Harsh Realities of Being a Midwife | Tampa Bay Home Birth Midwife

This short rant was posted to Facebook many years ago by a midwife by the name of Louisa Wales LM, CPM in Poulsbo Washington- you can find her at Salmonberry Birth Center. It struck a deep cord within me and sang the words I have heard pass through so many sister midwives lips. It is beautiful and real- a raw glimpse into how beautiful and challenging midwifery can be. 

"Tonight I'm exceptionally proud to be a midwife. Like a few of my beloved colleagues this week, I've had a busy and very intense few days that took every last bit of my clinical skill, knowledge and training, energy and nerve. But here I sit on the other side.

Let me begin by saying that midwifery is, I think, one of the most challenging, exhausting and incredibly satisfying careers one could imagine. It's also *brutally* hard emotionally and physically. I don't know ONE midwife who's back doesn't hurt, who's health doesn't suffer from the rigors of the business. 20 hour days are routine, 24/7 call for women and babies not just during labors but prenatally and postpartum, tying oneself in knots around birth tubs for hours and suturing in ridiculously cramped spaces will all punish a tired body. I have midwife colleagues who's bodies struggle with infertility, and who's families (occasionally my own) who go without "their" midwife mama or partner on important days, like birthdays and holidays, but also the ordinary ones, the school parties, and field trips and weekends... Midwifery is decidedly NOT family friendly for the midwife's family.

As a profession we suffer the unkindness and unfair and undeserved reputation of being untrained, ignorant and dangerous. We are good at getting on with it and brushing off the sheer mean-ness of that, but I'm ok telling you that it really hurts when receiving staff ignore or are overtly, or more subtly hostile in their interactions with us as transferring providers. We absorb this hostility to protect our clients from it. We suffer it, so they don't have to. The ignorance in these interactions does not belong with the midwives. We understand this, but it still hurts. The job can be hard enough, this stuff compounds it. Little cuts. With every transfer. All the time knowing there will be hundreds in a career...

If you didn't know this already let me say it here: Midwives are really fucking brave. Maybe a little crazy, yes. But really, really brave.

They carefully shepherd a pregnancy, nurturing a deeply personal relationship with their clients and their babies while they do so. And then, when the time comes, they walk into that woman's birth space and they sit with the woman and her family, and her baby in her most extraordinary day. She brings with her all the skill and intuition and experience of countless hours spent doing this at labor after labor for years. Midwives know, *really know* that on the other side of birth, is death. They walk right into this intensity always with the possibility of catastrophe and stand there calmly. Trusting the wisdom of a process which has brought an entire species forth, but being ready with modern and ancient tools to intervene and fight like hell to find order if and when it's needed.

I truly believe that midwives are the penultimate multi-taskers. Midwives are asked to, and can, and DO terrifying things. All at once sometimes. Manage a torrential hemorrhage, resuscitate a baby, free a stuck shoulder, get a woman to higher level care when its needed FAST. By themselves, or with the help of only one or two others. Usually this occurs without fuss, quietly and efficiently at home or at the birth center and no transport is ever needed. Often the families don't even know that anything dramatically out of the ordinary unfolded. It *is* monumental though, the responsibility the midwives hold. I often wonder what the mean staff would say if they saw my extraordinary colleagues do what they are so good at, all the while holding the experience of the mother and her baby as the central piece in all the chaos to be respected and preserved, a unit which should only ever be separated in the most significant circumstances. Would they be kinder and gentler, or more respectful and encouraging to midwives if they saw the amazing care they can accomplish without the support of a wall of support staff, or many friendly colleagues, or whole teams to swoop in to manage "pieces" of the events? I continue to think that they would. If they could see what we do...

I'm busily manifesting a day when we midwives and our clients are accepted and encouraged and welcomed more thoroughly into the bigger system, where we don't have to put on armor before walking into hospitals, where my friends in GA don't have to fear prosecution for providing the same care I get paid by WA medicaid to provide.

Today I reminded a colleague of this enormity, because in the depth of the awful hardness of this work, even the midwives forget sometimes. You are brave, and you are fierce and you do extraordinary, terribly important things. We get to hold the slippery, hot, wet, pure future. We stand there and we meet it (and whatever crazy comes with it). Because being born is important, and giving birth is important and the women and the babies and families are important.

Tonight, I want to acknowledge my midwives. All of you out there. Those of you who trained me: Peggy, Darlene, Kathy, Carol and Beth. My beloved sister-midwives who learned with me Tina, Nicole. My midwife friends Elias, Melanie, Christine, and Tracy and all the other remarkable midwives who practice around me and work tirelessly not only in their own practices but in the community of midwives in this state and nationally who's names pepper my feed too many to name.

All of you are so unbelievably inspiring. It's a privilege to serve beside you."

-Midwife Louisa Wales LM, CPM

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