08/24/2026
I’ve joked over the years that in addition to attending a whole lot of births, I’ve also given birth to and raised a few midwives. The longer I do this work, the more true that feels.
Training new midwives has been one of the greatest privileges of my career. It has also been one of the hardest, most frustrating, most exhausting, and sometimes most humbling parts of it. There is something incredible about watching someone come into this work at the very beginning, often knowing just enough to realize how much there is to learn. We start building the knowledge and the hands-on skills together, while they slowly begin to understand what midwifery actually looks like in a real room, with a real family, during a real birth. At first, they watch everything. They ask a thousand questions. They look to you before making decisions. Then, little by little, their knowledge grows, their hands become steadier, and their assessments become sharper. Their questions change from “What should I do?” to “This is what I’m seeing, this is what I’m thinking, and this is what I think we should do.”
Eventually, you realize you’re no longer talking to a student quite as much as you’re talking to another midwife.
Getting them there, though, is a labor of love.
Precepting means doing two jobs at the same time. I am still responsible for providing excellent care to the family in front of me while simultaneously teaching someone else how to provide that care. Everything takes longer when you’re teaching. It would almost always be faster to do something myself than to explain it, demonstrate it, watch someone else do it, correct it when necessary, and then talk through the why afterward.
At a birth, that responsibility becomes even heavier. There is a constant calculation happening somewhere in the back of my mind. Does she see what I’m seeing? Can I give her another minute to work through this? Should I ask a question that helps her get there herself? Is this a safe place to let her struggle a little, because sometimes that struggle is exactly where learning happens? Or is this the moment when learning stops and my hands need to take over?
No matter how much independence I give a student, I cannot hand her my responsibility for that family.
The technical skills are actually the easier part to teach. Clinical judgment is much harder, and intuition is part of that. I don’t think good midwifery intuition is magic; it’s pattern recognition built through knowledge, observation, relationship, and attending a lot of births. It’s knowing normal physiology so well that sometimes you recognize something has shifted before you can fully explain why. Intuition doesn’t replace evidence or assessment. It’s the little voice that tells you to pay closer attention, ask another question, reassess, or stay a little longer. That kind of knowing takes time and experience to develop.
There are harder lessons in raising midwives too. Sometimes a student thinks she’s ready for something and I know she isn’t. Sometimes she is capable long before she believes she is, and I have to push her out from behind me. Sometimes feedback hurts. Sometimes personalities clash. Sometimes we disagree. Sometimes I have to say, “You’re not ready yet.” And occasionally, a preceptor has to ask the much harder question of whether someone is truly suited to this work.
I don’t take that responsibility lightly, because I’m not helping someone collect enough numbers to qualify for a credential. Someday a family is going to trust this person with their life and their baby’s life. I feel a responsibility to those future families too.
It’s also one of the reasons I’ve come to believe so strongly that midwives should be doulas first.
Doula work teaches something I don’t think clinical training can adequately teach: how to serve before you have authority. It teaches you to walk into a birth room thinking, “What does this family need?” rather than “What am I going to get to do?” You learn comfort measures and positioning, but you also learn to refill the water, rub a back, feed a partner, change the sheets, sit quietly in the corner, and stay awake when everyone else is sleeping. You learn how to support normal physiology without constantly needing to manage it.
You also learn pretty quickly that birth work is a lot less about holding babies than people imagine. We hold moms a whole lot more than we hold babies.
Sometimes that means literally holding her through a contraction. Sometimes it means holding space while she finds strength she didn’t know she had. Sometimes it’s holding her fears, her questions, her disappointments, or her joy. Sometimes it’s protecting the quiet while she does exactly what her body knows how to do. Sometimes it’s recognizing that she doesn’t need our hands at all.
Midwifery is so much bigger than the moment a baby is born. We’re caring for a woman through pregnancy, attending her birth, helping her become a mother to this particular baby, and walking beside her into postpartum. That’s why I’ve never wanted students who are simply excited about catching babies. I want students who love caring for women and families.
Playing a vital role in a birth room and being the center of the birth room are two very different things. Doula work teaches that beautifully, and I want that lesson deeply rooted before we start adding clinical authority.
There is another difficult conversation I think our profession needs to be willing to have with a lot of honesty and compassion: burnout, boundaries, knowing our worth, and the sometimes uncomfortable line between healthy boundaries and entitlement.
My generation of birth workers did not always get this right. We glorified exhaustion. We wore being awake for 36 hours like a badge of honor. We missed birthdays, holidays, family dinners, and sleep. We answered messages at ridiculous hours and sometimes charged far less than our work was worth because we had been taught that being “called” to this work meant we shouldn’t care too much about being paid for it. Somewhere along the way, we confused self-sacrifice with dedication, and then we watched really good midwives burn out.
I don’t want that for the next generation.
I love that newer midwives are talking about boundaries, sustainability, fair compensation, family time, mental health, and knowing their worth. I hope they do those things better than we did. I want the midwives I raise to have families and friendships and hobbies and vacations. I want them to sleep. I want them to charge enough to sustain themselves. I want them to build practices they can still love twenty years from now. I don’t want them to believe that destroying themselves is proof that they are dedicated enough to be midwives.
But I also don’t want us to swing the pendulum so far that discomfort becomes exploitation, inconvenience becomes a boundary violation, or necessary but unglamorous work becomes something we’re too qualified to do.
Birth will inconvenience you. Babies don’t know it’s Christmas morning. Labor doesn’t care that you have dinner reservations. Sometimes learning midwifery means being tired. Sometimes it means driving a long way only to miss the birth by five minutes. Sometimes it means attending a birth where absolutely nothing exciting happens. Sometimes it means hearing feedback you don’t particularly want to hear.
That doesn’t mean students should be exploited. Students are not free labor. They shouldn’t be hazed, humiliated, placed in unsafe situations, or expected to destroy their health or relationships to prove how badly they want this. Preceptors have responsibilities to their students too, and I take those responsibilities seriously.
But there is a difference between being taken advantage of and being expected to participate fully. There is a difference between protecting yourself from burnout and never being inconvenienced. There is a difference between knowing your worth and believing certain work is beneath you.
That last one matters to me.
Most preceptors aren’t paid to teach. We don’t get an educator salary added to our midwifery income. We still have the same clients, appointments, births, phone calls, charting, expenses, and responsibilities. Teaching usually makes all of those things take longer, and ultimately the responsibility for what happens in our practice still belongs to us.
We also open up something that took years, sometimes decades, to build. We share our knowledge, systems, relationships, mistakes, lessons, and clinical judgment. We teach someone how the practice actually works, knowing that eventually she’s going to leave us and build something of her own. Maybe she’ll practice across the country. Maybe she’ll practice right down the road. Maybe someday a family who could have chosen me will choose her instead.
And I genuinely hope she’s good enough that they do.
Because if I really believe families deserve access to excellent midwifery care, then I have to be willing to invest in creating excellent midwives, even when there isn’t an obvious tangible return for me.
And none of this happens without the families who are willing to let students into some of the most intimate moments of their lives. They allow someone who is still learning to measure their bellies, listen to their babies, ask questions, sit beside them through labor, and eventually participate in their births. Those families are helping raise the next generation of midwives too, and I will always be grateful for the trust they place in both of us.
I also want students to understand the value of what is being given to them, and I want them to leave apprenticeship knowing how to actually be an entry-level midwife, not simply how to attend a birth.
That means learning the paperwork. Answering phones. Scheduling appointments. Ordering supplies. Following up on labs and referrals. Charting. Understanding expenses and how a practice stays financially alive. Stocking bags. Cleaning equipment. Preparing rooms. And yes, sometimes mopping the floor and cleaning the toilet.
Because I still mop floors and clean toilets.
There should be no part of caring for our families and our space that we believe is beneath us. If there’s blood on the floor after a birth, someone cleans it. If the trash is full, someone takes it out. If the birth tub needs scrubbing, it gets scrubbed. Having letters after your name doesn’t magically make those things someone else’s job.
There is a humility in midwifery that I hope we never lose.
Sometimes you’re the person calmly managing an emergency while everyone else in the room is terrified. Sometimes you’re sitting quietly in the corner while a mother births her own baby into her own hands and barely notices you’re there. Sometimes you’re holding someone while she cries. Sometimes you’re doing paperwork late at night. Sometimes you’re cleaning bodily fluids off the floor.
All of it is midwifery.
I also can’t talk about raising midwives without talking about the midwife who raised me.
Her name was Wanda Smith.
Wanda gave me her time. She opened her practice to me, answered more questions than I could possibly count, corrected me, challenged me, trusted me, and eventually helped me become a midwife who could stand in a birth room without her.
Except the funny thing is, all these years later, I still don’t entirely stand in a birth room without her. Wanda is still one of the voices in my head.
There are things she said so many times that I can still hear exactly how she said them. There are moments when I’m assessing something, making a difficult decision, or teaching a student and realize I’m repeating something Wanda taught me years ago. There are lessons she gave me that I didn’t fully understand until years later, when I was the midwife carrying the responsibility myself.
Of course I didn’t become Wanda. I became my own midwife. I’ve questioned things, learned more, changed things as evidence changed, made my own mistakes, developed my own judgment and intuition, and built a practice that is mine. That’s exactly what I want for my students too.
I don’t want to raise little copies of myself. I want them to question me. I want them to read things I haven’t read yet and bring me new evidence. I want them to challenge the things we’ve always done simply because we’ve always done them. And the truth is, my students have made me a better midwife too. Their questions have made me examine things I had stopped questioning, their curiosity has sent me back to the evidence, and teaching them has forced me to put words to instincts and knowledge I had almost forgotten were learned.
I want them to take what my generation got right, recognize what we got wrong, and build something better. I hope they have better boundaries than I did. I hope they create more sustainable models of practice. I hope they know their worth without losing their humility. I hope they’re confident enough to make difficult decisions and humble enough to say, “I don’t know.” I hope they learn when to sit on their hands and trust physiology and when to move those hands quickly because something has changed.
And someday, I hope they’re BETTER midwives than I am. Because isn’t that what raising the next generation is supposed to accomplish?
Wanda’s legacy didn’t stop with me. I know that now because mine hasn’t stopped with me either.
There are already women I have never met who have labored in rooms I have never entered, cared for by midwives I helped raise. I wasn’t there to hear the sounds in the room, feel the energy shift, listen to their babies, or make the decisions. But a midwife I taught was.
Maybe she waited when waiting was exactly what was needed. Maybe she recognized the moment waiting was no longer safe. Maybe she listened when a mother said something wasn’t right. Maybe she protected someone’s autonomy when it would have been easier not to. Maybe something she learned beside me helped her recognize a pattern, trust that little voice telling her to look closer, or know exactly what to do when everything suddenly changed. Maybe she simply sat beside a woman who needed to know she wasn’t alone.
Those aren’t just future families anymore. It’s already happening. And somewhere inside some of those birth rooms is something Wanda taught me.
Something she taught me became part of the midwife I became. I carried it into births she wasn’t attending. Eventually I taught some version of it to another student, and now she carries it into rooms neither Wanda nor I will ever enter.
One day, when I’m no longer standing behind my students, maybe my voice will be in their heads too.
Maybe they’ll hear one of those things I repeated so many times they were sick of hearing it. Maybe it will remind them to wait, to look closer, to ask another question, to listen to the mother, to trust physiology, to recognize when something has changed, or to have enough humility to say, “I don’t know. I need help.”
And eventually, if we’ve done this well, their voices will live in the heads of the midwives they raise.
That’s legacy to me.
Midwifery knowledge has always traveled this way. From hands to hands, birth room to birth room, generation to generation. We don’t preserve everything exactly as it was handed to us. We shouldn’t. We learn more. We question. We grow. We correct what needs correcting and hopefully leave this profession a little better than we found it.
But there are things worth carrying forward: humility, service, curiosity, respect for physiology, respect for families, the courage to act when action is needed and the wisdom to leave things alone when it isn’t, the willingness to keep learning, and the understanding that none of us ever becomes too important to mop a floor, clean a toilet, hold a hand, or admit that we don’t know.
Wanda passed those things to me. I’m trying to pass them on as well. And I hope the midwives I raise will take the best of what all of us gave them, make it their own, add something better, and pass it on again. None of us starts the chain, and none of us should be the end of it.
I can only attend so many births in one lifetime. But just like Wanda helped raise me, I have helped raise others, and those midwives are already walking into birth rooms neither of us will ever enter.
For all the good, the bad, the exhausting, the frustrating, the messy, and occasionally really ugly parts of giving birth to and raising midwives, there is so much love and so much hope in that. And I can’t think of many things more worth doing.
