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In my emailbox...

...was a short note from a woman who's been reading my blog since I began writing and yet has never commented before. She said she'd long wanted to be a midwife, but the likelihood was so remote, she went on to get another advanced degree. However, the desire to be a midwife still plagued (my word) her, so when the opportunity (her word) presented itself to begin midwifery school - to start school all over again - she snatched it up.

This woman emailed me to thank me for inspiring her (I think) - for making her think, to cry, to hunger, to keep moving until her hunger could be statiated. I sat reading - and re-reading - the letter and wondering if she could possibly know what she was getting herself into. As much as I have written, there are a million more words I have not/ CAN NOT share here. Some descriptions defy comprehension... are so utterly exquisite any words used to describe them would be vulgar and offensive. Other experiences have no words in our language to describe them, therefore trying to write about them, even for me, would seem painfully futile.

In Wicked, Glinda, waxing poetic about her happiness at having all of her dreams come true, realizes that, in fact, it isn't all so wonderful as she expected. (Please read the words carefully... they hold special importance here.)

No, I couldn't be happier
Though it is, I admit
The tiniest bit
Unlike I anticipated
But I couldn't be happier
Simply couldn't be happier
(spoken) Well - not "simply":
(sung) 'Cause getting your dreams
It's strange, but it seems
A little - well - complicated
There's a kind of a sort of : cost
There's a couple of things get: lost
There are bridges you cross
You didn't know you crossed
Until you've crossed
And if that joy, that thrill
Doesn't thrill you like you think it will
Still -
With this perfect finale
The cheers and ballyhoo
Wouldn't be happier?
So I couldn't be happier
Because happy is what happens
When all your dreams come true
Well, isn't it?
Happy is what happens
When your dreams come true!

I was just talking to a student midwife this past weekend about this very thing and she was saying how having a license would change things for her and I told her how not having a license freed her from things she didn't even know about - that grass being greener thing in action.

It is tough having a license. When I got mine I said I would never let the law dictate what I did with women, yet, today, 2 years later, I am allowing the law to cinch my corset tighter and tighter for fear of losing that license. If I lose the license, then I can't help the majority in the name of the one that I step out of the boundaries for in the moment. Is this fair? Probably not. Does this make me happy? Absolutely not. Is it safer for me? Sure. Do I like it? To be honest, in some ways, it's comforting to abdicate responsibility to The Law instead of fretting over whether I should step out of the boundaries and risk my license for someone who may or may not get angry... who may or may not have to transfer care anyway in the end, pissing off the medical folks... who may or may not understand all the ramifications of the alternatives anyway. It's just sometimes easier to say, "No, the standards say I can't do that."

Do I practice midwifery because it's easy, though? Of course not. Do I take the easy way out? No. But I don't want those without a license to presume that having a license makes things easier simply because there is a piece of paper with their name on it. It complicates things tremendously.


I want students and apprentices to think about that as they head towards licensure - to temper their excitement with a heaping dose of fear for the realities of the responsibilities that come with it.

Two lives, legal issues, political wrangling with sister midwives, fighting for women's rights, struggling marriages, the never-ending pull to be with our children, but having to be with our clients instead, the waterfall of money that goes towards midwifery and office supplies, the oceans-full of love that is given to family after family (with your own lives becoming entwined no matter how hard we try to keep it from happening), the constant threat of lawsuits, the constant threat of having our licenses taken away, the constant threat of going to jail - or worse, prison - the pain of second-guessing ourselves over every single mistake or, even if it wasn't a mistake, an outcome that was less than perfect, the pain of considering leaving midwifery when a tragic outcome occurs, the pain of realizing our human-ness and how horrible that is when it comes down to it.

Singing love songs about midwifery happens all the time. The struggles are glossed over. I'm in a sad and pain-filled time and wanted to share just a tiny snippet of what is going on in my head and heart.

Oh, dear blog-reader who is excited to become a midwife, I am happy for you - somewhere. But, I am also frightened for you. I know what is coming. And I shake my head in sadness for the day when you remember this post... and cry right along with me.

Reader Comments (8)

Food for thought: I understand you've experienced some difficulties, but so often you speak of midwifery and of your own office with disdain and disgust. How can you continue to offer loving, attentive, quality care with all that swirling in your head and heart? I'm not so sure you can. WHY do you continue? Why bother? It doesn't serve the people your work is meant to serve, and you've made it repeatedly clear it isn't serving you. If we consider the law of attraction as a factor, you might consider finding work you DO love and can speak kindly of, because this continued attitude isn't going to turn things around for you anytime soon. If potential clients could all read what you think about it, I wonder if they would want to trust you as their midwife, and just because they can't all read it...doesn't it emanate from you anyway? How will that truly build a practice?

And while I respect your right to hold and discuss your feelings about it, I personally feel it's unfair and selfish to speak of it as if it's the bottom-line truth for everyone, as if you're revealing the one real truth about being a midwife. This is what it's been like for YOU, but it is NOT every midwife's experience...it is NOT the truth of midwifery.

March 21, 2007 | Unregistered CommenterSam

I don't think I *ever* speak of midwifery with disdain or disgust... difficulty and hardship, yes. Disdain. Never. Midwives? Yes. Midwifery. No.

I went home last night and watched "The Secret" again. I understand I need some (a LOT of) work in the laws of attraction. I get that and am working on that really hard. You can not know the difficulties I have experienced; a handful do. But, that isn't here nor there.

I want to find the joy in my midwifery life and move forward and bring forth light and glee in everything I do and say when it comes to the work I am called to do.

I want to let someone else tell the shitty stories of bitch midwives, abusive doctors, nurses who assault women - I want to be one of the midwives who lives in Pollyanna-ville with her eyes straight ahead and her hands crossed and keeps to her Self.

Whomever voted for me to be the storyteller (me?), I abdicate the job.

March 22, 2007 | Unregistered CommenterNavelgazing Midwife

You know, Barbara, Bob Marley said it best, "Who feels it, knows it, Lord".
I have never heard disdain or disgust in your words, but I have felt the pain, the hurt, the frustration, the anger, the fear, the love, the joy, the hope,the honesty, the longing, and the BE-longing that pour so eloquently in your words, from your fingers to my mind.

It is impossible, in a profession that requires the very heart and soul of the midwife, to not be affected by the emotions that come from being so intimately involved in people's lives.
The hope that this beautiful woman before you has the birth she is dreaming about.
The rage and frustration of seeing her transported and treated like a perfect idiot, watching her being assaulted, and being powerless to stop it, because she needs the level of care they will grudgingly give her.
Crying in pain and exhaustion before turning the car around and forgetting about the shower, bed, and family that hasn't seen you in 2 days while you put on a cheery smile for the third laboring woman in as many days.
That even though your bones and your muscles and your heart and your soul is aching, you still jump when the phone rings, dress in the dark, kiss your sleeping children goodbye, write a note saying "I'm sorry I missed your birthday, your recital, your Championship game, your award banquet, watching you open your Christmas presents or cooking your Thanksgiving turkey, I love you and we'll do something special when I come home." and you go with joy and hope and love of what you do in somewhere in your heart, because how could we do it without a deep commitment and a calling to serve?

I am not the one to tell the starry-eyed wanna-be's how birth is perfect and complications only happen to a "certain type" of midwife. I am not the one to tell them that all her clients will love her and honor her and be eternally grateful to her forever and ever. I won't tell her that drinking red raspberry leaf tea, taking the Perfect Prenatal, and having the "right" mindset will gaurantee a perfect birth with a perfect outcome.
I won't tell her it's all chubby, pink babies, joyful mamas who breathe slow and deep, push without guidance, squat for the placenta and hardly bleed at all.

Bob Marley also said, "The Truth is an offense, but not a sin".

It's not always pretty, it's not always happy. But it always is just what it is.

And it needs to be told.

March 22, 2007 | Unregistered CommenterAnonymous

I've always felt your love in your words. I am beginning to see more clearly the increadibly hard road which midwives walk, and I'm greatful more and more for the slice of reality which you offer. At the same time I'm sad for the shadow you seem to be in right now. I read less and less of the cheerful joy in your writings and more of the tiredness and the sadness.

I recently spoke with a NZ midwife about how lovely their system is. Midwifery care is the standard of care for all pregnant women, even if their pregnancies are complicated and they require obstetrical assistance and hospital birth. The woman choses her place of birth, her midwife may serve her where she (the client) chooses, and no matter what, her midwife is always her primary maternity caregiver.

It's **that** world I walk and work toward, even here in the States. In the meantime I may practice defensively, with attention to the "standards of practice", and with some fear in my heart, for myself, for my family. It's not perfect, but little in the world is. I still believe that I can do great good for the women and babies I care for.

Perhaps I'm naive and very green, so forgive me if this is the case when I say that it's only those women, brimful of hope and flush with the bright, vivid love for this work, who will meet the challenges of their training and education and graduate to be the next generation of midwives. They are the women who will carry the profession forward. I'm not sure it would be possible to be a good midwife and not love it, need it, like you need air.

March 23, 2007 | Unregistered CommenterLouisa

Louisa! This is realated/unrelated to what Barb (who I love dearly and inspires me to write and emote) says.

There is a shadow side to NZ midwifery too as I have been exploring what it means to be a midwife there. Midwives, because of the level of responsibility, have their own to wrestle with as well...They are in the news anytime there is a "poor outcome", fight amoungst each other, struggle for equal pay for services etc...

Rates of Cesarean birth are fairly high, even with midwifery care.

A perfect world exists, when we can live perfectly in it (despite hardships, sadness, the reslities of the physical body) somewhere, in our dreams, in what we are capable of manifesting, but reality is our challenge....

One cannot separate or fully distingish shadow from light but live and dance in both. It is part of the process of

March 25, 2007 | Unregistered CommenterSunshine

I just want to say thank you for continuing to post your world here. As a student midwife I like to read many different experiences. Knowing what's ahead really helps me grow because I realize after reading each post (on many different sites) things I should work on NOW as opposed to being suprised by them later. I think the truth (whether yours or the light it sheds on someone elses) must be spoken, especially when it can be done as articulately, eloquently, as you do it.

And on another note, I really like the song you just posted...when I read it, it didn't hit me in the "happy to finally be studying midwifery" way (which is what I expected), but I felt it acutely as a first generation college student trying to get a graduate degree at an ivy league institution...which my life experiences pretty much made seem entirely impossible...and how crazy it feels that in all this happiness I still feel a very real sense of sadness for everything that it means to be in this position.

Keep blogging.

Thank you.

March 27, 2007 | Unregistered Commenter"Loving Pecola"

dear barbara, I've been skulking about reading your marvelous blog for a while. I'm an RN on a midwife unit in a large midwestern city. I hate what I see here, sometimes I hate it so much I think that I'm beginning to hate birth. I've wanted to be a midwife since I was 14 (now 31) and have delayed as I was a single parent for eight long years. Now I waffle. But just reading the description for Marsden Wagner's "Born in the USA" rekindles my fire for (homebirth) midwifery. I don't feel like I'd being going into a midwifery practice with rose colored glasses, if anything I sometimes wonder if I've been too jaded by my hospital life, but I do feel that I would be a good midwife, I just know that I can't change the system, but I can fight it.

March 30, 2007 | Unregistered Commenterredpomegranate

I've chewed it over time and time again. I've read so much information about The Law and about what it's doing to the work of midwifery. I've said I would then said no I wouldn't. See I would be that person risking my license for that one risky birthing mama who wanted to just keep going. I'd stick my neck out and I know I'd be up shit creek. So, I appreciate the layeredness of what you've written here. I also hear and feel your tears and your worry about the road up ahead for midwifery and for those who practice.

April 7, 2007 | Unregistered Commenterdarkdaughta@yahoo.ca

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