The Apprenticeship Model of Learning
Alternative title: Hanging out with midwives helps you learn the science and art of midwifery.
Alternative title #2: Students are bussin’ bussing’ no cap.*
There are several types of midwives. Nurse midwives and Certified Professional Midwives are the two recognized by Texas as legal providers of maternity care. Lay Midwives is a term used in some states for direct entry midwives, but thankfully that’s not a legitimate term anywhere, but especially not in Texas statutes.
Certified Professional Midwives are all trained using an apprenticeship model alongside the didactic (or formal/textbook) portion. It’s a beautiful way to pass on the philosophy, art, and clinical skills of midwifery to the next generation of midwives. The apprentice is encouraged to have more than one preceptor but she usually has one “main” preceptor and may pick up some births or clinical experience with with others. While it happens that students come in and out of various apprenticeships due to life changes or ill fits, they often spend a significant part of their student years with one preceptor.
The student is required to observe ten births and is then allowed to start assisting in births. Once she’s mastered assisting, she is able to move on to “primaries” in which is is manages the care of the mother-baby dyad with her preceptor nearby supervising. She must also follow a similar pattern for prenatal and postpartum visits as well as newborn exams. All of these visits and births are documented (without client identifying information) and signed off by the preceptor. They’re turned into the school or the certifying board along with several complete charts. If the powers that be are satisfied that the criteria is met, the student may sit for the national boards (NARM) and obtain a midwifery license.
A preceptor must meet specific criteria as well, namely three years experience or 50 births as primary midwife. I love teaching and even as a student I started collecting pins on Pinterest for my future students to use as learning aids. I can apply to become a preceptor in March of 2023.
If you’ve followed my social media, you’ve seen me mention Matison Davis, my student. So how can that be? Well when I attended a birth emergency skills training this summer, I learned that there are women who would love to learn midwifery even without the “checkoffs” that a registered preceptor could give them. I was awestruck by this idea. It was the perfect solution to the lack of skilled help in rural midwifery.
In areas like DFW where there a midwives a-plenty, assistants and backups are not too hard to find. Out here in the rural areas, there are no assistants, few or no fellow midwives, and therefore, no help. We have to train up our own.
While I’ve been called impatient, I know it’s a great investment to start from scratch and teach future midwife, I just didn’t know anyone would want to learn from me if I couldn’t give them checkoffs in return for their assistance. I came home and talked to Matison about it. We’d met through my mentoring service to students and then got to know each other better when I started practicing at Kueo Birth Center in Decatur, TX where she is student. She loved the idea and immediately started sitting in on my clinic days. We spend hours together talking midwifery things each week. Teaching her helps me sharpen my skills so it’s a win-win.
Students are a huge blessing to a midwife, though it takes work to slow down and teach. Hopefully preceptors are also blessings to the students, but there are many stories of abuse in the midwifery world. We’ll explore some of these aspects in future blog posts and I’ll introduce Matison. I think you’ll love her as much as I do!
*Students keep us young! Matison taught me that “bussin’ bussin’” means “very good” and “no cap” means “no lie.” See? Everyone needs a student in their lives.