Nancy Reinhart, MPH, CNM, Class 155 knew what she was looking for, and was willing to travel as far as necessary to find it. Her journey has taken her from her hometown of Louisville to Hyden, Kentucky; Fort Hood, Texas; Shiprock, New Mexico; and, currently, Gettysburg, Pennsylvania. The common theme behind every choice and step she has made has been her drive to serve rural and underserved communities.
Even with that as her guide, however, Reinhart did not set out to be a nurse-midwife. That began to change when she participated in Frontier’s Courier program during the summer between her junior and senior years of college.
“My family has always been committed to helping people and giving service,” she said. “But the rural healthcare piece was inspired by my experience in the Courier program. I saw my first birth and it made a tremendous impact on me. I actually chose my master’s program because of that history.”
After her Courier experience — which included meeting current FNU President Dr. Susan Stone, who was the Midwifery Program Director at that time — Reinhart earned a masters’ degree in public health and began a job in social justice. Soon thereafter she was contacted by Frontier and offered the opportunity to run the Courier program.
“I just knew it was a good fit for me,” Reinhart said.
It was also the beginning of her journey to become a nurse-midwife. Like all staff and faculty members at FNU, Reinhart attended Frontier Bound as part of her orientation. That experience convinced her that her dream of becoming a nurse-midwife could be a reality.
“When I was at Frontier Bound I was so amazed at the diversity of people and ages that were starting this journey,” Reinhart said. “I had been thinking I was too old and too far along in life. I was putting up all these barriers against myself, but that dream just wasn’t leaving me and that really helped me to get over the hump. So I went ahead and started chipping away at the educational requirements while running the Courier program.”
One of those requirements — acquiring clinical hours — proved to be a bit of a challenge. She found opportunities close to home at the University of Louisville and the Tree of Life Birth Center in southern Indiana. She enjoyed working with Damara Jenkins, MSN, CMN, Class 48, her primary preceptor at both sites, but both sites were in very high demand with other student requests. She also wanted some of her training to be in a rural setting with a strong collaborative physician-midwife model. Determined to find the experience she was looking for, she decided to expand her search.
“There was an intense amount of clinical pressure on the sites local to me. As soon as I gave up a spot at both of the sites that I had for brief periods of time in Kentucky, they were taken by other students who needed clinical hours, particularly births,” Reinhart said. “I wanted to be at a higher volume site and one with a rural focus because that is how I envisioned practicing. That was a governing factor in why I chose to travel. It felt like to get what I was looking for, I was going to have to expand my horizons.”
That led her to the Carl R. Darnall Army Medical Center in Fort Hood, Texas. There, her primary preceptor was FNU graduate Susan Clapp, MSN, CNM, Class 81. She next went to Northern Navajo Medical Center in Shiprock, New Mexico, where she was primarily precepted by Venay Uecke, CNM, and another FNU graduate, Kerena Satlzgiver, MSN, CNM, Class 91.
“I traveled quite far,” Reinhart laughed. “We took our whole family on a roadshow from July to December in 2019.” Reinhart’s family consists of her husband, Dave Mitchell, who is a therapist, and three children ages 4, 9, and 11.
Reinhart expressed her gratitude to all the preceptors who taught her and to all the families who allowed her to participate in their births as a student. She said she learned a tremendous amount from the regional variation in midwifery practices that she saw across four states during clinical.
When the successful “roadshow” came to an end, it was time to find a full-time opportunity. Once again, the family had a vision for their desired next step.
“My husband and I were pretty clear about what our priorities were,” Reinhart said. “I prioritized rural health as something I was committed to serving. So we looked at what places and locations both had job openings, were rural serving underserved, and were relatively close to home, family, and friends. I had job opportunities in New Mexico and far afield, but we limited our search to Virginia, Maryland, Pennsylvania, and North Carolina. I wanted to serve women in a rural area through a full-scope midwifery position with a good work-life balance. I also wanted to be in a place with really supportive physicians. I know what it’s like for midwives when they don’t have supportive physicians to work with. Gettysburg fit all those things for us.”
Reinhart joined WellSpan OB/GYN in Gettysburg, Pennsylvania, as a full-scope nurse-midwife in July 2020. The practice, which consists of four nurse-midwives and four physicians, is the only one in the area that offers 24/7 nurse-midwifery care.
“We serve several surrounding, rural counties,” Reinhart said. “We have a largely low socioeconomic class of women and families that we serve. This is an orchard and farming area, so we serve migrant workers and their families as a part of our base. Just like anywhere that you have a diverse population, we have language barriers. One thing I really value about our hospital is that we have in-person Spanish language translators. It is such a nice human touch to have that for someone going through labor and often scary situations.”
The COVID-19 Pandemic has only added to the fear and stress of those situations, for both the patients and their caregivers.
“One of the things I love about birth is the intimacy that midwives provide before, during, and after labor,” Reinhart said. “The pandemic definitely disrupts that process. Most of our patients are good champs about it, but it is a different experience when you’re in labor and you see your healthcare provider covered from head to toe with protective equipment. I grieve that for my patients and I look forward to a time when we can be more physically connected.”
Reinhart went on to point out the mental health impact of the pandemic. Feelings of anxiety and isolation are understandably magnified when loved ones are not able to be as involved in welcoming a new addition to the family as they would like.
“Sometimes partners aren’t allowed in the appointments depending on the level of infection we have in our county,” Reinhart said. “Postpartum, the experience with so many partnerships and families trying to have this source of joy in their home and not being able to share that baby’s life with loved ones because of the pandemic is pretty tough on people.”
Even after the pandemic is over, there will be other challenges in healthcare and society in general. While serving as a certified nurse-midwife is enough, Reinhart is determined to do more to help others. Already involved in the American College of Nurse-Midwives (ACNM), she intends to increase her participation and to seek more ways to make a difference in her community.
“Frontier curriculum provided a high level of dedication to the aspects of public health, how the social determinants of health underlie our practice, identifying the political and practical trends that impact how we serve our clients,” Reinhart said. “That got me thinking about how I think of myself as a midwife outside of the hospital. What are the things I can be involved with in my community and ACNM to make a difference in the lives of the clients I serve to work to dismantle racism and other obstacles that people face to be able to be well and healthy? Frontier helped me see that bigger picture within the context of midwifery.”
Even though she’s only been in Gettysburg less than a year, Reinhart said she is considering applying to the local human relations commission and plans to start a perinatal loss support group. Further on the horizon, she would like to get her doctorate and eventually teach. No matter how long the route, Reinhart has proven she’s willing to put in the work — and the miles — to reach whatever goal is in her sights.
Editor’s note: Nancy’s father, Philmar Reinhart, a longtime supporter of Frontier who was very supportive of Nancy’s journey into midwifery, passed away during the time it took this story to come to print. We mourn with the family and are thankful for Nancy and her father, who attended many FNU events.