Student Midwife Suffering

The tales are all to frequent and all too harrowing. Being a student midwife can be the worst work of your life. Thankfully this was not the case for me but I’d like to address it for those interested in student midwife life.

I only know the stories second or third hand but I always think of them when the topic of students comes up. One rumor says that a midwife had her student hang Christmas lights for her adult daughter on Christmas Eve. Is this likely? Probably not in whole, but in part, absolutely. There are stacks and stacks of stories of students being asked to do personal tasks like pick up dry cleaning, run errands, watch her preceptor’s children, and so on.

One of the most bothersome stories to me is that students are asked to sell their souls schedules to their preceptor for the years she’s a student in the practice. Midwives might change an appointment to another day at the last minute and inform the student she must attend at the new time even if the notice was short and the student has a child in a school play at that time. Midwives might take clients all over a large geographical area and the student is expected to attend every single appointment and birth with her preceptor, no excuses, ever. Never mind that the student lives an hour from the preceptor and might live two hours from the client. Never mind that the student is likely also a mother with child care to secure.

I get it, midwifery students need to learn the hard truth about life on call and being flexible. They need to realize the demands of midwifery can take the shine out of the title. But they don’t need to be treated as slave labor or taught in a way that must be undone if she is to find any kind of work-life balance.

Yet many midwives bring on a student who becomes her right-hand-woman. She is teaching her the craft and in exchange the midwife gets a solid assistant. To invest in her, especially from scratch, and have the student be flakey about appointments and meetings is unacceptable.

There must be balance. This is not new, many student midwives and new-to-the profession midwives are speaking up and begging for change. Midwifery need not be synonymous with martyrdom and we must teach our students about sustainability. We do that by modeling it.

This means we must have clear boundaries with our clients (i.e. asking that only emergent phone calls happen after hours, for example), make time for recreation and family, get paid a reasonable rate for the responsibility we shoulder, and take care of our bodies, minds, and spiritual lives like we ask our clients to. We can’t do this ourselves without also encouraging our students to do it.

Should students get paid? Maybe. Should preceptors get paid to teach students? Maybe. I don’t know the answer but I know that when I was a student and also employed by a birth center, I was told over and over than in Texas the law says a student can’t get paid. This is absolutely not true but it’s been said over and over so much that many midwives believe it (maybe the ones who would never pay a student? Ouch…sorry, not sorry). I hear that the Association of Texas Midwives (of whom I am not a fan) won't allow their students to be paid, but I’ve not verified it.

I know that clients can’t pay the student or she could be accused of practicing without a license but a midwife can pay anyone she wants to assist (well not an ATM student, I guess). I could pay a student to pick up the trash after a birth or wipe down instruments and it not break the law. I could pay her to actually assist in the birth as a legitimate helper, because she is, and it would not break any laws.

Midwives paying students and students paying midwives is a much bigger topic than this blog post is meant to cover but it is a discussion worth having. For me personally, I lean toward it being a mutual partnership in which they pay each other by trading teaching for learning opportunities but I’m not ruling out paying a dedicated student to assist me at some point. I hate asking students to do tasks I can do myself but I also really want them to learn. I tend to push them into trying clinical tasks (with my help) but then hesitate to ask them to make copies or take business mail to the post office. I need to work on that because it is fair to ask for this help from them. I don’t think I’ll ever be tempted to ask them to hang Christmas lights for me though.