The Course of Instruction
Each module in the midwifery program is completed in one month and the knowledge gained in each module provides the foundation for the next module’s learning activities. There are 38 required modules. Students attend class all day once a week and must complete an internship with one or more approved preceptors. The North American Registry of Midwives certification examination is the final examination required for graduation from the program. Students are in the classroom setting for a minimum of 912 clock hours of didactic instruction and practicum. Completion of the clinical portion of the program requires 2,000 hours of supervised clinical experience with an approved preceptor. The entire program requires a minimum number of 2,912 clock hours of education. Because of the prescribed program structure, enrollment status for all students is considered full time. Nizhoni reserves the right to alter, modify or change the order of modules at any time.
Student Orientation is provided to acquaint incoming students with the midwifery education program. Students meet with faculty, administrators, graduates, and student representatives from other cohorts to learn what they may expect in the midwifery program.
1. Foundations of Midwifery (24 hrs. didactic)
The introduction to the Midwives’ Model of Care establishes the context for professional midwifery practice. Students discuss the social and political landscape of contemporary midwifery and global, national, and local professional issues. Introduction to evidence-based best practices in midwifery.
2. Practice Documentation (24 hrs. didactic)
Introduction to legal and ethical guidelines for documentation of patient care. Students apply medical terminology to simulated patient care scenarios. Informed consent is introduced as the cornerstone of the midwife-patient relationship.
3. Midwifery and the Law (24 hrs. didactic)
Laws relative to midwifery in the students’ intended areas of practice. Legislative systems as mechanisms for improving the legal climate of birth locally and globally.
4. Cultural Sensitivity and Communication Skills (24 hrs. didactic)
Communication, education, and counseling skills with emphasis on cultural sensitivity, learning styles, social styles, and versatility in human interaction.
5. Midwifery Research (24 hrs. didactic)
Introduction to basic statistical applications used for midwifery and medical studies. Evaluation of research studies for merit and evidence-based practices.
6. Introduction to Midwifery Skills (18 hrs. didactic, 6 hrs. practicum)
Universal precautions, aseptic technique, and basic midwifery skills with skills practice for clinical settings.
7. Foundations of Reproductive Science (24 hrs. didactic)
A review of reproductive anatomy and physiology, genetics, fetal development, and teratogenic complications related to pregnancy with applications to midwifery, preconceptional counseling, and referral to maternal-newborn specialists.
8. Complete Health Assessment (18 hrs. didactic, 6 hrs. practicum)
Detailed midwifery and medical history, evaluation of documentation provided by other health care providers, and performance of the complete physical examination.
9. Well-Woman Care (18 hrs. didactic, 6 hrs. practicum)
Well-woman exam, including Pap testing and vaginal cultures. Evaluation, treatment, and referral for treatment of sexually transmitted diseases. Study of human sexuality and options in family planning.
10. The Placenta (18 hrs didactic, 6 hrs practicum)
The structure and function of the placenta and umbilical cord in normal and complicated pregnancies. A functional overview of fetal circulation and the baby’s transition to extrauterine life after birth.
11. Nutrition in Pregnancy (24 hrs. didactic)
The impact of nutrition in pregnancy, including prevention of complications such as preterm labor, anemia, preeclampsia, and abruptio placenta. The impact of nutrition on perinatal outcomes and long-term health indicators in women and infants.
12. Diagnostic Testing in the Childbearing Year I (18 hrs. didactic, 6 hrs. practicum)
A survey of laboratory testing in pregnancy and introduction to the use of these tests to improve pregnancy outcomes. Students learn phlebotomy skills.
13. Diagnostic Testing in the Childbearing Year II (24 hrs. didactic)
The uses of obstetrical and perinatal technologies in midwifery care. Selection of appropriate diagnostic tools during pregnancy to improve maternal-infant outcomes.
14. Prenatal Care I (24 hrs. didactic)
Critical reasoning skills relative to facilitating health during pregnancy, provision of midwifery care, and treatment of common complaints during normal pregnancy. Risk assessment relative to normal birth is a central focus of this module.
15. Prenatal Care II (18 hrs. didactic, 6 hrs. practicum)
Clinical skills involved in the provision of prenatal care. Students learn about the unique value of the home visit and explore the psychosocial impact of abuse issues relative to pregnancy, birth, and perinatal outcomes.
16. Complications of Pregnancy I (24 hrs. didactic)
Recognition and treatment of pregnancy complications from conception to 28 weeks gestation.
17. Complications of Pregnancy II (18 hrs. didactic, 6 hrs. practicum)
Recognition and treatment of pregnancy complications from 28 weeks gestation to term.
18. Assessment of Fetal Well-Being (18 hrs. didactic, 6 hrs. practicum)
Low- and high-tech approaches to the assessment of fetal well-being, including the indications for consultation and referral in the presence of complications.
19. Normal Labor and Birth (24 hrs. didactic)
The significance of neuro-hormonal pathways relative to labor and common variations that occur in normal childbirth.
20. Intrapartum Care (24 hrs. didactic)
Skills to support the laboring woman and development of practices, skills, and attributes required to assist a primary midwife during labor, birth, and the immediate postpartum period. Introduction to fetal heart rate patterns and monitoring in labor.
21. Pharmacology I: Intro. to Biomedical Pharmacology (18 hrs. didactic, 6 hrs. practicum)
Biomedical pharmacological treatment of problems during pregnancy, birth and the postpartum period. Correct techniques for administration of medications.
22. Pharmacology II: Intravenous Therapy for Midwives (18 hrs. didactic, 6 hrs. practicum)
Applications of basic chemistry to fluid and electrolyte balance. Selection and administration of IV fluids during pregnancy, labor, birth, and the postpartum periods.
23. Pharmacology III: Intro. to Traditional Chinese Medicine (12 hrs. didactic, 12 hrs. practicum)
Introduction to theories and philosophies of Chinese medicine, acupuncture, and acupressure, with applications to pregnancy and well-woman care.
24. Pharmacology IV: Homeopathy for Midwives (12 hrs. didactic, 12 hrs. practicum)
Foundation principles of homeopathic practice with techniques for acute prescribing for mothers and infants.
25. Pharmacology V: Botanical Medicine (12 hrs. didactic, 12 hrs. practicum)
Botanical pharmacology as applied to women’s health care. Students learn practical skills for making herbal preparations of all types.
26. Pharmacology VI: Intravenous Skills Practicum (12 hrs. didactic, 12 hrs. practicum)
Techniques for starting an intravenous infusion. In combination with Pharmacology I, satisfies requirements for Intravenous Therapy Certification standards for midwifery practice in California and other states.
27. Perineal Integrity and Repair (12 hrs. didactic, 12 hrs. practicum)
Preservation of the perineum, lacerations, episiotomy, and techniques of perineal repair. Sterile technique, selection and use of sutures and surgical equipment, administration of local anesthesia, and use of both hand and instrument ties.
28. Intrapartum Complications I (18 hrs. didactic, 6 hrs. practicum)
Treatment of complications of labor and birth, including dysfunctional labor, recognition and evaluation of abnormal fetal heart rate patterns, meconium staining, and the needs of clients planning a vaginal birth after cesarean section.
29. Intrapartum Complications II (18 hrs. didactic, 6 hrs. practicum)
Comprehensive overview of the management of complications of labor and birth, including hospital transport, recognition and treatment of shock, assisted and operative deliveries, hemorrhage, placental abnormalities, and shoulder dystocia.
30. Intrapartum Complications III (18 hrs. didactic, 6 hrs. practicum)
Continued overview of the management of complications of labor and birth, including malpresentations, emergency breech births, and multiple gestation. Considerations of vaginal birth after cesarean section.
31. The Postpartum Period (24 hrs. didactic)
The normal postpartum course with recognition and treatment of postpartum complications and application of appropriate practice guidelines.
32. Care of the Normal Newborn (18 hrs. didactic, 6 hrs. practicum)
Indicators of normal neonatal transition and effective practices for stabilizing the baby after the birth. Complete newborn physical examination and care of the infant during the first six weeks of life, including metabolic screening and referral.
33. Complications of the Neonatal Period I (18 hrs. didactic, 6 hrs. practicum)
Neonatal complications and guidelines for treatment and referral of babies with complications to hospital-based providers.
34. Complications of the Neonatal Period II (18 hrs. didactic, 6 hrs. practicum)
Continuation of Module 34, including support of women and their families when outcomes are difficult.
35. Infant Feeding (24 hrs. didactic)
Biologic breastfeeding and management of common complications of nursing. Local and global politics that affect patterns of infant nutrition.
36. Midwifery Care in a Global Context (18 hrs. didactic, 6 hrs. practicum)
Review of research regarding measures of maternity quality improvement in order to examine trends and disparities in benchmarks of maternal-newborn and community health care. Consideration of global, national, and local health care services to improve access to midwifery resources.
37. Birth Disaster Preparedness Training (6 hrs didactic, 18 hrs practicum)
Recognition of high-risk pregnancies and management of obstetrical emergencies in out-of-hospital, low-resource settings. Disaster preparedness simulation exercises that require students to apply concepts and skills acquired over the duration of their educational program.
38. The Midwifery Practice (24 hrs. didactic)
Market analysis, business plan development, practice marketing, insurance coding and billing, and tax requirements for midwifery practices.
The Integration Phase allows a student additional time, if needed, to complete graduation requirements, including supervised externship, during which time the student functions as a primary midwife under supervision. The length of the Integration Phase is a minimum of three months and varies according to the individual needs of the student.