Elder Midwifery Student Project, Phase 2

Elder Student Project, Part 2: Interview with Marian*

For my interview with a Phase 2 student, a student I have never interacted with was kind enough to volunteer. Marian is nearing the end of her assist phase work, having just garnered signatures for her last assistant midwife numbers. She has also finished her year-2 clinic courses at Midwives College of Utah and is beginning to shift into a primary midwife role in prenatal visits. When asked what she is liking most about clinic right now, Marian shared that she is excited to be making real progress in both numbers on paper and in her skill-set. She said it is still a challenge not to be the one making the calls yet with clients and cited this as the biggest drawback of being a clinical assistant to a midwife. She craves the responsibility of being in charge even though she knows she is not quite ready to be independent as a practitioner.

Since I am just inching my way toward entering the assistant midwife phase here in Orange County, I was super curious about the logistics of balancing school and clinic. Marian was honest that this phase of midwifery education is just plain hard. In fact, this is the area in which she gave explicit advice to me. Marian said “Phase 2 brings different instructors who grade more rigorously at the same time as you are getting more responsibility in clinic, so you have to be gentle with yourself.” Marian feels so strongly that because midwife preceptors expect their assistants to do many tasks, be physically present a lot, and learn quickly, student midwives should expect to feel overwhelmed at the start of that relationship and therefore benefit from a slower paced course load. I was really interested to learn what Marian had done and learned in her time as a midwifery assistant, so I began asking her about her role and the path she’d been on thus far.

Marian lives outside the Orange County, CA area where very few midwives practice and fewer take students. Though she originally began assisting with a local preceptor, she ran into a lot of personal challenges in that relationship and knew she needed a change. So, in order to progress in midwifery school, Marian now travels over 100 miles each way to a bigger city where she works with two preceptors. She admits that though her preceptors are flexible with her, it does strain their relationship overall when she has to miss appointments or when quick labors are attended without her. The logistical pieces such as dropping everything to drive two or more hours for a birth have been a lot to handle. Upon reflection of our conversation, I feel grateful for the midwifery community that exist within a short distance of my home in Orange County as I know that if my first apprenticeship relationship does not work out well, I have other opportunities to explore.

Marian also disclosed that she has seen tremendous growth in herself over this long period. Whereas she once thought most people should try to have home births until/unless they risked out, she now believes in a more conservative approach about who makes for ideal midwifery clients. Marian believes that honest conversations around emotional, physical, and financial capabilities related to home birth need to happen early on in pregnancy. She shared that she now struggles to check her internal bias around midwives who choose to work with higher risk clients in home birth settings and don’t give thought to the potential ramifications for the profession and their community.

Marian closed our conversation with an overview of what I can expect as I move into a home birth or birth center assistant role. She recalled that at first, she was simply the person who used the dipstick in the urine of pregnancy clients and read the results to the midwife or another student midwife. She progressed to practicing pulse-taking and getting blood pressure readings in prenatal visits. Then, Marian slowly began doing some of the charting work and even got to ask questions in prenatal visits here and there.

At birth, she began as an extra set of hands for setting up and cleaning at the end. Over time, she became more and more responsible for the monitoring of the birther and the baby until she was at a place where collaboration and dynamic back and forth was possible with her midwifery preceptors. Hearing these memories of progression made me feel excited and hopeful more than anything else. Knowing a long road is ahead in my own path toward becoming an Orange County midwife, it was lovely to hear someone sharing about all that they have accomplished and all they are looking forward to still.

*Name changed for privacy. Interview occurred live in the Summer of 2019.

Amanda Cagle is a professional doula, educator, and student midwife located in Orange County, CA who offers comprehensive services to growing families and birth professionals alike. Amanda can be reached via email at yourbirthteam@gmail.com or through www.yourbirthteam.com.