A New Midwife in Town
What a pleasure it has been to see the bright-eyed, active little girl who lived across the street become the assured young woman who came to tell me about her new job as a nurse midwife in Dr. Wesley Hedges’ office. That woman is Susan Smith, Dr. Bob and Carol Yager’s daughter. She and her husband, Brian Smith and their children came back to Tiffin two years ago when Brian started teaching at Terra Community College.
Midwifery has been around for thousands of years. The word, “midwife”, means “with women”. It was only at the end of the nineteenth century that it became customary for doctors to deliver babies. Now it is possible for women to have the best of both worlds. They can choose a trained woman to support them in their pregnancy who has most likely given birth herself, or they can chose a doctor who also can be supportive and has had additional training and can do C-sections in difficult births.
Midwifery in the United States took a giant step forward as a profession when, in 1925, Mary Breckenridge started a nursing clinic in rural Hazzard, Kentucky. She had lost two very young children to illness and she devoted her life to delivering health care to the people in eastern Kentucky. Her nurses, affectionately, Nurses on Horseback, traveled on horseback and mule through mud, snow, and rain, and forded rivers to deliver babies. They carried torches to light their way at night. Their charge was five dollars for complete prenatal care and delivery, or whatever the family could afford. In that rural county, there were 36 stillborn babies in 1,000 in 1925, and by 1936 this had been reduced to 25 in 1,000.
The clinic has grown to become a national center for training midwives who come from all over the world. Around 200 midwives graduate from their program each year. This is the program where Susan received her training
After finishing high school at Columbian, Susan majored in premed at Ohio Wesleyan. While she was there she met several nurses and was attracted to their profession by their stories. She graduated with a B. S. in Nursing and married Brian Smith, a Heidelberg graduate. They traveled to Wyoming where at first she was a general medical nurse. Then she completed a Master ‘s Degree in Maternal and Child Health and worked in obstetrics.
While she was in Wyoming, she met an enthusiastic midwife from Chile who assisted in home births and was often paid in chickens or rabbits or farm produce. Susan, who by this time had two children, Drew and Payge, set her sights on becoming a midwife.
She and her family came back to Tiffin, and she enrolled in the Certified Nurse Education Program at the Mary Beckenridge Frontier School in Hazzard, Kentucky. This school, in partnership with Case Western School of Nursing, grants degrees in midwifery. Students are involved in a distance learning program which links them with the center. Applicants must identify a Certified Nurse Midwife in her community who will provide a clinical site and serve as her precept and mentor. The Banyon Tree, an electronic bulletin board, serves as a link between the students in their homes and the center. After completing two levels of instruction, students go to the Mary Beckenridge School for hands-on training. For the fourth level, students work on a clinical rotation with their Nurse Midwife mentor. Susan delivered 40 babies, did newborn exams, annual checkups, and gave advice to young mothers. Then she had to take a comprehensive exam and a six-hour National Board Exam.
Part way through this two year program, Susan gave birth to her daughter, Brooke. Her mentor, Eileen Sirois, assisted at the birthing. For the birth, Susan was in a four by five foot whirlpool tub and her baby was born under water and quickly helped to the surface for air. Susan says that this kind of delivery allows the mother to be more comfortable and is less traumatic for the baby.
Susan could tell of many successful deliveries, but one particularly comes to mind. A teen-aged mother had her mother and her boyfriend in the delivery room with her. Her delivery progressed nicely. Susan was traveling back and forth between her room and another room. At one point she asked for an epidermal, an anesthesia administered by needle in the back. She said that she never planned to have the baby without anesthesia. She was so near delivery that Susan persuaded her to have the baby naturally. She pushed and the baby came out easily. The young mother was so proud of her accomplishment
One of the reasons that births assisted by midwives has become so popular is the time that a midwife takes to calm another woman’s fears and answer her questions. Many times a close partnership develops between the mother and her midwife which continues through annual exams.
Safety is a priority, and all Certified Nurse Midwives work in collaboration with doctors. Nurse Midwives spend a lot of time in their training learning to evaluate pregnancies to determine if they are high risk. Often a doctor and a midwife will co-manage high risk patients like those who have diabetes or high blood pressure.
Readers who think they might be interested in nursing or midwifery can go to the Mary Beckenridge Center to work as couriers. They deliver supplies and assist other ways. The age requirement is eighteen years or older. One RN came to Mary Beckenridge because she wanted to move out of the hospital setting where she dealt with the last stages of illness. She wanted to be involved in primary care. The center will grant free tuition and books to nurse’s aides and home health care aides who want to become nurse practitioners or midwives.
– Mary