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The Latent Phase: Transitioning into the Second Oldest Profession

By Stephanie Tillman, CNM, MSN

What is the first year of midwifery practice like? Experienced midwives might remember theirs with assured and distant hindsight, considering both the beauty of that time and also cringing at the scars of the learning curve. Student midwives may anticipate the first year with anxiety, uncertain of skills still being practiced and facts yet memorized, always knowing the limitations of school learning. Those currently living the first year may fear their experiences are singular, or that to have anything but a confident approach while proving knowledge and skills to other midwives, to collaborators, to Residents and Attendings, is to allow an opportunity to be pushed into the familiar student role: a role worked so hard from which to graduate.

Do you think you are the only one who drips gluteal sweat down your legs during a birth when something happens that you've never seen before? Do you think you are the only one going to the bathroom to look up drug dosages and EFM criteria while grabbing a few precious moments alone on the toilet? Do you think you're the only one figuring out how to be your own midwife, after shadowing and admiring great midwives for endless months as a student? Do you think you are the only one having second thoughts about who the heck thought you could do this? Do you think you are the only one who feels so passionate about the profession of midwifery and caring for women that it can bring you to tears, and you cannot imagine doing anything else?

I write to you from the throes of my first year of practice. I began blogging in my first few months as a CNM at, where I continue to process ideas related to women, health, and care: often midwifery-related, but always women-focused. Through readership at ACNM, I have been given an opportunity in this space to focus on the first year of midwifery practice and offer recently lived advice and wisdom, to the best of my ability. Here I will work through my experiences of the practical, the cerebral, the therapeutic bottles of wine, the flashlight-lit sleepless nights spent with Varney and Frye, and my experiences with the profession of midwifery as a whole. I am here to remind experienced midwives, to assure new midwives, and to give space to those on their way, that the first year is to be absorbed, loved, and conquered.

Is there really some magical comfort, some corner that is turned at 100 births when a new midwife can take a deep breath and feel confident in her experience? Is there a hazing period of a waiting game, waiting for something to go wrong, waiting for the true shoulder dystocia or rapid hemorrhage that finally inducts a midwife into the profession? Are we all, at one time, Jenny or Chummy from "Call the Midwife," our experiences only known to others if we take the time to share them?

Midwifery is an incredible profession. The sister midwives from my graduating cohort, the midwives in my current practice, and the midwives working internationally: we all labor side-by-side, each day fighting the fight of safe and compassionate women's healthcare. I am honored to be a part of this work, amazed at these moments to serve women, and humbled at the opportunity to share some of my work with others also living this for the first time. Here, twice monthly, I will do my best to work chronologically through the process as a new grad, and also chronologically through my own thought processes. My first few posts will provide concrete information about preparing for the first year, including passing the certification exam, finding and acquiring the first job, and discussing everything grads wish they had learned while still in school. Mixed in with these, I will have more cerebral topics, including the politics of clinical practice, individuality of midwifery practice, and the emotional impacts of a busy clinic day or labor-and-birth shift. I welcome your suggestions, advice, and words of support for myself and others in this first year. Join me!

Stephanie Tillman is a recently-graduated Nurse-Midwife now practicing full-scope midwifery in the urban United States, at a Federally Qualified Health Center (FQHC) and as a member of the National Health Service Corps (NHSC). With a background in global health and experience in international clinical care, the impact of public health and the broader profession of midwifery are present in all her thoughts and works. Stephanie's blog, Feminist Midwife, discusses issues related to women, health, and care. Find out more at and follow her on Twitter at @feministmidwife.

Posted By Barbra Elenbaas | 1/10/2013 2:03:48 PM



Any opinions expressed in this blog are those of the individual participant(s) and do not necessarily reflect the views of the American College of Nurse-Midwives. ACNM is not responsible for accuracy of any of the information provided by guest bloggers and/or members via the Comments section. We welcome all feedback – including comments, ideas and suggestions. We also welcome civil, friendly debates. However, any and all content that is deemed inflammatory or rude will not be posted.


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