Course Syllabus ©National College of Midwifery 2012
01/2012
Course Title: Well Woman Pharmacology
Credits: 1.0
Course Description: This course is designed to give students a thorough introduction to
pharmacology as it relates to well-woman care. The pharmacology of contraception methods is
explored in-depth in this course in addition to an exploration into non-allopathic protocols for
common well-woman problems. This course uses current research in midwifery and obstetrics
to broaden the student’s understanding of the following NARM skills and MANA core
competencies learned under clinical supervision:
NARM Skills
I. Midwifery Counseling, Education and Communication
(1)-I A. Provides interactive support and counseling and/or referral services to the mother
regarding her relationships with her significant others and other healthcare providers
(3)I C. Provides education and counseling based on maternal health/reproductive/family
history and on-going risk assessment
(7)-I G. Applies the principles of informed consent
(8)-I H. Provides individualized care
VI. Well-Women Care
(144)-VI E. Provides education
(145)-VI F. Assesses client’s family planning history and needs: counsels/prescribes
(146)-VI G. Provides opportunity for client to discuss problems or concerns
(147)-VI H. Refers client to other healthcare professionals, services, agencies, or other, as
indicated
MANA Core Competencies:
I. Guiding Principles of Practice.
The midwife provides care according to the following principles:
1 E. Midwives understand that female physiology and childbearing are normal processes, and
work to optimize the well-being of mothers and their developing babies as the foundation of
care giving
1 H. Midwives recognize the empowerment inherent in the childbearing experience and strive
to support women to make informed decisions and take responsibility for their own well-being.
1 J. Midwives synthesize clinical observations, theoretical knowledge, intuitive assessment and
spiritual awareness as components of a competent decision making process.
1 K. Midwives value continuity of care throughout the childbearing cycle and strive to maintain
continuous care within realistic limits.
II. General Knowledge and Skills
The midwife provides care incorporating certain concepts, skills and knowledge from a variety
of health and social sciences including, but not limited to:
2 C. Community standards of care for women and their developing infants during the
childbearing cycle, including midwifery and bio-technical medical standards and the rationale
for and limitations of such standards
2 M. The ability to develop, implement and evaluate an individualized plan for midwifery care.
2 N. Woman-centered care, including the relationship between the mother, infant and their
larger support community.
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Course Syllabus ©National College of Midwifery 2012
01/2012
2 O. Knowledge and application of various healthcare modalities as they apply to the
childbearing cycle
V. Postpartum Care
The entry-level midwife provides health care, support and information to women throughout the
postpartum period. She determines the need for consultation or referral as appropriate. The
midwife uses a foundation of knowledge and/or skill, which includes, but is not limited, the
following:
5 G. Support, information and referral for family planning methods, as the individual woman
desires.
VIII. Woman care and Family planning
Depending upon education and training, the entry-level midwife may provide family planning
and well-woman care. The practicing midwife may also choose to meet the following core
competencies with additional training. In either case, the midwife provides care, support and
information to women regarding their overall reproductive health using the foundation of
knowledge and/or skill which includes the following:
8 A. Understanding of the normal life cycle of women.
8 B. Evaluation of the woman’s well-being including relevant historical data.
8 C. Causes of, evaluation of, and treatments for problems associated with the female
reproductive system and breasts
8 D. Information on, provision of, or referral for various methods of contraception
8 E. Issues involved in decision-making regarding unwanted pregnancies and resources for
counseling and referral.
Learning Activities:
A. Student reads appropriate sections from the Learning Materials/Resources.
B. Student answers the questions listed in the Learning Objectives by researching the
Learning Materials/Resources for the course and correctly cites the sources and page
numbers for each of their answers.
C. Student presents answers the questions listed in the Learning Objectives for review by
preceptor.
D. Student participates in preceptor elaboration/discussion of Learning Objectives.
E. In the case that the required texts are more than 5 years old, the student must research,
prepare & present a summary of current best midwifery care/practices appropriate to a
topic covered in this course from a current journal article/study, less than 5 years old.
F. Recommended Role-playing and/or Clinical Interactions
Note: The clinical requirement of NARM /Clinical Skills is completed at any time
throughout the ASM apprenticeship during actual clinical practice and is NOT a
requirement to complete this academic course.
Activities specific to NARM skills learned in this section:
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Course Syllabus ©National College of Midwifery 2012
01/2012
1. Create a reference chart with the different forms of birth control and their
theoretical rates of effectiveness to discuss with clients.
2. Create a reference chart with different forms of birth control that are
considered safe during breastfeeding.
3. Show another student or preceptor how to effectively use spermicide with
a diaphragm.
4. Arrange a day to shadow a nurse-practitioner in a Planned Parenthood or
other county health agency clinic that provides well-woman care.
5. Create several documents that outline herbal/dietary protocols for the
treatment of common reproductive tract infections to give to clients.
Learning Materials / Resources:
Please use textbooks less than 5 years old or most recent edition.
1. Romm, Aviva. Botanical Medicines for Women’s Health. Churchill Livingstone Press.
2010.
2. Tharpe, Nell and Farley, Cindy. Clinical Practice Guidelines for midwifery and women’s
health. 3rd edition. Jones and Bartlett Publishing. 2009
3. Manning, Loretta. Pharmacology Made Insanely Easy. 3rd edition. ICAN Publishing Inc.
2009
4. Romm, Aviva. Botanical Medicine for Women's Health. Churchill Livingstone. 2010
5. Misoprostol in obstetrics and gynecology website 2011. www.misoprostol.org
6. The North American Menopause Society website 2011. www.menopause.org
7. MEAC Abbreviated NARM Skills Form.
8. MANA Core Competencies for Midwives
9. Midwives Model of Care®.
10. Students must find 1 article/study less than 5 years old. Recommended internet links
as needed for latest developments in midwifery care:
The Cochrane Collaboration
EBSCO
National Library of Medicine
PubMed
Medline
SCIRUS
Medscape
World Health Organization
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Course Syllabus ©National College of Midwifery 2012
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Evaluation Tools / Methods:
Minimum passing grade for each course is a cumulative 80% / B-. Students and preceptors
are encouraged to work together until the student masters the information.
Final grade for the course is based on preceptor evaluation of the following:
A. Learning Objectives count for 80-90% of the final grade.
The preceptor evaluates each answer based on three elements:
1. Answers should reflect a thorough review of current literature regarding best
current practices in midwifery care.
2. Each answer should be formed in the student’s own words or paraphrased
from the text. The answer should be minimal, not a re-write of the entire text,
but enough to show appropriate comprehension of the learning objective.
3. Student identification of sources and page numbers for each of the Learning
Objectives. (Preceptor should do a random check to determine that sources
cited are correctly identified.)
B. Summary of current journal article / study counts for 10% of the final grade in the case that
other scholarly resources used are more than five years old.
C. Exam counts for 10% of the final grade.
Course credit:
One Academic credit equals approximately 15 hours of formal time plus 30 hours of additional
study or homework. Formal time is defined as the amount of time taken to answer the Learning
Objectives to the level of 80% and to complete any learning activities to the preceptor's
satisfaction, including any time spent face to face with the preceptor. Informal time includes
any time spent actively reading relevant sources and textbook/s, researching Learning
Objectives, and studying for examinations.
Learning Objectives:
A. The student must research, prepare & present a summary of an aspect of current best
midwifery care/practices appropriate a topic from this course from a current journal
article/study.
B. Student answers the questions below and cites the sources and page numbers.
1. Discuss the pharmacology of emergency contraception. How does it act to reduce the
chances of conception after unprotected sex?
2. Give the standard dose and route of administration of emergency contraception.
3. Describe the contraindications and side effects of emergency contraception.
4. Describe the pharmacology of spermicide. How does it act to kill sperm?
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Course Syllabus ©National College of Midwifery 2012
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5. Describe the standard dose and route of administration of spermicide.
6. Describe the contraindications of spermicide use.
7. Describe the pharmacology of injectable hormone contraception (Depo-Provera).
8. Describe the standard dose, route and timing of administration of Depo-Provera.
9. Describe any contraindications and side effects associated with Depo-Provera.
10. Discuss the pharmacology of progestin-only pills. How do they work to prevent
pregnancy?
11. Describe the standard dose and route of Progestin-only pills.
12. Describe any contraindications and side effects associated with progestin only pills.
13. Discuss the pharmacology of Implanon (subdermal implant). How does it work to
prevent pregnancy?
14. Describe the standard dose and route of Implanon.
15. Describe any contraindications and side effects associated with Implanon.
16. Discuss the pharmacology of combination estrogen and progestin hormonal birth control
pills. How do they work to prevent pregnancy?
17. Describe the standard dose and route of the combination hormone birth control pill.
Include a brief distinction between low-dose, ninety-day, and year round pills.
18. Describe any contraindications and side effects associated with combination pills.
19. Discuss the pharmacology of transdermal birth control patch. How does it work to
prevent pregnancy?
20. Describe the standard dose and route of a transdermal birth control patch.
21. Describe any contraindications and side effects associated with a transdermal birth
control patch.
22. Discuss the pharmacology of the contraceptive vaginal ring. How does it work to
prevent pregnancy?
23. Describe the standard dose and route the contraceptive vaginal ring.
24. Describe any contraindications and side effects associated with the contraceptive
vaginal ring.
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Course Syllabus ©National College of Midwifery 2012
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25. Discuss the pharmacology of a hormonal IUD. How does it work to prevent pregnancy?
26. Describe the standard dose and route of a hormonal IUD.
27. Describe any contraindications and side effects associated with a hormonal IUD.
28. Discuss the pharmacology of mifepristone (RU-486) in its use as a medical abortion
agent. How does this drug act to end pregnancy?
29. Discuss the dose, route and timing of administration of mifepristone as an abortion
agent.
30. Discuss contraindications and side effects associated with mifepristone.
31. Discuss the pharmacology of misoprostol (Cytotec) as an medical abortion agent. How
does this drug act to end pregnancy?
32. Discuss the dose, route, and timing of administration of misoprostol as an abortion
agent.
33. Discuss contraindications and side-effects associated with the use of misoprostol.
34. Explain of the significance of using a drug such as misoprostol (cytotec) for an “offlabel” use that is not FDA approved.
35. Discuss the use of homeopathic remedies in the recovery process after a medical
abortion.
36. Discuss the use of herbal remedies in the recovery process after a medical abortion.
37. Briefly discuss the pharmacology of hormone replacement therapy for the treatment of
symptoms related to menopause.
38. Describe the side effects and contraindications associated with hormone replacement
therapy.
39. Discuss the pharmaceutical agents that are often prescribed for treatment of bacterial
vaginosis.
40. What is the dose, route and frequency of these agents used in the treatment of bacterial
vaginosis?
41. Describe an herbal douche that can be used in the treatment of bacterial vaginosis.
Include details such as herb ratios, timing and contraindications.
42. Discuss how garlic can be used in the treatment of bacterial vaginosis.
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Course Syllabus ©National College of Midwifery 2012
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43. Describe another herbal protocol for the treatment of bacterial vaginosis that is not yet
listed. Include the dose, route and contraindications of this protocol.
44. Briefly discuss the pharmaceutical agents that are used in the treatment of genital
candidiasis (yeast infection).
45. Discuss the different protocols for drug treatment of candidiasis and their relative
effectiveness.
46. Discuss the use of cranberry, cranberry extract and cranberry juice in the treatment of
candidiasis. What action does the cranberry have against candidiasis?
47. Discuss probiotic and yogurt therapy in the treatment of candidiasis. What is the
rationale behind its use?
48. Discuss herbal suppositories in the treatment of candidiasis. Give an example of at least
one type, how it is used and what its expected effect is.
49. Discuss the use of pharmaceutical agents in the treatment of herpes simplex virus
(HSV). What agents are most commonly used and what are their expected effects?
50. Discuss a herbal/dietary protocol for management HSV. Include when it should be used
and its desired effect.
51. Discuss vitamin therapy for the treatment of human papilloma virus (HPV). What
vitamins are said to have an effect on HPV?
52. Discuss the use of pharmaceutical agents in the treatment of severe premenstrual
syndrome (PMS). What agents are often prescribed and what is the rationale for their
use?
53. Discuss an herbal protocol for the treatment of PMS
54. Discuss a vitamin protocol for the treatment of PMS.
55. Discuss at least two herbs that are used in the treatment of hot flashed associated with
menopause.
56. Discuss at least two herbs that are used in the treatment of vaginal dryness associated
with menopause.
57. Discuss at least two herbs that are associated with sleepiness/night sweats associated
with menopause.
58. Discuss two homeopathic remedies that are associated with the relief of symptoms
related to menopause. Include a brief explanation of the substance each remedy is
derived from.
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Course Syllabus ©National College of Midwifery 2012
01/2012
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