Somewhere along the line, hiring a home birth midwife has become synonymous with hiring one trained birth attendant who will be with you for every prenatal, your birth, and every postpartum. It's a one-to-one relationship that spans the entire childbearing year. This is part of the appeal: the continuity of care from the very beginning, the knowing for certain who will be showing up to catch your baby, and being well known and respected by your care provider. It stands in stark contrast to the obstetrical model, in which you see "your" OB for several 5-8 minutes appointments through your pregnancy, but may also see the many partners in his/her practice, and you still don't know who is going to show up on the day you go into labor, and whether you will have ever met him/her or not.
Rightfully, women are starting to say, "That's not good enough. I want and deserve better." This is true! And a good home birth midwife will offer a depth of relationship and quality of care that is unrivaled by any other option.
The flip side of that -- and the one you don't hear about often because midwives are passionate, devoted and selfless servants -- is the cost on a midwife's personal life. In addition to you, she is probably serving at least 2 other women (sometimes 8 or 10!) with due dates the same month as yours, plus all the women due before and after you. And she fiercely cares about each of you. But if she is the one and only person assigned to care for you and each of the others, there are some logical "consequences":
- she can't EVER turn off her phone.
- she can't EVER have an alcoholic beverage.
- she can't EVER make firm plans with anyone, not even her own family.
- she can't EVER take a trip to unplug and rest up.
- she probably isn't getting much sleep.
Most midwives are happy to do it. In fact, the thought of taking a day with her phone off can set a midwife into a tizzy of "But what if I miss Ms X's text/call?!". Your midwife loves to be with you. She loves to walk with you through every single appointment and the hours of your labor and birth. It is most sincerely a joyful sacrifice, and it's probably one of the reasons she chose to do the work that she does.
And yet burnout is real. Recent research on midwives shows an alarming array of ill effects on the mental, emotional, physical and relational health of midwives. Somehow, midwives have given the world permission to not give them room to be human. To rest. To process a difficult birth. To give their husbands and children undivided attention. To travel. To know for certain that they can get a full night of sleep now and then. It's not your fault. Midwives themselves have been active in shaping and writing this script because they so badly want to offer something better than what you've had, better than the medical/obstetrical system can offer.
But what if. What if we can write a new script together? What if there can be a middle ground, one that gives both midwives and the women they serve something that is healthy, sustainable, and satisfactory? We're dreaming about how it can be possible.
In our next blog post, we'll be unrolling a plan, which we are very excited to share with you. Stay tuned!
