My last two guest posts over at the ACNM have focused on what learning I have found in these first six months, on-the-job. This is learning that, I have found, perhaps could only be fully absorbed once I was working independently, and not focused on didactic or busy clinical rotations at the same time. More tangibly for me in the past few days, this is learning that could not be learned until I was truly able to have connections with my patients as their official provider, and no longer as the intermediate student.
I now feel differently about many things: about evidence-based practice, about the spaces and places where I provide care, and about the flexibility I have learned to apply to each person’s needs and to my own understanding of the type of midwife I want to be. I wrote these posts and share my experiences not in assuming that this is everyone’s experience, or that all student midwives miss out on these light-bulb moments until working as a midwife: I would never seek to assume that my experience is anyone else’s. Rather, I share my own processing and emotions as I seek to create an environment where we, as midwives, as providers, can speak about these phenomena, name them as influential for ourselves and our care, and to support each other through each and every learning opportunity. This work is not always easy, but we are working together. I certainly am here for anyone who is seeking someone else with whom to work through these issues. I hope that these posts provide solace for others, whether student or new or experienced, who are working through these and similar issues.
Excerpts from the latest two posts are below. Click on the links to read the full posts!
“…But, what of the evidence? Though much of what we do is evidence-based, I learned quickly that evidence does not necessarily translate into actions or protocols. Through rotations at clinical sites as a student, I witnessed doubt of the “latest evidence,” belief in learned experience, and emphasis on caring. I remember, vividly, questioning various practices and discussing the most recent evidence I had learned in school, holding it up like a shining trophy to my preceptors. And each midwife had her own response, ranging from true interest, to patient encouragement toward caution around the latest and greatest (“Now, was that a meta-analysis?”), to pointing out her own trophy: evidence & experience, rightfully shining bigger and brighter than my own.
I recognized the wisdom in these circumstances, but I still judged their practices, knowing that they were not what I had been taught and that perhaps I would do differently some day. I still do that with the midwives in my own practice, to some extent, but I have come to believe in midwifery and midwives. I follow my brain and heart in my work. I am realizing the best midwives tried to teach me that all along. Do I now practice evidence-based? I practice that evidence which is most important; the rest is, and must, be flexible to the woman and the situation…”
“…My relationship with rooms feels different now. Each midwife finds connection with her surroundings, finds beauty in what is available, and ultimately focuses on the patient and her needs. Now that I am their midwife, and my professional and emotional life is tied to these women, I feel differently. I can feel my patients’ connectedness with me, and the end of each clinic visit leaves a wisp of our experience in the room after we part. And when I re-enter the room, I breathe it in and out as I greet the next person, who will now create her own history in the room. We will create a history for each other through the care provided in those moments. I draw from each woman to bring renewed strength to my own work, but there are days when I am out of strength. When the women I see are looking for solace in an unfamiliar space, looking for strength from me when my well feels dry, when they are unfamiliar with the history I am carrying, those are the toughest days.
I have written about how beautiful and difficult days can be, and have recognized selfishness in midwifery care when I find women who can provide strength for me. I tap into it, for my own sake as a midwife and for the sake of the women coming into the rooms after her. I try to remind myself of the presence, the numbers, of midwives caring for people, and how we are all together in what we do each day. I try to remind myself that I am not alone in this work, as I try to remind the women I serve that they are not alone. I recently found solace in Walker Karraa’s important post about difficult births and their effects on care providers. For now, it seems of utmost importance to name, to recognize, and to find ways to support all the aspects of the care we can provide…”