Do you know how when a pregnant person is in labor, and you ask them, “How many more children do you want?” Or when they are done giving birth, and someone asks, “Do you want anymore children?” What is the typical response to that? “NO!! I never want to do this again!!” Or, “Are you kidding me? That was the hardest thing I’ve ever done, and I never want to go through it again!” Give it a few months, or a couple years, and she will have put away the hard work of labor, and will once again think about having another baby.
Well, I am currently the laboring person, and I am around 5 cm dilated, and it is a ton of work. I’m sweating, and wondering why I did this to myself? What I need is rest, sleep, nutrition, hydration, and a good support team which will help me while I dilate to 10 cm, and hopefully I can begin second stage of labor. However, there is still quite a bit of work left. I’m only half-way there, and the hardest part of labor is about to begin: transition. I cannot wait for this to be over so I can hold my baby, but I don’t want to do it again!
Laboring person: the student midwife, ie ME
5 cm: Half way through didactic work
Support team: family, friends, doulas who offer support, and other midwives
Transition: Clinical work
Second stage of labor: prepping for NARM exam, and taking NARM exam
Baby: certification and license
I’ve had several people ask me about midwifery school. A few weeks ago, I met with someone who was interested in becoming a midwife. I cannot be anything but honest with anyone who wants to know what it’s like. So this post will detail what I said to this person. It’s real. It’s raw. It might not be what you want to hear. It may sound like I’m complaining, like I’m discouraging people from beginning this journey. However, my goal is to make sure that anyone who wants to begin this journey is well informed. Someone tried to tell me how difficult it would be way back when I first was considering becoming a midwife, and I didn’t quite pay attention to what they were trying to explain. Now I look back, and I honor their words, and I know they were only trying to prepare me for what lay ahead.
This is no cookie-cutter, gum ball machine degree. This is a four year, full-time, degree which includes at least 1.5 to 2 years of clinical work. Sure, it can be accomplished a little sooner, but at what cost to the student? Going to midwifery school takes dedication, perseverance, and a lot of late night hours completing assignments. The didactic work isn’t much different from other didactic work. We have teachers, syllabi, assignments, exams, research papers, APA formatting, long hours, and deprivation of sleep and good nutrition. When completed, I will have an Associates of Science in Midwifery. When I pass the NARM exam, I will be a certified midwife. Then I will apply for licensing through the California State Medical Board, and become a licensed midwife. The point is to say, we work hard for our degree, same as any other associate’s degree.
Financially, it is not a low-cost expenditure. Midwifery schools range from $5,000 – $40,000, depending on the school. From what I understand, that low range number is about to go up considerably in June (will update when that happens). Since I’m in California, we cannot go the PEP route, and must attend a MEAC school.
Add to that books which are expensive, school supplies, and any equipment needed. When clinical work begins, add gas expenses, especially if travel needs to be made. I’m currently traveling 90 miles one way for my apprenticeship. Add also any conferences or student enrichment courses that may be needed, including NRP and CPR certifications. Some schools provide federal financial aid, which is a huge help to students. There are a few who provide scholarships. However, for the majority of people, it is an out-of-pocket expense.
Clinical work is a must. Many students cannot find a preceptor in their own city, so they must travel long distances to complete clinical work. Some have had to go out of the country to meet the clinical requirements. Some students need to move to another state, or attend month long placements in another state to get some clinical requirements met. Finding a preceptor is a huge challenge and can be a huge obstacle. There are students who are nearing the end of their didactic work, and still have no preceptor.
The partner in the relationship cannot be over-looked. I really cannot emphasize this enough, and while there may be a few who don’t have to deal with this, the partner in the relationship goes through a lot, too, while the student is working on their didactic and clinical work. I don’t really care how supportive people tell me their partners are, there WILL be push back, I guarantee it. There will be times when home life is not perfect, or there is an important discussion being had, and the call comes in from the preceptor that a client is in active labor. You have to get up and go. There’s no time to finish the conversation. Everything gets put on hold, or you miss the birth. Missing the birth is traumatic for you, but also for the client who got to know you. There will be times when you are driving to that birth, and you have to clear your thoughts of what you left behind, and you have to walk into the birthing space, and leave all your worries at the door.
So, make sure you discuss this with your partner, in detail. This is no easy road for both of you, and no easy road for your children…
Our children…sigh…this is by far the hardest part. Our children miss out so much when we are going through this journey. There are missed birthdays and holidays. There are cancelled or postponed trips. The T.V does become the prime babysitter. Healthy meals, well they don’t happen as much, or at all. Fast food is easiest when it’s the end of the semester, and you have to turn in all your assignments in order to complete the class. Oh, I can be all romantic and say, “but my children see how important this is to me, and they will remember that mom went to school while she had a family.” Yeah, I don’t know. I think they will say, “I missed mom a lot when she was going to school.” Tears…
For me, it helps that my children are older, and can drive themselves here and there, and that they don’t need a babysitter, and can fend for themselves when I’m not home. They don’t need help bathing, getting dressed, brushing their hair, etc….However, if your children are young, then you have to consider the need for an on-call babysitter. Realize that a lot will be missed when you are away on births, and while you are needing to complete your assignments. Your children will grow up while you are going through this journey, and are you prepared for what you will miss, and what they will miss out on?
Extra-curricular activities are no longer a part of your life when choosing this route. Be prepared to not be able to just take a weekend to the mountains or to the beach, because assignments need to be turned in, or a client is within dates. That research paper won’t get done while you are frolicking in the mountains. Sure, if you finish all your work on time, there might be time to enjoy a mini get-away, but I’m sure you’ll be catching up on the messy house, and cluttered corner!…or cluttered cornerS.
Responsibility to our clients. Going from doula to student midwife, and then eventually to midwife has given me much to ponder. As a doula, I am not responsible for anyone’s well-being or life. The care provider is responsible to make sure the pregnant person is continuing down a low risk route. They are responsible for an unborn baby!! There are so many health issues to consider: How’s the pregnant person’s blood pressure? How is the fetus’ heart tones? How is fetal growth going? What do the lab results show? Is there GBS present? How about gestational diabetes? Is that pre-e developing? Let’s consider the possibility of shoulder dystocia and how we will manage that if it occurs. Fetal heart tones are not recovering well after a decel. We must always be prepared to resuscitate a newborn.
These are things I never had to think about as a doula, because as a doula, I offered education, emotional, and labor support. Midwifery is not just about offering support. Midwifery is about offering individualized, competent, prenatal, intrapartum, and postpartum CARE, meaning, it’s not simply about offering support. Midwives have to deal with life and death situations, and make sound judgement about when to continue at home or birth center, and when to transfer care to an OB or hospital. Midwives and doulas have such different roles, that the two can’t ever be compared. They are two different worlds in their roles, yet, can be the perfect team for a laboring person.
I didn’t even mention our personal well-being! A small note: It’s not easy performing self-care like eating healthy, drinking enough water, exercising, meditation, etc. I gained 20 pounds the first year of midwifery school, ugh!! I’ve been able to get a handle on that, and have lost those 20 pounds, plus another 27 pounds. I still have not been able to find time to exercise, though. Additionally, sleep deprivation is real: long hours on school work and then births.
There’s so much more I could write, but I’ll leave you with these few items to think on. Like I said, I’m not trying to discourage anyone from going into the midwifery profession. I’m also not going to romanticize this journey and make it all rainbows and unicorns, and skipping merrily through the woods. This road is H.A.R.D. Is it worth it? For me, it definitely is. Ask me again in five years, and I’ll probably tell you, I’d do it all over again. Right now, I’m in labor, so be prepared to get the nitty-gritty of this extremely challenging, birthing experience. Who knows, I might even yell and moan a little as labor continues. We need MORE midwives! And now you are informed on the challenges and you can make an informed decision to go into midwifery work.
Left picture is Winter semester, 2017 when I was doing research for practice guidelines.
Center picture were some of the books used for Winter semester, 2017
Right picture is self-explanatory