Thursday, January 27, 2011

When my mind wanders, this is where it goes...

Today I had lunch with a great friend. We don't do it often enough... and we really, really should do it more often. Hmmm... how to 'dub' this friend? She is full of awesomeness, a truly free spirit, a little bit flighty (like all free spirits should be), and just all-around fun, fun, fun. Let's call her, simply... Friend.

Friend and I have worked together for years... I was a new nurse, and she was the "seasoned" nurse (albeit, still a newer nurse --- but, she had a few years on me, so it all worked out!). She had a little guy who was a year or so older than my oldest Mini, and it seemed as we always had some common interests. Over the years - and many snacks, deliveries, and desserts - I like to think we've become pretty good friends.

(I'll interrupt myself here to say that I don't really have many close friends... or maybe I do. I don't know... what is a 'friend', really?? I think in the past year or two, this has changed a lot... I don't know. Anyway, where were we?!)

So, moving on. Friend and I are both moving towards the common goal of midwifery, but via different paths. While I am pursuing a degree in nurse-midwifery (CNM), Friend is going a slightly different route to earn a Certified Professional Midwife license. Basically - from my understanding (and I would love to be further educated, so please let me know if I have this wrong!) - Friend is learning from "the best", a very well-known and well-respected CPM or "lay" midwife in the area. This midwife has been doing births in our area for the past 30 years, and has welcomed hundreds (if not more) of healthy, beautiful lives into this world in the warmth and love of their own homes. She is active in the midwifery community and - I can only imagine - a wonderful source of perspective and learning for Friend. So while my education is coming from a variety of sources, primarily distance-based (online) until my clinical rotation finally started a few months ago... Friend has been immersed in midwifery since deciding to take the leap into apprenticeship.

There's pro's and con's, certainly, to each method. She's been able to attend births as a midwife - and get her hands (and her brain) - on those delicious, slippery babes from the beginning; I have had to wait until getting successfully past all of the theory behind the birthing. I've had a large community of support from fellow classmates and those who've come before me via my school's online forums; Friend has been cocooned in the intimate circle of the two CPMs that she has been apprenticing with. Friend's coursework is self-paced, whereas my program has traditional terms - with equally traditional (and stressful) deadlines, midterms, and headaches.

Our paths will also determine our future course (as is so often true). As a certified nurse-midwife, I will be - in theory - eligible to deliver clients in a hospital, birth center, or home setting; in my state, though, over 90% of CNMs attend patients in the hospital setting. Friend, however, will be limited to seeing clients in out-of-hospital settings (at least in our state).

This is where my mind starts to wander... I don't know that I am courageous enough to catch out-of-hospital births (that's a topic for another day) - but I like to think that someday I may be. When my mind wanders, though, I think about a modest clinic site offering prenatal and well-woman care, just outside of 'town' (our small town is around pop. 8500); a few exam rooms, a space for education, perhaps room to have a lovely display to sell some "nice" stuff that the kind of mamas that might seek out a midwife may be interested in - cloth diapers, breastfeeding supplies, etc. We could offer childbirth classes, breastfeeding support groups, and - possibly? - one or two birth suites adjacent to the main space; while (in my wandering self) I imagine most women opting for hospital births, Friend would also be available to attend home births, and the birth suites would be available for a birth center birth.

I don't know the logistics of any of this. I have no clue on the feasibility of it. In all honesty, it really is just a mind-fantasy, but such a sweet one. I don't know if Friend would seriously consider "joining the fun" - in the past, we have joked about starting such a venture... but how much was seriousness, and how much was jest is hard to say.

If nothing else... this all gives me a nice bit of something to start with for a lovely, 60-odd page paper that I need to write (and have yet to even start thinking about, by the way) this term, so that I can graduate this spring. Happy trails, on that happy note!


  1. I found it really interesting that you use the word courageous here to describe home birth, because my friends and I that have birthed at home always say that we think it takes true courage to try and deliver naturally in a hospital. :) I can certainly understand where training in the hospital and seeing all the high risk patients and bad outcomes mixed in with the low risk and good outcomes would make home birth seem... I'm not sure what word to use here... risky? foolhardy? too many variables?

    Anyway, I'm enjoying reading along with your adventures! And how fun to have a Friend on the "other side" of midwifery to be a sounding board. What a great resource you two will be to each other.

  2. ^^ i'm with the being courageous to birth in a hospital!

    anyways.. your mind could go on with so many great ideas for that! the birth center in denver have 3 birthing suites and offices, ect.. and their old 'exam' building is now used just for classes and activities.. they have a chiropractor that comes in 3 times a week and takes apts for ANYONE, breastfeeding classes, cloth diapering classes, ect. they even started their own herb garden this last summer. i wish i lived closer so i could work there!!

  3. i understand completely what you are both saying --- i LOVE homebirths and the philosophy (and evidence supporting them!), and yet as someone who's never been to one... there is still that fear of the unknown. birth is, of course, so very natural and normal down to its core - in the hospital setting, unfortunately, we almost strive to twist it into something abnormal. it is, truly, sad (for everyone!) that it comes to that.

    @carolyn --- that it exactly what i'm fantasizing about... an open, relaxed space. maybe a new office area? an old, renovated farmhouse just outside of town? one of the empty storefronts on main street? not sure exactly what the 'home' would be --- but i picture an exam area, a meeting area for new moms/babes (breastfeeding/new mama support - and dads, too, of course, lol), a little shop area for the things that you just can't *get* in this rural area but are really so wonderful to have (cloth diapers, slings, funky breastfeeding tops/accessories, natural/ecofriendly mama/baby supplies, etc). plus, of course, breastfeeding classes, childbirth/parenting/etc --- i dunno... maybe hypnobirthing or the bradley method. (i don't know that there would be a 'right' kind of education/method...)

    anyway, thank you guys for coming along with me! :)

  4. You don't know me..but I like to read your blog to see a nurses perspective toward midwifery since I'm going the (long) CPM route.

    From my experience, my CNM (who turned out to be a real nasty thing) had an office in a clinical setting. You know, the building that houses several different providers of different types and while they tried to make it cozy, it still had the hospital feel.
    My CPM (who I'm also going to apprentice with) has a studio apartment in an old mansion. It's like she opens her home to us everytime we go for an appointment and if you're lucky, you catch cookies baking in the oven. You can give birth there, or at home (like with a CNM) and there is a front room that would be perfect for displaying all sorts of "store" goodies.

    And (I know it's a small town..stay with me) what if instead of having a specific class, just providing a place for meetings? A cozy comfy place for anyone who wants to hold a class or meeting that is open to everyone.

    For future reference as well -- the loophole for many midwives to get around CPMs only being able to have a 1 room birthing suite is to create separate LLC's for each room and have a door that serves as a definite barrier. You could technically use a 3 story house for homebirths and just bill and do paperwork through one of the LLCs :)

  5. thanks for chiming in Randee! i love to hear the different perspectives :)

    the type of setting i have in mind is definitely leaning more towards your CPM's 'office' --- there are several abandoned (that sounds spooky - maybe that's not the right word! -- maybe i'll say historical looking?!) store fronts on our main street that i've always pondered the possibilities of. otherwise, there are definitely several big old victorian homes in town that would work... or a comfy, cozy farmhouse on the edge of town...

    And, a resounding *mmm* on the cookies baking (and/or hot apple cider?)... definitely.

    the 'classroom' or meeting space would certainly be cozy and comfy, with big plush chairs - not conference room type furniture - and lots of soft, warm things.

    and a fireplace. definitely, a fireplace...