This is actually one of my favorite questions.  I have so much to say on this topic I don’t know where to start.

First,  Ancient Art Midwifery’s Advanced Midwifery Studies is incredibly comprehensive, so it is difficult in that there is a lot of work to do.  It is not difficult in that any of the assignments are exceedingly complex. Yes, it is a daunting undertaking, by design,  and as long as I am in charge, it always will be.  There has been a lot of pressure to conform and make the course shorter and easier but I think mothers and babies deserve midwives with the level of knowledge and wisdom that this kind of work produces.

When I got started there was NOTHING in the way of academic education.  I created this course originally for my own apprentices based on what I had done for myself prior to my becoming a midwife.  I did not think the curriculum was too hard, then or now.  Have been told that many times in the past 34+ years, but I tend to disagree.  I think that if you are going to call yourself a midwife and hang out your shingle as such, you need to know EVERYTHING.  If you are going to advocate for, and educate and encourage women you work with, you need to be on the cutting edge, so to speak of all things birth.  You need to have a very clear understanding of the birth process and every possible birthing scenario. You need to be a walking encyclopedia on birth.

Originally, most of our enrollment was comprised of women who were already serving as midwives….some had been serving for many years, and some with numbers that exceeded 1000.  That is no longer the case.  Once midwives have the CPM, they tend to not enroll with us these days.  That being said, the exception is that our students often get their CPM in the first year of enrollment with us; some continue, some don’t.  Our piece of paper is considerably more difficult to get than the CPM. For those of our students who want the CPM, we help them to whatever degree they want with an additional NARM FOCUS option.  Most do not take advantage of that option as they are so well prepared without it, but we offer it nonetheless.  We do not feed anyone actual test questions. We do not “teach to test” and the NARM FOCUS is only available after a good portion of the course has been submitted and evaluated. There were no midwifery tests in place, or credentials to punctuate a midwife’s education when I created the course in 1980.  Our graduates created the MSAT (Midwifery Scholastic Achievement Test) which is one of several tests our students have to pass before graduation in the mid 80s.  It is still quite difficult to pass that test the first time, and my students tell me it is much more difficult to pass than the NARM written exam.

Many of our students are not interested in credentialing, but those who become credentialed and/or licensed often do that long before they finish with us. We have had many students quit to become CNMS and a few CNMs come back and complete what they started. I love those midwives who want to keep learning even after someone has deemed them official. What is says to me is that they are truly interested in better serving women even when no one is watching or giving them credit for it.

Birth is inherently safe and becomes less safe the more it is messed with.  As in all aspects of life, there are exceptions, but in general, birth is a biological function and not a medical “procedure.”   Birth is safe; interference is risky.

It has always been my conviction that midwives who know MORE, do LESS.  Doing less makes birth safer, but knowing how to do LESS requires a lot more in terms of education.  It was my observation in my training, and my experience beyond that, that the midwives who knew the least about the science of birth, interfered the most. My many years as a midwifery educator has borne that out.  You know the old saying, “a little knowledge is a dangerous thing.”  That is true in midwifery.  A woman who goes into labor and just has her five year old there or her neighbor is not likely to have any interference with her birth.  Her chances of something going wrong are actually quite slim. Knowing nothing at all means that whoever is there is not going to do anything.  However, that same woman’s chances of something going wrong increase dramatically if she has a scaredy cat midwife or a midwife with an inadequate comprehension of physiology and birth. (That was the kind of midwife I had first time around.)  Chances of something going wrong increase at a rate commensurate with the interference.  Her chances of something going wrong are kept to a minimum if interference is kept to a minimum. PERIOD. We all “say” that about hospital birth, but a lot of midwives are not willing to accept that it is just a true statement about birth in general.  Leaving woman and babies alone to do their thing is safer.  Midwives are NOT the guardians of normal birth. (Heck, many midwives have never seen an unhindered normal birth. ) Midwives are, according to the original meaning of the word, more accurately the guardian of the woman’s space so that she and her baby can experience the normal birth they deserve to have….and that would be with minimal interference and NO interfearance.

The most fear I see among midwives, is in those who don’t have the scope of preparation that my students have.

I think I have been doing this long enough to be able to say with some validity that knowing more gives a midwife confidence and competence to do less….and doing less adds safety.  Therefore, my extremely well educated students who stick it out through the whole course are qualified to know what to do in any situation but beyond that they know what NOT to do and they can tell you WHY.  Yep, we think it is important to know everything there is to know about the medical model, the medwifery model, the midwifery model…..but actually serve in the mamma model by dismissing most of all that.  How? by knowing how to judge the validity of the protocol.  We keep asking the question: what does the science say?  Not tradition, not fear, not medicine….good science; best service. Another thing that my students spend hundreds of hours working on is the most valuable skill a midwife needs to possess: how to communicate with, educate and encourage women to own their own births.

I want to assure you that my students are well prepared to handle anything that might need to be handled, but they are not very likely to precipitate such an event. Midwives with less of an education, who have a fear based education or who are practicing according to the state’s or a midwifery organization’s protocol rather than accurate science…..well, I can’t vouch for them.

My students spend hundreds and hundreds and hundreds of hours becoming qualified to do as little as possible TO a mamma and baby so they can most effectively SERVE a mamma and baby. And we think that is what midwifery is about: serving.