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Being a midwife means you must be able to drop whatever it is you're doing at any time to attend to a birth. Of course, you also need to love babies.

The Midwives Alliance of North America (MANA) says midwives are responsible for giving the proper care and advice to women during pregnancy and labor. They can help with deliveries as well as care for the newborn.

The alliance says that means a midwife must be able to detect abnormal conditions and know when to seek medical help. They must also be prepared to use emergency measures if a doctor isn't available.

Another aspect of the job involves education, says MANA. Midwives are involved in health counseling for pregnant women, their families and the community. They can practice in hospitals, clinics or people's homes.

Midwife Wendy Huculak explains that in order to be a good midwife, you need to be devoted to the three philosophies of midwifery. These philosophies are:

  • Choice of birthplace -- a pregnant woman can decide to deliver at home or at the hospital
  • Continuity of care -- a pregnant woman is cared for by a maximum of four midwives throughout her pregnancy
  • Informed choice -- planning in advance how a pregnant woman would want to deal with complications, and which procedures and medications she would want to avoid

"It is an honor to be involved in the lives of women and their families and attend their births," says midwife Kristy Hook.

She also enjoys the community aspect of the profession. "Midwives generally work in groups and have strong intraprofessional relationships."

In the U.S., each state has its own laws and qualifications regarding midwifery. In some states, a nursing degree or a master's degree in nursing or midwifery is required. In other states, an apprenticeship or some midwifery schooling is necessary.

Many states are now accepting standardized testing by the North American Registry of Midwives (NARM). To qualify for that test, you need at least two years of experience as an apprentice.

There are many formal midwifery schools in the U.S. There are also distance-learning courses.

The cost of running a midwifery practice varies from state to state. Birthing equipment can cost up to $5,000. Basic birthing equipment includes stethoscopes, blood pressure units, fetoscopes (for looking at or listening to the fetus), scales, otoscopes (for looking in the ear) and diagnostic equipment.

According to New Hampshire midwife Adrian Feldhusen, midwifery practices are often set up as home businesses. Basic costs include a computer as well as costs associated with filing your business papers. The major costs are incurred by midwifery education, not by business overhead.

Huculak says that all potential midwives would benefit from a combination of business education and experience.

"Start at the beginning," says Feldhusen. "Get a good education, and don't consider yourself a midwife until you're ready to take on the responsibility of being a primary health-care provider.

"When you open your own practice, don't be discouraged if clients don't come right away. People will seek out alternative care if given the ability to seek it out."

Since babies don't arrive on a schedule, midwives operate almost entirely on call. The number of on-call hours varies from practice to practice. But being on call 24 hours a day up to seven days a week requires a flexible lifestyle and patient family members.

Midwives must be self-motivated. They must also be comfortable with the responsibility entailed with providing primary health care.

Loving what you do is important. You must be passionate about babies. Midwives devote a great deal of time not only to births, but also to prenatal care and postpartum checkups.

Feldhusen notes that you must allow enough time for each family you are working with to feel sufficiently cared for, so you need to pace yourself. It's important to strike a healthy balance between attending births and having enough time for your own family.

For Huculak, the benefit of midwifery is a high degree of job satisfaction. But she cautions that there are serious demands on a person's personal life, especially if you have toddlers. She suggests that you have to have extremely good family backup and a very willing partner, because you can disappear for 12 hours at a time.

"You have to spend some time with a midwife, or speak to someone who has been through it to get a strong sense of what you are looking at doing," says Huculak. "It's not just a job. It's a life commitment. It's more than just a vocation; it's a passion."


Midwives Alliance of North America
This site provides detailed descriptions of different accreditations for midwives

North American Registry of Midwives
Performs standardized testing and certification of midwives in most states

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