The Homebirth Midwifery Option

Many say that practicing as a midwife is a calling.  It is as if some invisible force compels a person, forces a person, to become a midwife.  Maybe those of us who are midwives like to think that way because midwifery is difficult work, exhausting work.  Taking on the health concerns of women and staying up all night to welcome a new life may sound noble and fulfilling (it is!), but the physical, emotional and spiritual energy expended to hold space for the transition to motherhood cannot be discounted.  If I can blame my lack of self-care and work-life boundaries on an outside force or calling, I can continue to be drug along the rocky midwifery path.  But, is a person who feels compelled into her work by forces beyond her control really the best attendant at birth or clinician in the clinic?  I would argue that we midwives need a perspective change.

I sometimes think I’m an addict, not a professional.  I search for my next high in the timeless birth room, the heightened awareness of adrenalin or the smell of a new baby.  Those births where you leave to go home and look at the sky and think, “I can’t believe I get paid to do THIS.” Those births feel like falling in love.  Those births cause me to meet the world with senses and a heart that is wide open and gloriously in the present.  Supporting and guiding a birthing mother or really connecting with a women in clinic is a meditation where every second, every word and every breath matters.  Am I an addict or just lucky enough to know what it means to be truly alive and present in the moment?  I would argue that shouldering the burden of life and death work requires utilization of supportive tools.  Only when the midwife is armed with the tools of self-care and teamwork, can she be “with woman.”  Only then can the midwifery compulsion act as a positive force for change in the world. Only then will the work nurture the midwife instead of tear her apart.

I also see that as a midwife I am an artist.  The birth room is my studio and in it, I am guiding the most divine of all creative processes: the birth of a new person and the birth of a new, altered woman.  That creative process takes extreme concentration and energy! In poet Mary Oliver’s newest book, Upstream: Selected Essays (2016), she says:

In creative work — creative work of all kinds — those who are the world’s working artists are not trying to help the world go around, but forward. Which is something altogether different from the ordinary. Such work does not refute the ordinary. It is, simply, something else. Its labor requires a different outlook — a different set of priorities.

I would argue that the priorities in the birth room would be to embrace fear of the unknown, to be sharpened by the strong emotions of creativity and struggle, and to be strong enough to hold back space and time to allow a new being passage into the world. The work is emotionally crushing and physically exhausting at worst.  The work gives us a taste of the beauty and love at the very heart of life at best.

I have worked as a midwife in all settings–home, birth center and hospital.  I have worked as a midwife in many roles–clinician, teacher, business development and practice administrator.  I have struggled with my own ideas of what constitutes career success.  I have tried to climb the proverbial ladder in search of more power to change our broken maternity care system.  I have enjoyed sleeping through the night in exchange for long days of mindless administrative meetings.  I have dreamed of quitting midwifery altogether because the work is too hard; the windmills I’m charging at too big and too strong.  Maybe there is an error in my perspective here; I do not have the power as an individual to change systems.  My focus has been misplaced.  I need a team of passionate people committed to that goal.  A strong team that works daily in their own lives to push for system change.  A team that is committed to the wellness of each other.  A team that includes the birthing families supporting each other and their care providers as we all strive to do our best and care for our bodies with respect. 

So as part of a team I have pulled my focus inward.  Within the strength of the team, the focus shifts to my community, my neighborhood, my own family, and my own wellbeing.  I struggle with the selfishness of that thought as I want desperately to see healing and equality in our maternity care system.  The system is so entrenched!  No one person could effect change. Is it enough to think that each individual interaction between woman and midwife is what matters and will bring about change, albeit slowly?  Yes, I think that is exactly what is necessary.

Within the strength of the Midwifery Model of Care, I do believe that each individual conversation and interaction matters.  The strengths of the model will allow midwives to take care of families and each other.  What I have found is that by focusing on my health and desires for my life, a deeper understanding regarding my talents and what brings me joy has emerged.  I know I want to connect again with women as a midwife and I know that each family will join in the swell of maternity system change. I do not have to abdicate myself to achieve this, I have to recommit to work that I respect and aligns with my values.

And so, I choose the homebirth midwifery option.  I choose to hold space for the women and colleagues in my care.  I am not forced into this profession by fate.  I will chose to be part of a collective group that is pushing back against the system and works to promote wellness for women and families.  I will be an artist and embrace the uncertainty of the creative process.  I will chose to nurture myself as well, being honest in my capabilities and need for self-care.  I will choose to embrace this life that I’ve been given and play my part in healing our world.