[1stimestar]

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<div>Originally Posted by <strong>DoulaSarah</strong> <a href="/community/forum/post/7807118"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Exactly! Which is why as a doula, I get criticism from other doulas on occasion. Most doulas support birth no matter what the family wants. I guess I am more of a baby doula, as in, if you are handed a non-medicated baby at the end of a long birth journey, your breastfeeding and recovery are more likely to go smoothly! You don't have to process medications, you don't have to heal from being cut, you don't have severe edema from IV fluids...ect.</div>
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You wont get flack from me. I am glad you have such a pool of mommas to pick from and that birthing moms in your area have such a wide variety of doulas to choose from. I get clients all the time, matter of fact, MOST of my clients, when they first call to interview me, want to "leave that option open" when it comes to pain medication. I can proudly say though that the only ones who have ever ended up actually using an epidural was after severe extenuating circumstances, 40 hours of labor, b/p shooting up without us being able to get it down again, etc. Once the pros and cons of interventions are explained to them so that they not only understand them, but KNOW in their hearts and minds both, how everything interacts with each other, and when they have someone who totally believes that they CAN birth without them, then they choose not to use them. I try to take them from where they are to where they say they want to be. Obviously your clients are already "there". My goodness, what do you talk about in prenatals? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol">

 

[courtenay_e]

So, dragging the thread even more away from the OP's question...<br><br>
I think that perhaps it really depends on the from whom/where the doula got her training, and what she has inside of her, whether or not she'll do well in midwifery.<br><br>
I am a doula. I attend primarily hospital births. HOWEVER, many, if not most, of those births are attended by midwives (who trust birth)...and easily 95% of the mothers have read extensively and/or attended some really good out of hospital birthing classes. This makes my job a lot easier. I also think that, having been trained by ALACE, I was trained to be sure that my clients are educated, and can make informed choices. I was trained that being hands on and being supportive are not synonomous, nor are they mutually exclusive. For me hands on is touching if they need touch, not doing VE's to check where they are. Because, if I'm doing my job correctly and paying attention to her cues, most of the time I can <i>tell</i> you where she is.<br><br>
My best tool is simply being in the room. I have to tell my clients that, sometimes, I sit in the corner and knit or read, if they are laboring well without my being in their face. Knowing that I'm there if they need me--to have a bath drawn or walk with them or look them in the eyes and say, "you're right, this DOES suck, but you're DOING it, and you're doing great, and you'll be done before you know it", or to offer them some essential oils to sniff,or whatever...just being there to be the symbol of that help is a major strength of being a doula. Midwife means "with woman," right? And I think that the doulas who can be WITH the woman without commanding her labor experience, if that vocal presence isn't called for, can be valuable as midwives.<br><br>
My next best tool is my voice. When a woman is vocalizing out of her nose, throat, face, I can mi8mic her in a lower tone, out of my chest. Often times that brings her tone lower and relaxes her a bit. The above mentioned "pep talk/affirmation" really probably sounds like the "grownup speak" from the Peanuts cartoons...but I've been told over and over again that that's what she needed to hear at that point. ALSO, something that I have done from the beginning, but they also covered in the ALACE training is "speaking low, and in her ear, if she needs vocal support during pushing." I have also been told over and over again by moms in the hospital who haven't had the midwives that, with all the yelling and cheerleading going on, my voice, whispering in her ear, was the most important sound in the room.<br><br>
So, then if she really needs it, I DO touch her, do massage, hold her hand, do a "head squeeze."<br><br>
SO, and here is the tiny bit defensive part of the post, I understand what the flow of an unhindered birth feels like. I understand what birth "feels" like if you just let a mother labor how she needs to labor. For some reason, luckily, I've had the chance to experience labors that are allowed to happen. I understand that there are MANY doulas who don't have that experience,and who may not WANT to. However, I also understand what a benefit it is that I was trained by ALACE, who trusts birth. Later realizing that I am going to, someday, be a midwife (and yes, homebirth is like heaven when compared to even a midwife attended hospital "birth center" birth), I was glad to have training from a group who believes as strongly as I do that birth is inherently safe. That being said, my partner is DONA trained and I trust her with no question to cover my clients. She has "it" inside of her, too. Of course, she's a homebirther herself...and that's not to slam DONA, ladies...just saying that I noticed (probably because it started as a homebirth education group)how much ALACE DOES trust birth, and encourages their doulas to do so, too.<br><br>
So, being a doula who is going to be a midwife? I think whether it's a good thing or not depends on the doula and her core beliefs about birth.<br><br>
I do believe that a woman should be supported in her choice to have a natural birth, even if she wants it in the hospital...and LOVE it when I can support that choice at home! I think, down deep, I've known that I would be a midwife for probably the last ten years. But I came to doula work first, because it presented itself as an option first...and it's great!...for now.<br><br>
Sorry, mamas. That was long, wasn't it? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/redface.gif" style="border:0px solid;" title="Embarrassment">

 

[riomidwife]

Commenting on the original topic...<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>GrrlyElizabeth</strong> <a href="/community/forum/post/7788006"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">What were your apprenticeships like?</div>
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I had three apprenticships, two long-term with LMs/CPMs (in a legal and illegal state) and one short-term with a hospital-based CNM. Three of my preceptors had been practicing for 20+ years, and two for between 1-4 years. One OOH practice a constant flow of students enrolled in a formal midwifery school and they had established very explicit and formal duties and expectations and of the student. The other OOH practice was less formal, more flexible, and ultimately provided a different set of clinical learning opportunities for me (I was also a more senior student then).<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>GrrlyElizabeth</strong> <a href="/community/forum/post/7788006"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">And what should apprentices (or wanna-be apprentices) look for in a midwife?</div>
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Well, often as a student or apprentice looking for a mentor you don't get to do much choosing, YKWIM? You will have entirely different learning experiences and personal experiences with all of your preceptors, so ideally I think attending births with as many midwives as possible will serve you best. In the beginning I'd probably stick with just one steady midwife, then mix things up.<br><br>
If I had to do it all over again and I had the luxury of choosing a mentor midwife/preceptor, and I could only have one apprenticeship I would opt for the midwife that seemed to have the least amount of personal ego on display in her care. This could be the most newly practicing midwife, or the one that has been around the block thousands of times. (In my case it was always the midwives who have been practicing for ages, but this is not always the case). These are the midwives who offered me the most, and whom I learned the deepest lessons with (and the lessons most relevant to me as a midwife today).<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>GrrlyElizabeth</strong> <a href="/community/forum/post/7788006"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">What personality traits do you look for? Should your apprentice have finished all the reading/coursework for one of the midwifery learning programs already?</div>
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Pamamidwife's list is a great start. I totally agree with everything on it. I'd prefer someone who already had some academic midwifery backround beacuse I would not have time to teach a student all the book learning. AND I'd hope that that they were motivated and interested in it enough to have already delved into it on their own.<br><br>
For me, being a midwife goes beyond serving women and families; being a midwife is also an active creative expression of my beliefs, values, and committment to community. So working with women I enjoy and who inspire me is a priority. (my needs need to be nourished too!). Personality-wise, I think it is important to actually <i>like</i> each other. You're going to spend a LOT of time together. If the midwife or student has personality traits or behaviors that the other just can't stand, it's going to be a long a hard road ahead! As a pp mentioned, sense of humor is important. Yyou have to be willing to laugh at yourself and your mistakes (when appropriate).<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>mwherbs</strong> <a href="/community/forum/post/7799639"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">you are also a provider- so you learn the different facets of care and the whys and were fors-- so rather than you deciding that eye drops are useless <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1"> it is your job to give parents an informed choice--</div>
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Providing informed choice is such a big part of my function as a midwife that any apprentice I took on must also have a desire to provide informed choice on clinical issues. Even if she has her personal biases I would expect her to want clients to make the best decisions for themselves, and be able to offer them all the relevant and current info to assist their process. I know a lot of new students come into midwifery with somewhat black and white opinions and beliefs about various interventions and treatments. Fine, but they must posess the flexibilility to question their postion, evaluate the evidence, and allow the clients the freedom to decide for themselves, rather than telling a mama vitamin K isn't necessary, etc., etc.

 

[1stimestar]

I am enjoying the doula portion of this discussion so much that I made it its own thread so we don't highjack this one.

 

[Holistic Midwife]

This is a great thread. I think apprentices are great and the apprenticeship model is an essentially beautiful thing! I skimmed all of the posts on this thread so far and think most things that I would be looking for in an apprentice have been mentioned. A goldmine for an aspiring apprentice/midwife, I think. I'll add my brief (I hope) two cents.<br><br>
Here are some things that I look for:<br><br>
~A good communicator.<br>
~Honesty and reliability all the way around.<br>
~A supportive husband and/or family. Reliable childcare.<br>
~Available by phone or pager at all times when on-call.<br>
~Discretion.<br>
~Enthusiasm, with at least a willingness to work as hard as I do.<br>
~Emotional maturity.<br>
~Knowing their limits!<br>
~Be active in and/or members of midwifery organizations.<br><br>
What I don't want:<br><br>
~Midwifery to be their new hobby.<br>
~Constant updates on an apprentice's life drama.<br>
~Complainers! (I have had an apprentice like this who does not realize how big of a deal this is. I've noticed that her negativity is contagious.)<br>
~Passive-aggressiveness. I like for people to be open about their concerns.<br>
~Acting too much like a friend in a professional situation. I don't care if she's joking or whatever. Making jabs about my eating preferences or how she's never home because she's busy working with me is *inappropriate*!<br><br>
I also will chime in on the advantages of being a doula for a FEW births first and maybe finding one's own didactic program to compliment their apprenticeship. I like for apprentices to already have a sense of being on-call and how their family reacts to it. I don't want to have to tell an apprentice to carry a change of clothes, etc., or have her car reasonably gassed up while someone is due. I also don't have time to completely structure their studies. They need to be proactive about finding a study group and going to classes and workshops in addition to the the ones that I teach whenever possible. There you go. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">

 

[mothercat]

Just wanted to pop back in and clarify about wanting my BA's to be doulas or CBE. I don't necessarily want them to have learned birth in the hospital, because OOH is so much different. I just think that it gives them a place to start. They have skills that complement mine, a basic knowledge of the flow of labor and how they can help facilitate the process.<br><br>
The BA I work with most actually had doen no doula work before she and I started working together. With her knowledge from my practice she has started doing a little doula work for hospital clients who aren't quite ready for OOH. I think she has developed a stronger faith in normal birth and it gives her a good base to take into the hospital with her.<br><br>
Plus she can come back and debrief with me about her feelings, procedures, etc. We don't talk about the client w/o her permission because they are her clients, not mine.<br><br>
BTW: there is some really good stuff in this thread. Does it qualify as something that needs a sticky for future reference?

 

[sirref]

** I do think this is sticky-worthy. I am glad to have dug deep enough to find this thread tonight.<br><br>
I think I have benefited from doula work first, for everything from basic birth knowledge, to living on call, to being a great benefit in the transports I've been present for in the ast 18 months.<br><br>
Not being a teaching midiwfe, I can't answer that side of the question, but when seeking a placement I can say personality and respect are key. Both directions. I expect to be respected for the experience I have gained ad the skills and work I have done for my preceptor, and I would want to work with someone who's skills and birth sense I respect. Even if I were to be apprenticeship-less for a time to find that situation.<br><br>
Also, I intend to work with more then one preceptor. I feel it will be benificial to learn from more then one person no matter how much I respect my current preceptor. I would want to work with midwives who are not threatened by that. You may find two women who you can work with concurrently- if the schedules & personalities involved gell, or more likely you would need to have some goals in mind to complete with one preceptor, then move on to another- if only to shadow another mw to a couple births and see another style. I know of midwives who only practice right handed, or can't practice without Vag Exams, or hardly any.... I want to have multiple skills to draw from.

 

[GrammyMidwife]

I'm coming on to this discussion kind of late, but I so appreciate this topic and basically agree with all the different ideas. I've had many apprentices over the years..some have continued to labor coach and some have just dropped out, but I have a couple of young ladies working with me right now that seem very promising..both have a passion for birth and the willingness to learn (they seem ok with the middle of the night stuff as well...) This being said, we had a lady assisting with us a short time back, and she had a hidden agenda that she failed to share with me. First she tried very hard to discredit my apprentice, especially with birthing mothers. I had to work very hard to get that straightened out. Then she decided to "be the midwife", contacting and assuming care of a couple of ladies we were working with. Ok, its all about choice. Then she has proceeded to "inform" several of our contact people that I am no longer practicing and she is filling in for me. She was present with us for 6 labors, three of which were transports! But she feels confident to work with vbac moms..Sorry, I don't mean to whine, and I certainly don't have a problem with other midwives being in the area (there are 3 of us) but I DO have a problem with her assumption that she can just make me go away..ugh. So I guess if I were to consider working with an apprentice, I would hope she was not using me as a stepping stone to further her own ambitions!

 

[mothercat]

So who do we ask to have this made a sticky?

 

[Maggi315]

subbing...I am getting very busy and need help. Since I'm so new I didn't really feel comfortable taking on an apprentice, but I need the help and I have been approached by a friend. I am wondering how it is having a friend become an apprentice.<br><br>
I'm also wondering about the difference between an assistant and an apprentice. Trying to decide which I need or what experience I am looking for.<br><br>
I know I want someone who has done more than just "book learning". Someone who is active in the birth community, has some hands on experience. I understand what others are saying about doulas, I can definitely see the potential for a problem there. And I don't want someone who thinks they know everything even if they have only been to 3-4 births but "read" something about it.<br><br>
But since I'm so new myself, I mainly want to learn from this discussion and try to find my own path in my journey.

 

[mothercat]

I think I was the one who brought up birth assistants in another thread: Midwifery as the latest trend... (Multi-page thread 1 2) . My post is #24.<br>
Sorry, not sure how to do the link to that thread.

 

[mamato3cherubs]

Just wanted to thank everyone for this thread. I was present at my first homebirht yesterday, and have to say it was more amazing than I could ever have dreamed. And I had to leave right after the birth. Then i come here and find this thread and I am really rethinking my plan of attack.<br><br>
This has been wonderful insight, even the stuff i dont fully agree with. And even if I did fine it late

 

[Maggi315]

thanks mothercat for redirecting me to that other thread. I think I probably need a birth assistant at this time. I need someone with knowledge who can help me out by doing a pku, a jaundice check, etc. That's where I get time-crunched, driving one hour+ just to do a jaundice check plus have all my prenatals, etc. that day.<br><br>
For those that have birth assistants, what percentage of your fee do you pay them? Do they come to every birth too?<br><br>
Someone needs to write a book about all this (maybe there is already one? maybe I should write one?<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"> ). There is a great book about the business aspects of work for lactation consultants written by Linda Smith. It talks about hiring, agreements, insurance, setting up, business laws, family, etc. It was a godsend when I started practicing as a private practice IBCLC and although some of the stuff applies to midwifery, I would love to see that format just for midwives.

 

[Earthy Birthy]

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<div>Originally Posted by <strong>DoulaSarah</strong> <a href="/community/forum/post/7807118"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Doula work is definately more physically demanding then midwifery work!</div>
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I know that I am taking this thread OT again, but I just have to tell you that I totally disagree with this statement. Each birth is different, and some mamas want more hands-on type care (massage, back counter-pressure, etc.) from their mws, but I never leave a birth *not* feeling exhausted. I would say that most of my work actually occurs after the birth is over. Helping mom up and to the toilet and shower, draining the birth tub, cleaning up the birthing space, getting everyone settled and making sure that mama is okay and baby is nursing well... The biggest drain though, I think, is the responsibility of it all. Especially in a birth with an SD or a baby's funky position or just a long drawn-out labor with a tired mama, that is something that takes a toll on not only the mama, but the mw too.

 

[GrrlyElizabeth]

Thank you all for so many great responses!<br><br>
I have another question for the midwives: Do you expect your apprentice to pay you? I've heard of this, and I have to admit I don't love the idea. It's not like being in school, where you can easily have a part-time job, for example, and apprentices seem like they do (and should do, IMO) quite a bit of work for their midwives. OTOH, I can see a midwife wanting a payment as a sign of taking the apprenticeship seriously, and I know in the traditional apprenticeship model a family would pay the preceptor for their time and for training the apprentice to practice that profession... Thoughts?

 

[mothercat]

TXmidwife I so agree with what you said about how exhausting the responsibility is.<br><br>
I usually don't realize until I start getting a headache , how much tension I am holding when there are problems and transports. With a butter birth, I'm usually in pretty good shape after 24 hours. With a difficult birth, it takes me 24-48 hours to feel normal again. There is worry about the family, did I make any mistakes, supporting the family emotionally, all the processing and questions. Then all the PP and NB visits. The constant knowing in the back of your head that you are ultimately responsible and the family has so much trust in you.<br><img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:<br><br>
I once asked an instructor, who was pretty high energy, how she gave so much to her clients and still seemed relatively sane. Her answer was lots and lots of exercise. You just need something physical to balance the emotional part of what we do.

 

[Charmie981]

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<div>Originally Posted by <strong>mothercat</strong> <a href="/community/forum/post/7923642"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The constant knowing in the back of your head that you are ultimately responsible and the family has so much trust in you.</div>
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Yes, the weight of that responsibility slammed down on me during my first birth as *the* midwife (not as an apprentice who was a primary, but as the senior midwife at the birth). It ended in a transport for fetal distress and a c-section that revealed thick mec and a velamentous insertion of a 2 vessel cord. I'd had transports before (many, many transports) as an apprentice but the weight of the responsibility was not fully felt until that first one where I was *it*. It is physically and emotionally exhausting, even at an uncomplicated labor/birth. I always need rest afterwards. As an apprentice, I never felt that. After an uncomplicated birth during daylight hours, I loved to go home and just be with my family and enjoy that I hadn't been away for so long. NOW I know what my preceptor meant when she said you'll never be as free as you were as an apprentice.

 

[mwherbs]

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<div>Originally Posted by <strong>GrammyMidwife</strong> <a href="/community/forum/post/7914616"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">This being said, we had a lady assisting with us a short time back, and she had a hidden agenda that she failed to share with me. First she tried very hard to discredit my apprentice, especially with birthing mothers. I had to work very hard to get that straightened out. Then she decided to "be the midwife", contacting and assuming care of a couple of ladies we were working with. Ok, its all about choice. Then she has proceeded to "inform" several of our contact people that I am no longer practicing and she is filling in for me. She was present with us for 6 labors, three of which were transports! But she feels confident to work with vbac moms..Sorry, I don't mean to whine, and I certainly don't have a problem with other midwives being in the area (there are 3 of us) but I DO have a problem with her assumption that she can just make me go away..ugh. So I guess if I were to consider working with an apprentice, I would hope she was not using me as a stepping stone to further her own ambitions!</div>
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So I understand what you mean- it is more about her value system, I don't think many of us want an apprentice who would act this way. Unfortunately I too have been around would-be apprentices who have done similar things, don't know exactly how to keep these folks away- but sometimes you can see them coming-- sooner

 

[mwherbs]

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<div>Originally Posted by <strong>GrrlyElizabeth</strong> <a href="/community/forum/post/7922627"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Thank you all for so many great responses!<br><br>
I have another question for the midwives: Do you expect your apprentice to pay you? I've heard of this, and I have to admit I don't love the idea. It's not like being in school, where you can easily have a part-time job, for example, and apprentices seem like they do (and should do, IMO) quite a bit of work for their midwives. OTOH, I can see a midwife wanting a payment as a sign of taking the apprenticeship seriously, and I know in the traditional apprenticeship model a family would pay the preceptor for their time and for training the apprentice to practice that profession... Thoughts?</div>
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there is a mw who I have worked with that has developed over the years a series of classes- the printed materials alone for cheap copies is over $100- and she teaches the classes in a workshop style- hrs and hrs of lectures this gal I would expect an apprentice to pay- also if you go to some of the more organized clinical sites there is a cost - I don't charge but if teaching were to start costing me- or if I taught a specific class that was outside of normal clinic and birth days - yes I would want some compensation for my extra time

 

[Maggi315]

I don't think apprentices should pay for the normal apprentice opportunities. I do think they should do some of the extra work for the midwives and help her out. This is a fair exchange in my part.<br><br>
I do agree that if there are workshops, extra education, handouts, etc. then I would expect payment. A midwife a few hours away from me is hosting a series of workshops and I am trying to arrange to go. I think I could learn so much and even though my husband is balking at the cost, I understand the amount of work behind this and think it is reasonable.<br><br>
A friend of mine went to Bastyr and completed their midwifery program for naturopaths. She had to pay the college for each birth, that seemed a bit much for me, why should they get paid all that money, all they had to do is look at the form for each birth the student and preceptor filled out. but they probably have liability, administrative costs, etc.<br><br>
I am enjoying this thread very much, I think it should get a sticky, it answers so many questions for both the midwives, apprentices, and future apprentices.