When I visited the Island of St. Martin in November 2000 with my children, I had a wonderful time on the French side of the island. It's a nice place, BUT we took a side trip to Saba which is wonderful. Saba has a very well-to-do population and even has a two-year medical school! What is doesn't have are women who have their babies on the island. They go to St. Martin to have their babies. I would think that Saba would be a nice place to go. First off, there would be an opportunity to teach some midwifery skills at the medical school (I'd imagine) and access to a good medical library and people who want and need to learn these skills. I would think that the sort of students who attend the first two years of medical school on an island are either avid scuba divers or the sort of people who expect to practice in the area or other isolated areas. I would also think that the women on Saba who have babies would welcome a midwife...someone who can give them some care on the island and either help them deliver locally (not sure what the laws are!) or go with them to St. Martin and stay with them for a while in lodgings there. The high-speed ferry trip is one hour to St. Martin but it's very bumpy, from what I understand either private launch is arranged that's a bit smoother (and longer) or they go well in advance. There is a large Dutch population on Saba as well. (Netherland Antilles). So I think they would be open to the idea of midwives! One older lady I talked to said they used to deliver on the island but they lost their OB/GYN or something like that. So now women must go to St. Martin.
On Saba, there is a rain forest! There are goats and chickens and a really nice road that goes all around the island. There is an airstrip (seeing is believing!) and a town wharf. They grow some food via hydroponics. The tourism industry is very high-end. Mostly scuba diving and day tours. The social services on the island are good - fantastic compared to the rest of the world? The first thing I noticed was the big commitment to taking care of their elderly. Crime is very, very low. Almost non-existent. There is one beach, you must walk down many stairs to get to it. But if you want to go to the beach, just go to St. Martin. There's loads of them there and the ferry is inexpensive and convenient enough.
If you need more info, just PM me.
I think you could go to St. Martin and then figure out the opportunities on Saba...or maybe it's possible to get a job on Saba and then do the midwifery on the side. I have NO idea about laws and such there. I didn't ask about that.
Edited to add: I did have the chance to chat with a girl who was going to school on Saba. It appears their standard of education there is HIGH. I would imagine you could get a job easy teaching there. The school is quite nice.