Those who apprenticed at Casa...

[Maggi315]

HI,
I need to get more catches to sit for the CPM. I am already taking my own clients but only have 1 due before next deadline for NARM. I really want to take it!!! I have waited a long time and thought I had all of my births, but due to a miscommunication with my preceptor and NARM, I don't

So, anyway, one of my friends mentioned Casa to go for 2 weeks or so to get my catches done. Anyone do a short term like this? Will they even let me catch right away? (I have finished apprenticeship already, all skills, everything else done!) My family would come and stay with my husband in a hotel or something, I can't leave little ones for too long, although I understand that I will be very busy and only see them occasionally.

I know there must be threads about this, but I couldn't find them on search, so if you know of one, could you link me?

[tema]

I think it's possible..

It depends how many 'catches' you need, I think...Casa is busy, when I was there in 2003 they used to have about 90 births a month, but some times are slower than others...so you might have shifts with nothing going on...be prepared to maybe not get ALL your numbers...as there are also other students there at the same time...so your roles changes, sometimes you're a primary, sometimes a secondary midwife..
There were some students who came in looking for a certain number of births when I was there and not all of them got it...it will depend on how many births you need.

I had no prior experience before Casa and I did my first birth as a primary under supervision about 10 days later...people who had more experience were put to work earlier...

You could call Casa and explain your situation...I'm sure they'll want to see you for at least a day or two show your skills and adjust to Casa routines...

I stayed at Casa for three months and my family came along...my husband was a SAHD to my 2 yrs old son at that time...it's doable but shifts are 12 hours long, be prepared for that...

Send me a PM if you need more info...

[pamamidwife]

Catches are one thing, continuity of care is something different. The NARM doesn't require very many primaries - I say give it time, but that's me. I have a personal bias against places that practice on minority women so white women can benefit.

I don't mean to sound harsh, but I think that primary midwife has far more to do than how many babies have been born into your hands.

[lrpurro]

my Casa experience

Hi Barbara,

I spent 9 weeks at Casa in 2003. When I got there, I did orientation and demonstrated my skills [vital signs, basic prenatal exam skills, accurate vaginal exams, etc.] and then began "catching" babies right away. I had received 23 babies prior to Casa. I was primary at almost 30 births during my nine week stay, started three very necessary IV's, sutured 4 women [with awesome feedback from the supervising midwife who teaches suturing workshops] and actively participated in 3 transfers. It was an incredible learning experience, just know going in that it is NOT a homebirth environment! I went into the experience with "open eyes" and just learned as much as I possibly could within that particular environment.

Good luck!!!

[mwherbs]

look take the time to finish your apprenticeship. I am with pam on this one-
One of the biggest pieces of midwifery is patience -- so with your client will your preceptor support and supervise you as primary?

[Maggi315]

Well, let me clarify. I have my continuity of care patients, worked full time apprenticeship for about 15 months (practice does about 10-12 births/month), worked in clinic, blood draws, IV's, etc. So I consider myself to be experienced and ready to move out of my own. But since this mess up, I can't take the test. And my preceptor has accepted other apprentices, in fact, in December she will be taking on 2 new ones. So she will not really be able to help me much.

So what I really want to do is finish my catches (I think I need 6-7), everything else is done for NARM.

I have been working towards this for a long time, been a LLLLeader almost 10 years, a IBCLC almost 4.

I am excited about having my own clients, I would just feel better with those initials, I guess, although in my state they don't mean much. But some of the people around here feel more confident with the right initials.

Doing another full time apprenticeship over a long period will be impossible. Now that I have my own midwifery clients, lactation clients, and teach nursing students, I can't be on call for another midwife like I was before. I am working with another midwife, however, she has only had her CPM for about 1 year so she can't sign off. She would feel better if I also had my CPM when working with me.

That's why Casa seemed ideal. I don't think I would be taking advantage of these women, although I understand why some see it that way. But I need to be able to take off work and call and finish up. Or I could easily be waiting around for another year or two. And then I might lose my other midwife and some clients.

Ah, what a dilemma. On top of all of this, my husband is pushing me to go to Frontier and my CNM so I have more options (teaching, for instance) and working at a birth center. He thinks that this path is getting old, having spent so much time and money and still no return. His patience is wearing thin, I'm afraid.

OK, that is probably way too much info. Just pouring out my soul and frustrations for the world to see. But I love what I do and I am good at it, so it's impossible to stop! It took my 7 years to put myself through nursing school, I know I can do this!

[mwherbs]

So let me tell you about myself- I have been a direct entry, unlicensed midwife starting - 1982.... I did not continually practice, after DD#3 was about 2 or so I moved away from practice to be a full time mom- and still ended up doing a few births every year and slowly became more active again I have been to more LLL meetings than I can count-- I have trained midwives--and you know what I have been serving a 4-5 year apprenticeship to be licensed in the state I currently live in. For the most part I have been unpaid in this venture- I have exchanged my labor to obtain a license- and have done so working for/with power hungry younger newly licensed midwives who think that they know it all, and have no concept of cooperative working ( just the someone is in charge and someone is the peon) - and with the competitive older midwives who have self-esteem issues, with midwives who think I must know nothing because I was unlicensed for so long and with midwives who think I am too medical because I push for informed consent, or just the assumption that because I am older I have no idea what someone wants now, that maybe I don't understand hands off,but who are in their essence very invasive themselves- either personality wise or through certain routines they do - and yes in many ways all these women have been gracious and open because they have shared with me and have tried to further my own ambitions. it just takes as long as it takes--
I have been told by many people to just go do a quickie program- and from my own deepest history- the motivation and trauma I had that lead me into midwifery to begin with - has a realtionship to these clinics the practices are similar and the systemized mistreatment of the women does not make it right- just does not make it right --- do you speak Spanish? do you know what culturally approprate behavior is? these women like women in the past are making trade-offs -- no matter how they are treated- there is always the bait that something is better or will be better... midwifery is about serving women, uplifting women- respecting women, protecting women and their families. In essence these border clinics and the island clinics have been operating a long time- what has changed in how they function? have things improved?- what has improved ? this is the mickeyD's of midwifery--do not be tempted --

[ldsapmom]

mwherbs, that seemed harsh. Wonderful that you found your path -- every woman, every midwife -- needs to find her own path.

Good luck on your journey, Maggi.

[nurnur]

I really appreciate the feedback on casa...lurking here! I have thought of going there too and it's good to hear all sides. Thanks

[pamamidwife]

I'm curious as to why what mwherbs said was harsh...to me, its definitely the reality. There is much more to becoming a mw than numbers.

[Babes in arms]

Originally Posted by Maggi315

Doing another full time apprenticeship over a long period will be impossible. Now that I have my own midwifery clients, lactation clients, and teach nursing students, I can't be on call for another midwife like I was before. I am working with another midwife, however, she has only had her CPM for about 1 year so she can't sign off. She would feel better if I also had my CPM when working with me.

Why can the CPM not sign off after 1 year of practice? Does your state have regulations about this?

[Charmie981]

A CPM signing off for NARM (and not for a state) as a preceptor must have three years of experience in order to be a NARM qualified preceptor. The exception is if your state is listed on NARM's website as a state where NARM accepts their training requirements (I believe the word is equilivency) and in that case NARM accepts preceptors who have less than 3 years of experience. Texas and Lousiana fall into this category.

Regarding Casa or other "other culture" birth centers. I have experience with one, and went to get 6 or so catches. It was very hard on me financially and emotionally. The trade off, however, was to stay in an unhealthy apprenticeship situation for another 6-12 months and I chose the lesser of two evils. Knowing what I know today I'd make the same decision again, but I wouldn't be nearly as excited about it as I was two years ago.

[Maggi315]

And the CPM must have 50 OOH births in those 3 years. I know a few I could travel and possibly work with, but they only doing about 1 birth per month so they wouldn't qualify either.

I think the whole apprenticeship system needs revamped. I mean, you are at the mercy of whoever is your preceptor, how they treat you, what they will/will not sign off. Then some of them turn around and don't want the competition.

I know that issue has been discussed to deat on sagefemmes and RMA yahoo groups, but the more I talk with other apprentices and new midwives the more I find it to be true.

And I understand the flipside that the experienced midwives are giving of their time, energy, etc. to help an apprentice who statistically won't even be practicing in a few years.

[Charmie981]

Originally Posted by Maggi315

I mean, you are at the mercy of whoever is your preceptor, how they treat you, what they will/will not sign off.

YES, we are, aren't we?

I agree that some standardization in the apprenticeship model would probably be very beneficial.

[mwherbs]

I don't think that standardization improves much- look at the medical models- nurses and docs have a great deal of abuse they go though--
I am sorry that it is yucky to work with
now why would the 1/month midwives not do if they have been a CPM for 3 years? that is basically what I have been doing working with low birth numbers in a rural area-

and there are some recommendations for apprentices that we should all take heed of- like getting everything signed as soon as possible after having done the action.. so you have managed a birth- put together the info on the log and have the mw sign it-

how about using a mediator to help if you are having trouble with a particular mw you worked for in the past?

maybe what else we need is a board or something where openings can be posted for some short term assisting- I know that north of here I was offered a couple of situations - but I could not leave my family for the time it would take.

[ldsapmom]

Originally Posted by pamamidwife

I'm curious as to why what mwherbs said was harsh...to me, its definitely the reality. There is much more to becoming a mw than numbers.

I thought it seemed more along the vein of, "This is how I did it -- I struggled, pulled myself up by my bootstraps, and I didn't conform to needing any standarization, and this was the right way to do it." It seemed to show her experience as an ideal to follow, not a 'one way to do it.' She was painted as the underdog in her community, and she categorized those she works alongside with as less-than (power-hungry, or self-esteem issues). At most, she appears to not think highly of the midwives she has around her. At least, she appears as though she is trying to prove something about the way her education has been acquired. I thought this was a direct dig at the OP's shared Leader status:

I have been to more LLL meetings than I can count

Other than a dig, I wasn't sure why she included it. The fact that the whole post seemed written very quickly, further fueled the idea that she was writing a little more in anger than in wanting to help enlighten a fellow midwife-mama who was looking for some insight.

But I am on my high pms'ing days, so I could be reading into it .

[mwherbs]

Originally Posted by ldsapmom

I thought it seemed more along the vein of, "This is how I did it -- I struggled, pulled myself up by my bootstraps, and I didn't conform to needing any standarization, and this was the right way to do it." It seemed to show her experience as an ideal to follow, not a 'one way to do it.' She was painted as the underdog in her community, and she categorized those she works alongside with as less-than (power-hungry, or self-esteem issues). At most, she appears to not think highly of the midwives she has around her. At least, she appears as though she is trying to prove something about the way her education has been acquired. I thought this was a direct dig at the OP's shared Leader status: Other than a dig, I wasn't sure why she included it. The fact that the whole post seemed written very quickly, further fueled the idea that she was writing a little more in anger than in wanting to help enlighten a fellow midwife-mama who was looking for some insight.

But I am on my high pms'ing days, so I could be reading into it .

well lets see- I could have said I went for LLL leader stuff and did all the reading and xyz meetings ec but was turned away at the time because LLL policy at that time was to not accept midwives as leaders-- "breastfeeding should be the highest priority not birth setting" so did not want to say that- but still continued to participate actively with LLL for 15+ years- yes it was written quickly not because I am angry. quickly as in getting it all written down online timely. I am a bit angry at the midwives I have worked with - I get it that it is a mine field out there of personality quirks and temperments I also understand that being seasoned in care of others doesn't open any door for you- if anything it creates a bit of resentment- if I were a blank slate I would be better treated as an apprentice because I would have no opinion - and mws would glory in initiating me into certain bits of info and this other gal probably has some of the similar problems, including her own sensibilities that are offended by certain choices actions her past senior midwife has made- so if anything I gave her my info mostly because I identify with her plight and the impatients you can have to be done but yes I still have some standards- and the remote locals caring for brown folks -places where you too can yell in a woman's face to push harder- even if she is screaming and trying to get away from you, or learn to give pitocin in off label ways.. in doses that match IVs , or slip um cytotec.. lets see in Jamica - you can learn how to do nothing for a laboring woman and snap that perineum back at just the right time to prevent tears- and catch all sorts of babies for the poor and indigent. women laying flat on their backs, possibly shaved - when we talk about not liking what is happening in hospitals here and the lack of informed choice- what are the informed choices of these women- we are stepping into similar "medical provider" roles when we go to clinics in hospitals and we are treating women the way they have been treated by docs in this country in fact worse than the docs in this country because we have patient advocacy and some degree of cultural warewith all ... Navelgazing midwife went to one of the southern clinics she has some far stronger things to say about it than I ...

There are some long term programs that women spend 1 year in the Philliphines and get 1 weekend off in that time and you work clinic and births-- sort of 3rd world emersion- and after you are done to hold up your end of the bargain you owe some training time - to train other midwives around the world, maybe a bit better than the quick get the numbers in stuff.

[vanessab23]

Originally Posted by Maggi315

And the CPM must have 50 OOH births in those 3 years. I know a few I could travel and possibly work with, but they only doing about 1 birth per month so they wouldn't qualify either.

I think the whole apprenticeship system needs revamped. I mean, you are at the mercy of whoever is your preceptor, how they treat you, what they will/will not sign off. Then some of them turn around and don't want the competition.

I know that issue has been discussed to deat on sagefemmes and RMA yahoo groups, but the more I talk with other apprentices and new midwives the more I find it to be true.

And I understand the flipside that the experienced midwives are giving of their time, energy, etc. to help an apprentice who statistically won't even be practicing in a few years.

:
much needs revamping...especially the apprenticeship model.
I did MLL-- and then stayed to work for while. Loved & hated it at the same time. But I got a lot of clinic experience. what i regret is that I still haven't attended a homebirth. that seems REDICULOUS, no?

--Vanessa

[pamamidwife]

it is hard to apprentice if births are rare in the community you live, I understand.

I also know that a high volume birth center will NOT prepare you for homebirth midwifery on your own. It just won't. The continuity of care, paperwork, business side, etc., are not available for you in the same way.

I worry about students putting so much emphasis on hurrying through and getting "numbers"....you may get your CPM, but you also may not be as prepared as you believe to practice solo.

Then there's the whole racism issue for me, too.

[Lizafava]

Originally Posted by pamamidwife

it is hard to apprentice if births are rare in the community you live, I understand.

I also know that a high volume birth center will NOT prepare you for homebirth midwifery on your own. It just won't. The continuity of care, paperwork, business side, etc., are not available for you in the same way.

I worry about students putting so much emphasis on hurrying through and getting "numbers"....you may get your CPM, but you also may not be as prepared as you believe to practice solo.

Then there's the whole racism issue for me, too.

This is a really tough issue! For people who are interested in becoming midwifes in places where homebirth midwifes are illegal, rare and who maybe don't have the best records as preceptors - what should they do?! I know the few midwifes around here have come to their profession in ways others *might* not find safe or acceptable. But the only other alternative is UC or HB with an OB, and so it goes. I posted about this awhile back, and I am still really stuggling with it. I am extrememly disturbed by the racism inherent in the Casa model, but seriously wonder how else anyone who lives in a place like this could get numbers and experience without leaving the community for a very long time, or by attending a place like Casa for short period of time.

What are others ideas on this? I think expecting people to apprentice in communities like this until they have the numbers and experience is unrealistic. One MW near me attends 6 or 7 births a year, and I'm not sure she even has "the numbers" she would need to take the NARM.

I mean I guess the answer is to advocate like h*ll for a change in the laws and hope that more options follow.

Please, someone help me gain some clarity on this.

-L