The first annual alumni weekend is scheduled for September 30 through October 3, 2005. It promises to be a fun and productive weekend. There will be CEU sessions with presenters including Joani Slager, Kitty Ernst, Susan Stone, Suzan Ulrich and Julie Marfell with topics ranging from Hypertension in Women to Billing for Midwifery and NP services. This is Mary Breckinridge Festival weekend in Hyden, KY so we will all get FSMFN Alumni T-Shirts and march in the parade on Saturday morning. We will of course have dinner and stories from Kitty at the Big House. Arrival will be Thursday evening and we will be leaving right after breakfast Sunday morning. We have to limit the number of participants to 40 people. Price for the entire weekend will be $300. We will be posting a web site shortly that will provide enrollment information. Stay tuned, we will send info to your email shortly.

One day this past Spring, we had the unusual event of having the entire FSMFN on site in Hyden at the same time. I convinced them all to come on outside and let me take their picture. I thought everyone would enjoy it as much as I did. They include:

Back Row:
Betty Wells, Housekeeper and Cook; Brandy Owens, Secretary, Billie Couch, Quality Assurance Coordinator; Judy Pennington, Financial Aide Officer; Sherri Davis, Registrar and Office Manager; Frank Baker, IT Coordinator; Lonnie Dean Brown,Maintenance

Front Row:
Russell Pruitt, Multimedia Coodinator; Heather East, Director of Multimedia Operations; Justin Rice, Mutlimedia Coordinator and Cherie Bunch, Multimedia Coordinator

Thanks to all of you for all that you do!!

Congratulations!

• • Julie Paul received the Varney Participant Award and the ACNM Foundation Memorial Scholarship. Julie is a Class 42 CNEP student who lives in Manchester, New Hampshire. Julie represented the Frontier School well at the ACNM Annual Meeting this year serving as a Student Representative and a Page. Thank you Julie and Congratulations!

• Patricia Reddy received the Edith B. Wonnell Scholarship. Patricia is a Class 39 CNEP student who lives in Eugene, Oregon. Congratulations Patricia!

To win these awards, both students had to write about their career goals and obtain recommendations from both their Department Chair and one faculty member. Congratulations to both of you.

Patricia Caudle, CNM, FNP, DNSc received the 2005 Excellence in Teaching Award at the annual meeting of the American College of Nurse-Midwives (ACNM). This award is given by the ACNM to one teacher in each ACC accredited educational program. The teacher is selected by the students. Pat teaches Pathophysiology, Reproductive Physiology and Primary Care. Students often rave about her teaching skills as well as her patience and perseverance with some difficult content. She is also very active on the test development committee of the ACC. Congratulations Pat on this well deserved award.

Any librarian will tell you – the question that most academic library patrons have goes something like this: “I have a research project/paper/etc. - how do I do it?”

This is the first in a series of newsletter articles that will hopefully help those of you who find yourselves overwhelmed by the thought of beginning a research project to become more comfortable with the idea.

You have just been assigned a research project. Your first instinct is to: A. Cry; B. Dig a hole and hide in it; C. Cry AND Dig a hole and hide in it.

Come out of the hole, and wipe your face – it’s really not that bad.

For most people, the hardest part about beginning a research project is just that – beginning. Knowing where to begin is the most daunting part of the whole ordeal.

It’s been said before, but remember that it is best to begin, logically, at the beginning. What do you have to work with? Most likely, your project has been assigned by an instructor – what does the assignment say? It may seem surprising, but there are those of us – you know who you are – who jump headlong into the assignment without taking the time to peruse the instructions. They’ve glanced over them, sure, but haven’t really perused the instructions. Those are the people who are usually freaking out two days before the deadline.

Consider, carefully, now, the assignment: what exactly are you supposed to do? Are you supposed to form a thesis and support it? Construct a literature review? The nature of your assignment will not only inform how you actually complete it, but also how you go about your research. (For the sake of this discussion, we are going to assume that you have been given an assignment that requires you to select a topic, research it, and then write about it.)

After looking the assignment over carefully, discuss it with your instructor. This is the time to ask questions about any parts of the assignment that you find confusing. This is also the time to ask for suggestions or helpful information from your instructor. If your assignment requires you to select a topic for research, one of the best discussions you will ever have with an instructor is the one where you ask for suggestions or clarification about your topic – trust me on this. You can’t succeed at a research project until you know your topic as well as you know your own name, so the more help you get in this area, the better off you will be.

Selecting your topic of your project should be the most important step in the research process. A poorly chosen, or simply poor, topic will not only plague the outcome of your project, but it will also make research difficult.

So how should you choose a topic? Here are some suggestions:

• Does the instructor offer a list of suggested topics in the assignment? If so, use one of these if at all possible.
• If you are left to select a topic on your own, consider the circumstances: do you know anything about the field in which you are being asked to research? If so, use what you know – if not, ask your instructor where to go for beginning information.
• Once you have an idea for a topic, decide where you must go next with it. Some topics will need to be narrowed down, others exploded, in order to write an intelligent analysis with research supporting. Stem cell use, for example, is too large and too vague. It would need to be narrowed down in such a way that it could become manageable. Stem cell legislation issues is a much more concise, and therefore workable, topic. However, stem cell legislation in Leslie County, Kentucky, is obviously too narrow!
• Having trouble narrowing your topic? Ask your instructor or even librarian for help. Or, go to an online database like Ebsco, PubMed, or ProQuest, type in your topic, and look at a couple of article citations. Chances are, this will help you to find a narrower topic, and is a good way to begin your research.
• When you have decided on a topic, return to one of those online databases, and do a search for your topic. What did you get? 1589 articles? Then you have not narrowed your topic enough. 9 articles? Your topic is too narrow. 20-50 articles may seem like a lot, but that’s about right for a search on a topic that is right on the money.

The topic that you choose will determine not only the quality of your research project, it will also determine whether the project is relatively straightforward, or arduous and time-consuming. It’s too much to ask that you enjoy doing a research project, but if the topic is of interest to you, and is right for the project, then it will at the very least be painless.

Next edition – finding resources.

Announcing the release of the official "Frontier Benefit"; CD! It's called Motherhood~Babyhood, and includes many songs that are special to FNS students, such as Amazing Grace, It's in Everyone of Us, our school song played on a harp, and Babycatcher's Rag (AKA the Crotch-Watch song, newly sanitized for the unitiated!)

On June 11, 2005, at the annual meeting of the American College of Nurse-Midwives, FSMFN’s President and Dean, Susan Stone, was inducted as a Fellow by the American College of Nurse-Midwives (ACNM). Fellowship in the American College of Nurse-Midwives (FACNM) is an honor bestowed upon those midwives whose professional achievement, outstanding scholarship, clinical excellence, and/or demonstrated leadership have merited them special recognition both within and outside of the midwifery profession. In light of the vast wealth of expertise and collective wisdom represented within the body of Fellows, its mission is to serve the ACNM in a consultative and advisory capacity.

This was the bio that was read by Helen Varney Burst, CNM, Chair of the FACNM Board of Governors at the awards ceremony:

The Mi Amiga Coordinator torch has been passed on. In preparation for Level 3 attendance, I felt the time was right to pass on the coordinating of this wonderful program. The new Mi Amiga Coordinator is Cammie Hauser, CNEP class 45. She is excited about taking on this new role, and carrying on the great tradition of support that the Mi Amiga Program provides. Thank you for the past year as the Coordinator. I have greatly enjoyed working with the program and everyone that has been involved!

On June 13, 2005, at the Frontier Nursing Service celebration of 80 years of service, the ACC awarded Mrs. Breckinridge the 10,000th certificate awarded in nurse-midwifery. This was a great honor that was well deserved. Dr. Nancy Lowe, an alumnus of the FSMFN and currently the President of ACC made the presentation. Accepting the award were Susan Stone, President of the FSMFN, Leigh Powell, Chairman of the FNS Board of Governors, and Bill Hall, President and CEO of FNS. Below are Nancy’s words as she made the presentation.

Mrs. Powell, Mr. Hall, Dr. Stone, “mother Kitty”, FNS faculty, staff and alumni, and distinguished guests, I am privileged to serve as the current president of the ACNM Certification Council, ACC, soon to become the American Midwifery Certification Board. In 2002, ACC awarded the 10,001st nurse-midwifery/midwifery certification. At that time, the ACC Board of Directors decided to hold out certificate number 10,000 to award ceremoniously at the time of the 50th Anniversary of the American College of Nurse-Midwives.

The decision of who should receive the 10,000th certificate number was an easy one for the ACC Board to make. I distinctly remember that board meeting when the decision was made. As the Board president, I asked the question “Who should receive the 10,000th certificate or how should be go about choosing the individual?” There was a momentary pause and then, almost simultaneously several of the CNM members of the Board said “Mary Breckinridge” with immediate enthusiastic affirmation by the other members of the Board. Our decision was made in a matter of minutes.

My own story illustrates the ongoing effect that Mary Breckinridge has on both the care of underserved women and their families and the profession of midwifery. I read “Wide Neighborhoods” in 1975 as a graduate student in a maternal-child health nursing master’s program that had a major emphasis on community-based care and outreach. I was deeply affected by the account of Mrs. Breckinridge’s work to improve the health and well being of underserved women and their families through community-based midwifery care, by her personal story of loss, and by her resolution to serve. I was a young mother myself at the time and remember distinctly saying in jest, but at the same time with a deep-seated longing, to my dear husband that he could have the three kids, the dog and the house, I was going to KY to become a nurse-midwife. Thankfully a number of years later after I earned my doctoral degree, I was finally able to fulfill that dream (without abandoning my own children and husband) by becoming a nurse-midwife and FNS alumna through the CNEP program, class 4. My story is a minor illustration of the multitude of nurse-midwives and midwives whose personal journeys in midwifery have been directly influenced by the legacy of Mary Breckinridge.

Mrs. Powell, Mr. Hall and Dr. Stone, on behalf of the ACNM Certification Council it is my humble honor to present to you this certificate that reads:

In honor and recognition of her leadership in the development of

American nurse-midwifery through the health care services

And educational programs of

The Frontier Nursing Service and

The Frontier School of Midwifery and Family Nursing,

The ACNM Certification Council, Inc. posthumously awards

Mary Breckinridge

Certificate number 10,000

Therefore acknowledging her as a Certified Nurse-Midwife

June 13, 2005

Nancy K. Lowe, CNM, PhD, FACNM, FAAN

Today, my friends, I have an amazing offer for you… it is a product like no other, often imitated but never duplicated! You will be awed, you will be intrigued, and you will NOT be able to say no to this fabulous product! It’s the amazing, wonderful….. BREAST MILK! (insert cheesy infomercial music and fake-audience clapping)

Breast Milk is by far the most superior way to feed your baby EVER! It is a perfect balance of major macronutrients (protein, carbohydrate, and fat), which means your baby gets excellent nutrition to help them grow. In addition, Breast Milk also contains all of the vitamins and minerals needed by the growing neonate. And if that wasn’t enough, there are also a number of milk-borne trophic factors in Breast Milk. These are growth-related factors that aid the newborn in growth, metabolic processes, and organ/tissue differentiation. Can you beat a deal like that (Coad, 2001)?

But we’re not going to stop there, folks. Breast Milk ALSO contains immunological components to help protect your baby from illness. These components include immunoglobulins IgA, IgG, and IgM. In addition, iron-binding protein helps limit the growth of some types of pathogens, protecting your baby from potentially dangerous gastrointestinal illnesses. Other immunological components of Breast Milk include white blood cells, lysozymes, and fibronectin (Coad, 2001).

Customer testimonial: “I’m telling you, I was skeptical at first when I started the free trial of Breast Milk, but the results were so amazing that now I’m a loyal customer. I couldn’t believe how healthy and radiant my newborn looked after just a few days on this product. His eyes sparkle, his skin is healthy, and as a bonus… his dirty diapers don’t even smell bad! My husband is elated! I can’t recommend this product enough!”

BUT WAIT! THERE’S MORE!

For an (un)limited time, you will not ONLY get the amazing Breast Milk, but you’ll also get the exclusive Breast Milk Delivery System. This system is specifically designed to meet the needs of you AND your baby, regardless of how often your baby needs to eat. In fact, this system is so adaptable that you can actually produce enough milk for two babies, or perhaps you’d just like to pump some extra for those days when you and Baby can’t just be together. The system works like this: your baby begins to nurse at the breast, and the stimulus provided by the baby sends a special signal to the hypothalamus, which then tells the posterior pituitary to release oxytocin. Oxytocin then triggers the myoepithelial cells within the breast to contract, which thereby squirts milk through the lactiferous ducts and sinuses and into the baby’s mouth. But that’s not all, my friends. The same sucking stimulus also tells your body how much milk to produce and when! Prolactin secretion by the anterior pituitary is responsible for the actual production of the milk itself, and can adjust as needed to baby’s needs (Lowdermilk, Perry, & Bobak, 2000).

And how much do you think this amazing product costs? Well, folks, artificial versions of this product are retailing for as much as $1,500 a year. But you won’t pay $1,500. You won’t pay $1,000…. or $500… or even $200. You won’t pay a single dime for this incredible feeding system. Nope, my friends, breastfeeding is practically free. Granted, you could opt to purchase optional equipment such as a breast pump and bottles, but our basic Breast Milk system is absolutely free. Now how can you beat a deal like that?

References
Coad, J. (2001). Anatomy and physiology for midwives. Edinburgh: Mosby.

Lowdermilk, D.L., Perry, S.E., & Bobak, I.M. (2000). Maternithy & Women’s Health Care. St. Louis: Mosby, Inc.

This year, the FNS Foundation provided an award for outstanding accomplishments by a FSMFN Alumni. A committee of three alumni was formed to review the nominations. They chose Kitty Ernst. The award was given at the 80 th celebration reception in Washington, DC on June 13, 2005. I think Kitty was really surprised. I can think of no more deserving person for this award. Below you can read the nomination letter that was submitted by Kathryn Osborne, Frontier Alumni, CNEP Class 3.

Nomination for Kitty Ernst

FNS Outstanding Alumni Award 2005

I am writing to recommend Kitty Ernst for the Outstanding Alumni Award given by the Frontier Nursing Service at the 80 th Anniversary Celebration.

I’m not exactly certain of the year that Ms. Ernst graduated from FNS. I’ve known Kitty for almost 15 years, and have had the privilege of hearing many stories about her work with FNS, including the time she spent as a student under the tutelage of Mary Breckinridge. I can say, with utmost certainty, that Ms. Ernst has committed her life to the mission of FNS. Kitty came to FNS as a young nurse – looking for a way to combine her love of horses with her work as a nurse. She had worked previously as an obstetrical nurse, and was fairly certain that she was not interested in working with women in labor and birth. She had only seen the medical management of obstetric care, and knew that she wanted no part of that. So when she learned that she needed to be a midwife with a nursing district in order to get a horse, she was ready to leave FNS and return to her work in the city. Fortunately, Mrs. Breckinridge saw the budding nurse-midwife in Kitty, and suggested that she attend a home birth with one of the midwives before making the decision to return home.

Over the years, hundreds of Ms. Ernst’s students have heard the rest of that story, which she tells with absolute eloquence. We all know that the young Kitty Ernst witnessed, in those midwives, the delivery of maternity care in a model that she instinctively knew was better for mothers and babies. We also know that with the limited number of opportunities for the practice of nurse-midwifery, staying to complete her education as a nurse-midwife meant taking a leap of faith.

After graduating from The Frontier Graduate School of Midwifery Ms. Ernst went on to bring health care to the women of Appalachia. From there, she went on to teach in various midwifery education programs and ultimately found her niche within the Birth Center. She knew that just as the midwives were offering a better model of care for the women of southeastern Kentucky, so too could nurse-midwives, working in birth-centers, offer a better model of care to women all across the nation. And because the birth-center concept was outside of “main-stream” thought when it came to the delivery of obstetrical care, making a commitment to the development of birth centers necessitated taking another leap of faith. Thank goodness she took that leap. She worked hard to establish the National Association of Childbearing Centers, and provided support to hundreds of nurse-midwives who went on to open birth centers. Those midwives continue to provide care to thousands of families, in the spirit of Mary Breckinridge who dedicated her life to providing better care to mothers and babies.

In the late 1980’s Kitty took the ultimate leap of faith. With the help of several organizations and many supportive colleagues, she breathed new life into the Frontier School of Midwifery and Family Nursing by restructuring it as the Community-based Nurse-midwifery Education Program (CNEP). For a brief period, the school was headquartered in her back yard, under the watchful (and mighty critical) eye of the ACNM Division of Accreditation. The school attained preaccreditation status in 1989, and since then it has gone on to offer the finest midwifery education in the nation to over 1000 nurse-midwives. Most of the students of the CNEP were like me: unable to relocate for school, trying to make the best of jobs that were deeply imbedded in the medical model of care, knowing in our hearts that surely there was a better way to deliver care, and wishing desperately that we had access to an education in nurse-midwifery. I’m certain that I speak for many graduates of the program when I say thank goodness she took that leap of faith. She knew that there were nurses in practice who would seek midwifery education if they did not have to relocate for school. Despite the criticism of many academicians in nurse-midwifery who said that distance learning in midwifery would never work, she knew that it would. Much like Mrs. Breckinridge, she is a visionary of the highest order. And because of the distance learning that was made available through CNEP, Mrs. Breckinridge’s vision to bring better health care to wide neighborhoods of men and women has come true, for thousands of families who are cared for by FNS graduates throughout the nation and around the world.

I’m sure I’ve left out many of her accomplishments. Those that I have listed here offer only a glimmer of Kitty’s life as an alumnus of FNS. In addition to creating opportunities to improve options and access to health care, and increasing access to midwifery education, Kitty has been a tremendous role model. She has taught her students to never be satisfied with the status quo when we know that there is a better way. She has taught us that change is difficult – and that when change means improvement it is worth the struggle. She has taught us that in order to get where we want to go, we must “just do it” – take that leap of faith, and has instilled in us the confidence in ourselves to do so. For these reasons, I recommend that FNS give Kitty Ernst the award for outstanding Alumni.

Respectfully submitted,

Kathryn Osborne MSN CNM and CNEP graduate

Aggie is in a full scope nurse-midwifery practice at Gunderson Lutheran Health Care System Center in La Crosse, Wisconsin. Aggie has been a dedicated preceptor for FSMFN students for over a decade and has precepted over 35 students for Frontier. Over the years she has offered not only clinical education for FSMFN students, she has been a role model of the highest order, demonstrating the role of the nurse-midwife as an important member of a health care team built on collaboration and collegiality. She and all of her dedicated midwife partners, have hosted nurse-midwifery students almost continuously during the entire last decade. Even when finding clinical sites in Wisconsin was becoming increasingly difficult, Frontier could always count on Aggie and the nurse-midwifery service at Gunderson to find a way to make room for a student when the need arose.

In addition to offering clinical teaching, Aggie has taught students about the role of the nurse-midwife through example. She was the service director for the first (and now longest running) nurse-midwifery practice in Wisconsin. She also served as Chair of the local chapter of the American College of Nurse Midwives (ACNM) for two terms, always encouraging her students to become involved with the work of ACNM on the local level. During her term as Chapter Chair, the Wisconsin nurse-midwives successfully negotiated a new practice act, allowing them to work as independent practitioners in the state. She is also involved in international work, establishing women’s health care centers in Russia and other parts of the world. She willingly shares her experiences with students and nurse-midwives across the state.

Today, Aggie continues to offer outstanding clinical experiences for the students of FSMFN. She now fills the role of Regional Clinical Coordinator for Wisconsin (and most of the states in the Midwest). In addition to precepting students in her site, and following clinical students throughout the Midwest, she is a leading recruiter of students to FSMFN. Aggie is a midwife’s midwife. She has continually offered outstanding clinical teaching, mentoring and nurture. The fruits of her labor can be seen all across the country (especially in the Midwest), through the graduates of FSMFN who have gone on to start new practices and work in existing nurse-midwifery services. Her willingness to work with FSMFN students has been a gift. We can think of no better way to honor the gift that she has given us than by recognizing her with this reward. Frontier also wants to express their great appreciation to Gunderson Lutheran Health Care for supporting Aggie’s efforts to provide an excellent education to nurse-midwifery students.

Announcing the birth of Tristyn Michael D’Aurora to Candice D.Aurora. Tristyn was born on May 9th, 2005 at 19:05 in Catania, Italy. He weighed in at 5# 12oz. He was 5 weeks early but Candice reports that “he is growing strong”. Trysten’s brothers, Brayden 6 yo and Dylen 3yo are thrilled with their new little brother. Candice is a Class 42 student in the CFNP program. Both she and her husband, Dan, are in active duty in the Navy and are currently stationed in Italy. Congratulations to the D’Aurora family and welcome Tristyn, to the Frontier family.

The goal Kitty set for the Community-based Nurse-midwifery Education Program (CNEP) was to “increase the number of nurse-midwives exponentially.” Progress toward meeting this goal has been terrific with over 1000 CNEP graduates since 1991 increasing the number of certified nurse-midwives in the USA to over 10,000.

This goal needs a renewed commitment. News from the 2005 Annual Meeting of the American College of Nurse-Midwives showed a 36.8% decline in the number of midwives certified in the past 5 years. There were 454 midwives certified in 2000 compared with 287 in 2004.

The Frontier School of Midwifery and Family Nursing is launching a new campaign to educate more nurse-midwives with the help of our alumni. Historically our alumni have been the best recruiters for our school. We are told often that the reason someone is applying to our school is because they have seen the care our graduates give to women and they want to do that too!

Now we are asking each alumnus to offer a special invitation to the FSMFN to a nurse they feel would be a great midwife. The alumnus will give the nurse a beautiful invitation with a birth photograph by Harriette Hartigan that has the hands of the mother entwined with the hands of the midwife at the moment of birth. The invitation acknowledges the outstanding qualities of the nurse and encourages the nurse to become a midwife. It also includes a coupon for $25 off the application fee. A very special gift will be given to each graduate who invites a nurse that applies to the FSMFN.

This special campaign will hopefully touch the heart of each nurse who receives an invitation and encourage her to become a nurse-midwife so every woman can have the option of midwifery care.

Ruth was awarded the 2005 Dorothea M. Lang Pioneer Award at the annual meeting of the American College of Nurse-Midwives.

The Dorothea M. Lang Pioneer Award honors an exceptional CNM/CM who has demonstrated vision and leadership in or is innovatively working within the following criteria:

• Pioneering midwives who after 1958 demonstrated what midwifery care could and should be on the health team
• Pioneering efforts to integrate midwives/midwifery into the health care system within the United States or internationally
• Unsung heroes who initiated/rescued/enhanced/saved midwifery services or educational programs or are working to accomplish these goals
• Visionaries who encouraged/created open-minded pathways in education for professional midwives or are working to accomplish this goal
• Energetic anticipants who have furthered or are furthering the legislative agenda for ACC certified midwives – CMs/CNMs full scope of practice on the team
• Pioneers in other unique ways, with the approval of the Dorothea M. Lang Pioneer Committee

The faculty practice at the Frontier School of Midwifery and Family Nursing are sponsoring the 2nd Annual FNS Campaign for Safe Kids. On June 15, 2005 Julie Marfell, FNP, Chairperson of the Department of Family Nursing, Michael Claussen, Assistant Courier Coordinator and Couriers Sarah Dotter-Katz, Becky Hess, and Alana Jonat presented a Safe Kids education session to 25 girl scouts at the Big Creek Elementary School in Perry County. More educational sessions are being planned for children’s’ groups this summer.

The faculty practice has also sponsored the purchase of batting helmets with face guards for the Tee-ball and Little League teams in Leslie County. What follows is an article that Julie Marfell wrote for the papers in Leslie County. Have a safe summer!

According to the National SAFE KIDS Campaign, every summer, 2.7 million children in the US under the age of 14 are treated in the emergency room for unintentional injuries. That represents a 20 % increase for accidents and injuries during the summertime months. Of those children injured during the summer months, 2,000 will die. This means that 42 % of deaths from unintentional accidents and injuries are during the 3 months of summer.

It is most important that we protect our children from the number one cause of childhood death, unintentional accidents and injuries. For summertime safety it is important to focus on safe riding, swimming, wheeling, walking and playing.

Riding safe means buckle up, not just your kids but you too. Whether we believe it or not our kids really do look to us to set the example and copy everything we do. Making sure we buckle up and have our kids in the correct safety seat can save their lives in an accident. Kids belong in the back seat and kids from 40-60 lbs should be restrained in a booster seat. Children under the age of 6 years must be restrained in a booster seat regardless of age. Children under 20 pounds and or under the age of 1 year must ride facing backwards and in a car seat that is for the correct weight.

Safe swimming means never let a child that does not know how to swim more than an arms length away from you in the water even if they have a life jacket, floaties or on a raft or a noodle. Older children should not swim alone. Make sure all children wear personal flotation devices when out on boats, are near open bodies of water or participating in water sports. Young children also drown in bathtubs, toilets and buckets so do not leave them near these unsupervised.

Safe wheeling means a helmet that is properly fitted and other protective gear every time they ride a bike, a 4- Wheeler or anything with wheels. Make sure your kids know and follow the rules of the road. A proper fitting helmet needs the eyes, ear and mouth check. For eyes, the helmet should be one-two fingers about the eyebrows when placed on the child’s head. For the ears, the straps of the helmet should form a “V” under the ears when buckled and the strap should be snug but comfortable. For the mouth, when the child opens their mouth they should feel the helmet hug their head. If not the straps should be tightened. Make sure that if you are wheeling with them that you set a good example and wear a helmet as well.

Safe walking means not letting children under the age of 10 cross a busy street alone. Children under the age of 10 have not completely developed their depth perception and cannot accurately judge the distance between them and a moving car. Don’t let them walk alone at night.

Playing safe means supervision on playgrounds or in the backyard. Also make sure that your kids are wearing the correct properly fitted protective gear when they practice or play team sports.

After visiting Frontier Bound, I was informed that a birthing center existed in my hometown.  Whenever I returned to Pittsburgh, Pa, I immediately called and transferred my care to the midwives.  I loved it there, and everyone was so welcoming to my husband and I.  My pregnancy was moving along flawlessly.  I desparately wanted to deliver naturally there.

On June 17th I began to labor at home for several hours.  We decided that it was time to go around 10:00pm.  I was between 3-4 cm whenever we arrived, and progressed beautifully to 8cm by 4:00am.  We were the only ones there....so quiet...so peaceful...the room was light by candlelight....soft music on the radio....relaxing in th jacuzzi...rolling on the birthing ball....I even baked cookies with the midwife at 2:00am. 

It was like a trip to the spa...minus the contractions! 

Then.... 

I got lost in transition. 

She had turned to the not so lovely OP position, and stayed there for 6 painfully long hours.  The last 3 being unbearable.  My contractions were lasting 3-5 minutes a piece, with only 10-30 seconds between them.  Her heart rate had started to drop, and continued to drop the longer she was there. 

They decided that I should be transferred to the hospital to get on the monitor, and to let her passively descend.   

I was heart-broken. 

When we got there, the cluster and chaos started.  My husband was pushed to the corner of the room (b/c he was not sterile)...the L&D nurses were placing monitors, IV's, drawing blood, placing catheters, you name it.  Then the anesthesiologist were there to place the epidural.   

I felt so out of control.   

I said as loud as I could, "This is Kathy the midwife, and SHE is in charge!" 

Kathy did some crowd control, and consoled me. 

It was only one hour and I was fully dilated and ready to push.  Kathy tried to make it as natural as possible.  We had the epidural turned down so that I could feel the contractions, closed the blinds so that the room was dim, and she did not break down the bed.  I asked for a mirror at the foot of the bed so that I could see the progress.  I sat up and pushed like a champ. 

Kathy told me that she would be born with the next set of contractions and said, "Let the first baby that you catch be your daughter!" With that, I reached down and delivered/caught my daughter! 

I was able to breast feed her instantly; and my husband cut the cord while she was nursing. 

She was 6 pounds, 12 ounces and 19 inches long.  She was born 6-18-05 at 12:22pm. 

It was not the place where I wanted to deliver, but we had a nice delivery afterall.  We had to stay 24 hours, and took our baby girl home.  Our twins love her!  Now we have 3 kids under the age of 2 in our home! 

Take care! 

Mary Kwiecinski
class 44

I had the most amazing experience at the 50 th annual meeting in Washington, D.C. I had the opportunity to represent FSMFN as a student representative, student page and as a Varney Participant. This afforded me the opportunity to meet the ACNM board of directors, witness Susan Stone become a Fellow, and spend time with Helen Varney Burst.

I believe the experience was so powerful because of the behind the scene activities I was exposed to. I started the trip with a meeting of the student pages. Our job was to make sure the workshops, education sessions and business meetings ran smoothly. Basically, we were gophers. However, the announcers always made sure we and our schools were recognized at the beginning of each session. In addition, we were sometimes the announcers ourselves. This gave us a taste of public speaking. That was not my favorite part. Also, by paging the sessions we were able to meet some of the most influential midwives in the industry. An opportunity I am glad I had. I highly recommend student paging for all those who are able to make it to the 51 st annual meeting in Salt Lake City, Utah.

The next few days, I was able to meet with a variety of students from other programs. We discussed student issues and tried to find solutions. Once we did this, we put together a student report to be presented at the closing business meeting (our report got a standing ovation). It came out really well, so be sure to check it out in the next issue of Quickening. Because of this opportunity, I joined the national student committee. We will be meeting (via internet) about every 6 weeks, so be sure to provide me feedback for issues you may want me to bring up.

In the middle of the meeting, I was able to attend the Frontier Nursing Services’ 80 th anniversary reception. That had to be the highlight of the trip. Not only did we get to meet faculty, board members, fellow students and alumni, but we also got to take a trip down memory lane. The main presenter provided a detailed history of Mary Breckenridge, the school, and the future vision of the FNS. In addition, we were privileged to see the presentation of Mary Breckenridge receiving the 10,000 Nurse-Midwifery Certification from the ACC. It was definitely well worth the trip.

Finally, I had the opportunity, as a Varney Participant, to spend time with Helen Varney Burst. It was fun to sit down and chat with her about where I am now and where I will be going. She also helped me adjust my schedule in order to gain the most out of the meeting. I have learned so much. The women in our profession are so motivated, educated and driven. It was a pleasure to be in the presence of such excellence. I look forward to continued participation in the ACNM. It is through our participation as students that the profession will continue to grow and prosper.

On June 13, 2005, the Frontier Nursing Service held a grand reception at the Mayflower Renaissance in Washington, DC. The purpose was to celebrate 80 years of health care service to the people of Southeastern Kentucky and to honor the Frontier School of Midwifery and Family nursing for its many recent accomplishments. The reception was held in D.C. at the same time as the annual meeting of the American College of Nurse-Midwives with the hope that this would allow many graduates and students who were attending the convention to also attend the reception. We also hoped that many of the friends of FNS who live and/or work in the D.C. area would be able to come. And come they did! There were close to 200 attendees including current FSMFN students, alumni, board members and many friends. Leigh Powell, Chairperson of the FNS Board of Governors led the presentations. She spoke of the wonderful history and recent accomplishments of the FNS. The new video presentation “80 Years at FNS” was shown. Mary Breckinridge was awarded the 10,000 certificate of American College of Nurse-Midwives Certifying Council (see article elsewhere in the issue). There was much food and drink, talking and laughing, reacquainting with old friends and making of new friends. A great time was had by all.

Click here to see pictures of the celebration.

I've been teaching now for about fifteen years. I have two kids myself, but the best birth story I know is the one I saw in my own second-grade classroom a few years back.

When I was a kid, I loved show-and-tell. So I always have a few sessions with my students. It helps them get over shyness and usually, show-and-tell is pretty tame. Kids bring in pet turtles, model airplanes, pictures of  fish they catch, stuff like that. And I never, ever place any boundaries or limitations on them. If they want to lug it to school and talk about it,  they're welcome.

One day this little girl, Erica, a very bright, very outgoing kid, takes her turn and waddles up to the front of the class with a pillow stuffed under her sweater. She holds up a snapshot of an infant. "This is Luke, my baby brother, and I'm going to tell you about his birthday.

First, Mom and Dad made him as a symbol of their love, and then Dad  put a seed in my Mom's stomach, and Luke grew in there.  He ate for   nine months through an umbrella cord."

She's standing there with her hands on the pillow, and I'm trying not to laugh and wishing I had my camcorder with me. The kids are watching her in amazement. "Then, about two Saturdays ago, my Mom starts saying and going, 'Oh, oh, oh!' Erica puts a hand behind her back and groans. "She walked around the house for, like an hour, 'Oh, oh, oh! Now the kid's doing this hysterical duck walk, holding her back and groaning.

"My Dad called the middle wife. She delivers babies, but she doesn't have a sign on the car like the Domino's man." "They got my Mom to lie down in bed like this." Then Erica lies down with her back against the! wall. "And then, pop! My Mom had this bag of water she kept in there in case he got thirsty, and it just blew up and spilled all over the bed, like psshhheew!" This kid has her legs spread and with her little hands are miming water flowing away. It was too much!

"Then the middle wife starts saying 'push, push, and breathe, breathe.'" "They started counting, but never even got past ten." "Then, all of a sudden, out comes my brother. He was covered in yucky stuff, they all said was from Mom's play-center! , so there must be a lot of stuff; inside there."

Then Erica stood up, took a big theatrical bow and returned to her seat. I'm sure I applauded the loudest. Ever since then, if it's show-and-tell day, I bring my camcorder, just in case another Erica comes along.

A total of 18 Russian OB providers including obstetricians, midwives and family practice doctors visited Gundersen Lutheran in La Crosse, WI from April 26 th through May 17 th. They were part of a reproductive health project between providers in La Crosse and four different cities in the Moscow Region. It is a two year project funded by the American International Health Alliance, an organization that funds several projects in the former Soviet States.

The overall goal of the project is to improve the reproductive health status of people in the Moscow Region. Specific objectives include decreasing the rate of abortion and increasing use of contraceptives. We are also focusing on sexually transmitted infections, breast health and domestic violence. A team of doctors and midwives from each city met twice in Russia during the last year. This was their first trip to the United States.

Kris Handley, class 40, leading a discussion on patient education in pregnancy.

During the visit we spent a day each observing providers in the clinic and in the hospital. We provided workshops on breast cancer, domestic violence, counseling techniques for teenagers, new methods of contraception and other topics. Kris Handley, class 41, talked with them about the role of nurses and an overview of a nurse New OB visit. Terri Payne, class 40, was ready to share with them our work in labor and delivery but unfortunately the only births we had that day were planned caesareans.

The role of the midwife is quite different in Russia. Midwives typically have 6-9 months additional education than nurses who have 2-3 years. Midwives are trained to be assistants to the OB doctor in the clinic. They do conduct some return prenatal visits and do childbirth education but otherwise their role is more like our Medical Assistant role. They do not have other nurses or Medical Assistants in the OB clinics so the midwife is the only one who can get the chart, do weights and BPs etc. In the hospital midwives deliver babies but do not manage labor. An OB makes most of the management decisions. We spent quite a bit of time talking about the differences in roles and how midwives could help to meet the additional educational needs of patients that the doctors complain they do not have enough time to do.

Women who get early abortions report to a special section of the hospital where doctors who only do abortions work. They get no education regarding contraception unless they return to the clinic 2 weeks later to see their gynecologist. We are working to change this and also adding classes about contraception during childbirth classes and post partum. In addition, they are creating a curriculum for sexual education in the schools.

It is an ambitious project especially considering that the salaries of doctors and nurses are already so low in Russia and the project is completely voluntary. I really admire the hard work and willing attitude of their providers. Doctors generally make less than $200 per month and midwives make less than half that amount. Working internationally has really opened my eyes to our wealthy health care system and the huge amount of waste. We really take so much for granted. An hour of pain relief with an epidural here would pay for the salary of a midwife in Russia for a year.

Russian Birthing Room (Man in green is looking at the delivery table)