The Benefits and Value of Becoming a Nurse Midwife
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Interview with MaryJane Lewitt: Nurse Midwife and Faculty Member at the Emory Midwifery Program
To say that MaryJane Lewitt has had (and continues to have) a seasoned career in as a nurse midwife is an understatement. Lewitt’s career has spanned over two decades and her professional journey has allowed her to be a part of the nurse midwife field both in practice and as an educator. Currently she holds positions as Co-Coordinator of the Dual Major Nurse Midwifery / Family Nurse Practitioner Program and is an assistant professor of the certified nurse midwife program at Emory University. And beyond that, she remains a practicing certified nurse practitioner midwife, working with women at all stages of their lives.
Lewitt's extensive education started with earning her Bachelor in Nursing Degree and Masters in Nursing Degree, from the University of Florida. She then went on to earn her certificate in Executive Education and Leadership from the John F. Kennedy School of Leadership, before eventually earning her PhD in Nursing at Emory University, where she currently instructs graduate level nurse midwives and advanced practiced registered nurses (APRN).
In addition to her seasoned career, Lewitt is also an informative voice on the best practices and safety of midwifery, regularly speaking at healthcare conferences on topics such as “Shaping Birth by Connecting, Protecting, and Intervening: The Nurse-Midwifery Process of Care and Evidence Based Practice” and "Promoting Physiologic Birth through Partnership with Hospital Administrators." She has received many awards and has had articles published in journals for such varied topics as how nurse care coordination affects the architectural planning of a healthcare facility, and training healthcare staff as a team.
There’s much more to learn from MaryJane Lewitt’s career and where she thinks the practice of nurse-midwifery is headed, so read on for our full interview with her.
What led you to earn your degrees in nursing and then nurse midwife?
When I was a young girl, my mother was diagnosed with cancer. This made quite an impact upon me. I knew I wanted to go into healthcare or research to help others. As part of my undergraduate program at University of Florida, I undertook a career/personality test that led me to the profession of nurse midwifery. I had always been fascinated by birth. With the discovery of the profession of nurse-midwifery, I had found a career path that would allow me to combine my interests in birth and healthcare with my desire to help others.
To you, what is a nurse midwife, and how is pursuing a degree in nurse midwifery different than a nursing program?
A nurse midwife is an advanced practice registered nurse (APRN) who supports women at all stages of their life cycle. They work with women during their reproductive years, during pregnancy and birth, but continue that care through the post pregnancy period and into menopause.
Nurse midwives create very special relationships with their patients, working collaboratively to address each individual’s personal healthcare wants, desires, and needs. The knowledge base of nurse-midwifery builds upon what students learn in a baccalaureate nursing program. The knowledge of the healthcare system, healthcare of people with a variety of diagnoses, and how to meet people’s needs as individuals all provide a strong foundation for advanced nursing practice. As a nurse midwife, you learn the additional skills of advanced health assessment, diagnosis, and the treatment of essentially healthy women throughout their lifespan. In addition, we also learn about the care of women in pregnancy and birth, gaining knowledge about the appropriate treatment for complications, but also about the myriad of options for women who want a healthy experience.
How has completing a midwife program prepared you for your responsibilities in the professional positions you’ve held?
After completing my nurse midwifery degree and certification, I had thought I would work within an established practice and continue to gain confidence and experience. However, this did not happen. I found myself in a situation where I was creating my own nurse midwifery service and became the first nurse midwife on staff at the local hospital. I wrote protocols, established a caseload, trained hospital nursing staff about various techniques that nurse-midwives use with women in labor, and created relationships with the other OB (obstetrician) providers. This seemed very daunting initially, however, I quickly learned that the same skills I had learned in my education (communication, negotiation, anticipation, collaboration, consultation) were extremely effective for this process as well. I had a successful practice with offices in inner city Atlanta and suburban Atlanta for 7 years, before my family relocated to Jacksonville, Florida.
At this time, I joined the faculty of the University of Florida (UF) in the nurse midwifery department. At UF, I was able to use my skills of practice development to assist in the creation of a nurse midwifery service to serve rural, underserved women for both gynecologic and obstetric care. While teaching in the nurse-midwifery program at UF, I recognized my love for working with future nurse midwives, which would ultimately motivate my future return to midwifery education.
After a short time, my family relocated to Atlanta, and I had the opportunity to join a larger nurse-midwifery practice. For 7 years, I had the privilege of working with many wonderful women who specifically sought low intervention, supportive nurse midwifery care. Near the end of this time, I recognized that I personally desired to make a larger contribution to the management of pregnancy and birth. This desire led to my return to school and the completion of my PhD in Nursing. During my PhD, I focused on the process of care provided by nurse midwives and discovered that nurse midwives are active participants in the shaping of birth for the women they work with.
How do you work as an advocate for developing quality and safety practices of the nurse midwife profession in the United States?
From the moment that I entered my nurse midwifery education, I became involved in the professional organization of the American College of Nurse Midwives. Through this organization, I have worked on quality and safety initiatives throughout my entire career. Recently, I chaired the Maternity System Quality and Safety Committee of the ACNM Healthy Birth Initiative.
This initiative focuses on educating consumers, providers, and healthcare institutions/systems about how to support women during birth in an evidence-based, healthy way. The Maternity System Committee is focused on creating resources for institutions, administrators, and quality/safety leaders to learn about evidence for healthy birth and resources available for supporting healthy birth in their institution. Our first document, “Birth Matters[i],” presents this argument in a succinct manner specifically for this audience.
What do you find is the most rewarding or exciting thing about midwifery?
One of the most rewarding things about being a nurse-midwife is when you are able to connect with another person and support them in their ability to achieve their desires. When you work with someone who is in the midst of achieving their personal goals, whether it is giving birth, laboring with limited intervention, improving their own health, or actively improving the health and well being of their family, you reach a moment when all the struggles disappear and everyone feels this incredible sense of accomplishment. At this moment, all of the long nights and long conversations become instantly worthwhile. The patient achieves a sense of empowerment and she matures into a strong, capable person for whom nothing is impossible. This is the ultimate reward of being a nurse-midwife.
From your experience, can you discuss the role of midwives in the healthcare industry and community?
Nurse-midwives are ideal providers to participate in all aspects of healthcare. We are team leaders, team members, collaborators, educators, hands-on providers of care, managers, organizers, evaluators, diagnostic clinicians, planners, and implementers of healthcare. Nurse midwives work closely with all members of the healthcare team to create and implement a holistic and complete plan of care for the women and families that they work with. They understand the healthcare system and are capable of helping patients navigate its intricacies.
Nurse midwives continuously collaborate with specialists while maintaining an understanding of the overall care for the women they serve. Nurse midwives fulfill the role of patient advocate all the while individualizing care for the unique needs of each person and their family.
During your education and career, have you been confronted with many misconceptions about midwifery?
There remain multiple misconceptions about midwives to this day. I have often been asked if I only deliver babies in homes or if women who seek care from me are required to labor without pain relief. With every patient I meet, I always take the time to explain that I am a nurse midwife and explain what this means to them. It is my professional responsibility to make sure that every patient knows who I am. I am a certified nurse midwife and I provide care to women throughout their lives, including meeting the reproductive healthcare needs of women from menarche to menopause. I work with women during pregnancy and birth and deliver patients within the hospital. Nurse midwives assist women in birth in their homes and in birth centers, but the majority of nurse-midwives provide this care within hospitals. Our patients have access to the same full range of pain relief options as any other laboring woman and, in addition, have access to the labor support skills and holistic knowledge of the profession of midwifery.
Do you think that it is an ideal time to pursue a nurse midwife program and if so, why?
Any time is a great time to pursue a career in nurse midwifery. Nurse midwives enter this profession at all stages of life. You are never too old or too young to consider becoming a nurse midwife.
Right now, we are at a wonderful moment in the healthcare industry. People want and desire different options for their care. People are extremely interested in becoming active in improving their health and the health of their families. Advanced practice providers and nurse midwives are recognized as crucial members of the primary healthcare team. Students entering the profession today are becoming active members of the trans-disciplinary healthcare team that is shaping the future of our country’s health.
What should students expect from an online nurse midwife program?
There are various options for nurse midwifery education in the US. There are full-time and part-time based face-to-face classes. These are considered some of the more traditional programs where students meet for classes with faculty.
There are also online programs, where students participate using internet-based distance technologies, sometimes combined with face-to-face classroom experiences periodically during the educational process. In both of these programs, students still obtain clinical experiences working with patients within the healthcare system. Typically, online programs require students to be self-motivated. Students are responsible for maintaining their own study plan and schedule. Degree options for programs in nurse-midwifery include Masters degrees, Post Masters Certificates, DNPs (Doctor of Nursing Practice) and PhDs.
Which skills do you think are necessary for pursuing a nurse midwife program?
The most significant thing that potential future nurse midwives need is the desire to help others. This motivation will get you through many long lectures and long nights. Seeing the smile on the face of a new mother, as she gazes into the eyes of her newborn, makes every second of the educational process worthwhile. Realize that while you are a student, you are earning a future filled with these moments—moments when you get to share the incredible privilege of working with women during birth.
>What advice do you have for students interested in or pursuing a nurse midwife program?
If you are interested in entering the nurse midwifery profession, find nurse midwives in your community and ask them about their jobs. Contact universities or schools that offer educational programs for nurse midwives and schedule an appointment to talk with the nurse-midwifery faculty. Discuss your goals and explore how becoming a nurse midwife will help you achieve these goals. Once you become a nurse midwife, your outlook will forever be altered.
Nurse midwifery is not just a profession; it’s who you become. As a nurse midwife, you see the world through a different vantage point. You will see potential in every person and opportunities for positive change in every interaction with others. As a nurse midwife, when you share your knowledge to improve the health and well being of others, you are actively enriching the world, one birth and one interaction at a time.
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