What Exactly Is It That Midwives Do?

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Defining midwifery care can elude us when questioned by friends that do not work in health care or interviewed by patients that are considering their obstetrical/gyn options for care. It is difficult to explain to our families and loved ones what transpires over a 24-hour+ call. They think me quirky when I choose to go to bed fully clothed, knowing I am going to get called away in the middle of the night by a term multip. I cannot put into words what profound tiredness feels like, nor how, despite a lack of sleep, I am still able to come home and get the kids off to school.

My cousin is dying of metastatic breast cancer. I have become her Thursday caregiver and hospice nurse. I leave my house in the early morning, shop for groceries for her, then head to her home to provide a full bed bath, massage, Foley check, medicine review/plan, and anything else needed that day. Due to the recent Coronavirus pandemic, her primary caregiver, her sister, cannot leave the house to get essentials, and no one can visit due to the risk of infection.

I realized during these Thursdays that in caring for her personal needs – physical cleaning, hair care, massaging her bed-weary body parts and swollen extremities, positioning – doing this in an intentional, loving way felt very familiar. That feeling of being there for another vulnerable human being in need is exactly what midwifery is: real-time, full sacrifice to another person. Supporting mental and physical well-being and doing so in a loving, intimate way lets them know they are respected, cared for, and loved in their vulnerability. This care tells them they are in a safe, protected space and will be well cared for in that space, their wishes and desires honored. This is what midwives do.

Honoring and nurturing the family and the individual with respect, intention, and kindness is midwifery.    When touched in an intentional way, our clients and patients can feel the respect and love we have for them, and they respond to this. A midwife’s touch enables them to open up to be the fullest they can be in their given situation, and provides them with a measure of comfort no matter how small or difficult in their time of need. Honoring someone in their time of need is a sacrifice, a commitment, and a calling – not everyone has the capacity to do this. Many practitioners can perform skills and provide physical care, but few can do this in a deep meaningful way – where as a provider we listen with our hands, ears, eyes, and gut to a patient’s cues; using these cues to identify needs at a time when verbalization may not be an option.

The daily life of a midwife can include toasting a new mom with champagne in a paper cup after an arduous birth, grieving with a family who has lost a baby or loved one, providing a listening ear and guidance to a woman involved in a dysfunctional relationship, or teaching self–care and guiding a young woman in life navigation. Sometimes it is simply a touch when nothing else will help.

My cousin will die, surrounded by family in a sacred intimate space, knowing she was loved and cared for and her wishes respected. She will have set a plan in motion that we will honor and carry out. And the next time someone asks “What exactly is it that midwives do?”, I will look back at my 40 years of clinical practice, ponder my response, and try to sum up (as concisely as I can) the things we do that make us so very special.