A revealing guide to a career as a midwife written by award-winning health reporter Sandi Doughton and based on the real-life experiences of the chief of the midwifery practice group at the University of Washington—required reading for anyone pursuing a path to this life-changing profession. Becoming a Midwife takes you behind the scenes to find out what it’s really like, and what it really takes, to become a midwife. Midwives are medical professionals who provide care for childbearing women on their birthing journey. It is a growing career that combines compassion and emotional intelligence with nursing and healthcare. Expert midwife Mary Lou Kopas, MN, CNM, specializes in healthy pregnancy and birth. As a veteran of the field, she has helped countless women on the path to labor by delivering their babies and following up with breastfeeding support, newborn care, and insight into the many psycho-social challenges women face in the transition to motherhood. Gain professional wisdom as acclaimed health reporter Sandi Doughton shadows Kopas at work, telling the story of her professional path. Learn the ins and outs of this dynamic job, helping soon-to-be mothers bring new life into the world. Sandi Doughton is an award-winning science and writer for The Seattle Times and the author of Full Rip 9.0: The Next Big Earthquake in the Pacific Northwest . Doughton has been covering science, health, and the environment in the Pacific Northwest for more than twenty years. She lives in Seattle, Washington. Chapter 1 1 By the time the call comes in at 2:30 p.m., Mary Lou Kopas has already helped three women give birth. The first was Monique, at 8:30 a.m. Aided by an anesthetic called an epidural, she pushed for a scant half hour after her water broke before delivering her second child into Kopas’s hands. The little girl needed a few puffs from a neonatal respirator to boost her breathing but now is nursing with gusto. Next was Sofia, who had hoped for an unmedicated birth until three days of labor left her ragged and exhausted. She opted for an epidural, which allowed her to sleep for a few hours. The delivery went fine, but a bit of placenta refused to detach from the uterus. Kopas couldn’t dislodge it, nor could the obstetrician she called for assistance. Facing the risk of hemorrhage, the new mother was whisked to the operating room, where Kopas helped the surgeon perform a procedure to remove tissue from the uterus called a D&C: dilation and curettage. Then came Nayantara. After four hours of labor, she delivered her first child, a boy, without pain medication. “That one was very nice,” Kopas says, smiling. “The baby just glided out.” Back-to-back-to-back babies aren’t the normal order of business at University of Washington Medical Center–Northwest, where Kopas leads a team of six certified nurse-midwives. “I might get a day this busy once a year,” she says, plopping into a chair after the third birth—and just before the phone rings. On the line is Amie-June Brumble, a thirty-seven-year-old law firm supervisor nearing the due date for her second child. She tells Kopas she’s been having sporadic contractions since early morning but isn’t sure whether they signal the start of active labor. Kopas hasn’t eaten anything but a handful of hazelnuts since breakfast. She’s barely had time to pee. But as she chats with the expectant mother, her voice is unhurried and calm. There’s no hint of stress, no indication she has been running nonstop for nearly eight hours. “The patient doesn’t care how busy you are,” Kopas explains later. “Your job is to be there for her, to give her your full attention.” In that way, midwifery has changed little from its ancient roots. Derived from Old English, the word midwife means “with woman.” Centuries later, that’s still how Kopas defines her basic commitment to patients: “It means being there with her no matter what happens.” Following in the footsteps of midwives through the ages, Kopas helps women navigate the joys, terrors, and transformations of pregnancy and birth—experiences that rank among humanity’s most primal. But midwifery today is backed by the power of modern medicine. While midwives of old had no formal training and helped women deliver at home, nurse-midwives like Kopas are highly educated professionals who work mostly in hospitals. They offer their patients the personalized, holistic care that is the hallmark of midwifery—and the peace of mind that comes from knowing surgeons and state-of-the-art resources are close at hand if needed. That’s why Brumble chose the UW midwives for both her pregnancies. She knew she didn’t want a typical hospital experience, with bright lights and medical staff rushing in and out and an obstetrician she might never have met before. She wanted to see if she could give birth naturally, with no pressure from busy doctors to speed up her labor or dull the pain with drugs. “I didn’t want to be treated as a medical emer