July 3, 2024

I am starting my blog page with answers to the central questions of my business. Why did I start Mindful Midwifery? What do I hope it will become? To answer these questions, I must take you back a bit.

I remember as if it was yesterday, sitting in class in midwifery school and having the horrifying realization of just how much advocacy is required of midwives and how often midwives can be forced into working against a broken system, I remember being totally overwhelmed by this realization and thinking, “What have a gotten myself into?!  I am not strong enough of a person for this! I won’t survive this!”

In those early moments I wasn’t wrong, this profession requires tremendous strength, will and voice. It requires daily advocacy, often in ways you can’t predict or prepare for. But what I didn’t realize at the time was dually that there is strength in numbers and that you can be “mentored” into this voice. I was not and have never been alone on this journey. I have worked with many midwives over the years and each one has helped develop my ability “to midwife”.  I believe I have influenced them as well. We are in many ways a collective.

At my first practice, in Baltimore, I learned the importance of holistic, patient-centered midwife care. The midwives there shared my philosophies of care, and I learned through excellent mentorship how to give the type of midwife care that most women imagine when they think of the word midwife. Leaving that practice was one of the hardest things (I have done) in my life. When I came to Delaware, I knew that the way I practiced in Baltimore would not easily be possible here. Dover, Delaware was particularly difficult then in its lack of understanding and appreciation of midwifery. I went from a city, Baltimore, where midwifery was known and sought after to a much smaller city, Dover, that had a very limited, and often wrong, perception of midwifery care.

Thankfully, we midwives made excellent progress in Dover in the ten years since I moved back! For the best years of these years, we had 24/7 midwifery coverage on Labor and Delivery at Kent and the midwives were catching 700+ babies a year! While I was not able to provide waterbirths and labor sit the way I did in Baltimore, I felt proud to be part of a thriving midwifery team. The midwives were able to provide care to both low-risk women and women that had medical concerns but still wanted the guidance of a midwife. Unfortunately, this 24/7 midwife coverage was a more fragile arrangement than it looked to the outside.

When the pandemic hit, it poured gasoline on the simmering fire that was healthcare in this country, particularly obstetric healthcare.  The broken system that converged providers with low health insurance reimbursement, lawsuit risk, high-risk patients and workplace violence was further strained by the additional challenges the pandemic brought. I found myself in tears regularly over my inability to reconcile the care that this system forced with my understanding of midwifery care. I have often been told to compartmentalize this, but it has never worked for me. It has not been helpful that while Delaware has progressive leanings towards our advanced practice practitioners, Dover is still archaic in its interpretation of the advanced practice role within the community. During this time, I lost my footing. I realized that I had to leave the system to be able to survive it. To be able to heal from the burnout that I had experienced during my 15+ year career, I had to completely step outside of the current care model.

This all led me to open a business. One of the things I believe is most missing from healthcare is the provider-led patient education. A huge part of midwifery is empowering women to advocate for themselves. This can’t be realized without education being central in the care plan. Medical distrust is at an all-time high. This didn’t happen overnight and didn’t happen without cause. The fix to most medical distrust is individualized patient centered education. It can’t be politicized education, it can’t be paternalistic, condescending or lacking empathy. If education is presented empathetically, it is amazing what can be accomplished. This led me to choose a business centered on education.

I launched Mindful Midwifery in 2022 as a women’s health focused education service. Over the last two years I have taught puberty classes, childbirth and postpartum classes and offered a menopause class. I was also able to round at the hospital M-F on the postpartum floor through Dedicated to Women and make sure that women and their families left the hospital prepared for the postpartum transition. This greatly helped with my burnout. I began to remember what I loved about midwifery. This spring, I learned that I would likely lose my rounding position. Dedicated to Women was no longer going to have independent privileges and the hospital didn’t believe the rounding position would be needed with potentially three providers on at time. I started to look at other options for continued clinical care.

In late May, I decided to add services to Mindful Midwifery. I decided to open for prenatal and postpartum care on my terms, the way I feel care should be given. One of difficulties for any practice is that insurance does not reimburse at rates that make holistic care and education financially feasible. I had been considering care outside of insurance parameters since 2022. There are increasing models, particularly in the primary care setting, that are stepping outside of insurance driven healthcare. Through research I have landed on a membership service similar to a direct primary care model. Through a low monthly membership, I have created prenatal and postpartum care that will provide services that practices going through typical insurance can’t provide any longer. Visits will be longer, education opportunities will be built in and access to your provider outside of your appointments will be streamlined. The last thing I want my patients to do is feel that they must go down a google rabbit hole because they didn’t get enough information at their visit.

Often, providers that venture into membership services draw criticism for not being financially feasible for all people to seek care. There is truth to this. But it is also important to remember that no provider can give care to all people. Monopolies in healthcare should not exist. Healthcare, like all businesses, is made better by patients having options. We need innovators in the healthcare industry to push the boundaries of what healthcare can and should look like. We need our providers to address their burnout, name it and work in manners that can heal their burnout even if it means stepping outside of traditional care. I am on a journey with Mindful Midwifery that is just getting started. I know that this journey will include patient-centered care, empowerment and education. I know that I will adjust, pivot and continue to grow in ways that perhaps I can’t even see yet. I know that I will meet people during my business venture that will help me move Dover in a better health direction. I am excited for this journey and excited to meet those who will be on this journey with me.