Consider your decision
As a senior midwife I receive requests to act as primary provider in all sorts of interesting cases - often from great distances. It is a great complement to be so thoughtfully regarded, however it is also ignores some very important realities. Not only am I just one person with limitations to time, but most importantly: There are wonderful midwives working throughout the state that have worked hard at their craft.
Wisconsin is an extremely rural state with clusters of midwives in some areas and only one or two in others. Some are new in the work; some have been at it most of their lives. Regardless of each midwife's experience, every midwife works very hard to build her experience and she can maintain her valuable presence within community only through sufficient community support.
CONSIDER: An average range for a midwife in rural areas of Wisconsin typically includes a rough cumulative population of 5,000 of the small towns and may involve one medium city with a possible population of 8,000; roughly a total population of 13,000. Homebirth is on the rise but is only slightly higher than 1% meaning that any midwife may have up to 130-150 families choosing homebirth within her area every 2-3 years or an average of 46 births annually. Although the total numbers of potential homebirth families may be greater in large cities, so too are the numbers of midwives making this example similar in these more urban environments. The average midwife spends 1/2-3/4 of her fee on expenses. Every midwife is confined less by her willingness or ability to support than by the commitment her community makes to her financial security.
When weighing your options for care please consider the midwife in your immediate area first, always. If you are experiencing great challenges in your childbearing year which may best be served with more experience than your local midwife can provide, consider asking her to contact a more experienced midwife for support during your pregnancy and birth. Almost every more senior midwife offers this support (at a fee) and are willing to act as a consultant during the pregnancy and voice of experience during your birth. Your willingness to support your local midwife is the real measure of your commitment to the future of midwifery in your area.
CONSIDER: The true cost of our run-around life is just beginning to be understood. The global dependence on oil is increasingly destroying entire environments. I believe strongly that -beyond issues of community support- we are all increasingly being called to recognize the need to limit our use of energy. The classic travel pattern of midwives has always been heavy and beyond the tremendous expense, the reality is that we are becoming part of the carbon-footprint problem. Consider the ways in which your decision helps shape your children's future energy resources.
Every midwife arranges her practice according to her circumstances. Some see clients in their homes, some in clinics and others work exclusively through home visits. Whichever arrangement is made, the childbearing year includes many opportunities for mini-crises that create potential for unbelievable travel. From sudden shifts in wellness of the mother, changes in pre-birth patterns of the baby to rounds of pre-labor having a midwife close by is not only reassuring but environmentally sound.
CONSIDER: The concept of community-based healthcare seems to have been lost by the larger medical establishment but is the heart and soul of midwifery the world around. While we might only rarely consider our personal little corner of the world as being unique, we each live in micro-environments. The landscape itself creates micro-climates: Rolling hills control winds better than flatlands while flatlands offer better spacial awareness than twists and turns of hills; suburban communities are shaped by controlled water sources while rural farmland by wells. So too do our environments change our health potential: Farm work provides for daily exposure to fresh air and sun but also physical risks and exposures to farming chemicals; suburban lives allow for ready access to a vast multitude of health options from out-of-season foods to supplements but also increase exposure to radiation and sedentary lifestyle. Each community midwife builds her skills around the families she serves and the ability to truly know the community she serves changes everything in her practice from the items she carries on her shelves and in her bags to the ability to know the health experience of her community and what is most helpful in their care.
I very strongly believe that it is possible for every community -defined as a 30 minute drive in any direction-
to support a midwife and her assistant.
In my youthful past I covered areas as vast as 3 hours in any direction; madness. Today most of the families I serve are less than 30 minutes in any direction of my home. My farm is 27 minutes from Reedsburg, Hillsboro and Richland Center. Since extreme weather can make crossing major bodies of water and interstate highways a dangerous choice I have chosen to use them as my natural boundaries.
MY PRACTICE AREA IS DEFINED AS: North of Route 14, West of Route 12, South of 82 in Mauston or East of 80.
I make it a rule not to work within other midwives' areas and will consider breaking this rule only under very specific conditions, the following of which are the most common:
OUT OF STATE: I do work with out of state families often. For families to make such a radical decision, something is terribly unacceptable for them and thus every effort is made to help them find a solution that reduces the stress and (imposed) risks of their birth. We work with such families on an individual basis to find reasonably close short-term housing options (we have a short list which we are constantly working on adding to) that are as close to my home base in Cazenovia as possible.
SPECIAL CONDITIONS of PREGNANCY: Families who are experiencing a pregnancy that is being judged as "at-risk" may not be able to find midwifery care in their area. If every midwife within 45 minutes of a family has refused their care, I will consider discussing options.
INCOMPATIBILITY: Not everyone gets along well; it is human nature. While I will push hard for better communication and frequently offer to assist at a birth with a midwife a family is having difficulty getting along with, I do understand that there are situations under which nothing feels right. I will discuss such situations individually but I am firm that I will limit my travel to no more than just over one hour. If a family is at a great distance I will discuss options for finding local rooms for their birth. Once my own center is finished this will be an option for such circumstances.
I always try to make exceptions in support of families working with midwives who request my assistance.
Please, please consider your area first when considering your options. In the following list are the known midwives in Wisconsin and surrounding areas. The majority of the midwives on this list are members of the Wisconsin Guild of Midwives however there are many midwives not on this list -licensed and not- and if you know of one who would like to be included please forward her name to me. I believe that there is a best midwife for everyone and knowing who is available is the first step in finding that right fit. If you cannot find a midwife don't hesitate to write. Several very interesting options are opening up in Wisconsin, some of which are not public yet.
My location is the PURPLE flag on the map contained within the link below.