Guest Editorial: Once a Nurse-Midwife Always a Nurse-Midwife

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Nurse-midwifery cannot possibly have a significant impact upon maternal and infant care in this country until we have far more practitioners. Understandably, then, many have strongly criticized those nurse-midwives who are not practicing, decrying their apparent waste of specialized knowledge and skills.

As one who has been in the position of having to justify to colleagues, and admittedly to myself, my retreat from nurse-midwifery practice and re-entry into nursing education, I believe that I can now earnestly plead “not guilty” to the charge of desertion.

One year ago, I joined the teaching staff of a baccalaureate nursing program (in a geographical area where nurse-midwives are still anathema). I must admit to having initially experienced pangs of guilt that I had abandoned my “sister-pioneeresses” of nurse-midwifery. Yet I no longer see this as the case. In fact, I now subscribe to the position that a nonpracticing nurse-midwife has a valuable contribution of her own to make to the profession.

How can that be? To be sure, I am not monitoring labors, delivering babies, or assessing the normalcy of the patient. However, I have been able to bring to the classroom and to clinical settings something which, although more intangible, is nevertheless of great importance to the widespread promotion of nurse-midwivery. Publicity — Public relations — Recruitment of prospective nurse-midwives — all these are essential to the growth, recognition and acceptance of our profession. Yet, here in the nation's Capital, nurses, doctors, and the lay public — virtually everyone — are unaware of the underlying “who, what, where, when and why” of the contemporary nurse-midwife; this, of course, is true of countless other localities across this nation. Given this almost complete lack of recognition of nurse-midwifery, I chose to make an all-out effort to make our identity known and our services coveted as far as my voice could be heard. To date, the response has been most encouraging.

Within my own limited work situation, my “brainwashing” strategy is finding professionals and students suprisingly receptive. Students have shown real and serious interest, and I would expect an influx of applications to nurse-midwivery educational programs from them. And some faculty members have expressed regret at not having studied nurse-midwivery. The spirit and enthusiasm have been contagious, and the pleasure I derive more than offsets the time and effort involved.

Certainly the best means of selling our product to the general public is to let them see us in action. But this is not always possible — nor is it sufficient. To become more effective, we must stand up for ourselves. First, we must tap the communications media more resolutely. We have to tell our story to the people — on television, in the major news supplements. We need lobbyists in Congress who will take up our cause, and to communicate regularly with legislators and bureaucrats. We need especially to bombard the medical and nursing journals with articles and research documenting our achievements, and we must seek speaking engagements for our representatives before important audiences. And yes, we must “storm the Bastille” and convince hospital administrators to permit nurse-midwives to assume their rightful position within the obstetrical team.

All of this and more is needed … now. There are perhaps a thousand of us in the United States. If each of us were to devote a fraction of our leisure time to these endeavors, the net result would have to be a thousand-fold more fruitful. And upon those of us not actively engaged in clinical practice, the heaviest burden should fall. We owe it to ourselves and to our profession! We must prove to our colleagues and supporters that “Once a Nurse-Midwife Always a Nurse-Midwife …”

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