On Choosing to Be a Clinic Midwife

My pace of life is different now. There’s less sprinting from labor room to labor room. There’s fewer tears, less pain. My path is different, but my stride feels the same.

Being a midwife who doesn’t catch babies is a strange thing to explain to someone. They look at you like you don’t do what you say you do. Like your life should look like something it doesn’t.

I’ve explained before that I don’t think “midwife” is a descriptor of what one does, but is an attitude and a philosophy with which one delivers care. After the birth of my joyous baby E, I just could not imagine returning to a world in which I would be gone for 6 days out of the month completely, and another 6 in which I am exhausted and sleep for half the day. In short, I couldn’t imagine being a mother to an infant and mother the mothers, and be absent from my child’s life literally half the time.

It is the unfortunate reality in the U.S. that most full-scope midwifery positions do not offer a very good work-life balance. In other parts of the world midwives work 8 or 12 hour shifts, get adequate rest, and are able to have the kind of life I knew I couldn’t have. My partner and I thought long and hard about a change in my career path. Would we be able to make it work financially? Would this be a backwards step to all the hard work I had done to learn to be a baby catcher? In the end I chose my family, a great group of providers to join, and a return to the days of more gynecologic care and birth control work.

I still see people when they are pregnant, but no longer have my own patients, which has been the hardest thing to grapple with. I no longer watch families form, a cohort of women coming and going, changing like the seasons.

What I have gained though is the space to bring midwifery into places that midwifery usually doesn’t live. First pelvic exams. Well woman care. Contraception. Pain with sex. Menopause.

I’m given the space to listen deeply, counsel thoroughly, and talk with my coworkers about what midwifery is and why it is important.

I am about to insert my 100th IUD since January. I’m not sure when it will happen, but I’m on track to do it some time this month. Contraceptive work is one of my favorite parts of my job because it hands direct control of a fertile person’s future into their hands. It’s the reason I love abortion work as well, which I have also joyfully returned to in the last few months.

I worked a long day at our local abortion clinic a few weeks ago. I love listening to the stories of where pregnant people are in their lives, how old their other babies are, and where their plans for the future lie.

I talked with a young woman recently, not much older than myself. She had four children, and didn’t want a fifth. She had multiple health issues that put hormonal birth control off the table. She didn’t want an IUD. And she couldn’t find a physician to sterilize her. We live in a world that infantalizes women. We can’t make our own decisions to terminate a pregnancy. We can’t make our own decisions to know when our families are complete. In this moment, I had the joyful experience of being able to make my worlds meet. I knew the physicians I work with would help this young woman at my other day job. I just had to get her through her abortion today.

I had the wild and also completely normal experience about a week ago of catching a baby, completely unexpectedly. I was hanging around in the hospital, waiting to assist on a cesarean birth and a labor nurse ran in to grab me. The doc I was working with was tied up at the moment and they needed someone, anyone who could catch a baby. My reflexes sprang into gear and like a midwife lightning bolt, I followed the nurse down a long hallway. Not running, but doing the quick stride we all learn that says, “I’m in a hurry, but I am composed. Everything is fine, I will not run. Running signals an emergency. This is just an unexpected event.”

I saw a packet of gloves on the table, ripped them open and got them on just in time before a sweet, pink babe had made its way into the world. Catching that baby was at once like a reflex and incredibly foreign. My brain screamed at me that I don’t do this anymore. My heart yearned for the joy and pain, the relief and elation of a birth.

The days following this surprise baby had me wound up. Did I make a mistake? Did I leave birth too soon after starting down its road? Why did I give up learning its wily ways, its’ secret predictability, coming to it again and again like a long-lost lover?

The emotional high that follows birth eventually faded, as it always has done for me, and I was left with a clear heart. That world is still not for me. Not at this time in my life. I keep reminding myself that careers are long. There are many babes that will be born into my hands, but when I am ready again. When I have embraced the sweet early years of my son’s life and he needs me less. When my heart has fully healed and the disasters I have seen are distant memories, not still nightmares that play out when my brain finds unexpected triggers.

When I talk to patients in the office, they often ask if I might be one of the people at their births. I jokingly reply that I have hung up my baby catching hat. Hung up, but not retired. The hat I wear now is one that brings me immense joy, and is one that is called the Mamma hat. It’s the one that wipes tears and runny noses. Rocks softly in the twilight before bed, carries the hiking backpack up a mountainside, and watches a small person explore our world for the first time.  I wish I could wear all the hats simultaneously, and that the sexism of our society didn’t make me feel less than for prioritizing my child’s needs above an idealized career goal.

Baby E turns one next week. Just writing out that statement brings up an immense emotional response, but in this first year, I can’t imagine not being there and missing him fiercely in the long, lonely nights midwives often face.

The more I talk about leaving birth to focus on clinic work, the more midwives I have found that have done the same. Midwives that work in academia. Midwives that are experts on HIV. Midwives that do abortions. Midwives that are now hospice nurses. This is the beauty of midwifery. It’s is literally cradle to grave care, versatile and touches families throughout their lives. Right now, midwifery is just what I need it to be, and that is providing care that allows me to come home at night, sing my baby to sleep, and be there with him as the sun comes up.




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