in a way that’s built for busy midwives, midwifery students, and anyone responsible for newborn care. We explain what the Ballard score is designed to do, when it matters most (limited prenatal care, language barriers, uncertain dating, misleading third-trimester growth ultrasound), and why the exam usually isn’t asking you to memorize a chart. The goal is safer clinical reasoning: term vs preterm vs post-term, and what that means for newborn transition, thermoregulation, blood sugar monitoring, and when to consult pediatrics.
You’ll hear our highest-yield neuromuscular maturity checks (posture, square window, arm recoil, popliteal angle, scarf sign, heel-to-ear) and the physical maturity signs you can spot head-to-toe (skin texture, lanugo, plantar creases, breast buds, ear cartilage, and genital findings). We also work through real clinical scenarios: a “term” baby who acts like a 34-weeker, a baby with post-maturity features, and a small-for-gestational-age newborn who is physiologically mature, pointing you toward growth restriction rather than prematurity.
If newborn assessment has ever felt intimidating, this is your reminder that “normal” is the foundation and your best safety net. Subscribe for more midwifery exam prep and clinical refreshers, share this with a classmate who wants more newborn confidence, and leave a review. What’s the first sign you check to decide if a baby is truly term?
Newborn #BabyBabyAreYouOkay #GestationalAge #Transition #Term #Preterm #Postterm #NewBallardScore #Maturity
Send us Fan Mail
Trying to conceive can turn into a crash course in hormones overnight, and the medication list can feel like a different language. We slow it down and translate what fertility medications actually do in the body, why midwives still need to understand them even when we are not the prescribers, and how to support patients through the stress that often comes with IUI, IVF, and “why is this taking so long?” moments.
We walk through the most common reason fertility care starts: ovulation problems. From anovulation and PCOS to the sometimes overlooked conversation about luteal phase length and early progesterone support, we talk about what might be happening on the HPO axis and what clinicians are trying to change with treatment. Then we break down the big names patients hear, including Clomid (clomiphene citrate) and letrozole (Femara), comparing how they work, what side effects to expect, and why practice has shifted toward letrozole for many people with PCOS and insulin-related hormonal patterns.
We also dig into metformin and insulin resistance, because PCOS is not just “about weight” and fertility care should not be built on shame. Finally, we zoom out to the broader IVF medication lineup, including gonadotropin injections, GnRH agonist or antagonist protocols like Lupron, the hCG trigger shot, and progesterone support. We end with practical safety counseling, including multiples risk and ovarian hyperstimulation syndrome warning signs, plus clear guidance on when it is time to refer to reproductive endocrinology and infertility (REI).
FertilityMeds #PathToPregnancy #TTC #NavigatingFertility #PharmacologyForMidwives #ConceptionSupport #ReproductiveEndocrinology #EvidenceBasedMidwifery #InfertilityCare
Send us Fan Mail
Milk supply can feel mysterious when you’re tired, sore, and staring at a hungry newborn. We sit down and make lactogenesis practical by walking through what’s happening in the breast during pregnancy, what flips hormonally right after the placenta delivers, and why “milk coming in” usually peaks around days 2 to 5. Along the way, we translate the science into the questions we hear every week: Is leaking in pregnancy a good sign? Why does engorgement happen? When should we worry about a lump, redness, or nipple discharge?
We also get honest about the lived experience of feeding in the real world. We talk delayed lactogenesis and the common culprits like retained placental fragments, postpartum hemorrhage and pituitary effects, PCOS, cesarean timing, and edema from heavy IV fluids that can make latch feel impossible. Then we shift into lactogenesis 3, where supply becomes locally regulated and milk removal drives production, including the role of the feedback inhibitor of lactation. If you’ve ever panicked because your breasts suddenly felt soft or you stopped leaking around week 3, we explain why that can actually be a sign your body has calibrated beautifully.
Letdown is its own puzzle, so we dig into oxytocin, what blocks it (stress, fear, pain, cold), and simple tools that help, including warmth before feeds, cold after, and the “three Ws” that support pumping and letdown: warmth, water, and watching. We wrap with fast myth-busting and one of our favorite postpartum interventions: teaching partners and families how to protect the “oxytocin bubble” so the feeding parent can focus on rest, baby, and recovery. Subscribe for more evidence-based midwifery conversations, share this with a friend who’s feeding a newborn, and leave a review with your biggest milk-supply question.
TheGoldenHour #Breastfeeding #ChestFeeding #NourishingNewborns #DemandAndSupply #Lactogenesis #BreastfeedingJourney #ProtectTheOxytocinBubble #Support
Send us Fan Mail
What if the biggest driver of a healthy pregnancy isn’t found in a chart, but in a bus schedule, a work shift, or a zip code? In this episode, Cara and Missi pull back the curtain on social determinants of health and talk candidly about why late or no prenatal care rarely means a patient doesn’t care—and how midwives can meet these barriers head-on.
We break down the big five domains—economic stability, education, healthcare access, neighborhood and environment, and social context—and connect them to preterm birth, preeclampsia, and low birth weight. You’ll hear real stories from triage to community clinics that reveal why “proximity” isn’t the same as “access,” how immigration fears suppress visits, and how chronic stress leaves a physiologic mark. Then we get tactical: validated screening tools like PRAPARE and the AAFP Social Needs Screening Tool, the three fast questions that catch most needs, and scripts that normalize sensitive topics without stigma.
From there, we move into action. Warm handoffs, bedside calls, and referrals that put the follow-up burden on the system—not the patient—turn intentions into impact. We dig into practical documentation with Z codes that make populations visible, and we frame advocacy as a clinical skill that spans workplace notes, hospital policy, and conversations with legislators. Along the way, we draw a bright line between equality and equity and share simple ways to right-size support: flexible hours, interpreters, transportation help, and trauma-informed consent.
If you’re ready to turn empathy into outcomes, this conversation will give you tools you can use on your next shift. Subscribe, share with a colleague, and leave a review with the biggest barrier you see in your community—and how you’re tackling it.
Send us Fan Mail
Day-one decisions shape a newborn’s first week, and small changes can prevent big problems. In this episode, Cara and Missi dig into what’s truly evidence-based now—delayed bathing to protect vernix and temperature, uninterrupted skin-to-skin to reduce energy burn, and clear thresholds for when to check and treat low blood sugar. Along the way, we unpack how updated NRP guidance simplifies early care: extend cord clamping to at least 60 seconds when possible, start term babies on room air, broaden ventilation rates to 30–60 per minute, and skip routine suctioning unless the airway needs clearing. Less fuss means warmer babies, steadier vitals, and fewer glucose crashes.
Cara and Missi clear the fog around GBS prophylaxis. Penicillin remains the standard, with cefazolin for low-risk penicillin allergy and vancomycin when high-risk reactions are present or clindamycin sensitivity isn’t confirmed. That clarity matters for maternal safety and newborn outcomes, especially in units where ampicillin lingers from past shortages. If your patients report a penicillin allergy early in pregnancy, consider formal evaluation to avoid unnecessary second-line antibiotics later.
Finally, we connect physiology to practice. Newborns lose the maternal glucose “buffet” at birth and lean on glycogen and brown fat to bridge the gap; cold stress accelerates that burn, making hypothermia and hypoglycemia frequent partners. We outline who needs screening—IDMs, SGA, LGA, late preterm, and resuscitated infants—and how to manage lows with a calm, stepwise approach: warm the baby, feed early and often, use donor milk or glucose gel when indicated, and escalate to IV dextrose for symptomatic cases. It’s a practical, exam-friendly, and family-centered guide to safer newborn care. #Baby #Newborn #BabyBabyAreYouOkay #Resuscitation #EatingAtThePlacentaBuffet #BloodSugar #NRP #SkinToSkin #GBSProphylaxis
Send us Fan Mail
The ocean isn’t magic, but it helps the healing. We went to the beach with a full slate of work—course updates, new cases, retreat planning—and a fuller heart, talking honestly about what it takes to recover and what it means to care well. Missi is four weeks post‑mastectomy, relearning daily life without lifting, reaching, or rushing. Cara remembers months on bed rest, the longing for a hair wash, and the quiet panic of being still. Together, we map the gap between “Let me know if you need anything” and help that actually helps.
We get specific. Meals that work now: soup kits, coordinated signups, gift cards for flexible nights, and a simple text that asks, “What are you craving?” Practical gear that makes life easier soft button-front pajamas, the best mid-calf socks, body butter, pillows, and just things to make you comfy. We talk about partners who carry silent fear, why giving those people a break matters, and how to name needs without feeling guilt. We share how to build an Amazon list so friends far away can send the right things, and why short notes and small jokes land in the loneliest hours.
There’s identity work too. Losing the “before” version of yourself—the runner, the teacher, the do‑it‑all person—hurts. We name the grief, celebrate tiny wins like sleeping in a bed again, and lean on survivors who text the latest guidelines at just the right time. No Googling spirals, just trusted teams and steady pacing. If you’ve ever asked, “What should I do for my friend who’s sick?” or struggled to ask for help yourself, this conversation hands you a clear, compassionate checklist you can use today.
DeliverEDExamPrep #RelaxED #YouveGotAFriendInMe #RecoveryJourney #BreastCancer #Bedrest #WeBelongToEachOther #LoveWins #WeCanDoHardThings #Survivor #Brutiful @somaintimates @ugg @lululemon @lolablankets @takethemameal @giveinkind
Send us Fan Mail
Ready to land a midwifery job that actually fits your philosophy, pace, and life? We open up about our own first-job journeys—what went right, what we’d change, and how each step shaped our expectations. From researching practice models to reading culture, we walk through the practical prep that matters most: knowing how the team truly functions, how midwives share call, and how collaboration shows up when the unit gets busy.
We also get tactical about interviewing without sounding scripted. You’ll hear simple ways to show your value as a new grad, even without L&D experience: bring a lean portfolio, summarize your clinical sites and numbers, and frame weaknesses as active growth plans. We share the questions that reveal the soul of a practice—what a clinic day really looks like, how decisions are made, and where midwives can train in procedures like first assist, colpos, or circumcisions. We also address the productivity myth, explaining how OB-heavy roles unlock revenue capacity across the team while improving access and experience.
Career seasons don’t always unfold on your timeline, and that’s okay. We talk about handling rejection as redirection, running mock interviews with mentors, and keeping notes on what bothers you so you can ask sharper questions next time. If you want a job that respects physiologic birth and evidence, values your voice, and gives you room to grow, this conversation will help you get there.
DreamCatch #BabyCatchers #MidwifeLife #NewGradMidwife #MidwivesSupportMidwives #MidwiferyCareers @growmidwives
Send us Fan Mail
A new season meets a new reality: we’re grateful for 100K downloads, proud of students who crossed the finish line after multiple tries, and honest about a recent breast cancer diagnosis that changed the rhythm of our days. Missi walks through the surprise pathology, why we chose an aggressive plan, and what bilateral mastectomy and a forced season of stillness look like for a do‑everything human. We talk openly about anxiety, support, and “aggressive optimism,” because clarity and community make uncertain roads feel possible.
Then we shift gears to a masterclass on the labor patterns every clinician grapples with: malposition and asynclitism. We break down synclitism versus anterior and posterior asynclitism, how to read the sagittal suture and fontanelles, and why uneven effacement is a blazing clue. You’ll hear practical tools for OP and OT that move beyond clichés—mapping interventions to the inlet, mid‑pelvis, and outlet so each position serves a purpose. Think the jiggle as gentle myofascial work, forward‑leaning inversion to free tension, and strict sidelying release with stacked hips. We show how peanut balls, fire‑hydrant, rock‑the‑boat, sacral massage, and internal femur rotation widen the right spaces at the right time.
For second stage, we dig into manual rotation: when to attempt it, how to disengage enough to succeed, and how skilled hands can shorten labor and prevent operative delivery. Along the way we highlight nurse‑midwife teamwork, patient‑centered pacing, and trusted resources like Spinning Babies and the Labor Progress Handbook that give units a shared language and a sharper plan. Variation in fetal position isn’t failure—it’s an invitation to find the position, create the space, and encourage the movement.
If this conversation helps your practice or your spirit, follow, share with a colleague, and leave a quick review. Your support fuels more teaching, more tools at the bedside, and more stories of perseverance and healing.
Send us Fan Mail
A packed hallway at the ACNM Annual Meeting turned into the perfect backdrop for a clear, compassionate deep dive on adolescent gynecology. We talk candidly about what really helps teens feel safe in care: transparent consent, real confidentiality, and avoiding unnecessary pelvic exams. From there, we walk through the high-yield topics every clinician faces with young patients—irregular cycles after menarche, painful periods that derail school days, and the difference between normal discharge and vaginitis that needs treatment.
We spotlight the red flags that can’t be missed, especially ovarian torsion posing as vague lower abdominal pain, and why transabdominal ultrasound often beats transvaginal imaging for adolescents. You’ll hear how we build a thorough menstrual history that captures timing, flow, and impact on daily life; how we normalize the maturing hypothalamic-pituitary-ovarian axis; and where first-line therapies like NSAIDs, combined pills, progestin-only methods, and levonorgestrel IUDs fit. We also lay out a patient-led approach to contraception counseling—centered on goals like bleeding control, privacy, and ease of use—while weaving in emergency contraception, STI screening strategies, and the crucial role of the HPV vaccine in preventing cervical and other cancers.
Throughout, we keep the focus on trauma-informed practice. That means offering safe words like stop and out during exams, letting teens handle instruments to reduce fear, and moving complex conversations to when patients are fully dressed. We include considerations for transgender and gender-diverse adolescents, from menstrual suppression to reputable clinical resources. By combining practical tools with a respectful tone, this episode gives you a roadmap to adolescent gyn that improves comfort, detects danger early, and builds trust that lasts into adulthood.
If this conversation helps you care for teens with more confidence, subscribe, share with a colleague, and leave a quick review to help others find the show.
Send us Fan Mail
A fracture rarely starts with drama. It’s often a quiet misstep, a stumble off a curb, or a slip on a throw rug—and that’s exactly why bone health deserves our full attention. We’re taking a clear, practical tour through osteoporosis and osteopenia: what they are, why they’re “silent,” and how to get ahead of them with smart screening, daily habits, and targeted treatments.
We unpack the biology of bone remodeling—osteoclasts that break down old bone and osteoblasts that build new—and the outsized role estrogen plays as it declines through perimenopause and menopause. You’ll hear exactly who should get a DEXA scan at 65 and who needs it earlier based on risk factors like prior adult fractures, long-term steroid use, low body weight, family history, or conditions like hyperthyroidism, celiac disease, and rheumatoid arthritis. We demystify T-scores versus Z-scores so you can read your results with confidence and know where osteopenia ends and osteoporosis begins.
From there, we get tactical. Nutrition that actually moves the needle, weight-bearing exercise and resistance training you’ll actually do, and when medication is actually warranted. We round it out with fall prevention you can implement today: balance training, better lighting, grab bars, safer footwear, and a clutter-free path through your home. If you care about staying strong, steady, and independent, this conversation gives you the tools.
Send us Fan Mail
Ever wonder how midwifery knowledge makes its way from practice to publication? This episode pulls back the curtain on the world of midwifery publishing with two luminaries who shape how we learn and share our profession's wisdom.
We're joined by Dr. Melissa Avery, editor-in-chief of the Journal of Midwifery and Women's Health, and Dr. Julia Philippi, lead author of the foundational text Varney's Midwifery. These publishing powerhouses share their journeys and offer practical advice for midwives at every career stage who want to contribute to our collective knowledge.
"Your work doesn't do you," Dr. Avery reminds us. "Until we write about it and disseminate it, no one else is really benefiting from it." Both guests demystify the publishing process, from crafting that intimidating first draft to navigating peer review. Their message is refreshingly straightforward: just start writing. Whether you're considering a clinical case study for JMWH or wondering how textbooks like Varney's evolve to reflect contemporary practice, this conversation provides the roadmap you need.
We explore the differences between journal articles and textbooks, the value of becoming a peer reviewer, and practical strategies like forming writing teams and protecting your writing time. For students and educators, Dr. Philippi offers fascinating insights into how midwifery texts might evolve to meet changing learning styles, potentially moving beyond the "eight-pound two-ounce textbook" to more interactive formats.
Whether you're a student, new graduate, or seasoned midwife, this episode will inspire you to share your unique midwifery knowledge and experiences. Your voice matters—and with the right approach, it can strengthen midwifery care everywhere.
EveryMidwifeHasAStory #AcademicMidwife #GetPublished #MidwivesWhoWrite #TheScholarlyMidwife #TeamworkMakesTheDreamWork @jblearning @midwiferyandwomenshealth @juliaphillippi
Send us Fan Mail
The ACNM hallways are still buzzing in our heads, our voices are scratchy from a thousand hugs, and we’re curled up with a year’s worth of holy-grail favorites to share. This is our practical, joyful guide to small upgrades that make real days better. If you’re looking for thoughtful gifts, travel allies, or daily comforts that punch above their weight, this roundup is our best-of—the things we buy again, gift often, and swear by. If something here makes your day easier or your night softer, share this episode, leave a review, and tell us your favorite under-the-radar find so we can try it next.
Send us Fan Mail
A 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 Fan Mail
Midwifery 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 Fan Mail
It’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 Fan Mail
Feeling 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 Fan Mail
The 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 Fan Mail
The 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 text
Wrapping 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 text
Are 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 text
When 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 text
Ultrasounds 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 text
What 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 text
Thinking 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 text
Ever 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 text
Ever 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 text
In 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 text
To 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 text
Cheers 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 text
In 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 text
For 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 text
In 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 text
What'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 text
Missi 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 text
In 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 text
In 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 text
In 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
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
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 #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.
- https://physicianguidetobreastfeeding.org/
- https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf
- https://www.amazon.com/Improved-Medihoney-Wound-Dressing-Sciences/dp/B007EBRA6A
- https://www.motherlove.com/?gclid=CjwKCAjw4ZWkBhA4EiwAVJXwqRuMkcQNaaQ42eGxLfXlJjP0x_vNkG7G4QXmh_oOhkcVTe6yoqnF1xoCLBwQAvD_BwE
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
In this episode, Cara and Missi outline the TORCH infections and considerations for the antepartum period and the newborn. TORCH can have serious implications during the neonatal period. Passing the TORCH will remind you about IgG and IgM, symptoms to look for, and risk factors that may contribute to infections. #TORCHinfections #cytomegalovirus #rubella #herpes #toxoplasmosis #parvovirus #COVID #zika #syphillis #neonataloutcomes #MFM
In this episode, Cara and Missi chat on fetal monitoring and implications for the intrapartum period. Catch Me reviews fetal monitoring categories, the difference between non-stress and contraction stress, as well as the guidelines for intermittent and continuous fetal monitoring. This episode is for anyone out there that dares to catch those Babis...if they can. #intermittentauscultation #continousmonitoring #EFM #lowrisk #IFKYK
In this episode, Cara and Missi offer amazing insight on the most stressful topic of all for students- EXAM PREP! Don't worry focuses on tips and tricks for students and offers revelations that the girls have had from teaching exam prep for 10+ years together. Students won't want to miss this hour long conversation about get ready, feeling confident, and passing that test. #examprep #deliverEDexamprep #studyhall #resources #podcast #differentiatedlearning #talknerdytome #learningstyles #theEngagEDmidwife #testanxiety #USPSTF #asccp #cdc #boardvitals #statpearls
In this episode, Cara and Missi get way out the midwifery comfort zone with a conversation postpartum patients that present with complications. Triage and the Postpartum Patient covers topics such as infection, postpartum pre-eclampsia, and bleeding just to name a few. Join in to ease your "uncomfortableness" with this complex topic. #postpartum #complications #endometritis #sepsis #urosepsis #preeclampsia #infection #symptoms #triage #thinkfast #depression
In this episode, Cara and Missi get intimate with a girl to girl conversation about all things sex. From understanding your body to the anatomy of the clitoris, you won't want to miss this real talk about how to get the most from your sexual experiences. Have a great sex life- amazing- join us to hear how to talk to your patients about how to improve what happens when they want to get down. #forfun #vibrators #goodvibrations #toys #findyourjoy #good #giving #game #rosetoy #wecandohardthings #comeasyouare #bedsidetable #donotdisturb #selfcare
In this episode, Cara and Missi get serious about gestational diabetes. In this short review, the girls talk about screening and diagnosis and well as who needs early screening. Not to Sugar Coat it offers listeners a reminder tour while briefly discussing treatment and follow up. #diabetes #gestationaldiabetes #glucosechallenge #nutrition #medicalmanagement #insulin
In this BONUS episode, Cara and Missi talk about what it's like for students at the ACNM annual meeting. This year's meeting will be in Orlando, FL May 5-8. Tune in to get all of the insider information about how to get ready to explore this valuable conference. #annualmeeting #workshops #exhbithall #businessmeeting #kittywinners #fellows #mentoring #PACRally
In this episode, Cara and Missi get serious about puberty. Join this important conversation about helping adolescent patients and their parents navigate changing bodies, volatile moods, contraception, and body issues.
In this episode, Cara and Missi dive into care of the newborn in the immediate post-natal period. Every wonder what to say when describing screening tests, blood draws, and procedures? Listen in for some great tips on understanding those first 48 hours post-birth.
In this episode, Cara and Missi explore the endocrine system and those primary care topics that can be hard to grasp. They review the top two issues that are seen in the care of women- diabetes and thyroid dysfunction. Join in for this conversation on diagnosis, management, and referral for these important disorders.
In this episode, Cara and Missi dive deep into menopause and all it has to offer. From hot flashes, to menstrual abnormalities, and all thing in between, join the girls for this conversation about understanding physiology and symptomatology while gain insight on providing supportive pharmacologic and non pharmacologic treatments for midlife.
In this episode, Cara and Missi break down the many opinions of breast cancer screening including the big three- ACS, USPSTF, and ACOG. Join in to listen to this comprehensive conversation about screening, diagnosis, and consultation of breast complaints across the life span. In loving memory of Chelsea Rust.
In this episode, Cara and Missi get serious about how we communicate in our professional lives. Do you feel emotional ? Powerless? Do you hate difficult conversations? Tune in here the girls give all of their successful strategies for communicating effectively in all situations.
In this episode, Cara and Missi review diagnosis and management of headaches. Wether you work in primary care or pregnancy, join this conversation and learn about types of headache, pharmacologic, and non-pharmacologic strategies for treatment.
In this episode, Cara and Missi Discuss the dynamic of precepting from the student and preceptor perspective. Precepting is one of the most important aspects of midwifery education and should be a value to both student and midwife. Listen in for tips and tricks to make the most of this important relationship.
In this episode, Cara and Missi compare and contrast active versus physiologic management of the third stage of labor. Using the evidence as a guide, this conversation will help nurses and providers alike find their own way to manage third stage and understand the risk factors that may prompt active management.
In this episode, Cara and Missi discuss the ins and outs of vaginitis. Most midwives can easily treat normal presentation of vaginitis using the CDC recommendations. In this overview, abnormal presentations and treatment for recurrent infections are reviewed and tips and tricks for clinical practice are discussed.
In this episode, Cara is joined by her twin sister Diana Bowman, who is a Critical Care Nurse Practitioner. Diana shares her expertise in caring for critically ill patients with us, while Cara highlights the importance of interprofessional collaborative care. Topics include sepsis, respiratory support, and resuscitation.
In this episode, Cara and Missi provide an overview of the physiology, diagnosis, and treatment of jaundice. As care providers for babies up to 28 days, it is imperative the midwives understand how to identify jaundice and provide anticipatory guidance to parents of newborns with hyperbilirubinemia. Join in and build your foundational knowledge of management of jaundice with the girls.
In this episode, Cara and Missi step away from clinical conversations to talk about what it looks like to prioritize your life and get organized. The girls discuss how to micro-schedule, make effective lists, and establish priorities to help you live a more well rounded life.
In this episode, Cara and Missi are joined by Dr. Teresa Ash for a conversation around interprofessional collaboration between APRNs and Pharmacists. Dr. Ash is a PharmD who is the Chief Operation Officer at Mercy Anderson in Cincinnati, OH. Her wealth of experience provides insight on how to utilize pharmacy in the care of patients. She offers up valuable advice on resources, chronic disease management, and clinical pearls for midwifery and women's health practice.
In this quick update, Cara and Missi give all of the updates about what's coming from DeliverED Exam Prep. The girls are so excited to announce our their new products and updates to the existing programs to help ensure student success.
In this episode, Cara and Missi discuss induction of labor. Everything from bishop score to pharmacology to mechanical ripening, the girls are here for all of it. We recognize that induction of labor is certainly facility dependent, but tune in to listen as the girls give the scoop on getting babies out.
In this episode, Cara and Missi are joined by Elizabeth Holbein, RN, IBCLC, for a discussion on breast feeding you won't want to miss. Elizabeth gives us awesome tips on how to help our patients be successful and how to manage those not so easy complications.
Resources:
Elizabeth's go to haakkaa https://a.co/d/cHuXMFg
Breastfeeding network https://www.appalachianbreastfeedingnetwork.org/lactation-resource-database.html
Breast feeding helphttps://ohiobreastfeedingalliance.org/breastfeeding-help
In this episode, Cara and Missi discuss identification and management of the acute abdomen in pregnancy. This conversation specifically focuses on non-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.
In this episode, Cara and Missi explore the concept of scope of practice for midwives in the US. Several factors affect scope including national standards, state boards, and individual facilities. As many states fight for full practice authority, understanding scope is of the utmost importance. Listen in for tips on advocacy, knowing the role, and fighting for practice at the highest level of our training.
In this episode, Cara and Missi give their advice for getting down to studying. Everything from how to read, and how to take notes, to how to use your questions banks more efficiently is covered here. Don't know what kind of learner you are? Listen carefully as the girls tell you how to unlock your own studying potential. We know you can do hard things. Even studying.
In this episode, Cara and Missi discuss the GBS treatment guidelines. Dealing with GBS can be tricky, especially when a patient presents with an unknown status. Tune in to hear a review of all of the algorithms for managing this common diagnosis in labor.
In this episode, Cara and Missi give you all of the tricks that you might not read about in all of those textbooks. Fun antidotes from nurses, tips from preceptors, and intuition gained from years of practice are all highlighted in this not-so-evidence-based episode.
In this episode, Cara and Missi take a deep dive into anemia. Join the girls for a conversation around diagnosis, treatment, and education geared toward patients with anemia.
In this episode, Cara and Missi discuss preconception and prenatal genetic testing. Find out the differences between screening and diagnosis and the appropriate tests for each trimester in this information packed session.
In this episode, Cara and Missi dive into the topic of perinatal loss and support. They are joined by Stacey Gripshover who is a board certified Pysch- Mental Health Nurse Practitioner. Through perinatal loss, Stacey, along with her husband Leo, honor their baby Blue by relentlessly pursuing other grieving families in hopes of helping them navigate their grief journey. You won't want to miss the story of her journey to the goal of providing maternal mental health to women in need.
In this episode, Cara and Missi are joined by Belinda Lashea, CNM, MSN and Erin Meyers in an exploration of community birth. Belinda and Erin explain why out of hospital birth is so empowering and how midwives are seen in the community. You won't want to miss this discussion on midwives in the community and the impact they make.
In this episode, Cara and Missi explore the important psychologic tasks of pregnancy. Midwives can provide the best support both physiologically and psychologically during pregnancy. This episodes works through t the major tasks in each trimesters and how midwives can provide support to their patients.
In this episode, Cara and Missi review the screening, diagnosis, and treatment for depression in women across the lifespan. Here you will find a review of recommendations, screening tools, and pharmacology that can help you be a light to the people that need you most.
In this episode, Cara and Missi talk about mentoring and what it has meant in their careers. The girls give shout outs to important people that have shaped their professional lives and explain formal versus informal mentoring. You don't want to miss this episode on when to phone a friend.
In this episode, Cara and Missi review the AGOG practice bulletin and recommendations for overweight and obese patients in the antepartum period. We understand that this is a sensitive topic to consider with patients and this episode is meant to serve as a way to start this conversation.
In this episode, Cara and Missi give you all of the details of their holiday wish list including gifts for students, preceptors, midwives, and all those birth workers we love so much. You won't want to miss this one.
In this episode, Cara and Missi are again joined by Amy for a conversation around the new CDC guidelines for the treatment of sexually transmitted diseases and infections. This quick chat focuses on the main treatment changes that were highlighted in the July 2021 update. Don't forget to bookmark the webpage and delete that app!
In this episode, Car and Missi breakdown the physiology behind abnormal uterine bleeding. Beginning with a brief overview of the menstrual cycle, the team will talk about correct language, assessment, and how to correctly diagnose bleeding disorders.
In this Episode, Cara and Missi get real about the postpartum period. Everything from breastfeeding, bleeding, and contraception, tune in to hear their advice for patient teaching, anticipatory guidance and what to expect in the postpartum period.
In this episode, Cara and Missi are joined by Amy Palmer to talk all of the details on getting that first job. Everything from malpractice, to salary, to asking the right questions, students and new midwives won't want to miss this midwives tell all episode.
In this, the last episode of season 2, Cara and Missi start with an overview of the hypothalmic-pituitary-adrenal axis as a basis for a comprehensive conversation around contraception. Progesterone only, LARCS, combined methods, and everything in between. Come one, come all. If you need a refresher on contraception, then this is your episode.
In this episode, Cara and Missi get real about the ins and outs of being a midwife. They discuss schedules, balance, and mental health in a candid and open way to help others process their own professional lives. Grab a cup of coffee and join as the girls talk about the #midwifelife.
In this episode, Cara and Missi review the new guidelines for postpartum hemorrhage identification, prevention, and management. Citing the ACOG practice bulletin, the World Health Organization, and the Alliance for Innovation on Maternal Health, this discussion will bring students and midwives up to date on what is new for clinical practice.
In this episode, Cara and Missi run through a list of common discomforts of pregnancy with a mind toward midwifery management. Curious about what to take for heartburn or how to help patients deal with hemorrhoids? This episode is for you.
We have updates on all things Exam Prep. Cara and Missi will talk about new products and opportunities, as well as, some exciting opportunities for Spring 2022.
Meet the Busenhart and Stec children. Cara and Missi's kids dish about what it's like for their mom to be a midwife. Join us for this fun, sweet, and insightful conversation with Rory, Brooks, Max, and Julia as they talk about life with their moms.
In this episode, Cara and Missi breakdown all thing TOLAC and VBAC. Discussing indications, calculators, and protocols, you won't want to miss this conversation about how midwives can be instrumental in helping women have successful vaginal deliveries.
In this episode, Missi is joined by Dr. Sara Edwards for a conversation on physiologic birth, caring for birthing people and supporting during labor.
In this episode, Cara and Missi host Missy and Sarah Furlette-Koski and invite their own partners to join in on a conversation about what it's like to be married to a midwife. You won't want to miss this candid talk about partnering with a midwife and how to make it work.
In this episode, Cara and Missi are joined by certified nurse-midwife Amanda Treon to discuss the link between the gut and inflammation. Amanda will build on the current research and science to give us tangible ways to help clients struggling with overall wellness.
In this episode, Cara and Missi will discuss PCOS- everything from presentation to diagnosis to treatment. Join us to brush up on your knowledge of how to best help our patients manage this multi-factorial diagnosis.
In this episode, Cara and Missi are joined by their midwife colleague, Mandy, to discuss substance abuse in pregnancy. This thoughtful and insightful conversation will provide listeners with practical tips on the care of women with abuse disorders.
In this episode, Cara and Missi will review helpful tools for screening assessments and tests in primary care. Utilizing the United State Preventative Service Taskforce (USPSTF) guidelines, they will walk the student and practicing midwife through the recommendations of when to screen and when to not.
In this episode, Cara and Missi get real about infertility. Describing the history, workup and basic management, they will help provide a foundation of how to care for families experiencing difficulty achieving pregnancy. Additionally, Missi will share her insights regarding her personal journey with infertility and importance of her care team.
In this episode, Cara and Missi will give their thoughts on terminal degrees in nursing. The discussion will focus on the DNP and the PhD and why those degrees are a good fit for clinicians. A lighthearted conversation that you won't want to miss about why a doctoral degree can be relevant in advanced practice.
In this episode, Cara and Missi breakdown common symptom clusters that can be prevalent in the care of the newborn. These deviations from normal should be understood by midwives in order to effectively stabilize newborns and employ consultation, collaboration and referral.
In this episode, Cara and Missi give you all the tips and tricks for apps in clinical practice. The Mobile Application Rating Scale (MARS) is broken down for clinicians and students while sharing all their favorite apps.
In this episode, Cara and Missi discuss the hallmarks of hypertension in pregnancy including important diagnostic features, testing and midwifery management.
In this episode, Cara and Missi are joined by their friend and colleague, Dr. Heather Hines for a frank discussion on mindfulness, feeding your midwifery spirit and maintaining mental wellbeing.
In this episode, Cara and Missi get down to basics and review the menstrual cycle from the HPOA axis all the way to menstrual disorders. Join in this refreshing review of the role the female body plays in reproduction.
In this episode, Cara and Missi will dish about all things test taking. From what to expect to how to prepare, this episode will help student to focus on what is important when taking their certification exam.
In this episode, Missi and Cara will talk about how they conceptualized their company, DeliverED, and how the company has come to be a great solution for certification exam preparation.