The Midwife’s Role as Educator

Posted by Andrea Altomaro on April 20, 2020
Spoiler Alert: This post discusses events in Season 9 Episode 4.
andrea blog s9e4
Editor’s Note: The opinions expressed in this blog post are solely those of the author.

Most people are aware that midwives are responsible for educating future midwives, either as faculty at a university or as a preceptor within their job role. However, many people may not realize that midwives also play an active role in educating future physicians as well. I loved seeing the midwives of Nonnatus house take on the role of resident physician educators in this week’s episode of Call the Midwife.

I certainly understood the midwives’ hesitation when they first learned of the imminent arrival of the residents. So often, midwives are thought of as an extension of our nursing roles, or as “mid-level providers.” The Feminist Midwife Stephanie Tillman, CNM has so perfectly stated, “[W]e are not the ‘middle’ of anything: we are trained to the full extent in our professions, and to refer to us as anything less or in reference to physicians is to incorrectly understand our capacities.” We can, at times, be met with resistance when we are working with residents or medical students who don’t understand the full role of the certified nurse midwife. However, I’ve found that in hospitals where the midwives immediately take an active role in resident education from the first year of residency, we are able to impact future attending physicians in an extremely positive way.

As I touched on last week, midwives have a unique philosophy of care. The ways that we communicate with and care for our clients can be very different from traditional medicine. It is such a gift to be able to share the philosophy of midwifery care with all students. I loved when Benedict pointed out to Trixie that he could see the compassion and kindness of the midwives, and the elation they felt at every birth. Although I am sure there are exceptions to every rule, I think that for most of us, we see midwifery as a calling. No matter how tired we may be, how many years we have been in practice, and no matter how much we initially sigh in exasperation when our phone rings again in the middle of the night, we are proud and joyful and grateful for the kind of work that we do. It never gets old to hear a baby’s heartbeat for the first time, and watch the look on the parents’ faces. It never gets old to see that final part of the baby’s head crowning, and that beautiful new human being’s face emerge. It never gets old to empower our clients into taking charge of their own health, whether that is through providing trauma-informed screening exams, contraception, or abortion care. While midwives are certainly not immune to stress and burnout, we by and large love the work of midwifery.

I loved watching the midwives offer simple suggestions to the resident physicians, like addressing the woman they are caring for directly instead of talking about her. Valerie was able to show resident Dr. Kevin McNulty how to stay calm in an emergency when Leslie’s baby had its shoulders stuck. Her calm attitude, coupled with the knowledge of how to manage such a complication, led to the successful delivery of that baby girl. I thought it was the perfect example of both the types of relationships we forge with our patients as well as the skill set that we have from our extensive training.

I feel a sense of satisfaction each week after taking in a new episode of Call the Midwife when I can relate to the experiences of the midwives of Nonnatus House, and this week was no exception. Midwives have been taking an active role in the education of medical students and residents for many years, and it was refreshing to see the portrayal of how much our unique skills can impact future physicians. I am so proud that Call the Midwife has brought the role of midwives into the mainstream, projected into people’s homes weekly. Certain practices may change over time as new evidence emerges, but the hallmarks of midwifery care remain strong.

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About the Author

Andrea Altomaro MS, CNM, IBCLC has been nurse-midwife since 2012 and is currently working for the Henry Ford Health System. Andrea knew from a young age that she was interested in pregnancy and birth, and decided to become a nurse. When she learned about the role of certified nurse midwives when she was in nursing school, she knew she had found her path.