Essential Documents for Midwifery
SBAR Transport Form
This is the form every practice must have for professional and timely Intrapartum transports.
Midwifery Apprentice Handbook
The intention of this handbook is to serve as a baseline for expectations for the midwifery student experience. The cornerstone of excellent relationships in apprenticeships is communication. We all bring our history, our needs, and our wants to midwifery. My hope for all reading this manual is that the expectations laid out through these pages will serve as a catalyst for effective communication and learning throughout the dynamic relationship between a student and preceptor.
This 50 page, full-color document outlines all the details and steps of the community-based midwifery apprenticeship process in the US including chapters on appearance & conduct, confidentiality, attending births, universal precautions, postpartum care, attending emergencies, equipment, self-care, hipaa & charting, graduating, dismissal from apprenticeship, and compensation. We also include a sample preceptor/ student agreement, plus a recommenced reading list, charting abbreviations, midwifery acronyms, and the master list of related organizations, associations and institutions.
If you are a midwife, purchasing this document allows customization for your own practice and use with any and all your students.
Release of Medical Records Form
Certain states have signed into law a requirement that written consent must be given to perform a pelvic exam on a client. The law references us by statute.So depending on the state you reside in, you may have to get all your clients sign a consent for you to perform a pelvic exam.
Standardized, Evidence-based, Informed Decision-Making Documents
All Informed Consent Documents Package
Purchase our whole suite of documents for a discount. A must for a new midwives, especially as a companion to the upcoming Birth Business Club Masterclass.
If you need help adding your logo or contact info or want to consult on how to implement these informed consents in your practice, please also purchase an hour or more of consulting services.
Informed Consent - Gestational Diabetes
Purchase this standardized, evidence-based, informed consent document for use in your practice.
Here is an excerpt:
"In approximately 6% of pregnancies the mother may develop Gestational Diabetes Mellitus or GDM. This is a condition in which blood sugar is abnormally elevated during pregnancy and generally develops because the pancreas cannot meet the extra requirements for insulin. Signs and symptoms of GDM are mild and mimic other signs of pregnancy: increased thirst, hunger, and urination. GDM has been linked to higher incidence of pre-eclampsia, primary c-sections, premature birth, and shoulder dystocia.
Infants born from diabetic mothers may need to have their blood sugar levels monitored for the first few days. These babies are more likely to develop low blood sugars as their bodies are now withdrawn from their mother’s continuous high glucose supply and are also more susceptible to jaundice, hypoglycemia, respiratory distress, type 2 diabetes later in life and excessive birth weight. Problems for the baby are generally related to the degree of severity of GDM in the mother." © 2019 Augustine Colebrook All Rights Reserved
 Correa, A., Bardenheier, B., Elixhauser, A., et al. (2015). “Trends in Prevalence of Diabetes Among Delivery Hospitalizations, United States, 1993–2009.” Maternal Child Health Journal. 19, vol 3(2009): 635-642.
 Clausen, T. D., Mathiesen, E. R., Hansen, T., et al. (2009). “Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes”. J Clin Endocrinol Metab;94( 2009):2464–70.
Informed Consent - HIPAA
Midwives like all health care providers need to provide clients with a HIPAA privacy practices document outlining how they will care for their medical records and other protected data. Some midwives find this topic confusing and frustrating to apply to community-based midwifery - we have taken up the challenge and have created a document that outlines all the pieces of this important national law and how they apply to midwifery clients.
And for a limited time, we are offering this Informed Consent absolutely free with any other Informed Consent document purchase!
Excerpt: "The HIPAA Privacy Rule was first enacted in 2002 with the goal of protecting the confidentiality of patients and their healthcare information, while enabling the flow of patient healthcare information when it is needed. Also known as the “Standards for Privacy of Individually Identifiable Health Information”, the HIPAA Privacy Rule regulates who can have access to Protected Health Information (PHI), the circumstances in which it can be used, and who it can be disclosed to.
The HIPAA Privacy Rule not only applies to healthcare organizations. It applies to any entity that may encounter personal information about a patient that – if it were disclosed to malevolent third party – could present a risk of harm to the patient´s finances or reputation. Therefore “covered entities” include health insurers, healthcare clearing houses, employer-sponsored health plans and third party medical service providers to covered entities – generally known as “Business Associates”.
Informed Consent - Group Beta Strep
True informed consent requires the option of refusal too. Non-biased information is vitally important when parents are being asked to decide on their children's health care - no choice could be quite as salient of this point than GBS.
Excerpt: "Group B Strep stands for Beta-Hemolytic Streptococcus. This is a type of bacteria that is usually found in the lower intestines and in the vaginal canal in 10-35% of healthy adults. GBS is not the same is Group A strep which causes strep throat and other diseases. Among pregnant women, 10-35% of women will be colonized and have GBS in their vaginal canal. Most colonized women have no problems from GBS but in some cases the GBS can cause infections that can put an unborn baby at risk. For example, a GBS infection in the urinary tract can increase the risk of a premature birth.
Approximately 50% of babies who are exposed to GBS will become colonized with the vast majority having no problems. Of those,1-2 % will develop Early Onset GBS Diseases. Of that group, there is a 5-9% mortality rate. This means, if left untreated, 1 in 17 500 babies will die from Early Onset GBS Disease.
Around 80% of GBS cases among newborns occur within the first week of life. This is called early onset disease. Most of these babies are ill within a few hours of birth; most cases can be linked to a mother who is colonized with GBS. Babies who develop early onset disease may have one or more of the following; unstable temperature, breathing problems, grunting, fever, seizures, unusual change in behavior, stiffness and/or extreme limpness." © 2019 Augustine Colebrook All Rights Reserved
 Johri, A. K., et al. “Group B Streptococcus: global incidence and vaccine development.” Nat Rev Microbiol 4 vol 12 (2006): 932-942.
 Schuchat A. “Epidemiology of group B streptococcal disease in the United States: shifting paradigms.” Clin.Microbiol.Rev. 11, Vol 3(1998):497-513
 “GBS.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, May 17, 2019. https://www.cdc.gov/groupbstrep/about/symptoms.html.
Informed Consent - Distance From Services
The NIH 2010 VBAC study says it is safe if the time from decision to incision is less than 75 min. So I have recommended clients who’s location combined with the local hospital situation is outside that limit, should be informed and consent to that increased risk for distance to services.
Excerpt: "If your midwives determines that your intended birth location would delay treatment beyond 75 min, you are aware of these increased risks and still plan to proceed." © 2019 Augustine Colebrook All Rights Reserved
Informed Consent - Genetic Screening
Excerpt: "There are many options for prenatal testing, that is, testing that parents can choose to find out more information about their baby. This information may include estimated due date, baby’s gender, and gathering details about baby’s overall health. Some parents choose to “test for everything,” others choose just the minimum, and some parents choose to decline all testing. All pregnant women have a small chance (3-4%) of delivering a baby with a physical and/or mental birth defect. Most birth defects (65-75%) have an unknown cause, whereas others are genetic (15-20%) or caused by environmental exposures (10%). Optional testing is available during pregnancy to detect some genetic disorders in the baby, including certain chromosomal abnormalities (e.g., Down syndrome) and neural tube defects (e.g., spina bifida). Families may choose to use this information to decide to terminate a pregnancy, or to become emotionally and financially prepared for a higher needs baby. Other parents, knowing they would do nothing differently if they had the information, choose to forego all or most prenatal testing options." © 2019 Augustine Colebrook All Rights Reserved
Informed Consent - Maternity Lab Tests
Excerpt: "Here at [ insert practice name] we care deeply about you and your health throughout pregnancy. Midwifery care and community birth are excellent choices for [women/people] with low-risk pregnancies. We consider the information provided by these standard pregnancy lab test to be vitally important in ensuring that your pregnancy is low-risk and appropriate for midwifery care. This document is meant to provide you with the information needed so that you can decide if this testing is right for you." © 2019 Augustine Colebrook All Rights Reserved
Informed Consent - Student Participation
Student participation is common in most midwifery practices, and yet, clients should be able to consent or refuse this at the start of care. Many disagreements and discomforts could be avoided if clients were truly informed. This informed consent aims to do just this.
Excerpt: "This practice runs partly on the help from students, you, the client can choose not to have students participate in care, but there will be an extra fee to cover the cost of hiring assistants" © 2011 Augustine Colebrook All Rights Reserved
Informed Consent - Prenatal Ultrasound
Prenatal Ultrasound has become ubiquitous in american obstetrics. If midwives don't also offer prenatal ultrasound as standard of care, we are liable for not discovering dysfunction. This doesn't mean pregnant people must choose to receive an ultrasound, but it does me that we should be offering THEM the choice, not making it for them.
This important document outlines the benefits and risks for clients to choose for themselves.
Excerpt: "Ultrasound imaging of an unborn baby is achieved by projecting intense sound waves through the tissue of the abdomen and bouncing them off of the baby. The sound waves that are reflected are interpreted by a computer and displayed as an image on a screen. Your midwives can refer you to an ultrasound clinic at various times in your pregnancy for various reasons. Routine ultrasound is an amazing tool for determining normal growth and development of larger systems in the baby's body (spine, heart, etc.), visualizing the physical symptoms of some birth defects, finding out where the placenta and cord attach to the uterus, and confirming the position of the baby. More in-depth ultrasound can be used for more detailed diagnostics when needed.
Other forms of ultrasound include the fetal doppler, which is very low-level in both intensity (megahertz frequency) and dose (strength of the signal) compared with imaging. A doppler only detects movement, such as a baby's heartbeat, and interprets the movements into sound through a speaker. A doppler with a waterproof probe can be used in a birth tub, and requires very little interruption to the laboring mother as it can be used quickly in almost any position." © 2019 Augustine Colebrook All Rights Reserved
Informed Consent - VBAC
Choosing how to birth after a c-section is a complicated endeavor - and everyone has a strong opinion about this choice. Help your clients make an informed decision by providing them with this evidence-based form for choosing Vaginal Birth After Cesarean out-of-the-hospital.
Excerpt: "[Insert Practice Name] supports a client’s right to self-determination.
Therefore, we support clients who would like to have a VBAC (vaginal birth after cesarean). We believe that in most cases, VBAC is a safe option for families. Because VBAC does carry some increased risk, we want to make sure that you fully understand the risks and benefits and are choosing this option knowing how a VBAC is different from other births.
“In keeping with past recommendations, most women with one previous cesarean delivery with a low- transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC [trial of labor after cesarean].” " © 2019 Augustine ColebrookAll Rights Reserved
 (Humphry, Laura. New VBAC Guidelines. ACOG Today, August 2010.)
Informed Consent - Water Labor & Waterbirth
Water has been shown to be incredibly helpful for laboring people in pain, however there are still some actual and theoretical risks that parents and professionals need to be informed on. This informed consent allows those risks to be assessed in conjunction with the benefits so that parents can make an informed choice to use water in their labor and/or birth.
Excerpt: "Water has many soothing benefits and has been shown to calm and comfort, especially during labor and delivery. Often called a "gentle birth," waterbirth/ water labor is a safe option for both mothers and babies. It has steadily gained in popularity in recent years all around the globe, as many women have found they prefer the calming effects of warm water to a traditional, or "land," birth.
During a waterbirth, the mother gives birth under water in a birthing tub. She may also spend part of her labor in the tub. This special tub is larger and deeper than a regular bathtub and it allows the mother to try a variety of different positions during labor and delivery. The baby emerges into the warm water before being brought out to take a first breath of air.
One common question is, "Doesn't the baby try to breathe under water?" Actually, babies start breathing when there is temperature and pressure changes and since the birth tub water is kept at body temperature the baby does not breath until it feels the different air pressure. The baby goes from the fluid in the womb, into the warm water of the tub. The baby is then gently brought out of the water. The mother can hold the baby immediately. After being brought out of the water, the baby takes a first breath of air. The umbilical cord is still attached and the baby continues to get oxygen through the cord." © 2019 Augustine Colebrook All Rights Reserved
Informed Consent - Prenatal & Postpartum Rhogam
RH neg pregnant people must choose whether or not to receive RhoGAM, help them make this critical choice by providing them this evidence based, informed consent document.
Excerpt:" Prenatal blood work test for a variety of things, one of which is blood type. A person's blood type includes being positive or negative for the Rh factor. The red blood cells of most people carry this Rh factor, making them Rh positive. Those who do not carry it are Rh negative. The only time this factor is a concern is when an Rh negative mom is pregnant with an Rh positive baby. This is only possible if the baby's father is Rh positive AND the baby has inherited the Rh positive factor. We don't know what babies blood type is until after birth, unless you choose to undergo a blood test. This blood test is extremely low risk; however, it can be expensive.
During pregnancy the mom's and the baby's blood do not usually mix, in rare cases the baby’s blood may mix with the mothers. Examples of these rare cases could include abdominal trauma such as in the case of a car accident or bad fall on the belly. If the mom and baby’s blood mix and the mom is Rh negative and the baby is Rh positive the mom's body views the baby's blood as an invader and will produce antibodies to the Rh factor. The job of the antibodies is to find and destroy the foreign factor, which in this case is the baby’s Rh-positive blood. When the mom's body begins this process, we call it “sensitization.” © 2019 Augustine Colebrook All Rights Reserved
Essential Equipment for Midwives
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