How did you become interested in being a midwife?
I actually had another career prior to this. I was a regulatory compliance officer for a brokerage firm, which is not a fun job. I was present at the births of my niece and my nephew. Both of my sisters received care from midwives. When I was looking for something else to do in terms of my job and career, my sisters both said I should become a midwife. I looked into it and it sounded like something I wanted to do, so I went back to school for nursing—my first degree was in economics—and then worked as a nurse while I was going to school for midwifery. I’ve lived happily ever after ever since.
What type of training is required to become a midwife?
A graduate degree in nursing. You have to have your bachelor’s degree in nursing, and then you have to go back for your master’s. Penn has a combined program that has both women’s health nurse-practitioner and midwife. I’m actually dual-licensed. Then you have to sit for national boards and you’re good to go. You can get yourself licensed in the state where you practice. Midwives can, in terms of birth, do home births, they can work in a birth center, or they can work in a hospital like I do. Some specialists care for very sick or high-risk people. It really is based on the job that you get because not all women want to birth their babies in a hospital, so midwives allow them that choice of where they want to go. All of our patients deliver at Pennsylvania Hospital.
Are expecting mothers assigned a midwife, or do they request one?
They often seek us out. They tend to be women who want high-touch, low-tech. We spend a lot more time with our patients and educate them about what normal is. Even though they may be uncomfortable or their body is changing, that doesn’t mean it’s abnormal, so there’s a lot of education involved. We’re partners in care with patients so we really do believe in having them make educated decisions about their care rather than us dictating what their care should be. People who are looking for that in a provider seek us out.
What do you mean by ‘high-touch, low-tech’?
People speak of midwives as being ‘high touch, low-tech’ because we spend time, and we talk to people, and we make sure they understand what we’re doing. We don’t order tests and not explain it to them. Our patients are pretty well-educated by us about what the process entails, so they know what tests are being done and why we’re doing them. We don’t do ultrasounds at every visit; we don’t rely on them primarily for the care we provide. Often, for example, we’ll get people who have had to go through fertility and every time they went to the doctor’s office, they got blood drawn and they got an ultrasound. Then they come see us and we’re like, ‘We don’t do that. We’re going to listen to the baby and we’re going to feel your belly. We’re going to use our hands, and we’re going to talk to you, and we’re going to make sure you understand what’s happening.’
Am I correct that you work with patients before, during, and after childbirth?
Yes, we see them postpartum to make sure everything is good. We assist them with breastfeeding, if they’re having any problems or concerns, and then we’ll see them for their gynecological exam for their annuals and their well-women visits. But most people are exposed to midwives through birth. That’s what they think we do, and that’s why they come to us for care. Then after they have their baby, they’re like, ‘I can stay?’ They’re excited because they can stay with us and continue to see us for their gynecological exams, birth control, and things like that.
Do you keep in touch with patients after delivery?
Oh yes. We’re Facebook friends and they post pictures of their kids, so I watch them grow. They bring their kids to their gynecological visits so we can see them. I had a woman the other day bring her son, and she said to him, ‘I’ve told you about your midwife; this is the woman that brought you into the world.’ And he was like, ‘What does that mean?’ And I kneeled down and said, ‘That means I was the first one to meet you in this world, even before your mom.’ And he was like, ‘Wow! Cool.’ It’s very much a family process. I’ve caught multiple babies for people, which is nice because you’re almost a part of the family at that point.
Do you have a lot of natural births?
Not at Pennsylvania Hospital. We do have a birthing suite. We care for patients as long as they are normal and stable. If a patient wants to get an epidural, she can get an epidural. We have plenty of patients that get pain medicine, but there are many who hope to deliver without pain medicine, and we’ve been trained on techniques to help them manage their pain.
How do you help women who don’t want pain medicine deal with the pain of childbirth?
Some of the people who want to go un-medicated use water, so they’ll use a Jacuzzi or a shower. There are those that just want to be mobile and walk around, or use a birth ball. Some women just get really tired, so we can give them narcotics to help them sleep and lessen the pain a little bit, but they don’t get an epidural. A lot of the times, they just want to walk around or eat something.
I noticed on the Penn Medicine website that you have a colleague named William McCool.
He’s the director of the Nurse-Midwifery Graduate Program at the School of Nursing.
Men serve as midwives, too?
Yes. Midwife is a Middle English term that means ‘with women.’ It doesn’t mean we have to be women; it means we’re the ones supporting them. The majority are women, but there are male midwives as well.
What is the favorite part of your job?
I really love everything about my job. I love the honor of being present at such a seminal moment in my patients’ lives. It’s such an honor. I also love the intimacy of gynecological visits, and talking to people about problems they’re having with their bodies, and talking to them about what that means and how we can help. I love teaching teenagers about their bodies. There is a lot of shame around women and their bodies, so I enjoy just normalizing things for people and telling them, ‘No, your body is healthy, it’s normal, it’s beautiful, it’s growing a baby.’ Every aspect of the care is really enjoyable. It’s one of the reasons I’ve been doing it for 15 years. I’ve never once thought of doing anything else.
