On Baltimore

Over the past year, each time another story emerges of police violence leading to the death of yet another black man, I’ve found myself at a loss for words. What can I possibly say that hasn’t already been said?

Partly out sheer anger, frustration, and overwhelm, I sat back quietly on this blog and social media, listening carefully and appreciating the voices of others who somehow seem to be able to give words to the outrage that I know many of us are feeling as a new name rolls across the ticker on the bottom of the news screen: Garner, Brown, Scott, Gray...

Watching the media coverage of the recent protests in Baltimore has once again brought back this feeling…and the questions I keep asking myself are, “What is it going to take to create a cultural change in this country? When will there be enough outrage over the unnecessary, violent deaths of black men and women in this country that it boils over not just into protests, but into policy, into research agendas, and into a universal understanding that it is unacceptable? When will people stop dying at the hands of the very people who are supposedly working to ‘keep us safe’?

This morning I happened across this incredible call to action within the medical community by pediatrician Rhea Boyd:

In the wake of Sandy Hook, the response from physicians, and pediatricians in particular, was astounding. The tragic deaths moved doctors to address gun violence and its health consequences.

But week after week, as black boys who could be my sons and black men who could be my father, are shot and killed by police, doctors remain silent. As a pediatrician, I’m appalled.

We are watching a public health problem unfold in front of us and we aren’t doing anything to stop it.

These words stopped me in my tracks.

We are watching a public health problem unfold in front of us and we aren’t doing anything to stop it.

Yes.

As a future midwife, I place my work in the context of reproductive justice: my role is to serve my community, to help ensure that women and their families are healthy, as individuals and as members of their community. My role is to help reduce the institutional barriers that prevent equitable access to healthy outcomes. Yet we know that rates of preterm birth are higher among African Americans, and that there have been links made between chronic stress and preterm birth.

As Boyd writes, “Like the trauma experienced by war veterans, living under the threat of unprovoked police violence triggers intense emotional and physical stress, even in moments of relative safety. The chronic stress that fear generates may place African-Americans at increased risk for health problems like heart and lung disease, and depression.”

I simply cannot fathom what it must be like right now, or ever in US history, to be an African American mother. I think about my own unborn child, who will come into this world with privileges they did not ask for. My child, for simple virtue of the appearance of their skin, will not have to fear driving in Portland, among the whitest of white cities in America, and being pulled over by the cops for no reason at all.

My child, by virtue of appearing “Asian” in heritage, will be assumed to be intelligent, well-spoken, “safe.” My child will not be unduly punished for minor infractions in school, nor will they face increased risk of being suspended or expelled simply because they cannot sit still and learn quietly.

My heart will only have to bear the average amount of anxiety as a parent when my child starts wandering around the city independently…but I will not have to fear that my child might “accidentally” be shot by police. Such an occurrence would be an outrage, it would be unthinkable.

And this only scratches the surface of privilege that my child will experience.

Yet it’s not what many parents in this country live with every day. As a future parent and a future midwife, I find myself unable to breathe sometimes, I am so angry at the injustice of it all.

What keeps me going is knowing that as a midwife, I will have an opportunity to connect with people during pivotal moments in their lives, especially during the child-bearing year. I hope that I can be a supportive presence for all the pregnant people I serve, no matter what stresses and injustices they are facing during their pregnancies. And beyond the level of individual care, I want to use my voice and skills as a midwife, researcher, teacher, and activist to help shape policy that improves the health of families and communities.

I believe that the midwifery profession can and should be doing more to speak out the public health consequences of race-based violence. I intend to do everything I can to ensure that my professional organization, the American College of Nurse-Midwives, plays a role in moving our country in a direction in which all families can raise their children in safe communities.

 

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Networking 101

This post has been percolating for a while…in part because I know there’s probably a post out there in the world already that is very similar to what I’ve been thinking. But you know, sometimes, it’s just easier to write your own instead of spending hours trying to find that perfect link to share.

Over the past two years that I’ve been writing this blog I’ve connected with students, prospective students, as well as currently practicing midwives and other health professionals. These connections have been both personally and professionally enriching in ways I could not have imagined. I had no idea when I started this blog how many people it might reach. As a student or prospective student, it’s easy to feel like you’re out there all alone on your journey, especially when your politics may veer in a slightly different direction than the mainstream culture of your profession.

I’ve loved connecting with the many prospective students who have reached out, hearing their stories, hopes, and dreams about midwifery, while also sharing my own experiences and bits of insight gleaned along the way. I know when I was in the midst of researching and applying, I was so hungry to hear those stories and use that information to help me decide what my own path to midwifery was going to look like.

One of the things I’ve noticed is that many folks start out their emails in a general, “Hey, I’d love to connect and hear more about your experience!” kind of fashion. While I would love to sit down with each person and have a heart to heart about midwifery, the reality is everyone is super busy. So, in the spirit of encouraging effective communication, I thought I’d share some tips on how to reach out to other students or practicing midwives and get the most out of those “cold calls” or “cold emails.”

Do your research. Before you write that email, that is. While I love helping folks connect with each other and with good resources, I think it’s also just good manners to do your own research before you send that first email. Know the lay of the land, which for prospective midwifery students, means researching the professional organizations, knowing the pathways to midwifery, and having a sense of what appeals to you about those pathways. If there are things that are unclear as you peruse the professional websites (and student blogs, etc!), write those questions down! Which leads me to my next tip:

Get specific. I get a lot of emails from folks asking something along the lines of, “I’m thinking about midwifery school, can you tell me more about your program?” I could tell you a lot, for sure…but realistically, each program is a universe unto itself and I could spend days talking about the ins and outs of my programs and the ones I’m familiar with. So think about what you really need to know. Get really clear on how you think the person you’re reaching out to could help you. Is it that they know something about a specific program, or faculty member and their research, or practice climate in their state? It’s okay to ask several questions, but it sure is helpful to have a concrete list. An email asking me to share my experience and thoughts on my program leaves me feeling overwhelmed about where to even start. An email with two or three bulleted questions is much more manageable.

Think about timing. When you reach out and make an ask, it’s really helpful to have a sense of both your own timeline and that of the person you’re connecting with. Emailing at the beginning and end of terms, for example, may not be ideal…and you should know that those emails may not get the speediest reply (as badly as we students feel about that!). Also, tell us what your timeline is, and if a reply is more urgent, it’s ok to be honest about that. I’d rather know that you’re coming up against a deadline and then I, in turn, can be honest about whether I realistically have the time in that moment to give a thoughtful response…or whether I might need to pass your request on to someone else who might be better situated to answer your question.

Keep it brief. The shorter, the better, really. When I’m sending these kinds of emails, I try to keep it to what can fit on one window without scrolling, in easy to read paragraphs.

Don’t be afraid to reach out. Having said all that…I want to underscore how valuable I think it can be to reach out to someone you may not know personally but suspect could help shed light on your path. My philosophy when I was applying to programs was the more perspectives I could hear, the better. That’s also part of how I make decisions, too…and I would say that knowing your own decision-making process is a really useful insight that you can use to your advantage when considering midwifery and midwifery programs and how you craft those emails.

I think all these points apply to midwifery students networking with other students…and with connecting with midwives in practice, too. I’d love to hear your thoughts, whether you’ve been on the reaching out or responding end. What’s worked well for you, what would you add to this list? What have you learned about networking over the years?

A Safe Passage

“It is part of our task as revolutionary people, people who want deep-rooted, radical change, to be as whole as it is possible for us to be. This can only be done if we face the reality of what oppression really means in our lives, not as abstract systems subject to analysis, but as an avalanche of traumas leaving a wake of devastation in the lives of real people who nevertheless remain human, unquenchable, complex and full of possibility.”

~Aurora Levins Morales, Medicine Stories

***

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I just spent a transformative two days in a workshop for birth workers, exploring the dimensions of providing support to survivors of abuse during pregnancy and their transition to parenthood. My heart and mind are stretched wide open and I am flooded with gratitude for the space that was created by this amazing circle in two short days.

When I tell people I am on the path to becoming a midwife the response is usually some variation of: “Oh, wow! That’s so amazing! What a joyful way to spend your days, welcoming babies into the world!” Or, more to the point: “Oooh, I love babies, that sounds so fun!”

I haven’t yet figured out a gentle, graceful way to reply that it wasn’t just the babies that called me to midwifery. I do love babies, and the thought of being able to attend births as a midwife fills me with delight and excitement.

And yet…

Again and again, I am reminded that my calling to midwifery is different.

It’s about supporting the people who are deciding whether or not now is the right time to become parents, who may be struggling with their ambivalence about being pregnant and feeling invisible in that struggle.

It’s about sitting with the thirteen year-old who showed up for her first annual exam, who’s terrified of what she’s about to experience, prepared to feel humiliated and ashamed of her body. 

It’s about discussing birth control options with the person who’s never felt truly seen by their health care provider because their legal name doesn’t “match” the way they look to the over-culture of gender binary. 

My calling to midwifery is driven by the deep, desperate need for more health care providers to be holding space and offering compassionate care for the stories and experiences no one else wants to hear about: abortion, adoption, loss, domestic violence and abuse. It’s about affirming the spectrum of potential experiences of pregnancy, acknowledging that while one family may be ready to welcome a baby into their lives, another is confident that now is not that time. I want to be the midwife who compassionately provides care in both these scenarios.

These aren’t necessarily the things that most people envision when I say I’m becoming a midwife. But this is how I envision spending my days.

This weekend was another one of those affirmations of my calling. It came at just the right moment, too. As hard as it is to believe, it’s been nearly a year since I started nursing school. The last few weeks of the term are always a period of reflection on my learning, while setting goals for the term ahead. This particular transition has raised lots of questions for me about how to intentionally move forward to not only meet basic skill competency, but also how to build my own practice, or way of being, with those that I will serve.

What I gained from this weekend was more than a checklist of indicators for abuse, or evidence-based guidelines on routine universal screenings, or a cheat sheet of “Things to Say When Someone Discloses a History of Abuse And You’re Caught Off-Guard and Would Rather Go Hide In the Bathroom Because What They Shared Was So Enormous.”

While there is value to the “concrete take-homes,” I also carry with me the space that was created to reconnect with the reasons why I felt called to become a midwife in the first place. It was an opportunity to reassess what I bring to this work, in terms of both skill as well as underlying assumptions. It was a reminder to critically examine how I take on the privilege and power of being a “licensed” health care professional, and the unintentional harm I might be causing in that process.

It was also a pretty harsh reality check. For the first time since moving away from my doula practice and starting nursing school, I have to come to terms with the fact that my role, scope, and responsibilities are shifting. In just a few short weeks I will begin my 10-week integrated practicum in labor and delivery, the final step of my nursing education. It will be my first time at a birth in over a year and a half, but I will be coming back in a very different position than when I left…a position that affords me a different status and level of access to institutional privilege.

This weekend was not just an invitation, but an obligation, as Audrey Levins Morales so eloquently writes, “…to be as whole as it is possible for us to be” and to “face the reality of what oppression really means in our lives.” For better or for worse, I am choosing to become a part of a system that has marginalized and oppressed generations of people–and continues to do so–in often insidious ways. No matter what I say or do, assumptions will be made about me because of the position I occupy in that system.

It is a daunting task–some days, indescribably, breathtakingly painful–to knowingly step into a role that will require bearing intimate witness to the pain of those who are both systemically and individually oppressed. But as a midwife called to “deep-rooted, radical change” I find great hope in our collective capacity to be present for each other. The most precious thing I gained from this weekend was the courage and wisdom of the stories shared–it is the stories that I carry closest to my heart as I continue my journey to become a midwife.

{this moment}

{this moment} – A Friday ritual. A single photo – no words – capturing a moment from the day, week, or year. A simple, special, extraordinary moment. A moment I want to pause, savor and remember.

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Asian-American Midwives

I am so, so excited to launch a new website today, Asian-American Midwives!

API Midwives

I have long believed that there is a midwife for everyone and that the strength of our profession lies in the diversity of midwives available to serve and teach in our communities. I created Asian-American Midwives to celebrate and highlight the often hidden diversity of Asian-American midwives who care for women across the life-span.

My hope is that over the next month and half, we will be flooded with submissions of profiles of Asian-American midwives from across the country. We’ll share these profiles during Asian Pacific Islander Heritage Month in May.

How can you get involved?

  1. Share the website far and wide, encourage Asian-American midwives you know to submit a profile!
  2. Write a guest blog post about Asian-American midwifery history or women’s health traditions.
  3. Engage in conversation in your community about diversity in the midwifery community. Share your ideas with us on Twitter!

Creating More Inclusive Midwifery Communities

Birth Workers Of Color Scholarship 1

I’ve been thinking a lot lately about inclusion in the midwifery profession. Of course, this is not the first time I’ve written about this. Those of you who know me know that I think about issues of inclusion and diversity all the time.

For me, midwifery has never been simply a matter of supporting individual choices in birth, although certainly that is one aspect of it. In fact, I often hesitate to blindly associate the concept of “choice” with birth, as it assumes that we all have equal access to knowledge, support and empowerment to advocate for our preferences. It doesn’t take long to realize that the illusion of choice in birth doesn’t extend very far when we’re still privileging some people as parents over others.

On a broader level, I see midwifery as a public health tool to address major disparities in birth outcomes and family health in our country. However, one big stumbling block is that the midwifery community currently does not reflect the broader community of those we seek to serve. While race is only one of many components of diversity, I do believe it is an important one. As an Asian-American woman, I rarely see myself reflected in either the general media covering empowered birth choices, or in my chosen profession. Some days I can be lulled into thinking that something as simple as seeing other Asian midwives is almost trivial, and yet, there is a substantial body of research on ways in which people of color, especially Asian-Americans, are made invisible in the Black-White racial paradigm of the United States.

In 2011, 6.6% of CNM’s who responded to ACNM’s triennial membership survey identified as people of color. Out of 2,230 total respondents (about a third of the membership that year), a whopping 4 midwives identified as Asian or Pacific Islander. Granted, a total 4% of midwives did not answer the question at all or had missing info. However, 91% (2,034 respondents) identified as white. Only 2.6% of CNM’s who responded identified as Hispanic. The last census placed the Hispanic population of the U.S. at 16.9%. The report notes that these numbers have not changed much between 2009 and 2011. Looking at the 2006-2008 report yields similar results.

So, what are some solutions?

As in any of the health care professions, addressing pipeline issues and lack of funding support are key.

How are we supporting the development of a strong, qualified applicant pool? What programs are being put in place to connect potential midwives with good mentors? How are midwifery organizations connecting with young students to introduce them to the option of midwifery as a career path? What financial supports are in place to support students who come from disadvantaged backgrounds?

This is why I’m so excited to see leaders within the CPM community take it upon themselves to make concrete changes that will support more midwifery students of color. Spearheaded by CPMs Vicki Penwell, Claudia Booker, and Jennie Joseph, they have created an opportunity for midwifery programs to commit to providing a full scholarship each year to a student of color.

And so, our Grand Challenge is this: What if every midwifery program in America, big or small, non-profit or for-profit, were to offer one FULL scholarship per year to a qualified candidate who was a woman of color?

If every school or program now in existence were to offer one full scholarship per year, the burden will not be too much on any one school’s budget. We will all share the responsibility and privilege of addressing a grave injustice in our own time and country. Within a few years we could see this imbalance shift and begin to see many women of color serving their own populations with quality midwifery model care.

It’s one step towards making our community more inclusive. What other ideas do you have? I’d love to hear them! Let’s keep this conversation flowing!

{Becoming a Midwife} Part Three and a Half: The Interview

I know, I know, I’m skipping ahead in my series on applying to midwifery school. In part, this is because it’s Interview Season and I have received numerous emails from folks asking for advice on interviews. There’s definitely some specific things I could offer on my particular program, but what I want to offer here is a general overview of the interview and things to consider when preparing for what most people find to be the most anxiety-inducing part of the process.

So.

You’ve made it through the long nights of writing essays. You’ve agonized over whether you were detailed enough or too detailed; personal enough or too personal, ad nauseum. You’re probably sick of those essays, in fact. But my first piece of advice is this:

Step 1: Take a deep breath.

Step 1 and a half: Re-read your essays.

Spend some time re-reading your essays. This is what the midwifery faculty had to go on when making their decision to extend an invitation to interview, so it’s useful to make sure that you can address and expand upon any aspect of those essays. There’s nothing worse than an interviewer saying, “I read in your essay that…” and you having that moment of disconnect when you try to remember what you wrote. I’d also pick one or two things from the essay that you especially want to be sure to highlight during the interview.

Step 2: Write a list of questions that you imagine a midwifery faculty would want to know about you to help make their decision.

Step in their shoes for a minute. How might you go about evaluating a potential midwife? Make a list of those qualities. Then think about how you might assess for those qualities in a candidate. Generate a list of questions that might help you highlight those qualities. Now answer those questions for yourself, drawing upon examples from your past experiences.

I am lucky to be married to someone in a completely different field than me: my husband is a software engineer, with an undergrad in theater and computer science. He was in business school when we met, and I’ve learned a ton from him about interviewing, personnel assessment, recruiting, management etc. One of the big take-homes I’ve learned from him is that the best predictor of future performance is past performance.

What this means for you as a candidate for midwifery school is that the best way to look for potential midwives is to find people who have demonstrated the qualities of a good midwife in their previous experience, even if it’s completely unrelated to birth or reproductive health. To repeat: The interview is not about seeing how much birth experience you have, but about assessing your capacity to step into the role and responsibility of a midwife.

So spend a good long time thinking about what led you to midwifery and how your experiences have guided you to this path. In particular, be able to talk about:

  • how you have overcome challenges
  • how you handle conflict, both interpersonal and ethical
  • how you work as a member of a collaborative team
  • how you see yourself as a leader
  • the core values that will underlie your practice as a midwife

Keep in mind, none of these things are set in stone. They’re not looking to see that you have the right answers. They’re looking to see how you craft an argument, how to present your ideas, how you maintain flexibility even in the face of ambiguity. A midwife is nothing if they are not flexible and open to change and it will serve you well to have examples of that to share with the interview committee.

Step 3: Practice.

I mean it. It sounds silly, but it’s so worth the effort.

Find someone to do a mock interview with you. This doesn’t have to be a health care professional, just someone you trust and who’s willing to take it seriously. Practice with your language, practice being concise. This is the time to get used to telling your story about what drew you to midwifery. You’re going to have to answer this question a lot. My husband was a great model for this. He would have to do presentations in business school and he would actually rehearse. Like, with note cards. At first I thought it was silly. But I realized what a gift he was giving himself…in his presentations, it was clear he was prepared, confident, and polished.

Now, this is not to say that you should have pat answers memorized. The interview is a conversation. But, practicing helps relieve the anxiety of the unknown…and that’s what makes this such a nerve-wracking experience!

Step 4: Make your list of questions for the faculty.

This is not just a time for you to be grilled by your prospective professors. This is a chance for you to make sure this program is the right fit for you. Not all programs are the same. You should have a solid list of questions about the program and its culture. Many people are afraid to ask questions because they worry it will make them appear unprepared. And yes, there’s a balance. But what you’re trying to suss out is: can you imagine yourself here? do you share the same values? will you find the kinds of support you need as a learner? 

So, you need to understand what your own learning needs are. (Add that to your list of things to consider and be ready to talk about what you anticipate your learning needs to be.)

Step 5: Be Yourself.

I know this sounds cheesy. But it’s true. The most important thing we bring to the work of midwifery is ourselves–our complex, unique, individual ways of being and moving through the world. So as much as experience is helpful to your application, it’s not everything. When posed the question on my FB wall as to what midwives would offer as “advice” or words of encouragement to those applying to midwifery school, the responses included things like this:

I think if you truly have a passion or calling to midwifery, it will resonate in your words and actions…Be clear about your goals as a midwife, and aim high!

Stay on message: your passion for midwifery led you here, let it continue to lead you through your applications/interviews (and beyond).

All of which I think can be summed up as: You’re being is important as your doing.

So, as much as you can, be gentle with yourself. Rest well. Take care of yourself. Surround yourself with positive people who are supportive and encouraging and who remind you of why you love midwifery. And then take another deep breath.

You’ve got this.