Question about apprenticing

[kypovan]

So, the apprenticing thread has been very interesting, and it has raised some questions for me. Would you mind answering some for me?

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice? (I ask, because as a military wife, I would have to apprentice wherever we moved to when it was time for me to apprentice, and then we would move away after 2 -3 years)

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?

4 - Does apprenticing differ if you are going through NARM vs the CNM route?

5 - Would a home birth midwife take on a CNM apprentice?

6 - What is considered 'young children' at home?

7 - Is there an ideal age for an apprentices children to be?

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?

9 - Would you take an assistant over an apprentice? Or vice versa?

Anyway, I appreciate you being willing to read and answer any questions you are able to.

Wendy

[Charmie981]

From what I understand, the CNM route does not require, nor accept, apprenticeship for clinical experience. You're required to meet your clinicals in a more traditional setting. I may be mistaken, though, so if I am, someone can feel free to correct me.

So, to answer your questions:
1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice?
I would take moving specifically for an apprenticeship as a sign of commitment. I think also, that it's a great idea for an apprentice to plan to practice in a different area than the midwife she trains with, so moving after an apprenticeship isn't a bad thing. I do think, though, that if you're new to the area, you may find that you'll need to take some time to acclimate yourself to the birth climate and community in that area, maybe through some volunteer work, through joining birth network, through attending LLL meetings or whatever it takes to plug yourself into the birth community in the new area.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?
My apprenticeship was...let's say MORE DEMANDING...for a number of reasons. I would like to say, though, that practicing midwifery is actually more WORK than apprenticing. The benefits of being an apprentice over being a midwife is that there is always a safety net. You are not going to be the one losing sleep over a 41w mama who refuses an u/s or the one who worries about whether X client is on the road to devloping pre-E and what you can do to help her change her diet before it's too late. As an apprentice, you really do get to show up and do what you love to do most, which is wonderful. The disadvantage, though, is that it is 100% on someone else's terms. If your kid has scouts on prenatal day, you won't be getting to cut out early for that scouts meeting. If you don't want to attend 7 births in one month, you don't get to say "Hey, I'm only taking three clients a month, after that you'll have to find someone else." If someone is 2 hours from you but only an hour away from your preceptor...guess what? She'll still take that client and you may not make it to the birth, even if she is someone you've been providing continuity of care for, KWIM? It's all on someone else's terms. My apprenticeship was also made more difficult by the fact that I drove 1.5 hours for every prenatal day and pretty much every birth. The closest birth I attended was, I think, 45 minutes from the house. It's a tradeoff...you have less responsibility as an apprentice, but you are on someone else's schedule.

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?
Haha. Good question. My teaching MW had two apprentices and tried to give us each an off-call weekend a month, but that only lasted about...two months? After that we all went to everything, pretty much, with the exception of pp visits...the apprentice who was primary at the birth did the pp visits alone (as in...w/o supervision of the teaching midwife also). I think I could see doing this in my practice, but I would require the apprentice to choose clients and stick with them. So maybe if I were taking 4 births a month, she would only be responsible to attend prenatals, birth and pp for two of those clients. I'd love to hear some tales about part time apprenticeships and the logistics of them, though. I'm not busy enough right now to even entertain the idea of having a part time apprentice, though, because my practice is already very part time--something I hope will change with the opening of our birth center this month.

4 - Does apprenticing differ if you are going through NARM vs the CNM route?
Again, I think you can't apprentice to be a CNM...that's why CPM/NARM is called "direct-entry."

5 - Would a home birth midwife take on a CNM apprentice?

6 - What is considered 'young children' at home?
This is going to vary for everyone. For me, young children is anything under about 13-14. Maybe when I have a 13-14 year old I'll start to consider them "young," too, though. I definitely think anything under 6 is YOUNG. And don't get me wrong, I have a 8, 6, 1 and one on the way, so I understand having young children and having this lifestyle.

7 - Is there an ideal age for an apprentices children to be?
Only you know your children and know what they can tolerate and when. My thinking was to get my apprenticeship done while my kids were young enough not to remember if I missed anything like birthdays or school plays or whatever, so my kids were 6 months and just under 3 when I started. They were 2 and 4.5 when I finished my apprenticeship and we took a vacation to Colorado for me to take NARM at the MANA conference. They still vividly remember that vacation, but don't remember the month I was gone that summer to get experience at a missionary birth center overseas, missing my second son's second birthday in the process.

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?
My apprentices gain their didactic experience through another route, so I don't feel that I lose as much of my family time as if I were trying to educate them, do workshops for them, etc. I strictly provide clinical experience and they are required to maintain good standing with a distance program for their bookwork, but with that comes some decompression time after each birth--time to debrief and explain anything that may not have been explained in the heat of the moment.

9 - Would you take an assistant over an apprentice? Or vice versa?
I like having an apprentice. I like the idea of being a midwife who contributes more midwives to the homebirth community. I can see the benefit of having an assistant instead, but I'm not sure I would know how to do my job without teaching someone as I do it, KWIM?

[Maggi315]

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice? (I ask, because as a military wife, I would have to apprentice wherever we moved to when it was time for me to apprentice, and then we would move away after 2 -3 years)
Most midwives are hesitant because many times people don't move away and then there is direct competition. In most areas, there isn't enough work for one midwife, let alone a bunch. In my area that isn't a problem and I would welcome another experienced midwife.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?I keep trying to post about that in the other thread and can't post? Apprentices don't get to call shots, you have to be there, you have to go to clients you don't choose, times you don't choose, follow someone elses rules, policies, and you have to work hard to be of use to the midwife. Since everything is new, everything takes longer for you, and for the midwife.

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?This is very hard, I need someone who can come whenever, if there's a birth, and there is an apprentice, they have to be there. If someone is training to be a midwife, they need to understand and commit to that. Having said that, I worked out an agreement with my preceptor and another apprentice, it worked out great and I would be willing to do that with apprentices. We altered weeks in the office and on the weeks we were on, we went to those births, prenatals, postpartums, calls, etc. It worked great, but I did try that with my apprentices and it didn't work out.

4 - Does apprenticing differ if you are going through NARM vs the CNM route?If you are going through CNM, you would arrange things through your school, site must be approved, CNM must be approved. You would pay school for the apprenticeship and clinical, which is ALOT, right now, you pay per credit, usually 500-1000 per credit. And you need so many clinical hours, I think it's 1000 hours, or more, I am in graduate school and will need to do my clinicals next year, there's not very much choice, you have to be on call when you are told, you can't call with a problem, it's just like nursing clinicals. Some schools, like frontier, offer a part time route, but most want full time clinicals.

5 - Would a home birth midwife take on a CNM apprentice?
they cannot do that unless they are a CNM themselves, and they have to have a masters degree, some don't! CNM's can sign off for NARM applicants, but you can't do the second set of skills then, even if only one birth is froma CNM (I learned the hard way!)CNM's who take a student have to be approved by the school, have to have the right insurance, a certain volume and some other criteria.You don't apprentice as a CNM student, you do "clinical", which means you have to meet the hour requirement and can't go home early if there's nothing to do. You can expect to spend 40 or more hours physically present at the clinic or hospital each week.

6 - What is considered 'young children' at home?that depends, for me, it's mainly the nursing issue, but I've seen that worked out if there is more than one apprentice and apprentice is willing to pump. I would hope that those with young children would pick a slower pace to get done and not pick a very busy practice, but one with only a few births per month.

7 - Is there an ideal age for an apprentices children to be?There are challenges at all ages, which I discussed at great length on the other thread. Instead of "ideal age", I want to see childcare arrangements, backups, and backup for the backup! And I like to see someone who is realistic and doesn't have a bunch of other commitments in addition to apprenticing and children.

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?I tried to post but couldn't on other thread. an apprentice takes alot more time. Extra hours teaching office and business stuff, probably a few hours each week for the first few months. Extra time teaching skills, both before seeing women and during the actual visits, this takes HOURS!. Extra time at visits, I can count on 2-3 extra hours per week. Extra time at births, usually at least one extra hour, plus debriefing and teaching afterwards, either right after or the next day. Time spent on the phone, discussing problems/clients/calls, etc. You will be together ALOT and can spend another hour or more each week on phone or email. None of this extra time is spent when you are just in regular practice. You have to plan to meet the apprentice, let them borrow your equipment, spend the money on extra supplies, change your schedule to allocate extra time for teaching and visits. I think there is easily an extra weeks worth of work(each month) in the beginning few months with an apprentice.

9 - Would you take an assistant over an apprentice? Or vice versa?An assistant would only work if that midwife is looking for help and can pay for it, has to have the volume. Apprentices are great for midwives who need some help, but don't have the volume to pay someone and are willing to trade time for help. I would take an assistant if I had the volume, though, it would depend on the situation. it's hard to be responsible for someones paycheck, I would have to let them know I can't guarantee any income and they may go a month or so without. and of course, you need to make sure the assistant has the same birth philosophies as you do.

I hope this is helpful! Very good questions, I hope the other midwives answer!!! (Hint, hint). Most midwives have a specific contract and you can't count your apprenticeship or births towards NARM unless you finish a specific amount of time. Some midwives will let you apprentice a few midwives at time, others won't. Some can be more flexible with vacation, conferences, etc. and some can't.

[mwherbs]

to reply as to why apprenticeship is alot of work, probably no more real work than working in partnership. but it is usually unpaid and it is work- you have to be dedicated to the work and during training is when apprentices face that reality and their families face that reality too- I would say out of 75 mw want to be's 5 will actually become midwives- it may be even less- getting the study done is good> but it is still a steep filter after that and midwifery is less romantic and more genuine work than most people who are not midwives grasp- long hours, you will miss anniversaries, birthdays, any special occasion you can name, called out of bed, called out when your kids are sick it is hard on your relationships ; the realities of being responsible at a birth, stopping hemorrhages, resuscitating babies, figuring out how to physically support a mom and not get injured doing that,sleeping in strange places, having a good sense of humor when you haven't slept much in 2 days - and beyond that the state questions your practice/if it is even legal- insurance is hit and miss as payment, client expectations are all over the place, and if you transfer there is no telling how you will be received it is a case by case situation and you have to really try and walk that out as best you can not just for that birth but for anyone else you ever want to bring in ; screening women out of your practice ; degrees of competition and conflict with other midwives...

[kypovan]

These replies have been great! Thank you so much! I look forward to more input from others. I'm learning so much from you all!

[Holistic Midwife]

You very concisely hit the nail on the head, mwherbs!

[Defenestrator]

Every time I have space for a new apprentice I put out a detailed and somewhat tough-sounding job description. Usually I find that out of the 20-30 women in my community who have told me that they are interested in apprenticing, I might get about 5 applicants and out of those 5 I feel that only 2-3 are really ready to do it.

I am open to job sharing. The way that I do it now is that my 3 apprentices (one verrry part time and one on maternity leave as of last week) each have clients who are assigned to them and they go to the visits and births for those clients. It makes for a very patchwork appointment schedule, though I do my best to group together appointments for particular apprentices' clients.

I had a baby in the middle of my apprenticeship and found that to be hard. I took 5 months off of births and about 6 weeks off of appointments. The midwives I was working with were in a partnership and mostly just got by without me. They knew when they hired me that I was likely to be pregnant during the apprenticeship and they took me anyway. Really, though, the hardest thing about apprenticing for me was trying to make it for 3 years without much of an income (I worked as a doula and freelance writer but it never added up to much) while paying for childcare for two kids. The midwives I worked with would routinely schedule stuff at times I didn't have good childcare as well, making me have to scramble and pay extra-high rates for care. That was the hardest thing for me -- not the births, but keeping on top of the postpartum visits and rescheduled visits and other random work. One of the things I do in my practice is state that I want the apprentices to be at 75% of the visits. If something is totally unworkable then they can skip it. I do also let the apprentices block stuff out on the calendar like classes or kids activities or whatever. Mostly, though, our main prenatal day is something they have to make time for.

If my partner was ever resentful, it was because our debt was skyrocketing while I was doing all of this work and he couldn't really see where it was going. The midwives I worked for never made over $20,000 per year, often less, and were burnt out and quitting by the time I was done. I have seen other apprentices quit in their last year because they just can't make the finances work anymore. I think that in our area, about 1 in 10 apprentices eventually practice for more than 5 years. That's not a lot.

I love the flexibility that practicing as a solo midwife brings me and I think it has been a good life for my family. I do have the freedom to change my schedule (I mostly took the summer off, but have a packed schedule this fall) and I find that flexibility to be easier than apprenticeship. But, I do have lots of paperwork to do that I didn't before, I worry a lot more about my clients, and their phone calls and emails easily add about 2-3 hours of work a day.

[MonkeyPrincess]

What great questions! And wonderful answers.
Thanks for taking the time to post such thoughtful responses.
Looking forward to more...

[birthgreeter]

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice?
I would not be hesitant if someone moved to the area. I would still judge by how committed they are.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?
As the time goes on, the apprentice will begin to make decisions. (I will expect them to think on their own as this is a way to gain knowledge.) We will always discuss the things they are learning, I want them to process what they have experienced, and discuss it with me..asking questions. It is hard because of the time involved. I expect them to study, we will cover stuff from books, not just hands on. They will be given written assignments, we will discuss the things I have 'assigned' to them...etc etc. It is just very time consuming.
For the apprentice, she is away from her family, even during special family times. she is not getting paid (When I attended college, I paid them, they did not pay me to learn...that is just the way it is) so that is tough, and puts a financial burden on the person. She has gas money expenses, babysitting expenses etc. tough.

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day? They would be assigned to certain days (for me it would be 24 hour shifts) but the problem with this is if your at a birth, and it is close to the end of your 24 hour shift-I would not want you to leave the birth! part time really (imo) works for the beginning stuff the best, but not for the attending births part... Attending prenatals, assignments, book learning-the full clinical part that involves attending the birth, you need (again-imo) to be full time.

4 - Does apprenticing differ if you are going through NARM vs the CNM route?
yes

5 - Would a home birth midwife take on a CNM apprentice? cant unless she is also a CNM.

6 - What is considered 'young children' at home? Children of all ages need attention. I do not feel that I can really set a age for this. I think it depends on the child really...
I sometimes think a van load of toddlers would be easier to take to the store than a van load of teens! So for me, dealing with young children was easier, for others, the teen years are the easy part. Again depends on the child! I do think that with nursing children, the mother should wait until the child is weaned.
I want the person to have ready to go-child care, good child care lined up. By that I mean, at the moments notice-ready to step in so the person can leave quickly! That is what it is like for a midwife, if someone calls, you have to be able to drop what your doing and go. The apprentice has to be ready to do that too. I can not wait for her while she waits around for someone to show up ...I can and do not want to wait at a birth for her to finally get there because of child care problems. Like someone already said, she needs child care, then back up and back up.

7 - Is there an ideal age for an apprentices children to be? see above.

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own? I want to take time to talk about the birth with her, or the appointments...how it is going. There will be times that we need to get together for a number of hours to discuss all of that. There are a lot of hours that you spend teaching skills, discussing the births, prenatals etc...what you have to remember is that someday she will be practicing and will be able to say she was trained by me, and that is a big responsibility.
We spend a lot of time together, at times it will be more than with our own family. I expect her to not miss 'clinicals' just like when I attended nursing school, miss more than one day and your out of the program. That may sound tough, but it builds commitment to the program. You need that if your going full time. Now on the other hand, I am not that mean, if there is a family emergency, I am not going to kick the person out of the apprenticeship if she misses more than one day...for a very good reason!

9 - Would you take an assistant over an apprentice? Or vice versa? depends on the person. We have some assistants that help a number of us mws in this area, and they are just wonderful. Very committed, don't want to become a mw, and love their roles as an assistant. I enjoy training new assistants just as much as apprentices.

[Peppamint]

Originally Posted by kypovan

So, the apprenticing thread has been very interesting, and it has raised some questions for me. Would you mind answering some for me?

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice? (I ask, because as a military wife, I would have to apprentice wherever we moved to when it was time for me to apprentice, and then we would move away after 2 -3 years)

The opposite is true here, but apprentices must move away when they are done apprenticing. It took me two years to find a midwife who would apprentice me because of that, and I'm driving 1-2 hours for 90% of the births and prenatals I attend.

Originally Posted by kypovan

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?

For me, I imagine it is harder than it will be when I'm on my own, simply because I'm not the one choosing clients, picking prenatal days, etc (don't get me wrong, my preceptor takes my schedule into consideration also but she's just over 2 hours away so it's a lot of time on the road).

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?

I have no idea how that would work, and don't intend on taking on any apprentices that won't be on-call full-time just like I am. It's the reality of midwifery.

7 - Is there an ideal age for an apprentices children to be?

I don't think so, because children are so different... what matters is that particular mom and baby/child couple can handle long separations.

9 - Would you take an assistant over an apprentice? Or vice versa?

I am planning to take on an assistant initially, unless by chance a truly committed apprentice comes along.

[Traceyky]

Starting a new apprentice means pouring out my time to care, explain, teach, help, go over, show repeatedly, listen, and usually become truly attached to someone, only to have them realize that midwifery is not for them. It is hard - I am currently finishing an excellent apprentice, but starting another is hard to even think of...
My daughter recently said "midwifery is so much less work than we do (In the midst of a hormonal 14 yr old girl meltdown) "I" have to do the morning dishes AND clean the bathroom AND do 2 loads of laundry AND do school"... To which I reminded her that "I" had gone out AFTER she went to bed, rubbed legs and back, held the bowl for vomit then cleaned it up, helped through the birth, cleaned the toilet, floor, started laundry, cleaned moms legs and backside, did paperwork, drove home, started laundry before she got up, slept 2 hours, and was now standing in front of her..... Thankfully she answered with "oh......" and nothing more.....
My apprentice works part time, Monday, Tuesday, Friday - so I schedule most appointments on Wed / Thurs. If I were by myself I'd sprad them out more, run more errands between them, etc... but training her is worth my inconvenience.

[~Kristina~]

I'm not an apprentice, but hope to be once my youngest (3m) is in Kindergarten full days. There is childcare at the school if I'd need it, and my oldest would be 13/14yrs old.

[ANewDoula]

For those of you who couldn't find a local, or close preceptor, how far did you travel? I'm curious how far away a student could live and still be considered for the position.

Also besides Casa and MLL, where else could one travel to do hands-on if local preceptors aren't an option?

Thanks
Jes

[nikirj]

I agree with most of what others have said. I've lived 45 minutes away from three separate preceptor sites without having major issues. For one of them it was a little bit of a problem because they were used to having students that were REALLY local, but for others it wasn't an issue at all.

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice?

Sometimes MWs want to train others who would then be part of their community. During the preceptor/student experience you get to know each other really well, and having someone nearby you can rely on in a pinch is very helpful. Training someone to send them out into the ether, particularly when you live in an area that actually needs more midwives, feels less productive than training someone you'll eventually work with on some level.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?

Apprenticeship is hard because you in no way set your own schedule. I had to come when my preceptors wanted or needed me, not when it was convenient for me (not counting births, just clinic time - there were many times when I could have come in the morning for a postpartum visit and not had to arrange childcare, for example, but my preceptor was busy in the morning so afternoon it was, even if I had to drive a lot and pay for childcare).

I have never been in an apprenticeship situation where I had to blindly follow. I think I'd have to be pretty desperate to accept a student position with a MW or MWs who weren't going to listen to me/answer questions. There are a ton of subtleties there - like you don't disagree with your preceptor in front of a client and hopefully your preceptor extends the same courtesy to you - but there isn't really a point to apprenticeship if you're following orders all the time.

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day? HAHAHAHAHAHA is there any such thing? Actually, I've worked as solo student more than in a place with multiple students, and really appreciated that when there is more than one student you can block off some off-call time. We did take a couple of days a month off call when we could. But where I've been an only student, it has been 100% on call all the time, for months at a time.

4 - Does apprenticing differ if you are going through NARM vs the CNM route?

A lot; the schools set a much more restrictive schedule (where the students are really not expected to take 100% call the way most CPM apprentices are). More CNM students are assigned hospital birth practices to follow rather than given specific preceptor/apprentice relationships, also.

5 - Would a home birth midwife take on a CNM apprentice? CNM students can only be apprenticed to CNMs. There are homebirth CNMs in many areas, but those slots can be hard to get. I've had a CNM preceptor who also teaches at the CNM school here, and she tried really hard to get all of her students through her practice if they were at all interested.

6 - What is considered 'young children' at home?

That's super subjective...

7 - Is there an ideal age for an apprentices children to be?

I think it would be easier once the kids were more self-sufficient; where I could reasonably leave them at home by themselves until DH got off work so that I could get to births quicker, for example.

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?

I misread this question initially - here's my original answer: The schedule is based on what your preceptor's needs are. As a MW I can decide to do most of my clinic on the day DH is off or when a friend can watch the kids without disrupting everyones' schedules, but while I was a student my preceptors not only had no clue when those openings in my schedule were, they had busy lives of their own that didn't line up with mine at all schedule-wise. Particularly for those last-minute scheduling things (like postpartum visits), I had to call off family stuff that I could have worked around if I had been making the schedule on my own (could have done the visit before heading out to our family event, but my preceptor wasn't available then).

And having reread the question - yes being a preceptor takes some time away because you are spending a little time meeting with your students etc. I haven't had a student and don't know how extensive that is, but I imagine it isn't a very large chunk of time, particularly considering how much work an apprentice does for you, things that normally are really time-consuming like charting and ordering labs and preparing equipment. A student does take time but I'm not sure that "from your family" is the right way to put it...particularly since, again, a student is putting in a lot of time doing things that you'd have to do on your own if they weren't around.

9 - Would you take an assistant over an apprentice? Or vice versa?

In my area, most often a student is also an assistant. This is also a reason to take two students - one junior who is more getting used to the birth scene, learning the equipment, etc; one senior who is actually doing most of the hands-on and decision-making work. As a newer practitioner I feel more comfortable with an assistant for a little while - someone familiar with birth and well trained, but who doesn't need as much "teaching" from me - and most schools wouldn't accept me as a preceptor yet anyway. I personally really like to discuss cases/clients a lot and get fresh thoughts, like the brain exercise that comes with answering questions and looking up new information, and will preferentially take a student over an assistant once my practice is better established after this baby is born .

[Peppamint]

Originally Posted by ANewDoula

For those of you who couldn't find a local, or close preceptor, how far did you travel? I'm curious how far away a student could live and still be considered for the position.

My main preceptor is almost 3 hours from me, and we serve an area that is 2-2.5 hours for both of us (she is moving that area in the next couple of months). Additionally, I am spending five weeks at a birth center (they do HB too) that is 1,500 miles from home... I am starting my third week and really missing my kids right now!

Originally Posted by ANewDoula

Also besides Casa and MLL, where else could one travel to do hands-on if local preceptors aren't an option?

Thanks
Jes

Better Birth... it's where I am now. I like that it's smaller than Casa but still much larger than the average HB practice. They take two students at a time, one on the AP track and one on the PUS track. I have been very happy with my experience here thus far- it is a nice complement to a traditional apprenticeship.

[completebeginnings]

Better Birth... it's where I am now. I like that it's smaller than Casa but still much larger than the average HB practice. They take two students at a time, one on the AP track and one on the PUS track. I have been very happy with my experience here thus far- it is a nice complement to a traditional apprenticeship.[/QUOTE]

How did I not know about this and I live in UTAH??? And am on all the midwifery lists. This is an answer to my prayers. I am 2 years into my apprenticeship but my preceptor isn't licensed and it makes signing off on skills complicated. My sister literally lives across the street. I could go and bring my nursing baby. And my mom or another sitter could stay there with the baby. Thanks for posting this.

[ginapueblo]

I don't think my answers are much different than the others, but having just completed my apprenticeship/internship, I thought I would offer my perspective:

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice? (I ask, because as a military wife, I would have to apprentice wherever we moved to when it was time for me to apprentice, and then we would move away after 2 -3 years)

I can only imagine that it might take awhile to build relationships/trust with local midwives if you are new to the community. If you will be in this position, I would plan on having an outline of your experience with some personal references available when you meet with a potential preceptor. I've heard of these non-competition clauses where the new midwife must agree to leave the area, but that's not something that is common (I'd never heard of it in our community) in Colorado.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?

I think there are several reasons:

• it can be hard to find a preceptor
• it can be hard to find a preceptor that you want to practice like
• it can be hard to find a preceptor who you click with emotionally
• you don't get to choose the schedule
• you don't get to choose the clients
• you don't get paid
• you might be balancing this unpaid work with other paid work so that you can make ends meet

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?

This would vary from situation to situation and would depend on your preceptor. However, I can only see this working if there are multiple apprentices/assistants. When I've "shared" a preceptor, we each had our prenatal day each week and then were on call for whatever births we had been requested for. So, you are still on call 24/7, but maybe not for as many women.

4 - Does apprenticing differ if you are going through NARM vs the CNM route?


CNMs do not apprentice.

5 - Would a home birth midwife take on a CNM apprentice?


Even if they did, this wouldn't be allowed unless the home birth midwife was, herself, a CNM.

6 - What is considered 'young children' at home?


This is kind of like defining gray, but for me, if you have to arrange childcare before dashing out of the house, your children are young.

7 - Is there an ideal age for an apprentices children to be?


My youngest was fully weaned (meaning over 3 years) before I started my apprenticeship. This may not be strictly necessary, but at a minimum they would need to be night weaned and feel secure with mom disappearing for a day or sometimes more at a times. I did not entertain the thought, personally, of starting my apprenticeship before this time, but I know many who make it work. If I accidentally got pregnant now (God forbid, lol--and it would be odd given the vasectomy) I would get back to my practice probably within a year, however--simply because of logistics.

My oldest is nearly 13 and that is certainly helpful at this point, but he wasn't able to watch his brothers when I started. I had a friend a mile away and a lot of support. It's a necessity.

8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?


Again, being an apprentice means being away during times that may be particularly inconvenient for you and your family. You can schedule yourself better than others can. It's not necessarily more time, though--just depends on how busy your preceptor's practice is. I've wasted a LOT of time as an apprentice that would have been streamlined much better if I'd been the one doing the scheduling.

9 - Would you take an assistant over an apprentice? Or vice versa?

I'm not in a position to take anyone on as an apprentice, but I might have need of a competent assistant from time to time, but I'm sure that will change over time. When I am ready to precept, I think I would prefer having an apprentice as I could ensure things are done to my specifications and my apprentice has the background knowledge I'd want her to have.

[MidwifeErika]

1 - What is the reason why some midwives would be hesitant to train someone that moved to the area to apprentice? (I ask, because as a military wife, I would have to apprentice wherever we moved to when it was time for me to apprentice, and then we would move away after 2 -3 years)

My only concern is that somebody would stay in one place long enough to actually be a benefit to my practice after spending all the beginning time doing the training. I wouldn't have any problems with someone coming from out-of-area though.

2 - You are talking about how hard an apprenticeship is. Why? How is it different from your own practice? Is it only because the apprentice doesn't make the decisions, and has to 'blindly' follow?

It is hard for a few reasons. One of the biggest reasons is that it is not your schedule, your practice, your clients, etc. If your preceptor takes on a case that you think is dangerous, you have to try to figure out if you can bow out of it or if you should stay involved. You have to practice by someone elses standards. I think actually once you get to primary-under-supervision this is the most difficult as you may have strong opinions about how you would handle a situation, but your preceptor may not agree with you. So, you are then in a situation where you have to make clinical decisions, but only if they match the clinical decisions your preceptor would make. Sometimes you also have to adjust your personality to fit in your preceptor's practice. There is no money and you may put in a ridiculous number of hours. Some preceptors also demand that their students perform tasks not related to midwifery such as cleaning their car, watching their kids, cooking them dinner, running their errands, etc.

Actually being in my own practice is more difficult on many more serious levels though. I am the one holding all of the responsibility now.

3 - How would a part-time apprenticeship work? Are you only on call certain days of the week? Certain hours of the day?

I have no clue!

4 - Does apprenticing differ if you are going through NARM vs the CNM route?

Totally.

5 - Would a home birth midwife take on a CNM apprentice?
I am sure, although it wouldn't count towards the CNM's educational path if the preceptor was a CPM. I have known of a few CNM students who have apprenticed with a CPM just to get more out-of-hospital experience though.


6 - What is considered 'young children' at home?
Kids who need babysitters or daycare.


7 - Is there an ideal age for an apprentices children to be?

I don't know. My kids were young and I am not sure if it was easier or harder than any other age. I started apprenticing when my youngest was about 8 months old and finished right before her 3rd b-day. My 3 kids are all 2 years apart, so they were all very little when I started. I really think this answer depends on your children, overall lifestyle, your goals and needs, etc. I know others who couldn't even dream of beginning this journey until their kids were grown and out of the house. It is only a call that you and your partner can make.


8 - Most of you are saying that being a preceptor takes time away from your families. How so? How much more than if you were on your own?

Absolutely it does. Often, an apprentice is coming in pretty green. May not have any clinical skills at all and the preceptor needs to teach all of those. There is also going over academic work, discussing the care of clients, answering questions, debriefing after births, instructing the apprentice how to do all the tasks you eventually want her to do, etc. To be honest, I cannot think of any way that having an apprentice would save me any time. It is nice to have help at births and it is important to keep midwifery alive, but I cannot think of any ways it would save me any time at all, only ways that it would take extra time.

9 - Would you take an assistant over an apprentice? Or vice versa?

Either.

[Peppamint]

Originally Posted by completebeginnings

How did I not know about this and I live in UTAH??? And am on all the midwifery lists. This is an answer to my prayers. I am 2 years into my apprenticeship but my preceptor isn't licensed and it makes signing off on skills complicated. My sister literally lives across the street. I could go and bring my nursing baby. And my mom or another sitter could stay there with the baby. Thanks for posting this.

They stay busy and are booked with students through August IIRC... you'd want to secure your spot before too long I imagine! They have a calendar available on their website if you want to see what slots are open.

[jljeppson]

I just wanted to comment on the part-time apprenticeship. When I started out, this was the way it was for me and another apprentice. Our midwife had 1 clinic day a week; the other apprentice attended morning prenatals and I attended afternoon prenatals. Clients chose the time frame that was best for them and then they stayed with it. That way they saw the same apprentice at all times and that was also the apprentice that attended their birth. The midwife started off having at least two people with her at all births (she had a former apprentice she could call on occasionally) but that only lasted for two births and then for the births I assisted at it was just me. Don't know about the other woman. For postpartums for the births I attended, the midwife and I both went to the immediate ones together (unless she was at a birth and then I went by myself) and then I took care of the rest of the home visits and we were together for the last at 6 weeks since it was at the office. I will say, however, that my apprenticeship went quicker than most. I ended up with more responsibility, at a quicker pace, than most others I've talked to.