Birth: A Midwife's Perspective

A photo I took of Tiffany helping to catch baby Willow. 

A photo I took of Tiffany helping to catch baby Willow. 

I had the pleasure of meeting Tiffany at a recent home birth. I really enjoyed working with her, she was always smiling and laughing and sweet. I really value those qualities in birth workers. Especially women that work with other woman so intimately, like midwives, doulas and nurses do. A hospital environment is both physically and mentally draining for the birthing women and workers alike. I had been wanting to get the perspective of a labor and delivery nurse, as I only have my own perspective of giving birth in a hospital setting. Coincidentally, Tiffany has worn both the nurse and the midwife hat. I was excited to hear what she had to say about working with women, being on the more medical side of things, and how that differed from her new practice in midwifery. I really enjoy that Tiffany has been able to see both sides of the coin, each are so valuable. No matter where a woman chooses to birth, I think what makes or breaks her birth are her support team. She was kind enough to answer a few questions on the topic. . . 

When did you know you wanted to have a career in birth work? Can you talk a little about your experiences as a labor and delivery nurse?

My passion for moms and babies started when I was in high school and had the privilege of volunteering on the mother/baby unit for 4 years. I had always thought I was going to be an OB/GYN but I soon realized the doctors saw very little of their patients and participated very little in their care and I realized, the nurses did everything! The nurses continually reminded me that nursing was the better career and I soon fell in line! My true career began 8 months after I graduated nursing school and was working on a medical/surgical unit when I found out I had finally been offered my dream job on the labor and delivery unit! I was thrilled! I no longer cried every day I went to work and I loved everything about my job. However, within six months of starting there, I realized that the practice I had to maintain was not in line with what I believed normal, natural birth to be and within a couple years, it became too much for me to bear. I loved the patients I worked for and served them to the best of my ability but every day I had to go against policies, practices and beliefs which made practicing as the holistic nurse I was nearly impossible. I was returning to my previous state of crying every day I had to work because I constantly felt berated and bullied just because I felt women deserved choices in how they delivered. When I left in 2013, I was so exhausted, burnt out and hurting, it took over a year for me to recover and find my joy again. I loved working for mothers but could not maintain the practice expected of me in the hospital setting. I knew that there had to be something more out there for me.

What made you switch to midwifery, and can you speak on the differences you've observed so far?

I am still a nurse and I am very proud of the work I put in to become a nurse. Some have asked me why I didn't choose to become a CPM and I believe with all my heart the plan was for me to be a CNM and I don't regret the decision one bit! I had found out about nurse-midwives in my senior year of nursing school and told myself that one day when I’m not burnt out on school, I was going to go back and get my master’s in nursing. After the first six months on the labor and delivery unit when it became clear I would spend nearly every shift fighting for what I believed my patients deserved, I decided I wanted to be the person who would give women options and provide high-quality care without the rush and force of the hospital setting. I learned about home birth through a couple I babysat for as a teen and decided from then on that that was the setting I wanted to practice in. I couldn't do this independently as an RN, so becoming a nurse-midwife became my goal!  

The initial challenge for me was getting used to the pace. I have been “raised” in the hospital setting where visits were 20 minutes long and any “slow” labor was put on Pitocin and forced off the unit as quickly as possible. I distinctly remember my first home birth labor and thinking to myself “this is so slow and boring, what am I going to do?!” But within a few births, the pace has become more normal and comfortable (though I am still improving my patience)! The differences are that I feel like I can “allow” women to do what feels right to them and allow them to take the reins and lead me where they want to go. There is peace with each delivery and I feel like I’m right at home where I have always belonged. Another major difference is I am now the responsible provider. This can be a heavy load to bear but I feel like my clients are gracious and forgiving of me as I learn the ropes. I still can support women and offer my knowledge base as I did as an RN and I do feel my nursing experience gives some of my clients reassurance about my knowledge base and experience which is another great reason why I don't regret working in the hospital setting!

Tell me about a favorite memory you have of a birth...

This is a tough question since I’ve seen so many births in my few short years in practice! I would rather share my favorite moment in birth that happens just about every time after baby delivers. When the mother is exhausted and has been laboring and pushing and finally hits that peak of delivering her baby, it’s almost the same response every time; this sigh of relief and the expression of pure joy knowing her journey is over and her baby is in her arms. Many moms say something along the lines of “I did it!” or “I’m done!” and there is instant calm in the room. Often, this is when my tough daddies break down and cry and the whole room is filled with emotion! I love this moment as everyone breathes a sigh of relief and we watch the instant bond between mom and baby!

Can you lend any advice to women thinking of going into either field? 

Make sure it’s the right choice for you; shadow another nurse, volunteer, become a CNA. I can’t tell you how many women I graduated with went to work in the nursing field and hated every second of it. That is too much time and money to commit to change your mind like that! Prepare to be challenged. Especially if you choose to become a nurse-midwife. The education alone is difficult but the challenges, disapproval even sometimes hatred you’ll experience in the real world can sometimes be enough to make one walk away. I have shed many tears and had to rebuild my confidence over the challenges I have faced as a new nurse-midwife, I can’t imagine the blood, sweat, tears and extreme challenges the midwives who have gone before me have experienced! The path has been well-paved for me to practice and though there are always battles that will need to be fought, my mom’s deserve me to fight for them! On the flip side, there will be rewards, joy, beauty and love! I can't imagine being in any other field of work, I tear up at the thought of my nearly walking away from everything two years ago because I was so beaten down. I would've missed out on so much, I would’ve let so many mothers and their families down. Women deserve options. I don’t care what anyone says about home birth, midwifery, or out of hospital birth in general, women will choose to come to us and birth in the location they feel the most comfortable whether naysayers like it or not and that will never change! So why not be the options women deserve?! I say, if you like be challenged on a daily basis, using critical thinking skills, fighting for the rights of others and standing up for what you believe in, nursing and nurse-midwifery might just be the perfect fit for you! You are the patient/client advocate and your every day is spent drowning others in compassion, love, empathy and hope even down to their last minutes. It’s worth every laugh and every tear.

More concrete advice; Pick a good school that you can agree with their mission statement and beliefs. Don’t go to Yale University unless you can pay for it, it’s not worth the name recognition or student loan debt when UCCS or PPCC will give you the same degree and the same job! Go for your bachelors. This is not a slam to anyone who chose to get their associates but eventually, the associates degree will be phased out as the nursing force increases. Soon anyone who wants to be in independent practice will need a masters and the bachelors may become obsolete! Prepare yourself to work night shift after graduation. If you get a day shift job, you were just lucky, night shift is where it’s at and often it’s for two or more years! Take time for yourself. The work we do is exhausting and compassion fatigue is a very real thing. You MUST take time off or you will burn out. Lastly, enjoy each moment and learn something new each day. You are ALWAYS learning and no one knows everything. Stay humble and you will be successful!


-Tiffany Jorgenson, MSN, CNM
Mountain Miracles Midwifery, Inc.