Sunday, July 18, 2010

My Path to Midwifery

Posted by D
For so many midwives, the path to midwifery begins usually sometime in early childhood or adolescence, and I'm no different. I remember at 12, learning what a midwife was and being the one who willingly stayed up at night to "labor watch" the horses that were part of the breeding farm I worked on.

Fast forward to the birth of my first daughter in 1996. The story of her birth has been told many times, by many different women, in many different hospitals. Premature rupture of membranes, no contractions, posterior baby, pitocin, epidural, oxygen, internal fetal scalp monitor, and finally cesarean section. I wasn't aware at the time how much my body "failing me" affected me, but when it came time for my second daughter to be born I had to seek out answers. I got my records, wrote down questions and met with the hospital CNM to find out why things happened as they did. Her answers were honest, and I am thankful for that, if nothing else. The answer to many of my questions ended with, "Well, if you were at home, that wouldn't have happened. If you were at home, we could have waited. If you were at home..."

So began my journey to finding a homebirth midwife. It ended almost as quickly as it had begun. I am amazed at the ease of finding options today for most women. The Internet has changed the face of birth. Women can learn about all of their options at the click of the "search" button. At that time, all I had was a phonebook, with one local midwife listed, and she wouldn't take a primary VBAC mom. She did, however, give me the name of a local birth center. We met and loved the midwife there and planned a birth center birth. Because my daughter was 42 weeks, I ended up with a hospital induction, which thankfully ended in a successful VBAC. My third and fourth births were far less dramatic and can be summed up in a short sentence or two...two beautiful home/waterborn babies, with peaceful and non-dramatic births, weighing in at 9 lbs and 10 lbs 2 oz.

After the birth of my third daughter I became a doula and childbirth educator and co-directed a non-profit birth network. It was fabulous work that we did, and I loved attending births. My goal of becoming a midwife was always framed with "someday" since I was homeschooling my four kids while doing birthwork in my spare time.

Last February, I decided that "someday" would never come if I didn't get started so I applied to nursing school. Around the same time I was asked to attend the homebirths of two VBAC moms, one who was a planning a primary VBAC and the other who was planning a VBA2C. The realization hit me, leading up to their births, that as a CNM, I would be unable (in Pennsylvania) to attend their births because of their VBAC status. The midwife that they hired, however, was a fabulous and fun CPM (the first I had met) and she seemed perfectly capable of handling the safety aspects of birth, desite the fact she didn't have a medical background. In fact, she practiced pretty much exactly the way I imagined myself practicing (someday). So, I began to consider the CPM certification an option, but still reserved it for "someday."

Someday came in December of last year, when in a fast and furious turn of events I inquired into going down to Casa de Nacimiento in El Paso, Texas, and then within days of that sent in my deposit. I remember sitting on the plane taking off out of Philadelphia Airport and as the plane wheels came off the ground, I sobbed. I could not believe that I was finally, after 13 years, on my way to becoming a midwife, that I had my husbands support, and my children would be taken care of without me. I completed 6 weeks in the spring of this year, came home and started an apprenticeship with first a direct entry midwife who has done about 1500 births, and shortly after switched to a CNM/NP who has also done about 1500 births. I am currently working with her and loving it. I've attended, as a birth assistant/apprentice, about 25+ births in the last 6 weeks, with 3 or 4 of those births being with local homebirth CPMs. I am loving life right now, realizing my "someday' dreams, but I am not looking through rose colored glasses either. I can already see the stress on my family and the physical stress on myself doing high volume birth. I have set the next year and a half aside to focus solely on getting through NARMs PEP process and attending about 15 births a month, in addition to another 6 weeks down at Casa. My family knows that life will be crazy and exhausting, but in theory, at the moment, we are up for the ride.


  1. Welcome, and great intro. It sounds a little like you regard a high volume birth practice as a given, and hearing your concerns about the impact on you and your family, I'm wondering whether that is the style of practice you want to have? Perhaps because I live in a place with a larger than average proportion of midwives, I see a high volume approach as the exception rather than the rule when it comes to solo practice.

  2. Wow! That is very high volume. Must be great but exhausting. I have never attended more than 3 births in 1 month but I look forward to being able to work at a higher volume.

  3. No, high volume is definitely not how I plan on practicing, but it is how I learn the best. To have a system and use it every few days (went to a birth Saturday and again today, Monday) is amazing at solidifying in your mind what needs to be done. Not to mention that the two most high volume midwives in this area, are also the two most well-respected, hence why I chose to work with them. The next mw I plan on going to sees 200 a year, mostly Plain (Amish and Mennonite). I told her I would like to stay at least 6 months, which gives me the potential to catch close to a hundred babies, if all goes well. To then start taking 3-5 ladies a month myself, would seem EASY, and would come very naturally after doing the high volume work. The Plain ladies are so low maintenance, that if my practice was only Plain, I could imagine doing maybe 8 a month, but with English women who are often higher needs, I could really only see myself doing about 5 max. But, I can do anything for a different than if I were in a college/academic setting juggling that and family as well.

    Also, it will be interesting to see what happens in the next 5 years, as many of our local mws are getting up in their 50s. The one mw who sees 200 is going to be retiring in the next couple of years. Where will all these women go? This area has so many mws. Probably 13 or so CNMs in Lancaster County alone and the ones that are here are working so hard. We could totally use more. So, in that sense, I'm not really sure how to keep your practice small. My first step is to establish a practice and then I'll worry about keeping it small. LOL