There seems to be a pervasive myth in American society that midwives are uneducated. This is unfortunately perpetuated since the myth is not only that midwives are uneducated, but often even that it’s acceptable for midwives to be uneducated. The very term “lay midwife” insinuates that all midwives who train through the traditional apprenticeship model are uneducated and have little training at all.
lay – adjective [not gradable] (NOT TRAINED)
not trained in or not having a detailed knowledge of a particular subject:
“To a lay audience, the mathematics would be difficult.”
Putting aside the question of whether or not this is true in some cases — in my experience, this perception can lead to non-midwife birthworkers, particularly doulas and apprentice midwives who don’t have much knowledge or experience yet, thinking that they know enough to attend births as “lay midwives.” After all, being a midwife is easily assumed, by the very terminology used, to be a largely untrained profession and it’s all too easy for doulas and student midwives to believe the also pervasive (in the natural birth community) myth that all or nearly all birth complications are caused by interventions.
The truth of the matter is that it takes a great deal of time, studying, and experience to become a good midwife. Not all complications are caused by the overuse of interventions. Some complications happen in even the most tranquil and supportive birthing environments and these sometimes require the use of judicious interventions in order to ensure the mother’s and baby’s safety. In my experience, most women who are looking for a midwife are looking for someone who’s experienced enough to understand when to intervene and when to leave well enough alone and these women are not looking for someone to be present for an unassisted birth. Generally speaking, if a woman wants an unassisted birth (a completely different topic), she’s usually not looking for a midwife to hire – hands-off or otherwise.
There’s a saying in the midwifery community about how, for a time during training or their time working with birthing mothers, most apprentice midwives and many doulas know “just enough to be dangerous.” Basically, that means that the student or doula in question has been to some amazing births and read some medical textbooks and thinks that they have a really good handle on this baby-catching thing, when really, they don’t know enough yet to realize how much they don’t know.
The saying, “The more I learn, the more I realize how much I don’t know.” is particularly applicable here and the vast majority of apprentices move past the point of knowing “just enough to be dangerous” and go on to learn and gain experience and become amazing midwives. This is a stage of development that’s healthy to move through, but can potentially be very dangerous if someone gets stuck there.
One of the most dangerous things about being stuck in the not knowing how much you don’t know phase is that you don’t realize you’re there until you’re out of it and look back with some horror at how much you used to think you knew. I’ve been to some truly terrifying births with a woman who sincerely believed that she was ready to take on her own clients and attend births as a primary midwife. I look back and realize that she not only lied to her clients and to me about various important things, but – far more dangerous – she lied to herself.
How can potential clients tell whether their midwife is experienced and knowledgeable, given the state of midwifery in many areas of the country? You, as a client, can and should ask questions, get solid references, see if a midwife is a member of her state’s midwifery association, and talk to the other midwives and birthworkers in the area to get an idea of whether your midwife has as much experience as you believe she has.
Watch for red flags, such as being reluctant to tell you their statistics – how many births/prenatals/postpartums they’ve been to – or not letting you know with what midwife they apprenticed and/or school they attended. The information about where your midwife trained, with whom, and for how long really shouldn’t be a secret and, in the absence of state licensure, is one of the best ways to check on and know whether or not your prospective midwife is telling you the truth about her background and experience levels and that you are comfortable with those levels.
Even with state licensure and a professional certification, find out your midwife’s experience and education levels. Be an informed consumer and ask around before choosing a doula or midwife. Don’t just interview one doula or one midwife – interview at least a couple so that you can find someone you feel comfortable with.
If you’re hiring a doula or midwife, please, for the love of all that is good and holy, check what they tell you about their history and experience. With a doula, your birth experience could be at stake; and with a midwife, your birth, your life, and your baby’s life could be on the line. If your prospective doula or midwife is anything other than completely forthcoming about names and phone numbers of references or about how many births she’s been to or about her training or education, check with their state midwifery organization or the doula organization she claims to be certified with and with any midwives she claims to have worked with.
Your birth, your comfort, and your safety is worth the trouble of double-checking and asking questions.