Pharmacology and midwifery are not mututally exclusive

Abstract

Several years ago, a group of midwifery educators gathered to discuss methods of teaching pharmacology. In the midst of all the various comments, it was noted that most midwifery competencies could be taught by using a pharmacology framework. After a collective gasp emerged from the group, an appreciation of the statement grew. After all, the discipline of pharmacotherapeutics, like midwifery, underscores not only when to use an agent but also when nonpharmaceutical agents are superior. The point of this anecdote is to illustrate how important pharmacology is to midwifery practice and how pervasive pharmacotherapeutics is within the health care profession. Conversely, when information about pharmacology is lacking and prescriptive authority is not available, practice is hampered. The pursuit of prescriptive authority has been both a legislative challenge and a clinical challenge for midwives. When midwives are equipped with adequate knowledge of pharmacology, they can engage in discussions with peers and colleagues about the risk and benefits of various drug choices and clinical use. The need to incorporate pharmacology knowledge in midwifery practice has been reflected in the increasing inclusion of material on how to critically evaluate pharmaceutical drugs and therapies in journal publications over the last few years. One outcome of the legislative effort by midwives and other advanced practice nurses for prescriptive authority are new state rules and regulations that require continuing education credits. Specifically, these credits must be related to pharmacology and are usually mandated to initially obtain, and then further retain, the authorization to write prescriptions. This two-issue home study series is one mechanism to obtain these continuing education credits. More importantly, these articles were commissioned for the purpose of updating knowledge and introducing the reader to new and emerging fields relevant to the science of pharmacology and the profession of midwifery. Rather than falling down the “Wonderland” rabbit hole and becoming smaller and smaller in focus, the first article, “Pharmaceutical Therapy in Midwifery Practice: A Culturally Competent Approach” by Eva Doyle and Mary Ann Faucher, remind midwives of the larger cultural context that affects how individuals use pharmacologic agents. This article explores cultural implications of pharmacotherapeutics, which include the emerging field of pharmacogenetics, the science that explores drug differences associated with racial and ethnic variation. Three articles in this issue provide updates on the most common prescriptions written throughout a woman's life. Ron Ruggerio and Francie Likis review information about the basic pharmacologic action of estrogen, with pharmacotherapeutic implications. The two articles by Sharon Schnare and Francie Likis complement their work by expanding on uses of estrogen and progesterone in practice, including new contraceptive options. Use of foods in the healing arts is an old approach. Remember “Feed a cold and starve a fever?” Until recently, little science has been applied to looking at how foods function in supporting health or healing illness. An article on nutriceutical therapy, included in this issue, addresses the use of food, vitamins, and other complementary therapies to promote cardiovascular wellness and prevent cardiovascular disease in women. This home study program is organized around topics that address pharmacology. However, these articles contain information for all midwives in practice. It has not been written only for those who have prescriptive authority or who need continuing education credits. Midwifery and pharmacology are not mutually exclusive. Further knowledge about these topics empowers all midwives in clinical practice.