Get to know nurse Jody Lori, as we focus on maternal and child health this month on Nursing Notes Live. Jody Lori is a certified nurse midwife and is senior director of Global Affairs and director of the PAHO/WHO Collaborating Center at the University of Michigan School of Nursing. Jody specializes in safe motherhood, human rights and community-based interventions. Here’s that interview.
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Jamie Davis: Hi, Jody, welcome to Nursing Notes Live. It’s great to have you here on the show and we’ll start off with my traditional first question for our Get-to-Know Nurse each month, and that is, tell us a little bit about why you wanted to become a nurse.
Jody Lori: Thanks, Jamie. I decided to become a nurse at a very young age. It was probably mainly the influence of my mother who, for very practical reasons, told me that I should consider a career in nursing because I would always be able to find a job. So she was raised in the Depression Era and she was very cognizant of the need to be able to support yourself. So it was for a very practical reason that I went into nursing at a young age.
Jamie: So tell us a little a bit about your educational background as a nurse, how you got started in nursing and progressed to the point where you are now with the PhD and all of the other certifications and qualifications.
Jody: Sure. It was a very circuitous path. My first degree was from a community college where I attended for one year at the time and I became an LPN, which is a licensed practical nurse. I wouldn’t recommend this route to people these days. I then obtained an Associate degree, which is a two-year university degree. Then I completed my Bachelor’s degree at the University of Michigan. I practiced all along through those years. I then went into midwifery and received a Master’s degree from the University of Michigan in Maternal-Child Health and was certified by the certifying board for the American College of Nurse-Midwives. Finally, I finished my PhD at the University of Arizona in 2009.
Jamie: That’s amazing. It’s one of those continuing themes I hear from the nurses I talk with is that continued drive to seek more education either formally or through an additional degree level or at least through continuing education and advanced certifications in your specialty. Why do you think that’s so important in nursing?
Jody: I think that the field is ever-changing. I think there are so many opportunities, that continuing your education just continues to open more and more doors for you as a nurse. There was always sort of the next thing that I was interested in pursuing or the next area that I was interested in looking at that often included returning to school to further my education.
Jamie: Now you’re working in collaboration between the University of Michigan School of Nursing and the World Health Organization Maternal and Child Health, how did that come about?
Jody: So the University of Michigan School of Nursing is one of the WHO Collaborating Centers that’s been designated in the Americas. There are 18 schools of nursing in the Americas that hold this designation and actually 10 in the United States. So it’s not a very common designation. There are many kinds of collaborating centers for the World Health Organization. We belong to the PAHO region or the “Pan-American Health Organization” region so our work for WHO is within this region. There are different kinds of collaborating centers. One is in Nursing in Midwifery. You can be a collaborating center for WHO in Occupational Health for instance or in Bioengineering. There are lots of different types of collaborating centers. But there are only 44 nursing and midwifery in the entire world and as I told you earlier only 10 in the United States.
Jamie: Nurse-midwifery specifically is really one of the oldest nursing specialties and it predates organized modern nursing I guess you could even say. Why is it so important to have this opportunity to collaborate and look at dealing with maternal and child health issues in a modern society like we live in today?
Jody: Well, you know that there are still many people in the world that die during childbirth or young children that die in the first 30 days of life. There are great disparities across the world and across the Americas. For instance, a black baby born in Detroit is three times as likely to die as a white baby born in the same area in the United States. So having this WHO designation allows us to work not only in our own country though but also with other schools of nursing in other countries. So we have done projects with University of Chile with the midwifery school there. We have done work in Ecuador with the school of nursing there. We have colleagues from Brazil who are actually at our school right now working on research projects with different faculties here. So it opens a lot of doors for our students and for our faculty to do different types of collaboration around maternal-child health.
Jamie: So looking in maternal-child health here in the United States specifically, what do you see is one of the biggest issues surrounding, say, perinatal problems or challenges with childbirth and the mother? I really am curious what your thoughts are. I’ve looked up, done some research on this, and found a couple of different things, but they seem very broad. I know with your specialization, you probably have a few issues that are very of interest to you I would say.
Jody: I do. There are lots of problems and we could talk about lots of problems. March of Dimes has done a big campaign on preterm birth. So that’s a huge problem in our country. But I think from the standpoint of nursing and midwifery, when we look at childbirth, it’s a different thing than going to receive care for an illness. Most of the time when you access healthcare for whatever reason, it’s because you have a problem. You have an injury or you have a medical problem or you have a problem that needs surgery which is very medical driven, very diagnostic driven. Pregnancy, on the other hand, is a normal part of a woman’s life. So what she really needs during pregnancy is a lot of support, a lot of education so that she can make the right choices and healthy choices for her and her baby. She needs to be able to be supported during her pregnancy. I think that’s really where midwifery and nursing shine is that we support the normal process of childbirth. That’s what makes the kinds of care that we give, the kind of care that we give unique.
Jamie: Yes, I think that, in so many aspects, nurses excel at that kind of a global approach to the patient care especially in situations where we’re talking about normal healthcare processes and helping people through the early the things that occur to them as part of their healthy lives by helping to guide them through the process and provide that resource. Why aren’t more nurses going in this direction or do you see more nurses heading in this direction?
Jody: I think we definitely see more nurses going in this direction. I think that we do have a society that’s very medically model driven and that it’s taken a while for nursing to be able to sort of being in the limelight, but I think it’s really almost a perfect storm for nursing in midwifery right now because we know that most babies in the world are delivered into the hands of a midwife. We know that midwifery care is on par with care that’s provided by the medical community. That the services that we provide are cost-effective. That women are very satisfied when they receive services from us. So I think we’re really at a moment where there’s going to be a change, where there’s already a change. I see change going on. I think that a lot of things that are happening within our healthcare system that are driven by insurance and by reimbursement are looking very closely at the kinds of outcomes that that nurse-midwives and nurses can provide.
Jamie: One of the things I found when I was kind of preparing for this interview was looking at the fact that, in recent years, the fertility rate in the United States has declined, that we find that women are having children in an older and older age, while we have been successful in reducing the teen birth rates to lowest levels in recent memory. What is it that nurses can do to help women that are maybe past the age of 30, that are nearing closer to the end of their childbearing life, rather than in the beginning to successfully carry a baby to term and have the full experience of motherhood?
Jody: That’s a really good question, Jamie. I think one of the things that I always like to highlight is that even if you’re having a problem during your pregnancy, there’s always a part of it that’s normal. That’s the transition to parenthood. So there are normal steps that every woman go through, that every family goes through, as they are becoming a unit with a newborn. Those are the things that midwifery can help with. So even if you are having problems because you have some underlying medical condition when you become pregnant or, as you said, women are older so therefore they are more likely to have more medical problems. It’s helping the woman to make the transition to motherhood and helping her to stay healthy and helping her to have a healthy baby.
Jamie: Looking forward, we’ve seen more nurses coming in to nurse-midwifery as you said earlier, what would you offer in the way of advice to someone who is a nursing student right now or a new nurse or even a nurse that’s been out working for five or 10 years and decides that they want to go in this direction? What skills do they need to develop and prepare themselves to go into this field?
Jody: Well, being a nurse, to start with, is a very good preparation for becoming a midwife because you learn how to communicate with people, you learn how to assess people, you learn how to look for different signs that might be a red flag and you learn how to think critically about problems. So just that as a base is very good for becoming a midwife. I think if a person is interested they need to follow their passion. There are multiple schools in almost every state in our country where you can become a nurse-midwife. There are even a couple of states where you can go directly into midwifery without being a nurse first. There are less opportunities for that kind of education, but there are certainly opportunities out there. If you’re not already a nurse and you think that you want to be a midwife, there are many programs that bring you in and allow you to get that nursing degree first and you go right through to become a midwife in that program.
Jamie: Excellent. We get questions from time to time, especially from nursing students asking to share information or share your thoughts about the nursing process and nursing careers. One of them is my favorite question to ask is, what is it that piece of information or that piece of advice you received in your nursing career that you carry with you day to day clinically?
Jody: I think it would have to be probably what I just said that you need to follow your passion. There are so many opportunities in nursing. Once you find what really excites you about it, you should follow that because it’s fabulous. The opportunities and the growth and the interaction with, for me, mothers and families and newborns that makes me get up every day and go to work. It’s wonderful.
Jamie: The final question I have is really about what you would like to talk about to the general nurse out there, a nurse that’s working maybe in a Med-Surg environment or in a physician’s office, what steps can nurses take even if they aren’t specializing in maternal and child health or nurse-midwifery that they can be proactive about in helping to improve maternal and child health?
Jody: I think for the general nurse, we run into women of childbearing age every day in practice. She might not be pregnant. She might be thinking about getting pregnant. You might be seeing her for some other condition. You might be seeing her child for something. But to just see and question her and make sure that she’s as healthy as she can be, that she knows how to stay healthy, that she knows the right foods to eat, the kind of exercise that she needs, how to take care of herself because starting out a pregnancy healthy is the best way to have a healthy baby.
Make sure you check out the entire April 2015 issue of Nursing Notes where we look at maternal and child health nursing. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month where I had a panel discussion on maternal and child health nursing with Karen T. Harris, president of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), and vice president of Patient Care Services and Chief Nursing Officer at Henry Ford West Bloomfield Hospital in West Bloomfield, Mich. Also joining us is Ginger Breedlove, president of the American College of Nurse-Midwives and professor of graduate nursing at the Eleanor Wade Custer School of Nursing at Shenandoah University in Winchester, VA. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes and check out the new podcast player at DiscoverNursing.com!