A certified nurse midwife, or CNM, provides care for women of all ages, from pubescent to menopausal years. For pregnant women, they provide care during appointments, the birth, and even after they deliver. They are both a registered nurse and a midwife, having completed education for both. According to the Mayo Clinic, “Nurse midwives have similar roles to OB/GYNs but focus on natural techniques for childbirth and reproductive care.”
Connie Breece, 71, has been a CNM since 1986 when she graduated from her midwifery program at Yale University. After graduating, she started her training at Boston City Hospital. After working at other clinics, she graduated and started working at Boston City, then Cambridge Hospital, founded her clinic, and now works at South Shore Hospital. Breece also has two daughters and loves to quilt and travel in her free time.
“I did not know what a midwife was until I was about 30 years old,” Breece said. Before being a CNM, sheworked at a women’s state prison that didn’t provide prenatal care. “The very first woman that I saw go into labor in Framingham was pregnant with twins. Now, where she was gonna run away to? She was in labor, and she was shackled.” When she saw this, she knew that this was wrong and discriminatory towards the women. After her experiences, she started looking into women’s health and started working at a high school in Boston for women who had previously dropped out. “At that point in my life, I was working as a teacher. I was working in classrooms. My mom was a teacher. I thought I was gonna be a teacher.” However, later, when she started traveling, she kept meeting all these women who were midwives. They told her these great stories about how amazing it was to be a midwife and how it’s the best job. As she was learning from them, she became more interested in women’s health and midwifery. When she finished traveling, she applied, and got accepted, to the midwifery school at Yale.
To become a midwife, Breece had decided to take the nursing route, because in Massachusetts you can’t practice as a midwife in a hospital unless you’re a nurse. “The reason I went into nursing is because I wanted to do international work too, and you can’t work internationally as a midwife unless you have a nursing degree.” According to the Nursing License Map, “Your first step toward becoming a CNM is to become a registered nurse, which is a requirement that must be met in order to apply to a nurse-midwifery program.” Breece first had to study nursing for a year, recounting, “You don’t sleep for a whole year.” She had to do different kinds of nursing modules, pass her nursing boards, and go to midwifery training. “You have to work in a postpartum clinic, take care of wives and babies. You have to do some rotations in an intensive care unit for babies, you have to work in labor and delivery units….” When she was done with everything she needed and passed her midwifery boards, she left for her internship at a hospital.
The internship moved fast. “One day you’re walking down the hallway and there’s this woman screaming in the hallway and the midwife you’ve been working with says ‘Go in there. Do that birth…you’re on your own,’ and that’s how it happens.” When it is time to help give birth, you just have to go in. “You’re scared to death, are you kidding? It’s a very sacred responsibility to have the life of a mother and a baby in your hands.” Even with how trained and prepared she was it was still scary because she had two lives in her hands. This is a moment that the mother will remember for the rest of her life, so making sure it goes well is a midwife’s job.
Breece agreed that midwifery as a profession is generally undervalued. She explained how one hundred and twenty years ago almost all babies were delivered by midwives. A small percentage were delivered by medical doctors, but most women had their babies with midwives at home. Most women either could not afford or did not want to see doctors. “Doctors were very interventionist in birth and labor. Medicine views birth as a sickness as an abnormality. Midwives view birth as a normal part of life.” From her experience as a midwife, she sees that midwives have more of a natural and positive look on birth, while doctors have a more “abnormal” and pessimistic view of it.
In the 20th century, there was a move to get rid of midwives so that more women would go into hospitals to have their babies for money. “There was a counter-midwife campaign all over this country, and it worked…92% of the babies are delivered by doctors in hospitals.” Based on an article from the ACLU, in the past, “Gynecologists explicitly revealed their motivations in undermining midwifery: They desired financial gains, recognition, and a monopoly.” Doctors were trying to put midwives out of a job, all for recognition and profit, which is awful not only for midwives but also for pregnant women. “We are very threatening, I think, in the medical profession because we believe in normalcy. We don’t believe women are sick.”
Breece’s biggest challenge is “teaching this whole generation of women that they can labor, they are strong enough to have their babies naturally. It is better to be born not full of drugs. We don’t really know the long-term results of the drugs we put into mommies and babies.” Breece is a big advocate for women not having to be drugged for birth, so one of the hardest things for her is that so many women get induced to have their babies. She believes a whole group of women do not have the full experience of labor, which she believes they should get the opportunity to feel.
Breece’s advice to people considering being a CNM is “Do it. Go into the profession and change it in important ways.” She wants them to advocate for women having normal, spontaneous births and to make sure they listen and take into consideration all aspects of what women find important. “I am so lucky to have had a profession and still love it after all these years.” There’s nothing mid about midwives.