Monday, March 30, 2009

Where are we going, and why am I in this handbasket?

One of my AAMI assignments and suggestions for Phase 1 is starting a journal of my birth-related experiences (check) to chronicle my growth as a midwife (check). What brought me to this point (check) and where am I going (uncheck).

So, where am I going.

I sincerely hope that I'm going to a place where I can practice midwifery legally, and that the restrictions placed on my license are appropriate within the scope of the midwifery model of care, and not difficult for either me or my clients to follow. I would like practice somewhere where I can legally do VBACs, twins and breeches.

This location may not actually exist. (It might be Texas or Oregon.)

I realize that I'm answering the question very literally, like what specific place do I want to go and practice as a midwife. What I really want is to be able to follow the midwifery model of care. I'm not sure that a place where I can't handle breech (which is a normal variation) is really a place that supports the midwifery model of care. Same with VBAC. Twins, well, maybe. I realize that some twins can be more risky, like MZ mono/di twins. But DZ twins usually aren't very risky. I wonder what the Cochrane Database says about DZ twins and midwifery.

To answer where I want to go: I want to be a midwife. I want to understand normal physiological birth. I want to know enough about complications to be able to handle them calmly, or know when and how to transfer to the appropriate medical facility. I want to be able to help clients prevent complications to the best of their ability (whether they choose to do so or not) and treat pregnancy-related issues in a holistic way. I want to know. I want midwifery-related concepts and ideas and physiology to be second nature for me.

In order to do this I'm going to have study and learn learn learn. Despite being a doula, it really amazes me how little I know about midwifery. I (happily) turned off my brain when it came to midwifery (or obstetrics) because it was outside of my scope as a doula. Now my scope is changing and I feel like a total moron! I have absorbed practically nothing in years of being around pregnant women!

I feel like such a beginner that I kind of disbelieve that I'll be able to license as a midwife in three years. It doesn't seem like enough time to get me from here to there. (Seriously, did I mention I'm a moron?!?!) Maybe in some ways I know more than I think, but I don't ever want to be cocky about what I know anecdotally to be true, that might not be backed up by science.


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