My name is Kathryn, and I'm an aspiring midwifery student. For the last year or so, I've been reading all of the materials I've been able to find on midwifery and am now planning pursuing midwifery training. Before embarking on a course of study, however, I have a number of questions I'd love to pose to seasoned midwives, and if any of you have the time to answer some or all of them, I would be so much obliged.
(1) Knowing what you now know, would you encourage someone to pursue midwifery?
(2) In your opinion, what's the best way to become educated/trained in midwifery? (for instance, nurse-midwifery programs, direct-entry programs, apprenticeships, etc.) And, what would you say are the best first steps for an aspiring midwife? For example, would you recommend first acquiring doula training and certification?
(3) I'm often asked how squeamish I am, and the truth is, I'm not entirely sure, because there've not been many times that I've been exposed to considerable blood loss. To what extent have you find that squeamishness is something a person is able to overcome, and to what extent should that kind of tolerance be innate?
(4) How do you adjust to the pace of midwifery (ie, the unusual sleep schedule)? How stressful would you describe midwifery work as being?
(5) Where do you learn about and how do you handle the business side of midwifery? For instance, where/how do you find and attract a client base?
(6) How feasible have you found it to make a livable income as a midwife?
There is a lot of variety among midwives and midwifery practices in the US. I will try to answer your questions - though I find they have different answers depending upon whether we're talking about CPMs, CNMs, hospital-based practices or OOH practices.
(1) Knowing what you now know, would you encourage someone to pursue midwifery?
Absolutely. If you want to become a midwife, do it!
I would say the most thorough training as far as skills and experience goes is nurse-midwifery training. Especially if the midwife has prior experience as an L&D nurse - she will have a lot of experience and skills in labor monitoring, assessment, handling emergencies, etc.
Initial steps - get as much certification and training as you can: EMT, nursing, lactation counseling, doula, all those things have skills that midwives need to draw upon in their work.
If you're too squeamish to attend births, you'll know it when you witness one. And you'll probably decide to do something else.
OOH: most/many midwives who have OOH practices are on call 24/7/365. This is a very hard schedule to maintain. Though there will be busy times (where births happen one on top of the other), then weeks of no births. (and adequate rest.)
Hospital: scheduled shifts on-call and back-up providers usually provide for periods of sleep.
Midwifery is stressful.
Word of mouth.
OOH: very difficult
Hospital-based: livable income. Though the cost of CNM programs can cause considerable student-loan debt.
Here's my two cents, but with the disclaimer that I am currently a nursing student, birth assistant for a home birth CNM and an aspiring CNM.
1. I would encourage anyone who has, or thinks they have, a passion for birth should explore midwifery. If you love supporting women and their choices, love birth, labor, and breastfeeding then this might be for you.
2. In my personal opinion, becoming an RN and then a Certified Nurse Midwife is the best way to get experience and education to become a midwife. The first best steps in my opinion are to go to births however you can! Go as a doula, friend, sister, assistant for a midwife, nurse, etc, etc.
Other great things are to get education/experience with breastfeeding, childbirth education, postpartum doula work, etc. This will give you a good idea of what parts you like about birth and postpartum. Many midwifery programs require or strongly suggest doula certification so you may want to look at programs to see what they require.
3. Attend some births and see how you feel about it. I will tell you I've almost passed out twice at births. Every nurse will tell you that there have been times that they pass out or almost have. It just depends on what bothers you, or sometimes just whats going on that day, maybe you didn't eat breakfast.
But I believe that it can be overcome. Seeing blood drawn used to bother me, but now I've successfully drawn blood on someone. Go to a few births and see how it affects you.
4. Since I'm not a midwife I can't necessarily speak to the stress of "being a midwife" although from watching my midwife I work for I can see that IT IS STRESSFUL, especially depending on where you live and the birth climate in that state. You can face a lot of criticism especially for home births, also you have to be able to deal with super stressful situations like emergencies, infant deaths, diverse family situations, etc.
Being a home birth midwife in a solo practice: on call 24/7/365 unless you schedule months where you don't take clients or have a backup midwife. It is hard to be on call that much. Also you will be the one doing all the office visits as well, so factor that in.
Personally I don't usually mind the waking up in the middle of the night, driving off to a birth, usually. Although it can be hard when you only got 2 hours of sleep or you've been at a birth the day before and are exhausted. Scheduling time off, time for yourself and taking care of your body is extremely important when you're living the on call life.
5. As far as the business side, a good school should teach you some of it. Other options are finding a mentor in your community or somewhere else that can help you out with how to do things. How to find clients: word of mouth, mothering groups, organizations you may be a part of.I think a GOOD website is key! One with lots of info about birth and your practice that actually lets people know about you.
6. Income really depends on how/where you practice. How many births you attend a month, how much you charge for each one, how much you charge for office visits, etc, etc. Being a CNM you can make a good living at home or in the hospital/birth center.
I think midwifery is a great profession and i would defintely encourage others to pursue it. Also, although nursing was purely a means to an end for me, I am proud to be a nurse as well.
2) becoming a CNM was a better choice for me for the flexibility and financial security it provides. I appreciated the more structured educational route and the diversity of practice styles I was able to experience as a student (hospital and birth center). I also had amazing classmates and we learned a ton from each other and most of us are still very close today (9 years later). I'm glad I wasn't learning on my own or with only one preceptor
3) I'm fairly squeamish myself about non-birth stuff but not at all about birth. You'll have to see for yourself how you feel.
4) I work in a hospital now and absolutely love my schedule. I work 1 24 hour shift and one 12 hour shift a week. This is considered almost full time but I am home with my kids 5 days a week- or 6 if my 12 is a night shift. I think people who are insomniacs or not good 'nappers' struggle more with the weird schedule. It works great for me but I'm a good sleeper. I do feel tired often, but I also have small kids so its hard to know what to blame for that. I and most of my midwife friends see the schedule as a bonus and would hate working m- f 9-5. In the other hand, it is
June 12 and I don't have my schedule for July yet. My family and babysitters have had to learn to live with that kind of uncertainty. In terms of stress I would say that some jobs are
more stressful than others but regardless there is always a TON of responsibility when you are a midwife and that is not something to be taken lightly. I don't believe that I had a good understanding of that as an aspiring midwife.
5) I got very little education about the business side of things and would have been completely ill-equipped to try to set up a practice. But I also never ever had any interest in working in a solo practice ( nor would I ) and have learned a bit about the business end of things over the years from my co-workers
6) I make a very decent living
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