The Sacred Calling of Midwifery: Light and Shadow

Midwifery is beautiful. Sacred. Awe-inspiring.

For twenty-eight years, being a midwife fed my soul on a level few could comprehend. Still there are moments it breaks me wide open.

People see the beauty of midwifery, but not always the cost to those who hear her calling and answer. And that’s okay. Behind the sacred moments are sleepless nights, missed milestones, and the weight of outcomes that shape us forever. This blog is my heart laid bare: the beauty and the shadow of this calling, and why I still choose it every single day.

To sit at the bedside of a woman in labor is to hold her hand, to whisper courage into her ear as she crosses into motherhood; there is nothing else like it. This is not just a job. It is a calling. For some of us, like Midwife Bri and myself, it runs in our blood, deeper than choice.

But beauty always casts a shadow as this calling demands so much from us.

We miss birthdays. We miss holidays. We miss baseball games and school concerts. We miss sleep. We miss meals. We miss the comfort of our own beds. Mother’s Day, for us, is often spent helping another woman become a mother herself. And yet, we wouldn’t have it any other way.

Our families know this. They know sometimes they come second. Not because we love them less, but because we are called to this work. It feeds us even as it empties us.

A huge challenge that each of us faces is when our safety or our ethics are questioned. It cuts so deeply because this work is so much more than a job. This work lives in the innermost place of our hearts and our souls.  A place so sacred, it’s rarely seen but always there.

Simply put, midwives are held to a higher standard than any obstetrician. An expectation that we deliver nothing but perfection and there is no room for anything else. Obstetricians have bad outcomes, too even the best ones. It simply is the reality of the work we do and still we show up for it. None of us is infallible. We are human. And humans, no matter how devoted, cannot control all outcomes. Still. We try. We strive. That is our life’s work, the light and shadow.

I learned this early. In my first year of practice. My third birth as a baby midwife ended badly. It nearly destroyed me. I carried that baby on my shoulders for years, and in many ways, I still do. That family has not forgiven me and that is theirs to hold.

What I can tell you is that I never forgot.

That little one has been beside me at every birth since, whispering, guiding, reminding me to choose the safest path.

In the more than two decades that I have served women and their families, I have had two bad outcomes. They did not make me unsafe. They did not make me unethical. They made me human in a profession that walks the edge of life and death. In fact, they made me a safer midwife; because I vowed, I would never see another baby or family endure what they did.  Those outcomes sharpened my instincts and drove me to dedicate years to strengthening our profession, creating guidelines and systems so my sister midwives wouldn’t have to endure what I did.

Over the course of 2,000 births, my outcomes have consistently equaled or surpassed national benchmarks. I have never lost a mother, and I have never had a case of postpartum uterine infection. The national stillbirth rate is 3–5 per 1,000; I have had 2. Out of all 2,000 births, only three newborns required NICU admission beyond brief observation at a rate of 0.15%, compared to Texas’ average of 11.7%. I have had one case of hypoxic-ischemic encephalopathy (HIE), a rate of 0.5 per 1,000, which is lower than the national average of 1–3 per 1,000.

I also cared for one baby who suffered brain damage, not from a birth injury, but from a rare and undiagnosed metabolic disorder that only became apparent after birth. These are the difficult outcomes in my career, and I share them because they are part of my story and the truth of midwifery practice.

These numbers do not erase the grief of families who experienced loss, nor do they make me immune from criticism. But they matter. They show that midwifery care, when practiced with skill, transparency, and devotion, is safe. They remind me, (and I hope reassure others) that midwives carry both beauty and burden, and we do so with integrity. The salacious truth is those outcomes are 27 and 11 years old and aside from them, my record has been impeccable.

Still, I have been accused. We didn’t move from another state because of those births. My husband and I moved down here to retire, but life had other plans. God still wants me to do midwifery related work down here. So, I persevere because people will say unsubstantiated, ugly things people speaking the truth is much less exciting and gets a lot less “clicks”. I had the respect of my colleagues and the hospital staff. They knew me. They trusted me. When I transferred a client, they did not fear the worst. They knew I had already given the best of my judgment and skill.

Unwanted outcomes do not mean a midwife is unsafe or unethical; they mean we are practicing in the real world of birth, where even the deepest devotion cannot erase all risk. And still, we strive for perfection, even knowing we will sometimes fall short. Because we understand this: no matter what the outcome, we will always be part of that family’s story. For better or for worse. That truth humbles us.

It shapes how we hold each birth like glass in our hands.

Midwifery is brave work.

In the hospital, emergencies are met by a team. In our world, it is often only two of us. Shoulder to shoulder, we act quickly, sometimes saving the day, sometimes not. Even our best efforts cannot always rewrite fate. That is the quiet trauma midwives carry.

Yet, we rise again. We return to the birth rooms. We pour ourselves out, over and over again. We do it with little pay, little recognition, and little understanding from the outside world. But still, we do it for our mama’s. For the families we are called to serve.

Birth is fragile, sacred, unforgettable.

Midwifery is the intersection of life and death, joy and grief, bravery and surrender. We rise to it, again and again, knowing the cost. We give our rest, our time, our families’ milestones, because we were called.

This work matters. It completes us.