American College of Nurse-Midwifery (ACNM) ACNM merupakan organisasi Profesional nasional bagi Certified Nurse-Midwives dan Certified Midwives.

Misinya adalah meningkatkan derajat kesehatan dan kesejahteraan ibu dan bayinya dalam keluarga mereka dan dimasyarakat lewat pengembangan dan dukunga profesi kebidanan seperti yang dilakukan oleh CNM dan CM. ACNM menjadi badan usaha pada tahun 1995, didirikan sebagai jawaban terhadap perkembangan berkelanjutan serangkaian keadaan yang membutuhkan kreasi secepatnya. Pertemuan tahunan ACNM yg pertama diadakan pada tanggal 12 dan 13 November 1955 di Kansas, Missiouri. Hattie Hemschemeyer (direktur maternity Center Association School of Nures-Midwifery) yang terpilih menjadi presiden pertama ACNM. Pada tahun 1956, ACNM dan AACNM diterima oleh ICM atas rekomendasi Negara inggris dan Skotlandia dan seluruh lembaga ICM. Tahun 1969, AANM bergabung deng ACNM membentuk ACNM. Tahun 1972, ACNM menjadi tuan rumah dalam kongres tiga tahunan ICM di Washington,D.C., ketika Lucille Woodville (presiden ACNM periode 1960-1971 yang juga menjadi Consultant Bureau of Indian Health Affair) menjadi Presiden ICM periode 1969-1972. Sasaran yang ingin dicapai ACNM, pertama kali diuraikan dlm articles of Incorporation pd thn 1955 dan diperbaharui pada tahun 2000, mencerminkan perhatian perawat-bidan terhadap kualitas pelayanan kesehatan bagi ibu dan bayi. Keanggotaan ACNM sejak awal dibentuk memiliki karkteristik berdedikasi, berkomitmen, kerja keras, berani menyampaikan pendapat, pengorbanan diri, visi dan semangat untuk menjadi perintis. Catatan riwayat singkat ACNM melibatkan orang-orang

dengan pemikiran besar kreatif, yang juga berkeinginan untuk melakukan kerja terperinci sementara, disisi lain, bersedia merogoh saku sendiri untuk membiayai hal tersebut. Dimulai dengan 124 anggota, berkembang menjadi 860 pada tahun 1975 dan meningkat menjadi 1500 pada tahun 1980, meningkat lagi manjadi 2534 di tahun 1984 dan 5000 angg. Pada tahun 1995. ACNM telah menyatukan setiap aspek perawat-bidan: pendidikan, praktik, pengakuan, legalisasi, surat izin, jaminan, komunikasi, penelitian dan hubungan antarprofessional dan antarorganisasi. Saat ini ACNM menyediakan atau berupaya supaya semua mekanisme ini memungkinkan untuk bertahan dan berbicara atas nama profesi perawat-kebidanan dan kebidanan seperti yang dilakukan oleh CNM dan CM. History Of MANA (Midwives Alliance of North America) July 1985, MANA News supplement When MANA was founded in 1982, there were many organizations in North America which midwives had been instrumental in organizing or that somehow provided a means of communication and support among midwives. Among them were the National Midwives Association, the Association for Childbirth at Home, Inc., Informed Homebirth, and NAPSAC. However, none of these organizations had a membership base broad enough to draw all midwives together in one organization that provided strength of numbers, an internal support system, or the credibility and political clout necessary to promote midwifery as an accepted part of the maternal-child health care system in North America. The American College of Nurse-Midwives was the only professional organization of midwives that promoted inter-

professional relations with doctors, nurses, and other health care provider; that provided guidelines for midwifery education and quality midwifery practice; and that had developed a reliable communication network keeping midwives around the country informed of each others efforts. But ACNM membership was limited to midwives who were nurses who had graduated from ACNM accredited midwifery training programs and were certified by national exam. The ACNM was beginning to hear from midwives who did not meet these requirements but were interested in being part of a professional organization. Many nurse-midwives were eager to open communication with midwives outside of the ACNM but were thwarted by the lack of an equivalent organization with which to establish a formal liaison. Many midwives, both nurse-midwives and others, recognized the vacuum that needed to be filled. Certain ones had the vision, leadership and organizational skills necessary to institute the formation of such an organization. One such midwife was Sister Angela Murdaugh, President of the ACNM from 1981 to 1983. In October 1981, Sister Angela called a meeting in Washington, D.C., which she hoped would plant the seed for the formation of this new organization. She invited 7 midwives from around the country, a mix of nurse-midwives and other midwives educated in a variety of ways. This initial meeting was called Dialogue Day and consisted of a round-table discussion of the issues confronting all midwives in the country, with special emphasis on the communication concerns between nurse-midwives and other American midwives. The upshot of this first meeting was a decision to form a Guild that would include all midwives with the following purposes in mind: 1. To expand communication among midwives. 2. To set educational guidelines for the training of midwives.

3. To set guidelines for basic competency and safety for practicing midwives. 4. To form an identifiable professional organization for all midwives in this country. Present at this first meeting were several midwives who were on the first MANA Governing Board: Teddy Charvet, Ina May Gaskin, Susan Leibel, and Fran Ventre. An open meeting was planned for Lexington, Kentucky, in April 1982, before the ACNM Convention to follow-up on these discussions. Despite communication problems between October and April, nearly 100 women from around the country attended the next meeting. Everyone was encouraged to speak to the idea of a national professional organization for midwives. Input came from many different states and many different types of midwives and their supporters, all supporting the idea of an organization. The upshot of the meeting was that the time was right to start the work of putting together such an organization, and throughout the next several days, a core group formed and the work began. The name of Midwives Alliance of North America was chosen and the decision to include Canada was made. The rough draft of the Articles of Incorporation was drawn up, a communication vehicle (Practicing Midwife) established, officers chosen, and a plan to have a national conference in October 1982 was hatched. From April to October 1982, communication channels were further developed and more work was accomplished, but the organization was not prepared to put together a national conference. Instead, in October, a smaller work meeting was called and any midwife with the interest, energy, and ability to get herself to Boulder, Colorado, was invited. Twenty-three women from all over the U.S. and one Canadian midwife attended. This broad-based, organizationally skilled group worked well together and the structural backbone on MANA was sketched out. Committees

were established and various projects started. This crucial meeting facilitated by the generous efforts of Laine Gerritson and Carole Shane of the Colorado Midwives Association, gave MANA the big push it needed to really get off the ground and working. From October 1982 to April 1983, more background work was done, although communication was still less than ideal. The Governing Board and officers that were appointed in Boulder, developed networks for communication and worked on their appointed tasks, but the MANA membership at large was still not well-informed about MANAs progress. At the May 1983 board meeting in Los Angeles, the decision was made to publish the newsletter, MANA News, thereby hoping to accomplish the first and most important of our original goals expand communication among North American midwives. Also, at the L.A. meeting, work on the first National MANA conference was consolidated, questions of finances and membership were clarified and important liaisons with other groups at the ACNM convention were made. Kebidanan di Amerika Serikat 1In the US there are three types of midwives. Di AS ada tiga jenis bidan. I. Certified Nurse Midwives I. Certified Perawat Bidan CERTIFIED NURSE MIDWIVES (CNMs) are trained through approved programs of the American College of Nurse Midwives (ACNM). CERTIFIED NURSE bidan (CNMs) dilatih melalui program disetujui American College of Nurse Midwives (ACNM). CNMs are trained in the disciplines of nursing and midwifery, but their primary focus is the practice of midwifery. CNMs terlatih dalam disiplin ilmu keperawatan dan kebidanan, tapi fokus utama mereka adalah praktek kebidanan. These programs are run by Nurse-Midwives, and usually affiliated with a University or medical school. Programs are either a one year Certificate Program

or a two year Masters Program. Program-program ini dijalankan oleh perawat-bidan, dan biasanya berafiliasi dengan Universitas atau sekolah kedokteran. Program-program baik Certificate Program satu tahun atau dua tahun Master Program. Some Masters degrees are in Nursing, some in Public Health, and some in Midwifery. Beberapa gelar Master dalam Keperawatan, beberapa di Kesehatan Masyarakat, dan beberapa di Midwifery. Some states are requiring a Masters Degree for a CNM to practice (such as Washington and Oregon) for licensure. Beberapa negara yang membutuhkan Masters Degree untuk perawat-bidan untuk praktek (seperti Washington dan Oregon) untuk lisensi. Some programs admit two year degree RNs, and some programs require a BS in Nursing for admission into the program. Beberapa program tahun mengakui dua gelar RNS, dan beberapa program memerlukan gelar BS in Nursing untuk masuk ke dalam program. There are several accelerated programs, such as the one at Yale that admits non-nurses with a 4 year degree and in three years the individual graduates with a Masters in Nursing and become eligible to take the boards to become both an RN and a CNM . Ada beberapa program dipercepat, seperti yang ada di Yale yang mengaku nonperawat dengan gelar 4 tahun dan dalam tiga tahun individu lulusan dengan gelar Masters in Nursing dan menjadi layak untuk mengambil papan untuk menjadi baik suatu RN dan perawatbidan. The Community Based Nurse Midwifery Education Program (CNEP) is an innovative distance learning program which allows a student to study at home and gain clinical experience locally. Perawat Berbasis Masyarakat Program Pendidikan Kebidanan (CNEP) adalah sebuah program pembelajaran jarak jauh inovatif yang memungkinkan mahasiswa untuk belajar di rumah dan mendapatkan pengalaman klinis lokal. Some midwifery programs for RNs seeking a CNM are developing innovative curriculums and channels to increase access to education. Beberapa program kebidanan untuk RNS mencari perawat-bidan yang mengembangkan kurikulum dan saluran inovatif untuk meningkatkan akses pendidikan.

The list of schools for CNMs is long, and new programs are approved each year. Daftar sekolah untuk CNMs panjang, dan program-program baru disetujui setiap tahun. You can contact the American College of Nurse Midwives (ACNM) at ACNM@aol.com to determine where the schools are and what the requirements for admission are. Subscribing to the Journal of Nurse Midwifery (the journal of the American College of Nurse Midwives) will provide you with updates about programs, and articles about CNMs and the issues facing them. Anda dapat menghubungi American College of Nurse Midwives (ACNM) di ACNM@aol.com untuk menentukan tempat sekolah dan apa persyaratan untuk penerimaan ini. Berlangganan Journal of Nurse Kebidanan (jurnal dari American College of Nurse Midwives) akan memberikan update tentang program-program, dan artikel tentang CNMs dan masalah yang dihadapi mereka. In the USA, Certified Nurse Midwives are growing and flourishing, numbering over 4000. Di Amerika Serikat, Certified Perawat Bidan tumbuh dan berkembang, yang jumlahnya lebih dari 4000. They are making inroads in many ways, bringing midwifery care into the hospitals, providing care for low income families and becoming a respected provider and part of the team of providers in medical school programs, training residents in normal birthing. Mereka sedang membuat terobosan dalam banyak cara, perawatan kebidanan membawa ke rumah sakit, memberikan perawatan bagi keluarga berpenghasilan rendah dan menjadi penyedia dihormati dan bagian dari tim penyedia program-program di sekolah kedokteran, pelatihan warga melahirkan normal. Usually, CNMs work in a collaborative or co- management relationship with physicians. Biasanya, CNMs bekerja di kolaboratif atau co-manajemen hubungan dengan dokter. This implies teamwork and promotes continuity of care. Ini berarti kerja tim dan meningkatkan kesinambungan layanan. In some states CNMs also hold a separate title, and must use it with their legal signature. Di beberapa negara juga mengadakan CNMs judul yang

terpisah, dan harus menggunakannya dengan hukum mereka tanda tangan. For example, in Washington state, I am an Advanced Registered Nurse Practitioner (ARNP) and Certified Nurse Midwife (CNM). Sebagai contoh, di negara bagian Washington, saya Advanced Registered Nurse Practitioner (ARNP) dan Certified Nurse Midwife (CNM). I am licensed through the Board of Nursing as an ARNP because I am a licensed as a CNM. Saya berlisensi melalui Dewan Keperawatan sebagai ARNP karena saya berlisensi sebagai perawat-bidan. This is important for our future viability, because nurse practitioners are uniting, and someday that might be the title across the nation. Hal ini penting untuk kelangsungan hidup masa depan kita, karena praktisi perawat bersatu, dan suatu hari yang mungkin judul di seluruh bangsa. I am required to use the title ARNP, and choose to use CNM also. Saya diminta untuk menggunakan gelar ARNP, dan memilih untuk menggunakan juga perawat-bidan. This is confusing sometimes to the public. Ini kadang-kadang membingungkan masyarakat. II. LICENSED OR CERTIFIED (direct entry) MIDWIVES II. Berlisensi atau CERTIFIED (direct entry) bidan LICENSED OR CERTIFIED (direct entry) MIDWIVES practice in a home or birth center setting. Berlisensi atau CERTIFIED (direct entry) bidan praktik di sebuah rumah atau kelahiran pengaturan pusat. They can receive their training through a combination of formal schooling, correspondence courses, self study and apprenticeship. Although this is a non-nurse entry route for midwifery, nurses are not excluded. Mereka dapat menerima pelatihan melalui kombinasi pendidikan formal, korespondensi kursus, belajar dan magang diri. Walaupun ini adalah perawat nonentri rute untuk kebidanan, perawat tidak dikecualikan. These midwives must show that they meet or exceed the minimum requirements for the practice of midwifery by documenting experience and passing both skills and didactic exams. Bidan ini harus menunjukkan bahwa mereka memenuhi atau melampaui

persyaratan minimum untuk praktek kebidanan oleh mendokumentasikan pengalaman dan keterampilan baik lewat dan didaktik ujian. In the United States, direct-entry midwifery is legally recognized in 29 states. Di Amerika Serikat, langsung masuk kebidanan secara legal diakui di 29 negara. Licensure, certification or registration is available in 17 states and Medicaid reimbursement is available 6 states. Lisensi, sertifikasi atau registrasi tersedia di 17 negara dan Medicaid penggantian tersedia 6 negara. Licensed or certified midwives usually have a working relationship with the State Health Departments, do sign birth certificates, have lab accounts and usually have doctor back-up and emergency procedures lined up. Berlisensi atau bidan bersertifikat biasanya memiliki hubungan kerja dengan Departemen Kesehatan Negara, melakukan menandatangani akte kelahiran, memiliki account laboratorium dan dokter biasanya memiliki back-up dan prosedur darurat berbaris. Licensed or certified midwives are reimbursed by many insurance companies for birth center and home births. Berlisensi atau bidan bersertifikat diganti oleh banyak perusahaan asuransi untuk klinik bersalin dan rumah kelahiran. There is a movement in the United States towards Professional Midwifery: a process through which those aspiring to be midwives can proceed and at the end be called a CERTIFIED PROFESSIONAL MIDWIFE (CPM). Ada gerakan di Amerika Serikat terhadap Kebidanan Profesional: suatu proses melalui mana orang-orang bercita-cita menjadi bidan dapat dilanjutkan dan pada akhir disebut CERTIFIED PROFESIONAL bidan (BPT). The North American Registry of Midwives (NARM) is the first certifying body to offer both a national examination and a national validation process for professional direct-entry midwives, and CNMs who assist with birth at home, who come to their practices through multiple educational routes. Amerika Utara Pendaftaran Bidan (NARM) adalah sertifikasi pertama tubuh untuk menawarkan baik ujian nasional dan proses validasi nasional untuk profesional bidan langsung masuk, dan membantu dengan CNMs

yang lahir di rumah, yang datang ke praktek mereka melalui berbagai jalur pendidikan . NARM has been offering a registry examination of entry-level midwifery knowledge since 1991. NARM telah menawarkan pemeriksaan registri entry-level pengetahuan kebidanan sejak 1991. NARM has just completed a pilot project for a certification process which validates skills, knowledge and experience. NARM baru saja menyelesaikan sebuah proyek percontohan untuk sebuah proses sertifikasi yang memvalidasi keterampilan, pengetahuan dan pengalaman. This certification is now being offered nationwide and the new credential is for Certified Professional Midwife. Sertifikasi sekarang ini ditawarkan secara nasional dan mandat baru untuk Certified Professional Bidan. The CPM has successfully completed prescribed studies in midwifery accomplished through a variety of educational routes. BPT telah berhasil menyelesaikan studi di kebidanan ditetapkan dilakukan melalui berbagai jalur pendidikan. The examination is based on Core Competencies established by the Midwives Alliance of North America (MANA) Manainfo@aol.com the national organization representing midwives. Pemeriksaan ini didasarkan pada Kompetensi Inti yang didirikan oleh bidan Aliansi Amerika Utara (MANA) Manainfo@aol.com organisasi nasional yang mewakili bidan. The CPMs then practice in accord with the MANA Standards and Guidelines for the Art and Practice of Midwifery. The CPM kemudian praktek di MANA sesuai dengan Standar dan Pedoman Art and Practice of Midwifery. III. LAY or EMPIRICAL MIDWIVES III. LAY atau bidan EMPIRIS LAY or EMPIRICAL MIDWIVES, also referred to as direct entry midwives, obtain their training through a variety of routes. LAY atau EMPIRIS bidan, juga disebut sebagai penerimaan langsung bidan, mendapatkan pelatihan mereka melalui berbagai rute. These are midwives who have chosen not to become licensed or certified

for a variety of reasons, ranging from the lack of experience necessary for licensure to not wanting to work under any type of mandated protocols or guidelines. Ini adalah bidan yang telah memilih untuk tidak menjadi berlisensi atau sertifikasi untuk berbagai alasan, mulai dari kurangnya pengalaman yang diperlukan untuk lisensi untuk tidak ingin bekerja di bawah mandat semua jenis protokol atau pedoman. Some are part of a religious group, and practice only within a specific community. Beberapa bagian dari sebuah kelompok keagamaan, dan praktek hanya dalam komunitas tertentu. In some areas they cannot charge for their services, and can be prosecuted for doing so. Di beberapa daerah mereka bisa tidak membebankan biaya atas jasa mereka, dan dapat dituntut untuk melakukannya. Community-based midwives have been providing care for pregnant women across North America for many past years. Currently there are two to three thousand independent midwives in the US alone. Bidan berbasis masyarakat telah menyediakan perawatan bagi wanita hamil di Amerika Utara selama bertahuntahun-tahun sebelumnya. Saat ini ada dua sampai tiga ribu bidan independen di AS sendiri. There are many types of providers providing prenatal care and birthing assistance in the United States: Midwives with different sorts of titles and qualifications, Physician Assistants, Family Practice or General Practitioners, and Obstetricians. Ada banyak jenis penyedia menyediakan perawatan pra-lahir dan bantuan persalinan di Amerika Serikat: Bidan dengan berbagai macam judul dan kualifikasi, Asisten Dokter, Keluarga Praktek atau dokter umum, dan Dokter kandungan. As you can imagine, the process and outcome of a birth will be different, depending upon the provider chosen to assist the birth. Seperti yang dapat Anda bayangkan, proses dan hasil dari kelahiran akan berbeda, tergantung pada penyedia dipilih untuk membantu kelahiran.

2. WHAT CAN MIDWIVES DO? 2. APA YANG BISA DILAKUKAN bidan? This will depend on the type of licensure and the laws and restrictions within the local area. Ini akan tergantung pada jenis lisensi dan hukum-hukum dan batasan dalam area lokal. CNMs can obtain hospital privileges, in some states can prescribe most medications needed by women, and can attend birth in the home, hospital or birth centers. Rumah sakit CNMs dapat memperoleh hak istimewa, di beberapa negara dapat memberi resep obat yang dibutuhkan oleh sebagian besar perempuan, dan dapat menghadiri kelahiran di rumah, rumah sakit atau pusat kelahiran. They can provide family planning and womens health care in addition to the full scope of prenatal and birthing care. Mereka dapat memberikan keluarga berencana dan kesehatan perempuan di samping cakupan penuh pralahir dan perawatan persalinan. How they practice will depend upon their work setting. Bagaimana mereka praktek akan bergantung pada lingkungan kerja mereka. Some CNMs practice in large, busy Level III hospitals. Beberapa praktek CNMs besar, sibuk Tingkat III rumah sakit. This is usually episodic care, and they might work shifts and specific clinics, and be able to work a limited 40 hour week. Hal ini biasanya episodik perawatan, dan mereka mungkin bekerja shift dan klinik tertentu, dan dapat bekerja yang terbatas 40 jam seminggu. Some CNMs have a solo private practice and others work in group practices with other CNMs and/or physicians. Most CNMs provide total midwifery care, with a physician for consultation and comanagement as needed. Beberapa solo CNMs memiliki praktik swasta dan lain-lain dalam kelompok kerja praktik dengan CNMs lain dan / atau dokter. Kebanyakan total CNMs memberikan perawatan kebidanan, dengan seorang dokter untuk konsultasi dan co-manajemen yang diperlukan. CNMs can earn a consistent income, and can also practice as an RN if she cannot work as a

CNM. CNMs dapat memperoleh pendapatan yang konsisten, dan dapat juga praktek sebagai RN kalau ia tidak bisa bekerja sebagai perawat-bidan. Sometimes CNMs work for a family planning agency such as Planned Parenthood or the Health Department providing family planning services and womens health care. Kadang-kadang CNMs bekerja untuk badan keluarga berencana seperti Planned Parenthood atau Departemen Kesehatan memberikan pelayanan keluarga berencana dan perawatan kesehatan wanita. Some CNMs practice midwifery internationally on special projects for the American College of Nurse Midwives. Beberapa praktek kebidanan CNMs internasional untuk proyekproyek khusus American College of Nurse Midwives. Present projects include work in Ghana, Egypt, Uganda, Indonesia, Morocco and Bolivia and include work with family planning agencies and the training of training of Traditional Birth Assistants and working towards improving the overall standard of living for women and their families. Proyek sekarang termasuk bekerja di Ghana, Mesir, Uganda, Indonesia, Maroko dan Bolivia dan termasuk bekerja dengan badan-badan perencanaan keluarga dan pelatihan pelatihan Kelahiran Tradisional Asisten dan bekerja menuju keseluruhan meningkatkan standar hidup bagi perempuan dan keluarga mereka. Obtaining hospital privileges in the United States is a critical element in a midwifes ability to practice and use the resources found within the hospital, such as the lab, radiology and the emergency room. Perolehan hak rumah sakit di Amerika Serikat adalah elemen penting dalam kemampuan bidan praktik dan menggunakan sumber daya yang ditemukan di dalam rumah sakit, seperti laboratorium, radiologi dan ruang gawat darurat. Hospital by-laws can be written to either include or exclude this nonphysician provider. Rumah sakit demi hukum dapat ditulis baik untuk menyertakan atau mengecualikan dokter non-selular. Some by-laws require physician supervision and sometimes their presence at the birth. Beberapa oleh-undang-undang memerlukan

pengawasan dokter dan kadang-kadang kehadiran mereka di kelahiran. Other by-laws are more liberal. Lain oleh-hukum lebih liberal. CNMs have made many strides over the past few years, and many hospitals are receptive to midwives. CNMs telah membuat banyak kemajuan selama beberapa tahun, dan banyak rumah sakit yang menerima bidan. Women are requesting the care of midwives, and hospitals choose to offer this option. Perempuan meminta perawatan bidan, dan rumah sakit memilih untuk menawarkan pilihan ini. Non-physician providers in some institutions, can independently admit and discharge their clients, however cannot vote on any committees. Non-dokter di beberapa lembaga penyedia, dapat secara independen mengakui dan pengosongan klien mereka, namun tidak dapat memberikan suara pada setiap komite. CNMs attend the perinatal committee, which discusses the rules and regulation of the particular obstetrical unit, but they are not allowed to vote on rules which might affect them. Perinatal CNMs menghadiri komite, yang membahas peraturan dan peraturan dari unit obstetri tertentu, tetapi mereka tidak diperbolehkan untuk memilih pada aturan-aturan yang mungkin mempengaruhi mereka. CNMs attend these meetings, and their visible presence makes an impression at some level to their viability. CNMs menghadiri pertemuan ini, dan terlihat kehadiran mereka membuat kesan pada tingkat tertentu untuk kelangsungan hidup mereka. The by-laws limit who can practice. Hukum yang oleh-batas yang dapat berlatih. Each candidate is carefully screened for accuracy of licensure and educational program. Probationary periods exist for different practitioners, and requirements for non-physicians might differ somewhat from what is required for a physician. Masingmasing kandidat dengan hati-hati diperiksa untuk ketepatan lisensi dan program pendidikan. Ada masa percobaan untuk berbagai praktisi, dan persyaratan untuk non-dokter mungkin agak berbeda dari apa yang diperlukan untuk seorang dokter. Hospital administrators are looking at different models of health care, and at

countries where midwives provide most of the care. Administrator rumah sakit melihat pada model-model yang berbeda perawatan kesehatan, dan di negara-negara di mana bidan memberikan sebagian besar peduli. The issue of hospital privileges affects non-CNMs, if they were to want privileges, or even to use the services available at the hospital. Masalah rumah sakit tidak mempengaruhi hak-hak istimewa CNMs, jika mereka menginginkan hak-hak istimewa, atau bahkan untuk menggunakan layanan yang tersedia di rumah sakit. The midwife without privileges would need to go through a physician or other provider to get an ultrasound ordered, and the results would go to the physician, not the midwife. Bidan tanpa hak istimewa akan harus melewati dengan dokter atau penyedia lain untuk mendapatkan memerintahkan USG, dan hasilnya akan pergi ke dokter, bukan bidan. Many midwives do not seek hospital privileges, but others want to be able to transition their clients into the hospital should the need arise, and be able to continue care within the hospital. Some DEMs also sit on various committees in their states and are able to promote change in obstetrical care, along with the consumers in the community. Banyak bidan rumah sakit tidak mencari hak-hak istimewa, tetapi yang lain ingin untuk dapat transisi klien mereka ke rumah sakit jika perlu muncul, dan dapat melanjutkan perawatan di dalam rumah sakit. Beberapa DEMs juga duduk di berbagai komite di negara-negara mereka dan mampu mempromosikan perubahan di perawatan obstetri, bersama dengan konsumen di masyarakat. Midwives without a formal license practice in a variety of ways and with a variety of tools. Bidan tanpa lisensi resmi praktek dalam berbagai cara dan dengan berbagai alat. Some use homeopathic, herbal and other non-allopathic therapies within their practice, such as massage, accupressure and reflexology. They assist births in the home or within a birth center. Some midwives are considered to be practicing illegally in their state by some

authorities. Beberapa menggunakan homeopati, herbal dan nonallopathic terapi dalam praktek mereka, seperti pijat, accupressure dan refleksologi. Mereka membantu kelahiran di rumah atau di dalam sebuah klinik bersalin. Beberapa bidan dianggap mempraktekkan secara ilegal di negara mereka oleh beberapa pihak berwenang. It is not illegal to have a home birth, but it might be illegal for a midwife to attend the birth without appropriate licensure. Hal ini tidak ilegal untuk memiliki rumah kelahiran, tetapi mungkin ilegal bagi seorang bidan untuk menghadiri kelahiran tanpa lisensi yang sesuai. A good example is in Washington State, where there are CNMs, Licensed Midwives and non-licensed midwives. Sebuah contoh yang baik adalah di Washington State, di mana terdapat CNMs, Izin Bidan dan nonlisensi bidan. If the non- licensed midwife charges for her services, this is considered illegal by state law. Jika lisensi non-biaya bidan jasa baginya, ini dianggap ilegal oleh hukum negara. Licensed midwives and CNMs can bill for their services through the state, and be reimbursed by insurance plans. Berlisensi bidan dan CNMs dapat tagihan untuk jasa mereka melalui negara, dan akan diganti oleh asuransi. Many midwives practice independent of any major medical community, consulting with a specific physician if necessary that is supportive of their cause, or having the client seek a consulting physician should problems arise. Banyak bidan praktik terlepas dari besar komunitas medis, konsultasi dengan dokter jika perlu khusus yang mendukung perjuangan mereka, atau memiliki klien mencari dokter harus konsultasi masalah muncul. In some situations, midwives contact whatever back-up is available, using the hospitals on-call physician should transfer be necessary. A hospitals reception of a midwifes transport may vary. Sometimes the midwife and parents face a physician or nurse who disapproves of the intended birth at home. Dalam beberapa situasi, bidan kontak cadangan apa pun tersedia, dengan menggunakan rumah sakit on-call dokter harus mentransfer perlu. Sebuah rumah sakit

penerimaan bidans transportasi mungkin berbeda-beda. Kadangkadang wajah orangtua bidan dan dokter atau perawat yang tidak setuju yang dimaksud lahir di rumah. However as midwives and out-of-hospital birthing have become more common, the hospital staff has become more likely to greet the transport with professional respect. Namun sebagai bidan dan di luar rumah sakit melahirkan telah menjadi lebih umum, staf rumah sakit telah menjadi lebih mungkin untuk menyambut transportasi dengan hormat profesional. Licensure or certification provides a minimum standard to which midwives adhere. Lisensi atau sertifikat menyediakan standar minimum yang mematuhi bidan. The intention is to protect the consumer from harm by a practitioner without adequate training, but is no guarantee of competency. Tujuannya adalah untuk melindungi konsumen dari bahaya oleh seorang praktisi tanpa pelatihan yang memadai, namun tidak ada jaminan kompetensi. Licensure and certification also imply a peer review process to help midwives feel accountable for their actions. Lisensi dan sertifikasi juga menyiratkan proses tinjauan rekan untuk membantu bidan merasa bertanggung jawab atas tindakan mereka. In the USA, CNMs usually work from standing protocols that they have developed themselves. Di Amerika Serikat, biasanya bekerja dari CNMs berdiri protokol yang mereka kembangkan sendiri. These are reviewed by their consultant physicians, and guide care. Ini diperiksa oleh dokter konsultan mereka, dan panduan perawatan. Generally these are of a medical or allopathic orientation, however there are CNMs who use herbs and nonallopathic treatments within their practice. Umumnya ini adalah seorang medis atau allopathic orientasi, namun ada yang menggunakan bumbu CNMs dan non-allopathic perawatan dalam praktek mereka. The ACOG (American College of Obstetrics and Gynecology) has well documented and clearly presented guidelines for practice, and most seem respectful of the diversity of practice within the USA. The ACOG (American College of

Obstetrics and Gynecology) telah didokumentasikan dengan baik dan disajikan dengan jelas pedoman untuk latihan, dan sebagian besar tampaknya menghormati keragaman praktek dalam Amerika Serikat. Following these guidelines are not required for practice, but are considered part of the standards of care within the community. Should legal action be taken against a physician or midwife, these guidelines will be reviewed, and used as a standard against which the outcome could be judged. Dengan mengikuti panduan ini tidak diperlukan untuk latihan, tetapi dianggap sebagai bagian dari standar perawatan dalam masyarakat. Apakah tindakan hukum akan diambil terhadap seorang dokter atau bidan, pedoman ini akan ditinjau, dan digunakan sebagai standar yang hasil bisa dinilai. 3. WHAT DO MIDWIVES DO? 3. APA YANG bidan DO? Midwives teach, educate and empower women to take control of their own health care. Bidan mengajar, mendidik dan memberdayakan perempuan untuk mengambil kendali atas perawatan kesehatan mereka sendiri. In most communities, they provide prenatal care, or supervision of the pregnancy, and then assist the mother to give birth. Dalam kebanyakan masyarakat, mereka menyediakan perawatan sebelum melahirkan, atau pengawasan kehamilan, dan kemudian membantu ibu melahirkan. They manage the birth, and guard the woman and her newborn in the postpartum period. Most midwives encourage and monitor women throughout their labor with techniques to improve the labor and birth. Reassurance, positive imaging and suggestions to change positions and walk helps labors progress. Mereka mengelola kelahiran, dan menjaga wanita dan bayi yang baru lahir dalam periode pasca-melahirkan. Kebanyakan bidan mendorong dan memantau perempuan di seluruh tenaga kerja mereka dengan teknik untuk meningkatkan tenaga kerja dan kelahiran. Diyakinkan, pencitraan positif dan saran untuk mengubah posisi dan berjalan membantu buruh kemajuan.

Many midwives provide family planning services and routine womens health examinations such as pap smears and physical examinations. They teach women about sexually transmitted infections, and focus on prevention of the spread of infections. Banyak bidan memberikan pelayanan KB dan kesehatan wanita rutin seperti pemeriksaan pap smear dan pemeriksaan fisik. Mereka mengajarkan wanita tentang infeksi menular seksual, dan fokus pada pencegahan penyebaran infeksi. What specifically midwives do will depend upon: her training, her licensure, and what is allowed in the state, province, or country in which she practices. Bidan melakukan apa yang secara khusus akan tergantung pada: pelatihannya, lisensi-nya, dan apa yang diperbolehkan di negara bagian, propinsi, atau negara di mana dia praktik. Certified Nurse Midwives (CNMs) in most states within the USA can prescribe most medications, and in some areas also provide womens health care throughout the menopause years. Certified Nurse Bidan (CNMs) di kebanyakan negara bagian di Amerika Serikat bisa memberi kebanyakan obat-obatan, dan di beberapa daerah juga menyediakan perawatan kesehatan wanita menopause sepanjang tahun. CNMs can attend birth in the hospital, birthing center, or home. CNMs dapat menghadiri kelahiran di rumah sakit, klinik bersalin, atau rumah. All midwives specialize in understanding normal aspects of the childbearing cycle. Semua bidan mengkhususkan dalam memahami aspek normal dari siklus melahirkan anak. They are trained to recognize deviations from the normal, recommend holistic means for bringing the situation back into the realm of normal, or refer to another practitioner when necessary. Mereka dilatih untuk mengenali penyimpangan dari normal, merekomendasikan holistik berarti untuk membawa situasi kembali ke dunia normal, atau merujuk ke dokter lain bila diperlukan. Midwives believe it is important is to provide time for questions, teaching, and time to listen to the concerns and needs of the women they care for. Bidan percaya penting adalah

menyediakan waktu untuk pertanyaan, mengajar, dan waktu untuk mendengarkan keprihatinan dan kebutuhan perempuan mereka peduli untuk. 4. HOW DO I BECOME A MIDWIFE? 4. BAGAIMANA MENJADI seorang bidan? There are many different paths to becoming a midwife. Ada banyak jalan yang berbeda untuk menjadi seorang bidan. Which path you choose will depend on many factors: where you live, what the rules and regulations are in your state or country which govern midwives, your age and education, and what sorts of experiences you have had with birthing. Jalan mana yang Anda pilih akan bergantung pada banyak faktor: di mana Anda tinggal, apa aturan-aturan dan peraturan di negara Anda atau negara yang mengatur bidan, umur dan pendidikan Anda, dan apa macam pengalaman Anda telah dengan melahirkan. The most important thing is that you need to look at your reasons for wanting to become a midwife are, both short term and long term. Yang paling penting adalah bahwa Anda perlu melihat alasan Anda ingin menjadi seorang bidan adalah, baik jangka pendek dan jangka panjang. This will help you determine which path is best for you. Ini akan membantu Anda menentukan jalan mana yang terbaik bagi Anda. The resource published by Midwifery Today Getting an Education: Paths to Becoming a Midwife gives good guidance and information about the various paths to becoming a midwife. Sumberdaya diterbitkan oleh Midwifery Today Memperoleh Pendidikan: Jalan untuk Menjadi Bidan memberikan petunjuk yang baik dan informasi tentang berbagai jalan untuk menjadi seorang bidan. Some women start as childbirth educators and/or doulas to see how it feels to them. Beberapa wanita melahirkan mulai sebagai pendidik dan / atau doulas untuk melihat bagaimana rasanya kepada mereka. I started as a childbirth educator, and offered to labor support births with my students. Aku mulai sebagai pendidik melahirkan, dan menawarkan dukungan tenaga kerja Kelahiran

dengan murid-murid saya. It reaffirmed my decision to become a midwife, and the fire within me became very strong. Ini menegaskan kembali keputusan saya untuk menjadi seorang bidan, dan api dalam diri saya menjadi sangat kuat. I lived in California at the time, and already had a 2 year degree in nursing, so decided upon sought a Certificate program, through the University of Mississippi, which was one year. I could have done things differently, but this path seemed the best one for me at the time. Aku tinggal di California pada waktu itu, dan telah memiliki 2 tahun gelar dalam perawatan, sehingga diputuskan mencari program Sertifikat, melalui University of Mississippi, yang satu tahun. Aku bisa melakukan hal-hal yang berbeda, tapi jalan ini sepertinya yang terbaik satu untuk saya pada saat itu. While teaching childbirth classes and gaining experiences with childbirth, I soon met midwives and others interested in birthing. Ketika mengajar kelas melahirkan dan mendapatkan pengalaman dengan melahirkan, aku segera bertemu dengan bidan dan orang lain yang tertarik dalam melahirkan. I observed many different types of births and began develop a personal philosophy about birthing. Aku mengamati banyak jenis kelahiran dan mulai mengembangkan filosofi pribadi tentang melahirkan. I also became good friends with a midwife, and she mentored me to help me gain experience. She was an unlicensed midwife who became an RN at 35 and then a CNM. Saya juga menjadi teman baik dengan seorang bidan, dan ia membimbing saya untuk membantu saya mendapatkan pengalaman. Dia adalah seorang bidan yang tidak berlisensi menjadi RN di 35 dan kemudian perawat-bidan. She has practiced in every type of setting as a midwife, including a private home birth practice and large Health Maintenance Organization (HMO) practice. Dia telah dipraktikkan di setiap jenis pengaturan sebagai seorang bidan, termasuk rumah pribadi praktek kelahiran dan besar Pemeliharaan Kesehatan Organization (HMO) praktek. 5. WHERE DO I FIND A MIDWIFE? 5. MANA SAYA MENEMUKAN seorang bidan? Seek midwives in your

community, state and country of province. Carilah bidan di komunitas Anda, negara negara dan provinsi. Speak with local childbirth educators about midwives they know, and of course, talk with your friends about their birth experiences and their particular choice of provider. Berbicara dengan pendidik melahirkan lokal tentang bidan yang mereka ketahui, dan tentu saja, berbicara dengan teman-teman Anda tentang pengalaman kelahiran mereka dan mereka pilihan tertentu selular. Watch for health fairs in your area, check with herb and health food stores and ask questions of other types of health providers such as massage therapists and doulas. Perhatikan pameran kesehatan di daerah Anda, cek dengan jamu dan toko makanan kesehatan dan mengajukan pertanyaanpertanyaan dari jenis-jenis penyedia layanan kesehatan seperti pijat terapis dan doulas. Call the local hospitals and ask about midwives, childbirth educators and doulas. Teleponlah rumah sakit setempat dan bertanya tentang bidan, melahirkan pendidik dan doulas. Some systems have referral systems for midwives well thought out, and you can easily locate a midwife. Beberapa sistem memiliki sistem rujukan untuk bidan dipikirkan dengan baik, dan Anda dapat dengan mudah menemukan bidan. In other areas you may need to ask lots of questions. Di daerah lainnya, Anda mungkin perlu mengajukan banyak pertanyaan. Ask La Leche League leaders for names of midwives they know, as would any other groups that work with mothers and infants. Tanyakan La Leche League nama para pemimpin untuk bidan mereka tahu, seperti yang akan kelompok-kelompok lainnya yang bekerja dengan ibu dan bayi. There might be a listing within your phone book for midwives, but some midwives are not listed there due to finances or legalities. Mungkin ada dalam daftar buku telepon Anda untuk bidan, tetapi beberapa bidan tidak terdaftar di sana karena keuangan atau yg berkenaan dgn hukum. In Georgia, in the US, only CNMs are found in the yellow pages and none of them attend homebirths. Di Georgia, di Amerika Serikat, hanya CNMs ditemukan di halaman

kuning dan tak satu pun dari mereka hadir homebirths. Contact nurse practitioners in your area, and also your local Health Department and Planned Parenthood. Kontak perawat praktisi di daerah Anda, dan juga Departemen Kesehatan setempat Anda dan Planned Parenthood. They will usually tell you their favorite providers first. Mereka biasanya akan memberi tahu Anda pertama penyedia favorit mereka. Contact the American College of Nurse Midwives ACNM@aol.com Phone: (202) 728-9860) for information about schools and practices within your area or The Midwives Alliance of North America Manainfo@aol.com Phone: (316) 283-4543) 6. Hubungi American College of Nurse Midwives ACNM@aol.com Telepon: (202) 728-9860) untuk informasi mengenai sekolah-sekolah dan praktik di daerah Anda atau The Bidan Aliansi Amerika Utara Manainfo@aol.com Telepon: (316) 283-4543 ) HISTORY OF MIDWIFERY IN THE UNITED STATES (in de DAFTAR PUSTAKA Helen Varney,Jan M. Kriebs, Carolyn L. Gegor Buku Ajar Asuhan Kebidanan Ed 4 jilid 1, EGC, 2007 Dwana Estiwidani, SST, Niken Meilani, S.SiT, Hesty Widyasih, SST, Yani Widyastuti, S.SiT, Konsep Kebidanan cet. 2, Fitramaya, 2008 Cristine Handerson, Kathleen Jones, Buku Ajar Konsep Kebidanan, Mosby-EGC, 2006 www.midwiferytoday.com/international/usa.asp www.acnm.org www.mana.org/we.html www.dona.org/abboutus/index

www.efn.org/%7Edjz/birth/midwifefaq/usmid.html www.mamahalvito.blogspot.com/donwload/MAMAHALVITOSEJARAH-KEBIDANAN.htm www.highman-purwanto.weblog.com/download/sejarahperkembangan-pelayanan-pendidikan-kebidanan