Program Content & Clinical Requirements

The ATM Midwifery Training Program (ATMMTP) curriculum is based on the Midwives Alliance of North America Core Competencies for Basic Midwifery Practice, MANA Standards and Qualifications for the Art and Practice of Midwifery, NARM written and skill test specifications, and the Midwives Model of Care™.  As a Texas Department of Licensing and Regulation (TDLR) approved program, the ATMMTP curriculum also includes the laws and rules applicable to Texas Licensed Midwives.  The ATMMTP requires all students to document a minimum of 500 hours of academic study. Most students will need significantly more time than 500 hours to complete all assignments. All of the time spent reading textbooks, research, completion of coursework and projects, and classroom time count towards the minimum of 500 hours. Clinical training does not count towards academic education hours.

Prerequisites

The Texas Midwifery rules requires midwifery students to have a high school diploma or GED certificate, and current certification in healthcare provider Basic Life Support (BLS) CPR.  

PLEASE NOTE CPR certification must be from one of the following:

Additional Requirements:

  • Must be able to provide references (specified reference form is part of the application packet)

  • Must have a valid driver's license

  • Must be a student member of the Association of Texas Midwives prior to Orientation

  • Must demonstrate academic readiness by means of a written essay

In Person Workshops

Every ATMMTP module ends with a one to three-day mandatory workshop.  Workshops are in-person, classroom-style workshops. The workshop for Anatomy & Physiology is completed virtually. These workshops are taught by a team of experienced instructor-midwives who use various teaching methods to help reinforce learning and help the student begin to integrate and apply theory with clinical practice. Module content is reviewed using lecture, audio/visual aids,  discussion, and clinical simulations, with demonstration and hands-on practice of skills. Students are challenged to practice critical and clinical thinking skills. At the end of each workshop, the student must pass a comprehensive exam over the material covered in the module before advancing to the next study module.

  • Module Length: 14 weeks

    Part One: Coursework

    • History and Profession of Midwifery

    • The Midwifery Model of Care and Shared Decision-Making

    • Introduction to Medical Terminology

    • Birth Planning: Benefits and Risks of Birth Sites

    • General Nutrition and Fitness

    • Vital Signs - accuracy and assessment

    • Research, Reading, and Evidence-Based Practice in Midwifery

    • Basic skills practice assignment (vital signs)

    Included with the first module:

    • Independent Study assignments to complete throughout the program, including

    • Pharmacology & Alternative Modalities Project

    • Community Resources Project

    Part Two: Online Workshop

    • Review of the History and Profession of Midwifery

    • Review of general nutrition and fitness

    • Review of vital signs

    • Ethics and role of the midwife in community and professional relationships

    • Final Module Exam

  • Module Length: 14 weeks

    Coursework

    • General and reproductive anatomy & physiology

    • Human anatomy and physiology of all organs and body systems, including normal changes due to pregnancy

    • Overview of human genetics

    • Human reproduction: human reproductive cycles, fertilization

    • Embryonic development and fetal growth

    • The placenta and fetal membranes

    • Fetal circulation and the transition to neonatal life

    • Module Final Exam

    • *note* no in person workshop

  • Module Length: 14 weeks

    Part One: Coursework

    • Vocabulary

    • Reproduction and Pregnancy

    • The Female Pelvis & Pelvimetry

    • The health and obstetrical history; pre-existing risk factors

    • Cultural issues affecting pregnancy and birth

    • Maternal health history and physical assessment (Physical Assessment ISP due)

    • Prenatal Care 1

    • Prenatal Fetal Assessment 1

    • Exercise during Pregnancy

    • Prenatal Nutrition and Counseling

    • Common Discomforts of Pregnancy

    • Basic Diagnostic Testing

    Part Two: Workshop (in-person)

    • Pregnancy

    • Prenatal care

    • The Health History

    • Nutrition and Exercise in Pregnancy

    • Routine fetal assessment

    • Basic diagnostic testing

    • Skills (initial physical exam and obstetrical exam; venipuncture; Pap smears)

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Physiology of labor and birth

    • Fetal skull and fetal positions

    • The Bishop's Score

    • First stage of labor

    • Normal second stage of labor

    • Intrapartal maternal assessment

    • Intrapartal fetal assessment

    • Comfort measures and techniques for labor

    • Waterbirth and hydrotherapy

    • Third stage of labor

    • Fourth stage of labor and the immediate postpartum

    • Birth equipment and supplies

    • Cultural Competency Health Practitioner Self-Assessment

    • The Newborn at Birth ISP due

    • Professional Ethics in Midwifery Practice

    Included with the fourth module:

    • Mini-course: The Normal Newborn at Birth

    Part Two: Workshop (in-person)

    • Fetal skull & fetal positions

    • Mechanisms of labor

    • Signs of labor

    • Initial labor assessment

    • Stages of labor

    • Maternal and fetal assessment

    • Labor support & comfort measures

    • Waterbirth

    • Setting up for birth - equipment & supplies

    • Charting

    • Skills (Estimating blood loss, vaginal exams, urinary catheterization, placental inspection)

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Prenatal Care 2 - Advanced and Special Situations

    • Psychosocial Aspects and Issues in Pregnancy

    • Diagnostic Testing 2

    • Perinatal Epidemiology: Infections during the Childbearing Period

    • Prenatal Fetal Assessment 2

    • Danger Signs during Pregnancy

    • Antepartum Complications

    Included in fifth module:

    • MINI-COURSE: Social Determinants of Health and the Midwife

    • MINI-COURSE: Female Genital Mutilation or Cutting

    Part Two: Workshop (in-person)

    • Prenatal Care -- Special Situations

    • Psychosocial Aspects and Issues in Pregnancy

    • Social Determinants of Health

    • Fetal Assessment 2

    • Infections during the Childbearing Period

    • Cultural issues and disparities in birth outcomes

    • Complications of Pregnancy

    • Diagnostic Testing 2

    • Ongoing Risk Assessment

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Complications of 1st and 2nd stage labor

    • Fetal Assessment 2

    • Vaginal Birth After Cesarean

    • Complications of 3rd and 4th stage, and the immediate postpartum

    • Complications of Labor and Birth project

    • Case studies

    Included with sixth module:

    • MINI-COURSE: Disaster Preparedness for Midwives

    Part Two: Workshop (in-person)

    • Complications of labor & birth

    • Transports

    • Vaginal birth after cesarean

    • Fetal assessment 2

    • Skills: simulations of emergency situations

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Required reading

    • Vocabulary

    • The postpartum period

    • Complications of the postpartum period

    • Family planning

    • Pre-conception and well-woman care

    • Pap smears

    • Applying the Midwifery Model of Care

    • The Business of Midwifery

    Part Two: Workshop (in-person)

    • Immediate postnatal care: monitoring, complications

    • Postpartum period: exams, postpartum depression, unexpected outcomes

    • Family planning

    • Well-woman care

    • Basic Business Skills

    • Community Resources Project due

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Required reading

    • Vocabulary

    • The newborn period

    • Newborn complications

    • Breastfeeding & bottle-feeding

    • Applying the Midwifery Model of Care

    Part Two: Workshop (in-person)

    • Immediate postnatal care: monitoring, complications

    • Newborn period: normal & abnormal, newborn exams & assessments

    • Breastfeeding & bottle-feeding

    • Skills: Newborn exam, newborn screening

    • Module Final Exam

  • Module Length: 14 weeks

    Part One: Coursework

    • Suturing

    • Introduction to Pharmacology for Midwives

    • Medication administration

    • Intravenous (IV) Therapy

    • Module Final Exam (must be passed before skills workshop)

    Part Two: Workshop (in-person)

    • Standard precautions and needle safety

    • Medication administration

    • Starting an IV

    • Suturing

    Due prior to graduation:

    • Pharmacology and Alternative Modalities Independent Study Project

    • Practice Guidelines

  • Upon successful completion of all ATM Midwifery Training Program requirements, including clinical training, a graduation certificate will be awarded. A copy of the certificate is submitted to the Texas Department of Licensing and Regulation toward fulfillment of the educational requirements of the licensing process, required to practice midwifery in Texas. The graduate is then eligible to take the NARM exam as a Texas Agency Candidate.

 

 Required Textbooks

The textbooks required for completion of academic coursework include the most current and evidence-based midwifery textbooks, and will provide the student with a thorough understanding of midwifery care, and the tasks and skills expected of a competent midwife. These books are generally available through the publishers and may be ordered on-line, or through bookstores and libraries. A list of recommended reading, which will broaden and enhance the student's learning experience, is included with the list of required texts. The Required Textbooks and Reading list identifies each required text by the module. Students should order the required textbooks well in advance of need. Please note that each instructor has autonomy over the module they teach. They may require additional textbooks or not require textbooks on the list. Most of the textbooks are used in more than one module and become reference material once the student becomes a licenced midwife.

Some publishers offer our students a significant discount on textbooks when purchased from the publisher's website. Remember to check with your local library for books you can borrow or get from an Interlibrary Loan. Also, Amazon may offer these textbooks to rent or as digital versions.

Computer Requirements

Students will require a computer and the ability to upload your work in PDF form. Both MAC and PC are used without issue.

 Clinical and Skills Requirements

This section reviews information on the minimum clinical requirements that every student must meet. During the course of clinical training, most students will require experience beyond the minimum number listed here. All clinical requirements must be supervised by an approved ATMMTP preceptor.

During the Clinical Phase, each student will progress through three levels of their apprenticeship, with a set number of clinical goals taking place during each phase.

  • Level One: Observer

  • Level Two: Assistant

  • Level Three: Primary Midwife Under Supervision (PMUS)

Minimum Clinical Requirements

The below clinical requirements are the minimum number required to fulfill ATMMTP graduation requirements.

Observer

  • Attendance at a minimum of 10 births in the role of an observer.

  • Students must be present for the birth; intrapartum transports may not count towards this requirement.

  • As with all other requirements, these births must be under the supervision of an ATMMTP preceptor.

 

Assistant (learning the skills of a midwife)

  • 20 newborn exams

  • 25 prenatal exams, 3 of which must be the initial physical exam and medical history

  • 10 postpartum exams

  • 20 births

    • No more than 2 intrapartum transports may count towards this requirement.

    • 18 must occur before births as Primary Midwife Under Supervision

Primary Midwife under Supervision (PMUS)


Students must learn, practice, and perfect the skills necessary to provide all components of each requirement before care can be provided as PMUS. As PMUS the student must be able to competently provide all aspects of care, and be able to communicate the rational for the care and her clinical decisions, all while under the direct supervision of an approved preceptor.

In the role of Primary Midwife under Supervision the student must complete a minimum of the following:

  • 20 Newborn exams

  • 20 Initial physical exams and histories

  • 75 Prenatal exams

  • 40 Postpartum exams

  • 25 Births

    • Each birth must include one prenatal and one postpartum exam

 

The 25 births as PMUS must include the following:

  • At least 10 of the births as PMUS must be out-of-hospital births

  • 10 “Full Continuity of Care” births (includes 5 prenatal exams as PMUS spanning 2 trimesters, the newborn exam, and 2 postpartum exams)

  • 3 “Continuous Continuity of Care” births (same as above but includes all prenatal care beginning no later than 15 weeks gestation)

  • A total of 3 of births as PMUS may be intrapartum transports; the student must accompany the woman to the hospital. Only 1 of the 3 transports may be a Continuous Continuity of Care client

 

In addition to the above requirements:

  • At least 2 of the 55 total births must be planned hospital births (any role)

  • At least 5 of the 55 total births must be home births (any role)

  • At least 5 of the 55 total births must be under the supervision of a Licensed Midwife (as opposed to a CNM or physician)

All required clinical requirements must be supervised and verified by ATM approved preceptors.

The clinical component (apprenticeship period) must be ongoing for a minimum of twenty-four (24) months duration. The clinical time will be verified by the preceptor in a letter stating that the student has completed an apprenticeship period of at least 24 months.

Skills Requirements

Required skills will be learned according to specific techniques described in the Practical Skills Guide for Midwifery, by Weaver & Evans.  Students must demonstrate mastery all required skills, to be verified by the preceptor.  A second verification of certain skill-sets, such as a "basic physical exam" or "newborn exam", will be evaluated by a second, independent preceptor prior to graduation eligibility.