by Raichal Reed
A midwife, a patera, a “granny”, and sage-femme are all names for the same person. The name midwife means “with mother” in basic translation. Since before time was recorded there have been people or a person who had the very important job of caring for the pregnant person and their baby. Depending on what country and sometimes what area you research, there are different stories concerning their roles, abilities, and relationships with the community. Coming into current day in the US, these individuals now have roles that extend beyond pregnancy, labor, and postpartum. Before schools and universities, the midwife directly taught and trained their apprentices/assistants/etc. in order for them to work with them and hopefully in their place once they were no longer able. Skills were passed from family to family and generation to generation orally and through practice along with the more skilled midwives. The first registered midwife in the US was in NY in 1716 and now we have more than 11,000 according to the American Midwifery Certification Board in 2017. This only counts for how many are registered with NARM in regulated states, but some states still do not have regulation or approval and so those midwives work independently and sometimes illegally to make sure that healthy parents and babies survive.
“A midwife does not have off days, and a midwife is always on call” was one of the first things I heard when I became a student midwife. I didn’t understand the heaviness of this statement until months later. During the time of being a student midwife, I am at the beck and call of not only the pregnant individuals but also my preceptor. We have clinic all throughout the week and if we have a birth that interferes then we must schedule them on days that we normally aren’t there for. I learned to keep my phone, my watch, my tablet, and any other device that could always make a noise on loud. Babies come when you are in the shower, they come when you are in church, and even when you are asleep. If you plan to be somewhere then they especially come those days because for some reason, when you are busy, they like to start trouble. Labor and delivery are a wonderful, magical process but it is also one that you have no control over, neither you nor the birthing person. Midwives are medical providers for the people who depend on them before, during, and after the delivery of the baby as well as in the months postpartum. They differ from your local obstetricians and gynecologists because there are no office hours for a midwife. If a birthing person has a question or concern, they depend on being able to contact their midwife at any point. Some midwives set hours for less concerning questions (like what kind of belly support system to get) to waking hours, but when someone is having vaginal bleeding at 3am on a Saturday, they find confidence in getting answers quickly or at least knowing that they need emergency attention.
Self-care is important for everyone regardless of what job they work, but in the same breath, self-care for a midwife can sometimes be the quiet moments between labors. It is especially important when there have been difficulties in the labor and birth (not saying a hospital transfer, but fetal demise or NICU stay). I’ve seen midwives take deep breaths in their car in the driveway with no music to find their calm and collect thoughts. My preceptors sometimes meticulously pack their cars as a form of meditation, and a means of making mental checklists of what needs to be done for this client. Other midwives play certain music as a mantra. Some kneel and pray for the health and safety of everyone involved. Some find comfort in coming home to their family and pets who welcome them with open arms whether the outcome was good or bad.
For me personally, I like to play music that pops into my head when I think of the family or when I see the baby. Replaying older births in my head makes me feel more confident going into another one. I remind myself that I am knowledgeable and worthy to bear witness to this event.
When a midwife goes on vacation, I can’t say that they completely empty their mind of their clients or what they have to go back to. The easiest way to put it I guess would be that sometimes “you end up thinking about not going on vacation because when you go you think about how long until you go back”. Many midwives take small week-long breaks between clients and then have to jump right back into the motions when they return. Some midwives can take longer breaks when they are in a partnership or hire another midwife to take over their clients while they take time off.
Self-care can also be community. We try to have dinners at least once a year where all the local midwives can come and talk together, and there’s always peer review time but that can be more stressful than comforting. Learning to not shut yourself off and depending on others in your profession can keep you sane and help you self-care emotionally, spiritually, and mentally. Watching my preceptors and other midwives I know and respect find their own way into caring for themselves, I’m sure I will find my way with a community as strong as them behind me.
Raichal Reed – ” So my name is Raichal Reed I am a 24 year old, fourth year student midwife originally from South Mississippi now residing in Central Texas. I’ve always been in love with the birthing world ever since childhood and decided in the second grade I was going to work with women and children. Coming to Texas I found that midwifery was regulated and decided to take that route instead of medical school after receiving my Bachelors in Sociology/Pre-Med. I am the current volunteer director for Giving Austin Labor Support, a non profit of volunteer doulas, and a midwife student to two wonderful Midwives (one CPM and one CNM).”