Nancy Jo Reedy, CNM
Last fall, we lost two influential cultural voices: Steve Jobs in October, and
Andy Rooney in November. Both of these men left behind legacies that we as midwives
can carry on and learn from.
Jobs, the founder and visionary behind Apple, died at the early age of 56. In
his younger days, he left college—it wasn’t teaching him anything he wanted to
learn. He followed his dream and vision by working with a friend in a garage to
create Apple. He left Apple, founded another company that Apple then purchased,
and was back again. He was “not in the mold” and actually hated the mold.
Working in jeans and tennis shoes, hiring other visionary misfits, he pursued perfection
in everything he developed. He thought outside the box, was unafraid of doing
his own thing, and never lost sight of the people who would use his products.
What does the consumer want—or what would
they want if it were a reality? Each time you go “app crazy” on your cell phone
or iPad or put buds in your ears to block out the chaos of the airport while
you listen to your iPod, you can thank Steve Jobs.
The similarities between Jobs and midwives may not be apparent, but I see some
real parallels. What would Jobs think about our colleagues who are blazing new
roles for midwives as hospitalists, triage providers, faculty for nursing and
medical students, and developing midwife-oriented businesses? What would he say
to us about “listening to women” and redesigning health care to meet the needs
of women in their choice in site of birth, support through centering groups, or
declining traditional medications in favor of alternative/complimentary
therapy? What have women not thought of yet that they really would want/need if
it were available? How do we support visionary midwives who will lead us in
creating new care options to meet those needs?
Andy Rooney retired from 60 Minutes at
the age of 92 and passed away soon after. Rooney was my favorite resident
curmudgeon. He had unfailing common sense. How often have midwives turned to
each other and lamented the lack of common sense in health care? Midwives
cannot have hospital privileges “because you are not a doctor.” Did I say I
wanted hospital privileges as a doctor?
No, I want credentialing for what I am, a midwife. The state says it must “know
who is writing prescriptions. Therefore, the prescription must be written or
delegated by the physician.” The midwife or nurse-practitioner who actually saw
the patient and wrote the prescription is not recorded. How does this help the
patient? Episiotomies used to be the standard of care—and midwives were all
taught to do “an epis” particularly for primigravidas. Midwives fought
this—believing that episiotomy is unnecessary in virtually all births and leads
to increased incidence of third and fourth degree tears. Today, after several
studies, medicine has determined “There is little
evidence to support routine use of episiotomy. This procedure may well increase
the incidence of third- and fourth-degree lacerations.” What would
Two very different men, with two very different messages that can both serve us
well: We need to avoid the temptation to lose sight of the obvious and search
for the most complex solutions to problems—sometimes the answer really is just
common sense. On the other hand, innovation and visionary people are treasures
that need to be nurtured and encouraged. Thinking outside the box and focusing
on the women we serve is the right way to have a “successful product.”
Cain and Todd Benson on Flickr.