I am a midwife and that is how I think of myself. As such, I proudly walk With Woman on the path through life’s cycles. I am a community based provider, practicing my craft at a free standing birth center. Caring for pregnant people and their families is a monumental responsibility. As such, I spent years studying and training to do this work. My training took place both in a classroom and at the side of women. Eventually, I earned a title, which happens to be CNM or Certified Nurse Midwife. Other midwives that I know spent years studying and training, both through books and at the side of women. These midwives also earned a title; CPM or Certified Professional Midwife. I do not consider myself better or worse than my CPM sisters or vice versa. I also realize that there are other midwives who consider themselves neither CNM nor CPM that are equally valid. They are different paths that each midwife chooses for her own reasons and seasons of her life. Sound simple? Apparently not.
Early on in my work towards this profession, I wanted to make connections and be with others who shared my passion. I was undecided on which path to take; CPM or CNM. I knew in my heart that I wanted to work out of hospital but I also knew that I wanted to be able to provide support throughout all of life’s cycles; menarche, early adulthood, contraception, pregnancy, birth, postpartum, breastfeeding, menopause and everything in between. I reached out to make connections, I spoke with CNM’s and I spoke with CPM’s, attempting to understand each path better. Eventually, I took the steps towards the CNM credential. My reasons were personal and practical. I was a single mom at the time and could not see how to make the CPM apprenticeship model work while supporting my child, whereas nursing school and then CNM training had a more defined structure that I could make work financially. Additionally, I liked the broader scope of practice available as a CNM. I was confident that I could hold onto my principles of holistic, natural, family centered care. I joined my local ACNM chapter and my state’s organization of home birth midwives, the beginning of my straddling of the worlds.
I was very excited to attend my first conference put on by the local home birth midwifery organization. I had finally finished nursing school, which is an ordeal unto itself, and was waiting to start courses through the Frontier School of Midwifery and Family Nursing (now known as Frontier Nursing University). Eager to meet other women who shared my ideals and goals, I started a lovely conversation with the first person I met. The conversation ended abruptly after she asked me who I was apprenticing with and I told her of my recent acceptance to Frontier. Upon hearing that I was planning to become a CNM, she simply walked away from our exchange in mid-sentence. A couple months later, I was at a meeting of the local ACNM chapter and speaking with a CNM. When I mentioned my plans to potentially start a home birth practice after graduating, I had an eerily similar experience to that of the one above. I will never forget these encounters; I was naïve in my understanding of American midwifery and the fracture between the types of midwives. I had known that there was tension, that the histories were long and varied. I had thought that through personal contact and openness I could avoid some of the conflicts. However, it soon became apparent that the wounds run very deep for many and are difficult to heal. To be clear, I have also met midwives of all stripes who are supportive, open and non-judgmental of each other. I have developed strong relationships with both CNM’s and CPM’s. Unfortunately, I am also aware of a certain mistrust from some members of each group. It is not easy to put me in a box, I am a CNM but I work out of hospital. In each midwifery world I travel through, this often leads to confusion. Most times, the sentiments are not overt but are very subtle; funny looks here and there, pointed questions and simply an avoidance of interaction. Often, I feel like an external observer in each setting, just outside the center. To me, it seems simple; I am a midwife as they are midwives.
Women come in all shapes, sizes, political leanings, cultural groups, religions and from all social classes. As such, midwives also come in all shapes, sizes, political leanings, cultural groups, religions and from all social classes. It seems only natural that there would be different types of midwives in this context. There will always be folks who want or need to birth in a hospital, they deserve midwifery care. There will always be folks who want or need to birth in their homes, they deserve midwifery care. Free standing birth centers can strike a balance between the two, and folks will also want that option, they deserve midwifery care. Should we judge the women? No? Then how can we judge each other for standing beside them in each setting?
In the midst of all this, I cannot help but ponder on the fact that all the fighting and negativity between midwives makes it easier for the mainstream establishment to keep us marginalized. If we could only come together, as a united force, that force would have the potential to be unstoppable. I can’t help but think that the Women deserve better, that the Babies deserve better. I have a challenge. My challenge is for each midwife, whether CPM, CNM or any other type, to heal yourself. Let go of the anger and the hurt, allow the wounds to knit and fade so that we can all better serve our communities. Reach out to your sisters across the aisle, lay the judgments aside. Let us all simply be midwives, together.
Image Credit Monet Nicole
This article originally appeared in Midwifery Today magazine, in Spring 2014, Issue #109