Curriculum Overview by Quarter

First Quarter

Academic: 319 Contact Hours / 31.9 Academic Credits

This quarter serves as an introduction to midwifery and provides an opportunity to acquire basic midwifery skills. Classes are usually on Monday, Tuesday and Thursday from 1:00 to 4:00 PM. The Tuesday class is devoted to “birth talks” where students have the opportunity to discuss and review the births that they have recently attended. First Quarter classes concentrate on pregnancy and prenatal care and include:

Introduction to Midwifery & Orientation (43 hours / 4.3 credits)

• Orientation I
• Orientation II
• Regulation of Midwifery
• Ethics in Midwifery Practice
• Client Care & Education
• Infection Control & Applied Microbiology
• Writing Practice Protocols
• Medical Terminology
• Orientation Synthesis

Prenatal Care (44 hours / 4.4 credits)

• Initial Interview & Communication Skills
• Prenatal I—Maternal Assessment
• Prenatal II—Venipuncture
• Prenatal III—Abdominal Exam
• Nutrition and Lifestyle
• Pregnancy Discomforts

Basic Intrapartum & Postpartum (27 hours / 2.7 credits)

• Labor Support & Documentation
• Birth at Maternidad La Luz
• Immediate Postpartum Skills
• Neonatal Skills
• Postpartum Skills
• Breastfeeding

Well Woman Care (34 hours / 3.4 credits)

• Self-Breast Exam
• HIV/AIDS/Hepatitis A, B, & C
• Physical Assessment
• Sexually Transmitted Infections
• Principles of Preventive & Community Health in Well Woman Care
• Family Planning

Psychosocial & Cultural Issues in Midwifery Care (25.0 hours / 2.5 credits)

• El Paso & Juarez: Living on the Border
• Antiracism
• MLL Spanish Phrases
• Domestic Violence & Sexual Abuse
• Special Topics in Midwifery Care

Anatomy & Physiology (23 hours / 2.3 credits)

• A & P I—Reproductive System
• A & P II—Female Endocrine System
• A & P III—Pelvimetry
• Maternal Adaptation I: Integumentary, Skeletal, Muscular & Cardiovascular Systems
• Maternal Adaptation II: Lymphatic, Respiratory, Nervous, Urinary & Gastrointestinal Systems

Laboratory Work & Screening (35 hours / 3.5 credits)

• Applied Chemistry: Laboratory I & II
• Genetic Screening & Counseling
• Ultrasound in Pregnancy

Prenatal Complications & Emergency (35 hours / 3.5 credits)

• Emergency Procedures I & II
• Emergency Skills I
• Hospital Procedures
• Anemia and Teratogens
• Hypertensive Disorders of Pregnancy
• Gestational Diabetes
• Common Prenatal Complications I & II

Topics in Midwifery (53 hours / 5.3 credits)

• Birth Talks
• Chart Review and Risk Assessment
• Consolidation of 1st Quarter Material / Exam Review

Academic work includes reading assignments, homework, research, book reports, oral presentations, site visits, take-home quizzes, and exams.

Clinical: 600 Clinical Hours / 30 Clinical Credits

During the First Quarter each student is required to work a rotating schedule of two to three twenty-four hour shifts weekly, generally in a one day on, two days off pattern. These shifts include prenatal and postpartum appointments and participation on the clinical birth rotation list. Students on birth rotation take turns with birth attendance as primary care giver providing labor support and coaching, catching the baby and providing immediate postpartum care of mother and baby; as an assistant on the birth team during second stage and immediate postpartum; or as a go-for or documenter. The twenty-four hour shifts enable Maternidad La Luz to provide continuity of care within a clinical setting.

Second Quarter

Academic: 147 Contact Hours / 14.7 Academic Credits

This quarter is designed for students who have completed the First Quarter or who have been accepted in the Advanced Placement Program. Classes during the Second Quarter concentrate on normal labor, birth and postpartum, as well as intrapartum and postpartum complications. The class schedule is the same as outlined in the First Quarter. Classes include:

Normal Labor & Birth: (29 hours / 2.9 credits)

• Physiology of Labor and Birth
• Normal 1st Stage · Normal 2nd Stage
• Normal 3rd and 4th Stage
• Normal Birth Videos
• Posterior Presentation
• Water Birth
• Fetal Heart Tones

The Postpartum: (16 hours / 1.6 credits)

• Normal Postpartum
• Normal Neonatal Adaptations
• Newborn Issues

Intrapartum & Postpartum Complications: (52 hours / 5.2 credits)

• Shoulder Dystocia
• Hemorrhage and Shock
• Uterine Complications
• Prematurity, SGA, & IUGR
• Postmaturity, Postdates, LGA & Meconium
• PROM, Hydramnios, & Cord Prolapse
• Neonatal Resuscitation Program (NRP)
• Postpartum Complications
• Basic Suturing.
• Emergency Skills 2

Topics in Midwifery (50 hours / 5.0 credits)

• Birth Talks
• Chart Review and Risk Assessment
• Consolidation of 2nd Quarter Material / Exam Review

Clinical: 600 Clinical Hours / 30 Clinical Credits

During the Second Quarter each student is required to work a rotating schedule of two to three twenty-four hour shifts weekly unless in the extended program. These shifts include prenatal and postpartum appointments, labor support and coaching, birth attendance as primary care giver, assistant, documenter or gofer. This quarter will broaden the student’s knowledge of basic and advanced clinical skills and give the opportunity to increase her clinic and birth numbers. Students may take one on-call client during this quarter.

Third Quarter

Academic: 80 Contact Hours / 8.0 Academic Credits

Upon successful completion of the 2nd Quarter, students advance to intern level. Students must complete certain clinical and academic assignments before advancement. Interns continue to attend Birth Talks/Peer Review and classes, as well as Midwifery Seminar. They also participate in Community Outreach and begin preparing for their research paper and presentation. The Third Quarter, with its light class schedule, provides time for interns to integrate their academic knowledge and complete homework assignments.

Advanced Midwifery Skills: (19 hours / 1.9 credits)

• Counseling
• Childbirth Education
• Advanced Chart Review
• Advanced Physical Assessment
• Emergency Skills 3

Topics in Midwifery: (61 hours / 6.1 credits)

• Community Outreach Project
• Midwifery Seminar
• Birth Talks
• Introduction to Midwifery Research

Clinical: 600 Clinical Hours / 30 Clinical Credits

The Third Quarter focuses on improving clinical skills. Interns are given more responsibility as they continue to provide primary care under the supervision of a Senior Midwife. Clinical experience consists of two to three twenty-four hour shifts weekly. Students will also take one or two on-call clients in this quarter.

Fourth Quarter

Academic: 170 Contact Hours / 17 Academic Credits

During the Fourth Quarter interns attend Birth Talks/Peer Review on Tuesdays and participate in Midwifery Seminar. Other classes during this quarter are generally held all day on Wednesday or Friday and include:

Advanced Midwifery Skills: (45 hours / 4.5 credits)

• Breech Presentation
• Multiple Birth
• Other Presentations
• IV Therapy
• Pharmacology
• Advanced Suturing
• Home Birth
• Cesarean & VBAC

Alternative Therapies: (20 hours / 2.0 credits)

• Herbology
• Homeopathy
• Other topics have included T’ai Chi, Shamanic Journey, Pregnancy Massage, Infant Massage, Aromatherapy, etc.

Topics in Midwifery: (102 hours / 10.2 credits)

• Normal Birth II
• Midwifery Seminar
• Birth Talks
• Embryology
• Genetics
• Unexpected Outcomes & Grief
• Research Project (independent study)
• Transitioning from Student to Midwife
• Consolidation of One-Year Program Material

Emergency Skills: (3 hours / 0.3 credits)

• Emergency Skills 4

Clinical: 600 Clinical Hours / 30 Clinical Credits

Interns continue to do 2 to 3 24-hour shifts per week, providing prenatal, intrapartum, and postpartum care. They work towards mastering skills and accepting more responsibility as a midwife providing primary care under supervision. They also complete the remainder of their on-call requirement unless doing the Fifth Quarter Option.

Fifth Quarter

Academic: 84 Contact Hours / 8.4 Academic Credits

Students who have completed the One-Year Program and those enrolled in PLEP who are advance placing into the Three-Year Program become Senior Interns in the Fifth Quarter. They attend Birth Talks/Peer Review and participate in Midwifery Seminar during the Fifth Quarter. Senior interns meet individually each week with a director during Senior Intern Seminar to establish clinical goals and to assess their progress in meeting these goals. Fifth Quarter classes include:

Advanced Well Woman Care (6 hours / 0.6 credits)

• Advanced Physical Assessment
• Human Papilloma Virus

AdvancedWell Baby Care (10 hours / 1 credit)

• Child Development in the First Year
• Advanced Breastfeeding Skills
• Advanced Newborn Exam & Gestational Age Assessment

Topics in Midwifery (68 hours / 6.8 credits)

• The Past, Present, and Future of Midwifery
• Senior Intern Seminar
• Emergency Skills
• Midwifery Seminar / Peer Review
• Birth Talks

Clinical: 360 Clinical Hours / 18 Clinical Credits

This quarter is a time for clinical synthesis and continuity of care by continuing to provide care for and attending the births of their on-call clients, as well as spending the equivalent of three 12-hour shifts a week in the clinic.

Sixth Quarter

Academic: 75 Contact Hours / 7.5 Academic Credits (18-month Program) or 96 Contact Hours / 9.6 Academic Credits (3-Year Program)

The academic focus during the Sixth Quarter is on Research and Statistics. Students choose a research topic and design a research project. Students continuing in the 3-year program earn maximum credits by carrying out the research project. Other advanced classes include IV Therapy and NNR recertification. During the Sixth Quarter interns also attend Birth Talks/Peer Review, Midwifery Seminar, Senior Intern Seminar, and have classes on emergency skills and chart review.

Clinical: 520 Clinical Hours / 26 Clinical Credits

During the Sixth Quarter interns provide care for and attend the births of three on-call clients and spend the equivalent of two 24-hour shifts per week a week in the clinic.

Seventh Quarter

Academic: 78 Contact Hours / 7.8 Academic Credits

The Seventh Quarter academic classes focus on Epidemiology. During the Seventh Quarter interns attend Birth Talks /Peer Review, Midwifery Seminar, and Senior Intern Seminar, and have classes on emergency skills and chart review.

Clinical: 520 Clinical Hours / 26 Clinical Credits

During the Seventh Quarter interns provide care for and attend the births of three on-call clients and spend the equivalent of two 24-hour shifts per week a week in the clinic.

Eighth Quarter

Academic: 80 Contact Hours / 8.0 Academic Credits

The academic classes during the Eighth Quarter focus on Cultural Competency and Sociocultural Sensitivity in Midwifery Care. Interns attend Birth Talks/Peer Review, Midwifery Seminar, Senior Intern Seminar, and classes on emergency skills and chart review. They also recertify in IV therapy and neonatal resuscitation and refine their protocols, forms, business plan, and other documents needed to set up a practice.

Clinical: 520 Clinical Hours / 26 Clinical Credits*

During the Eighth Quarter interns provide care for and attend the births of three on-call clients and spend the equivalent of two 24-hour shifts per week in the clinic.

Ninth Quarter

Academic: 87 Contact Hours / 8.7 Academic Credits

The Ninth Quarter is a time for academic synthesis, is entirely independent study in addition to Birth Talks/Peer Review, Midwifery Seminar, and Senior Intern Seminar. Interns will complete all of the legal requirements to begin practice in the jurisdiction of their choice. The research paper begun during the sixth quarter should be completed and handed by the end of the Ninth Quarter.

Clinical: 520 Clinical Hours / 26 Clinical Credits

During the Ninth Quarter interns provide care for and attend the births of three on-call clients and spend the equivalent of two 24-hour shifts per week a week in the clinic.

Academic and Clinical Credits

Maternidad La Luz uses NARM’s formula for calculating academic contact hours: One contact hour is defined as fifty-five clock minutes of time. Ten contact hours of classroom instruction with 20 contact hours of additional student effort are equivalent to one quarter credit hour.

The formula for converting clinical experiences to credit hours is twenty clinical contact hours are equivalent one quarter credit hour. One clinical contact hour is defined as sixty clock minutes of time There are an average of 600 clinical hours, or 30 clinical credits, for each quarter. The mechanism for determining this was based on several factors:

• We know that every student in the One-Year Program (except extended) attends a minimum of seven 24-hour shifts in a three week time period, for a total of 672 hours at the clinic.
• Shifts sometimes run over 24 hours for postpartum care and transports.
• Students also provide care for a minimum of five On-Call clients. This care is provided in addition to regular shifts.
• Some of the time at the center is “down time”, and sometimes there are quiet nights when students sleep through the night.
• Sometimes students leave the clinic to be in class.
• Based on documentation of direct hour-by-hour care, interns and students perform a minimum of 600 direct clinical hours per quarter.