Wanna Be A Midwife?

Everything you need to know to pick your path to midwifery
June 10th, 2013 by Mayri Sagady Leslie

You Have a Call…

It’s no secret that a woman’s choice of provider (midwife or type pf physician) and place of birth (home, birth center, or hospital) are the two factors that most influence what kind of birth experience she is going to have. In fact, not just experience, but even outcomes for her and her baby. But if you had to choose between the two – provider and place of birth – which one element would you think is THE most influential?  Let’s assume a healthy mamatoto (motherbaby), a normal course of labor and a desire for minimal intervention. Now let’s picture a few different scenarios.

The first is an interventionist provider in a home birth or birth center setting. Not as likely I know, but possible. The number of interventions available are fewer, but one can still perform artificial rupture of membranes, do frequent vaginal exams, put time limits on the labor, restrict intake of food and water, and transfer when concerned things are not going well. In the next scenario, picture a non-interventionist provider in a hospital setting. All the interventions are available, but they are able to steer clear of many of them if not all, depending on the power dynamics of the hospital. So far, this discussion has focused on the labor and birth, consider also the impact of the provider on the antenatal period and the postpartum period when the birth setting has little influence.

My obvious point is that I believe choice of provider is the more critical of the two. I would hope that all women could make both choices freely, but sadly this is not true and we know it. Many women in today’s health system can’t make either choice. Their providers and places of birth are chosen for them – and in many settings midwifery is not available. That’s a problem and it is where you and I come in.

Stepping on the path to midwifery (and staying there) fulfills a critical need for our world. Mothers need midwives. The World Health Organization knows this, the international community knows this, and the research world knows this. Within a context of collaboration with the larger healthcare system, midwifery is the ideal form of maternity care for almost all mothers and babies. Yet in the US, nearly 9 out of 10 don’t have a midwife at their birth.

One of my concerns is that midwifery is sometimes associated only with homebirth, or birth centers, or drug-free birth. None of these things alone are midwifery. Midwifery is woman-centered. Caring for the mother and her choices. Some of the most beautiful, empowered, awesome births I have attended have not met any of those descriptions, yet I have also been at all of those types of birth. Most of the nearly 4 million births in this country are not at home, in a birth center nor drug free. Let’s meet women where they are, give them midwifery care and then go from there. Midwifery is for every woman.

So if you have been called. Answer that call. Don’t wait. Really. If you need support, ask for it. You are needed in every setting by every mother. We are here waiting to teach you, precept you, nurture you along, and welcome you to the midwifery community.

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