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Welcome to the Midwifery Wisdom Podcast
This podcast is your go-to resource for practical education, thoughtful insights, and relevant conversations tailored to modern midwives.
Each week, we bring fresh content and engaging guest speakers to explore key themes in midwifery, including:
Advocacy, business, and clinical skills
Self-care and professional growth
Current issues shaping midwifery today
Listen to meaningful stories and essential advice from leading midwives working to elevate care for families across the globe. Gain clarity, encouragement, and actionable guidance to support your business, practice, and personal life.
Wherever you are in your journey, the Midwifery Wisdom Podcast is here to empower you. Together, we strive to make midwifery the gold standard of care worldwide.
Aubre Tompkins Rerun
===
[00:00:00] We need to stand up and start
saying our country is killing people.
It is dangerous to be pregnant in this country,
particularly if you were a member of Bipoc community. Right.
The data is irrefutable and we need to start,
shouting that from the rooftops and being very clear when we talk about that data,
where does that data come from?
It comes from the medical industrial complex.
These horrific outcomes aren't coming from birth centers.
They're not coming from home birth,
they're not coming from midwifery models of care.
They are coming from hospital-based physician models of care.
They need to own these outcomes .
[00:01:00]
First of all, thank you for being here.
Oh, well, you're welcome.
Yeah. And at Midwifery Wisdom Podcast,
we have mostly midwife and student listeners.
But we also have other birth workers,
spread around and talk to lots of different kinds of guests,
but I'm really excited to be back here talking with a midwife.
Yay. So tell me, about where you are in the world,
what got you into midwifery, and then we'll
go into all the amazing things you've done. [00:02:00] Okay. I am in Thornton, Colorado.
Which is essentially just north of Denver.
It's one of the little suburbs of Denver.
I actually live in Denver, but my birth center is in Thornton.
Along the Colorado front range, urban corridor.
I love Colorado. I am the clinical director of a
freestanding birth center, called Seasons Community Birth Center.
We have an interesting history.
We opened as this new entity in January of this year.
We are a nonprofit, birth center.
Prior to that we had been, part of a larger physician group
that actually had multiple, O-B-G-Y-N physician
clinics and practices in the area.
And then they decided to open up a birth center, hired me
to design it and build it for them.
We opened that iteration in April of 2019. Right, right. Yeah. [00:03:00] Mm-hmm.
And that was pretty close to like the
mountain midwifery closing, I think. Right.
So Mountain Midwifery Center closed in 2019, in, October.
If I remember correctly.
I left Mountain Midwifery Center in 2017.
I wasn't, involved in, or know much about the closure other
than everybody who know from the outside. Right.
I wasn't on the Yeah. Yeah. I wasn't on the inn.
A space opened up in the community of like, this is so needed.
So you guys presumably stepped into that space?
No. This first duration?
No, we were in works before Mount Moody Center closed.
Oh, okay. Okay. Okay.
So we started building this birth center in 2017.
Okay. When I left Mount Moody Center,
because we are a complete build from the ground up.
We had to have an architect and a construction company
and build the building and then go through licensure and accreditation.
So we had no idea that Mount Ry Center was gonna close.
It was a shock, [00:04:00] right? Yeah. It was a shocker for everybody
and not what I would have wanted, in any way.
So, what happened to make you then open your own nonprofit?
Tell us about that shift. So we opened in the spring of 2019,
and then in 2021, the private practice physician group,
sold themselves to a private equity firm.
The private equity firm, said, we're not like all the other
private equity firms and we don't wanna just
clo you know, strip ev all the assets and close everything and
we really like the birth center.
We think it's great and like the future
of healthcare, and so we're gonna really invest in it.
And they lied. And they stripped the physician practices,
and closed us in October.
They came to us the very end of September
of last year and said, we're closing you effective October 31st.
And because [00:05:00] you are not profitable enough for our business model,
we had in that month of October, we had.
I think just over 20 families do,
and many of them were due at the end of the month.
As you know, and as most midwives know,
who are practicing, out of hospital community-based care,
people don't have babies around right at their
due date can actually go past their due date.
We were looking at a significant number of families
in the third trimester already. In limbo. Yeah.
So, and it's so devastating. I mean, I mean,
this is why profit doesn't belong placed on people's bodies, right?
It's correct. It's so devastating to imagine that kind of like
order from on high after you had these plans
with a midwife that you knew.
I can't even imagine what it felt like for you.
Oh, it was, it was devastating.
The meeting was devastating because [00:06:00] first of all,
to be told that you're not profitable enough, is disgusting.
Right, right, right. So that was maddening.
The meeting was very frustrating.
One of the original physicians wanted to
start the birth center with me.
A representative from the private equity group.
It was very matter of fact, it was kind of cold.
My staff across the board, their first reaction was,
what about our families? We were all just fired as well.
Like everybody, oh God.
At this meeting, lost our jobs. Oh my God.
Their response was, what about the families?
I think that just goes to show, who does this work?
We had 52 families due between November and December.
Oh my God. So we, I demanded slash requested
slash asked for a meeting with the CEO of the private
equity group. And I essentially shamed [00:07:00] him, and said,
you can't just close on October 31st.
That doesn't make any sense.
These people, will be left out, in the cold and we can't do that.
He, after, 45 minutes of me hammering on him
agreed that we could finish the October due dates,
even if they went into November?
Through their two week postpartum, period.
So we technically had our last babies in November,
with the new model. What happened next is
nothing short of miraculous the community really rallied
and said, no, we don't want you to close.
We are one of the few birth centers in Colorado working with Medicaid.
We have a very inclusive model.
And we're really seen as a safe space for a
lot of marginalized members of our community and our state.
The community stood up.
And we were approached by the amazing organization,
elephant [00:08:00] Circle, which is Yeah. Colorado Bath Space.
Yes. Amazing, amazing, amazing.
And Elephant Circle came to us and said,
the community is demanding that you stay open.
We want you to stay open.
How do we make this happen?
And so they became our fiscal sponsors for the nonprofit.
We had some serious fundraising efforts.
We had, two, what I would call,
I guess like angel donors. Amazing.
Who we had no idea were around.
Do you know what I mean?
Who came out? The private equity group,
to their tiny credit.
I don't like to give them.
But they agreed to sell us all of the equipment,
all of the hard things, right in the facility.
And one of the donors agreed to cover the cost of that,
the landlord of the building because
the physician group we had, uh, you know,
it was a long-term lease.
And so the landlord of the building agreed after some [00:09:00] work,
but did agree to transfer the remainder of the lease
to us through Elephant Circle.
And we, like I said, our last birth renewal.
That's a miracle. That's a miracle. It's a miracle.
Like I, yeah. You know,
I've been in the birth center world for 15 years.
And, I've been involved on the
national stage for several years. This is, unheard of, unheard of. Definitely. Definitely. And part of that is,
your knowledge expertise and advocacy,
and part of that is Elephant Circle and their incredible reputation
and leadership. And then there's a lot of luck there.
That's a big ask and a big leap in both directions.
The equity firm and the location.
I'm really impressed. Great job. It is nothing short
of miraculous really. So we had our last verse in November. December was a whirlwind. I don't really know what happened anyway, we reopened on January 9th was our first, reopened clinic day.
And we had our first birth on January [00:10:00] 13th. Amazing. Which was a family who had been coming to us before, and had temporarily had some visits, in November and December. With another practice and then came to us. She was very special to us because she was a second time family for us.
She, has Medicaid and the other birth center that would take Medicaid wouldn't accept her because of her BMI.
So she had no birth center option. In Colorado,
CPMs cannot, this is a whole other side story,
but CPMs cannot currently, bill through Medicaid.
Her only other choice was a big hospital based.
Churn and burn practice. She was terrified of that.
She was in all of our hearts and heads as
we were scrambling in December.
Sometimes that's such a powerful motivator,
to have that person you're opening for.
Yes, I know that feeling. Yes. Yes.
That's beautiful. She was in her, she
and her [00:11:00] family were incredibly motivating for us.
So yeah. We opened on the ninth.
She had her baby on the 13th.
Her due date was in the twenties, I think the 23rd.
But yeah, it was pretty phenomenal how that worked out.
That's amazing. And that alone would be incredible
and impressive. 15 years of practice and
mostly out of hospital and opening
birth centers and negotiating lease changes.
But Aubrey, you also work on the national stage.
So tell us what you do there.
Yeah, I am currently the president of the
American Association of Birth Centers,
which, has been around for decades
and is an amazing resource and supporter,
for birth centers and the midwifery model of care.
I am really honored to be the president.
It's been a wild ride. I'm coming into my fourth year,
the term is four years. We switch in October,
the elections and everything is in October.
In October I'll enter my fourth year and
the next president [00:12:00] will be elected that person and I will have
a year of co-leadership where I'm mentoring them.
Beautiful. That's a really smart system.
In that role as the president of AABC ,
you've had the opportunity to peak,
speak publicly recently about the problems in the South.
So, I got to hear some of your words,
because of internet. Will you explain kind of the overview
of what's happening there and what you spoke on?
Yeah, so the state of Alabama, and
I'm not an expert, in the intricate details of
the long history of Alabama and midwifery.
Sure. A little snapshot of right now is that,
there were regulations written for birth centers
in the state of Alabama in 1987.
I don't know that there ever were any birth centers.
There may have been. That's part of the history I'm not,
familiar with. But in 2010, Alabama, there were no birth centers,
and Alabama passed a law that they call the Red Tape Reduction Act,
which meant that they were kind of like.
[00:13:00] From their perspective, they were going through regulations
and old laws cleaning things up and
getting rid of things that weren't needed anymore
so they took down the birth center regulations,
and, you know, made them not, not up anymore,
not legal anymore or whatever.
And that was in 2010. Since then, there are three,
amazing powerhouses of black women
working towards opening birth centers, in Alabama.
One is Dr. Yashika Robinson, and her organization is called
the Alabama Birth Center. She's a black, female OB gyn.
Heather Skees in Birmingham. Yep.
And her birth center is Oasis Family Birth Center.
And she's also a black ob, GYN.
And then there is, Stephanie Mitchell.
Who's also Dr. Stephanie Mitchell. Yes.
And she's a double certified CPM and CNM.
And she has her DNP, so she's a doctor midwife.
And, and that's her handle on Instagram too?
Yep, yep, yep. And she is working to open up,
[00:14:00] birth Sanctuary Gainesville, which is in one of the rural,
maternity care deserts in the state.
So the three of them, are working to open birth centers.
And there was a request made to reinstate the birth center regulations
or open up the process for birth center regulations,
so that they could get open.
Last August, the health department essentially
reposted those regs from 1987.
And said, here they are. Here's the regs.
And they opened up for public comment and
written submission of comments.
When health departments, what it's called promulgate,
new regulations, they have to post some publicly.
Then there's a period of open comment and,
you know, there's a process.
The clearly since they were written in 1987,
a lot has changed since 1987. Yeah. So, you know,
there was a lot of things wrong with them.
They were written before CPMs were
legalized in the state of Alabama.
Right. So there was a lot [00:15:00] of, comments
and things that needed to be changed.
I went last year to Alabama to represent
A, B, C and tell them, these regulations
are really old. From 1987, A B, C
submitted a 40 something page rebuttal
line by line of what in the regulations wasn't appropriate all of that closed at the end of August,
last year. The health department said,
we're gonna take all of this information the oral testimony,
the written submissions, and
we're gonna make new regs and let you know.
Stay tuned. A year went by of basically radio silence.
People on the ground in Alabama would attend the
public meetings that the health department
had in hopes that they were gonna say something
about the regulations, and they never did.
Then on June 20th.
They promulgated the regulations,
which means made them public, and released them with a letter.
The letter said that they had,
created a committee of [00:16:00] stakeholders and
had consulted with multiple organizations.
A B, C was the first one they listed.
And that they were, you know, here's the new regs.
And they are awful. They are even worse
than the ones that were written in 1987.
How is that possible?
I don't know. Oh God, that's so weird.
Part of the problem is from what we can tell,
there were no maternity care providers of any type
involved in the, oh my God. It's laughable.
It's laughable. What are they doing? It's unbelievable
the list of people they use in their
committees to rewrite regulations.
There's a, there's, there's physicians,
but there's no ob, GYN, there's like a orthopedist
and a neurologist. That's helpful.
The really helpful ones I thought were the veterinarian.
And especially the other really powerful voice
[00:17:00] I'm sure was the funeral home director.
Oh my lord. Yeah, you can't make this shit up.
No, you cannot. If it wasn't real and it was like a movie,
it wouldn't be believable. It's just awful.
So crazy shit. Right? Yeah. What are they doing?
Nobody knows. It's very bizarre.
The regulations are now, well, that caught my
attention was that they never actually did what
they said they did in their letter, right?
No. So, the evidence that they're presenting is not real.
Correct. They never contacted A A, B, C.
The second organization they have on their list is the CABC,
which is the, organization Accreditation credit.
Yeah. Mm-hmm. Uhhuh Uhhuh. Um, it's,
it's actually, it's a very separate organization that seems fraudulent.
That seems like fraud. Yeah.
So they said that they consulted them.
So we as AABC,
reached out to CABC 'cause they are two separate,
[00:18:00] organizations. And we reached
out to them and said,
Hey, did they contact you? And CABC
was like, no, nobody contacted us.
This feels like the foundation of a lawsuit.
Yeah. This is really frustrating.
I was talking to a good friend of mine here in
Colorado and she's like, well, there
has to be something you can do.
And I said health departments are very
interesting because there's no oversight of them.
There's no place you can go to demand accountability.
Their processes are extremely opaque.
They don't have to tell you what they're doing
or why, or give any reasonable timeframe.
Lots of times when states open up,
they leave like 24 hour comments that
start and stop at midnight Their version of publicly posting them
is often on some obscure website that nobody knows about.
Buried behind links. You have to be checking it,
to be able to notice it and there's no oversight.
There's no place you can go to say,
Hey, who's watching these people?
Yeah. The left, which is interesting because
[00:19:00] their stated purpose is to be watching
out for other professions.
It's a really interesting irony.
We went through something similar in Colorado,
tell us about that.
Mountain Midwifery Center opened in 2006,
and previous to that, there had been a
birth center in Colorado in the mid to mid nineties
that I think was maybe open for one or two years.
It was very short-lived. And so that was technically,
officially the first birth center in Colorado.
But from that closure in the
mid nineties to 2006, there was nothing.
And so we had a very similar thing at Mount Mody Center
where there were these regs.
Ours were, had been written in 1983,
and hadn't been updated.
And ours were not nearly as bad as the Alabama ones.
We were able to kind of be,
to actually open and function underneath
the Colorado ones, but they were very restrictive.
They, required physician involvement or [00:20:00] supervision.
You couldn't have had more than five babies.
You uhhuh, you know, all these weird random
BMI over 35 and, you know, well they
were so old that it didn't even use the term BMI,
it used the term ideal body weight.
Yeah, so it just, bad stuff. I took over
to be the clinical director of Mount Midwifery Center in 2012.
I started reaching out to the health department
to say, this is ridiculous. These regs are horrible.
We need to reopen them. I was essentially,
you know, patted on the top of my head
and said, oh dear, you know, you don't matter.
You're not big enough.
You're not serving enough people.
We can't justify the time and expense
for just little old you.
Thankfully a couple of other
birth centers opened, in the state and I contacted them.
We formed a coalition, the Colorado Birth Center Coalition.
We pulled some money and hired Elephant Circle,
and Indra as an attorney to [00:21:00] file a lawsuit
to force the health department to open the regulations.
Yeah. And at first the health department was like, no.
Still no. And then we actually put,
started in motion the filing the lawsuit.
And then they said, hold on.
We'll open the regulations.
So that was in 2000, the end of 2015.
And then 2016 was a very laborious process of
monthly and sometimes more than monthly stakeholder
meetings where we That is so labor intensive.
Yes. Yeah. Oh my gosh. We rewrote them line by line.
We had, met representatives,
but the thing that was different in Colorado
is we actually had community stakeholders.
Right, right, right, right, right.
So the health department was at the table.
The hospital association was at the table.
Huff and Medicaid, the Dora, the nursing, regulatory body.
The state. Fire [00:22:00] marshal and safety people were there.
Elephant circle was there
Consumer groups were there?
Yeah. Yeah, yeah, yeah. Yeah.
The CPM organization was there, A CNM was there?
ACOG came occasionally,
but it was the actual meeting of real
community stakeholders and people
who know about birth centers.
Right. And so we were able to hammer out,
I'm not saying the process was easy,
and I'm not saying there weren't some
major hiccups in the road, but we were able to eventually
hammer out some pretty decent,
I feel really proud of our regulations,
Right. That are new and standing and
so since we're on Colorado, really quickly,
can I ask you, one of the things that
I know that's been up for conversation is adding CPMs
to being able to own and operate birth centers.
That's changed recently. Yes, absolutely.
That was one of our pushes that we wanted
to do in the 2016 rewrite, and for various reasons
it didn't get put in there. But that happened
in [00:23:00] the most recently ended legislative session.
So now CPMs are a listed approved provider
in birth centers in the state of Colorado,
which is huge. The problem right now is that still CPMs
in Colorado cannot bill Medicaid. That is a major problem.
So there are two birth centers
in the state currently that have CPMs on staff.
And they can't bill Medicaid, a hundred percent.
So it's a problem.
And of course CPMs are perfect for birth centers, right?
The majority of the workforce for community
based birth is CPM. Yeah.
So they should definitely be able to bill all insurances,
I mean Yes.
To be able to provide the care.
Let's put our, big picture,
30,000 foot view hats on for a second.
It's maddening that the stakeholder's
goals don't match their actions over and over and over.
Mm-hmm.
How, how do you handle this?
Like, I feel like it's gaslighting, this, this, you know,
[00:24:00] two doublespeak, reality.
It's like we need to improve safety outcomes.
We need to reduce poor outcomes.
We're in healthcare deserts,
we're in these physician shortages.
We need more providers.
And then they won't fund midwives
and they won't fund birth centers
and they won't take away the restrictive regulations.
And like, it's just this
total gaslighting experience,
how do you deal with that personally and professionally?
It depends on the day.
I guess, we have to keep moving forward
and we have to keep standing up.
I feel very strongly that it is time for midwives
and midwifery advocates to, stop being polite.
Stop trying to, go along to get along,
to start really standing up and saying things.
I could have been harsher, I think,
but in my testimony in Alabama.
I stood up and I said, I wanna give thanks to the
level of expertise and knowledge in this room,
which apparently was not in the [00:25:00] room,
when these regulations were crafted.
I think we have to start calling it out.
I learned a phrase a long time ago.
That's definitely informed a lot of my work.
We've gotta stop trying to sneak in
the back door and walk in the front door
like we own the damn house.
Yes. And that kind of imagery changes
how we are in relation to the space
and to the other stakeholders and to ourselves, right?
Yes. And as a profession,
as this community-based birth profession,
which includes multiple different license types,
the only way there's gonna be more
options in community-based birth.
The only way there can be more birth centers
and more home birth providers is if we
start acting like we belong in that space.
Yes. So. You speak loudly, you speak up,
you don't hold back any punches.
You also are using this position as a
leader of a major national organization to further this goal.
What do you think people without that
much influence can do?
What are some of the steps that they can do?
I believe that consumers really have a lot of power,
[00:26:00] especially if they band together, and
have a collective voice,
which I think is the other side of the coin, right?
I think midwives and birth workers
need to start standing up and speaking the truth
with power and really hitting home.
I think it's a cultural thing,
we have been acculturated in the mainstream
American culture to be polite and
build, all of these euphemisms
build bridges and put your hand across the thing
and da, da, da. I know that in our country,
we're in this extremely polarized time politically,
so I'm not talking about that kind of stuff.
I'm talking about we need to stand up
and start saying like, our country is killing people.
It is dangerous to be pregnant in this country,
particularly if you were a member of Bipoc community.
Right. We, the data is irrefutable and
I think we need to start, you know,
shouting that from the rooftops and
being very clear when we talk about that [00:27:00] data,
where does that data come from?
It comes from the medical industrial complex.
These horrific outcomes aren't
coming from birth centers.
They're not coming from home birth,
they're not coming from midwifery models of care.
They are coming from hospital-based
physician models of care.
So they need to own these outcomes
and we need to make them own these outcomes,
so that we can really start to
look at the things that we know that
work to improve the outcomes.
I get so frustrated when people are like,
oh, home birth, birth center isn't safe.
I'm like, no, what is not safe?
Irrefutably is the current
mainstream medical system, right?
Just it's really not. It's really not.
It's, it's, it's unethical. Yes, it's unethical.
It's a human rights violation.
And so I think we need to say it as
the providers and [00:28:00] the clinicians or
whatever kind of term you wanna use.
But we also need the consumers to stand up as well.
We can do our part but the consumers
are that critical piece that also have to
start getting angry and mad.
And they are, it's happening.
But it needs to continue to grow,
and build momentum and really start to demand it unfortunately,
our current healthcare model is for-profit driven,
which never should be.
I feel very strongly that healthcare should be nonprofit.
I am born and raised in America.
I believe in many aspects of the capitalist system,
but I don't believe that it serves us in any way,
shape, or form related to healthcare, or education.
Regardless of your feelings of capitalism overall,
I think it's pretty clear that it's failing the healthcare system.
Absolutely we have a capitalist healthcare system.
The consumers hold the [00:29:00] money.
And the power and if they start revolting
and acting up, then money will listen, to what that is.
So I think that's a critical component.
And also voting with their dollar,
because although some,
are Medicaid and Medicaid doesn't
quite contract with everyone that
we would want them to still
50, 60, 70% of the population is voting
with their cash or with where they spend their insurance dollar.
Yeah. And continuing to demand midwifery
care in all care locations changes the game.
And also how they voted you know?
Definitely, from city councils up to federal elections.
Like we have to start really paying attention to
who we're voting for and why. and who we're giving that power to.
And consumers being aware of who their
state representatives are.
Because these are the people who have
power in how Medicaid is distributed and
how [00:30:00] exchange insurance companies work and all of this stuff.
You know, these things are really important.
Yep. You're not wrong.
Well, Aubre, before we get to the end of our conversation today,
I wanna circle back to my first question
how did you get into all of this?
Because you are doing incredible work,
on the ground and, at the national level.
What enthused you to become a midwife,
a stakeholder and a leader?
Tell us your journey. Well, I never, intended to become a leader,
the best leaders never do.
Yep. That was kind of foisted upon me
very abruptly and suddenly.
To become a midwife, I think it's an
understandable cliche in that I had my first pregnancy,
and my first, encounter with pregnancy.
I had been an artist. I had been heavily into
kind of herbalism and, reiki and kind of all these,
you know, complimentary, healing modalities.
Was seriously flirting [00:31:00] with going to,
chinese medicine school. Mm-hmm.
To learn acupuncture and Chinese herbs.
And then, you know, became pregnant.
And it was interesting to me,
I was the first person in my friend cohort
age group to become pregnant.
My mother had very traditional 1970s
birth experiences in the Midwest.
Like Yeah. I don't, and what struck me
when I became pregnant was I knew two things.
They were like in my core self,
I knew I had to have a midwife.
Even though I didn't really know what a midwife
was at the time, and I knew I was gonna breastfeed.
I had never seen anyone breastfeed before.
These two things were like truths in my core.
Encoded wisdom. Yeah. Thank you.
That's a good way to describe it.
I had to figure out what that meant. Right.
Then I was like, what is it? How do I find this?
Where do I go? How do I find this? What's going on?
And [00:32:00] I eventually found, a hospital based CNM practice.
I had a very typical hospital based,
midwifery supported birth in a hospital here in Denver.
It was not traumatic, it was not uplifting,
it was just kind of
a thing that happened.
I know without a doubt that if I hadn't
had the midwives, I would've had a cesarean.
Um-huh. I had Ahuh, uhhuh asynclitic,
posterior oohs, almost nine pound baby as a Oh, that story.
Yes. Yes. I have that. That was me.
And I was induced because I had severe pups.
Oh, how frustrating. Like severe it was.
Oh, I'm so sorry. It was bad.
So I was induced. I never got an epidural
just because I'm a stubborn nut and I refuse to do it.
I tell people now, I don't know if it was the right choice.
I don't [00:33:00] share that story to be like,
you don't need to get an epidural
Pitocin labor is very different.
And anyone who says that it's not,
and that it's the same thing is
blowing smoke up your ass. It is not. Very different.
I left that birth just kind of like
feeling that there was more,
I wasn't traumatized, but I knew that there
was more, and it could be and should be different.
So, you know, then I started this whole,
how do you become a midwife?
And that's a sticky wicket.
This was in the late nineties, when
my oldest son was born.
So it was a while ago.
And, you know, knew I didn't
wanna work in the hospitals.
So I was looking at, you know, the other types,
the CPM was brand new credential.
Right, right. Did, right, right.
Really come about like 92, 94.
Yeah. I wanna say.
Yeah, it was really new.
The pathways to being a CPM were much more,
well, and it only was a thing in like five states to begin with.
Then it grew slowly. It wasn't in [00:34:00] my state
when I was in that process,
it wasn't as clear as it is now.
What year was this? Was 97. 98.
Same time for me. It was all very new,
it seems like not that long ago,
life is so different just that long ago.
Yeah. Somebody said the other day.
Somebody said, oh, that was last century.
And I went, excuse me. They're not wrong.
But I still don't like it. It makes us feel very old.
Yes. I remember, sending away
for, the newsletters by mail.
Yes. You would send in a check and
then two weeks later, you'd get a folded,
printed, mimeographed document,
and then you would read every single word
because it was your only access to midwifery.
I know. Now it's like, ooh. Very different world.
One of the early assignments with,
midwifery education was that you had
to create a file on every complication.
And it was actually a file folder.
With copied random things out of [00:35:00] random books.
Do you remember this? Yes, yes.
Oh, it's funny. How did we do it? I dunno.
Anyway, I know.
And you had to stay by a phone 'cause like
carry a pager and Oh God. I remember life was so,
I was looking into it. I knew I didn't wanna
be a hospital midwife, so I was looking
into the alternatives. And it was very difficult then.
But to find an apprentice, you know,
find a preceptor Yeah. And do this whole process.
Colorado, like many other places, it was a little bit insular,
you had to prove yourself, you can't just walk in
and say, this is what I wanna do. Yeah.
Understandably so.
And I was very stubborn
and wanted to do things.
So while I was in the process of figuring this out
and finding an apprenticeship,
I thought, well, I'm gonna take,
general nursing pre-req courses
at the community college, down the street from me.
I thought, anatomy and physiology is a
good course to take no matter what.
And, you know, those kinds of things applies to [00:36:00] everything.
Yeah. Okay. Yeah. Mm-hmm.
Good. So I started the pre-req program,
at the community college for nursing
and was building relationships and bridges
in the home birth world.
Getting known there. I finished the pre-reqs,
for nursing school. At that same time,
I was offered a possibility of an apprenticeship
with a midwife, here in Colorado, and I shadowed her for a
couple weeks. It became very apparent that we were not a fit.
Mm-hmm. That it wasn't gonna be advantageous
that it, you know, we just weren't a fit.
And so then I was like, well, now what am I gonna do?
It took me two years to get somebody to offer
me an apprenticeship and it's not gonna work.
Also, I was a single mom at that time.
I kind of realized like, I don't know how I'm gonna do this.
How am I going to be on call, be up all night
and have a baby and be able to provide for that baby.
How do I have a job? When I'm on call 24, it [00:37:00] started to become very difficult, impossible to wrap. Impossible really, is the word and it still is.
It was absolutely ludicrous. It's ludicrous the time cost
and sacrifice that it takes to become a community-based birth midwife.
Mid midwife right now keeps so many providers
that would be in this out. So then
I applied to nursing school. I didn't think
I was gonna get in at the time they
had 75 openings and 800 applicants.
Oh my gosh. I sent it in assumed
I wouldn't get in and started to find
another apprenticeship then, I don't know,
divine providence, who knows? I was accepted
and took that as a sign, like, okay,
I guess I'm supposed to go this way.
Wow. It's never what I meant to do.
I never wanted to be a nurse. I never wanted
to be a nurse midwife. I think sometimes the
universe takes you in different places though.
Now I'm thankful. [00:38:00] Now I love full scope.
I love, full scope healthcare.
I love annual exams and contraception
and menopause support and, all these
other things that I can do as a CNM. I
now appreciate and really like that.
It was a difficult year transition for me to accept it
'cause I always felt a little bit like a traitor.
'Cause my roots and my heart was always in
community birth. Well, it's interesting and
you didn't say this so, correct me if
I'm putting words in your mouth,
but it seems like this is a common challenge
really polarized midwifery world where
it seems like there is competition between
different types of midwives and
even a hierarchy. You feel that too?
Yes, 100%. I had built a lot of friends and
relations with people in the home birth world,
and as soon as I started to step into the CNM world,
I was treated very [00:39:00] differently.
Wow. Um, and I was actually, I'll never forget,
I was at a, local state kind of
conference day kind of thing, and I was talking
to another student and she was like, oh, where are you?
Go, you know, we had, we were having this
great conversation. It had been going on for several minutes. It was really lovely.
And then it came out that I was going to,
nursing school and she literally stopped talking
to me mid-sentence, turned her back and walked away.
And I was like, whoa, okay. Whoa.
That is some, bias. It wasn't everywhere,
but it was definitely there.
The interesting thing I've noticed,
because I am a CNM, but I work in the
community birth setting.
When I go to community based places,
I get side eyed because I'm a CNM
and then in the hospital space,
you get side eyed because you're community based.
This is why I've been advocating,
and this is why Midwifery wisdom,
our mission has nothing to do with
provider type and everything to do
with provider location.
The [00:40:00] difference, it's not how you were trained.
The difference is how you practice.
There's a different model of care,
a different way of practicing in the
hospital than in the community.
That's why everything we produce
and talk about at Midwifery Wisdom
is for community-based providers.
I've done, I did my master's thesis on this
education and there is seven different
provider types that practice in the
community setting for maternity care.
Primary comm, primary provider.
There's seven different types.
And yet we stay in these isolated silos without any,
you know, this information hoarding.
Because there's no space for all of us to exist.
Midwifery Wisdom was kind of born in,
a space for community-based Perth providers,
regardless of your pathway to education.
If you're in the community,
you're not doing epidurals in the community, you know, you're, you know, you're not doing c-sections in like,
there's a basic commonality in the locations of care.
The conversation about that we need to make it a conversation. I'm so glad you said that.
It means so much. Yeah, it's huge to feel like you belong.
I [00:41:00] think that's one of the reasons I was drawn to AABC
So when I would go to, and we don't have to
get into the whole situation that is MANA right now,
but when I
would go to MANA things, I'd get the side eye,
and when I would go to ACNM things, I would get the side eye.
Do you know? And ACNM
is also a hot mess right now too,
we don't need to get into those things. But at AABC,
what I found was it's more, about the birth center model
and there's CMS and CPMs and physicians.
And physicians who own birth centers.
And nurses and birth assistants and doulas,
like it's very much more welcoming.
Accommodating, yes. For the community birth.
Practitioners and providers and culture.
And that's why I've always felt kind of
more at home at AABC,
and why I was drawn to be more involved with them.
And work through AABC because it's, that more,
I don't have to explain,
yeah. I know I'm ACNM, but yeah. I know
I work in, in a birth center, [00:42:00] but, you know,
I don't have to do that. It's just all known.
Um, that's beautiful. Which is great and lovely.
That's beautiful. And let's see.
Then I started work as a birth center midwife.
My first job was at Mount Midwifery Center.
I had been working at
Mount Midwifery Center as a nurse.
I was their first employee hire. I was hired there in 2006.
I worked as a nurse and put together the first,
breastfeeding class and the first newborn care class,
and I was the educator for those.
When I graduated from midwifery school,
I became a midwife there. I have mostly worked
in birth centers When I came over to start seasons and the
physician practice hired me, I, you know,
we have hospital privileges. So that was
my first time being an in-hospital midwife. In 2017.
From 2010 to 2017, I was birth center only then
I, now I'm kind of both and I have, feed in [00:43:00] both worlds.
And I do, again, looking at the gratitude
for the universe leading me where it led,
I love the full continuity with our clients.
If we need to go to the hospital, they don't lose their care provider.
I get to facilitate, beautiful births within
the hospital system, because i'm a credential provider
I mean, it's really a beautiful thing and I think
if this could be replicated across the country,
it would be phenomenal, right? Like this is, well,
it's the future is integration.
Collaboration, balance the future for sure. Yeah.
Right. Which is why we just released our
boundaries for birth workers course.
Just plug there. But it's it's, it's really true.
And it sounds like, you know, what I always say around
boundaries is you have to be willing to disappoint
others to stay true to yourself. Yeah.
And I think that's what you are demonstrating by being like, I can't.
Because if, if I do that, I, I abandon myself.
I injure myself. If I do these things,
I know I can't do Yeah.
And I'm [00:44:00] willing to disappoint clients and say,
no, I only do birth center birth or no,
I work with a team, i'm willing to disappoint them
to stay true to myself. It's just brilliant.
Thank you for demonstrating that.
Yeah. I think that, um, birth center,
I'm obviously biased, but I think birth center
is this amazing thing because the families get midwife supported,
midwife driven, physiologic birth support.
And the midwives can have a work life balance.
And the thing that I always tell our clients, it's a small pool of midwives.
It's not 6, 10, 12 midwives that you're gonna meet.
It's a small group of us. But the thing is,
it doesn't matter if I'm there or if my partner
Valerie is there, or my partner Jessica,
because it's not about the midwife.
It's about the model and the individual family.
It doesn't matter which one of us is at your birth,
because we're gonna try that model.
There's the thing that happens in community birth
where midwives are kind of foisted up
on this [00:45:00] pedestal, and there's this worship thing
that happens with midwives, I don't want that
because there's only one way to go and that's down.
It shouldn't be about us. It shouldn't be about us.
Exactly. It's about the family.
The centering is wrong.
There's a great midwife in Texas, Margie Wallace
and she talks about how.
Everyone has to be the hero of their own story.
When the midwife takes up the hero location,
it means that the person birthing
has to choose one of two other options.
In the drama triangle, the hero is one archetype,
the villain and the victim are the other two.
And when the midwife is
occupying the hero archetype,
it means the client has to be the victim or
be angry and be the villain. And that feels horrible,
so I love this focus on the client.
The client has to be centered.
It's their story. It's not ours.
We're just the supporting characters.
But it takes a really different mindset.
It takes, humility, courage, teamwork.
It takes [00:46:00] having a life outside of
midwifery that you can be a hero in.
So that when you come to work,
you're just at work.
That makes a huge difference.
It's a different shift, right?
Of the mindset of it.
Such a different shift, but it's so healthy for everyone.
For the client. For the midwife and the family,
the other thing that I love about my current model,
which kind of hearkens back to something
we were talking about earlier
is that in our current iteration
of seasons, we are dedicated to,
producing more midwives.
One of the things that we're
doing is paying our students I want that knowledge out there, because I remember.
When I was doing this. And that was a huge barrier.
One of the things that we are dedicated to
as an organization here at Seasons is to pay students
while they are here with us so that we can
help make it a more feasible path for people.
Beautiful. And I think that is something
that needs to be talked [00:47:00] about a lot too,
because the current midwifery especially in the CPM route, right?
You're, you have a student who's an
advanced student and they're essentially, they're your birth assistant.
Yep. And that's free labor. Yeah.
They are doing free labor.
And unfortunately there is,
you know, story upon story upon story
of that being abused horrifically. We are dedicated to.
Not doing that and to paying our students,
a wage for the skill and the time and
the energy that they bring to the table.
That's amazing. Well, I celebrate you.
It's been such a pleasure to speak to you and
I'm excited to share this with our listeners.
How can people follow you and get in touch with you?
Oh yeah. So I am on Instagram and, it's a midwife on the path.
You have a pretty good blog by the same name.
Yeah, I was gonna say it's the Instagram is at,
you know, a midwife on the path. I'm also on Facebook.
I'm, trying [00:48:00] to figure out threads I never really got on Twitter.
But I'm a midwife on the path everywhere.
Yeah. And I also have a website and a blog.
Yeah, that's a midwife on the path.com.
And I also, I have a book and
I'm really passionate about, we didn't even get into this.
You just published a book a couple years ago.
That's right, quickly tell us about that.
We'll link it in the show notes.
Yeah, so it's called Midwifery for Expectant Parents.
I'm really passionate about it because
it's not for midwives. It is for the regular person
down the street who gets pregnant
and doesn't know what to do. I love that.
So it really goes through there, you know,
there's a small history of midwifery.
There's a explanation about what midwives do.
There's a explanation of the types of
midwives in a non-biased, non-hierarchical way.
And why you might choose the
different types of credentials and what they are.
What is a physician and how is physician
care different, information about pregnancy and postpartum.
[00:49:00] I feel really passionate about the book.
There's birth stories in there that are true real birth stories
that I was, able to attend.
Going back to what we were talking
about before about engaging consumers
and making them kind of really understand
what's happening. I think that this book
is a great intro or primer, for the
consumer about what is happening.
I feel strongly about it.
And again, it's called midwifery for expectant.
Parents it's also very inclusive, for family types as well.
That's beautiful. Well done. Congratulations.
Thanks. Well, I really, again, so grateful to speak
with you today. Thank you so much Aubrey. Have a great day.