I’m honored to introduce to you Clarice Winkler, retired veteran midwife in Michigan – a midwife I knew and admired from a distance at Michigan Midwives Association gatherings rather than from much personal association. But I always was struck by and drawn to her humility, her approachableness, and her deep wellspring of love for others. And I’ve always appreciated Clarice for her unifying heart, too. She’s one of those rarified nurse midwifes who managed to find herself a treasured place among the direct-entry midwives of her community. She’s shares why so perfectly when she says, “We aren’t so different, it’s what’s in your heart that matters.”
Join us now as Clarice shares her story with us, as well as the wisdom she gleaned through 2000 births and over years and years of practice.
My real introduction to midwifery was reading Immaculate Deception by Suzanne Arms. I was vaguely aware of midwifery, especially midwives in the deep South, but honestly had no idea that there were midwives continuing to attend births. This was 1975, and I was in college studying biology and chemistry, thinking of applying to medical school. The book deeply resonated with me, and I realized that midwifery combined the best of the things that I loved studying – biology, sociology, and anthropology. I continued to read and research. Although Suzanne’s book was not particularly complementary of nurse midwifery, I transferred to a nursing program with the dream of becoming a nurse midwife. I was somewhat naïve, but knew in my heart that this was my calling.
When I completed nursing school I worked in a progressive hospital’s mother/baby unit for a couple of years. Then moved to labor and delivery at a hospital with a reputation for supporting unmedicated birth. I learned to attend women having normal birth with just enough complications thrown in for good measure. Of course, I later learned what “normal birth” truly looks like!
I was fortunate to find a position as a nurse in a free-standing birth center. The births were attend primarily by two wonderful physicians. Nurse midwives did not have hospital privileges at that time. I learned so much about birth from these physicians and nurses and most especially, the women. It was the perfect experience before applying to midwifery school.
Competition was very fierce to obtain a seat in a nurse midwifery program in the early 1980s.
I put all my eggs in one basket and applied to only one program and, thankfully, was accepted! I chose this particular program because, at that time, it was the only program with opportunities for experience in homes and birth centers for nurse midwifery students. I planned to start a home birth practice upon graduation.
My midwifery education was very arduous. I loved studying what I loved, but felt like a fish out of water. The first half of my training was in a large, poor, inner city medical center. I felt my midwifery instructors were always looking for what could and most likely would, go wrong. It truly was a high risk population and I experienced things there that I knew I most likely would never see again. But most of my instructors did not trust in the process at all and seemed to believe that birth was a disaster just waiting to happen. There were a couple of “jewels” among my teachers and I survived! But I wanted to quit so many times.
The second half of my training was in a free-standing birth center in an agricultural community. I was able to attend births in the birth center and in homes. My teachers were patient and knew birth to be normal, given half a chance. There were no unnecessary interventions. Of course, there were a few minor complications, as happens. Many of the families were Amish and Mennonite. My training ended on a very positive note.
When I returned home to Michigan, I began a home birth practice. It slowly grew. I was looked at with much skepticism by the community midwives in the beginning. What does a nurse midwife know about home birth? I was presumed to practice “medically.” Over time, these myths were dispelled. I am happy to say I have made many wonderful midwife friends. We aren’t so different, it’s what’s in your heart that matters.
I attended about 500 births in this ten year period. Wonderful births, wonderful women and families. I learned so much from them! Thank you!
This was a very difficult time politically for midwives. It was hard to obtain medical support when it was needed. Transports to the hospital were very stressful because I knew my mothers would not be well received. Nor would I. Emergency drugs were difficult to obtain for use if my herbal or homeopathic remedies weren’t enough.
Although I am single, a midwife’s income was not quite enough to get by. I always had an additional part-time clinic position. It was stressful. I always worried I would be called out for births too often and lose my job. Eventually the stress of it all caught up to me. I made the difficult decision to close my home birth practice and apply for hospital privileges. I was hired to establish a midwifery service at a small hospital.
My midwifery partner and I cultivated a wonderful practice. The physicians we worked with practiced “benign neglect” as far as we were concerned, and that worked really well most of the time. They left us alone to do what we did best. Our practice gained the reputation for low intervention and loving care. I’m happy to report that the episiotomy rate for the physicians fell dramatically with our influence. Over the ten years I worked there, there were several changes in physicians and administration. The younger physicians did not have the same trust for our skills that the older ones had, and wanted more oversight. The hospital administration loved our practice statistics, but wanted us to spend less time with our clients at appointments and in labor. They didn’t understand that when you change how midwives do what they do, you also change the outcomes for the moms and babies.
I learned you really just trade one set of issues/problems for another when you move from home to hospital. I traded a salary and health insurance for autonomy. I’ve always said “this is as good as it gets” in a hospital practice. I still believe this and am very proud of what we accomplished, but I also knew when it was time to leave.
My former midwifery partner invited me to help as she opened a free-standing birth center. The timing was perfect! I wanted out of the hospital. She had great vision and laid all the ground work for a wonderful community birth center. I had the luxury of attending births with my midwifery friends in a supportive setting.
We developed a good working relationship with the medical community. We were able to offer multiple support groups and classes for the childbirth community. The support for the birth center by our families was incredible.
In the end, we were forced to close the birth center on the advice our attorney following a malpractice law suit filed against me and the birth center. I chose to voluntarily surrendered my nursing and midwifery licenses. I did not have the financial or emotional resources to continue.
I graduated as a nurse midwife in 1984. I have attended women in homes, at birth centers, and in hospitals almost equally – in all, attending the births of over 2000 babies. This is what I’ve learned:
♥ I don’t know anything for sure. Just when I think I have figured something out, I see other possibilities.
♥ Birth is normal. But that doesn’t mean it turns out the way we imagine. Sometimes it’s much better, sometimes it isn’t. There are no guarantees in birth or in life.
♥ Women need privacy to give birth normally and spontaneously. Women deserve at least as much respect as we give a laboring cat.
♥ It’s about the mother and her baby. It’s not about the father, the grandmother, the other children, or the midwife. Mom and baby must be the focus for everyone for the birth to proceed safely and smoothly.
♥ Supporting women in labor sometimes is active, other times not. Often the most important thing I could do was simply be there and witness their experience. Knitting while labor sitting is the perfect lens to observe birth. It’s unobtrusive. There is a rhythm that seems to comfort the mother. It’s a normal activity. She knows when I was knitting, all is well.
Some of my favorite moments: the smell of labor – sweat, tears, amniotic fluid, blood. The expression on the mother’s face when touching the crowning head of her baby for the first time, when holding her newborn immediate after birth. Hearing baby’s first cry. Fathers who cry.
What do I miss? Spending time with families during prenatal visits, feeling pregnant bellies, hearing the baby’s heart beat for the first time, holding and rocking babies…
Would I do it again? In a heartbeat!
by Clarice Winkler
Photos provided by Clarice.
Clarice’s story is also told in Into These Hands, compiled by Geradine Simkins.
Clarice passed from this earth at 7:11pm, June 11, 2018. SUCH a beautiful life ♥
Kim Woodard Osterholzer, Colorado Springs Homebirth Midwife and Author
Books by Kim: