Midwifery

Certified nurse-midwife Sarah Webster ’05 has a special place in her heart for all the women she has helped become mothers. But she will never forget the one who labored with her second son in a truly unique way.

“She sang a verse of ‘Amazing Grace’ through every contraction. It was absolutely incredible,” said Webster, who has attended births of more than 240 babies in her time as a midwife for a birthing center in Wilmington, Delaware. “As she got closer to transition, it became more difficult as she wasn’t able to sing anymore. So, she wanted me to sing. And I was able to, and that’s what helped her through labor. It was amazing. It was such a blessing.”

The hours are long and the stakes are high, but moments like that one make midwifery much more than a job. In an “industry” that has seen trends come and go – right now water births are being questioned, Cesarean section rates are slowly dropping and birthing centers are en vogue – this centuries-old tradition has withstood the test of time. It is an art, a science and a ministry all swaddled together.

And at Messiah College, would-be midwives are taught the tools of this ancient practice of assisting, witnessing and celebrating the miracle of birth. While they are highly trained professionals, they are often misunderstood.

Is that legal?

“When I first became a midwife people would say, ‘Is that legal?’ ‘Yes,’ I’d say. ‘It is legal,” said Nancy Woods, Messiah College’s nursing chair who worked for many years as a certified nurse-midwife. “Midwives are reimbursed by Medicare, Medicaid and all the major insurance companies. And they’re independent healthcare providers, so we have prescriptive privileges, and admitting and discharge privileges. We always work in conjunction with a physician to consult with or refer to if we need to, but we do not work under a physician.”

Women have been giving birth since the dawn of the ages, yet in today’s world of modern medicine and conveniences it’s easy to become detached from such intuitive knowledge, leaning on Internet advice and pain medication instead of listening to the way a body responds naturally to labor. It is the midwife’s job to be that bridge for the modern mother, leading her down the path millions have gone before her, while respecting her choices all the way.

“As a midwife, I’m all about helping a woman trying to achieve what her body is trying to do,” said Webster. But all that helping and encouraging are backed by a solid education; you need a bachelor’s degree to be admitted to a certified nurse midwife or certified midwife master’s degree program. Though Messiah doesn’t offer a midwifery degree, its nursing program introduces its students to the specialty.

“Many area hospitals have midwifery practices, so all of our nursing students are exposed to midwifery care,” Woods said.

Midwives are considered primary health care providers, offering physical exams, prenatal care, medication and prescriptions in addition to labor and delivery assistance. Some assist home births or work in birthing centers, like Webster, but many are hired by traditional medical offices and hospitals.

“OBs and doctors’ offices are hiring midwives because they’re cheaper than hiring another physician,” Webster said. “Midwives can handle labor and delivery, freeing up a doctor’s time to do surgery and other things.”

Certified nurse-midwife Marsena Howard, an adjunct professor of nursing at Messiah, solely attends the births of babies at home; 90 percent of her patients are women in central Pennsylvania’s Plain community, such as Amish and Mennonite. Howard says she had no interest in midwifery until she found herself in that role while working as a nurse in Kentucky. Thirty-six years later, she just attended the birth of her 2,000th baby.

“They see birth as a beautiful, God-given experience and a woman’s job,” said Howard of the Plain women. “They go into it with a positive expectation and somewhat of a stoic expectation; they have a task-oriented thought process.”

Howard is careful to respect the modesty and privacy of the women under her care. In the Plain community, women don’t share their due dates with others, and only the husband is in the room for the delivery. 

“Their children don’t even know they’re expecting. It’s very much a private issue with people, it’s not something that’s talked about,” she said. “They’ll tease each other about when their due date might be, but it’s typically something that’s not told.”

Howard makes regular visits throughout the pregnancy, getting to know the woman and her family while staying in tune with how things are progressing, particularly once labor starts. With a home birth, the responsibility rests on the midwife alone to make an informed, quick decision to send a laboring woman to a hospital if more traditional medical care is needed.

“I think I’ve been at it long enough that there’s a sixth sense, a God-directed sense,” said Howard, who typically sends to the hospital about 25 percent of first-time moms and about 10 percent of mothers who’ve been around the pregnancy block at least once. “You’re always keeping your eye open for those, I send them to the hospital.”

Midwives typically stay with the mother and baby for two hours after the birth, caring for both during that time. Howard follows up with her patients the next day and then checks the mother and baby again during the next six weeks.

God-given intuition

Howard’s been on the job so long that at least one of the babies she attended the birth of now has grown to have babies of her own, and the seasoned midwife was present for those births, as well. It is a profession and a calling that both leans upon her faith and strengthens it, she says.

“I think it’s made my faith more a part of my daily life, when you’re faced with making decisions that matter for other people, and you’re relying on the Lord to give you direction for those kinds of things,” said Howard, who does not have children of her own. “And it’s my whole life; it’s all-consuming. To make the Lord a part of that is the only way to live.”

Webster, also not a mom yet, has relied on that mix of education and God-given intuition to keep her wits about her despite her own fatigue and sometimes troubling circumstances. She recalls one patient whose baby had a cord prolapse, where the umbilical cord falls below the baby’s head. With every contraction, the blood supply was cut off from the baby, necessitating a move from the birthing center to a nearby hospital so the woman could deliver via C-section. From the ambulance drive to the hospital straight into the operating room with the mother, the 32-year-old professional remained calm.

“I’m good at it. It’s something that comes almost naturally to me,” she said of midwifery. “Give me a laboring woman and I come to life.”