Taking the plunge

Well, the time has come. After nearly 5 years working with the vulnerable and inspiring women at an urban public hospital in New York City, it’s time to move on and follow my dream.  I have always, always known I wanted to be a home birth midwife, even when I was just a student, and now, after catching nearly 400 babies, taking care of hundreds of women (including triaging and managing some very high risk situations with collaboration), and going through my share of emergencies, I finally feel like I have enough experience and am  ready to take the plunge.  And what a plunge it’s going to be!  In many ways, I think I’m going to have to un-learn nearly as I’m going to have to learn for the first time: when to make the call on a transfer, how to resuscitate a newborn in a living room, how to let labor unfold without interference or vaginal exams (yeah, that one sounds pretty easy–and a pleasure to not have the hospital’s ticking clock hovering over my head–but even so, I’ve gotten very used to doing exams every few hours, and I’m going to have to rely on other signs now to assess labor progress), how to triage over the phone, how to be on-call 24/7, how to deliver women in any position of their choosing, etc. etc.  What a change it’s going to be!  I will say, though, that I feel like I have found the *perfect* situation for myself to learn all of this in.  I’m joining the private practice of a home birth midwife who’s already well-established, has been practicing home birth for several years already, and is really open to mentoring me and taking me under her wing while I’m learning, besides the fact that she’s incredibly intelligent, fun, enthusiastic and practices in a way very similar to me (for example, I think we’re both on the more conservative end of home birth, will definitely be following ACOG intermittent monitoring protocols to a T, and will probably be transferring sooner than other home birth midwives might–which isn’t to say that other home birth midwives are taking unnecessary risks, only that I think we’re both pretty similar in what we’re comfortable with in a home setting, which is a really good thing).  Part of me is wondering what I’ve gotten myself into, and is definitely nervous–no less for the life-style adjustment than for all of the new skills I’m going to have to learn. And I keep reminding myself that doing anything new is always hard, and always requires a big adjustment.  But part of me is so. damn. excited–it’s not even funny!  Hour-long prenatal visits, gyn and family planning–I’m even going to learn how to do IUIs (intrauterine insemination) and infertility consults–this is a chance to deliver the kind of care I have wanted to give to women since I was a student, but haven’t been able to since I was curtailed by the limitations of the public hospital system (15 min prenatal visits tops, for instance).  Anyway, I’m sure I will have much to update all of you with in the weeks to come. My new job starts next week!