Help Hannah Keep Her Promise - Midwifery Education
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Hi! My name is Hannah Rasmussen, and I am going into my second year of midwifery training in Mercy in Action College of Midwifery. I was born in the US, lived most of my growing up years in Canada, and am now studying in the US. I am fundraising to complete my education.
I blame my grandmother for getting interesting in midwifery, although I didn’t even know that such a thing existed at the time. She was supposed to watch me when my parents went to the hospital for the birth of my brother, but she didn’t fancy the idea of being a babysitter to a bundle of three-and-a-half-year-old energy, so I had the unexpected privilege of witnessing the miracle of life at that early age (see the picture above). As I grew, so did my interest in and ability to help those around me. I enjoyed serving as first aid support for half marathons and camping trips, as well as in the unexpected circumstances of life. While volunteering as a girls counselor at a non-profit academy, I started thinking seriously about midwifery. As I learned more about the model of care by which midwives practice and the excellent outcomes that can be attributed to this care, as well as the more personable continuity of care (the midwife you see during your pregnancy being the one there to support you at the time of birth), I felt myself drawn to this type of care. I found it overwhelming to recognize that our US maternity healthcare system falls so far behind other developed countries in which midwifery care is much more common, such as the Netherlands. After spending some time job-shadowing a midwife, I knew this was the calling I had been preparing for all my life.
Last September, I started my first year of the Bachelor of Science in Midwifery program with Mercy in Action College of Midwifery, a MEAC (Midwifery Education Accreditation Council) accredited college that prepares students to take the NARM exam and register and practice as a Certified Professional Midwife in the USA. I have been so grateful for every moment of the training so far! My desires to learn evidence-based methods for providing excellent and compassionate care have been gratified and yet stimulated, and I know there is so much more to learn. Very early in our training, I realized just how much midwives have to offer their communities in normal and abnormal situations, but over the past few months in particular, the value of and need for more midwives has been receiving more attention in the media.
I have always been a hard worker and enjoyed the independence of not having to rely on anyone else for my necessities, so, as usual, I lined up summer work to help earn support myself and prepare for the coming school year. I was thrilled when I found a possible preceptor (an experienced midwife who is qualified to oversee a student midwife’s clinical experience) even though it would mean that I would need to relocate to another state. Then COVID-19 lockdowns struck, and the jobs I had counted on to prepare for the move were no longer available. Unfortunately, it has also proved very difficult to find work in the area to which I am moving that is flexible enough to allow me to go to births on call, enough time to study, and yet meet my minimum school requirements. It is hard enough for student midwives at the best of times, but now it is even harder. Finally, I knew that if I was going to stay in midwifery training, I would need to reach out for help. But I’m not the only one that is struggling with the ramifications of this global pandemic lockdown, and my desire to stay in midwifery training isn’t all about me—there’s something bigger than my education at stake.
THE SOMETHING BIGGER:
I think we can all agree that the unprecedented response to COVID-19 has effected each of our lives in some way or another, but perhaps none so much as our expectant mothers. The sudden change in hospital policies limiting the number of companions during labor and their own concerns for their safety and that of their unborn baby is causing pregnant women to look for safe alternatives in the out of hospital setting with midwives. Midwives are skilled healthcare professionals who provide excellent care to low-risk women with low-risk pregnancies, but only relatively few women in the US deliver with them in birth centers or at home. As of 2017, women who gave birth at home accounted for only about 1% of the overall population, and the overall percentage of women giving birth out of hospital (including birth centers and home) was only about 1.6%,(https://www.cdc.gov/nchs/products/databriefs/db144.htm, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642827/).
However, expectant mothers who qualify and want to change their birth plan to an out of hospital birth due to COVID-19 are finding it very difficult due to the relatively small number of midwives. With so few women delivering at home or in birth centers, this sudden swing is overwhelming the practicing midwives; and experts predict that the social disturbances may continue on and off for the next two years or more. With these possibilities before us, compounded by the fact that when people are cooped up at home for long periods of time with nothing to do, an increase in unexpected pregnancies are sure to occur, the need for more midwives is painfully evident. In fact, even before the outbreak of COVID-19, the World Health Organization had designated 2020 as the International Year of the Nurse and Midwife in an effort to bring attention to the global need for more workers in these two professions.
In this time of unprecedented unemployment, student midwives can find it very difficult to stay in school due to the difficulty of supporting themselves. Although they are willing and able to work, employers may find it very unattractive to hire them as they must be on call 24/7 for births and so will leave work or call in unexpectedly. This can mean that student midwives are unable to support themselves while continuing to pursue an education, and usually the result is that the education has to be laid aside or pursued only part time. This cycle means that the shortage of midwives is perpetuated, reducing the options available to our expectant mothers.
I blame my grandmother for getting interesting in midwifery, although I didn’t even know that such a thing existed at the time. She was supposed to watch me when my parents went to the hospital for the birth of my brother, but she didn’t fancy the idea of being a babysitter to a bundle of three-and-a-half-year-old energy, so I had the unexpected privilege of witnessing the miracle of life at that early age (see the picture above). As I grew, so did my interest in and ability to help those around me. I enjoyed serving as first aid support for half marathons and camping trips, as well as in the unexpected circumstances of life. While volunteering as a girls counselor at a non-profit academy, I started thinking seriously about midwifery. As I learned more about the model of care by which midwives practice and the excellent outcomes that can be attributed to this care, as well as the more personable continuity of care (the midwife you see during your pregnancy being the one there to support you at the time of birth), I felt myself drawn to this type of care. I found it overwhelming to recognize that our US maternity healthcare system falls so far behind other developed countries in which midwifery care is much more common, such as the Netherlands. After spending some time job-shadowing a midwife, I knew this was the calling I had been preparing for all my life.
Last September, I started my first year of the Bachelor of Science in Midwifery program with Mercy in Action College of Midwifery, a MEAC (Midwifery Education Accreditation Council) accredited college that prepares students to take the NARM exam and register and practice as a Certified Professional Midwife in the USA. I have been so grateful for every moment of the training so far! My desires to learn evidence-based methods for providing excellent and compassionate care have been gratified and yet stimulated, and I know there is so much more to learn. Very early in our training, I realized just how much midwives have to offer their communities in normal and abnormal situations, but over the past few months in particular, the value of and need for more midwives has been receiving more attention in the media.
I have always been a hard worker and enjoyed the independence of not having to rely on anyone else for my necessities, so, as usual, I lined up summer work to help earn support myself and prepare for the coming school year. I was thrilled when I found a possible preceptor (an experienced midwife who is qualified to oversee a student midwife’s clinical experience) even though it would mean that I would need to relocate to another state. Then COVID-19 lockdowns struck, and the jobs I had counted on to prepare for the move were no longer available. Unfortunately, it has also proved very difficult to find work in the area to which I am moving that is flexible enough to allow me to go to births on call, enough time to study, and yet meet my minimum school requirements. It is hard enough for student midwives at the best of times, but now it is even harder. Finally, I knew that if I was going to stay in midwifery training, I would need to reach out for help. But I’m not the only one that is struggling with the ramifications of this global pandemic lockdown, and my desire to stay in midwifery training isn’t all about me—there’s something bigger than my education at stake.
THE SOMETHING BIGGER:
I think we can all agree that the unprecedented response to COVID-19 has effected each of our lives in some way or another, but perhaps none so much as our expectant mothers. The sudden change in hospital policies limiting the number of companions during labor and their own concerns for their safety and that of their unborn baby is causing pregnant women to look for safe alternatives in the out of hospital setting with midwives. Midwives are skilled healthcare professionals who provide excellent care to low-risk women with low-risk pregnancies, but only relatively few women in the US deliver with them in birth centers or at home. As of 2017, women who gave birth at home accounted for only about 1% of the overall population, and the overall percentage of women giving birth out of hospital (including birth centers and home) was only about 1.6%,(https://www.cdc.gov/nchs/products/databriefs/db144.htm, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642827/).
However, expectant mothers who qualify and want to change their birth plan to an out of hospital birth due to COVID-19 are finding it very difficult due to the relatively small number of midwives. With so few women delivering at home or in birth centers, this sudden swing is overwhelming the practicing midwives; and experts predict that the social disturbances may continue on and off for the next two years or more. With these possibilities before us, compounded by the fact that when people are cooped up at home for long periods of time with nothing to do, an increase in unexpected pregnancies are sure to occur, the need for more midwives is painfully evident. In fact, even before the outbreak of COVID-19, the World Health Organization had designated 2020 as the International Year of the Nurse and Midwife in an effort to bring attention to the global need for more workers in these two professions.
In this time of unprecedented unemployment, student midwives can find it very difficult to stay in school due to the difficulty of supporting themselves. Although they are willing and able to work, employers may find it very unattractive to hire them as they must be on call 24/7 for births and so will leave work or call in unexpectedly. This can mean that student midwives are unable to support themselves while continuing to pursue an education, and usually the result is that the education has to be laid aside or pursued only part time. This cycle means that the shortage of midwives is perpetuated, reducing the options available to our expectant mothers.
THE PROBLEM AND THE PROMISE:
So where does the keeping of a promise come in? In certain cultures, young women are chosen to train as midwives from an early age, learning from and working alongside the elder-midwife in their community, gleaning all the information and knowledge possible and developing skills under the guidance of this practitioner. This ensures that there will always be a qualified midwife to provide care to the mothers in their community. The young woman going through this process is called a “promise midwife” because she is a promise to her community of quality maternity care.
Although I am completing a rigorous academic program through a MEAC accredited school in the USA, I am still a promise midwife in that I am a promise of quality maternity care to those in the future and I work along side already qualified midwives as a student, assisting at births and thus helping to maximize our midwifery population. You have the ability to help me fulfill my promise of becoming a full midwife by donating to subsidize my earnings while I’m in midwifery school.
Please empower me so I can pass forward the empowerment to the women who will be in my care during the difficult days.
WHAT YOUR CONTRIBUTION WILL GO TOWARDS:
$278 - Cost of required English 102 and Statistics class that must be completed over this summer - Provided for
$300 USD - Estimated Expenses of moving and changing registration to preceptorship location - Provided for
$450 USD - Yearly Student Fee for college - Provided for this year, but needed yearly
$~300 USD - Textbooks (per semester) - Provided for semester, but needed each semester
$180 USD - Neonatal Resuscitation certification - Provided for
$55 USD - Basic Life Support (CPR)training - needed August
$2,232 USD - Tuition per semester - needed every July and December
$~150 USD/month - current cost of housing - monthly
$~93/month - Car insurance (necessary for work and attending births) - needed monthly
$~125/month - Fuel cost of driving to and from work, appointments and births - needed monthly
$~30 USD/month - cell phone plan - needed monthly
$100 USD/month - basic food - needed monthly
$350 USD - approximate costs of required equipment/supplies for school - need spread out over training
$499 USD - NARM Online preparation course - needed by 2023
$900 USD - NARM exam fees - needed by 2023
Please note that I am not expecting contributions to cover all of these needs, but these are all needs toward which your contributions will go. I am working to cover as many of these as possible, but your contributions are going toward what I cannot cover in each of these categories out of my own earnings.
HOW YOU CAN HELP
Please financially contribute as you are able to help me successfully complete my midwifery education so I can serve, both while a student and as a fully qualified and and skilled midwife. Even if you are only able to contribute $5 per month, I would be so very grateful. Only you know how much you can afford to give. No contribution is too small! If you are unable to help monetarily, you can help by spreading the word. Please feel free to share the link and your support for this fundraiser on your social media accounts. If you know other midwifery students, please reach out to them with encouragement and tangible support. And please keep us all uplifted in your prayers.
Thank you, thank you, thank you, to each one who will choose to support me in whatever way you are able. I cannot tell you enough how grateful I am to you! You are helping me keep my promise of quality maternity care to the families we all care so much about—maybe even you, your daughters, your sisters, and your friends. Thank you!
WHY DO I BELIEVE IN MIDWIFERY CARE:
I believe in the underlying principles of this type of care:
* Care is personalized to the mother’s specific needs and circumstances, leading women to have better outcomes and be more satisfied with their experience.
* It empowers the mother, acknowledging her as the one in charge of the care provided to her and her infant, providing her with all the information to make the decision.
* Birth is respected as sacred and a rite of passage for the mother, and she is given space to and support in celebrating it.
* The mother has access to immediate phone and texting with her care provider so any questions she has or concern over something she is afraid is “not right” can be addressed immediately, leading to complications being caught and dealt with before they become emergencies.
* It focuses on empowering the mother emotionally, helping the mother to be prepared for and require less pain relief measures during labor.
* This type of care places emphasis on lifestyle and preventative care as much as possible, helping to prevent complications.
* The overall costs of midwifery care are far less than hospital care.
* The mother can deliver in her own “safe space,” helping her to relax leading to a smoother, less painful birth
When the women in midwifery care are compared with a similar population (comparable low-risk status, parity, etc), it has been found that mothers in midwifery care have:
* less likely to be need hospitalization during their pregnancy
* fewer premature and low birth weight infants
* fewer Cesarean sections and more successful VBACs
* Reduction of risk of infections “caught” in the hospital (especially important with the rise of antibiotic-resistant superbugs)
* Less likely to develop hypertension during pregnancy
* Less likely to have an episiotomy performed on her or suffer a third of fourth degree tear during labor
* Less likely to need interventions for abnormal fetal heart tones during labor
* Less likely to suffer from fragments of her placenta being retained avoiding invasive procedures and reducing risks
* The baby is less likely to require extraction with a ventouse or forceps
* The baby is less likely to have shoulder dystocia
* The baby is less likely to have significant birth injuries/traumas
* Mother and baby are less likely to be separated, benefitting the mother/baby bonding and long-term relationship
* More likely to successfully breastfeed within the first hour after birth, which has been clearly associated with a better rates of survival.
And if you have a hard time believing what I’m saying, just take a look at this statement by the World Health Organization: https://www.who.int/maternal_child_adolescent/topics/quality-of-care/midwifery/case-for-midwifery/en/ .
Another excellent resource is The Business of Being Born by Abby Epstein and Ricki Lake: https://www.thebusinessof.life/ .
Also check out NACPM at https://nacpm.org/for-families/ .
It is worth noting that the USA has far worse outcomes in rates of maternal and infant mortality than other developed countries that use midwifery care for a much larger percentage of their population. In conclusion then, out of hospital midwifery care is a safe option for low-risk mothers, even safer than hospital care in many cases.
I want to be a part of offering culturally-sensitive, personalized, respectful, quality maternity care to all low-risk women in the midst of the crazy times in which we are living. I want to fulfill the promise I made to every mother in starting midwifery training.
Thank you for helping me keep this promise!
So where does the keeping of a promise come in? In certain cultures, young women are chosen to train as midwives from an early age, learning from and working alongside the elder-midwife in their community, gleaning all the information and knowledge possible and developing skills under the guidance of this practitioner. This ensures that there will always be a qualified midwife to provide care to the mothers in their community. The young woman going through this process is called a “promise midwife” because she is a promise to her community of quality maternity care.
Although I am completing a rigorous academic program through a MEAC accredited school in the USA, I am still a promise midwife in that I am a promise of quality maternity care to those in the future and I work along side already qualified midwives as a student, assisting at births and thus helping to maximize our midwifery population. You have the ability to help me fulfill my promise of becoming a full midwife by donating to subsidize my earnings while I’m in midwifery school.
Please empower me so I can pass forward the empowerment to the women who will be in my care during the difficult days.
WHAT YOUR CONTRIBUTION WILL GO TOWARDS:
$278 - Cost of required English 102 and Statistics class that must be completed over this summer - Provided for
$300 USD - Estimated Expenses of moving and changing registration to preceptorship location - Provided for
$450 USD - Yearly Student Fee for college - Provided for this year, but needed yearly
$~300 USD - Textbooks (per semester) - Provided for semester, but needed each semester
$180 USD - Neonatal Resuscitation certification - Provided for
$55 USD - Basic Life Support (CPR)training - needed August
$2,232 USD - Tuition per semester - needed every July and December
$~150 USD/month - current cost of housing - monthly
$~93/month - Car insurance (necessary for work and attending births) - needed monthly
$~125/month - Fuel cost of driving to and from work, appointments and births - needed monthly
$~30 USD/month - cell phone plan - needed monthly
$100 USD/month - basic food - needed monthly
$350 USD - approximate costs of required equipment/supplies for school - need spread out over training
$499 USD - NARM Online preparation course - needed by 2023
$900 USD - NARM exam fees - needed by 2023
Please note that I am not expecting contributions to cover all of these needs, but these are all needs toward which your contributions will go. I am working to cover as many of these as possible, but your contributions are going toward what I cannot cover in each of these categories out of my own earnings.
HOW YOU CAN HELP
Please financially contribute as you are able to help me successfully complete my midwifery education so I can serve, both while a student and as a fully qualified and and skilled midwife. Even if you are only able to contribute $5 per month, I would be so very grateful. Only you know how much you can afford to give. No contribution is too small! If you are unable to help monetarily, you can help by spreading the word. Please feel free to share the link and your support for this fundraiser on your social media accounts. If you know other midwifery students, please reach out to them with encouragement and tangible support. And please keep us all uplifted in your prayers.
Thank you, thank you, thank you, to each one who will choose to support me in whatever way you are able. I cannot tell you enough how grateful I am to you! You are helping me keep my promise of quality maternity care to the families we all care so much about—maybe even you, your daughters, your sisters, and your friends. Thank you!
WHY DO I BELIEVE IN MIDWIFERY CARE:
I believe in the underlying principles of this type of care:
* Care is personalized to the mother’s specific needs and circumstances, leading women to have better outcomes and be more satisfied with their experience.
* It empowers the mother, acknowledging her as the one in charge of the care provided to her and her infant, providing her with all the information to make the decision.
* Birth is respected as sacred and a rite of passage for the mother, and she is given space to and support in celebrating it.
* The mother has access to immediate phone and texting with her care provider so any questions she has or concern over something she is afraid is “not right” can be addressed immediately, leading to complications being caught and dealt with before they become emergencies.
* It focuses on empowering the mother emotionally, helping the mother to be prepared for and require less pain relief measures during labor.
* This type of care places emphasis on lifestyle and preventative care as much as possible, helping to prevent complications.
* The overall costs of midwifery care are far less than hospital care.
* The mother can deliver in her own “safe space,” helping her to relax leading to a smoother, less painful birth
When the women in midwifery care are compared with a similar population (comparable low-risk status, parity, etc), it has been found that mothers in midwifery care have:
* less likely to be need hospitalization during their pregnancy
* fewer premature and low birth weight infants
* fewer Cesarean sections and more successful VBACs
* Reduction of risk of infections “caught” in the hospital (especially important with the rise of antibiotic-resistant superbugs)
* Less likely to develop hypertension during pregnancy
* Less likely to have an episiotomy performed on her or suffer a third of fourth degree tear during labor
* Less likely to need interventions for abnormal fetal heart tones during labor
* Less likely to suffer from fragments of her placenta being retained avoiding invasive procedures and reducing risks
* The baby is less likely to require extraction with a ventouse or forceps
* The baby is less likely to have shoulder dystocia
* The baby is less likely to have significant birth injuries/traumas
* Mother and baby are less likely to be separated, benefitting the mother/baby bonding and long-term relationship
* More likely to successfully breastfeed within the first hour after birth, which has been clearly associated with a better rates of survival.
And if you have a hard time believing what I’m saying, just take a look at this statement by the World Health Organization: https://www.who.int/maternal_child_adolescent/topics/quality-of-care/midwifery/case-for-midwifery/en/ .
Another excellent resource is The Business of Being Born by Abby Epstein and Ricki Lake: https://www.thebusinessof.life/ .
Also check out NACPM at https://nacpm.org/for-families/ .
It is worth noting that the USA has far worse outcomes in rates of maternal and infant mortality than other developed countries that use midwifery care for a much larger percentage of their population. In conclusion then, out of hospital midwifery care is a safe option for low-risk mothers, even safer than hospital care in many cases.
I want to be a part of offering culturally-sensitive, personalized, respectful, quality maternity care to all low-risk women in the midst of the crazy times in which we are living. I want to fulfill the promise I made to every mother in starting midwifery training.
Thank you for helping me keep this promise!
Organizer
Hannah Rasmussen
Organizer
Camas, WA