The Latent Phase: Finding your first impression

My latest post is up at the ACNM! Check it out here and below. Lost for words when introducing yourself as a new midwife? Stumbling over the explanation of your recent role change while simultaneously trying to instill confidence in your care? Here are a few suggestions for how to make the best first impressions with clients and coworkers.“Are you sure you’re a midwife? You don’t half look young.” - Ingrid“Don’t worry Ingrid. You’re quite safe.” - Jenny Lee- Call the Midwife, Season 1 Episode 2I remember introducing myself as a student: the words felt awkward, I always had trepidation that the client would decline my involvement in their care, and the focus was largely directed toward my precepting midwife. My introduction always felt jumbled and not important in the larger scheme of things.Likewise, introducing myself as a midwife also was uncomfortable at first: the title and responsibility felt both exciting and heavy. Every encounter was an explanation of who I was and where the former provider went, and how long I had been a midwife. Often, a full third of a 15 minute visit was consumed with introductions. I needed to find a speedier introduction that still made a great first impression. There’s a lot riding on the first meeting with a client as a new midwife: building a practice, instilling confidence in your abilities, and developing a style all your own after following other midwives for years.On top of all of that, midwives who are entering the profession in their twenties and thirties like me (or midwives who are lucky enough to look young forever) often endure the question "how long have you been a midwife?" more than others. For those who are both young and new, answering questions can be a trial of labor in itself!A small, supportive, organized practice might help you introduce yourself – consider promoting your presence by posting a social media announcement, hanging a poster in the office, or handing out a flyer out to current patients. For practices similar to my own (a large FQHC with many clinics spread out over a huge city), advertisement of your new position may lie in your own hands, and is best tackled on an individual basis with each client and co-worker. Here are a few strategies I have found helpful:For new midwives, including those encountering the “How long have you been a midwife?” question:

• Be honest, but brief. Remember that being a midwife is less about you and more about the person for whom you are providing care. Find ways to make your answer more about how you will be caring for them and less about your new-ness to the profession. Some of the answers I use:

• “I am just starting in this clinic/practice, and I have been doing reproductive healthcare for __ years. I have worked with women in many different settings, and am excited to work in this setting because…”
• “I believe that women deserve compassionate care and to feel empowered in their reproductive health experiences, and this is the type of care I hope to provide.”
• “I am new to midwifery and very excited to be a midwife because of its holistic and well-woman focus. If you have never seen a midwife before, I am excited to introduce you to our model of care!”
• “I just finished my training of __ years, and am thrilled to join this practice of reproductive healthcare providers! Part of my midwifery care is to individualize my practice to each person, so let me know what your particular needs or questions are so I can best serve you as your midwife!”

• Be confident. “Fake it ‘til you make it” works as long as you check your work prior to finalizing your plan (see this post on double-checking your first instincts). Now that you are a midwife (and remember that you are!), you are officially the one people look to for advice, reassurance, clarification, and a plan. Confidence is visible and palpable - go with your gut, feel grounded in your training as a provider, and work with your clients to make plans and next steps.
• Be acrobatic. Balance proving yourself as competent and knowledgeable with the natural component of midwifery that involves humbling oneself before the power of women, individuals, and the spectrum of normal. Remember the roots of midwifery in all that you do.
• Be comprehensive. This is especially important when introducing yourself to a group of very experienced midwives. Discuss your background prior to midwifery, and other work you were involved in during your training. Describe where you hope to grow and move with midwifery, and the impact you hope to make in the clinic, hospital, community, and beyond. Midwives are some of the most interesting people I have met - make sure to show yourself off! Every midwife starts somewhere.

If you work in a clinic that has never had a midwife before, with a large OB/GYN patient base:

• Get to know who makes the appointments. While the midwifery scope of care and practice is very similar to physicians, there are clear differences - make these known! Additionally, if the people making the appointments know you and can recommend you to patients they’ve known for years, half the battle is won. A scheduler who can explain midwifery and its role in the broader world of outpatient primary care can not only acquire the correct types of patients for your care, but also screen out many for whom midwifery care is inappropriate.
• Get to know your collaborating provider and other midwives/physicians in your zip code: An incredibly important component of midwifery, and healthcare overall, is our referral system to more specialized care and consultation with other providers. You and your collaborator, as well as the other midwives in the group, should have a positive working relationship to encourage a mutual referral system and supportive communication when you have questions, which will happen fairly often at first.

You’ll have days when you feel too new to be practicing independently. That’s why the support network is there. Trust that your education prepared you for exactly what is required: entry-level midwifery. Your knowledge base will grow, as will your practice. You’ll have more and more days when you are surprised at your knowledge, your confidence, and patients’ reliance in you. Delight in your growth as a midwife, and cherish the days of your first patients, for whom your care may be an introduction into midwifery. How lucky for you both!What advice do you have for new midwives introducing themselves? How have you found yourself succeeding in introductions? What have been your best ways to feel confident, and instill confidence in those you serve?