Dealing with fear

Specialties CNM

Published

Specializes in Family Practice, Women's Health.

I have recently had to admit to myself that one reason I haven't pursued the CNM path yet, (even though I've been drawn to it w/varying degrees of obsession for the past 12 years), is that I haven't gotten past the fear aspect. Not fear of the birth process, which I know works and is safe most of the time, but fear of the responsibility. As a midwife attending births you have to have true skills, no BS-ing about it. The mom and the baby are in your hands. And you have to be so strong-to hang in there for moms during long, long labors and severe pain-- to cope without sleep. And what about bad outcomes? fetal demises? Lawsuits? Not to mention, having to take emotional energy and physical presence away from your own family.

I know responsibilty. I am an FNP. I have 2 small kids. I don't shy away from it. But, midwifery is a lifestyle, not just a job. How I wish I was content in my good job doing college health (sigh. . .)

How do you folks get past these fears to live your calling?

Specializes in Women's Health, L&D,hi risk OB.

Just wanted to post that moving through fear is the lesson of labor--by extension being "born" as a midwife. Some birthing techniques that address fear have their application for life. One is in the book "Birthing from Within". Some people who are familiar with the Bradley technique find it useful for many life transitions.

This is not to be condescending--I understand where you are coming from. Certainly you have accomplishments to draw from--I wish I were an FNP--and not just applying to CNM programs!

fmwf

Specializes in Family Practice, Women's Health.

no one else has fears about this stuff? or just doesn't want to go there in this forum?

since i first started this thread, i dicovered this quote:

"when i dare to be powerful- to use my strength in the service of my vision, then it becomes less and less important whether i am afraid."

audre lorde 1934-1992

love it!

Hi - I'm a recent CNM. You raise some important issues - but maybe too many important issues in one post. :) I mean, you are talking lifestyle changes, overwhelming responsibilities, emotional toil, coping with long hours, liabilities...

I think in terms of these issues, like anything else, they do happen to some degree, some more than others. For instance, I know you can live a balanced life being a midwife. Some people learn to leave their work behind when they go home. There are 12 shifts but that's like nursing. But then you have more days off and the average 9-5 person. And then there's being on call, which was hard for me to get adjusted to. I couldn't get that much accomplished whilst waiting for the other shoe to drop. And THEN there's the liability issue, which doesn't worry me, because I'm doing what I love, and I love my patients, and I don't go take care of a woman thinking that she's going to sue me. Although, unfortunately, there are few cases where you see it coming - there are people out there who are just waiting to make money from suing you, but I haven't personally encountered that, and if I did, I would know what to do - document the hell of out it. For the most part you don't think about it. It's a reality in the health care area, and I'm not going to let it prevent me from doing what I love. Many midwives are involved in a lawsuits, very few lose their license, and many midwives live long, satisfying careers uninhibited by any lawsuits.

You also brought being strong - interesting way to look at it, but I think of it as challenging and a life not challenged is a life not lived. I know I'm kind of rambling, but I'm trying to tell you personally that most of the issues you brought up is not my day-to-day reality, except maybe the 12 hours shifts on a full moon - but even on those days, I thrilled for the challenge at the end of it. I LOVE BEING A MIDWIFE.

And if it's something you could love deeply, and it's up to you to grab the brass ring. That's what I think.

Specializes in L&D, QI, Public Health.

Wow, Epiphany,

I was just thinking about you! Congrats on becoming a midwife! Please tell us more. How long have you been at it? How's the salary (don't necessarily need specifics), Do you feel UPenn prepared you well enough?

Specializes in Family Practice, Women's Health.

Wonderful response, Epiphany! Thanks so much! It's nice to hear that you LOVE being a midwife. Sometimes, I guess, I get caught up in too much negative thinking. But I agree that you can't let fears stand in the way of living one's life and fulfulling one's dreams. So glad you're doing it!

Yes, I'd love to hear more also. . .

Specializes in Mother Baby & pre-hospital EMS.

I have been interested in pursuing nurse-midwifery for a while. Fears hold me back from totally committing to it, too. There is a lot of responsibility. I have heard about how midwives work long hours and sometimes have to be away from their families longer than they'd like to be. I am not married nor do I have children now, but if I were to have my own family in the future, I do not know how I would handle spending so much time away from them. Of course, if this were my "calling" in life, I know that I would work around those fears and figure something out. And right now, there isn't any other grad school track I want to pursue more than nurse-midwifery.

It is always so nice to hear stories of midwives who love their job. :) Gives me hope and motivation!

Recently I read an article about “the greatest job is the world”. This guy won a generously paid “work” enjoying everything on the islands near the barrier reef. All he had to do was to try out everything the islands had to offer for free and blog about it. When I first came across this, my first reaction was (smugly) “that’s not the greatest job in the world.” (I know)

So in response to the fear element that’s being brought up, bear with me while I get a little gushy, and tell you I think why THIS, this midwifery thing IS really the greatest job in the world. Just saying I love midwifery doesn’t quite do it. So here goes…

When we first started our intrapartum semester and I started to learn birth mechanism and sciences, I was kind of in a suspended state of disbelief. I had an out of body experience, like I'm watching myself learn. I couldn't believe that I was going to be expected to do that, even though I had worked so hard to get there. When you first go into care of women and obstetrics it’s exciting, but it's not jumping off a cliff. So yes, catching a baby can be a frightening thing in the beginning. But once you’ve jumped off the cliff several times, midwifery is no longer about a fear. It’s about much more than that.

On a normal day, midwifery is a combination of hand skills, quick responses, whilst your mind scans the environment with a "periphery vision". Your woman is your patient, the baby is your patient, the family and friends present at the birth are your patients. So you're working on the psychological level and on a level invisible to everyone else. You are thinking about the baby and the mother's condition. You are on alert for any signs of danger. You know your intervention, your meds like the back of your hand. You've done your shoulder dystocia drills so that you can react fast if needed. You know how to summon the team together in a second when the need arises. But you look calm, in control, like nothing bad will happen on your watch. And when baby appears, and everything’s successful, which is the way it usually ends, the mother goes to bits, and darn it, she totally doesn’t think what you had to do.

She doesn’t know about your expertise, the pride you take in research based practice, your hand skills, your lightning reaction. She’ll never know quite how good (or bad) you are. BUT for the rest of her life, she will be affected by your touch, your voice, your words. And she will know, that in the neediest moment of her life, the most important moment a woman could experience, she was the center of your universe. That fraction of a percentage of the rest of her life, she will always recall with great joy. Or not. You can make that difference. And you can do it every day that you go to work.

Isn't that wonderful?

Specializes in Family Practice, Women's Health.

My heart is swelling and my eyes are welling! Thanks so much :)

Specializes in Women's Health, L&D,hi risk OB.

One thing I have learned about performing is to think less (or not) about your self/ego and more about doing the right thing and doing the thing right.

And breathe!

fmwf

Specializes in Cardiac.

Wow, thanks epiphany, that was so inspiring! That totally makes all MY fears melt away.

Ephiphany, your last post was amazing. I have wanted to be a midwife for several years now and have been working towards that goal. Occasionally, it is so overwhelming the responsibility I'm facing. School is just so much and I want to quit as times. Posts like yours inspire me to keep working.

A book that helped remind me of what I'm pursuing was The Midwife by Jennifer Worth. I would recommend it to help re-focus.

+ Add a Comment