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March 4, 2002

The Royal Treatment

By Eric Rangus


While it’s certainly a major part of the job, nurse-midwifery is much more than birthing babies.

“I’ve had patients come see me for their annual exams when they are in their 70s,” said Joyce King, assistant professor of nursing and a nurse-midwife for more than 20 years.

“The word ‘midwife’ simply means ‘with women,’” said King, who has taught nurse-midwifery for most of her 23 years at Emory. “I’m a nurse and a midwife, and a midwife simply cares for women throughout their reproductive life.”

The bond formed between midwives and their patients is stronger than that of perhaps any other health care professional, even other nurses. The intimacy of a baby’s arrival and all the preparation that goes into it—not to mention the birth itself—makes this connection natural. King estimated she spends double the time a physician spends with their pregnant patients.

“When a patient shows up at the hospital, I’m there with her,” King said. “I rub her feet. I rub her back. I get her into the shower. I get her into the rocking chair, I walk with her. If she wants pain medication, I get that for her. I am there to support her in any way I can, to liaison between her and her family and the nursing staff and anybody else she may have to interact with.”

The midwife then will deliver the baby and help new mothers with activities like breastfeeding. Six weeks after the baby’s birth, the midwife can perform postpartum checkups.

Most any issue regarding women’s health, from hormonal therapy for menopause to family planning and contraception, falls within the realm of a nurse-midwife. But it is childbirth that is most associated with the profession.

King said she has seen patients for whom she has delivered children outside the office. Not only the mother but the father will embrace her and tell her how glad they are to see her.

“You probably wouldn’t see that with a primary care physician,” she said. “It’s special sharing that with somebody.”

King received her master’s in nursing from from Vanderbilt University in 1976. Her first assignment was at a rural health clinic in Soddy-Daisy, Tenn., about 35 miles and 100 years from downtown Chattanooga. She, in fact, was the first nurse practitioner in that part of the state.

King recalled treating the children from one family who were suffering from amoebic dysentery, an affliction caused by drinking contaminated water. When she visited their home, she found a dwelling with no running water and no plumbing of any kind, not even an outhouse. Human waste was scattered throughout the yard, and the odor was repulsive.

“My whole job was to help them find a way to get clean water, and I helped them build an outhouse,” King said.
In Chattanooga, King found an old cement water closet, and she contacted people from the health department who took it out to the house. Together, they dug a latrine and built an outhouse around it.

“You think, ‘Am I in Africa? Where am I?’” King said.

In 1979, following a few years in Soddy-Daisy, she came to Emory to teach and has been here ever since.

King teaches not only in the Nell Hodgson Woodruff School of Nursing’s nurse-midwifery program but also its nurse practitioner program. Beginning last fall, King and Associate Professor of Nursing Sarah Freeman began co-coordinating a women’s health/nurse practitioner program. Funded with money from a grant King and Freeman secured, it focused on ambulatory care. With no promotion and barely a month’s planning, five students were recruited for the program last fall. King hopes to increase that number for next year.

King’s current research ties together her clinical work in women’s health and research she conducted while earning her Ph.D. in physiology at Emory in 1995. For her dissertation, King studied obesity and investigated the connections between obesity and diabetes.

She has just written a grant proposal for an investigation into gestational diabetes, which some pregnant women contract. When the pregnancy is over, the diabetes goes away. Little is known about the affliction.

“About 5 percent of women become diabetic during the time they are pregnant, and they are more at risk for developing diabetes later in life,” King said. Obese women, she added, seem to be more susceptible. A hormone called leptin, discovered in the 1990s, appears to play a role in gestational diabetes. What exactly that role is, though, is unknown. And it’s what King wants to find out.

Outside the classroom and laboratory, King’s passion is travel. Sometimes it’s for work, like last summer when she was one of 16 Emory professors who traveled to Germany for the Halle Institute for Global Learning’s faculty study trip.

“That was an incredible experience,” King said. “It wasn’t like being a tourist; we met with politicians, professors, bankers, rabbis, heads of factories—it gave me a feeling not just for Germany, but for all of Europe and the political, economic and social issues that are important.”

Getting to share the experience with other professors was meaningful, as well. “We’re so insular here [in the nursing school], it’s difficult to participate in activities on campus because we’re so busy. So traveling with people from the law school and Oxford and the School of Public Health was wonderful. If I see these people on campus now, they’re like my good friends.”

King travels for fun, too. For instance, she and her 16-year-old son John are hiking the Appalachian Trail—in weeklong increments. Each year since John was 8, the two of them, along with King’s sister Judy and her nephew Paul, take a few days or maybe a week to hike the trail from Georgia to Maine. Last year, they hiked about 50 miles over three days. This year, they will pick up where they left off (in North Carolina), go as far as they can, then start again in 2003.

When will they make it to Maine and the trail’s northern terminus?

“Probably when I’m 90,” King laughed. “But that’s OK.”