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Jun112009

Apprentice Midwife Material?

It's really cool, being interviewed as a midwife. Lately, here and there, I have been talking to several women either in (a) midwifery school (of one brand or another) or in an apprenticeship. Talking yesterday to Kim Pekin brought up a bunch of thoughts. Yes, I've written on this topic before, but it's been awhile, so here's a revisit.

Sweet women come to me, starry-eyed and their heads tilted sideways, looking at me with respect and (sometimes) awe. It's an honor to help women on their paths towards birthwork, but it is also a responsibility. I've listened to midwives wax poetic about being a midwife, pulling the potential apprentice along, muchly because the midwife needs some free help with her work. I think this is unfair and, as happens too often, the women end up leaving the "apprenticeship" once the realities of birthwork tarnish the dream. While I might be seen as a wet blanket with these dreamy women who come asking questions, I know it does no one any good if they begin and quit, one "apprentice" after another; it's just easier to get the whole picture out in the open from the get go.

"I want to hold babies" is a common refrain from the women who sit across from me. I smile and say, "Listen, we only hold babies from here (the vagina/vulva) to here (the abdomen)." Taken aback, I'm assuming they just hadn't thought of that since their faces goes blank. I then begin listing the things a midwife does hold: sweaty hair, the barf bowl as the woman throws up in it, the laboring woman as she dangles and the mother's hand as she squeezes it white and bloodless. We hold placentas as we demonstrate their amazing beauty. We hold scrub brushes as we wash blood off our instruments. We hold needle holders as we suture vulvas. It's important to me to make sure the woman knows the unglamorous parts of the "calling"/"job", just as much as she knows about the good parts.

She needs to know - the most important thing we hold is two lives in our hands.

If, after telling her all those realities, she is still drooling and her eyes light up more with every description, then it is obvious the woman is pretty darned birth-obsessed and a good candidate for apprenticeship.

But there's more. I let Donna (my apprentice) tell these parts of the apprentice story. She speaks about missing birthdays, telling them how many she missed in the first year along. She tells them about missing her kids' school awards... how we've had births on Thanksgiving, Christmas Eve (which requires us to make a home visit on Christmas Day) and wedding anniversaries. How we are called at all stages of the pregnancy, sitting with a woman with a UTI in the hospital at 30 weeks, going to a woman having a miscarriage at 13 weeks or driving 60 miles for a look-see if the woman's membranes have ruptured (nope!). She tells the woman how she can be gone sometimes for 3 days at a time, pumping her breasts so she can keep nursing her one-year old.

We both share the reality of putting 60,000 miles on your car a year, not having an income, paying for gas and child care, food outside the house, buying birth clothes or shoes, all kinds of incedentals that are easy to forget about.

As I said, this might sound all dramatic and tragic, but really, really, women need to know the realities of being a midwife's apprentice. And none of this includes the prenatals, the office work, the making of charts, the answering of emails, calling women back with lab results and all the other nuances in the life of a woman wanting to be a student midwife.

I imagine women's spirits sagging by this point, those sitting in front of me and those reading this, but there are AMAZING parts of being a midwife, too. But if you don't want... no, CRAVE... all that I said above, then reconsideration of this career is called for.

Being at a birth is glorious, but it is a blip in the life of a client's pregnancy. We become part of the family's life, we become part of the birth story forever, even if they can't remember our names 30 years later. We are invited in to see the wondrous joy a new baby can bring, but we also become counselors as the pregnancy brings out the warts and hoptoads lurking beneath the marriage's fascade or their relationship with the in-laws. As midwives (and students), we are privy to things most regular folks never hear from their neighbors, co-workers - and even closest friends. We become connections for women and their families to find food, help them see parts of themselves they'd hidden for decades and stand by them as their world is forever changed by the new soul coming to them.

Some clients become friends, but most slowly disappear over time, coming around again when the midwife holds an anniversary picnic or when they are again pregnant. It's important to keep a boundary between friend and care provider because care providers sometimes have to make serious decisions a friend would never even think of. It doesn't mean you can't empathize with your client... heck, if I don't cry with a client at least once during the pregnancy it's because she's changed care providers! Women become their own type of midwives, creating their style as they walk through their apprenticeship. A good mentor/preceptor doesn't want a clone, but fosters her apprentice's individuality. While I am a motherly type of midwife, other clients want a more business-like provider; there is a midwife for every type of client (in some areas like here in San Diego). Midwives are responsible for being perceptive as to how close or far her clients want to be. It can be a fine line and is crossed sometimes, but realizing it and correcting it quickly brings the relationship back into balance.

It's pretty clear, without even saying it, that a midwife must have worked through a great deal of her own issues... fear, abuse history, pregnancy, family dynamics, child-rearing and more. It's crucial not to bring one's own issues into the prenatal, laboring, birthing and postpartum periods. We talk about that with new doulas, to see each birth as an individual experience, not thinking, "Oh! My last lady had pitocin and a cesarean, so this woman will, too." But allowing the birth the unfold in its own way. Sure, there are themes and generalizations, but when WITH a woman, BE with her, see her as herself and see her birth as her own. With midwifery, this admonition is even more important because there can be a tendency to think her clients' births will be/should be just like her own midwifery birth. Midwives, too, must allow the woman to have her own walk, even if that walk includes a cesarean. We have to BE with her, not drag her along, but to stand by her side (or even a tiny step behind) as she feels her way through her birth experience.

Birthing women are extremely vulnerable. They (often) take advice literally. They(often) are easily swayed. I am not saying that they don't have a mind of their own or that they can't feel very strongly about certain things, but I have seen women bend to the will of her midwife simply because the midwife is The Expert. Midwives canNOT exploit this. Can NOT. When offering options and giving informed consent, it is imperative to keep one's feelings about the coming choice out of the equation. It doesn't mean you can't share how you feel about a test or a procedure, but not being married to the outcome is vital. I really can't stress enough how important it is to not exploit a client's vulnerability. I believe it takes a great deal of self-discipline not to. Midwives, please don't. Please.

This has gone on longer than I expected, but I felt led this morning to write this out. These are thoughts that come out in small spurts when I speak about what being a midwife is about. Of course, midwifery is different for every woman; these are MY experiences and they seem pretty universal, but others certainly have their own story to tell. I am honored... that word seems so small... so honored to be called to be a midwife. I hold the honor close to my heart and work so hard to do the blessing justice. I always have room to grow (who doesn't?!) and I welcome the ways my midwifery practice will continue to change, evolve, as I learn more and more with every client (and inbetween).

I hope this resonates with some of you. I write this for those birth addicts who know in their very soul they are destined to be midwives. I'm waiting to bring you into the fold.

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Reader Comments (37)

I wish all that wanted to get into 'birthwork' would read this blog post. Beautifully written thank you !

June 12, 2009 | Unregistered CommenterAnita J

I found your blog while I was trying to research on becoming a midwife.. I just love your stories.. Thank you for writing this, I am looking into being an apprentice here in california. I just am not ready to leave my family yet.. so when they are all in school and a little older, I cant wait to start... people always think that I am crazy when I saw the best part of being pregnant was delivery day... I could do that day everyday.. I LOve it... I have 5 kids of my own and I always joke that if I could just delivery other peoples babies that I wont have anymore of my own... You sound like such a great Midwife to apprentice for I just hope I can find one like you near me when it is time...

June 12, 2009 | Unregistered CommenterNicole

This post is so reassuring for me. It is interesting how you wrote about how many tell you they want to hold babies, I realized I have never given a thought to holding a baby when considering becoming a midwife. It isn't the baby I am in love with, it is the woman, it is the labor and birth process. I love pregnant women, and I want to be with that women throughout her pregnancy and birth. This post has been great for me, because I was still drooling after every description, it is wonderful to feel I truly have found what I want to do with my life at last.

June 12, 2009 | Unregistered CommenterAUbrey Hatch

I sit here crying through a huge smile. It's bittersweet to KNOW you're a midwife. :)

From one who's on the cusp but will join the fold...eventually.

June 12, 2009 | Unregistered CommenterAbby

Thank you for this. I'm a senior midwifery student right now, experiencing the highs and lows of this journey to become a midwife. And as much as I spend most of my time feeling overwhelmed, exhausted and 10 steps behind, it only takes one glorious smile as my eyes meet a new mothers as she holds her babe for the first time to make me remember why I do this work and make these choices.

June 12, 2009 | Unregistered CommenterCanadian Girl

FANTASTIC post, Barbara! Absolutely spot-on and one that I am going to be sending to all the women I know--midwives, apprentices, clients...just a really great read!

June 13, 2009 | Unregistered CommenterKaren

Well said! It's not easy to apprentice- I could never do it without support from my hubby, my kids (who love that mom "catched" babies and always want to know if it's a boy or girl when I get home) and my parents who care for my kids when hubby is working. I don't think it can be done with support from your family/partner.

But I love it. I rarely touch the babies once they are outside of their mama's bellies unless I am catching the baby, doing a newborn exam, doing the metabolic screening or just patting a cute baby while s/he nurses... and I'm fine with that! :) I enjoy a snuggle when moms offer though, don't get me wrong.

I love this quote from Barbara Katz Rothman:
"It's not just the making of babies, but the making of mothers that midwives see as the miracle of birth."

June 13, 2009 | Unregistered CommenterMotherNurtured

Re: "I want to hold babies" and other parts that some people associate with the glamour of being a midwife (catching the babies, guiding a mom through labor, etc)...I've always wanted to be a midwife but not necessarily need to be at the birth. In other words, I don't want to be an "energy vampire" (sorry, probably too negative of a connotation for what I'm getting at) and I really love the education, support, and relationship building of prenatal visits. But frankly, I do feel like an intruder, somewhat, when I go to births as a midwife's assistant. Or did, since I'm not doing it any more at the moment now that I have young children. I guess what I'm saying is: I would love to be a midwife but really don't want to have to actually go to the births and catch the babies! LOL

I'm just so happy that the midwife I saw turned out perfectly for my birth. She really didn't do much at all, except when I asked for it (such as cutting the cord about an hour after the birth, etc) and that was exactly what I wanted.

June 13, 2009 | Unregistered CommenterRixa

Love it, Barb. So honest and genuine and refreshing. The midwives-to-be who "just want to hold babies" kind of reminds of commercials for nursing programs I've seen run around where I live. They depict this rediculous perception of nurses, that they get to sit around for hours, holding people's hands or feeding babies. (Of course, a good nurse always will take the time to hold patients' hands, but they don't get to sit there for unextended amounts of time.) As one who has worked in various places in hospital positions, including a CNA on an oncology ward, obviously it makes me scoff to see these commercials!

Anyway, I love how you take your job and your mentorship so seriously in regards to "holding 2 lives in your hands." It's a blessing to learn from you (via your blog, of course!).

June 14, 2009 | Unregistered CommenterSarah B.

All the reasons you listed are the reasons I want to be a midwife. I want to be there for women during pregnancy and after. I want to be the support for women like the support I didn't have.
I love your blog, and I hope to find a midwife like you that I can apprentice with when I'm ready

June 14, 2009 | Unregistered CommenterKayce

Thank you for this, it was beautiful and true (as far as a non-midwife can know). It's funny, I think some of the women who are most excited about the babies are making the same fundamental mistake that our society does--that women are just vessels. But they're miracles! And so many of them want so badly to do the right things and pass through birth whole and strong, and they are hampered so much by the way we treat them.

I thought I wanted to be a midwife, but my heart does not seem in the clinical side, which it would need to be, the nuts and bolts and blood part. I do feel drawn to helping women in pregnancy and birth, but don't know if doula-ing would do that or if I should help in some other way. I spend a lot of time on my ICAN list sending links to blogs and studies and resources for women trying to VBAC in peace, or trying to find ways to help women deal with "loving" spouses/family members who sabotage them mentally at every turn. I just can't seem to find a way to turn that into a profession that puts food on the table :)

June 19, 2009 | Unregistered Commenteremjaybee

This blog really hits home. Recently I had a series of discussions about the preceptor/apprentice relationship with several midwives in my area.The expectation midwives have of apprentices are low.Too many starry-eyed women wander in and out.They leave at the first transport,the first 3 day labor.The midwives here are jaded -they have fought hard won battles in this state which came at a huge personal price for them. I feel midwifery is an art that changes.New evidence,new ideas,meshed with the old tried-and-true methods would be ideal. I wonder if the ego that makes some midwives in my area (not all !) refuse to allow women to make informed decisions is rampant in other parts of our country? I am really passionate about women's reproductive rights,and feel that families in my area would benefit from more provider options. I am just weary of the inner-circle fighting in our birth community. And I wonder how much groveling will douse my passion for apprenticeship in this state.

June 29, 2009 | Unregistered CommenterCaryn

This DOES resonate with me; thank you for sharing your thoughts...thought provoking as always. Please keep writing.

July 4, 2009 | Unregistered CommenterJenni

*tearing up*

Thank you. I spent five wonderful years doing all of the above and, Lord willing, will go back to it one day when my children are grown.

July 8, 2009 | Unregistered CommenterHerb of Grace

Thanks for this post!

July 13, 2009 | Unregistered CommenterAlbert

Since giving birth for the first time, I've felt the urge to become a doula. I remember (vividly!) one of my midwives saying how hard it is to be a midwife and a mother, so that's been in the forefront of my mind as I begin this journey.

Thank you for this!

July 15, 2009 | Unregistered CommenterAlison

Oh. My. Gosh. You COULDN'T have said it any better! As a hard working student midwife I definitely have had my share of hard knocks, barriers, and good lessons, but I am confident and peaceful about this ride I am on. I have my eye on the prize and know that each day brings me closer to my goal. The learning process humbles me as does every differing birth. I can't wait to finally be licensed. What a long, SO WORTH IT road I know this is. I think most women already have a family when they set out to take on their calling, making the rewards of the finish line that much sweeter because the sacrifices are many for the husbands, children, pets, holidays, birthdays, friends, messy houses, piles of laundry, miles on the car, pumped breastmilk, sleep deprivation, and wallets involved. Although I am often stressed, seeing a mama that I have cared for taking in her new little one with the "I can't believe I just did that" look on her face makes it all worthwhile. :)

July 19, 2009 | Unregistered CommenterChristy

What a lovely, heart-felt post. Thank you!

July 23, 2009 | Unregistered Commenterlabortrials

You're right not to fill their heads with cotton candy! They need to know exactly what they're in for!

July 24, 2009 | Unregistered CommenterJoy

Where did you go, NM?!

July 29, 2009 | Unregistered CommenterRachel Clear

I know! I'm lame as hell. I'm in Facebook incessantly and can hardly pay enough attention long enough to write a post.

Hoping to eek one out this weekend. I miss my blog. *hugging it warmly while I'm here*

July 29, 2009 | Registered CommenterNavelgazing Midwife

Nobody seemed to notice the *Biggie* for me in what you have said (so wisely) here: DO NOT EXPLOIT THE VULNERABILITY.

Oh, Barb. Do people really know what you are talking about? I bet there's more than one book to be written on this. And either you know exactly what's up with that or you don't. But bless you times infinity for not leaving that out.

hugs hugs hugs high fives, right on sista, all of it. You really do get it.

July 30, 2009 | Unregistered CommenterHousefairy

Simply Beautiful!!!!!! I have never thought about holding babies as a reason to become a midwife;I just want to empower women and I'm truly amazed with the human body. I'm at crossroads right now in my life. I have five kids and this year everyone will be in school,but I'm also an in home daycare provider and I love my job,but I also want to study midwifery. I guess I'm a little scared to leave childcare because,I'm so passionate about early childhood development and the kids are wonderful,it's like having extended family .......Right now I'm taking a few herbalism courses and love it!!!! I just don't know what to do? I love both and can't decide.
-Peace-

August 3, 2009 | Unregistered Commenteratlmom5

My former apprentice Donna did childcare for something like 17 years before beginning her midwifery walk. It can be done! In its season... in its season.

A little something I learned along the way. We cannot empower anyone; women empower themselves. We can offer information, support, love and respect, but they have to find their own path to empowerment.

Much good luck!

August 3, 2009 | Registered CommenterNavelgazing Midwife

I miss reading new entries from you! I'm sure you're writing elsewhere or just busy, as we so often are, but I hope you won't forget about your blog entirely. I'll keep checking back for updates. I hope all is well with you and hope to see something new here soon.

August 3, 2009 | Unregistered CommenterJackie

Hi, I just found this site as I take a breather from school work. I'm currently a midwifery student. It took me about 6 years from the time I first considered this trade, to the point where the "calling" was so loud I couldn't ignore it or work around it. I'm finding school amazingly stressful and at times inhumane and unreasonable. It is disappointing, given how much I love the field. Yet where I keep finding the strength to stay the path, is when I read other midwives tales. I get that butterflies in the stomach, this is forever-love flush and know in my heart it is what I need to do. Barf bowls and all...thank you for writing and inspiring.

August 13, 2009 | Unregistered CommenterMorigian

I just wanted to leave you a message to let you know how much I've been enjoying your blog. I've just started down my own path toward becoming a midwife and I can't stop reading. You are such a talented writer! Thank you (sincerely) for making your stories/accounts available for all of us to read.

I'm also so impressed with Donna for having the courage to change careers after 17 years. That just smacks of passion for birthwork - I love it. Go Donna!

August 20, 2009 | Unregistered CommenterJC

I read this...while crying...I went to college, got my EMT (but never employed in the field), while going to school for RN. I never finished due to having 2 kids in a row. I went to school til I was 9 months pregnant with my 1st, my final was 5 days before he was born. I've had 2 cesareans, and I only have 2 children. This is very sad for me. My "births" were completely uncalled for. I dont want to get off topic, but I have been thinking of getting back into school to be an RN, but since my "failed hospital VBAC" in 11/08, I've really had a change of heart. There is a birth experience I SO desire, and I have not experienced it. I want to, and I want EVERY other mother to!! I have been breeding horses since I was 16 yrs old, and that was the time of my LIFE! Being home and watching my mare in the middle of the night, watching a 120 lb baby born, and "tying" up the huge 20 lb placenta so mom doesnt step on it and tear it. So when I saw my first human birth at age 19 (my cousin), I was in such awe. I held back tears. I was so overjoyed. The placenta was so tiny compared to all the horses' placenetas, so it was nothing. None of that stuff grosses me out. I LIKE to see it. I've since had 2 horrible birth experiences, and I've done my research and I KNOW now, that birth is natural. I wish I would not have been so naive. I beat myself up everyday over that. My experiences have DEEPLY given me a passion to be a midwife instead of RN. I think if i went along with RN, I would speak my mind and lose my job. I would walk around all pissed off about all the pitocin inductions, and all the innocent first time moms that are about to go through the hospital interventions, and wishing i could say something. I dont want to spend my days around that. Midwifery is what I am meant to do. And I dont know what I need to do to pursue it at this exact moment. But I will be there someday. If you have any advice, I would really appreciate it!

September 7, 2009 | Unregistered CommenterSheila

Wow. I have decided to become a midwife, even though I'm a young woman and do not yet have my own children. I keep worrying that I won't have what it takes, or that I'll let someone down, or that I won't like it . . . but I was hanging on every word here.

I like babies. Don't get me wrong, they're wonderful. But I LOVE women. I love our bodies, how they can change and mold and become what they need to become. Our bodies are a metaphor for our selves.

As an EMT, I know about the hecticness, the stress, the hours. I've always been fascinated by blood and gore (but only in real life - I have trouble with violence on TV!) and I don't get disgusted by anything. I was the one who my friends asked questions about yeast infections and contraceptives. I've held hair while drunk people throw up in my ambulance, and I've mopped blood from gaping wounds, and loved every second. I've even gotten to witness a few surgeries! That was awesome!

But I cherish the long-term relationship building, and I wish I could work with women at their most womanly moments. So I'm going to become a midwife. My husband is amazing and supportive, and my family are in awe and universally agree that this will be a good step for me. (I originally wanted to go to medical school, but decided that I did not want to wait 12 years for my life to start!)

Thank you for sharing this beautiful post. I'm going to mark your blog and become a regular reader!

October 23, 2009 | Unregistered CommenterEmily

"It's pretty clear, without even saying it, that a midwife must have worked through a great deal of her own issues... fear, abuse history, pregnancy, family dynamics, child-rearing and more."

THIS IS SO TRUE, SO VERY TRUE

I heard the call to midwifery long long ago but delayed, waited and HEALEDI Now I am ready and in the right season to be aspiring to fulfill my calling, my passion, my soul purpose!

As a mother of five I never even thought about the "just wanna hold babies side" guess 'cause I've held my own babies my entire adult life. My focus was to just hold the mother in a high place of esteem, hold her so that she would heal, hold her so that she would be EMPOWERED and transformed and equipped to mother.

I've gotten to do that as a birth attendant, researcher and froula (friend doula) it was an honor and it's still the part I crave... the empowerment process.

THANK YOU for your authenticity!

~Ayesha

November 24, 2009 | Unregistered CommenterAyesha

I've enjoyed reading your blog, and it made me realize that a have to choose my own path. Reading this, made me want to check your blog for new post. :) Thank you for sharing an interesting story.

June 17, 2010 | Unregistered CommenterWedding Napkins

SO TRUE! So True!

Thanks for figuring out HOW to say all of this so well!

Kim.

October 27, 2010 | Unregistered CommenterKim Mosny, CPM

This is encouraging to read, it only reinforces my strong calling to become a midwife.

November 10, 2010 | Unregistered CommenterDonna, doula

I just came back and read this post, and I really appreciate it's honesty. I have started to feel the tug into midwifery, and I feel it even more strongly after reading this.

I really am not a baby person. Never have been. But after the pregnancy and birth of my first child in Jan. I realized that the birth of a child can only happen once, and that women NEED help in this system in order to have the best birth possible. I had a wonderful birth, so I'm coming at it from the angle of wanting to help women to experience birth as it should be experienced, with as little intervention as medically necessary. Several women that I know have had babies since I did, and all of them have had traumatic experiences, mainly due to the mismanagement of birth. I NEED TO HELP these women!. I can't just continue to sit at my computer and read about it and go about my normal life.
It may take a while, but I will get there. I am starting doula certification this month, and hope to be able to transition to midwifery after a year or two. It's so exciting to know what I want to do with my life at 28 years old!

November 30, 2010 | Unregistered Commentersara

Sara, I may take your comment and use it as a springboard for a follow-up post. Your passion is wonderful... and while I don't want to squash it, I do want to offer some temperance to the enthusiasm. It's an interesting wondering I have, when to say things that aren't always pleasant and when to stoke the fire in your belly. Maybe we can find the balance together? :)

November 30, 2010 | Registered CommenterNavelgazing Midwife

You can't trust all midwifes. Some of them are not licensed and are pretending.

"I KNOW now, that birth is natural. I wish I would not have been so naive. I beat myself up everyday over that. My experiences have DEEPLY given me a passion to be a midwife instead of RN. I think if i went along with RN, I would speak my mind and lose my job. I would walk around all pissed off about all the pitocin inductions, and all the innocent first time moms that are about to go through the hospital interventions, and wishing i could say something. I dont want to spend my days around that. Midwifery is what I am meant to do. "
Sheila, hold on to this as you go through the process... I was in Canada at the beginning of my RN/L&D career so there was no such thing as CNM at the time, just lay-midwives at home births. It just wasn't an option for me....
I do get pissed off all the time!!! It's so hard to keep my mouth shut. I was supposed to start Nurse-Midwifery School with my BFF, Natalie, last year, but the timing wasn't right and I was very stressed out at work (we moved from 250 deliveries/month to 350+/month!!!). I ended up leaving the hospital to go travel nursing again... my habit to get out of the politics or overwork in a hospital setting....
As an RN in Canada, we are able and encouraged to be at the bedside and avoid interfering in the natural process, even delaying the epidural if possible. But, down in the southern states, unless there are CNM's around then C Sections, vacuum-deliveries, early epidurals, etc are the norm.... Weird how things can be so varied. I guess with a public healthcare system, we promote natural labor to also save money....
Sorry about the vent. I too need to get my Midwifery program behind me so I can do what I love, the way it is supposed to be done. Thanks Barbara for all that you do!!!! Babyprep

August 27, 2011 | Unregistered CommenterTeresa Hoover

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