NARM Midwifery Bridge Category 1: Emergency Skills

During pregnancy and birth, maternal concerns often either start out as slight variations from normal, e.g. a slightly elevated blood pressure, or unexpectedly, e.g. a surprise breech. While these situations may not constitute emergencies from the get go, midwifes must be able to identify when action is required. This bundle addresses a variety of concerns affecting the birthing person and teaches midwives not only to identify and address them, but do so in a way that is respectful to the mother-baby unit.

$60.00 USD
Total CE Hours: 4.00   Access Time: 4 Weeks  
Lectures in this bundle (4):
Durations: 61 mins
The safe conduct of vaginal breech delivery at term

Andrew Bisits is the Director of Obstetrics at the Royal Hospital for Women, Sydney, Australia- a tertiary academic hospital which oversees   4000 births per year.  He moved there from Newcastle, 150km north of Sydney, four years ago. In Newcastle he had been the director of Obstetrics for eight years. Dr Bisits has been in full time obstetrics for 30 years this time including the training and residency positions.  He has had a strong interest in breech birth since the term breech trial was first planned. In the research arena he has a strong leaning towards epidemiology and biostatistics. In the clinical arena he has participated in several initiatives to promote normal birth through helping establish primary midwifery care programs for pregnant women. Dr Bisits has a conjoint associate professorial position with the UNSW and is on the Australian board of ALSO (advanced life support in obstetrics).

Objective 1: A clear understanding of the mechanism of normal vaginal breech birth
Objective 2: An appraisal of the evidence surrounding vaginal breech birth
Objective 3: The safe conduct of vaginal breech birth both planned and unplanned
Objective 4: Requirements for a vaginal breech service


The safe conduct of vaginal breech birth is an important competency for all maternity carers. It applies to the care of women who plan a vaginal breech birth at term or women who unexpectedly are labouring with a breech at term. Maternity carers in these situations must first have a good rapport with the woman which allows her to understand the special variations of a breech birth. Next all maternity carers need to know in detail the mechanisms of a normal breech. Correspondingly they need to know the mechanism of the abnormal breech birth and how to deal with it. These principles are best learnt in real birthing situations ; training for such situations can also occur with the excellent models that are currently available.

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Durations: 58 mins
Karen Kerkhoff Gromada, MSN, RN, IBCLC, FILCA
Multiple pregnancy and birth perinatal care – one size does NOT fit all
USA Karen Kerkhoff Gromada, MSN, RN, IBCLC, FILCA

Karen Kerkhoff Gromada, MSN, RN, IBCLC, FILCA works part-time on special lactation consultant projects for TriHealth Hospitals (Cincinnati, OH) after more than two decades of private and hospital IBCLC practice. She has worked as an adjunct clinical instructor for the University of Cincinnati College of Nursing and has experience in labor and delivery, childbirth education and postpartum discharge care. A La Leche League leader since 1975, she formed the first LLL group for mothers of multiples after the birth of her twin sons and still leads this group. The experiences of the group’s mothers provided the basis for her book Mothering Multiples: Breastfeeding and Caring for Twins or More. Her numerous articles and chapters about breastfeeding multiples have been published in professional and lay publications. A former ILCA president (1994-96), she was designated Fellow of the International Lactation Consultant Association (FILCA) in 2008.

Objective 1: Identify evidence-based maternal and fetal risks pertaining to multiple pregnancies and births.
Objective 2: Describe strategies that empower women having multifetal pregnancies to partner with obstetric healthcare providers in order to attain childbirth goals.
Objective 3: Discuss strategies for adapting prenatal education and birth planning to meet an individual woman’s needs and goals for multiple pregnancy and birth.

USA Karen Kerkhoff Gromada, MSN, RN, IBCLC, FILCA

Multifetal pregnancies – twins, triplets and higher-order multiples – are at increased risk for pregnancy and birth-related complications. However, many women, and even their obstetric care providers, don’t seem to understand the literal meaning of the “high risk” label. For many, it will change every aspect of long-held desires and plans for pregnancy, birth, type of obstetric care provider and birth place, unless that woman receives the knowledge and support needed to take “control” of her pregnancy and her babies’ birth. This session will look at the increased risks associated with multiple pregnancy and birth, and the meaning “high risk” should have for the expectant mother. Strategies will also be discussed about ways to help empower these women so they become partners with their obstetric healthcare providers in order to achieve childbirth goals.

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Durations: 60 mins
Sandra J. Edson, MSN, RNC-OB, C-EFM
Hypertensive Disorders in Pregnancy and the Postpartum Period
USA Sandra J. Edson, MSN, RNC-OB, C-EFM

Sandra received her BSN from Shenandoah University in Virginia in 2005 and began work at Yale-New Haven Hospital in Labor & Birth shortly thereafter. After gaining 3 years of L&D experience at Yale, she relocated to VT and took a job in the Birthing Pavilion at Dartmouth-Hitchcock Medical Center in Lebanon, NH where she stayed for 4 years gaining experience in their LDRP. While at Dartmouth, she obtained her MSN in Nursing Education from Norwich University. In 2014, she has accepted the role of Birth Center Nurse Educator at the University of Vermont Medical Center in Burlington, VT. She is certified in inpatient obstetrics as well as electronic fetal monitoring, an NRP regional trainer and an AWHONN Fetal Monitor Instructor. Sandra is the section Chair of the VT AWHONN section and a 2015 AWHONN emerging leader. She lives in Williston, VT with her three children. She is very passionate about Women’s Health, Obstetrics, and Newborns!

Objective 1: To understand the classification of hypertensive disorders in pregnancy and the postpartum period.
Objective 2: To review the recommendations for the ante, intra, and postpartum nursing management and assessment of preeclampsia.
Objective 3: To review the recommendations for use of antihypertensive agents in preeclampsia and the use of magnesium sulfate in the management of patients with preeclampsia.

USA Sandra J. Edson, MSN, RNC-OB, C-EFM

One of the most common disorders seen in pregnancy today falls into the realm of “hypertensive disorders of pregnancy” occurring in 12-22% of pregnancies. Understanding the classification and management of this population of patients will allow for better care and improved outcomes. Not only do these disorders account for 17% of maternal mortality in the United States but also account for one of the leading causes of premature birth which increases neonatal morbidity and mortality. National and International organizations have developed guidelines for the management of hypertensive disorders in pregnancy to reduce maternal mortality. These organizations include the American Congress of Obstetrics and Gynecologists (ACOG), National Institute for Health and Clinical Excellence (NICE), and Society for Obstetricians and Gynaecologists of Canada (SOGC). This presentation will review some of the guidelines developed and the importance of an interdisciplinary approach to the management of patients with hypertensive disorders of pregnancy.

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Durations: 59 mins
Nancy Irland, DNP, RN, CNM
De-Mystifying Gestational Diabetes
USA Nancy Irland, DNP, RN, CNM

- Nancy Irland, DNP, RN, CNM, is a highly respected nurse, author, and clinical leader. Her obstetrical experience spans more than 44 years. She has enjoyed supporting women through their journey into motherhood as a labor and delivery nurse, certified nurse-midwife, and perinatal clinical specialist in a high risk tertiary care center. She has presented nationally and internationally, most recently at the Royal College of surgeons in Ireland (RCSI). In 2013, Dr. Irland was honored by the Oregon March of dimes as Nurse Educator of the Year. She is the past AWHONN Oregon Section Chair, and has served on the editorial board of Nursing for Women’s Health. In that capacity, she wrote a column titled, “Understand What You Know.”Dr. Irland’s passion is creating materials for other peoples’ success. She incorporates humor and metaphor in her teaching, and is sure to provide you with “Aha!” moments that you can take back to work immediately.

Objective 1: Review the physiology of diabetes in pregnancy
Objective 2: Anticipate the potential impact of diabetes on both fetus and mother.
Objective 3: Recognize the epigenetics of diabetes in pregnancy, and the damaging role of insulin
Objective 4: Discover the impact of narrative on learning
Objective 5: Apply understanding of gestational diabetes to interventions and patient teaching

USA Nancy Irland, DNP, RN, CNM

Everybody loves a story! Diabetes concepts are easily understood by many when they are presented in narrative format. In this presentation you will learn not only the science behind high blood sugar’s negative effects on a developing fetus, you will also see how to draw them to make them memorable. The presentation will include a review of carbohydrate counting and the decision-making behind insulin dosing. By the end of the session, you should be able to explain diabetes concepts confidently, with uncomplicated illustrations to draw as you teach your patients.

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Midwifery CEUs (MEAC Schools):
Midwifery Education and Accreditation Council (MEAC) are applicable to CPM's & Recertification through NARM. Certain presentations will also qualify towards the Midwifery Bridge Program requirements. 4 MEAC CEU's Approved! (equivalent to 4.0 NARM CEU's)

If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please sent us an email to if you have any questions.

Presentation Original Offered:

GOLD Perinatal Online Conference: 2016
De-Mystifying Gestational Diabetes by Nancy Irland
GOLD Perinatal Online Conference: 2015
Hypertensive Disorders in Pregnancy and the Postpartum Period by Sandra J. Edson,
Multiple pregnancy and birth perinatal care – one size does NOT fit all by Karen Kerkhoff Gromada
GOLD Perinatal Online Conference: 2014
The safe conduct of vaginal breech delivery by Dr. Andrew Bisits

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