Twenty years ago when I started working in home birth, my father-in-law said to me “I don’t know why you are doing this, your family can’t afford a lawsuit”. At the time I felt insulted and unsupported by his comment. I have since pondered that statement many times throughout my midwifery career (especially when talking with our students) and have come to some conclusions:

1. Life is a risky business and…
2. Worry means you suffer twice.

Everything we do in our daily lives carries some degree of risk. We make choices regarding these risks almost without much thought for some and with great thought for others. When we start the engine of our vehicles, and back out of our driveways we start the risk clock ticking. If we obey the traffic laws and are mentally alert, the risks are small and the benefit is worth it. If another driver chooses to be riskier that I am and we collide I have the reassurance that I will not be held at fault. I may suffer the fallout of the collision but can rest in the knowledge that I was not at fault.

As I have discussed midwifery with my students, I have explained to them that the laws, protocols and practice guidelines that we ‘obey’ provide us a safety net that keeps us from being ‘at fault’ as we practice a profession that has many possibilities of risk and surprising and unexpected outcomes. One of my mentor midwives, Allison Osborn wisely advises to read your practice guidelines frequently, know them, keep them updated and use them as they will help to protect you.

If our practice of midwifery includes realizing our own boundaries, skill levels and we follow our laws and guidelines, our worry index can be reduced to a manageable and sustainable level that may allow us to serve women for many years. I consider myself a conservative midwife which means that pushing my guidelines and taking risks are not comfortable to me.

Caring for women and babies as an autonomous home birth midwife is one of the most amazing and challenging careers that is available. It is as close to a divine calling as I have ever experienced and it certainly brings its share of concerns, joys, worry, and celebrations. Being a home birth midwife is my dream job and I am so grateful to have been able to shoulder the responsibility that this job/calling has asked of me. Having had a midwifery partner who supports me and lightens my load whenever possible has also been a blessing to me. We have grown and come so far over the 20 years of working side by side in this ‘risky business’. And, It has been made incredibly more beautiful because of the association of the midwives in our community. We have grown together by sharing our knowledge, experiences, smiles and tears. Thank you!

Marlene Smith LM, CPM
One Heart Midwifery Care