The Root of Midwifery
American College of Nurse Midwives
Hallmarks of Midwifery- The art and science of midwifery are characterized by the following hallmarks
A. Recognition of menarche, pregnancy, birth, and menopause as normal physiologic and developmental processes
B. Advocacy of non-intervention in normal processes in the absence of complications
Every day I feel so blessed to have been introduced to the fact that birth is normal, and that we should not intervene unless complications present themselves, long before I began my midwifery training. The hospital where I learned to trust birth was a bit unusual-we didn’t offer epidurals, only offered labor induction when medically necessary, and practiced the art of labor support beautifully. The nurses and doctors who trained me were so skilled at this, I never knew it was out of the ordinary until I left.
And then, when I became a midwife and left the hospital, the women at Alaska Family Health and Birth Center showed me how these ideas could be taken to a whole new level. The midwives here live out the recognition of birth as normal, and advocacy of non-intervention in the absence of complications, to an extent I never even knew was possible. Here I was taught to beautifully blend the art of watchful waiting with the evidence based and scientific skill of closely, meticulously watching for any potential complications.
I never dreamed that a place that blended these two so well could exist. A place where the midwives are encouraged and empowered to educate on normal throughout pregnancy, to offer reassurance and guidance to help couples navigate the mystery of pregnancy, birth, and parenting. A place where midwives are taught to keep a watchful eye on pregnancy while reassuring normal, and to carefully and judiciously recommend testing and interventions when things deviate from the norm. A place where the midwives are charged with respecting and protecting the quiet, holy space of birth, while continually assessing the health of both mother and baby, and guarding these closely.
I never dreamed there could be a place where one day we discuss the implications of prenatal parenting, and how the birth memories of the mother can repeat into her own birth story, and the next day we drill on neonatal resuscitation and birth emergencies until everyone present can perform the skills proficiently. A place where during chart review our counselor who specializes in perinatal mood disorders can guide us in providing trauma informed care to a woman with a history of sexual trauma, and the next minute we can discuss the skilled management of a postpartum hemorrhage with medications and emotional support seamlessly blended.
There are no words to adequately describe the sacred beauty of birth undisturbed. If you have given birth with a midwife or provider who understands this, you may know it intimately. You may know the quiet of a room punctuated only by a mother’s soft moans as she rocks through the contraction. You may know the complete reverence of parents who stare at the wide, blinking eyes of their newborn, uninterrupted by noise or staff intrusion. But unless you have been a midwife in such a space you do not know that they are guarding this time, while also watching intently, ensuring that the baby is transitioning well, ensuring that bleeding is normal, and that both mother and baby remain healthy and stable.
Non-intervention is reserved for when all is normal. When things deviate from normal, a skilled, attentive midwife will have both the knowledge and the equipment to intervene and guard the health and well-being of the baby as much as they guarded the sacred rituals of birth. These two things do not have to exist separately.
I feel blessed to work in a place where we all believe in both the art and the science of midwifery. Where we all believe in the glorious magic of undisturbed birth, but temper it with a healthy dose of reality, and the skills to manage complications when they arise. Birth centers seem to be the best place to find a beautiful union of these two ideas, and I am so grateful I have found one to set down roots in.
In faith, love, and gratitude,
“Core competencies for basic midwifery practice.” American College of Nurse Midwives. Dec. 2012. http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000050/Core%20Comptencies%20Dec%202012.pdf