Midwife Connection

by Nancy Jo Reedy, CNM

Last fall, we lost two influential cultural voices: Steve Jobs in October, and Andy Rooney in November. Both of these men left behind legacies that we as midwives can carry on and learn from.

Steve Jobs, the founder and visionary behind Apple, died at the early age of 56. In his younger days, he left college—it wasn’t teaching him anything he wanted to learn. He followed his dream and vision by working with a friend in a garage to create Apple. He left Apple, founded another company that Apple then purchased, and was back again. He was “not in the mold” and actually hated the mold. Working in jeans and tennis shoes, hiring other visionary misfits, he pursued perfection in everything he developed. He thought outside the box, was unafraid of doing his own thing, and never lost sight of the people who would use his products. What does the consumer want—or what would they want if it were a reality? Each time you go “app crazy” on your cell phone or iPad or put buds in your ears to block out the chaos of the airport while you listen to your iPod, you can thank Steve Jobs.

The similarities between Jobs and midwives may not be apparent, but I see some real parallels. What would Jobs think about our colleagues who are blazing new roles for midwives as hospitalists, triage providers, faculty for nursing and medical students, and developing midwife-oriented businesses? What would he say to us about “listening to women” and redesigning health care to meet the needs of women in their choice in site of birth, support through centering groups, or declining traditional medications in favor of alternative/complimentary therapy? What have women not thought of yet that they really would want/need if it were available? How do we support visionary midwives who will lead us in creating new care options to meet those needs?

Andy Rooney retired from 60 Minutes at the age of 92 and passed away soon after. Rooney was my favorite resident curmudgeon. He had unfailing common sense. How often have midwives turned to each other and lamented the lack of common sense in health care? Midwives cannot have hospital privileges “because you are not a doctor.” Did I say I wanted hospital privileges as a doctor? No, I want credentialing for what I am, a midwife. The state says it must “know who is writing prescriptions. Therefore, the prescription must be written or delegated by the physician.” The midwife or nurse-practitioner who actually saw the patient and wrote the prescription is not recorded. How does this help the patient? Episiotomies used to be the standard of care—and midwives were all taught to do “an epis” particularly for primigravidas. Midwives fought this—believing that episiotomy is unnecessary in virtually all births and leads to increased incidence of third and fourth degree tears. Today, after several studies, medicine has determined “There is little evidence to support routine use of episiotomy. This procedure may well increase the incidence of third- and fourth-degree lacerations.” What would Andy say?

Two very different men, with two very different messages that can both serve us well: We need to avoid the temptation to lose sight of the obvious and search for the most complex solutions to problems—sometimes the answer really is just common sense. On the other hand, innovation and visionary people are treasures that need to be nurtured and encouraged. Thinking outside the box and focusing on the women we serve is the right way to have a “successful product.”

Image via Cain and Todd Benson on Flickr.