Meet a Midwife in Training

A home birth that was nearly “not allowed” in Iowa planted a seed that never stopped growing, and our anonymous guest follows that seed all the way into a Certified Professional Midwife (CPM) apprenticeship. 

Along the way, she takes a real detour, walking away from midwifery hierarchy, studying linguistics, working jobs like Starbucks and publishing, and spending years raising and homeschooling kids. 

Then a visceral dream pulls her back toward birth work, and we talk through what it really takes to return to a calling with more maturity and a clearer sense of the costs.

We get specific about the difference between a doula and a midwife, what each role does during labor, and how midwifery training works in the home birth setting. 

If you care about home birth, midwifery care, doula support, patient advocacy, and the real meaning of informed decision-making, listen through to the end. Subscribe, share this with a friend who’s expecting or supporting someone who is, and leave a review so more people can find these behind-closed-doors work stories.

Want to be interviewed? You can remain anonymous. Voice distortion now available. Email or Text us!

Transcript

Welcome And What This Show Is

SPEAKER_00 0:02

Welcome to Workplace Confessions Behind Closed Doors. I'm Elsa Barbie. And I'm Don Andrews.

SPEAKER_01 0:08

We have been friends since sixth grade. Somewhere between a car wash job, a few questionable boy choices, and 40 years of friendship, we became the kind of people who always want to know what's really going on, including at work.

SPEAKER_00 0:21

Don spent 25 years as an employment lawyer digging into workplace drama from the inside out. I built a long career in the beauty industry as a brand educator with a few TV cameos sprinkled in for fun.

SPEAKER_01 0:33

We came up in very different industries, but we have the same passion. Meeting new people and asking how they got their jobs, what they love, what they can't stand, and what happens behind closed doors.

SPEAKER_00 0:45

Every episode we talk to a new guest about their lived experience in the world of work. And because our guests stay anonymous, they can spill the truth without the fallout.

SPEAKER_01 0:54

We get into the choices they made, the tiny cruelties, the surprise kindnesses, and some of the moments that never make it into human resources reports.

SPEAKER_00 1:03

Equal Parts Informative and Tiddly. This show serves up all the tea while honoring the incredible, complicated, often messy work people are doing across the industries and across the map. Welcome to Workplace Confessions Behind Closed Doors. Let's get into it.

First Jobs And Midwife Training Today

SPEAKER_00 1:33

Okay, let's start from the beginning. What was your first paying job?

SPEAKER_03 1:37

So my first paying job was as a kid, just babysitting for people. And it does tie in with everything. But then my first kind of W-2 job was just working in a local natural food store.

SPEAKER_00 1:54

And what do you currently do?

SPEAKER_03 1:57

So currently I'm studying to become a midwife, and I'm studying to become a certified professional midwife, a CPM. And this involves a lot of self-study. And so it's not currently paid, but it is work. I'm in an apprenticeship model. Make some money on the side with putting together tinctures for people and natural remedies and renting the birth pool and side jobs. Going to birth is just has a lot of extras attached to it. So a lot of times people will want a water bird. They'll want to give birth in the water. And we provide the pool, but I do it for a rental fee. And not everybody structures their business that way, but we do. And it's just a way for me to make the money as an apprentice.

SPEAKER_00 2:58

Can you walk us through the journey that you've had from your first job to what you just explained, what you do now?

SPEAKER_03 3:05

Yeah. What brought me to Maidwickery was that my mother had a home birth with my little sister when I was eight years old. And so I was present for that. And it was very, it just shaped me. And at that time, I was even at age eight, I was keenly aware at how ridiculous it was that home birth was essentially illegal in Iowa, where I grew up. And so, not necessarily for somebody to have a home birth, but for a midwife to attend that birth. And so if somebody wanted to have a home birth and have a midwife there, it was not allowed. Or she could just go unassisted, have the balone at home. And so I was aware that was ridiculous. And then I began babysitting with my baby sister and other people in my community became aware of that and started hiring me at a young age to watch their children, which I look back now and I look at my children. I'm like, I don't know.

SPEAKER_02 4:12

Hiring a eight-year-old, nine-year-old to watch your baby. But I guess I was trustworthy even then with children.

SPEAKER_00 4:24

And then what did you do after that, after your high school over there in high school?

SPEAKER_03 4:29

I started thinking about what I could do with my life. And I came back to midwifery and was thinking about something that would always be needed. And I wanted to also be involved in promoting the freedom to have your baby at home. That was really important to me.

The Detour From Birth Work

SPEAKER_03 4:50

And so I began studying midwifery and uh apprenticeship in my late teens and early 20s. And then I just became disillusioned with it. There were some problems with the hierarchy. Midwifery is very hierarchical. And I had some problems there getting kicked down the totem pole with other apprentices. And so I walked away and went to school for something completely different. I did a 180 and studied linguistics. And then wow. Yeah. And then I worked at Starbucks for a while. And then I became an editor at a publishing house. And then I was a stay-at-home mom for years and years and years, and just homeschooled my kids. And then two and a half years ago, I had a dream that my oldest was giving birth, and I there was nobody there to help. And I just was casting back. It was such a real dream. If you have a very visceral dream, and in the dream, I was casting back in my mind, trying to remember what to do, and I couldn't remember. And I woke up just didn't know if it was a dream or real. And then I thought maybe this is a call back into midwifery. I don't know. I had always kept a toe in the birth world of the doula. I had become a doula in my early 20s to help me become a midwife. And so I never really stepped away completely from the birth world, but this was totally different to just consider really going full back into studying to become a midwife.

Doula Vs Midwife Explained

SPEAKER_00 6:34

So the first question is what is the difference between a doula and a midwife?

SPEAKER_03 6:40

Yeah. So a doula is someone who attends a woman in labor purely as emotional support. It's emotional and physical support. There are no medical elements to it. That's the very traditional viewers. Serve the mother and labor and help her through it. And so then a midwife carrying it forward from there is someone who carries more responsibility in the birds for recognizing when something crosses over out of normal into needing to bring on more tools or more help. And is also able to deal with certain emergencies that can come up during labor that are more common that don't require a transfer to the hospital. Sometimes there is a clash between doulas and midwives over who's in the birth space, who who gets to be there and who's doing who's the main support and that kind of thing. And then on top of that, which takes four years, and then on top of that, becoming a certified nurse midwife. So then you add another two to three years on top of that to specialize basically in labor and delivery. And midwives, they're a special breed. They carry a lot of responsibility and they own it. And I'm rightly, I think, and then there's underneath them typically there'll be like a head apprentice who has the most experience. Then under that apprentice, there'll be maybe one or two other apprentices, and they're all usually at different stages in the process of becoming a midwife. And usually in this hierarchy that I'm talking about, this is all the home birth setting. People who are probably trying to become a certified professional midwife rather than a nurse midwife. I can't really speak to that hierarchy, although in the hospital I'm I'm sure that's functioning in some way. So there's three phases in becoming a certified professional midwife. And phase one is simply 10 births as an observer. You're just there doing nothing, or maybe taking notes, maybe charting. And then after that, there's the assisting phase two, which is 20 births. And then after that is the primary phase, phase three, and it's an additional 25 births. Then also all along the way, you're counting your prenatals and your postpartum appointments and newborn exams and all the care that my wife does.

SPEAKER_01 9:56

So I'm really curious about what it's like to be a doula in when you're especially when you're in the room during the

Advocacy In The Hospital Room

SPEAKER_01 10:03

birth. What can you share about that?

SPEAKER_03 10:06

The being a doula is I am highly empathetic. And so I feel that served me really well in being a doula. You can really get to know your clients, and the goal is to understand their emotional state and their goals for their birth, so that you can just help them achieve that. And it then, if you're doing a hospital birth with them, you're also in an advocate role because oftentimes women will have things they don't want or want in their birth to happen, and the hospital has their um their plan for your birth. And so then it becomes very advantageous to have a dueler with you who can navigate that with you and help you reason with the doctors and talk through anything really that they want to do, uh as someone who's really actually taking informed consent seriously. And that's really important in midwifery care as well. I'd say it's one of the hallmarks is just really promoting informed decision making and not treating our clients as children who don't understand anything. And then at home, sometimes that has to happen like midlifes too, where a woman or a family needs to stand up and say, no, we don't want this. And that's becoming more common, actually, for people not to want cervical checks. And then it can be helpful to have someone there who's ready to, you know, have your back. Yeah. Why is it becoming more common? I hadn't heard this. Well, women are starting to realize that a cervical check really doesn't it gives information about the dilation of the cervix, but it doesn't necessarily tell you how close you are to giving birth. And so in a hospital setting, what will happen is you'll you'll go in, you're in labor, and uh you'll go in and the very first thing that they'll want to do is a surviv. And so it's a numbers game. And so really cervical dilation, it can be helpful sometimes to give information in certain scenarios, but oftentimes it just doesn't relate too much to how long they can't predict really how long until the baby's born. And so more women are becoming aware of that and are choosing to not have an invasive procedure done that is largely unnecessary.

SPEAKER_01 13:15

Yeah.

Pricing Marketing And Finding Clients

SPEAKER_01 13:16

How do you find clients as a doula?

SPEAKER_04 13:22

As a doula, I I think it's so community-based and it is for midwifery as well.

SPEAKER_03 13:31

It's a lot of self-promotion on Facebook, but everybody does everything on Facebook now. But much of it is, and that's still word of mouth, Facebook, really. It's just the community saying this is who we like, this is who we had a good experience with, and then recommending it.

SPEAKER_01 13:50

How do you decide what to charge for the that service?

SPEAKER_03 13:55

Yeah. Not I'm really not in touch with how much duas are charging nowadays, but for midwifery, it will range anywhere from I think five thousand to I think some people charge 10 to 12,000 for a birth.

SPEAKER_01 14:15

And that includes the pre and the post and the baby check?

SPEAKER_03 14:19

Yes, yeah, yeah, it'll include all prenatal care and then typically postpartum care up until six weeks after delivery.

SPEAKER_01 14:28

Nice.

SPEAKER_03 14:28

And caring for the newborn. And still only about one percent of the population has their baby at home. So it's a niche thing. And so what but to answer your question, what we've seen is the rise of the accredited midwifery school, and it's accredited by an organization called the Midwifery Education Accreditation Council me. Um, and so there are schools now, and when I first started, there's I don't know, maybe one or two, then there was no accreditation. And so that has become the standard for many entering a make accredited program, and they go through their it's called their didactic work, their basically their book study, and then find through whatever network the school has or they've created for themselves through their cohort opportunities for those clinicals. And also what a lot of people do to wrap up the numbers quickly is go to a hybrid, sorry, high-volume birth center, and you can get them quickly there. But I'm really doing a slower process. So I it's important to me that midwives are trained over at least a minimum of three years. I think that's been the average, three to five years. And then I believe even after that, a new midwife or a green midwife should still attend earth with an experienced midwife for some time, probably a year or two. Because I think of it as with we have doctors who have graduated from medical school, and we don't just boot them out into the world, we have them do a residency because there's just there's no way you can see everything that, and you'll never see everything, but at least be more prepared. So the meek accredited schools are there. I just happened to after I had my dream, and then I prayed about it and was looking for confirmation and felt I got it. And so I just started looking online at what midwives were in my area, and I saw that we had a new midwife here who had recently moved from another state, and I thought, surely she doesn't have any apprentices yet. And I was right. So she took me on, and I've been working under her and just getting to go to those births through her and her clientele. And they find her largely on Facebook or just word of mouth.

The Birth High And Relationship Care

SPEAKER_03 17:30

What's the best part about your job? Let's see. The thing I everybody talks about the birth high, which is really great, but really it's the foundation of midwifery, which is giving people an opportunity to have true informed consent, to have true decision making, to be someone who it's a collaborative effort. Midwifery is extremely relationship-based. So where you'll have a prenatal appointment with a doctor that lasts maybe 15 minutes or 20 minutes or whatever the case may be. And that when you know somebody, you also have a better feel when something steps outside the realm of normal. You know what somebody's baseline blood pressure is, and it's different for everybody, and it's not just so our continuity of care is based on that relationship, whereas the continuity of care in a hospital is largely based on the charting that they do, because you could get a totally different doctor for your birth than what you've seen throughout your whole pregnancy. And so that's I think probably the best part of my work.

SPEAKER_01 19:05

What's the birth high that you referenced?

SPEAKER_03 19:07

Yeah. Oh, okay. So yeah, being in a birth is it's like opening a portal to another dimension. It's a spiritual journey, and it's a transformation, it's a transformative experience. Even if a woman has be is becoming a m a mother for the eighth time, this is not the same as the last birth or the one before it. And and it's an honor to be there and to witness that and to help a woman through that. And the energy that is there is unlike anything else if you allow it to be what it can be. Um maybe a lot of that is adrenaline, but but it's nothing.

SPEAKER_01 20:12

Yeah, that's

Burnout Stress And Serious Self Care

SPEAKER_01 20:13

so cool. Well, what are some of the challenges about your work, whether as a jewula or what you're already seeing it's going to be like to be a midwife?

SPEAKER_03 20:21

Yeah. Well, even with how amazing it is, it's very difficult work. It's it often feels like you're sacrificing everything on the altar of midwifery in order to do it. So you're the point person for this person, for this woman, for this family, and it's their baby. It's so the responsibility can sometimes feel staggering, and there is an element cortisol and stress or PTSD that you have to deal with and be prepared, have a plan for how to do really good self-care. Yeah. After birth and between appointments. And that has been something that's been really important for me to learn in my apprenticeship. And actually, it's become a really good model for clients. Say this work has high value, I have high value, you have high value. Let's really value ourselves and make sure that we're as healthy as we can.

SPEAKER_01 21:34

What do you do for that?

SPEAKER_03 21:35

Yeah. So I this was I can't really overstate the shift for me in order to keep doing this work. I've had to institute regular chiropractic care for myself. Oh, I go do that twice a month, and I do a therapy called biofeedback. Therapy and I just do a lot of things in between, like salt baths and just being real gentle with myself, making sure that I have the tools on board, the tinctures that I need, not just my clients, to ensure that I can keep doing this work. Because actually, average burnout for midwives nowadays is between three and five years. So you spend all this time becoming a midwife. And then if you are not learning how to properly support yourself through that process, it's it won't last so long.

SPEAKER_01 22:44

So wow, that's a high rate of burnout.

SPEAKER_00 22:48

Yeah, it really is. I have a quick just a little pivot on you mentioned tinctures. You make your own?

SPEAKER_03 22:58

I have, but mostly I rely on store-bought tinctures. Yeah, I've really gotten into the Bachflower remedies, and I was really into homeopathy before that, which I still use, but I really like the Bachflower essences or remedies. They're very effective and they go, it's really interesting. It really honors the mind-body connection and the emotion between, not the emotion, the connection between our emotions and physical disease or dysfunction. And it's fascinating, really, how this become a soapbox for me.

SPEAKER_01 23:40

What do you find tinctures work best for? What do you routinely rely on them for?

SPEAKER_03 23:45

Like if there's something emotional going on, but even if uh there's some kind of physical presentation, like UTIs are extremely common in pregnancy. Like a pregnant woman can have a UTI no problem without even having symptoms, really. And so if you look at the root emotional causes of UTI, they tend to have to do with a lack of belonging and a lack of being able to mark territory. Those are the two really big ones. And so tincture of the flower remedies that have to do with that, I find are really ones that promote forgiveness. And and I've we've had good success with that, as well as using other natural remedies like vitamin C and garlic. It's it's pretty incredible what you can achieve.

SPEAKER_01 24:50

Yeah. How do you administer them? I don't know much about them.

SPEAKER_03 24:53

The backlower remedies are typically given you take them between two and four times a day, just four drops on a tongue.

SPEAKER_04 25:02

Four drops. Oh, okay. Yeah.

SPEAKER_03 25:03

Until symptoms are gone.

SPEAKER_01 25:06

Please. Is that helpful during pregnancy because you can't take antibiotics?

SPEAKER_03 25:11

Well, you can take antibiotics during pregnancy, but it's something that's more in line with midwifery care, I feel like, because we can't a nurse midwife is more has more access to antibiotics, probably, but but as midwives, we would have to send somebody to a doctor to get antibiotics. So we have a whole natural rec regimen that we do for the UTI.

SPEAKER_00 25:39

If you had, if you could wave a magic wand and change one thing about your industry, what would it be?

The Cord Clamping Story That Stuck

SPEAKER_00 25:46

Let's see.

SPEAKER_04 25:47

I did think about this a little bit. So it can be a magic wand.

SPEAKER_03 25:57

I think it would be the perception that seeking midwifery care is somehow irresponsible. So since obstetrics care is the norm now, it is a lot of times viewed by someone's family as taking uh an irresponsible step in the safety of themselves or their babies. So yeah, if I could change that instantly, I would because we it's a little bit crazy making because we pour everything into those relationships and ensuring as much as we're able to, there's no guarantees in either hospital birth or home birth, but bring what we know to the table, and I do research non-stop. So it we care and we care deeply about the safety and well-being of our clients. That is one of the main goals of midwitchery is to promote a sense of well-being. This is all about well-nourished care, and well-nourished moms create well-nourished babies. And when someone is well-nourished and not just food, but in their mind and the thoughts that they're thinking, the fear that they're experiencing, or the lack of fear, the outcomes are just so much better.

SPEAKER_00 27:43

Now, this is the juicy part. What is the wildest, weirdest, or most unforgettable thing that you've witnessed at any of the jobs that you've had?

SPEAKER_03 27:52

Yeah. This happened a hospital birth that I was at in my observed phase. So in the observed, the first phase to become a CPM, two of the births have to be planned hospital births. And so I did work as a doula in the hospital. And for one of those births, the woman wanted delayed court clamping, and she had conveyed that to the hospital, to the doctors. It was in her chart. And what happened was very different. So, and I only saw this because even no, I was there as her duelist. She had her mother there and a sister there who were on both sides, and I felt I just wasn't really needed right there, crowding that space. So I was more down where the doctor was. And after the baby was born, he called out delayed core clamping, and then immediately clamped and cut the cord. And so what this means is that delayed cord clamping for a hospital or a doctor has a very different definition than what most women are thinking it means. Most women, when they say they want delayed cord clamping, means they don't want the cord cut until it has gone white and is not bathing anymore. So therefore, it's not delivering any more blood to the baby. So when the baby emerges, the baby is squeezed. And as the baby is squeezed, the baby's blood is squeezed back up into the placenta, which is still inside the body and attached to mall. And then after the baby emerged that means a third of the baby's blood volume is in the placenta when the baby is born. And so people who want delayed cord clamping, what they're saying is they want their baby to receive all of their blood. They want that the pressure to normalize and the baby's blood pressure and for that blood to start flowing back to the baby so that they get all of their blood. So what that taught me is that you have to be very specific about definitions of terms with your care providers. And it traumatized me a little bit because I felt it was very sneaky. And but because he called out delayed cord clamping, it's on the record.

SPEAKER_04 31:02

Wow.

SPEAKER_00 31:03

Oh, I can't even imagine.

SPEAKER_03 31:05

That's just yeah, I know it hurts your heart. Yeah. And with me, part of my work as a duo too was always to preserve the memory of the mother, the mother's memory of the birth. And so one thing I would always do as a duo is I would be taking notes throughout the birth for what happened when, and then put together a cohesive narrative to give to her afterwards. And so I really didn't know what to put down for that. I didn't know if she wanted to know about it, or I just thought, okay, I'm just gonna hold space for this memory. I'm gonna let her know that something happened, but I didn't know if she wanted to know about it in this early post-parton period. But if she ever had a question about it later, she could come to me and we can talk about it. Did she? No. I guess she was happy with everything that happened. And so uh it's not my place to come in and mess with that. It's not your place, but yeah, here you are carrying it. Yeah, exactly right. And so that's a big part of this work is carrying things for people, and you have to learn how to I I don't want to say compartmentalize, but maybe that's a part of it.

Counting The Costs And Closing

SPEAKER_03 32:29

If you're thinking about becoming a midwife, you really have to count the costs for the toll it takes on your family. And you being gone for a long time. I sometimes there's stretches where there's births back to back and you're not home for days.

SPEAKER_01 32:48

And what else should someone know if they might be thinking about going into your field?

SPEAKER_03 32:55

I think the burnout reality is something to really consider. And definitely need to think about putting strategies in place to care for yourself, to even if you don't know how to do that, be thinking about what you'd like to do or looking at different options before you even start. I I think that's a really good tool to begin a negative apprenticeship with that already in place. Because I didn't necessarily start with that having that section in mind, and I took some hits because of it. So I helped it. The stress and the hormone releases definitely takes a toll on the body.

SPEAKER_01 33:48

Yeah. How has this time around been different than when you first started the process and decided to put it on pause?

SPEAKER_03 33:56

I am much more mature now. I was keenly aware in my first apprenticeship that I hadn't had children yet. That that was a disadvantage for me in knowing what the woman was going through, what she was experiencing. So I am able to bring that experience now. And yeah, I think it's just maturity, really. And also I'm now the head apprentice. So it's and not that I lured that over people apart from it. I welcome the extra hands and extra help. It's it, but it feels good to not be the lowest down on the totem pole.

SPEAKER_00 34:44

I'm curious, you say the lifespan of work is up to about five years. So have you thought about what happens after your five years?

SPEAKER_03 34:53

Yeah, I'm just anticipating that I'm setting it up to where after I license, I am just gonna continue practicing with my preceptor, my teacher, and essentially be in a group practice with her. And I don't plan to just go and strike out on my own and deal with all that stress on my own. And I have put a great deal of work into setting up all my coping and putting myself back together strategies. I have become really passionate about preserving the traditional art of midwifery, and I do feel that this is something that has been a bit lost in the rise of the accredited midwifery schools. They're much more and that can be an asset, but it also can be a hindrance. And so I really feel passionate about becoming more of a traditionally minded midwife and being able then to hopefully pass that on to students of my own someday.

SPEAKER_00 36:12

We want to thank you for sharing all the stories that you had with us. And you've officially joined the ranks of the brave and the bold. Awesome. Thank you so much so much.

SPEAKER_01 36:27

That's it for this week's confession.

SPEAKER_00 36:29

We've laughed, cringed, and maybe questioned our own career choices. Big thanks to our anonymous guests for keeping it real and reminding us that behind every job title is a story worth telling. If you've got a workplace confession of your own, we're all ears. Hit us up at our email address. And don't forget to subscribe, rate, and share. Your support helps us keep the secrets flowing.

SPEAKER_01 36:51

Until next time, keep your badge clipped, your coffee strong, and your stories wild. This is Workplace Confessions Behind Closed Doors.