This month we celebrated International Day of the Midwife – a day that not only highlights the critical work of midwives, but also rallies stakeholders across the world to invest in the future of midwifery. Thanks to their expertise, all counties have seen dramatic improvements in maternal mortality, yet we are still short in achieving the Millennium Development Goal to reduce maternal and newborn mortality. To achieve this, we not only need more midwives, but professionally trained ones.
In 2011, the United Nations Population Fund (UNFPA), published The State of the World’s Midwifery report which surveyed 58 countries and revealed a global shortage of an estimated 350 000 midwives – a third of which were needed in the world’s poorest countries. The second of its kind will be published this year and will examine availability, accessibility and quality of the midwifery workforce, including profiles of 73 countries.
Midwives face many challenges, from working in unsanitary conditions to lack of necessary equipment and medicine. And they do much more than deliver babies. The impact of midwives extends to newborn care, breastfeeding, family planning, and sometimes breast and cervical cancer screening. All the more reason to place midwives at the center of the continuum of care.
Investments in midwives can help prevent a significant number of the nearly 290,000 maternal deaths and three million newborn deaths that occur each year due to the lack of trained health workers. With such a global need, it is inspiring to meet those who are undeterred by the challenges ahead. One such woman recognizes not only the need, but the reward that comes from providing support to mothers and babies.
Nancy Termini grew up in Philadelphia and attended McGill University in Montreal. Studying Arabic Language and International Development Studies, Nancy had no plans on midwifery school. Now 26, she has returned to Pennsylvania and has begun prerequisites to apply for a 3-year BSN-MSN bridge program at the University of California, San Francisco. She also plans to apply to Georgetown and Frontier Universities. I had a chance to sit down with Nancy to learn how she chose this path, what challenges she may face, and how she hopes to make an impact in the world.
Girls’ Globe: How did you first learn about midwifery?
Termini: I was always aware of midwives growing up, but only through stories and in the stereotypical old-fashioned, folk-remedy sense. I learned about midwives as a modern and vibrant vocation when I began working for the Population Council – an international NGO confronting critical health and development issues, such as improving reproductive health. That’s where I learned of the critical role that midwives play in delivering care to women all over the world.
Girls’ Globe: What was it about midwifery that inspired you to go back to school?
Termini: I was first attracted to the holistic nature of midwifery. I loved that it is an ancient art and science that involves caring for the whole woman, not only during childbirth but throughout her reproductive life cycle. I also began to realize how important the direct, interpersonal nature of health care is to me. Midwives are so broadly qualified that there were many aspects of their work I found inspiring and am passionate about. I’ve met midwives who do everything from teaching, to providing well-woman care, delivering babies, conducting research, and leading college health programs.
Girls’ Globe: Trained midwives have skills in so many areas, what will be the most difficult aspect of midwifery school for you?
Termini: I imagine that a challenging aspect of midwifery school will be learning how to guide women through a process that I myself have never experienced, as I don’t yet have children. I think it will require an added layer of focus and empathy, and I’m sure I’ll learn as much from the women I work with as they will from me.
Girls’ Globe: Midwives are sometimes faced with difficult situations, such as health scares with mother or child, domestic abuse, and so on. How can you prepare yourself for what is ahead?
Termini: To gain experience with some of these situations in a lower-pressure role, I’m working as a doula as I apply to my graduate programs. Since Doulas focus on the emotional wellbeing of the parents, rather than the clinical, I hope that I can gain some comfort and familiarity with navigating challenging situations before it becomes my responsibility to direct them. I’m particularly looking forward to working with survivors of abuse, and plan to take specialized training so that I can better engage with their needs and experiences.
Girls’ Globe: With a worldwide shortage of properly trained midwives, do you have any ideas of where you would like to focus your work?
Termini: I’d like to work both domestically and abroad. It’s important to me that I work in the community I live in, but I’m also committed to supporting women in developing countries, whether it be working to train or support local midwives, or doing research. I’d also like to learn from midwife models abroad, in countries where midwifery is a much older and more institutionalized medical tradition than it is in the U.S.
Girls’ Globe: What are some of the challenges you see in midwifery?
Termini: Globally, midwives face a lot of legal and social barriers when it comes to their scope of practice – in which their ability to provide the range of services for which they are capable is constrained. Also, in the U.S., I think that midwives are often thought of as being anti-doctor, or anti-conventional medicine. This is definitely not the case, but it’s a social and institutional challenge that domestic midwives have to continually engage with. On an individual level, I’ve learned from a lot of midwives that working in labor and delivery is fulfilling but can be highly demanding in the long run, physically and emotionally – although there are obviously unique rewards.
Girls’ Globe: It sounds like you have had the opportunity to meet many midwives already. What has inspired you about those you’ve connected with?
Termini: When I began to be interested in midwifery, I spoke to about a dozen midwives who were either colleagues, friends-of-friends, or whom I cold called. I also had the pleasure of attending the 2013 American College of Nurse Midwives Conference. Across the board, the midwives I spoke with were passionate, smart, interesting women who had done a huge diversity of things and were all passionate about helping women to have healthy, fulfilling, reproductive lives. It’s such a supportive and exciting community, and everyone I spoke with was happy to share their experiences and engage with me to help me on my way there.
Girls’ Globe: Do you have any advice for young women who are thinking about midwifery?
Termini: Talk to midwives! Learning about their experiences and goals can help you to decide whether it’s a field you’d like to pursue, and help you understand your own desires and goals. Attend any kind of local birth event, and if you can, take a doula workshop. They are great ways to learn about other women’s birth or midwife experiences, and to meet people who work in childbirth. There are also some excellent books and films about birth and midwifery.
Nancy is a truly inspiring example of a woman working to make an active difference in the lives of women and children. She plans to work as a full-time midwife for several years and then shift to part-time so that she may engage some of the other skills of being a midwife, such as teaching or working with at-risk groups of women. I have no doubt that the hope and care Nancy puts into helping mothers will be reflected in her own life.
If you are interested in learning more about midwifery school, visit these resources: