The nurse-midwife as a family planner

Personnel other than physicians are necessary to supply adequate family planning services. At the Downstate Medical Center in New York, nurse-midwifery training was employed to solve the problem. The nurse-midwife role in family planning is described, and details are provided for the program, nurse-midwife training, and the program's expansion to foreign countries with Agency for International Development assistance. Nurse-midwives are taught all phases of family planning; accepted contraceptive methods, proper methodology, accurate record keeping and follow-up of patients, demographic and economic aspects of family planning, orientation into social service problems, and clinical planning and management. They are also taught to understand basic anatomical and physiological concepts of the reproductive systems andhow to do the following gynecological procedures: determining the position, size, and shape of the uterus and adnexa, determining the cervical canal direction, sounding the uterus, recognizing gross pelvic pathology, taking vaginal and cervical smears for neoplasia and trichomonas, and performing a Papanicolaou smear, pregnancy test, or hemocrit determination. It is the responsibility of medical and nursing schools to provide these programs for training of domestic as well as foreign personnel.