Apprenticeship, working with a midwife in a helper role, being able to help more and more as you get experience, is the most direct and, in my opinion, the absolute best way to learn midwifery.
The greatest teachers we have are the women we serve. It is through continuity of care that you get to know the uniqueness of each motherbaby. By observing your senior midwife ask questions, talk to the baby, palpate and the many other lovely experiences of prenatal visits, apprentices learn the most. It is through getting to know motherbaby prenatally that you can best offer your help at the birth. It is important to work with more than one midwife or midwifery practice so you can learn different ways of working but maintain continuity of care, which really is the humane approach to birth.
So very much of birth is in the mind. Many of my midwife friends have stated that if you get the prenatal course right, you are almost assured the birth will go well. The mind of the mother is most important, but if the midwife undermines the woman’s confidence or puts negative thoughts in her mind, the midwife bears responsibility. I think we are seeing more and more of this, as midwives bend to protocols that do not follow the midwifery model of care, such as the myth that you must have a baby at 42 weeks. (See my editorial on dating a pregnancy here.) Oh, how subtle birth is. To learn great prenatal care, apprenticeship is the best model. To learn birth care, apprenticeship is the best model. The same goes for postpartum care!
Didactic learning is important, too, and can be done along with apprenticeship to bring alive what you learn, seeding you with new ideas and insights. Books can also be an excellent resource for self-starters. Elizabeth Davis’s “Heart and Hands: A Midwife’s Guide to Pregnancy and Birth” is a great starting point. Elizabeth also runs a school, and there are many others, at least in the United States, that student midwives are enjoying. A few of my Facebook friends have shared their positive experiences with midwifery education. Homebirth midwife Celesta Rannisi said, “I cannot tell you how much I appreciate Ancient Art Midwifery. They are truly the last of the real homebirth midwifery training that is not polluted by the medical model of midwifery, not to mention it is very reasonable. … I studied the apprentice academic curriculum back in the 80s and still keep learning the real meaning of midwifery through the writings and sharing of truth. And Erika Obert posted, “Michigan School of Traditional Midwifery is the same way. Excellent academics and traditional philosophy.”
There are many others. I recommend you choose your program carefully. What goes into your mind when you are an aspiring midwife is ever so important and I personally want you to be the best midwife you can be, truly in service to motherbaby! To get you started in your journey to midwifery, check out two of our resources: Becoming a Midwife page and our book Paths to Becoming a Midwife.
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
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Domestic Violence and Birth Outcomes
A new study conducted by a researcher at Malmö University in Sweden concludes that midwives “need both updated knowledge and tools with regard to abused pregnant women who are victims of domestic violence.”
The study, which included 2652 first-time moms, found a link between experiences of violence (as well as alcohol consumption) during late term pregnancy and a higher risk of labor dystocia. This link was not found at full term. Labor dystocia, or slow, difficult labor, is responsible for half of unplanned caesareans and has a significant impact on labor outcomes.
Statistics show that between 1.3 to 11% of pregnant women in Sweden experience physical violence, and previous research reveals that a high percentage of midwives never disclose violence against the women they worked with. Finnbogadóttir, who was inspired to conduct the study based on her own clinical experiences as a midwife, hopes her work will draw more attention to the problem of domestic violence during pregnancy.
— “Domestic Violence and Pregnancy.” Medical News Today. April 15, 2011. http://www.medicalnewstoday.com/articles/222450.php
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Types of Midwifery Training: An Anthropological Overview
Apprenticeship learning involves the whole human being—body, emotions, mind, spirit—and therefore is the most powerful form of learning there is. We all learn to be full members of our cultures through this kind of experiential learning. Pure apprenticeship learning is connection-based, as opposed to didactic learning, which can seem to take place in a vacuum, with no apparent connection to anything. If the apprentice attends a birth with her mentor, for example, during which the woman hemorrhages, the apprentice will spend the next day studying every book she can find on postpartum hemorrhage and quizzing her mentor about its management. She knows, in an immediate and visceral sense, why this knowledge matters.
Because birth turns out well most of the time, apprentices attending home and birth center births usually are not exposed early on to pathology, and have the time to build up a profound trust in the process of birth and in women’s ability to give birth. Their training gives them a much broader experience of the wide range “normal” birth can take when it is not technologically controlled. The establishment of this kind of trust can have a great deal to do with the relationship between the apprentice and her mentor. I have interviewed a number of apprentices and mentors around the country, and am always impressed by the special quality of their relationship. Most mentors care deeply about the apprentices they take on, get to know them intimately, become committed to making sure they obtain the best education possible, and work to bolster the student’s trust both in birth and in herself as she learns.
To fear birth is to generate complications that result from the fear. Midwives who trust birth profoundly tend to help women give birth more effectively: to trust a woman to give birth is to help her trust herself—this is part of the magic and the great strength of apprenticeship training. Another part of that magic and strength is continuity of care. In high-volume programs, continuity of care can be very hard to achieve. But it constitutes part of the essence of apprenticeship training, where the student accompanies her mentor not only to the birth of a given client but also to every prenatal and postpartum visit. It is apprenticeship training that establishes the midwifery ideal for continuity of care, an ideal that other training programs do the best they can to emulate.
As Wells indicates above, pure apprenticeship training, which includes few didactic elements, is increasingly rare. Today’s apprentices are developing experiential trust in birth and learning continuity of care in the context of semistructured curricula that their mentors design to make sure the training meets the standards set by NARM. These curricula include a tremendous amount of reading and often involve weekly classes taught by midwives in their communities, which may be supplemented with college courses in the basic sciences and other relevant areas. Many apprentices complete their training by working in high-volume clinics in the United States or the Third World where they can be exposed to multiple complications of birth and can learn to deal with them effectively.
An additional benefit is that apprenticeship is both financially and geographically accessible. Women who do not have the money or the mobility to attend a private school or university-based program can still learn how to be competent practitioners and build an economically viable business to support their families while serving their communities.
— Robbie Davis-Floyd
Excerpted from Paths to Becoming a Midwife: Getting an Education, 4th ed., Midwifery Today.
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Learn from Expert Midwives.
Wisdom of the Midwives, the second volume in the Tricks of the Trade series, is packed full of useful ideas and techniques. You’ll learn about counseling as a tool in your birth kit, nutrition and healthy birth, herbs, homeopathy, Chinese medicine, premature rupture of membranes, first stage and more. Order the book.
|Witness an inspiring homebirth.|
When you order the new and expanded "Birth Day" DVD, you’ll receive the original eleven-minute documentary as well as ten additional chapters. Narrated by the baby’s mother, midwife Naolí Vinaver Lopez, the heart of this DVD is the birth of the family’s third child and first daughter. The new material includes additional footage of the birth, moments of family bonding and interviews with the grandparents, the midwife and others. Birth Day will help parents and practitioners alike understand the true and sacred meaning of birth. Click here.
Learn the essentials of supportive touch.
In Touch Techniques for Birth, Leslie Piper, LMT, and Leslie Stager, RN, LMT, show you how to make touch a part of your midwifery practice. You’ll learn about contraindications, acupressure, reflexology, hydrotherapy, general comfort strokes, pain relieving techniques and more. A special feature includes a midwife’s story of the use of belly rub and emotional support to encourage labor. This DVD belongs in your midwifery library!
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If you do, you need Midwifery Today’s Second Stage Handbook. This book explores how to best serve women at this crucial stage. You’ll learn from expert practitioners as they reveal their observations on when to push, what works and choices available for the mother. The Second Stage Handbook is part of the Holistic Clinical Series. Order the book.
Web Site Update
Read these reviews from Midwifery Today newly posted to our Web site:
- Wind in the Blood: Mayan Healing and Chinese Medicine—by Hernán García, Antonio Sierra and Gilberto Balám, translated by Jeff Conant
Excerpt: The three physicians, involved in rural health promotion in [the Campeche and Yucatán regions of Mexico], noticed a system of traditional beliefs and practices used by the curanderos surrounding the diagnosis and treatment of disease which the doctors, trained in the Western medical model, could only begin to understand when they used the “Chinese theoretical system as a lens through which to study tradition.” They then encountered concepts of the human body, of disease and health and the balance of opposing forces—ways of explaining the world—that allowed them to understand the shared information, while also allowing the Mayan healers to feel their system was understood and valued.
- Sleeping with Your Baby: A Parents Guide to Cosleeping—by James J. McKenna
Excerpt: I have shared the family bed with my daughter since she was born, believing that it was the best choice in my situation. James J. McKenna, a widely-recognized expert in co-sleeping, confirmed that belief in Sleeping with Your Baby.
- CALMS: A Guide to Soothing Your Baby—by Carrie Contey and Debby Takikawa
Excerpt: …Contey and Takikawa offer parents tools to help them learn to communicate with and calm their babies. The book also presents infant development information and narratives on how parents have successfully used the techniques. CALMS presents the refreshing perspective that children are meant to be respected and honored “right from the start.”
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Make the vision of natural birth available for all to see.
Ask your library to order natural birth and midwifery books for you. When a mother has more information about natural birth available to her, she can make more educated decisions about how she wants to birth her baby. Making requests is easy; here’s how.
Birth Wisdom from the Web
Editor’s Note: This issue’s Birth Wisdom comes from a Facebook discussion of the apprentice model.
I have recently been taken on as an apprentice. I am thrilled! One huge thing I appreciate about this midwife is that she encourages us to learn from other midwives…. I feel that this will be key to my being able to customize my learning experience to best suit my own desires, beliefs and goals. Being able to learn from various sources will broaden my learning and make me a well-rounded midwife. Hopefully, I will also be able to enrich her knowledge as I bring to the table things I have learned from others. She is humble enough to accept this, and strong enough to stand her ground when necessary.
— Kathy L. McRae
The art of midwifery is more than catching babies: It’s the knowledge of the structure and function of the human female—physically, emotionally, spiritually and scientifically. Apprenticeship is absolutely necessary in the development of a midwife to fine-tune her spiritual connection to midwifery and to master the skill set of her mentor.
— Brandy Harris
Apprenticeship is the only way in my opinion. Too many students come out of schools looking for a preceptor to get their clinicals in but then they discount what the preceptor has to say because they know it all from schools. As for me, I will never accept another student who has been to “school” for midwifery.
— Jennifer Rector
If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to email@example.com.
Think about It
Babies are astonishingly responsive to being “seen” and noticed when they are in the womb. Paying them attention, sending them love and actively imagining how they look, feel and respond on a soul level is rewarded with a very real sense of their appreciation. This appreciation is expressed not only with responsive kicks, but also with a feeling of well-being that emanates from them and is fed back to us through the invisible pathways of thought and a felt sense of connection in the body.
— Robyn Sheldon
Excerpted from “The Soul’s Knowing: Connecting with Our Babies in the Womb,” Midwifery Today, Issue 97
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