Dear Honest Midwife,
I have been a midwife for over seven years, doing home births. I have built up a good practice and really love working with women and babies. I am making decent money, enough that we are now finally making a comfortable living and have everything we need as a family. I should be happy, but I’m not.
As a midwife I have seen a lot of complications and even emergencies. I used to think this was because I was new to the profession and a few more years and I’d probably have the experience to be able to prevent these kinds of things from happening. But as I’ve continued to practice and attend midwife functions where other midwives share their stories, I have realized that birth is just often complicated, and can get dangerous regularly, not rarely.
Lately I feel certain that my luck is going to run out. I have never had a baby die, but I feel like if I keep doing this, I will. I have repeated all my neonatal resuscitation skills over and over again, and I feel like I’m very good at it, but I know that sometimes it is not enough compared to a hospital team.
What should I do? I don’t want to leave my clients to just go find another midwife who might take big risks with them; I want to be there to monitor them and convince them if they need to go to the hospital. I don’t want to quit and be without the income my family needs to survive. But I also don’t want to put women and babies at risk anymore pretending like I believe that what I’m doing is safe!
Amanda (not my real name)
- I completely left the profession to go back to school and study psychology
- Another midwife has closed her practice to attend nursing school with the eventual goal of becoming a Certified Nurse Midwife
- A CNM who had been doing home births has moved into a hospital-only practice
- At least one midwife has become a successful hospital-only doula
- Another midwife remains in the home birth profession, ensuring that women who don’t meet very strict risk criteria are risked out and is now maintaining malpractice insurance
[Midwife] has informed me that a hospital is the safest place for my baby and me during labor, birth, and immediate postpartum.
[Midwife] has informed me of the statistical risks of giving birth at home based on her understanding and research. I have been informed that the chances of death or significant injury to myself and/or to my baby are at least four times higher than the chances of death or significant injury within a hospital setting.
[Midwife] has in no way attempted to persuade me to give birth at home, nor has she made any assurances as to the safety or advisability of giving birth at home.