Job possibilities- RN position in L&D vs. midwifery practice

[MB_love]

Hi all! I'm a new RN with 1 year of med-surg experience. I went to nursing school out of a passion for maternity care and an interest in midwifery, and I have been trying to get my foot in the door since graduating.

Recently a couple job possibilities have surfaced. No offers yet, but trying to do some soul searching & gain some insight from others with more experience in the OB world. The first is an RN position at an independent midwifery practice (no births there- hospital and home births only), where you'd be the only office RN at the practice as well as the primary on-call home birth assistant. (A handful per month, with other assistants sharing call.) The other job is a little more traditional- as an L&D RN at the hospital I work at now.

My thoughts about the midwifery practice- more in line with my passion for natural/low intervention birth, a non-hospital environment, a unique opportunity- maybe even the potential to grow into a larger role at the center or create new roles for myself there, the ability to learn how to assist at natural home births births-learning from midwives! It would also be great to start with this holistic, "normal" perspective on birth- give me a frame of reference. The downsides would mainly be a large pay cut (not sure how large) and not sure yet if they offer benefits- a big deal since I provide health benefits for our family (not an option through my hubby's job). It's also full-time office hours plus on-call. I really want to start a family within the next couple of years (I'm older), so I'm not sure if this type of schedule is as flexible as traditional nursing jobs. I may also loose some hospital-type skills, which may be an issue if I eventually wanted to work at the hospital again, maybe L&D, down the road. Would it be harder to get hired as an L&D nurse if you had recent birthing experience, but not recent hospital experience? (It's really hard to get an L&D position at our local hospital!)

As far as the L&D position- the unit is highly regarded, baby-friendly, and midwives deliver there in addition to the MD's. I've heard that a number of nurses on the unit are amazing and incredibly knowledgeable and "mama-friendly." I've also heard good things about the manager. I'm sure I'd learn a lot, and possibly get more hands-on care time. However, it is still a hospital- with the average C-section rate of 30%. They handle all high-risk births (which probably ups that c-section statistic) in addition to low-risk births with special labor tub rooms, so you'd see full range as far as hospital births go. I'm already working there- so I'd keep my pay, benefits, etc. It would be a pretty seamless transition, EXCEPT, of course, I'd be on nights- for possibly a very, very long time. I hate nights, but understand it's a necessary evil when you move units- especially L&D at our hospital.

Anyway- any thoughts or insight would be greatly appreciated! I'd be a lucky person to get either job- much closer to my dream than med-surg nursing, for sure :) Just trying to weigh both options & think things through.

Thanks in advance for your help!