How Being a Midwife Made Me a Better Doctor


I have many professional titles and roles: physician, midwife, herbalist, author, teacher. Of these, being a midwife most informs and enhances all of what I do and who I am.

Midwife literally means “with woman.” But it also means, “to bring forth.” Midwives listen, coach, cheerlead, care, reassure, support, and speak truth. At my best, I am a midwife in all contexts – not just to the women I serve, but to my partner, my children, my friends, my patients. At my best I bring forth their best – their strength, confidence, and belief that they can do it. And as a midwife I am able to be patient about whether this happens quietly or with loud screaming! At my best I am deeply present and listen closely to what the people in my life are telling me. And I listen to the unsaid, as well.

When I graduated from medical school at Yale I was given an award as the most promising primary care physician in my state for that year. This was not a result of what I learned during my medical education. Being a midwife for 20 plus years prior to medical training imbued in me the art of caring that should accompany doctoring but too often doesnt. As a physician I care for my patients with the compassion, deep presence, and heart of a midwife, whether they are giving birth or being treated for pneumonia, whether they are trying to nurse their newborn for the first time, or have suffered a stroke, leukemia, or are in their last days of their life. And because the demonstration of presence and compassion is more rare than common amongst physicians, it was noticed.

It is my understanding and internalization of the midwifery model of care, which places a partnership model and a patient-centered model first and which treats the body as wise and self-healing rather than as a machine that requires repair that makes me the physician I am. It is being a midwife that informs the care in the health care I provide to all of my patients. And it is this true caring that inspires me to do what it best for my patients, and to truly know who they are as people, not diseases.

I not only midwife my patients, but their families at their hospital bedsides and in clinic rooms. I care just as I would for an anxious expectant father or other children at a birth. I bring the whole family in.

One evening a young woman came into the hospital in imminent labor with a 28-week pregnancy. It was the mother’s own birthday. She’d been out to dinner with her family to celebrate when her water broke and she began having back-to-back contractions. She arrived at the hospital “feeling pressure” and was found to be 9 cm dilated – nearly complete and ready to push. The baby was coming fast, and given it’s small size, didn’t even need full dilatation to emerge. We were in a small community hospital unequipped for the care of a severely premature baby, so it was quite a chaotic scene – trying to stall an imminent birth and arrange medical transport for the about-to-be newborn.

Obstetricians, nurses, and neonatal care specialists were frenetically running in and out of the room and the woman’s family had been brusquely asked to wait in the hallway outside of the delivery room. There were so many harried care providers in the room that my assistance at the birth was superfluous. So instead, I turned my attention to the laboring woman’s very scared family – her parents, sister, and best friend, explaining in detail what was going on, and what would happen – that mom was fine, baby would be born any minute and would be resuscitated as needed, and transported to a higher level care hospital. Mom could go with baby, and they could accompany her. I apologized for the chaos, and reassured them that I would keep them apprised. For the next 30 minutes, I did exactly this, stepping in and out of the room periodically to provide reassuring updates.

After baby was born (he was healthy and ultimately did quite well) and safely transferred to a larger facility, and the family was getting ready to leave, the sister came up to me. Unbeknownst to me, she was a hospice physician at a major hospital. She told me that what I had done was the most compassionate care she’d seen, and she wanted to commend me to the hospital. I thanked her and told her this would not be necessary. Isn’t this what midwives do? Care for the whole family?

To be a midwife requires one to step outside of the confines of self and selfishness. To be awake and present and loving and creative and generous and trans-personally connected even when we would rather be in the comfort of our own beds, deep in our own private dreams. It requires one to become truly present with those in our care. Being a midwife allows us to go deeper into the primal relationship of being human than any other experience – other than perhaps hospice, which comes close, and being a mother, of course.

It means letting the fears, dreads, concerns, worries of another wash over you and allows you to take all of these and spin them into a neat ball of confidence, courage, and grace that you hand back to the woman – and remind her that this was hers all along. And it is having a strong enough sense of self that we take no credit for the success of those we’ve midwifed – we are happy to be the invisible wind beneath their wings.

Midwives, in our professional roles, truly see everything life has to offer. We see sorrow, joy, triumph, suffering, loss, and ecstasy, and we see women work so hard it makes our own teeth clench just to watch. We see birth, death, and everything in between. I have comforted women in the hours of a miscarriage, through news of a late pregnancy loss, when an older child in the family is dying of brain cancer, when the story of their child, drowned in a pool accident years before resurfaces at the time of birth, when tormenting memories of child abuse, long buried, resurface in pregnancy, when a husband’s on-going extramarital affair becomes known weeks before a woman herself is about to give birth to same husband’s baby. And we know the intense resilience of the human spirit. We see people go on. And this is a powerful gift in our own “going on.”

We go to homes where there is not a clean surface in site and accept that cup of tea and drink it, regardless. We suspend judgment. We clean the house, wash the dishes, throw in a load of laundry.  Sometimes we do deeper cleaning too — of the heart, the mind, the soul.

We know that the woman’s story is all important to her pregnancy and birth experience and outcome. Unlike many physicians who generally tend only to the physical, we go deeper into the lives of our families, and are witness to aspects of the human experience that few know, in the intimacy of this process that is pregnancy and birth process. We translate this into all of our relationships. And we know when to suspend “being the midwife.”

I am so pleased to see midwives coming into popular cultural consciousness with deserved respect – midwife Ina May Gaskin winning the Right Livelihood Award, midwife Robin Lim being recognized for her work in Bali with a CNN award, Call the Midwife, the popular BBC series being aired by PBS and receiving popular acclaim. This world needs midwives – to care for women in childbirth – and to care.

I would love to hear stories about your experiences with a midwife.

Love,

Aviva

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Mariah Plumlee

THANK YOU FOR WRITING THIS. My first experience with a midwife is chronicled at the above website. I have been a fan of your for a long time, and it is a pleasure to get to see you on Facebook so often.

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    aviva romm

    Thank you so much Mariah! <3

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Sarahn Henderson

My friend, my sister, my teacher. You've wrapped it up. Now I like to have a pot of warm light soup ready for a mom after she gives birth. How soothing and healing it feels.... I love every bit of who you are, i wanna see you soon too! OK?! Mama Sarahn

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Sarah

Thanks - beautifully put. I had my first five children assisted by my lovely midwife, and my sixth baby (my first son!) assisted by one of her previous apprentices. Such amazing women! They never attempted to own my experience - the power and majesty of birth were mine to fully embrace. I learned from each and every birth something new and deep and immense about my own power and ability as a women, and I truly credit them for creating that safe place for me to experience that. Yay for midwives!

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Jennifer Margulis

I cried reading this. Compassion and communication make such a difference. Thank you for remembering that family in their time of crisis. If we can combine our excellent emergency services with a gentler and more compassionate way of helping people -- as you do in your practice -- we can make childbirth safer and more enjoyable.

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    aviva

    Dear Jennifer, Thank you so very much. Truly, my momma-midwife instinct just kicked in ...There is, thankfully, some terrific work happening in hospitals around dying -- there are amazing doctors and nurses working together to allow easier, natural death. I believe more attention to the emotional needs of all patients is critical in the healing process. Unfortunately birth is too often treated as a medical crisis, which it is only extremely rarely - yet the emotional experience of many new moms is compromised in the misinterpretation of all birth as a medical disaster waiting to happen (as one OB actually put it to me). Great to have you as a sister reader! Your work is terrific. <3 Aviva

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Hannah

I feel so blessed to have found your website and this post! I am an LDR Nurse and base my practice around the holistic experience of birth, instead of "a medical experience or crisis" bless you! I have be struggling with the decision of whether to pursue a Family Nurse Practitioner or Midwife Masters to Doctorate role and your post has made me realize that no matter which I choose, my patients with always be "midwifed". Thank you for that!

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K. Michelle Doyle

This post is just lovely. Lovely! For myself, as a midwife, mother, friend, business owner, cranial sacral therapist, teacher, writer, cook, artist... it is midwifery that colors everything. Just like you said "Of these, being a midwife informs and enhances all of what I do and who I am." Thank you, Aviva.

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Dassa

Thank you Aviva and thank you God for leading me to this post. How I needed to read it... I'm a CNM for four years and yesterday I felt acutely the pain of my role not being understood. Some days I feel like all women want to know is what if...what if I need an emergency c section....what if my pregnancy suddenly becomes high risk...isn't it an unsafe choice to use a midwife? So I decided that's it! I'm going to medical school so I can actually practice midwifery...so I "googled" midwife become doctor and I read your post. It was SO healing for me. I REALLY can't go to med school as I have six little kids. I need to remember that I offer valuable, safe, care and I have awesome days too! Thanks Dassa

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    aviva

    LOL! We really need midwives -- so own it strong and proud sister! I would not recommend going to med school with 6 little kids unless you can't sleep at night unless you do go. And if you were to go you definitely would never sleep at night, so see? You're doing just the right thing! Keep tuning in to the website and FB for support for who you already are!!!! <3

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Karin Fink

Dear Aviva, it has been a long time now, after reading many of your posts, that I have been meaning to write to you how inspiring you and your practice as a midwife and doctor are to me. I have never taken the midwifery path before, although I was blessed with fantastic midwifery care in all aspects that you describe for the birth of my second son. After this, I trained as a birth doula and have volunteered for several years. And then, in my 30ies, with two kids and after pursuing endless years of scientific graduate studies, I decided to go to medical school. I call myself "midwife in disguise" and my goal is to bring some of the wonderful midwifery quality into my future practice. I don't know yet in which field I will find myself one day, but you are so right....a caring, compassionate, patient-centered care is needed just anywhere, in so many different contexts, and will serve anyone, patient, family, friends. And I know you already know this but: Midwives rock! XOXO Karin

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Barbara Sinclair

You (and the precious others like you) are the bridge we so desperately need between Western medicine and everything else - complementary, alternative, holistic, etc. Thank you, Aviva, and keep shining your brilliant light! :)

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Genny

Dear Aviva, thank you very much for this post. Your post have given me more courage to move on and choose Midwifery to be my program of study and career. I have been confused on what career pathway to choose that will give me more knowledge and stepping stone to Medical school. Most of my friends seems to discourage me for choosing Midwifery but your post is life directing. Thank you very much.

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    aviva

    Midwifery is the most wonderful careers ever. I have never regretted my path and it has made my life so rich... Wishing you as joyous a journey.

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Cassie

This is a really great perspective! Thank you! As a nursing student finishing up soon, I'm keeping the idea of midwifery in my thoughts as a potential next step down the line. I just love the idea of providing care to everyone involved, in a holistic way.

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tina nebergall

what an accurate and beautiful description of all of the facets of being involved in the care of women ,families ,and babies.. AKA ..Midwifery

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Loretta Rappos

I just loved reading your beauty-full account of the many roles of a midwife, extending outside the hospital setting and how special each and everyone is, especially when they nurse and care from the heart. Midwifery is such a rewarding profession, the more you surrender to the situation and allow, you are given all the tools to deal with what is needed in the moment. Universal support is always available. The magic of God happens in many situations.

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Obi

Aviva, this is absolutely inspiring. Amazing.

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Michael Newman

My wife and I had our first Beautiful baby in Michigan back in 1999, We looks very hard for a midwife in our area until we found one we were comfortable with, we were very fortunate to come across Aviva Romm. Thank you Aviva, Our Beautiful Daughter is now almost 18, healthy and she has a Brother. In fact when we visited you in your then new home in Georgia we conceived her brother, we had him in a birthing tub. Will always be grateful. Thanks again Michael.

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