People sometimes point out that I wasn’t the first doula to open a birth center. Many midwives are doulas too, or were doulas long before they became midwives.
That’s a fair point, and I made peace with it years ago. The truth is I once wanted to be a midwife myself.
My Midwifery Dream Started in 1984
I looked into midwifery school as far back as 1984. The timing worked against me. Only about 2% of births in the United States had a midwife present at that point, counting home and hospital births together. Illinois, where I lived, hadn’t licensed or legalized midwifery yet. Graduate school in health education became my path instead.
The Two Routes Into Midwifery
Anyone considering midwifery usually chooses between two credentials.
A Certified Nurse Midwife, or CNM, holds a master’s degree in nurse midwifery and typically works inside hospitals.
A Certified Professional Midwife, or CPM, earns her credential through a national agency. A CPM can apprentice under a practicing midwife or complete a school program, but she doesn’t carry hospital privileges.
I thought about going back to school for one of these routes even after the birth center opened. By then I was in my 50s. Starting over would have cost more money and energy than I had left to give.
Building a Birth Center Instead of Becoming a Midwife
I didn’t become a midwife. I built a place for midwives to work instead.
The center ran on an open staff model. Independent community midwives brought their own clients and attended births at the center. Each midwife billed her own clients for the provider fee. I billed separately for the facility fee.
The Real Drawback of an Open Staff Model
This setup worked well most of the time, but it came with a genuine cost. Midwives on our staff could attend births either at the center or in a client’s home. Some families who planned to birth with us switched to a home birth partway through their pregnancy, and I lost them.
That switch stung every single time.
What Running a Birth Center Taught Me?
That loss also taught me something I still believe today. The credential in the room mattered less than making sure a room existed at all, one that fit whatever kind of birth a family actually needed.
I wasn’t a midwife, and I didn’t need to be one. I built the space that let midwives and mothers do their work.