From Undocumented to Nurse Midwife: Angela

Angela came to the United States from Venezuela as an undocumented teenager, speaking just enough English to interpret for her grandmother in an ER — and somehow found herself captivated by the people rushing around in scrubs. It took a perceptive teacher, a husband who said, "we'll make it work," and one pivotal moment at a midwifery orientation to unlock a calling she didn't know she had.

In this episode, Katie sits down with Angela — one of the few practicing Latina midwives in Delaware — to talk about what it means to show up for patients in two languages, two worlds, and with lived knowledge no classroom can teach. They cover the staggering gap between the 25% of U.S. births to Hispanic women and the 5-6% of midwives who are Hispanic, the quiet weight of censoring yourself in a political climate that feels hostile, and why giving a Spanish-speaking patient your cell phone number is less a boundary issue and more an act of radical trust.

They also get into the unglamourous but essential stuff: how Angela funded her entire nursing and midwifery education with almost no debt (yes, really), the loan repayment programs hiding in plain sight, and why the system that needs bilingual, bicultural providers the most is often the least equipped to support them.

This episode is best paired with a Venezuelan favorite:  papelón con limón 

Transcript

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Katie 0:00

Welcome back to another episode of my podcast, mindful Midwifery Presents, the Labor Behind Labor. My name is Katie O'Brien, and I've been a nurse midwife since 2007. Midwives have tremendous pressure to show up to their workday every day as their best selves. We must show up despite bad weather, bad days, or bad situations. Additionally, being a midwife often isn't a role that you have just at work. Midwives are regularly tasked with showing up for their communities and in their personal lives, day in and day out as well. The goal of my podcast is to highlight this challenging world and give listeners an insider's view on what it feels like to be a midwife tasked with being your best self, both personally and professionally. My guest for this episode is Angela. It was really important to me to share her episode with you before we close out. The first season, Angela came to my house to tell her story of arriving in the US as an undocumented immigrant to gaining legal status and ultimately becoming a nurse midwife. Her story is about showing up in two languages in two worlds for patients who don't always get to see themselves reflected in their care. This is a conversation I've been waiting to have all season. Let's get started. I'm really excited to have you here. It was really important to me that I have a Latina voice on my podcast before I end the first season. I was just looking this up because I feel like this, I, I felt like this was true, and then I actually saw the statistics to say that it's true. So approximately. 24 to 25% of all live birth in the United States are to women who identify as Hispanic, but only five to 6% of our midwives are Hispanic. It's the biggest racial discordance we have. So that's very impactful to me because we don't have enough Hispanic midwives, like period. And so I wanna spend this episode talking about that and talking about your experience. And, I don't wanna tokenize anything. Obviously you can't represent the entire community, but you certainly can give your voice on your experience and, how it's gone for you. Things that have been good, things that, or have not been good. And also how we can work on hoping or how we can work on having more midwives that enter the field. So. I think a good starting place would be to talk about how you ended up being a midwife in the first place.

Angela 2:22

So thank you for having

Katie 2:24

me.

Angela 2:24

first of all, I didn't know that I was gonna become a midwife, and my knowledge of midwifery itself was basically what my mom thought when I told her that I was gonna be a midwife. I didn't know that midwives existed in hospitals. Like I had the, you know, the thought that it was midwives in the birth center and out in the community, and that was it. And it wasn't something that I was like super attracted to, but I was always attracted in, women's health, ob, GYN, like obstetrics. You know, taking care of women, I was always attracted to that. So, where I was working at the time where I was a prenatal nurse, two of my coworkers went back to school. I saw them do it. They became women's health nurse practitioners. And, they inspired me to continue my education, to go back to school, get a master's, start taking care of patients in another way. And I did that. So I started looking at, obviously places around my area, so Philadelphia, mainly. And then it was too expensive, for me at that time. And then I asked, my friends, I'm like, Hey, what school, that you guys went to get your master's? And then one of my friends mentioned that she went to Frontier. So then I was like, oh, let me find out a little more about it. Find out, submitted my registration.

Katie 3:41

I, I'm submitted

Angela 3:42

my registration, I changed jobs and I actually ended up working in another place where there was a, a midwife that was working there. So then

Katie 3:52

I started,

Angela 3:53

Like we started talking and I'm like, oh, so like you essentially do what a woman's health nurse practitioner does too, and then you also get to be with women

Katie 4:04

in the hospital setting. Right? 'cause that's what

Angela 4:06

was doing. And I was like, oh, that's kind of cool. I go to Bounce with Frontier. That's how they have you do it. And as we are sitting there inbound, they are, like talking to us about like midwifery because it's a very like, heavy midwifery school.

Katie 4:20

And a lot of

Angela 4:21

the information is focused on midwives, not so much on women's and nurse practitioners. And then I'm sitting there like, what if. I actually become a midwife. And then, you know, like I'm just sitting there, I'm like, no, I can't do that. I'm like, my husband is a police officer. Like our schedules are gonna be crazy. I can't do this.

Katie 4:39

At that time, I already had

Angela 4:40

my son was I think two years old and I was like, no, the schedule is gonna be crazy. How am I gonna work nights? Like, absolutely not. Like I can't do this. And just a lot of self doubt. And I'm like, no, I'm just gonna, stay. And then just talking to other people, like other students, in the program, everybody just kept saying you should do it. Just do it. So then I talked to my husband and I'm like, what do you think about this? And he was like, yeah. We'll make it work. We'll make it work somehow. to my support system, my sisters, my mom. Everybody's like, yeah, do it. Like, that's cool. So I'm like, okay. And then the way that I saw it too was I always wanted to work in the

Katie 5:15

hospital,

Angela 5:16

but I never did when I graduated from nursing school. Because my husband is a police officer and I was like, our schedules are crazy. I know we're gonna have a family. How am I gonna fit this into my lifestyle? But I always had that, I didn't get to do it. I didn't get to work bedside. And it's something that when we are in nursing school, that's where your clinicals are. That's where, the focus is. So then I, I said, yeah, I, I think I'm gonna do this. And then I think what really signed it off for me basically was

Katie 5:45

that I started

Angela 5:47

to myself, not only do I get to speak Spanish to my patients in their office, but I get to speak Spanish to them in the hospital setting or

Katie 5:56

like

Angela 5:57

I'm gonna be taking care of them. So it's

Katie 5:59

like

Angela 5:59

intimate and how beautiful is that, that now you get somebody that you know, knows your culture, knows some of your culture, speaks your language while you're bringing your child to the world. So

Katie 6:11

then that's when I was

Angela 6:12

oh, I have to do this. This is it. Yeah,

Katie 6:14

Yeah, that makes sense. Tell me were you born in the United States, so your mother, what was her experience with birth like and how did that differ from maybe culturally what you would have experienced if you were in Venezuela? So I was born

Angela 6:32

So, um, I was born in Venezuela. We came to United States when I was pretty young,

Katie 6:38

joining ninth grade.

Angela 6:39

And if anybody from Delaware is hearing this, William

Katie 6:42

Penn High School.

Angela 6:44

Biggest cultural

Katie 6:44

shock of my life.

Angela 6:46

as

Katie 6:46

It's very big. It's a very big school.

Angela 6:48

very, very,

Katie 6:49

like I came,

Angela 6:50

June 1st, we started school that August biggest cultural shock of my life. So, did all of my high school here. And

Katie 6:59

after

Angela 7:00

graduating high school,

Katie 7:01

I didn't

Angela 7:02

what I wanted to do. My grandmother fell. And because I was the one that that spoke the most English, I went into the ambulance with her, went into the hospital with her. And I remember in the midst of being scared for my grandmother, I was always like, this is so cool. Just like seeing people working in the hospital and like the si, like all of that. Like, it was just very intriguing to me. And that sparked something to me that said I wanna work. Like I see myself working in something healthcare related. Right? Forward graduate from high school. At that time we were undocumented. So when I go, to submit my applications for college, everybody is saying yes, you can start taking like your prerequisites, like your English, your math, like those classes, but you cannot get into nursing school until you're documented, until you have a social security. So that was really sad too because it was like almost like I was in school, but.

Katie 7:59

not,

Angela 8:00

Not really going to school. I was just like doing it to get like whatever degree I could get my hands on, but not because of something I wanted to do. I, had a wonderful teacher that noticed my shift in my academics and she talked to me.

Katie 8:16

me.

Angela 8:17

She, Helped me get through a pathway to become documented. She connected me with some, with some lawyer, some people that she knew. And then we were able to find a pathway for me to be undocumented. And as soon as I got my social security, I went and applied for nursing school immediately.

Katie 8:36

Was that something that your family was open with or did the teacher have to kind of figure that out on her own?

Angela 8:43

She had to figure it out. She had to figure it out. It was more so her and I working together, like, how can we do this? But obviously, like after I found a pathway to become documented, everybody was happy because

Katie 8:59

it, that, hard

Angela 9:00

explain it. And I think the people that have gone through it are the people that are going to understand how much your whole life and being opens when you have a social security number in your hand, it's like, it's almost like you get freedom. It's, it, it's, it holds such an important value to have that little blue car in your head. And it was almost like, I was like, finally I get to be somebody. I get to do something, I get to do what my mom brought me to United States to do. Basically.

Katie 9:37

So if this teacher hadn't intervened, what do you think would've happened? Was your family intimidated by the process? What was the story there?

Angela 9:47

Yeah. We were intimidated by the process. We didn't know how to do it. We were scared, because when you go, when you immigrate to another country and you know that you're there undocumented, it's scary because you always are living with the fear that you're gonna be sent back to the country that you don't want to be at. Right. If she hadn't helped me, I honestly think that I would be working like in

Katie 10:18

res at a restaurant. That's

Angela 10:19

what I was doing. Then I think I would probably still be working like as a server or a bartender or in that type of industry. That's what I was doing then and, and I liked it and I was making good money. And my mom, when she was in Venezuela, she works, in like finances in the university of the city that we're from. So we have always been really heavy on like finances and how to manage your money and how to do things like in the smart way, financially. So I feel like if I didn't get my hands on that social security card, I probably would've done another job that I knew was going to give me money, that I was going to help me afford my life, basically. Yeah.

Katie 10:59

That's fascinating actually. Yeah. There's just so much right now in the world that is upsetting and is lacking empathy, and I think you just described some of that because it's easy for people to be like, oh, I don't understand why. Why aren't these people just getting documented or these horrible stereotypes that maybe these people are not smart enough and it's not true. I mean, you're a midwife now. Like how amazing for that teacher to have changed your life so hugely. I just love that she,

Angela 11:29

so I saw her I think last December and

Katie 11:35

I was getting my nails done

Angela 11:36

and

Katie 11:36

then.

Angela 11:38

I look like

Katie 11:39

I'm talking,

Angela 11:39

obviously

Katie 11:40

I have a very heavy accent. So she turns and she's like, Angela,

Angela 11:44

and I looked at her, I'm like, miss Stu,

Katie 11:46

And I just like hugged her when I

Angela 11:49

nursing school,

Katie 11:49

I invited her. My mom

Angela 11:52

loves her.

Katie 11:53

I

Angela 11:54

for a couple years after,

Katie 11:56

I graduated,

Angela 11:57

I will send her emails, like little updates,

Katie 11:59

for a, like mm-hmm. A couple times a year

Angela 12:02

I will send her emails like, miss Stu, I'm getting married. Or, miss Stu, I'm ha I'm having a baby. Or I just finished, like this and like I'm working here. Like it, she, she was an angel on my path. Absolutely. She was the first step into

Katie 12:18

opening

Angela 12:18

the door for me to become who I am. A hundred percent. I believe that. Like I owe her everything. And you know what you said too, I feel like it's so important to let people know that is the stereotype that, they think of immigrants and everybody, it's like a criminal and we're not, providing anything to society and we're just like

Katie 12:41

working in the

Angela 12:41

fields. And I'm like, no,

Katie 12:44

I

Angela 12:44

am an immigrant. And I was undocumented

Katie 12:48

and.

Angela 12:49

Whenever conversations around immigration, pop, pop, where I start feeling, sensing some type of negativity,

Katie 12:56

I always

Angela 12:57

my face because now I have a United States

Katie 12:59

passport. So I don't care. Now I'm safe, but I

Angela 13:03

and I say, I wasn't documented. I wasn't illegal alien,

Katie 13:07

How you like to call us?

Angela 13:08

I'm a face of

Katie 13:09

that. And now look where

Angela 13:12

I am. So trust me when I say this, a lot of us want to come to United States to be members

Katie 13:21

of

Angela 13:21

country, not to just

Katie 13:23

like

Angela 13:24

come and do criminal stuff. Like we actually, we wanna do the things that we cannot do in our country. And, talking a little bit more about the, Venezuelan immigration that has been so big in the, last few years because of everything going on in our country. If you ask Venezuelan immigrants, oh, what were you doing? When you were in Venezuela, they're gonna tell you that they were doctors, that they were teachers, that they were lawyers, that they were engineers. And now they're here working in things like Amazon warehouses, like Uber, like restaurant industries. Which I'm not saying that to diminish, like the, the work that they're doing, but trust me when I say that, if they had a pathway to not do that and to do what they were doing in their country, like in our country, they will do that. They wanna be lawyers here too. And what are they going to do? The same thing that I did. They're gonna try to find a pathway to, become a citizen or to become documented. They're gonna try to learn the English, they're gonna try to go to school, and if they're unable to do that, they're gonna make sure that their kids do. That their kids are going to school, are getting good grades, that their kids are going to college and becoming good members of society. Like that was my mom's wish. All graduations that I always been, I always look at my mom and

Katie 14:39

I'm always like.

Angela 14:40

look, mom, this is you, miss Judy did it, but look mom, like you did this for us and it wasn't easy to bring all five of us. So look, this is for you. Right. And it's something that makes, I know, makes my mom really proud and my younger sister is a teacher and all of our graduations, like same thing. Like we, we do this for her. Like this is her hard work. Yeah.

Katie 15:07

And then now two of you are in very care providing industries. Yeah. You're a midwife, your sister's a teacher. That, that's pretty powerful stuff. So you probably run across a lot of patients then that you can relate to on a deep level. And how, how do you address that? I imagine that's very hard to run into them in the office setting. Feel like you have 15 minutes and you just wanna give them three hours. I am

Angela 15:35

no, to give my cell phone to my Spanish speaking patients.

Katie 15:39

And I feel like the

Angela 15:40

biggest reason that I, the biggest reason that I do it, it's because

Katie 15:48

I

Angela 15:48

them to feel safe. And because they, they are obviously seeing me in a position of power because I am the provider

Katie 15:59

and I,

Angela 16:00

I almost do it as a. You are safe with me. So this is another like, kind of like example of how you're safe with me. Like I'm giving you my cell phone, reach me if you need me, for them to feel completely safe. Oh, she's giving me her, her phone. Like she, she's a safe person to talk to and

Katie 16:17

It happened.

Angela 16:17

think my favorite thing is when I walk into a room and they don't know that I speak Spanish, and I just going

Katie 16:23

Ola,

Angela 16:24

and they're like,

Katie 16:25

oh.

Angela 16:25

And I'm like,

Katie 16:26

SI.

Angela 16:27

and they're like, oh my God.

Katie 16:28

That is

Angela 16:29

favorite thing to do every time that I walk into a patient's, in a patient's room, or it happens so many times. I don't go in and say immediately that I'm from Venezuela,

Katie 16:38

but we have very,

Angela 16:39

distinct accents.

Katie 16:41

And when I, I start catching like the

Angela 16:43

accent, especially in the hospital,

Katie 16:45

it's funny because we start

Angela 16:46

at each other like, do you are, are you, are we from the same country?

Katie 16:50

And then at the end of the conversation, there has been a

Angela 16:53

times where I say, you know, in Spanish. So do you have any other questions before I step out? Can I help you with anything else? And they go, so where are you from? And I'm

Katie 17:01

like, Issa.

Angela 17:02

they're like, oh my God, me too. And then

Katie 17:03

that conversation where I was just discharging you turns

Angela 17:07

another 20, 30 minute conversation of us.

Katie 17:09

Talking about like

Angela 17:10

immigration, always, always

Katie 17:13

about that topic.

Angela 17:13

Always about the topic of like, I've been living here for so many years and this and that, and like now I'm doing this, but in Venezuela I was doing that and it's so hard. Or like, I used to live in Chile and now I move to United States. It's always around those conversations and it makes me feel good when they also see an example of look, she's Venezuelan and she's an immigrant and she did it. So I also do it as a, you can do it like, go back to school. to kind of empower them or like them the example that they too can do it. It's a really nice feeling to, to represent Venezuelans, especially like part of the Latino culture. But when I step into those rooms where the patients are Venezuelan, it makes me feel like extra, what's the word that I'm looking extra seen? Extra like connected? Connected, yeah. Extra connected to them.

Katie 18:03

Do you feel that there's appreciation, understanding, support for the fact that you're representing such a large community, from the hospital? Because these visits do take so much longer, and I have an example of, a Latina provider we had at the office with us and she was the only one. Our office was very large and they really didn't have any accommodations or support of the fact that she inherently is gonna have longer visits. That she's representing and that it's a burden, actually, like it is. It's wonderful. And fulfilling in all the things I'm sure. But it also, you're, you are single-handedly doing that. You're, you're holding that support structure. So do you feel that your current workplace is aware of that and understanding and supportive?

Angela 18:57

So yes and no. I feel like where I work, yes. But I have the perfect example of when I was doing my clinicals here in Dover. I remember going into patient's rooms in the hospital, and I'm very white, right? And I look very American. But as soon as I say, hi, my name is Angela,

Katie 19:20

A word,

Angela 19:20

like a word, a word,

Katie 19:22

I say hi. And then like, I feel like everybody immediately looks at me like, oh. So I could

Angela 19:29

feel that shift in the environment.

Katie 19:32

I could

Angela 19:33

the, what did you say? Like for me to have to repeat myself and, and this is with English speaking patients, and I felt myself having to talk slower, talk more clear so that patients could understand me. Right. I do feel like where I work at,

Katie 19:52

it's

Angela 19:53

but we don't have anything that changes like between appointment to appointment and Yes, because patients feel more seen with a pa you know, with a provider who speaks Spanish. They do tend to unload everything to you. And I'm talking about like. Questions that belong to a social worker or questions that belong to the front desk and because they're like, oh my God, you speak Spanish. It's so much easier than using a translator. They almost want to use you as a translator, and I wanna help them. So sometimes, like I'm still having a hard time telling them like, oh, let me get you like another person who can help, help you with this. Right? But

Katie 20:30

it's hard because

Angela 20:31

you wanna help them because, I

Katie 20:32

used to

Angela 20:33

for my mom for her appointments, right? So I do understand that at that moment it's almost like I'm their daughter who speaks Spanish and they wanna use me as much at as they can in that, in that time that we have together.

Katie 20:46

Well, and that's the midwifery way actually, it's what we're trained as, as midwives, is to see the whole patient. And so then when you get into this situation in the office or the hospital where you are, in fact seeing the whole patient, that midwifery part of your heart is like, oh, this is part of what I trained in. But the structure, the systemic structure, is really not supporting that. It's not really supporting that you can follow them in that way because it's wonderful. We have social workers and we have front desk, and we have MAs, and we have all these support people. But as you were just saying. If somebody's coming to you and feeling seen for the first time in all of those touch points, they're gonna try to connect them all through you. And I think that's where the system fails, is not understanding that, that happens and that it's gonna keep happening. And there's nothing you can really do about that. You almost have to support that person, I think to have the best success you have to support that person in having to take on more of that role. And I

Angela 21:51

think the reason why it's so hard for me to not support them in all the, like, in all the things that they need, it's because I also. Come from a workplace where we had a large Latino community where it was easier to bounce a patient from, department to department for them to get all their needs met. Whereas in the place that I'm on right now, it's such a large institution that is not as easy as let me get the social worker who speaks Spanish to come into the room. Right. So, and, these are the patients that need a lot of handholding and or healthcare system doesn't like handholding or I feel like our health system likes giving you a phone number to call. You call and you figure it out. Right. And again, I come from, I, maybe it's because I'm used to that. I'm used to the handholding from the place that I come from when I was a nurse there and it's literally you go with a patient to another office and you walk them there.

Katie 22:51

So you have these like lore in Delaware, we have lore and so a lot of the Hispanic pregnant women go to lore. And in a lot of ways that's a, it's almost better for them in the sense of like, you're. Saying that they're able to kind of go through that whole visit and it's already structured for that, but it is a shame that that's like the only place, there's not a lot of options. So for somebody, let's say they didn't have a great experience or just doesn't feel like they wanna be there, then where did they go? Like it, it, it becomes a one size fits all to represent a community that is not a one size, if that makes sense.

Angela 23:34

It makes total sense. And I actually see that a lot because

Katie 23:38

I have patients,

Angela 23:39

same example who don't want to go. To the place where they will have their handheld because X, Y, or Z reason, and they wanna see me because I speak Spanish. So I can give them prenatal care, GYN care, but it's harder.

Katie 23:53

Right. And then that's the thing too. Let's say they bonded with you and now it's like, this is the provider I wanna see. Then they're gonna follow you, but they're not necessarily following you to a place that has the structure for it. Which is gonna certainly pull on your midwife heart strings. yes.

Angela 24:10

Yes. It, it definitely, it does pull. But

Katie 24:12

again, I

Angela 24:13

do try

Katie 24:13

that, and that's why I give

Angela 24:14

them my phone. And that's why I give them my phone because it's easier for me to save them a little. We all use WhatsApp, like in the Hispanic, culture is so funny. And I'm, I'm a big like voice message, like sender and like they'll ask me questions and I can just like quickly reply as I'm driving like a quick voice message. Okay, you have to do this, this, this, or maybe go to this place, or ask for this person. They'll be able to help you. It's almost like I do a little bit of social work. Yeah.

Katie 24:39

But how do you take care of yourself? I, I originally worked in, Baltimore and so I wasn't working in a hometown. When I went home, I went home like there was nobody. Texting me when I was home, being like, Hey, I had this situation happen. Can you get me in? Or I have a friend of a friend of a friend who's having this. How can you help? And then I moved to my hometown and realized that it is insanely different. It is like, unless you do it, you can't understand it. How, actually, how, how quickly you can fall into com, compassion fatigue actually, because it's, it's 24 7, like when I was in Baltimore, never had it. When I come here, it's like, on any random Tuesday, I could have three people tell me, one, they're not happy with the Karen Dover. Two, I can't get an appointment. Three, I have a, a sister who has a friend who has this happening. You know, it's just like constant and it can feel very overwhelming at times. And most people are very respectful about it. They'll even say like, sorry to bother you or whatever, and I, I understand why they're reaching out because. Th that's their lifeline in their mind. Like there's no one else to reach out to, so they know to reach out to me. But if you don't practice in that capacity, you'd have no idea how ex exhausting it is. And so I can pull in my head from practicing in my hometown how that could feel for you to just constantly be getting text messages. And, and it could be so far outside of the realm of what people would even imagine you'd get. It could be like, Hey, my, uh, my sister's cousin's mother is sick with the, with pneumonia right now, whatever. And it's not even

Angela 26:26

me GYN stuff or ob, it's

Katie 26:28

right? It's not even like a, an OB question, but you can like just become that token healthcare provider for people. So how do you take care of yourself? How, how do you have any kind of. Boundaries or, just the ability to keep doing that because it is, it can be very exhausting.

Angela 26:47

I luckily having come across like to a point where I feel overwhelmed and it doesn't happen enough, for patients to reach me, for me to start feeling overwhelmed. But I, I do have a therapist. Right. And not so much with my patients, but with friends and family members when I am being that person

Katie 27:08

that, know, they

Angela 27:10

wanna talk to. Because I feel like too, as a midwife, and it's something that I see on my midwife friends too. I just feel like we're very, like, how do I say this? Like, we're therapists. We know how to talk to people. We know how to listen to people. We know how to care for people. It's part of our persona. It's part of our personality and how we treat others. So we are a safe space. And I feel like sometimes family and friends, like they trust me and ask me those questions

Katie 27:41

and

Angela 27:42

I, have felt overwhelmed. In very few occasions by being the support system of like family and, and some friends, but not to the point where I have to set up a boundary. It has never gotten to that point.

Katie 27:57

I think

Angela 27:58

more so like if I don't have the head space right now to answer you, I just won't. And then when I have the Headspace, I'll reach you back and I'll just like say, Hey, I was busy. Do you need me? Like what can, what do you need me to do? Let's talk about it now. But I haven't been in a situation where I have felt like fully overwhelmed by people reaching me or anything like that. My therapist did say that I am the like, go-to person because I work in healthcare, period. So that does happen a lot. And funny enough happens to one of my best friends who's a nurse and she's going, to school to become a nurse practitioner. So now I'm

Katie 28:33

kind of using her as in

Angela 28:35

like, hey, my son has, like blah blah, this and this and this, what

Katie 28:38

is it? Right? So I am

Angela 28:40

using her too because like now she's like my go-to person and I'm her OB GYN person basically. Yeah.

Katie 28:46

Besides having a therapist, are there other things you do to decompress like self-care, rituals, that kind stuff.

Angela 28:54

My self-care is walking, just walking, like going out, walking, looking at the trees., You know how right now it's like the little win. That to me is therapy itself. Just going, walking, working out, eating good food. Like just I, those are the things that I really do enjoy. I started reading a little bit, but it's not something that I'm like, oh, I'm gonna go read, for for self-care. I, I think it's more so that working out, eating good food, making my Play-Doh food look pretty and full of colors. To me, that's like, it's a spa day for me

Katie 29:32

Do you have a lot of family that lives locally or are you able to

Angela 29:36

We don't. We actually, so my mom, has, my

Katie 29:40

mom has a lot of cousins

Angela 29:42

that live in the area and they have like their own kids, but we don't because it's her cousins and they're all adults with their own children. All of us don't really hang out together. My sister lives in Philadelphia and she just had a baby. And I have two sons, so her baby's my baby because it's a girl. She's a girl. So I get my girl. I feel like now we are in this, like in this life stage of my mom has three grandkids and I just wanna hang out with her or with my kids and my husband and like some friends when I can. So yes, we do have a lot of family in the area, but not too that we hang out a lot, but they do use me when they need me. When they have those medical questions, they reach me.

Katie 30:21

Where are your other siblings? I have two.

Angela 30:23

My, I'm a middle child. My younger sister is, Maria Fernanda. I am Angela Maria and Maria. Teresa is in heaven

Katie 30:31

Mm-hmm.

Angela 30:32

and we are all Marias. Funny enough, they used to call us re Marias the three Marias. So, my mom, when we came to United States, it was, she brought

Katie 30:41

her mom,

Angela 30:42

the three of us and

Katie 30:43

herself fire us

Angela 30:45

on a plane.

Katie 30:46

she,

Angela 30:47

and she started working, I think two weeks after we came to United States.

Katie 30:51

Wow. What was she working as in Venezuela versus what did she end up doing here

Angela 30:57

in Vene? Let me, I have to translate her title. She worked. In the, I think she was a director of finances or like a director of the bank, of the University of the state that we were in. And then when she came here, she was working in a warehouse. Yeah. In like, you know,

Katie 31:19

packing, packing things

Angela 31:20

of like an Amazon type type warehouse. Yeah.

Katie 31:23

So

Angela 31:24

very different. Right. Very different from what she was doing. But my mom was never ashamed, like my mom was never embarrassed over her having to switch jobs. In her mind. In her mind it was, this is what I need to do because we were living with my aunt back then and she knew this is what I needed, what I need to do to rent an apartment and move all of us together and become independent and for my girls to go to school and all of that.

Katie 31:52

Your successes are definitely, I'm sure her pride factor and a

Angela 31:58

percent. Yeah. Yes. She has all of her degrees in her walls.

Katie 32:01

all over high, all over, um, high school, college. It's like a wall of diplomas.

Angela 32:07

here,

Katie 32:08

mom, here's another one. I'm not going back to school.

Angela 32:10

told her done.

Katie 32:11

My master's did me. Well, you say that now, but I have

Angela 32:15

I know

Katie 32:16

people in my life right now that are going back for, doctorates, and they're, let's see, they're probably all hitting about 10 years of midwifery experience.

Angela 32:25

I, I love learning. So I do see myself. Once my kids are older, then I might go back and do something because I do learn school, I do making notes and like reading and like just being like in school mode with little children. It's really hard. Yeah,

Katie 32:41

Absolutely. I can't even read books. I like, I'm an avid reader and recently my kids are 13 and 15, so now I'm like, oh, I could actually start reading again because I do feel as though in enjoyable reading and raising children somehow do not go together.

Angela 32:58

It, it does matter. no, I, I been telling everybody now when I'm working a hospital shift, the shift ends at six. I have dinner at

Katie 33:10

5 55 and

Angela 33:11

I go

Katie 33:11

home because I'm not gonna be able to have dinner sitting down. I'm not gonna

Angela 33:15

able to have my beautiful plate of food and eats slow. Five minutes is not slow, but it's lower than

Katie 33:21

what I will

Angela 33:21

do at home. So

Katie 33:23

that's what I've been

Angela 33:23

doing lately.

Katie 33:24

Yeah. Home can be total chaos. Yes. Little kids. So how are you navigating having a husband that's a police officer and a midwifery career? How's that working for you?

Angela 33:37

It was extremely hard at first because of our schedules. And because of two little children, luckily my husband was able to change, jobs within the department. So now he's, in the community. It's funny because now he's in the community department and we both met

Katie 33:54

at West

Angela 33:55

Side Family Healthcare, which is a community,

Katie 33:58

Healthcare center

Angela 33:59

the area. So I feel like we're both very like community heavy, community

Katie 34:03

based.

Angela 34:03

And now he has a wonderful schedule. Like now he works, like Monday through Friday he's home most nights for dinner. Like he's home for at least bedtime. So it's been very manageable. And now I'm the one that has the crazy schedule, but he's able to be there. Or like his mom, my mom sometimes his sister-in-law. So. We're, we're able to do it. I'm not as scared as I was before, but it, it was pretty hectic. Also, I started, my midwifery career when I was pregnant and I started working in the hospital when I was three months postpartum. So that was really, really hard to just navigating postpartum hormones and changes. Being a mom of two and the schedule that I was having now, it was, it was pretty rough. But

Katie 34:53

what's your schedule that you have currently?

Angela 34:56

It varies, but I typically do like three office days. Most of the weeks. Three, to four, office days, and then one hospital day, or I will do like more hospital days and less of the, of the, office days. But for the most part it's four.

Katie 35:11

Is your hospital shift at 24 hours? Is it overnight?

Angela 35:14

It's 12. It's 12, but I get to work sometimes. Overnights too. We do have, no journalist, two midwives that work, most of the night shifts, so we are very lucky on that sense. But when I started working, as a midwife, on the floor, I had a night shift every week. And I just remember, I would literally go home, breastfeed the baby, like half asleep and he would just take him, drop him off at daycare and I would sleep for about three hours, get up, pump and sleep, like three more hours. It was, it was tough.

Katie 35:44

It is tough. Thank God for those night shift people that like doing that.

Angela 35:49

Yes, yes.

Katie 35:50

There's a lot happening. This is such an obvious statement, but there's a lot happening in the United States that I am sure is very hard for you to watch and to be a part of. How are you, like how are you dealing with that right now? How's it impacting you and how are you moving forward through that?

Angela 36:09

I think the biggest thing is the hate and the fear. The example that I gave before about, like when I walk into set, like into the, the hospital rooms, and they will hear my accent and I will, the ambience, the how people with treatment will change. It was happening during Trump's last presidency. And I remember, once he was gone it was almost like a weight was lifted and people were friendly again. And this is something that my mom has noticed too because obviously she doesn't speak as much English and she has a very heavy accent. So she has noticed that when she goes shopping and she has a question, pe people are less patient with her. And same thing, like I do feel like some patients. Tend to be less patient with me because they're figuring out that I'm not from here. And just like the fear of, like the fear of peop people treating me differently or like people hurting me or hurting my family or hurting my friends. Just because we are Latinos like that, it definitely is a fear that it's high end right now with our government because our government allows it. Right. It's, it becomes the norm. And when it becomes the norm, it's almost I don't wanna say that I hide myself, but I do tend to be, I do tend to sensorized, is that a word? Like I do tend to kind of

Katie 37:36

like sensor, sensor yourself. You censor myself.

Angela 37:39

Yeah. I feel like I am censoring myself a little bit more. Yeah.

Katie 37:44

And then how, when you're seeing people in the office and in the hospital that are, that you suspect potentially or undocumented, how, how, how is all that weighing into these visits that you have? I

Angela 38:00

very comfortable

Katie 38:01

asking.

Angela 38:03

Es, especially if I suspect that I feel very comfortable asking patients out of the bed. Are you documented? Right. And the reason that I feel comfortable asking them that, it's because I know what resources they qualify for and what things they can do. I don't just like flat out say like, Hey, are you documented? But I'm like, I'm gonna ask you a question. I hope you're not offended. You don't have to answer it. But are you documented? And they're like, actually, yeah, no. I'm undocumented. I'm like, okay, well there's this resource and this resource. I just wanna know that we don't share any of your information. You're safe here. Don't worry about it. So that's why especially if they're having a lot of those social, like social worker questions, that's why I flat out ask them because

Katie 38:44

I have

Angela 38:45

'cause I work at West Side and then I can like refer them so one prime example that I can give is patients, and this is like insurance health, insurance wise, whether you have, documentation or not, if you don't have insurance, maternal fetal medicine cannot see you. Right? And there are some patients that need more MA more MFM scans than others, right? So then if I have a patient that I know will need MFM, then I I tell them like, Hey, what's your health insurance situation like? Do you qualify for health insurance? Hint, hint, And if they're like, no, I don't qualify, I am undocumented. I'm like, it's gonna be more beneficiary for you and for your health to go to places like West Side because they're gonna be able to send you through maternal fetal medicine through their channel. You'll be able to get that care through them that I'm not gonna be able to give you here because we don't have that channel.

Katie 39:34

How do they, emotionally receive that information from you? Oh, they're grateful. They're

Angela 39:38

And I tell them like, I used to work there or this is how I know this resource. It's something that is gonna benefit you more after you're done with your care. Come back to me. I would love to continue seeing you. And I had a patient that, was pregnant, went there, and now she's back with me for her regular, like GYN care. So it, it also feels nice because they like me, they're coming back and I'm like, oh. You really do like me, don't you?

Katie 40:02

You are back. Do you have West Side up north too, or is it We do, yeah. Okay.

Angela 40:08

Yeah. There's a bunch of, offices. Yeah.

Katie 40:10

How, having worked at West Side, like you did, how national is West side? Is it just local to Delaware or is it local to Delaware. Okay.

Angela 40:16

Yeah. I have always said West Side holds such a special place in my heart because of what they do for our community. And mind you, they,, I don't speak for them. They not only take care of, the Hispanic community, they take care of the community in general. Right. But they just hold such a special place in my heart because of all the handholding that they do and all of the resources that, they give to patients. And I still had friends that worked there and my very best friends today, we all met at West Side. So it, it definitely holds a very, like

Katie 40:52

I see

Angela 40:52

myself working at West Side in the future, once I'm done, Maybe not seeing patients in the hospital. And I just wanna do like strict office, like I do see myself working there because I, they have a way larger, Hispanic population that, that we do right now.

Katie 41:07

You were a nurse for them? Yes. What did your husband do there? Or did he just come in as a patient? No, he used to work there. I was, so funny at West

Angela 41:17

Side Social Security card in him. I'm in school.

Katie 41:21

I immediately apply a website too. Once I had that

Angela 41:24

security card, I was like, let me apply a website. Because in my mind

Katie 41:28

at that time when I was

Angela 41:29

the medical assistants were so cool in my mind and

Katie 41:33

I was like,

Angela 41:34

oh, I wanna be a medical assistant or a nurse, something.

Katie 41:38

So I applied.

Angela 41:39

Obviously I couldn't be a medical assistant yet 'cause I was in school to become a nurse. Um,

Katie 41:43

but I applied

Angela 41:44

I was a front desk reception, then I was a medical receptionist, then I became a financial aid and then I became a nurse. So I

Katie 41:52

did everything. I

Angela 41:54

working my way up and yeah. So I, I do see myself being a provider there if they take me like in the future. Yeah.

Katie 42:01

So West Side is federally is, what do they consider themselves? A federally qualified healthcare health center. Health center. Mm-hmm. Federally qualified health center. Do you know how many there are in Delaware?

Angela 42:11

Um. I think it's Lare, west Side and Henrietta Johnson.

Katie 42:17

They like,

Angela 42:18

all like their own,, organizations, but they, I believe they're all federally qualified.

Katie 42:22

I feel like Delaware has a, a decent amount of, of those services, to speak kind of highly for Delaware, taking care of that, that group, compared to probably some other states. I

Angela 42:36

work in,, it's now called LCH in Kennet Square. It's called

Katie 42:41

ana,

Angela 42:42

ana, because Kennet Square

Katie 42:43

has a large

Angela 42:44

Hispanic population because of the mushroom farms

Katie 42:47

and that

Angela 42:48

it was the same, it's the same concept as West side, community based, community health, community, community, community, community. It's all based on that. And they were the go-to place for the patients in the community. Everybody knew if you needed a doctor, that's where you go. Right.

Katie 43:05

So the main driving reason, you're not there now, because it sounds like you, you love it, it's in your heart, is because you can't do inpatient and

Angela 43:14

a hundred percent yes.

Katie 43:16

But in theory, you could eventually do inpatient as a PRN maybe and work in the office.

Angela 43:25

I definitely could. I definitely could do like a PRN, like a PRN position in the hospital and

Katie 43:32

After

Angela 43:33

get my loans paid. My mind, I'm

Katie 43:35

just like, my mind is like shifting. It's like making plans right now. Oh yeah. That it's like my whole world talking to somebody and like, well you could do this.

Angela 43:46

Lemme think of actually sounds like a good

Katie 43:48

idea. I, I did pay,

Angela 43:50

repayment, the loan repayment through the Delaware State program and I am going to be student loan debt free in September. Cannot wait.

Katie 44:00

wait. That's amazing. Right prior to this, hitting the record button, we were talking about how I did the midwifery route. As expensive as you possibly can do it. And I'm still paying off student loans and I'm hitting 20 years soon. Which is terrible. Absolutely terrible. And I could go on a whole discourse on how I've qualified for, strangely nothing for help from that. Since which, once again, that could be a whole show, but you have done exactly the opposite. And I did wanna spend a little bit of time talking about that because I think that's very helpful. I think some people look at the student loan piece as they should, as almost being insurmountable, and so they just don't even pursue. So can you walk us through how you funded your nursing program and then also how you funded midwifery?

Angela 44:54

So,

Katie 44:54

I

Angela 44:55

my nursing at Del Tech and at that time I was doing it part-time, like my classes, I was doing classes part-time and I was working,

Katie 45:04

not part-time,

Angela 45:05

more like, you know, like three quarters and

Katie 45:07

that's how

Angela 45:08

pay for my classes. I wouldn't sign up for classes unless I knew that I could afford it.

Katie 45:13

So I

Angela 45:14

able to do my whole, associate's degree in nursing. Basically like paying myself for my bachelor's because the credits get a little bit more expensive. I use tuition reimbursement from my job and then I ended up paying a little bit and that was the time where I had student loans for the first time. And I think I ended up graduating with my bachelor's with like. I would wanna say like 10,000, 11,000 of student loans. So basically,

Katie 45:44

where were you working that they paid for your Westside Health. Okay. West Side. Yeah. So you went to West Side right after you got your As, so-so no, you went to West Side before your associates?

Angela 45:54

So I was doing, so then I was paying for it myself and I was using their tuition reimbursement program. And once I became a nurse, then I started doing their tuition reimbursement and paying again for my ma for my. Bachelor's. And then, I, I changed jobs. And then when I, so before I changed

Katie 46:13

jobs, that's

Angela 46:13

I started having this like idea that I wanted to go back to school, but how am I gonna do this? I don't wanna end up with, like student loans because I knew that I was gonna need student loans for my master's program. So, just talking to two of my colleagues that did it, the two of my colleagues that did it, they started talking to me about, this program that providers qualify for when they work at a federally qualified health center. So then, I said to myself, well, I can go back to school and I'll just work out a west side, Through that program and then I'll pay my student loans and I won't have the burden of having student loans for the rest of my life. Right. So

Katie 46:49

I have

Angela 46:50

idea already in my mind.

Katie 46:52

To

Angela 46:52

my master's school, started just doing racking the student loans. Racking them. Racking them. Just like, I need everything that you can provide me because

Katie 47:00

I,

Angela 47:00

needed it. Right? 'cause I was working less. And once I graduated, I needed a job that I was going to be able because I wasn't gonna work at West Side anymore. 'cause I couldn't, 'Cause I wasn't gonna be able to work inpatient. So then when I was hunting for jobs. Essentially I needed

Katie 47:19

a job that

Angela 47:20

was going to qualify for the Delaware Health Loan Repayment program, which is for new like doc, it's a

Katie 47:28

bunch of

Angela 47:29

like options that you have doctors, Of different specialties, advanced, practice, nurses, midwives. So then I needed a job that will qualify under that program. And honestly, there's a lot of places within, like in Delaware that qualify the birth center are qualify, dedicated to women qualify. Christiana obviously qualify. West Side doesn't, west

Katie 47:52

side qualifies, but

Angela 47:53

qualify through another, through like a federal like funding program. So, they can give you up to, up to if you qualify up to $60,000 for a two year contract. And then I just did my, I just finished the, do those two year contracts. I did another contract for a year and I'm done in September

Katie 48:13

That's so exciting. Dedicated to women. Did not qualify when I was No, they did not when I was there. Mm. Oh

Angela 48:20

Oh No, they didn't qualify. Now that I think about it, because I almost took a job with dedicated to women. But I got pregnant and ended

Katie 48:28

up.

Angela 48:29

working for Christiana. 'cause it was just more convenient for our family too. But it wasn't, now that I think about it, it wasn't that I was gonna qualify through dedicated to women. 'cause one of the jobs that I interviewed was dedicated to women to work in the hospital and then west side so that I could work. So

Katie 48:44

kind of like the

Angela 48:45

that you were saying like a PRN type job, with them and then in the office with West Side and I was kind of qualified through my loan repayment through West Side. Yeah. That's what I was gonna do.

Katie 48:55

This is part of why this, I'm just giving examples of how I have not had my student loans paid for.

Angela 49:01

They in fact don't qualify.

Katie 49:03

They maybe they do now, but they did not. Then there there's always been asterisk everywhere I've gone Yeah. Of like. Oh, it should qualify, but it doesn't because of this small little whatever. And, so it's been very frustrating, but I mean, it's hard. Like my husband

Angela 49:17

has to pay for student loans and same thing, like he keeps trying to apply for the forgiveness and student loans. You know, when I was looking for a job, like I remember like looking for a place because I was like, there's no way. Or even when I was thinking about if I wanted another, you know, another kid, I was like, either I pay my student loans or I have another kid, like

Katie 49:39

I cannot, like, I cannot

Angela 49:41

financially do both because not only is it the child that you're going to have, it's also daycare. Right? And if you're having a, if you're having hundreds of thousands in student loans.

Katie 49:51

you can't, this was a big factor for me not having a third child. I always envisioned I would have more children. I. And part of that was my husband telling random strangers after two girls that he was done having children. I'm like, they didn't actually ask, they'd always be like, oh, your children are so cute. He's like, I'm not having anymore. I'm like, they didn't ask you that, but anyway. Okay.

Angela 50:12

Okay.

Katie 50:12

And then by the time he came around, my youngest was four, and I was like, oh, the, the student loans and the how, how do I, go back to paying for daycare and all of the stuff, and then pump all of it. It's just, it's a lot.

Angela 50:29

It's, it, it really, it really is part of your family decisions, student loans, like you really, really is.

Katie 50:39

And

Angela 50:40

We can't keep applying for forbearance that ends. Right. So it, you know, that's, that's where my husband and I are right now with his student loans. It's like, how do we pay for these student loans now? Like, we gotta pay for them and it's, yeah, it's, they can definitely, affect families.

Katie 50:58

Yeah. Countries all across the world. Or you talk about these declining birth rates and I'm always like, ah, these damn student loans. There's, they are, they're such a part of the conversation, but not on a government level. I feel like it's more like in your own household, the, these decisions that you make. But anyway, that's kind of a, a side story, but what I think so many of us can relate to.

Angela 51:22

gosh, yes. Yes. So my, every time that, what my best friend who's in school right now, I'm telling her she wants to move to Florida, and I'm like, before you go get your student loans paid, like work here for a couple years, get your student loans paid. And then you can go,

Katie 51:38

and then you can go to Florida and they have a great college, situation in Florida. People move to Florida to get their kids college paid for. I don't know all the ins and outs, but we actually had a physician leave us to move to Florida specifically, so his kids would go to college for free. They have a very good, state situation there. Ooh,

Angela 51:56

Oh,

Katie 51:57

yeah. I

Angela 51:58

I'm gonna, I'm gonna find out about this. I love that.

Katie 52:00

Mm-hmm. Not that I'm trying to send another midwife, particularly Latina midwife, to freaking Florida when we need 'em here.

Angela 52:07

I

Katie 52:07

was, you know, um, I used to,

Angela 52:10

I think it's like something that I'm very

Katie 52:11

proud

Angela 52:12

Mind you, Delaware is very, very small, but I think I'm the only Latina midwife in Delaware.

Katie 52:17

No. Like, literally I felt very insistent on this. And I was thinking about this morning, I was like, if, if I didn't know you, I would have to start. Connect, like being like, who knows A Latina midwife that's kind of local. That's pathetic.

Angela 52:33

I remember like when I was like,

Katie 52:34

after I graduated, like when I was doing

Angela 52:36

my clinic, 'cause I was like, I don't think there's any other, like Spanish speaking, like midwives here. And I do

Katie 52:42

wish, you know, I

Angela 52:43

think we talked about this, but I do wish that other nurses that speak Spanish will go back to school. But I think student loans is intimidating, but also like it's needed, like midwives are needed, right?

Katie 52:57

But there is actually a good amount of Spanish speakers, but it is not the same. It's not the same. Okay. Because like when you do the, when you do the same breakdown that I was looking at earlier, of how many people speak Spanish, like providers, the number is much, much higher actually of how many providers actually speak Spanish. And out of the midwives that. We're in our dedicated group to, two of them out of seven spoke Spanish, but they aren't Hispanic. And there is a difference there actually, like people that speak Spanish but are not, especially, with what's going on in this country right now, they can't relate to the things that some of these patients are having the way you

Angela 53:43

Mm-hmm. The fear. Yeah. Yeah, yeah. You can relate,

Katie 53:48

but

Angela 53:49

you can have comp like

Katie 53:51

compassion.

Angela 53:52

and yes, you can relate, but

Katie 53:54

I leave it exactly like I have, family

Angela 53:57

that are still undocumented.

Katie 53:58

I have friends

Angela 53:59

that are undocumented. So like

Katie 54:00

I have that fear very

Angela 54:02

close, to my home. So, yeah, like, uh,

Katie 54:05

I do,

Angela 54:06

and it's, it, it's the same thing as like

Katie 54:09

my

Angela 54:09

therapist is Venezuelan. Right. And the therapist that I had before wasn't, and her and I just, we, we couldn't see eye to eye. And the very first therapy session that I have with my, with my therapist now, she, the things that she say that she said, and the way that she said it, it was coming. 'cause she's also an immigrant, right? So it came from an Venezuelan woman who immigrated to United States. So we see a lot of eye to eye, the financial part.

Katie 54:41

I worry

Angela 54:42

a lot about our finances. One because of who my mom is and, you know, the job that she used to do. And just like

Katie 54:49

I don't wanna

Angela 54:49

struggle, but this worry that we need money. Right. We need money. Money's gonna rent out and we need to save, and we always have to have a savings account. And money is very important to us. But I think that comes from migrating to another country where you came with nothing, right. Or with very little, and you have to build from that. And my therapy understand. My therapist understands that. Right.

Katie 55:12

And I feel like

Angela 55:13

what I understand with my patients too, when they come with some of their struggles, I'm like, yeah, I get it. I'm a midwife and you might see me in a, in a position of power or you might respect me because I'm standing on this side, but I I get it. I get it. What you're going through.

Katie 55:30

Absolutely. It's a, it's a cultural piece, that is otherwise absent. Bev and Haja were both on this podcast speaking about how as a, as black midwives, when they go into a room with a black patient, they have that same light up. Like, oh,

Angela 55:46

yes,

Katie 55:46

you look like me. You know, I speak the same freaking language as Haja and Bev. Okay. And as the patients that they see, it doesn't matter, like it language is a piece of it, but it is not the whole piece. I,

Angela 55:58

it, it's

Katie 55:59

kind of like hard to explain

Angela 56:00

it, but walking into a room and you just see how everybody's shoulders just goes and I'm like, SI.

Katie 56:07

So like it's that.

Angela 56:08

is just like everybody's like, or like, you know, if there are moms in the room, they're like,

Katie 56:12

MM

Angela 56:13

she speaks Spanish, look

Katie 56:16

right? But it's not the same. If one of the providers walks in that speaks Spanish, that does not look like them, that does not come from a country that, is not the United States or, or has parents that come from a country that's not the United States to say, Hey look, look at this midwife because it is different if that your, your experience matches. Because then it's like, Hey, also look at this midwife, but you could be this, you know? Yes. You don't get that same thing from somebody that speaks your language but doesn't have that cultural piece behind it. And I

Angela 56:52

say too, that, one thing about the immigration part, like me being immigrant, it's that I have noticed that it travels, it, it, it transfers to other cultures as well. I feel like

Katie 57:07

I

Angela 57:08

to see more eye to eye with patients from other countries just because of the fact that I'm a, I'm an immigrant And

Katie 57:15

I came to

Angela 57:16

States, like I immigrated here. So

Katie 57:18

like, I don't know how to

Angela 57:18

explain that, but My patients that are, like from Asian countries or from like India, like Middle Eastern countries, patients that are, from

Katie 57:27

Africa and

Angela 57:28

immigrating here. Right. Even though we are from different cultures, I think we all understand that we speak, that we

Katie 57:37

have an, I guess that's

Angela 57:38

I'm trying to say. We have an accent and we're not from here.

Katie 57:41

I just don't want anybody to have a take home message of, oh, let's just increase all of the Spanish speakers and we'll just fix everything. Yeah. Like, yes. That's wonderful. Coming from somebody that sucks at other languages and I wish I was better, it's just not inherently one of my grid skills that won't solve the problem. You have to have more midwives representing cultures, like coming from different places, different experiences, yeah. You have to have more midwives representing those places. Because that's, that's the deep relationship that develops with patients.

Angela 58:20

That's what it is. The deeper level of

Katie 58:22

They see themselves in you.

Angela 58:23

Yeah. She's not from here, She, she also travel here and she's making her life here. Yeah. That, that's what it is. It's

Katie 58:31

like they're

Angela 58:33

seeing me as, I guess, simple as that. They're seeing me as an immigrant, like them,

Katie 58:38

or like their mother. They could be, they could have been born here, but they'd still have that cultural connection. So anyway, that's why you were so special to me to end up on this podcast.

Angela 58:51

Thank you. Thank you.

Katie 58:52

When you think about midwifery embracing you as a provider and supporting you and your community, what, what do you think that looks like? What, what could we be doing better?

Angela 59:08

It's hard, it's hard to think about what can be done better, because I've been very lucky. I feel like all of the me, like all of basically like Laurel Haja, Megan, they were the midwives that I follow, the midwives that I have met and the midwives that I have met now on my workplace. A lot of them,

Katie 59:29

I

Angela 59:29

like every, everyone has been such a good example in not only. Profession, like professional midwives that I can look up to, like the midwives that have more years of experience, but also just like human beings. Like I being so well taken care of by the midwife community here. I've been babied by the midwives, so

Katie 59:53

I, I don't know

Angela 59:54

if I can think of anything more that I would want. I wish we would all hang more, like I wish we were all like, have more of, how do I explain this? Like more of the like not only friendships, but also like

Katie 1:00:10

the Delaware midwifery chapter, like where we are like learning, like that. That's one thing that I would wish

Angela 1:00:15

that we will all have more room and time to learn more together. That's the only thing, but yeah.

Katie 1:00:23

Delaware is interesting because we have periods. When I first moved back here from Baltimore, Baltimore had a very, very active Maryland chapter. We might have even had a Baltimore chapter within the Maryland chapter. I can't quite remember now, but it was pretty active. Delaware at the time when I was moving back was called a swing state with midwifery. Like a CNM was like, this is like a, a swing state. We have large numbers of midwives and then we have no midwives. And it was like dropping off and then increasing. I think the numbers of midwives are more stable now, thankfully. But I think when it comes to how participatory we are in the A CNM chapters, that really comes and goes. It's a lot of commitment and I think we're all kind of working so hard just to make Delaware a better place for midwives, that it gets lost sometimes on how to, extend that into more of our own community thing. Certainly that's one of my goals, of the podcast, is to have more, to connect people to each other, not just in Delaware, but even in, in a broader sense. And then to have gatherings and things because

Angela 1:01:34

yeah, like more gatherings where it's like midwives and opportunities to like learn, because where I'm working right now, yes, we do have a large group of midwives, but we work in an institution with residents and educations on Wednesdays are based like on surgery stuff and like high risk things and I'm like, can we talk about More stuff that I'm, that I,, I can do. Can I upgrade like my skills or can I, like learn or review this thing? Like things like that. Right? But it's so heavily focused on like physicians and not so much on APCs. That's where I wish that we have more time, and room to all be together and learn. think

Katie 1:02:19

is also a broader national problem. We have a midwifery presence at the hospital I'm at, and it's been there now pretty consistently where midwives are doing the majority of the vaginal deliveries for about 10 years or more. So it's well established, but I still feel like, as I'm sure you would feel, we're still just constantly hearing about, well this is what ACOG does. I don't wanna just sit here and hear all the time. In a hospital setting, what ACOG does, they're not the only source, certainly not in the world, but even within the United States, like the midwife voice as research or as, Policy is still very much lacking. And I would like to see that increase, especially in our state, that we are starting to say, well, it's not okay that, it's great that ACOG says that, but here's what we say.

Angela 1:03:11

Yeah. Here, this is our, here's our opinion. Right. Here's what our governing body is saying

Katie 1:03:17

or telling us. Yeah. And ac and m doesn't take a lot of strong stands on any particular protocol. But I would like to see a little bit more of that happening so that you can say this is what our board says. And I think some of that starts with getting midwives together locally and then nationally, but in a way that's not.

Angela 1:03:41

burdening. Yeah.

Katie 1:03:43

that's just more intrinsic or, organic. Organic. Mm-hmm. I think that's,

Angela 1:03:49

the key. Yeah. That it doesn't feel forced. It's more like

Katie 1:03:51

Mm-hmm. Yeah. Yeah, because when have you had this frank of a conversation with another midwife about your whole background? Like at A CNM? Have you had that in an a CM meeting or a, a CNM, conference like you No, it's gonna happen more likely in something that is at somebody's house.

Angela 1:04:12

Yeah. More intimate. Yeah. Yeah.

Katie 1:04:15

And I think that's where Midwifery Thrives is in that, those intimate settings. And, so I'm hoping that this podcast will somehow lead towards, more intimate settings for, for us to get together.

Angela 1:04:29

Yes, please.

Katie 1:04:32

That

Angela 1:04:33

that's a word that I can use to describe, like, if somebody ask me, like, describe midwifery in one word. Intimate, like Yeah. Intimate. We're intimate with, with our patients. Yeah.

Katie 1:04:45

Probably the best word. I agree. I'm gonna, I'm gonna use that in the, summary. Is there anything else you wanna talk about?,

Angela 1:04:51

Something that has always been on my mind and that.

Katie 1:04:56

I think about it often

Angela 1:04:58

too often. It was one thing that Laurel told me when I was in clinicals, and it has stuck with me. I think I just texted her the other day about this, that, when I was in clinicals with her, she saw me, with a Spanish, with my first, like Spanish-speaking patient and how

Katie 1:05:13

like, I was like out of my shell. And I remember after we were

Angela 1:05:17

were done with that delivery, she like tapped me. She was like, Angela, next time, treat the patient like she spoke Spanish, treat her like she spoke Spanish.

Katie 1:05:27

And I just remember

Angela 1:05:28

Oh,

Katie 1:05:28

oh, okay.

Angela 1:05:29

And she, you know, she saw the difference of me how I was like in my shelf closed with a patient who didn't speak Spanish. And then

Katie 1:05:36

when I had a

Angela 1:05:37

that spoke

Katie 1:05:37

Spanish, I was like, more like

Angela 1:05:40

I was myself. I was like treating her like. I, I was myself, so like she, that was the best, recommendation, compliment,

Katie 1:05:49

Advice that I have

Angela 1:05:50

And I found myself sometimes when I'm in like deliveries, like when I'm in birds reminding myself to, it's weird, but to speak Spanish in my head and to

Katie 1:06:01

translate,

Angela 1:06:03

like to tell patients because I have so many things that I wanna say in Spanish

Katie 1:06:09

That I

Angela 1:06:09

to translate them or

Katie 1:06:11

like that, I don't know.

Angela 1:06:11

It's weird to explain

Katie 1:06:12

What, it's a mask. You, and it's probably what you were referring to earlier, that you, the mask that you've been wearing has gotten, less translucent actually. Yes. More, more peg because of all the stuff going on politically. Yes. So you wear this mask, you go to the grocery store, you've got this mask on you wherever, and then you kind of have to remind yourself to take that off in front of patients. Yes. Because that is not helpful for patients. Yeah. Because of the intimacy

Angela 1:06:38

Exactly. Yep.

Katie 1:06:39

There you go. That's

Angela 1:06:40

it is. Yep. It's the mask. And I need to like,

Katie 1:06:43

I have to remind

Angela 1:06:44

to just like take it off and be myself and treat all my patients as if they spoke Spanish.

Katie 1:06:49

Yeah. I'm sure we can all have that version though. Maybe it's not, as if they spoke Spanish, but as if they were your sister, as if they, came from wherever. You have, you have people or places that you connect more easily to, but the goal is to bring that out. In a relatable way to the person in front of you.

Angela 1:07:08

Yep.

Katie 1:07:08

Well, thank you so much Angela. I'm so excited for this to be one of the episodes on the first season. And I'm sure we can think of something else to talk about for another episode next season. Innovation. Yes. There you go. Thanks. Thank you for listening to this episode of Mindful Midwifery Presents, the Labor Behind Labor with my guest, Angela. As you learned, Angela came into midwifery almost by accident, a conversation here, a nudge from a friend there, a husband who said, we'll make it work, and we are all better off because she stayed the course. If you are a student, a nurse, or someone sitting on the fence, the way Angela once was, this episode was for you. In two weeks, I'll be conversing with Carrie from earlier in the season. Carrie recently had a hysterectomy, and she agreed to share her story about her health journey leading up to this surgery and how recovery is going. This upcoming episode should not be missed. Let's reconnect in two weeks.