S. Tenuta 10-21-24
Midwife, “care for the midwife first!” Every midwife goes to school and studies for hours and even years to become a midwife. Some go to schools that sprang up from community needs. Some go to schools that have names that resonate with their thinking. Some go to schools slanted toward traditional, intuitive, and practical care, learned through hands on or eyes watching. Some go to schools that are more medically slanted in their teachings. The skills needed for emergencies are learned by each person and the chosen parameter of midwifery service is set by each individual midwife.
No matter what the learning is for excellent midwifery care, the midwife must be consciously deciding the boundaries needed to remain in good health. If a midwife is solo, (with an assistant) it is important to spread out her birth commitments the best of her ability. Of course, no one actually knows when babies decide to complete their journey to earth, unless there are cesarean sections jotted on the calendar. Midwives do not perform cesarean sections in normal situations or inductions are their practice.
When a midwife accepts all women in her care in a certain area, she is jeopardizing her own health, thinking clarity, and the woman she serves. We know babies will come no matter what, but the midwife needs to be alert, in tune and intuitive to the situations. She needs to evaluate if her innate wisdom says, “yes this is a good birth for you to take on.” If the answer is no, the midwife, in wisdom, needs to be able to say “no, there is another person you need to find to be with you at labor and birth.”
Midwifery care includes, spreading out appointments and planning for certain activities throughout the week. There could be a special day for prenatal visits. There needs to be a day for post birth visits and breastfeeding checks. There needs to be time for classes about birth, the natural physiological process of birth. There needs to be a time to do exercise for self, to nourish one’s self, to contemplate and to notate. There needs to be time to take classes that keep the midwife current with certification and skills. These are all necessary for good midwifery care and for a midwife to care for self.
If the midwife has a license, there is lots of paperwork and money to manage. The paperwork includes being aligned with the state’s midwifery groups and laws. The paperwork includes birth certificate records, license renewals, keeping abreast of any medical changes in the doctor laws, as being a licensed midwife means following the guides of the obstetrician/ gynecologist. Then there are the NARM guidelines. If a person wants to remain in good standing with them, tests must be taken, money must be paid, record keeping is required and deadlines are to be met. There is also a MANA (Midwives Alliance of North America) board which makes an effort to guide all the midwives. This is a fine board, however, it can not manage the whole country, or the world. Every area of the earth has learned special ways to care for their mothers, and one organization does not carry all the wisdom all the time.
Hesperian aims to help people in 3rd world countries. Their books have lots of down to earth, practical care in them until recently. The book turned more towards the WHO guidance and now is more medicalized. It seems to carry more rules and regulations than earlier versions of the book. Regulations are good in themselves, but they are not so good when the procedures put limits on helping mothers have natural physiological births.
So back to the midwife care. Midwives must go inward to themselves and discover and identify what their own beliefs are about birth. They must determine if the boundaries set are limiting to their style of work or enhancing their calling and beliefs. If the work is being limited per their own education and beliefs, then they need to decide how to serve mothers and respond to their own calling best.
If the midwife follows all the rules and regulations, doing, doing, and doing the work, the paperwork, the classes, paying the money requested, and is happy about the situation of midwifery that she practices, then this is the best for her. If the midwife is not satisfied, or has an inner restlessness, it is important that she discover the source of that discomfort. When discovered, she is called to take action. If that means leaving the midwifery system as she saw it, then there are alternatives. There is a phrase in the bible: “Seek and you will find.”
Midwifery care is many faceted. To care for women, the midwife must first care for self, and this care means being in tune with personal beliefs. It also means having the skills needed to serve in case of emergencies or to have resources available in case a woman’s care must be transferred. It is being honest with self and being honest with the people being served. It is giving enough time to reflect, to process experiences and to be present in all instances and challenges and situations. Peace within the midwife, can spread peace within the birthing room. Calmness and trust in the birth process and in one’s intuitive wisdom, enhances the labor and birthing moments.
Midwife, “Care for the midwife first.” Then go out and spread your presence and wisdom, when called upon, breathing in the wonders of this profession with gratitude. This can happen when the midwife cares for herself within this beautiful process, calling and transformative observation of each beautiful woman during pregnancy, labor, birth and postpartum time.
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