Posted by: emjb | September 7, 2006

Inside outside upside down

Lots been happening lately, but most of it in my head. Which has always been a busy place, what with the incipient paranoia that I’m somehow doing it all wrong,^ cravings for diet Coke (which we call “the crack” around the house), worries that my boss will realize how much time I spend noodling online,^^ and wondering if I will ever get a haircut that makes me happy.^^^

Anyway, I may have mentioned that I was thinking of becoming a lawyer. And I was! Really! But then I realized: I don’t have 80k+ lying around! (over 20k/year for the cheapest nearby school for four years, plus fees, etc.) So that seemed like maybe not so much a thing to do. Yes, there are loans, but I am violently opposed to collecting any more large debt. I can barely handle the debt I have now, and it’s a lot less than it used to be. My straight-B undergrad scores won’t be nabbing me any scholarship rides, either. I wasn’t scared of the homework, but I can’t say I was looking forward to learning about real estate law. All I really wanted was to work to change our sucky healthcare system, but doing so by being a lawyer began to look more and more like the long way around.

Still, I want a change in my career, and I still have a passion for fighting the birth-industrial complex and its army of knife-happy OBs. Despite my own sorry experience, and because of it, I’m still a huge believer in sane, natural, healthy birth that respects the woman’s strength and dignity instead of infantilizing her.

So…I’m thinking of becoming a Certified Professional Midwife. I had thought of midwifing before, but had no real interest in going through nursing school to be a Certified Nurse Midwife. And CNMs are (as mine were) highly dependent on OBs and the hospital system, which means I’d have more risk of my clients having the same experience I did.

CPMs on the other hand, operate independently where they are legal (Texas is one state, but there are many others) and tend to concentrate on homebirths, though of course they have to be able to handle transfers to hospitals if needed. Certification is done by several routes, including an apprenticeship and clinical component:

“…All candidates must demonstrate successful completion of 1350 contact hours of clinical experience. The clinical component must be at least one year in duration and must include 75 prenatals, 20 intrapartals, 40 postpartals and 20 newborn care by a student midwife acting as a primary midwife under the supervision of one or more perceptions. Ten of the 20 births must occur in out-of-hospital settings, and a minimum of three must be with women for whom the student has provided care during at least four prenatal visits, birth, newborn exam and one postpartum exam.”

It’s self-paced; you can attend an accredited college course, learn via distance programs, or learn everything on the job.Once you get the hours in, and pass the exams and skills assessments, you can be certified and begin practicing. You don’t have to have another college degree or shell out huge amounts of cash to get licensed, though of course being self-employed will not be the road to riches. You have to recertify every three years, and there are endless numbers of continuing ed courses you can take to sharpen your skills and learn new techniques.

Most importantly, you make an immediate difference in the lives of women in your area, by giving them a choice they might not otherwise have. There still aren’t enough CPMs to go around, and many women don’t even know they’re an option. Some insurance plans cover them, or they bill directly. I still haven’t been able to find out about liability insurance, but that’s something I’m researching. It must exist, or there wouldn’t be any CPMs practicing, but it’s hard to find that info without talking to the CPMs themselves.

I don’t know that I’ve actually decided to do this, but it feels like a definite maybe. I can at least say that body fluids don’t make me squeamish, and I have been told that I am good at soothing and relaxing people. I don’t get hyper or panic easily. I’m good at feeling and helping to smooth out the tension in other people, at finding ways to dial down stress when it starts to escalate.

I love babies, and pregnancy (well I didn’t always enjoy my own, but the experience as a whole) and the miraculousness of birth. I love the idea of giving other women the help I could not get, of helping them find their own confidence and strength. Even if they have to transfer and have c/sections, as some will, I love the idea that I can help them fight for a good c/section, for their rights as patients and mothers.

Speaking of bodily fluids, Nathan ralphed all over me tonight and while I cleaned us up the carpet still needs some work. Off I go.

^it being whatever; my career, my kid, my marriage, my wardrobe, you name it. Some part of my brain thinks there is a correct way to “do” these things, but it is certainly not the way I’m doing it now. I don’t like that part of my brain.
^^an amazing amount. And still they say “you finish things so fast!” Either I am a superhero or they really have no idea how easy my job is.


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