the midwife’s apprentice - indie birth...the midwife’s apprentice self-study guide volume 1 the...

INDIE BIRTH

52 Weeks of Study for the Beginning Midwife

THE MIDWIFE’S APPRENTICESelf-Study Guide Volume 1

THE MIDWIFE’S APPRENTICE

SELF-STUDY GUIDE Before diving in, make sure you have joined the Indie Birth Aspiring Midwives group on Facebook. As you work through the questions, feel free to post ones that you’re stuck on, share your answers, and engage in discussions around them with the Indie Birth crew and your fellow apprentices. We’ll chime in with extra resources, alternative perspectives, etc. And if you aren’t already enrolled in our Indie Birth Midwifery School, and want more structure and accountability during our insanely cool 2 year online program, please go learn more at indiebirthmidwiferyschool.com. You’re welcome to go through these faster or slower than outlined, but we HIGHLY encourage you to check in on the Facebook group weekly to let us know where you’re at, since you’re much more likely to succeed in community than you are on totally on your own. Week 1

1. What is the “typical” prenatal visit schedule (how many weeks apart?)? Why might it be set up that way?

2. What is blood volume expansion and how is it accomplished? Week 2

Copyright Indie Birth Association 2017

1. What lab tests and ultrasounds are generally offered at the first visit in mainstream US care? Describe what each of them looks for. Many of my clients decline some or all of these, but it is important to know what they are!

2. What IS blood pressure? How is it measured? How do you take a blood pressure?

Week 3

1. What are the categories of the Brewer Diet? What are your favorite 2-3 foods in each category?

2. What are some of the concerns about the safety of ultrasounds use in pregnancy?

Week 4

1. Read about how to palpate a baby (and watch our IB video on this). When we talk about fetal lie, what are some common acronyms that we use to describe a baby’s position, and what do they mean?

2. Learn as much as you can about fetoscopes! Where would you expect to find the baby’s heartbeat with a fetoscope? How early can you hear a baby’s heartbeat with a fetoscope?

Week 5

1. At what gestation of pregnancy might you first hear the heartbeat with a doppler?

2. Define “fundus”. At what point in pregnancy would you begin measuring the fundus with a measuring tape? How would you also use your hands to assess size/growth?

3. Research 3 different methods of calculating a due date. How would you come up with a date if the woman did not know or have a “last menstrual period” date?

Week 6

1. Does research support routine use of urinalysis sticks prenatally, or not? 2. What are all the components on a 10-11 parameter urinalysis stick and

what might they indicate? 3. Besides urinalysis, how can we assess a urine sample with our senses and

what do the results mean?


Week 7

1. Describe the use of pH paper for assessing vaginal pH and infection. What is a normal vaginal pH? Wha do acidic/alkaline variations possibly mean?

2. Briefly research vaginal yeast (candida) infections and bacterial vaginosis. Compare and contrast the two.

Week 8

1. Why might a pregnant woman experience swelling? What does it mean and where might she experience it, and at what gestation?

2. Describe how swelling is assessed. Week 9

1. You are concerned that one of your clients may have iron deficiency anemia. What are her signs and symptoms that lead you to investigate?

2. Besides s/s, you decide to turn to labwork for a diagnosis. What tests do you order and why? What results may indicate that she is indeed anemic? What remedies/solutions do you suggest to her and why?

Week 10

1. At what gestation would you expect the mom to begin feeling fetal movement? How might she describe this? When would expect her to feel kicks? What is the upper limit of gestation on this before you might be concerned? If someone wasn’t feeling any movement by this upper limit, what would you do or say?

2. A mom who is 21 weeks reports sporadic movement; one day she feels it, the next she does not. What would you do or say to her?

3. How would you describe and then teach a fetal kick count to a mom? When should kick counts begin?

Week 11

1. A mom at 18 weeks is complaining of headaches. What do you ask her? What are some remedies to help her and why?

2. A mom at 20 weeks calls you because she started spotting bright red blood. What do you ask her? What do you do to assess the situation?

Week 12


1. A first time mama client has confided in you that she’s an abuse survivor. What do you do with this information? What do you say to her? What resources can you share?

2. Another first time mama client is feeling unsupported by her family in her choice to birth at home. What do you say to her and what resources or things can support her?

Week 13

1. A client at 20 weeks reports being constipated. What do you ask her? What do you suggest?

2. A client at 35 weeks reports horrible heartburn at night that is keeping her up. What do you ask her? What do you suggest?

Week 14

1. You notice at a prenatal visit that your client’s lips are really dry. You take her pulse and it is 92. What do you ask her? What might you suggest?

2. Your client wants to know if it’s ok for her to travel by plane at 35 weeks. What do you suggest and why?

Week 15

1. Define oligohydramnios. What might this feel like when palpating? Feel like to the mom What might it mean?

2. Same question but define polyhydramnios. Week 16

1. Define pre-eclampsia. What are signs of potential pre-eclampsia? 2. How would you confirm or deny true diagnosis of pre-eclampsia?

Week 17

1. What is “gestational diabetes”? 2. How is a mom diagnosed with GD and what might the diagnosis mean? 3. If you were going to test a mom’s blood sugar, how would you do it? What

would be a healthy result? What results would concern you? Also, what happens to blood sugar levels in general in pregnancy?

Week 18


1. What signs/symptoms would make you suspect a baby in a breech position? What might mom report? What might you notice or feel?

2. What discussion would you have with the mom if you felt her baby was indeed breech at 35 weeks?

3. If she desired, what turning methods would you suggest? Week 19

1. What are s/s of premature labor? 2. What would you suggest if you indeed felt that a mom was experiencing

this? 3. Your client is 27 weeks and reports a “gush of fluid”. What do you ask?

What do you do and suggest? Week 20

1. Your 22 week client reports “not feeling connected at all with the baby”. What do you say, do or suggest?

2. What are some exercise guidelines for each trimester of pregnancy? Week 21

1. Your new client is not sure who the baby’s father is and desires STI testing. What do you discuss? What do you offer?

2. Your client has HSV-1. This is her first pregnancy and she says she has only had one outbreak years before. What suggestions/info do you give her?

Week 22

1. What are the reasons that a pregnant woman might develop a UTI? What might s/s be? How would you test? What are her treatment options?

2. A client is very prone to developing UTIs. What protocol or suggestions would you ask her to follow?

3. Why might it be dangerous to have an untreated UTI in pregnancy? Week 23

1. A client was herself born by c-section and she is pregnant for the first time. What questions do you ask? What might you recommend or suggest?

2. Research 2-3 local people (or virtual, if they do distance work) that you can refer to for working on intergenerational and cellular memory trauma.


Week 24

1. A new client is 16 weeks and you cannot palpate her fundus. List and explain all the reasons why this might be the case. With each reason, also explain how you would follow up or what you would do.

2. A new 12 week along client calls you to report bleeding and cramping. What do you do? What do you ask?

Week 25

1. Your new client asks if it’s ok for her to drink a glass of wine with dinner. She reports feeling very stressed and anxious. What do you ask her? What might you suggest? How do you follow up?

2. A mama at 25 weeks calls to say she has been having really terrible pain on each side of her belly. What do you ask her? What might you do? What do you suggest?

Week 26

1. Explain blood type and factor. Why would we want to know this about our pregnant clients?

2. Explain how a negative Rh factor may affect pregnancy and/or birth. 3. Create a document to explain the potential risks/benefits of Rhogam

(Anti-D) to an Rh negative mama. Week 27

1. Your client wants to find out what sex her baby is. What are her options? What do you recommend and why or why not?

2. Your clients want genetic testing for their baby. What information do you give them? What tests or procedures do you discuss and what are the risks/benefits of each?

3. A client’s screening test has come back as being high risk for Down Syndrome. What information do you give? What do you suggest as next steps?

Week 28


1. Your 12 week along client tells you she really thinks she is pregnant with twins. What do you ask her? What information do you try to gather at this point? What is your follow up?

2. A client at 28 weeks is measuring 34 cm. What do you ask? What do you look for? What do you do or suggest?

3. A different client at 28 weeks is measuring 22 cm. What do you ask? What do you look for? What do you do or suggest?

Week 29

1. When a pregnant client complains of back pain, what do you want to know? List all the reasons for back pain. What are your remedies for each?

2. What are some food sources of iron? Vegetarian sources? 3. What supplements do you feel are absolutely necessary? For everyone?

Why? Week 30

1. At what week of pregnancy (approximately) does the baby begin to react to external sound?

2. Explain sleep/wake cycles of the fetus to your pregnant mama. At what gestation does this begin?

3. Explain fetal hiccups. When does this begin? Why? What might a mama report when she is feeling these? What if she reports never feeling hiccups?

Week 31

1. Define “teratogen”. At what gestation in pregnancy is a fetus susceptible to teratogens? What might occur with exposure?

2. Outline fetal weight and length at 8 weeks, 20 weeks, 28 weeks and 32 weeks.

Week 32

1. When palpating, when and why would you perform a fluid “thrill”? What would you do with positive results? Negative results?

2. A mama at 34 weeks reports tons of fetal movement in the center of her belly. She also has a lot of pressure on her belly. What might you suspect the position of the baby to be? Where might you hear hearttones with a fetoscope?


Week 33

1. Make a document for your clients about self care in pregnancy. Include what that is, why, and some suggestions.

2. Make a document for your clients about oxytocin in pregnancy. Include what this is, why it’s important, how it may affect birth, and plenty of suggestions!

Week 34

1. Your 32 week client got the stomach flu and is violently vomiting and has diarrhea. What do you recommend? What questions do you ask? How do you follow up? What are the concerns?

2. What is the upper limit for having a fever in pregnancy? Why? What might you suggest to bring down a fever? What other questions would you ask if she reported a high fever?

Week 35

1. A mom calls with what sounds like prelabor s/s at 35 weeks. What do you ask her? What do you suggest? What is the earliest you feel it is “safe” to attend a birth at home? If she is indeed in labor, how do you prepare for the birth or what do you tell her?

2. Your 39 week mama has been having contractions nightly for the last week. She is tired and concerned. What do you discuss? What do you recommend? What do you “do” or not?

Week 36

1. What environmental hazards do you screen for or ask clients about? Why is this important? What suggestions do you make for someone that has a high load of exposure?

2. A mama wants to use a urine stick at her prenatal visit. She is 32 weeks. The stick comes back positive for leukocytes and nitrates. What do you discuss with her? What suggestions do you make?

Week 37

1. You are working with a mama who has a history of depression. What do you discuss with her or want to know? What resources do you have for her? How can you assess her current state of mental health?

2. What issues/concerns that a mama shares with you would have you reaching out for more professional support? Why?


Week 38

1. What is the definition of hyperemesis gravidarum? 2. How might you assess if someone is experiencing HG? What resources or

support would you offer? Week 39

1. WHat is PUPPS? How might it be diagnosed? What is the treatment? 2. Research other skin disorders in pregnancy. Make a document with

diagnosis name, information, photos, treatment. Week 40

1. What are the signs and symptoms of cholestasis? 2. What are natural treatments that may help, and what is the medical

perspective on treatment of cholestasis? Week 41

1. What are some of the theories of why pre-eclampsia happens? 2. What are the criteria for diagnosing pre-eclampsia?

Week 42

1. At what gestation does the pregnant uterus begin to contract, even if the woman is not noticing?

2. What is “irritable uterus”? Who defines this? What are the treatments or suggestions? How is irritable uterus different than contractions in labor? How is it different than “pre labor”?

Week 43

1. What is group beta strep? Where is it found in the body? What is the concern in pregnancy/birth?

2. Describe the testing methods for GBS. What do the results of each mean? Week 44


1. What are varicosities? Where on the body can one find them, especially in pregnancy? What complaints may accompany a varicosity? What are suggested remedies or treatments?

Week 45

1. What are some of reasons that some women struggle with insomnia in pregnancy?

2. What are some suggestions you could give someone who was experiencing insomnia?

Week 46

1. What are the necessary items for a birth bag? Why? 2. Research chiropractic care in pregnancy. What can it help with? What are

the benefits of a chiropractic adjustment for mom and baby after birth? Week 47

1. When in the prenatal period would you take baseline vital readings? Why might you need or want that information later or at or after birth?

2. What is a normal respiratory rate? In pregnancy? What might you consider if someone has a normal than average respiratory rate?

Week 48

1. When you are apprenticing/assisting at a birth, what should your role be in the event of excessive postpartum bleeding? Describe what steps you would take, what you are thinking, and what you would be doing.

2. When you are apprenticing/assisting at a birth, what is your role in the event that a newborn needs to be resuscitated? Describe what you are thinking and doing.

Week 49

1. What does the research say about perineal massage? 2. What are some of the most popular birth prep herbal formulas that

midwives suggest? Why do they suggest them? What are your thoughts about their safety, effectiveness, and the philosophy that women may “need” something to prepare their body for birth?

Week 50


1. Using Katy Bowman’s resources, what is proper pregnancy alignment? What natural movement would you suggest in pregnancy and why? What other lifestyle suggestions might you recommend for someone?

Week 51

1. What are some recommended postpartum sitz bath herbs? What is each used for? What else can be added to a postpartum bath recipe?

2. What are options for the placenta after birth? Why might someone want to consume their placenta?

Week 52

1. What are some common pelvic floor health issues that can show up in the postpartum? Describe/define them.

2. What are some resources on restoring pelvic floor health in the postpartum? Are their any pelvic floor specialists in your area?

You Made It!


the midwife’s apprentice - indie birth...the midwife’s apprentice self-study guide volume 1 the...

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