Hello hello! We’re continuing the State of the Midwifery series today and although this is a long, inspirational post, it’s definitely worth the time to read and share.
As we chatted last week, it’s important to know statistics about the midwifery force and the barriers ahead for the profession (see the first post on the State of Midwifery from last week).
But, what about the midwives on the front line every day? Or, the midwife student that wants more than anything to be a midwife, but is at a standstill in training because of a global pandemic?
To each midwife and student midwife, this post is for you.
It was a hell of a year.
In a time where division and differences are at the forefront of everyone’s mind, we must come together.
More than ever, we must stand together.
This year, I looked at the ways that we each could lift up each other and midwifery from exactly where we are.
You could be a midwife on maternity leave trying to navigate the new lessons of parenting. You could be a midwifery student waiting to start midwifery school. You could be retired, but recently started to look at ways you could support the profession with your wisdom and experience.
Wherever you are, you can help bolster the midwifery force by:
- Lifting up your fellow midwives – locally and nationwide.
- Lifting up midwife students by frequent mentoring.
- Looking for inspiration.
- Preventing burnout while building resiliency.
- Thinking sustainability.
- Getting back to the basics.
Let’s dive in!
Lift up your fellow midwives – locally and nationwide.
At the end of the hardest day and the hardest roads, we have each other. Choose to be each other’s biggest cheerleaders. Choose to pump your fists in the air when your midwives in another state break through practice barriers. Choose positivity and encouragement at every turn. Choose to recommend platforms, insta accounts, courses and resources that bolster midwives and the midwifery profession. Choose to lift up your fellow midwives.
Let’s start with some midwives that are doing some amazing things. Take a moment to honor what they are doing. Support these midwives in their endeavors, recommend their platforms, and follow their steps towards bright futures!
- Amber Wilson, CNM – creator of a Journey to Midwifery podcast. Amber interviews midwives from around the world about their journey to midwifery, their passion projects and their tips for aspiring midwives.
- Email: firstname.lastname@example.org
- Instagram: @journeytomidwiferypodcast
- Aubre Tompkins, CNM – author of Midwifery for Expectant Parents: A Modern Guide to Choosing the Birth That’s Right for You. Aubre was recently elected president of the AABC as well!
- Augustine Colebrook, CPM – creator of Midwifery Wisdom Collective, a site full of resources for midwives and an option for legal advice as well!
- Website: Midwifery Wisdom Collective
- Ginger Breedlove, PhD, CNM – creator of the site Grow Midwives! The site offers a variety of resources and consultation services – I particularly like their videos and a recent presentation they shared on RVUs!
- Leslie Cornwell, CNM – creator of Midwifery Business Consultation and mentor to midwives desiring to start their own practice, Leslie offers a host of resources and services!
- YouTube Channel: Midwifery Business Consultation
- Madeline Murray, CNM – founder of Believe in Midwifery and author of the two courses:
- Guide to Sustainable Practice: “This course was designed with you in mind to help you not only create a long-lasting and fulfilling midwifery career but also to regain a happy and healthy personal life.”
- Sustainable Midwifery – The Why, the What and The How: “This course is designed to help midwives develop the skills to create long-lasting, enjoyable practices that can continue for many years all while not sacrificing their personal lives.”
- Instagram: @believeinmidwifery
- Website: Believe in Midwifery
- Takia King, CNM – now a retired CNM, Takia offers a robust series of mentorship options for individuals interested in midwifery and nursing.
- Instagram: @sakina_health
- Website: Sakina Health
And across the nation, there are some states doing some amazing things.
Shoot them a “keep it up!” message or email. Follow their initiatives, websites, facebook, twitter or instagram accounts. Use other states as mentors and seek advice about starting initiatives in your own state. Send emails or letters to your state representatives and their state representatives about midwives and midwifery initiatives.
Even if you aren’t an ACNM/MANA member, or you are a student, it’s important to keep up with midwifery issues in you state! (Also, if you have an instagram/facebook account or a website for a state that isn’t listed, please email me and I’ll happily add it to the list: email@example.com).
- Facebook: @acnmalabama, @alabamabirthcoalition
- Website: Alabama ACNM Affiliate
- Website: Alabama Birth Coalition
- Website: Alabama Midwives Alliance
- Website: Alabama State Board of Midwifery
- Website: Alaska ACNM Website
- Website: Midwives Association of Alaska
- Website: The Alaska Birth Collective, instagram @alaskabirthcollective
- Facebook: AZACNM
- Website: Arizona Association of Midwives
- Website: Arizona Midwives
- Website: Arizona Nurse-Midwives
- A group of CNMs (without a lobbyist) got a bill all the way to Governor Asa Hutchinson! AMAZING! Show this group your support and send the Governor a message of support for full practice authority for CNMs – HB 1215!
- Facebook: @arkansasbirthmatters
- This video to promote the benefits of midwifery!
- Website: California Families for Access to Midwives, instagram @cafamiliesformidwives
- Website: California Midwives (CALM)
- Website: California Nurse-Midwives Association
- I hung out with this affiliate back in 2012-2014 and they were doing some great things! Jessica Anderson even taught a lecture on water birth in my midwifery program.
- Instagram: @colorado.acnm.affiliate
- Website: Colorado ACNM Affiliate
- Website: Colorado Midwives Association
- Website: Delaware ACNM Affiliate
DISTRICT OF COLUMBIA
- Website: Florida ACNM Affiliate
- Facebook: @Georgia Friends of Midwives, @GAACNM
- Instagram: @ga.acnm.midwives
- Website: Georgia ACNM Affiliate (they have a beautiful website!)
- Website: Georgia Midwifery Association
- Facebook: @Normal Birth Hawaii, @midwiveshawaii
- Website: Hawaii ACNM Affiliate
- Website: Midwives Alliance of Hawaii
- Facebook: @Friends of Indiana Midwives
- Website: Indiana ACNM Affiliate
- Website: Indiana Midwives Association
INDIAN HEALTH SERVICE
- No website/social media found.
- Website: Kentucky Association of Nurse Practitioners & Nurse-Midwives
- Website: Kentucky Birth Coalition
- Website: Midwives of Kentucky
- Website: Maine ACNM Affiliate
- Website: Maine Association of Certified Professional Midwives
- Website: Midwives of Maine
- Website: Association of Independent Midwives of Maryland
- Website: Maryland ACNM Affiliate
- Website: Maryland Families for Safe Birth
- Instagram: @mnmidwives
- Website: Minnesota ACNM Affiliate
- Website: The Minnesota Council of Certified Professional Midwives
- Website: Mississippi ACNM Affiliate
- Website: Friends of Missouri Midwives
- Website: Missouri ACNM Affiliate
- Website: Missouri Midwives Association
- Website: Montana Midwifery Association
- Facebook: @NVACNM
- Instagram: @nvfriendsofmidwives
- Twitter: Nevada ACNM midwives
- Website: Nevada Friends of Midwives
- Website: Nevada Midwives Association
- Website: New Hampshire Midwives Association
- Facebook: @acnmnj
- Instagram: @njacnm
- Website: New Jersey ACNM Affiliate
- Website: New Jersey Homebirth Midwives
- Currently there is a bill in the state’s legislature to support midwifery birth centers!
- See the letter of support here!
- Send a letter of support to your respective Congress member today!
- Instagram: @nysalm
- Website: Birth Net
- Website: NY Homebirth
- Website: NYC Midwives
- Website: New York State Association of Licensed Midwives
- No website/social media found.
- *Oklahoma became the 35th state to pass legislation that regulates CPMs in 2020!*
- Facebook: @ACNMOklahoma
- Website: Oklahoma ACNM Affiliate
- Website: Oklahoma Midwives Alliance
- Facebook: PA Affiliate of ACNM
- Instagram: @pamidwives
- Website: Midwives Alliance of Pennsylvania
- Website: Pennsylvania ACNM Affiliate
- No website/social media found.
- No website/social media found.
- Website: South Dakota Birth Matters
- Facebook: Tennessee ACNM Affiliate
- No website found.
- Facebook: @Texas Certified Nurse Midwives – CTCNM, @texasmidwives, @northtexasmidwives
- Instagram: @texansformidwifery, @texasmidwives
- Website: Association of Texas Midwives
- Website: Greater Houston Midwives’ Alliance
- Website: San Antonio Area Midwives Association
- Website: Texans for Midwifery
- Website: The Consortium of Texas Certified Nurse-Midwives
- No website/social media found.
U.S. VIRGIN ISLANDS
- No website/social media found.
- Instagram: @virginiaacnm, @postpartumsupportva
- Website: Virginia ACNM Affiliate
- *The Virginia affiliate wrote, advocated and pushed a bill for autonomous CNM practice all the way to the Governor’s desk in spring 2021! It was nothing short of amazing policy work. The affiliate was led by Katie Page (President) and Nicole Wardlaw (legislative representative).
- Website: Virginia Midwives Alliance
- Website: VA Postpartum Support
- This initiative aimed at helping women with postpartum perinatal mood disorders is knocking it out of the park. I’ve talked about them before but they deserve an honorable mention (again). Also check out this interview with Mara Watts M.A., M. Ed. – the Director of Outreach and Education Postpartum Support Virginia!
- The midwives in this state did some amazing work last year when the pandemic hit. They shared some really nice transfer checklists and transfer guidelines with the midwife and obstetric community last March and April. Check out their resources here! Bonus: The ACNM affiliate offers 6 scholarships to midwifery students – deadline is March 16, 2021 if you want to apply!
- Website: Midwives’ Association of Washington State
- Website: Washington ACNM Affiliate
- Facebook: @West Virginia Midwives
- Website: History of Midwifery in West Virginia
- Website: West Virginia ACNM Affiliate
- No website/social media found.
Lift up midwife students and mentor frequently.
Oh midwifery students! Give them coffee. Give the feedback! Give them a clinical site. Be their preceptor. Inspire them. Put your hands on their hands and teach them the art of midwifery. Teach them to be gentle and to be strong. Teach them to be courageous and to be humble. Teach them the hallmarks of midwifery. Talk to them about the type of midwife they want to be. What are their goals? How can you help them reach their goals? You might be teaching them the art of midwifery, but they will quickly be the soldier next to you on the front lines. Build them up to be the midwife you would want to practice with. Make it a priority to mentor someone this year on your path – student, fellow midwife, future midwife!
Sakina Health, produced by Takiya Sakina Ballard, also offers a series of mentorship services for aspiring midwives, student midwives and practicing midwives. Check her out here!
If you still can’t find a mentor, email me and I’ll happily offer mentorship to anyone on a midwifery journey however I can (firstname.lastname@example.org)!
You can also learn from an amazing group of midwives that have interviewed on the podcast Journey to Midwifery. Each has shared their own story, journey and lessons learned.
Look for inspiration.
The pandemic put stressors on every point of our lives. I want to take a moment to recognize the inspiration that glowed from within many individuals during the pandemic.
- If you were a midwife student, and your clinicals were put on hold, halted without any sign of when they would restart, moved to another site or another state, or your site simply stopped letting students come to practice, and you KEPT GOING, you are amazing.
- If you were pregnant or had a baby during the pandemic, you are amazing.
- If you lost a baby during the pandemic and went right back into life’s craziness while still grieving your loss, you are amazing.
- If you had small children during the pandemic and you had to teach (or convince) them how to put on a mask (and keep it on), you are amazing.
- If you had to learn how to home school children and work with your spouse to balance schooling and work demands, you are amazing.
- If you had to work extra shifts and extra nights and extra clinic via telehealth and your computer shut down unexpectedly while your patient’s phone dropped the call for the third time in a row – but you still gave exceptional care, you are amazing.
- If you read every email about every practice change, personal protective equipment change, protocol change, COVID testing recommendations, etc…you are amazing.
- If you answered the extra thousands of questions that patients, mamas, husbands, partners, children, families and friends of friends all had because you were the only healthcare worker someone knew…you are amazing.
There is inspiration everywhere you look. In the midst of the chaos, you just have to stop and look.
Prevent burnout and build resiliency.
I talked a lot about burnout this post! Look to achieve some of these in 2021…
- Build burnout prevention into your practice and your life. Where can you put boundaries and safety nets?
- Monitor yourself for signs of being overworked.
- Don’t underestimate how powerful routine and habits can be.
- Don’t hesitate to tell a fellow midwife they are burned out and need to take some time off.
- Don’t be afraid to say that you are burned out.
- One of the best analogies I have come across about resiliency is this:
- The Institute for Healthcare Improvement’s Carol Haraden, PhD, says there is a difference between using data for measurement and for monitoring. A helpful analogy is to think about a frozen pond. A reactive approach to safety would be to count the number of times people who try to walk across the water fall in. A proactive approach would be to monitor the thickness of the ice. My question to you is this: What can you do to increase the thickness of your ice so you don’t worry about falling through?
- And my favorite…ask yourself:
- What went well last year and what didn’t?
- Then take time to reflect on your answers and decide what you want to be different about this year.
This goal comes from my wise friend Sam! To me, midwifery sustainability comes in 100 different slices. I like to think about sustainability as carrying a large flag that says “support midwifery” with you everywhere you go and waving it for all to see at every opportunity.
These are examples of waving your midwifery flag:
- You decide to follow all the midwife groups on instagram (see above!). Cheer them on when they achieve great things. Send letters of support when they need them. Don’t let state lines hold the profession back.
- You join a new practice and work with a physician that has never worked with midwives. You take 10 minutes to share what a midwife is, the types of midwives there are, and how midwifery can benefit women with the physician. You emphasis that midwives are experts at normal birth and encourage the physician to ask any questions he/she may have about midwifery at any time.
- You put a bumper sticker about midwifery on your car. My favorite is the common “midwives do birth in any position.” (YES WE DO!).
- You do a journal club about midwifery care compared to OB/GYN care for your provider team. Or home birth?! Or water birth?!
- You do an inservice about ways to support physiologic birth on your unit. Bring coffee, fruit and muffins – they’ll be thankful for the snack, hot drink and your tips. Tie the inservice up with the hallmarks of midwifery care.
- You decide to attend a Midwifery Works conference.
- You take a friend out for breakfast that wants to be a midwife and tell her all about it. Let he/she ask you about anything and everything.
- You give your fellow midwife that had a terrible shoulder dystocia on the last shift a big hug. Emergencies wear us down, take every opportunity to build each other up.
- You choose to precept an additional student this year.
- You choose to precept your first student this year!
- You teach an OB/GYN resident about physiologic birth and coach them through a “hands off” birth or an out of bed birth (I love me some standing or toilet birth!).
- You choose to present at a local conference in your community.
- You choose to attend (and present!) at a national conference (Postpartum Support International; ACNM; AWHONN; MANA).
- You attend a conference to enhance your skills! I was signed up for a vaginal breech conference this past fall in Alaska that was cancelled and I was seriously bummed!
- You decide to open a birth center.
- You decide to open a home birth practice.
- You start a blog or podcast or website aimed at midwifery!
- You read three books on midwifery (fiction or nonfiction) – and recommend one of them to a fellow midwife or friend. Check out book recommendations here!
- You reach out to a fellow community service (doula, chiropractor, acupuncture, massage, physical therapist) and see what benefits they can offer your patient population.
- You write a letter to your local Congress member to advocate for autonomous APRN practice. (If your state already has autonomous practice, consider writing to a state that doesn’t.)
- You join a local midwifery group (or start a local meetup!) . Ask your local midwives about what your state needs to improve? Help each other make small goals and big goals to help women in your state. Look to other states if you need ideas (see their websites and social media accounts for ideas!). Consider a simultaneous freezer meal club too – midwifery love and meals…sign me up! I’ll bring the wine.
- You start an instagram account for your state affiliate!
- You help update or start a website for midwifery in your state (Georgia, Maine (CPM), Minnesota, New Hampshire, New Jersey and Ohio have beautiful examples of sites).
- You update your resume to reflect all of your credentials and experiences. You never know when someone is going to ask for it! This site by Ken Coleman is chock full of great resources for career building or career assessment.
- You take a vacation and turn off your phone for an entire day. Truly disconnect and recharge!
- You decide to go back to school for an advanced degree! MPH? DNP? PhD? You can do it!
Remember – what is obvious to you may not be obvious to someone else. Look for opportunities to put the midwife in the model!
Get back to the basics.
Midwifery care is safe, beneficial and should be available to every woman – there’s more evidence to support that fact than ever before. But in the midst of all the barriers and opposition, we must continue to point to the facts and fight the fight to give women more access to midwifery care.
To help you with your fight, to renew your spirit and to refresh your knowledge of the facts from the national midwifery organizations, I encourage you to review these documents:
- Hallmark midwifery documents
- Core Competencies for Basic Midwifery Practice (ACNM)
- Standards for the Practice of Midwifery (ACNM)
- Standards and Qualifications for the Art and Practice of Midwifery (MANA)
- Statement of Values and Ethics (MANA)
- Position papers
A few final thoughts about how to bolster the midwifery force…
Take a moment to remember why you became a midwife. Then find your light saber and holster it for the road ahead. We’re going to need it. Then choose something from this post to strengthen your practice as a midwife and the midwifery profession. I think the pandemic spotlighted midwifery in ways no one could have predicted – and prenatal care may be changed forever. But I also think midwifery is stronger from the pandemic – and the momentum for the profession is just getting started.
Hugs and light sabers,