Wednesday, February 16, 2011

A Good Midwife

Today I stumbled upon an online debate over different views of midwifery. As commonly happens in arguments each side seemed to think it was all or nothing. You must either believe totally in the rightness of their side or you were evil; a danger to your unsuspecting clients.

This got me thinking. As a doula I have been in the unique position of watching many different midwives and doctors working with birthing women. I have been present in hospitals, homes and a birth center. I have listened to women grieving and traumatized by their births. Contrary to popular homebirth myth these did not all happen in hospitals. There are times when women suffer terribly after their homebirth. Sometimes they are speaking to me during those early postpartum weeks and sometimes it is years later during their next pregnancy.

After listening and watching here are some of the things I believe makes a good midwife no matter where she practices.

A midwife needs to know when to keep her hands out of a client and when to put her hands in.

A midwife needs to have the ability to be patient, to move slowly and carefully and the ability to move quickly, decisively and without hesitation.

A midwife needs to absolutely trust birth, and a woman's instincts and birth intuitions, and yet be skilled enough to know when a woman needs guidance.

A midwife needs to know how to let the laboring woman be center stage, the lead in the play, while she is prepared to step in as needed in the supporting role, as the hero or just make a cameo appearance.

A midwife balances equally the importance of the mother's experience with the mother's and baby's safety.

A midwife needs to know when to lead and when to follow.

A midwife needs to know the depth of the waters she is swimming in and is prepared to transfer care when she is out of her depth.

A midwife needs to know how to guide without taking over control.

A midwife needs to know all the variations of normal, what they look like, what they sound like, what they feel like so she can help her clients be unafraid.

A midwife needs to know how to help without rescuing. A midwife needs to have the skills and character to rescue when it is needed.

A midwife needs to be skilled at suturing tears and vigilant at trying to prevent them.

A midwife needs to be able to monitor the health of the mom and baby through skilled and timely assessments, heart rate, blood pressure, and temperature without interrupting the flow of labor.

A midwife needs to understand every birth follows its own unique timeline and plan and that sometimes that plan includes transferring care or surgical birth.

A midwife needs to create a relationship of trust with her clients and has a responsibility to not break that trust.

A midwife needs to be able to speak to both the instincts and the intellects of her clients.

I have a deep respect for all the midwives I have watched supporting, guiding and sometimes rescuing my clients over the years. The work is complex, physical, emotional and draining. When births go as planned the midwife will be an adored friend for life. When births aren't the fantasy a woman imagined, the midwife will be blamed forever. It is often very difficult for the birthing woman to grasp all the pieces of what happened and why because she was in the thick of labor. Without real understanding, it is natural to blame the person she imagined was to keep all bad things from happening; the midwife. There are no perfect midwives, just as there are no perfect people. They are simply flawed humans with strengths and weaknesses just like the rest of us.

Thank you to Edana Hall, Brenda Ramler, Sandy Rodriguez, Tiffany Dietrich, Lisa Winick, Linda Seeley, Helen Cominos, and JoAnne Tarkington for devoting your careers to caring about women.

Do you have thoughts on what makes a good midwife? Comment here or email me:


  1. Elena wrote via face book: "Thanks Jennifer for a very eloquent expression of midwifery!"

  2. Beautiful Jennifer! You are so eloquent!