CNM giving up practicing...for now

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Specializes in OB.

I have been a CNM for almost a year. I absolutely, passionately believe in midwifery as the BEST model of care for healthy women. I actually went into school with the intent to get my MSN and "maybe" work as a midwife... I wasn't entirely sure it would be for me. Mainly due to the incredibly high responsibility and the 24 hour call. I had a job waiting for me right out of school, with the practice that I was familiar with from my time as an OB nurse. There are 2 CNMs and 1 OB. Great group with patients that adore them. Part of the reason the patients adore them is that they choose to each be on call 24/7 for their own patients. No sharing of call, unless one leaves town for a trip, then they cover for eachother. Otherwise, it is 24/7.

I just couldn't do it. I was miserable and constantly on edge. I would literally jump every time the phone would ring. The other midwives have children (as do I), but their careers are their lives. They have full time arrangements for child care and such and mostly do not mind when they do not get to see their families for days on end. I, on the other hand, hated not being able to promise my kids that I would be at their dance recital or spelling bee or anything. I couldn't promise I'd be there when they woke up in the morning and I couldn't promise I'd be there to tuck them in at night. That is too important to me and I can't trade it for a career. Not even an important career!

I did sit down with the other midwives and propose sharing call, but they were not willing to change their current method of doing things. So... after 10 months of being a CNM, I'm done as of today. :( I have such mixed feelings about this. I'm sad about missing out on the births of the patients I've already been seeing for several months, yet I know they are in excellent hands with the other midwives. On the other hand, when I realize that tomorrow there in NO chance that I will be called away from whatever it is I'm doing with my family, I feel so light! A weight is definitely being lifted.

It wasn't ONLY the schedule, either. The huge burden of responsibility of being that woman's primary provider in labor and birth was even more stressful than I had imagined. I don't think I want to have a career where any mistake I make (and I will make a mistake, since I'm human!) could result in harm and or death of a mother or baby!

So, I'm looking for a new direction. I would love to do something that will further the cause of midwifery in this country. For now, I'm planning to teach at a local nursing school. I figure I can maybe at least plant some seeds about the midwifery model in the OB students heads... ;) I've also interviewed for an OB mgr position. I don't know exactly where I'll end up or what I'll end up doing, but for me, I think I'm doing what I need to do.

Thanks for listening. Just felt the need to share this with some other midwives who may have been in a similar place.

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Specializes in Nephrology, Cardiology, ER, ICU.

So sorry that you are quitting - for now.

The call sounds incredibly stressful - not something I would want to do either.

Would you consider a different practice?

The responsibility can be overwhelming - agree. Did you have an adequate orientation?

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Best of luck to you! I think in your heart you know this was the best position for you :)

I am surprised to read though that you had to be on call 24/7 but maybe your practice is a little different than most. I have noticed that CNM like OBs in most practices have specific days where they are in the hospital handling births and the rest of the days, regardless, they are in clinic.

Hope you find the perfect job in the end that melds all your interests and priorities!

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Specializes in OB.

In the future I would definitely consider a different type of practice. The vast majority of practices with more than one midwife, share call. So you may spend a couple of days per week in the office, then be on call 2-3 days per week. I think I could function much better on such a schedule. Unfortunately, I live in a rural area with VERY few options...

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Specializes in Mother Baby & pre-hospital EMS.

It sounds like you made the right decision for yourself. The fact that you felt a burden being lifted is a sign that you made the right choice. I feel similarly, even though I'm just a nurse-midwifery student. I love the midwifery model and enjoy sharing with others what midwives do, but I feel hesitant on what I want to do in the future. The call part worries me a bit.

Best wishes as you find a new direction! It's interesting that you applied for a OB manager position because the OB manager at my hospital is a CNM!

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Specializes in CCU, OB, Home Health.

I think I know you. Do I know you? I am on the verge of joining a practice that exactly fits your description... Are you in the Midwest, Northeast IN/Northwest OH?

Regardless, it sounds as though you really did genuinely try and this position, at least, is genuinely not for you and your family. I truly hope you find a way to make your living at something you love.

Sometimes I wonder what family life will be like as a 24/7 midwife. I wonder if it will make a difference if I try to limit the number of births per month or not. My husband is very optimistic and supportive, but we don't have kids yet, and the more I wonder how this will work when we throw kids into the mix, the less optimistic I feel.

Edit: Found another of your posts. I'm Kori. :D

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Specializes in OB.

Hello, "Christine_Chapel"! ;)

You will be awesome at your position and I certainly don't want to rain on your parade! We are different people at different places in our lives, with different circumstances. Just because I have had the experience and reaction I've had, doesn't mean you will feel the same. I know you know that, but I just want to reassure you!

But, you know what?? There is nothing saying you have to do this forever or do it the way certain other CNMs do it...

Some day I truly think I will practice again- maybe full-scope, maybe not- but either way, I will do it with others who are like-minded with me, as far as family/work balance and sharing call.

Please keep your optimism! :) You have a wonderful future ahead of you!!

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Specializes in CCU, OB, Home Health.

Mommy2boys, never fear that you are raining on anyone's parade. I truly admire your integrity. I hope that, as you say, if the way "everyone else" is doing it isn't working, then I'll be able to find a way to make it work, somehow...

You are one smart cookie, and you're going to be fabulous wherever you go.

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That sounds like a really tough position to be in, and it sounds like you made the right decision for your family.

To me, the idea that each woman "has to" get her own midwife for labor is fostering the concept of "cult of personality." By acting as though each client must have that one midwife only, we act as though the woman should be depending on the midwife for labor. This is not healthy. Look at the toll this took on you.

The midwife should be the "guardian of normal labor and birth," not the force propping a woman up in labor. A quote attributed to Lao Tzu [sixth century, common era]

"Imagine that you are a midwife:

you are assisting at someone else's birth.

Do good without show or fuss.

Facilitate what is happening rather that what you think ought to be happening.

When the baby is born, the mother will rightly say: 'We did it ourselves.'"

I am a midwife, and when people tell me I was "amazing," I think I have a problem. I want the woman to know that she was amazing. I was just there quietly in the corner or down the hall, being the guardian of normal birth.

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