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Thursday
Dec012005

Apprenticeship - the not so glamorous view (un-published article)

Being a midwifery apprentice can take on many guises. Of course, it can be a wondrous and supportive experience. However, for too many, it can be a degrading and even humiliating moment in time. Depending on the community you find yourself in, the midwife you find yourself working with, the environment of birth in your community... all can have a distinct effect on the tone and vibe of your learning world. Talking with apprentices around the US and Canada, I have heard whispers of sadness, have “virtually” wiped tears, and listened to tales of "I could never practice midwifery the way she does!" over and over.

Women moving into an apprenticeship crave a great relationship filled with learning and understand the expectation of very hard work. Many senior midwives are able to fill their role as mentor lovingly and gracefully. Some apprentices never know that others midwife-hop to try and find a better fit. I applaud those that have found the "right" situation early on (or even on the first try!). Please remember, however, that not all are so lucky and when you hear of a woman going to a senior midwife asking to apprentice because she wasn’t a "good fit" with someone else, she might have really come from crap and just doesn't want to say as much. There is much to be said about discretion.

Apprenticeship in many communities is based on servitude. The book Becoming a Midwife fostered this (the book is out of print, but often used) by saying the potential apprentice in the courting phase should baby sit for the midwife, do her bills, cook for her, do her filing, etc. As she is accepted into an apprenticeship, that servitude accelerates into spending hours and hours a week in the midwife's office, attending prenatals, being the first at a birth and the last to leave postpartum, answering client questions over the phone, teaching childbirth classes and more. All of these are the general standard "requirements" for an apprentice.

When the relationship is reciprocal, and respectful, terrific! But, when the relationship is lopsided, it is a set-up for resentment and anger.

The mentor midwife typically would be responsible for assigning educational tasks, researching situations, answering questions, reviewing prenatals, reviewing/de-compressing after births, being supportive of difficulties, helping the apprentice work through relationship challenges, helping her to find the appropriate equipment, helping her to find training programs to augment her education, loaning her books, offering opportunities for her to learn from other midwives, doulas, lactation experts, etc.

Too many apprentice relationships forego the second half of the equation. And if the apprentice is not aware that there is another way of doing things, she can feel she is selfish for asking for anything. Some midwives, in their martyr space already, sigh and groan about being asked anything, even simple requests such as feedback from a recent birth experience. More offensively, in some communities, apprentices are being asked to pay for their education on top of augmented educational requirements for licensure.

I feel it is imperative for potential apprentices to keep their feet firmly planted in cement. Do not allow anyone, even the Great and Mighty Midwife, to make you feel badly about anything you ask for (or about) or need. Stay centered and believe in your Self as you know that you deserve respect, kindness, patience, and even compensation (eventually). If the mentor midwife doesn't want to offer an educational component, limit your access to the midwife. Some midwives feel that any birth talk is an educational component - I know several of these types of midwives and they honestly, truly, really feel that your working your buttocks off in the office and at births is the cost for the privilege of attending a homebirth (or birth center birth). That is inequitable. Don't doubt that.

No woman ever should be belittled, made to feel guilty, or yelled at either in private or at a birth. Communication skills are a hallmark of midwifery and if the mentor is unable to control herself with an apprentice, the apprentice really needs to reconsider where she wants to be. Is it worth your self-esteem or dignity to be a midwife via this avenue? How much does a person need to endure to meet a goal?

None of this speaks about a midwife that does things with and to a client that we might find unethical or even dangerous. Over the years, I have witnessed and even participated in activities I would never do today. I justify it now that I was able to see things/do things/learn things I wouldn't do in a million years... unless a mother or baby was dying in my hands. I have publicly and prayerfully apologized to the women I have hurt or witnessed being hurt and vowed to never operate in a space of uninformed consent again. As an apprentice, I had to find a place of understanding that women chose their midwife for a reason. However, if clients asked me, as an apprentice/student, my opinion on an issue, I would answer honestly and from my own reality. That got me in trouble more than once. As a senior midwife now, I would love to have an apprentice share her perception with clients! Her experiences, thoughts and ideas are all valuable and treasured. Learning through observation is crucial, yes. But, interaction is equally important.

Those of us with years under our belts, in life, not just birth, know that a certain amount of difficulty or challenge is necessary to get what we want in life. We take classes in school that have nothing to do with anything we need in life. We endure bosses who sign our paychecks. We even live in families where depression, addiction, or abuse reside because the benefits outweigh the risks of leaving. Sitting in an apprenticeship that is not healthy is no different. Weighing what you are willing to put up with before it begins and then re-evaluating as it goes along will go a long way towards keeping your sanity.

If the uncomfortable feelings tip the scales towards sadness and illness along with a distinct desire to not be with the mentor midwife, looking again at what you need is absolutely necessary.

Many of us who lived in a servitude-based apprenticeship have chosen a different way of taking on apprentices. We do not ask apprentices to do anything more than we are willing to do. We never ask an apprentice to go to a birth before us or leave after us. We never ask them to do the postpartum visits instead of us. We never send them to do PKU/Newborn screenings instead of us. We pay apprentices after 6 months' time. We always review prenatals and births. We strive for patience and kindness... nothing less than what we offer clients.

Experiencing several styles over the years has helped me to verbalize what others simply "feel" and don't have all the words for. I hope that this short piece helps others to find a great and wonderful fit with the mentor of your dreams!

Reader Comments (7)

Thank you for this. I'm an apprentice and you've confirmed just how lucky I am to have found a great balance "the first time" around. I feel blessed. Just as I'm sure your apprentices do!

December 1, 2005 | Unregistered Commenterladyelms

i am sobbing, and cannot read through all of this....hits too close to home, to some of my struggles to apprentice.
i will write you privately.

this is so needed.
it would save many many many depressions, doubts, midwives who never become midwives, and experience trauma as an apprentice, etc,

December 1, 2005 | Unregistered CommenterAnonymous

I wish this could be longer and more detailed. There are holes here - like the fact that sometimes there's nothing better for apprentices to chose from.
And sometimes apprentices need to get more humble. Sometimes, we do have to to whatever we have to in order to gain 'experience' because of the wasteland that is midwifery.

love to you

December 1, 2005 | Unregistered CommenterAnonymous

in the early 80's a friend and I approached a mw and asked if we could learn from her-- she said no go to ... I should I teach you!!! It made us mad but not discouraged and from there we did our own study group and got ahold of midwives from all around the region- many midwives traveled 300 miles to help us out for not alot of pay and do certain skill training or speak on certain subjects not famous mws just regular gals with a set of skills we didn't have - our group grew to about 13 women but maybe only 1/2 of us stuck with it and are mws. one or 2 of the gals worked with a woman who over worked and left very green apprentices to manage labor and post partum. I still meet this kind of mw and very few of them actually end up training someone all the way through to be mws-- so one thing to ask a mw you think might be iffy in the personality is how many of her students have become midwives.
I also agree that some students are very green and can be very challenging -- I have one younger student friend who was offended by some limits a mw had put on her while apprenticing and she left working with that gal in a huff, but now on reflection she says - what was I thinking I am so sorry I was acting out while working with her and she didn't yell at me but I just didn't like her telling me I couldn't talk or that she wanted me to clean something.
I think that students teachers and clients are people-- and all deserve respect. at times it takes some values clarification to figure out what is going on.
the statement buyer be ware could easily apply to apprentices as well as clients even if all your are paying is attention.
Interesting article Barb, once again thanks for sharing

December 1, 2005 | Unregistered CommenterAnonymous

I wanted to add that there can be a difference and not a bad mw difference where didactic learning is had either through self study or a distance learning situation like AAMI and that the preceptor mw is responsible for teaching/providing clinical skills but is not really assigning studies per se.

December 2, 2005 | Unregistered CommenterAnonymous

I can see why they would want it "+++'d up" some.
It tells the "other side" and right now there are a lot of entities that don't want to look at that other side.
This (IMO) is one reason why midwifery isn't recieving the accolades that it deserves - because there is little unification and common goals when it comes to programs, marketing, perceptions, etc.
Great things to think about and something that needed to be said. Tis a shame that they won't include/accept it.

December 5, 2005 | Unregistered CommenterWash Lady

I really appreciate the feedback regarding the article and will re-tool it with the added ideas. I did try to explain that not every woman will have choices when it comes to a mentor, but that she might need to become a midwife another way - perhaps like the midwives on The Farm... by DO-ing after reading like crazy.

It hurts that women are treated so poorly, but I know it happens still; many midwives are married to their style of teaching despite protestations and tears from their apprentices. I just don't understand except to suspect sadistic tendencies. As masochistic as I know I am, this was one area I eventually had to draw an S/m line.

I think that humility and the article are in two different places, but yes, humility *is* really important because the midwife is bringing the apprentice into her world (and many times, heart). It doesn't mean the apprentice has to be slavish, however, but humble isn't a bad place to be.

With regards to doing the didactic portion with another organization (NMI or AAMI for example) and apprenticing with a midwife - that is a common path around here at the moment. I think, in re-reading, I need to be more clear about what I mean.

It feels very unbalanced to me when a midwife says she will have nothing to do with the educational component - that if there are questions in the schoolwork, to look it up themselves. It seems unbalanced to have an apprentice do *all* the office work, processing insurance, making follow-up calls, teaching childbirth class, be first at a birth and the last to leave, do postpartum visits without the midwife - and the midwife feigning over-work and "look it up" issuing from her lips with every technical question - without any follow-up after the research is complete.

I know this scenario sounds extreme, exaggerated, or on the outer edge of possibility, but I have known several apprenticeships to go this way - and *not* just from the apprentice's perception!

I believe if clinical hands-on skills are the aspect of midwifery care being taught in the apprenticeship, an *even* amount of trade is appropriate.

If humility is present and one or the other party is feeling "used," a re-evaluation of the relationship might be wise.

Does this make more sense? I'll work on re-writing it, though I don't suspect it will be cheerful enough for the mag that turned it down.

Thanks to all for writing!

December 6, 2005 | Unregistered CommenterNavelgazing Midwife

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