Tuesday, April 17, 2012

Life in the Day of a Native American Midwife

"Every Day is a Good Day"

               As I sit here and write this blog, I find myself thinking about my purpose and wonder how it will all come together.  Please don't mistake this for doubt, but rather honesty.  You see, I have a big dream, at which I work daily to make a reality.  This deep purpose to use indigenous spiritual beliefs to help find solutions to contemporary problems....I think Wilma Mankiller said it best.." the creator provided us with ceremonies to remind us of our place in the universe and our responsibilities as human beings." It is with this view of the world that I see a way for our native people to thrive again.  However, I understand I have a long journey ahead of me, for this is not a task easily attained in a couple of years time, rather a lifetime goal.  For those who do not know me, I'm not a one task kinda gal, nor do I feel approaching this one task at a time will do either.  
                 Just to give you a little insight on what I've been up to I'm happy to say that I've teamed up with Longhouse Media to start making a film about Native American Midwives and the importance of tradition, culture and ceremony in pregnancy and birth.  It will be a documentary that will hopefully be shown on PBS and National Geographic.  No this is not a film that will give away all our ceremonial secrets, rather I hope it will emphasize our unique world view on birth and how important it is to Native American women to birth in a cultural way.  This idea steams from my own experience as a student midwife and the questions I received from my family about my chosen profession.  As much as I love Ina May's work, before entering school, I've never read a thing about her, nor did I view our profession as a "hippie" thing.  However, this was how it was viewed by my family.  It wasn't until I met my dear friend Ursula, that I realized that we had a deep cultural history in midwifery.  You can imagine my surprise, because me..a native woman did not even know this?  I can only blame this on the strong emphasis on the many health policy changes and the emergence of hospitals on our reservations that have taken  Native American midwives out of the picture.  I'm not sure whether it was purposeful and I will not lead you down that path, but hopefully your curiosity will cause you to read about this event.                
           This is actually a very large project and will take 3 years to make.  We are still at the planning phase, but hopefully a website will eventually be set up to view updates on it.  I feel blessed to have met up with Longhouse Media and that they are just as excited as I am about making this movie with me.  Movie making is way left field out of my realm, but I look forward to the story telling and learning about what other tribes are doing to keep birth sacred in a cultural sense.

Longhouse Media

            Additionally, I am also working with some pretty amazing midwives from Espanola to start a birth center.  That also is in the planning phase, we are still working on becoming a non-profit organization and gathering information to make it a sustainable practice in the community.  We happily have hired a project manager to help coordinate all our ideas and talents to make forward progress.  My piece in all this is still gathering cultural and traditional birth knowledge in the surrounding pueblos so that we can provide culturally appropriate care.  This however has proven to be a challenge, as that some tribes have made a decision to not write down their language and that it will only be passed down verbally.  It is also a challenge because it seems few elders remember what those traditional birth practices were before hospitals became part of the picture. 
               These projects are on going, but exciting too.  I love talking to elders about tribal knowledge and cultural practices.  As if these two projects were not enough, my Espanola midwife colleagues and I have agreed to present at a the New Mexico Public Health Association and University of New Mexico Health Disparities Joint Conference.  Basically " Birthing Options in New Mexico: Addressing health disparities through innovative models of midwifery care."  This presentation is not a 2 man presentation, we are teaming up with Women United, Nightingale Midwifery, and Taos Birth Center.  I'm all about collaboration and team work.  I'm also part of a panel of midwives who will be presenting at the ACNM conference in Long Beach, CA to talk about "Bringing Cultural Diversity to Midwifery."
                  I am happy to say that my small stabs at educating the greater public about midwifery and the importance of culturally diversifying midwifery, has not gone un-noticed.  There can now be two more Native American Midwives added to NM.  I am proud to see them stepping up to the task at hand and know that I am not alone in the work that needs to be done.  

     Brittany Simplicio
     Brittany is Navajo and Zuni Pueblo, who grew up in Shiprock, NM.  Like myself she is very dedicated to her work as a Native American student and midwife. Her interest in midwifery was sparked by a fellow midwife who noticed her calm nature with women in labor while she was a student nurse, she also credits her grandmother for being a strong and intelligent role model to look up to, as well as a pediatric nurse. Her desire to make an impact in her community was further intensified when she saw how health care was being delivered to the community and families on the reservation.  Time constraints, decreasing funding, lack of long term providers, and the distrust of the health care system streaming from the historical tribulations of our elders that did and still contribute to the fractionalized health care system today.  
          I am happy to say that she is almost at the end of her 1st year of nurse midwifery school and will soon be catching babies in the fall.  An important thing to understand here, is that she is also the family caretaker and has continued to mentor students while being in midwifery school.  She is currently completing her women's health rotation in Shiprock, NM. Meaning, she is commuting from Albuquerque weekly for this experience to work in her own community.

Nichele Salazar

            Nichele Jicarilla apache from Dulce, NM.  She attributes her interest in midwifery to first always having a passion for obstetrics and women's health.  Growing up on the reservation, she has witnessed how important women are to her community.  She has encountered many single mothers who would go to the clinic for care and only be judged for the life style they lead, rather then be encouraged to be caretakers of their own health.  Nichele was just recently accepted in the Nurse Midwifery Program at UNM and will be starting her journey in May.  She is a mother, wife, and works as a nurse at Lovelace hospital.  She received her Bachelors of Nursing from Georgetown University in Washington D.C. 
              Both of these women are an example of what I talk about in my blogs.  Despite their struggles they have managed to rise above it and strive to make an impact on there communities.  I hope they will also inspire other Native American women to become midwives and take the knowledge they learn back to their communities.  This is why midwifery needs more women from culturally diverse backgrounds, they have very strong desires to not just stay in the cities to work, but to bring it back to their rural communities.  They offer a perspective in Native American women's health care that is lacking now.  They understand first hand what the women on the reservations are dealing with on a daily bases and may have experienced a lifestyle that few have experienced in our profession. Most importantly, they bring hope to a community of women in their Native communities that, despite their struggles, you can still rise above it and give back.  Your life is what you make it and defeat is only when you stop striving towards something better.  

               So you see, my dream may be big and a long journey, but I'm in good company.  Once NM had only 2 Navajo midwives, now will have 4 Native American midwives.  Seeing these two women and what some may call mentoring, but I call friendship, has also given me even more hope.  And incase your wondering about my other duties...yes..being a mother, wife, and midwife commuting to Albuquerque for work several times a week does comprise much of my time.  However, participating in these other activities feeds my spirit and remind me every day that I have the greatest job in the world and I'm always in good company.  Yes..I sleep like the dead when I can, but often sleep is a necessity for my creativity.  At which with my work schedule lately, I've been lacking.  Which is why my blog has been somewhat neglected lately.  
                                           "Every Day is a Good Day"

 options in NM: addressing health disparities through innovative models of midwifery care
 Public Health Association and University of New Mexico National Health Disparities
2012 Joint Conference               


  1. Brittany SimplicioApril 18, 2012 at 1:55 PM

    I absolutely love it Nicolle :)

  2. This is a beautiful and inspiring post! How lucky New Mexico is that it is moving, however slowly, in this direction.
    Please keep posting updates on the documentary - I CAN'T wait to see it, though I suppose I will have to wait the three years. :)
    Same for the Espanola birth center! That is incredibly exciting news (I can't even express!), and I hope centers start to pop up in the other parts (particularly NW and southern) of New Mexico.
    Finally, one small possible request for you (and Brittney :) : as a doula (and first-year HS teacher in Zuni), I am always trying to learn from the culture here. I have already, of course, learned so much. However, like you were saying, I haven't found a living tradition of midwifery. I very well imagine that may be because I am a cultural outsider. But, I would love to learn more about the thoughts and wisdom and experience (!!!) of a midwife in a pueblo, from the pueblo. If you have any contacts / context, I would be so grateful. If not, no worries, of course. :)

    Elahkwa. Thank you so much.

  3. Have you asked the community about traditional midwives. I've been very fortunate with families from varies villages who have been willing to share this information with me. However, I have yet to meet one. I have also asked if she would be willing to meet with me, but no luck on that one yet. Pueblos are very private in the cultural sense. I am aware that Santa Domingo has a traditional midwife or "birth woman," I am not sure about Zuni. However, when I'm working with a native family I will ask if they have any traditional knowledge around birth or what they would like me to do once the baby is born. They are generally surprised when I encourage traditional words, songs, or prayers with the birth of there little one. As that I live in a pueblo with my husband, I am aware of some traditional things they might want or do in birth. But honestly, each Pueblo is so unique and birth practices are all different. I would say be patient with your new role as a doula for this community of women, they may not want to share this cultural knowledge with you, but I think over time if they trust you, they might. However, I've also noticed a sister or aunt or husband even will take on the doula role, they are very family oriented and supportive in birth.

  4. Hello

    I am an artist and curator of a collection of contemporary art on childbirth. I am coming to the Santa Fe region next year to hopefully work with native american midwives and traditional birth attendants. Would anyone be able to help me get in touch with women who would like to work with me on this? My email is helenknowles@yahoo.com

    Youcan see more about the collection on www.birthritescollection.org.uk and www.helenknowles.com for my work.

    Be great to be in touch! I am very much looking forward to this project. I will be based in Santa Fe at the SFAI.


  5. Hi Nicolle, can you tell me anything about Tuba city Arizona? I would love to connect with some of the midwives on an Indian reservation- my experience has always been big city hospitals and I am graduating midwifery school next May. I wanted to go to a reservation next December and part of January. I love what you are doing by the way- the documentary sounds amazing! Keep us posted :) Sarah

  6. I don't know any of the midwives personally in Tuba City. However, their are CNM's in Gallup, Fort D., Tuba City, and Chinle AZ. Are you wanting to working within IHS?

  7. Hi Nicolle,
    Your blog is really inspiring; birth is the cornerstone of cultures and although I agree that medicalisation of maternity services is a 'good thing' in terms of reducing risk, it can detract from the act itself and aid intervention upon intervention which isn't necessarily in the woman, families or cultures best interests.
    I'm a British student midwife and would love the opportunity to come and work with you and other IHS based midwives for my elective placement next year. I don't know if you would possibly be able to help point me in the right direction of who to speak to? I'm finding a list of 'media relations' people but no head of midwifery services or maternity lead.
    Regardless I will continue to read your blogs and feel inspired!

  8. Aarleys,

    I can recommend a contact for you. I'm not sure how it will work. I know the IHS has it written in their bylaws that they can take Nurse Midwife students, which can be a challenge if you are coming from another country with a different way of getting your midwifery degree and training. I had a friend who wanted to come get some training at IHS from Canada, but the problem was they are not trained as Nurses like we are in the states. This posses a problem when getting placed at IHS facility. Diane is the student coordinator at the Chinle service unit in Arizona. Diane.Roche@ihs.gov, trying contacting her.

  9. Hi Nicolle

    So sorry about the delay in getting back to you, it is the last few weeks of uni so it is a very busy time. In the UK you have to get a midwifery degree which is completely separate from nursing. The only 'nursing' I come in to contact with is performing general obs on wards, although some skills are transferable I suppose, like cannulation and prescribing and administering drugs. Anyway, thank you so much for replying to my message I really appreciate it. I will email Diane and see if it would be possible to visit.

    Thanks again,


  10. Hi!

    My name is Madeleine and I am studying to be a nurse midwife. I'm particularly interested in understanding the practices of birth, labor and prenatal care across cultures. I would love to better understand native birth practices. I live in New York state. Does anyone have any recommendations / know of a native midwife in new york who would allow me to shadow them? Thanks in advance!