The Midwife Conundrum

I've known for a very long time (more than ten years) that I was meant to be on the path to become a midwife. I had always envisioned being a lay midwife and had gone so far as enrolling in Ancient Arts Midwifery Institute, an at-a-distance school when I found out I was pregnant with my son. After an empowering homebirth I felt the need to find a way to support us and so, after much encouragement from my family and despite my own personal misgivings I began to pursue my nursing degree. Along the way I became certified as a doula and childbirth educator, I took a course in prenatal and postpartum massage, and tried to stay "true" to my trust in birth and love of homebirth.

Fast forward to the winter of 2004 when I received my ASN, let's not forget that I was a single mom, struggling to pay the rent, I needed my degree but fast! I spent six months on a high risk L&D unit in a hospital in St Louis, horrified by the nearly 100% epidural rate, the lack of family centered care, and the laissez faire attitude of the docs towards their highly interventive births. It did however give me greater respect for the need for heroic medicine when it was really necessary. It opened my heart to the tragedy of fetal demise, and I found that I was actually really good at caring for families who had experienced the death of their babies.

After moving home to Minnesota, I took a position on a midwife unit in a large metro hospital, and here I sit, feeling that I'm spinning my wheels, disillusioned by what should be a closer-to-homebirth setting, and feeling burned out by demanding management, high needs (and sometime high risk)patients, and lack of staffing.

I need to move forward. The question is...which direction?

As a direct entry/lay/certified professional midwife I'd certainly go back to my first love:homebirth. The problem is, I can't leave my family or ask them to move so that I can attend a school like Birthingway or the Seattle School of Midwifery. And I don't feel that I'd learn as well from an at-a-distance course like AAMI. Additionally, it's difficult right now to part with my considerable income. I know that I'm very fortunate to make this kind of money, and parting with one half of our income is simply not possible.

On the other hand, I could easily attend the local University's Midwifery program (after obtaining my BSN of course) and I could continue to work part while I did it. I could also receive a dual degree as women's health Nurse Practitioner/Certified Nurse Midwife, which would be great because I love well woman care and I'd be able to do all sorts of neat things like insert IUDs (fyi I am a big IUD lover!). Problem is, I have NO desire to catch babies in hospitals. None whatsoever. And practicing as a CNM doing homebirths in Minnesota ain't easy. We used to have a few CNMs who did them, but the political climate either pushed them back into the hospital, or out of state all together.

So I'm at the crossroads, wishing someone would read my future and tell me what path to take. But of course, no one can. I've got to find my own (very convoluted) path, and will only know years from now if I chose right. Though, there may very well be no right, only right for me. Who knows? I'll keep you informed.