I was only able to attend two of the lunchtime sessions for midwifery week last October, but in both of them, I had to fight the urge to spontaneously burst into applause every few minutes. Those sessions were the highlights of my week, and I left both of them feeling really great–about midwifery in particular, and nursing school in general.
I’m not sure if midwifery is the route for me or not because frankly, I’ve had relatively little exposure to birth or babies; I don’t even have concrete ambitions to have children of my own. And, while midwives deal with much more than just childbirth, that’s undeniably the central component of their practice. Midwifery wasn’t something I’d ever considered for myself before this year. But I love, love, love the alternative model of healthcare that midwifery defends.
The philosophical tenants of the American College of Nurse-Midwives—chief among them that midwives provide individualized, specialized, whole-woman and women-centered care—underscore the need for holistic and patient-centered care. Unlike other settings with similarly stated goals, midwives go about achieving that kind of care on a more structural level. As Peter Johnson of Jhpiego discussed in one of those lunchtime sessions last fall, midwives provide an alternative to the often assembly-line approach to labor and delivery that hospitals, by merit of the sheer number of patients (per clinician) they see, have to provide. Instead of seeing many different nurses during the course of a labor, and a doctor (who you’ve often never met before) only for the delivery itself, a midwife can stay with a woman during her entire birth. That’s enormous.
This spring I completed the JHU Birth Companions course, “Community Perspectives on the Childbearing Process,” and I’m now mid-way through my doula certification process. Doulas, or birth companions, provide “continuous physical, emotional, and informational support to the mother before, during, and after childbirth.” The idea behind the doula model is that, even if a woman is having a hospital birth with many different clinicians providing intermittent care, the mother can have a trained labor companion who will be with her, consistently and continuously, throughout her birth. Having a birth companion providing that kind of continuous support has been shown to result in fewer medical interventions, fewer complications, and shorter hospital stays.
I’m just scratching the surface of the world where culture, politics, healthcare and childbirth intersect. Having attended several births now, though, I’m beginning to get what people talk about when they describe themselves as “birth junkies.” It’s a huge rush to be present with someone during such a powerful life event. As a novice birth companion, I have been an advocate, an interpreter, a coach, and a friend. Most of all, though, I’ve been a familiar face in the middle of a chaotic experience. Two of the women whose births I attended were recent immigrants who didn’t speak English and who had never been in a hospital in the U.S. before. Both of them had had previous experiences that had predisposed them to be afraid of the hospital setting. Being able to be present with them during a major life event, encouraging them to speak up for themselves and take control of their birth experience, was both empowering and humbling for me.
Many of my friends at the JHUSON are on track to become midwives and already have a lot of experience working with mothers, infants, and birth. I don’t know if I’ll go down that route or not—my plan is to go into the MSN/MPH program after graduating from the BSN—but I do know that the skills and perspective that I have gained from working in the JHU Birth Companions Program will be with me throughout my nursing career.
- Here’s an NPR piece on midwives in Afghanistan
- Here’s a video, “Health Care in its Social Context,” on the Family Health and Birth Center in Washington, DC