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Editorial: Education Priority Check
by Jan Tritten

Jan Tritten (right) with Doña Irene Sotelo
[Editor's note: This editorial first appeared in Midwifery Today Issue 60, Winter 2001.]
We do midwifery to help families have good, healthy, and if possible, joyful pregnancies
and births. Our greatest love should be for women and their babies. The bottom line
for you as students and aspiring midwives is to keep your focus on motherbaby—not
on getting your professional degree as a certified nurse midwife (CNM), or approval
from the North American Registry of Midwives (NARM), etc. Your love of women, babies,
families and each other needs to be your focus. You are answering a calling, one
of service, not one that is self-serving. If you don't feel deep in your heart that
you are called to be a midwife, please do something else. This is not work in which
you will make a lot of money. In these times, it is one of the more uncertain jobs
you can undertake.
When I was at the Midwives' Alliance of North America (MANA) conference, I realized
that the focus of some students has moved away from serving women to serving themselves.
My associate editor, Jill, mentioned the difficulty in getting dedicated apprentices,
stating, "These days, everyone is looking for their 'numbers' so that they can
fulfill their NARM requirements and quickly set up their own practice." There
is nothing intrinsically wrong with NARM's requiring a certain number of births,
prenatals, etc., in order to prove competency—it is a wonderful way to train
and educate midwives. However, there is fallout we may not have expected.
I was having lunch with several early arrivals to the conference when one experienced
midwife said, "I'm not going to take apprentices from schools anymore."
Surprised, I asked why. She expressed that these "school midwives" were
focused on their own experiences and numbers rather than on the pregnant women my
friend was serving. A discussion followed that non-school students are looking for
their numbers too. I found it an interesting contrast to the complaint that going
to Jamaica was using women from poorer countries to learn our midwifery and get numbers.
It seems we can stay home and do the same thing. It basically boils down to the spirit
of the practitioner. Ask yourself, "Am I as a student of midwifery serving myself
or the families I am involved with?" What is your motivation? This is an important
question to ask throughout your whole career.
I think I just realized how much things have changed in the 25 years I have been
doing this lifework called midwifery. When I started, we became midwives almost accidentally.
(Isn't that a good name for a movie? The Accidental Midwife.) We set out to help
women have homebirths, period. Our concern was whether we knew enough. We were afraid
we would miss something important. The entire frame of our reference was women, babies,
families, pregnancy and birth. We studied like crazy to make sure we knew enough,
but the bottom line was not our license, profession, career or certification. The
only bottom line we knew was the families we were "serving."
I truly believe when we are talking more about ourselves and our politics and
profession that we have lost the true essence of midwifery. I don't care if I am
at an ACNM (American College of Nurse-Midwives), MANA or Midwifery Today conference,
we should be talking more about birth than ourselves. I exhort you to find a program
that is centered on families, a program that also nurtures you as a student.
Another interesting fashion I noticed is that licensed midwives can get their
license with 50 births, a certain number of prenatal visits, etc. This, in my opinion,
sometimes leads to an arrogance in recently licensed or certified midwives: I have
my credential and you don't. However, many who don't have credentials prefer it that
way. They have done thousands of births over two or three decades of dedication to
women. We have created a "license culture" within midwifery that does not
always honor or learn from the wise women who have gone before. We have fallen straight
into the paternalistic system so prevalent in Western culture.
My hope is that we, as enlightened, alternative thinkers and doers, can somehow
do better. I had hoped there would be mutual respect and a sense of harmony, or better
yet, unity with a lot of diversity.
It has always been Midwifery Today's role to encourage all kinds of midwives,
doulas and childbirth educators. We still do. There is more than enough room for
all kinds of practitioners. We need everyone working to change the way women are
treated in childbirth. For 15 years, one of our main mottos has been, "Each
one teach one." We need a great mentoring spirit in this field. And there must
be respect in these mentoring relationships, respect flowing in both directions.
I ask senior midwives: Please keep taking apprentices. It's a way in which we can
work toward the ideal of one midwife for every mother.
For those who are called to midwifery, there awaits a life that will take all
the love you have to give. You have the awesome honor of being "with woman"
on her most important life passage. You are there, often the first one to touch the
new life sent directly by God to reside awhile on this planet. You are there when
people become a family, when maidens become mothers. This is a powerfully spiritual
experience and you are there. You are a key person in this life-changing passage.
The deepest humility is a necessary characteristic of being a midwife. You will always
be learning because the women you continue to serve are your most important teachers.
Honor them and their babies by putting them first, before your numbers, before your
license—even before yourself.
Toward Better Birth,
jan
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Jan Tritten
Jan Tritten is the founder and editor-in-chief of Midwifery Today magazine and a midwife who was in active practice from 1977–1989. She became a midwife in 1977 after the powerful homebirth of one of her daughters. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences
around the world! [ PHOTO BY ANDREA NOLL ]
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1947 Born in Los Angeles, California. 1965 Graduated from Placer High School in Auburn, California. 1966 Trained for one year as a psychiatric technician. Courses included
basic nursing, pharmacology, microbiology, anatomy and physiology, psychology. 1966–1971 Worked at DeWitt State Hospital in Auburn, California
as a psychiatric technician. 1968 Graduated from Sierra College with an Associate of Arts degree. 1970 Graduated with honors from Sacramento State College with a
Bachelor of Arts degree in Social Science. 1971 Earned Lifetime California teaching credential with fifth-year
program from Sacramento State College. 1972 First daughter born in a hospital. It changed my
life forever. It was an unsatisfactory birth experience, but I had a wonderful
postpartum experience with 2-1/2 years of breastfeeding. 1976 Second daughter born. She was born at home
with a doctor who talked me into a homebirth. The difference between the
two births sent me on a path to do something to help women have positive
birth experiences. 1976 Began training as a midwife. Because I was raising young children
and running a business, and because there were no CNM schools in my area,
becoming a CNM was not within my reach. 1977 Began attending births with the Birth Co-op in Eugene while
organizing courses in our community taught by CNMs, physicians, nutritionists,
etc. 1978 Began a midwifery practice, New Life Care, with a partner,
Chris Howard, and apprentice Monika Dunsmore. 1979 Son born at home. 1980 Did a one-year program with Marion Toepke McLean, CNM. Four of us completed the program, which was modeled after CNM curriculum at that time. She took a year off from her practice to teach us and to go to our births with us. 1982 First group of midwives certified by the Oregon Midwives Council.
Our board was composed of CNMs and physicians. 1986 Slowed down practice and started Midwifery Today magazine.
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