Before learning more about certified nurse midwifery, I thought midwives were old ladies who traveled to people’s houses, but these midwives I read about had doctorates and were conducting research. [...] I then met a friend in a healthcare class who was a homebirth midwife, Certified Professional Midwife, and was studying to be a nurse midwife. I told her I was interested in Maternal and Child health and I thought I might want to work in policy and change laws to protect women and children. She told me “just be a midwife, that’s what we do everyday."
About Alison Young, MSN, CNM: Alison Young is a certified nurse midwife at Santa Rosa Women’s Health and Birth Center, where she provides full-scope midwifery care and gynecological care to women. Prior to her work at Santa Rosa Women’s Health and Birth Center, Ms. Young was a Certified Nurse Midwife Intern at both Feather River Midwifery and The GW Medical Faculty Associates, where she cared for low-risk gynecologic and obstetric populations, and collaborated with the larger healthcare team to care for women experiencing high-risk pregnancies.
Before working in nurse midwifery, Ms. Young served as a Clinical Nurse Specialist Intern for Sinai Hospital Labor and Delivery, where she researched and presented on the occurrence of sickle cell disease during pregnancy and participated in Patient Care Services Leadership meetings and initiatives. She was also a Clinical Nurse Specialist Intern for the American College of Obstetricians and Gynecologists (ACOG) Fetal and Infant Mortality Review Program, where she analyzed data to develop procedures to reduce infant mortality. In addition to her work in research, Ms. Young served for two years as a Doula at Johns Hopkins University, where she supported refugee mothers and their families throughout all stages of pregnancy.
Ms. Young earned her Bachelor of Science in Nursing from Johns Hopkins University School of Nursing in 2013, and her Master of Science in Nursing with a specialization in Clinical Nurse Specialist in 2015 from the same institution. She also earned a Post-Master’s Certificate in Nurse Midwifery from Shenandoah University in 2016.
[OnlineFNPPrograms.com] May we have a brief description of your educational and professional background?
[Alison Young, CNM] I started my career path as an undergraduate at UCSC while taking a course called “Community Studies of Health Care Inequalities.” There I learned about maternal and child health in the US versus other industrialized countries and was shocked that we do not take very good care of women and babies in this country. I read countless research articles assessing this problem and most of them were written either by or about the benefits of midwifery care. I wondered what this midwife profession was all about. Before learning more about certified nurse midwifery, I thought midwives were old ladies who traveled to people’s houses, but these midwives I read about had doctorates and were conducting research.
I then met a friend in a healthcare class who was a homebirth midwife, Certified Professional Midwife, and was studying to be a nurse midwife. I told her I was interested in Maternal and Child health and I thought I might want to work in policy and change laws to protect women and children. She told me “just be a midwife, that’s what we do everyday.” I come from a long line of nurses and the more I read about nurse midwives the more I realized I wanted to be one and support the field. That took me to Johns Hopkins, the country’s only CNS/CNM program. A Clinical Nurse Specialist is an expert in nursing research and policy and works to change how hospitals deliver care that reflects what evidence has determined to be most effective. I knew this was for me. I studied pre-nursing for 2 years, and got my BSN at Johns Hopkins in 15 months. I went straight into the MSN program and studied CNS with a focus in Women’s Health, and completed my post masters certificate at Shenandoah University, a joint CNS-CNM program with Johns Hopkins.
While studying nursing I worked as a doula at Johns Hopkins Hospital and did home visits for pregnant and post-partum women, mostly women who were refugees from Burma through the international Rescue Committee program that used federal funding. I did my midwifery residency at George Washington Hospital, a busy teaching hospital in Washington DC, and in Paradise, California at a small rural hospital.
[OnlineFNPPrograms.com] Could you please give an overview of the daily and long-term responsibilities you hold as a Certified Nurse Midwife for Santa Rosa Women’s Health and Birth Center? What types of low-intervention care, education, and support do you provide women before, during, and after pregnancy? What types of medical services are included in full-scope midwifery care?
[Alison Young, CNM] At the Santa Rosa Women’s Health and Birth Center I practice full scope midwifery. We see clients for gynecology, procreative management, pregnancy and menopause. We deliver babies at the birth center and at Sutter hospital in Santa Rosa. We provide every test and screening that is available to clients from a traditional OBGYN office- genetic testing, blood work, pap-smears, well woman visits, ultrasound, fetal non-stress tests, birth control, hormone therapy etc. Included in the traditional obstetric and gynecological services we provide, we focus a lot of attention on the importance of the psychosocial aspects of women’s lives, that means we talk about what home life is like, what access to fresh foods looks like, and the importance of family support. We also encourage breast feeding, eating healthy and generally being an active player in your health care.
[OnlineFNPPrograms.com] How did your clinical internships prepare you for your current work as a CNM? What are the different medical environments that typically employ CNMs, and how do they differ in terms of staff/team structure, patient populations treated, and the types and levels of care delivered? How does a hospital nurse midwifery setting differ from a private practice, for instance?
[Alison Young, CNM] I was trained in the hospital setting but was a doula in the birth center (out of hospital) setting for many years prior to going to nursing school to become a midwife. Most Nurse Midwives (90%) practice in the hospital, so much of the education in nurse midwifery reflects that. I think most midwifery care is pretty similar in the hospital setting vs. the out of hospital setting, the difference is the structure of who is supporting that care. In the birth center setting we do not have staffed nurses helping us at all hours of the day and night. So the midwives do a lot of the care that a nurse would help with in the hospital setting, so we typically have a lower volume of clients because it takes a lot of energy to provide that type of care. It means we have a wonderful relationship with our clients, but it means long hours and many midwives do not last very long in the birth center setting because burn out can happen.
[OnlineFNPPrograms.com] Why did you decide to become a certified nurse midwife, and what academic and professional experiences helped you determine that this area of advanced practice nursing was the right one for you?
[Alison Young, CNM] I did a dual training as a CNS because I love health policy and I think it’s an important addition to clinical practice. Clinical Nurse Specialists work typically in hospitals and change clinical practice to reflect evidence. They evaluate all the current research to determine evidence based practices and procedures for patient care. I dream to someday work in a hospital setting changing policies that reflect midwifery care. My dream is for every hospital to have nurse midwives on staff and have relationships with birth centers and home birth practice for easier transfer.
[OnlineFNPPrograms.com] You worked as a doula for Johns Hopkins University for over two years. Could you explain how the role of a doula differs from the role of a CNM? How did your experiences working in this role impact your decision to study nurse midwifery and become a nurse midwife?
[Alison Young, CNM] A doula provides physical and emotional support to a woman in labor and in the post partum period. The training to become a doula is a 2 day training in terminology, and supportive therapies as well as observing and participating in supporting several births. Many doulas also work in some other form of birth work, be it as a nurse or midwife, but the doula role is non-clinical. To become a nurse midwife requires about 6 years of college education: 4 years for a bachelor’s degree to become a registered nurse and 2 years for a masters degree to become a nurse midwife. Nurse midwives provide full assessment, diagnosis and treatment during the pregnant period, birth and post partum period. We are advanced practice nurses who function similarly to a nurse practitioner and have full prescriptive authority. The biggest difference between a doula and a midwife is that a midwife is your clinical provider making sure you are healthy and a doula is there to hold your hand and make sure your emotional needs are met.
[OnlineFNPPrograms.com] What have been some of the most rewarding aspects of working in nurse midwifery? On the other hand, what specific challenges have you encountered in this field of work, and how have you managed these challenges?
[Alison Young, CNM] The most rewarding aspect of being a midwife is assisting in the birth of a baby into the world as well as the birth of new parents. I value creating an ideal environment for the birth of families. Birth is sacred and private and the hardest thing a woman will ever do; I enjoy holding that privacy and keeping the environment safe for the whole family. The hardest part of my job is probably the expectations people have of midwives. On one hand some people do not know the full capability of a midwife and think we have less training than other providers, but others think midwives will be available to them at all hours and expect a lot from us, sometimes more than we can give. We LOVE doulas for this reason. I would say the biggest challenge for me is balancing the stress of keeping a mother and baby healthy and having optimal outcomes while also balancing the needs of my own family. I would say to students interested in midwifery there are a few things you need to have: 1. The ability to stay awake for 2 days at a time (this takes experience and is still hard.) 2. The ability to separate your work from your personal life and not let every poor outcome knock you down (I am still learning this). 3. Good communication–most situations in life are improved with explaining how you feel and what you are thinking. Mothers want it, families need it, and your staff appreciates it.
[OnlineFNPPrograms.com] For current and prospective MSN students who are interested in becoming certified nurse midwives, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Alison Young, CNM] If you are interested in becoming a midwife, you need to experience a lot of births first, to decide what type of midwifery is right for you. Homebirth? Birth center? Hospital? The more experience you have in seeing birth the more you will realize what you like. Volunteer on a maternity ward and just help out with births. Become a doula and be a volunteer doula at a hospital or birth center. Prepare for the CNM exam by reading ACNM practice books for the exam.
Thank you Ms. Young for participating in our APRN career guide interview series!