08Apr

On Touching and Being Touched

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I am in the process of reviewing for my certification exam – the test that will prove I can be trusted by the community to be safe and competent as I work with families to maintain their optimal health.  This is such an interesting experience for me as I realize how much I have learned in the past two and a half years, and continue to realize how much more I have to learn.  This has also caused me to reflect on my clinical experiences and the things I have learned about being a good health care provider.

I find myself continually pausing at the importance of a physical exam. The sheer amount of information I can obtain about a person’s health by looking and touching.  But I live in a society that seems uncomfortable with both looking and touching. These most basic of human interactions are reserved for only the most intimately connected to each of us.  Yet, somehow, I must look and touch if I am to participate.

On the one hand, I think of the importance of the midwife being willing to look and to touch.  My very fist semester of nursing school I was struck with how difficult it was for some of my fellow students to walk into a hospital room and introduce themselves to a stranger.  This seemed such a simple act, but at the same time was felt as such an invasion of privacy.  The first clinical learning was to be comfortable taking a step into someone’s private world, to risk being rejected.  As a midwife, this step into the private world is even steeper.  I ask her to tell me about her most intimate details of her life.  How is her menstrual bleeding?  Does she have any discharge? Does she have a new sexual partner? The physical exam is also more intimate – STD testing, PAP smear, assessment of uterine enlargement.

On the other hand, I think of the willingness of the woman to be looked at and touched.  On some level she is ready for the intimate exchange that is about to happen because she made the appointment, she is here.  But at the same time I am most likely a stranger to her.  I have only a short time to allow her to trust I will help her achieve her health goal.  I have only a few minutes to make or break this opportunity to be invited into her private world – her fears and her brokenness.  If I am invited in, she may share things she’s never revealed to anyone.  If I am unsuccessful, even my best advice will seem unimportant to her.

As I reflect on the importance of the first few moments of the first visit, part of me wonders if this exchange is easier for homebirth midwives.  Does it not seem logical that having more time for that first visit allows for more building of trust?  Some of my homebirth midwife friends feel the longer visits are key to establishing a relationship with the mother.  But is this relationship built because more time allows for the building of trust; or because the trust is successfully established in the first moments of the first visit, the time allows for a more broad relationship with the woman.

And I begin to wonder how it works when things do not go as planned on that first homebirth visit. When a relationship of trust is not able to be established in the first minutes of the visit, is it then less likely trust will be developed at all? Does more time without this trust cause the woman to feel she cannot be connected, or does it allow the woman the time she needs to be connected. My best guess is that it is different for every woman and every midwife.  Personalities are so hard to categorize and people are never “average.”

So then my thoughts return to the world of the nurse-midwife and abbreviated visits. What can I do to be ready to enter her world and be willing to touch…and to help her be willing to be touched.

06Apr

Midwifery Conference To Do List

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This will be the last in our series on attending midwifery conferences.  Today I want to share my to-do list for conferences – the things I do before and during the conference to make sure I am ready.

1.  Know the dates and plan to spend as much time as possible

I find it works best to accept that the time allotted for a conference is conference time.  This means I don’t try to sneak in on the last possible flight and miss the last few sessions to get out early.  Sometimes this is unavoidable, but the opportunities at a conference make every minute I spend there valuable. Plan around the dates, have work done early and be ready to focus on the conference when those dates come

2. Know the sessions and agenda

This lets me plan out my time.  I know before the conference starts which sessions I don’t want to miss, what days I can plan a long lunch or dinner and what nights I expect to be up late.  Nothing is worse than realizing the speaker you really wanted to see had a session this morning, and you missed it because you didn’t look at the day’s agenda until you woke up.

3. Stay at the conference

I have found that the money I can save by staying at a cheaper hotel isn’t always worth it. Think about how far away you will be, and if you will be able to walk back to your room if you forget something.  Will you need to pay for parking (or rent a car for transportation).  Think about how your choice of location will affect your ability to go out to dinner spontaneously or change plans quickly.  How will your choice of location affect the amount of time it takes to get to the first session in the morning.  Then look at how much money you will be saving and decide if it is really worth it.

4. Make this work time

I’ve noticed that many conferences choose exciting venues, and the temptation is to combine a family vacation with educational sessions.  Usually this doesn’t work.  Either the family or the conference gets ignored.  Your time at a conference is time you are working – educating yourself, making connections.  Evening hours, lunch time and the hours when you skip sessions are all important to making that work successful.  Speaking as someone who has been on both sides of the family at a conference, if you combine a family vacation and work, you will most likely find that you have not used the conference to its fullest potential or your family is annoyed they spent so many hours waiting for you.  If you must combine family and work, set out the schedule ahead of time.  Make sure your family understands which days they are on their own and which times you will join them.  Think of it as two separate vacations in one hotel room.

5. Pack a bag

Choose a bag that is easy and comfortable to carry.  Now place a few key items in this bag.  You will need some paper and a writing utensil.  A phone, computer or ipad doesn’t count because you will not use those to write a note for someone else.  Small cameras can be handy for capturing moments.  A small book to read while waiting for sessions — but don’t let this get in the way of networking opportunities.  Keep your schedule with you – with the sessions you don’t want to miss highlighted.  A map of the venue and possibly nearby restaurants is handy. A water bottle and a non-messy, non-noisy snack help you make it through long sessions. Be sure there is room enough in this bag to put all the handouts and information packets you will get.

So those are my best tips for being ready to make the most of a midwifery conference.  Enjoy the conference season!

05Apr

Networking Mistakes at Midwifery Conferences

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Remember I told you there were a few things that were not on the list of networking basics.  Here they are, and the reasons why I don’t consider them necessary.

Adding everyone you meet to Facebook (or other social marketing tool)

As I’ve said, I’m more of an introvert to begin with.  But even if I was not, adding potential business contacts I just met to my personal Facebook account is a bad idea.  In the first place, Facebook isn’t a very good contact storage solution.  Finding people again in a year or two might be difficult if you can not remember the exact name and need to wade through a couple thousand names.  Secondly, if they don’t really know you they might unfriend you after a few weeks of photos of your dog and discussions about your favorite ball team.  Why?  If they use Facebook for business they are not going to want to waste newsfeed with personal stuff.  It’s better to find out if they have a Fan or Business page and connect to that through your business page.

Handing out copies of your business card to everyone

You can do this, and in some industries it is still essential.  But don’t feel you have to have a business card to be successful at networking.  Building your network is more about who you can contact than who will contact you.  Business cards allow the other person to get in touch with you, and in some cases this will be necessary – so always have a few with you.  But most of the information you collect won’t be the type for a business card, so be ready to get that information too. And be sure not to let handing out a business card take the place of really talking to a participant and learning about what they have to offer.

Focusing on meeting the stars of the conference

Big name speakers are exciting to meet, but probably not your best networking connections.  Why?  Usually, everyone at the conference (including you) already knows about their programs and what they have to offer.  Meeting and talking to these speakers might be very motivational and inspiring, but is not likely to do much to build your network of new information and opportunities. A lunch with a group of participants you met in the morning session is more likely to give you more new information – provided you ask the right questions.

Attending every lecture

I love hearing the speakers at conferences.  I am usually challenged to think about things in a new way or gather some new information.  However, if I fill every second of my day with lecture I miss opportunities to meet and talk with the other participants – the key to building a good network.  Instead, be familiar enough with the conference agenda to know what speakers you don’t want to miss and what time slots have the least interesting sessions for you. If there is nothing interesting being talked about, find someone interesting to talk to.

Did I miss anything?  What networking mistakes do you see people make at conferences?

 

 

04Apr

Networking at Midwifery Conferences

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I will be the first to admit that outgoing and extrovert are not words anyone might use to describe me.  Even so, there are times when I need to find the energy to connect with more people, have more conversations and invite strangers to lunch.  Midwifery Conferences are one of those times.

It isn’t that I think this is the time to make friends.  In fact, sort of the opposite.  This is the time to network.  I don’t know how you define networking, but I think of it as building a web of information.  I find out who is doing what and when, keep track of the key information and move on.  And this does an amazing thing for me.

It allows me to discover new opportunities that may be available to me or someone I know.

Did you catch that?  It isn’t just about what is possible for me, but what is possible for other people I know too.  This is how the web is created.  I’m not just collecting information about things I might be interested in, but also listening for what might interest other people. And if something comes up that might be a great opportunity for someone I know, I let them know ASAP so they can investigate it.  And this does an amazing thing for me.

It causes people to see me as a source of information.

Yes, my website also makes me seen as a source of information, but this is different.  This information is about what’s happening in the midwifery world, who to talk to and where to get volunteers.  I become one of the first stops for people embarking on new and interesting projects.  And this does an amazing thing for me.

It widens my sphere of influence.

Not only do I learn about projects early, I am also asked to give input on format and who to include on the team.  I can have a positive effect on the program without having to volunteer myself because I take the time to be connected to other midwives.

This is all well and good, but you are probably reading this because you want to know, “How do I do this?”

You will work out your own style for the exact particulars, but here are the key principles.

1.  Show up and join the conversation.  Look at the booths, go to the luncheons, attend meetings.  Talk to people about what they are doing, what are their next steps and what is the long term goal.  Most people will love to talk about themselves and their projects, so do not feel intimidated.  Just ask questions.

2. Keep track of who you meet.  Make sure you have a way to find this person in the future either by website, organization, personal email or phone. If you can’t get in touch with this person again, your web has not grown.

3. Keep track of the interesting programs and how to get more information about them.  You do not necessarily need to get a “contact name” for each piece of the web.  Some pieces of your web may be books, videos, training programs, pieces of research.  Keep a list of the key pieces of information you learn about.

4. Have one place to store all the information you find. I say one place because if you have to dig through old files to figure out what that book about a subject was two years from now, you probably won’t find the small note on the bottom corner of your lecture handout.  People and organizations are a natural for keeping in a contact directory.  You could use a paper list, Pinterest, Amazon lists or other formats for books.  You might try keeping a special bookmark folder for important research or organization webpages.  Find a way that works for you, so when someone mentions a new project they are starting, you can quickly find the name of the book, or organization, or person that might be helpful to them.

There are some things that are NOT on this list.  I’ll talk about them later.

 

02Apr

Attending Conferences

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I have a couple conferences come up in the next few months.  It made me think about how nervous I was about attending my first conference.  I was not sure what to expect, or how to make the best use of the time.

I understood the value of the sessions.  I was eager to learn.  At that point, I underestimated the rest of the value of a conference. As I progressed in my knowledge, the value of the sessions decreased.  If I hadn’t had other reasons for attending conferences, I might have stopped.  It would have been a mistake, because conferences have value above and beyond the new learning and ideas I can glean.

So what is the biggest value of attending a conference?  The people.  While this may be a no-brainer to some, I’m more of an introvert with a few close friends rather than a large network of people I barely know.  However, my opportunities greatly broadened as I began to grow a network.

Attending conferences gave me a chance to be around like-minded people.  This helped to keep my energy fresh and my interest in birth growing. I do notice that the years I am not able to get away to a conference my work begins to drag.

Attending conferences gave me a chance to be around people who faced problems I had not encountered.  This helped me to have a much better understanding of the birth world, and to be prepared for issues that may affect me in the future.

Attending conferences gave me a chance to be around people who solved problems in a variety of ways.  This helped me to stay open to new ways of thinking about the issues facing families I worked with and helped me to become a better advocate for families that didn’t see things the way I see them.

Attending conferences gave me a chance to be around people who could learn from my experiences.  This helped me to be more open about sharing what I learn and where I struggle.

Attending conferences gives me a chance to volunteer to help promote safe birth. Understanding all the work that goes into a conference or an organization helps me to not judge organizations so harshly when they don’t do what I think they should do.

Attending conferences gave me a chance to be around people who approach the work of birth from many different angles.  This helped me to see the wide variety of opportunities available to me, encouraging me to set my goals bigger.

Attending conferences gave me a chance to be around people I love to chat with on the internet.  This builds and strengthens friendships that are the backbone of my support system.  But it also gave me a chance to be around people I don’t like on the internet.  This allows me to see them as a whole person and understand more about their view.

And privately, attending conferences gives me a chance to watch other birth professionals and see what characteristics I like and admire, and which characteristics I want to be sure I do not emulate.

Honestly, attending a conference will do more to help you grow professionally than giving you a few educational lectures.  You just need to know how to “work” at a conference – and I don’t mean hiring a table. I’ll share more about that next time.

05Mar

Internet Marketing Part 3: What to share

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One last post on internet marketing, just one last thought to share.  And that thought happens to be about what you should, and shouldn’t, share.

If you are using the internet to market your birth business, you probably have a blog, facebook page and/or a twitter account.  You might also have other social media pages and accounts you use depending on how tech savvy you are, but most non-tech savvy midwives know about these three ways to interact with the internet community.  While a blog gives you a platform to share complex thoughts and ideas, Facebook and Twitter demand a very short interaction.  As a rule, the shorter the written work, the longer it takes to plan that written work.

What do I mean?  A short sentence or paragraph doesn’t give you much room to explain yourself in a post.  Your thoughts need to be written as efficiently as possible to help prevent misunderstanding.

Making these resources even more difficult to work with is the reality that they are both short-lived and long-lasting.  The “lifespan” of a post will depend on the number of connections each member of your audience has made.  Some posts may appear to some audience members for less than 30 minutes, while they may appear to other audience members for several hours. Some posts will never appear to some audience members. Yet, every member of your audience has the option to visit your unique page and read every post you have made.  Within this environment we are told to “engage” with our audience, to build a “conversation.”

When deciding what to share, the first thing to understand is the audience for your posts.  If you are sharing birth business information on your personal social account the messages are potentially being shared with your family, close friends, people you attended grade school with, coworkers from an old job…do you get the picture?  On the surface you might think this will help you build a good network – your friends will share these posts with their friends.  The reality is a bit more like your friends ignoring or hiding the posts they are not interested in. The flip side of this is that your clients will now have the potential to see your photos from your brother’s wedding, your five year old’s dance recital video and your complaints about the weather.  Neither side of this equation sounds very professional.  I always recommend starting an account specifically for your birth business and inviting your friends, family and previous co-workers to find out about your work through the business page.

Once you have established a “birth” audience defined, you can start to make decisions about what is the best way to connect with this audience.  You have many options:

  • Links to interesting articles or videos
  • Links to new pages from your blog or website
  • Information about upcoming events
  • Interesting questions the members of your network would like to discuss
  • Quick recommendations for books or products
  • Quotes from leaders in the birth community.

What you choose will depend on the composition of the audience and the nature of their connection to you.  You will probably find the “right” sharing is a mix of most of the listed options.  Remember, your audience is “listening” to you not only for the latest information, but also to know what you think about something.  So don’t just link to the video, tell them why you are linking.  Your post might read something like this:

Great use of vocalization in this hospital birth video:  link

I do have a few rules I follow for what NOT to share.

  1. I never share information about someone else’s birth.  I would never steal a mother’s opportunity to experience the joy of sharing her own story.
  2. I never make critical comments about a person.  If I disagree with something written I explain my disagreement with the concept or idea while remaining respectful to the other person – I would hope they would treat me the same.
  3. I do not engage in name calling or bullying. I wouldn’t do it in real life, I refuse to do it on the internet.  Not only is it completely unprofessional, it makes me look as if I am only upset that someone thinks differently about the topic than I do and draws attention away from any additional information I have to add to the discussion.
  4. I do not give unsolicited advice.  If a reader has a question about how to talk to her doctor about something, I do not tell her to have a home birth with a midwife.  Although I might think it will solve her problem, in her mind I have completely ignored the issue she is facing and have not respected her decision to use this provider.

 

02Mar

Internet Marketing Part 2: Location

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Before we dive into the next common problem with birth business websites, I want you to think about how you find websites.  Pretend for a moment that you are going to do some infrequent home maintenance, maybe you need to repave your driveway.  How are you going to find information about professional driveway paving companies in your area?

Will you start at the National Driveway Paver Association and look for a link to someone near you?  Probably not until a last resort.

Will you search for a database of links to driveway pavers and look for one in your area?  You might search through a list if you find it, but like everyone else you will stop when you realize the number of bad and redundant links (a fate to which only the most well maintained internet link lists are immune)

Chances are the majority of your search will be conducted on a search engine using variations of the keywords:  driveway paving AnyTown.

If this is how the average person searches for something on the internet, you need a website that helps the search engines understand that you provide birth services in your town.  A search engine only knows what you put on each web page of your site, and thinks of each page as a separate entity.

So what does this mean?  Your website must clearly state the services you provide, and the area you serve on one page.  Here is an example:

Better Birthing Services

Doula and Childbirth Educator in Boise Idaho.

Here is another example:

Welcoming Hands

Central Indiana’s Home birth Midwife  

It is OK to have a separate services page which breaks down your fee schedule.  But what I want you to understand is that if you list services on one page and your service area on another, or not at all, your website will become very, very unimportant to the search engines.  This is because the little bit you say about midwives or doulas will be compared to the little bit every other website says about midwives or doulas.  When someone searches for a doula in your area, the search engine will look at all the pages it has about doulas and first list the ones that talk about doulas and that area.  Then it will rank all other doula webpages in order of importance – and due to the sheer volume of this type of website yours won’t be very important.

Being listed on other websites is helpful because search engines like to know that other websites think your website is important enough to link to.  But being listed on other websites is probably not going to get you the kind of traffic you would get if your website accurately listed your services and location.  Even worse, being listed on a website as providing services in an area, but not listing that area on your website means potential clients have to decide your business is worth the risk of emailing or calling to make sure you really do provide services where they think you do.

If you are afraid you will lose potential clients by listing your location too specifically, then think about the most broad term that locals use to define your area.  When I lived in New York, I lived in the “Capital District” which included three main cities in close enough proximity that I would act as a doula in any of the three.  My webpage might have looked something like this:

Welcoming Hands

Midwifery Services in New York’s Capital District

When I lived in Michigan using only the broad term of “West Michigan” would have included two cities I would not have been willing to drive to for doula work. By listing my home base city I could avoid getting doula calls from people I was unlikely to serve, but still received childbirth education calls from people who were willing to drive to me.  My webpage might have looked something like this:

Better Birthing Services

Childbirth Education and Doula Services in West Michigan

Serving Grand Rapids and Kalamazoo

Time to go check your website.  Google the services you offer and your location to see if you come up, then go make sure your services and service area are clearly listed on your main webpage.

 

 

23Jan

Your Internet Presence

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I realize that at this moment in time (having ignored my website for the better part of four years of nursing and midwifery school), I am not in any position to be a model of good internet marketing.  However, I do see a lot of birth professional websites due to the work of the Natural Childbirth Directory. I see a lot of what not to do, but I didn’t realize how confusing it could be to potential clients until my daughter started doing the directory updates for me.

You see, she had questions.  The exact questions I know readers have as they check out the websites.  The exact questions that have moved me to have such strict guidelines for putting a website into the directory.  The exact questions that many birth professionals don’t understand because they don’t see their website or their business as a potential client does.

I decided to spend a few days helping you see how an outsider views your business based on your internet presence, and hopefully help you fix any gaps that may exist.   So today we will begin with the first and most important concept:

If it is not listed as a service on your website, I cannot hire you to perform that service. 

Even birth professionals understand this about other industries, using websites to determine if a store caries a particular brand, dates for specific movies or what classes are available at a local school.  But when it comes to their own website many birth professionals forget to list everything they do.

As an example, consider Jane.  Jane is a doula who does private childbirth education for couples. On her website she lists her doula work, being sure to highlight that she does belly casting.  When she submits to the directory she indicates she does doula work and childbirth education. When I check the listing, all I see listed is her doula work (with childbirth education listed as part of the doula service package).  Nowhere does she list that I can hire her for private childbirth education without hiring her as a doula.  As a potential client, I assume she doesn’t offer this service and I search elsewhere for a childbirth education class.

I’ve heard many reasons why professionals choose not to list a service they are willing to provide.

“I don’t want too much business, I mostly get doula work from my childbirth classes.” 

“It’s just a side job for me, I don’t advertise myself as a childbirth educator.”

If either of these are true, you shouldn’t be listing yourself in the undesired role on web directories. Usually, the birth professional simply did not realize they had not listed all their services on the website – perhaps because in their mind they are so linked.  They think, “I’m a childbirth educator, of course I would do doula work for my students.”  The problem is outsiders (potential clients) don’t think that way.

The trick is to have someone else look at your website and have them tell you everything they can hire you to do.  Make sure that list accurately reflects all the things you are willing to be hired for, and then ONLY advertise yourself in those roles on internet directories.

 

21Jan

After Graduation

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I’ve been ignoring you…sort of.  I had to get through my final exams and the the last week of school.  Then I was visiting family out of state which, despite my best intentions on every trip, is NOT a place for me to accomplish any work.  Admittedly, I have been home and without classes for two weeks. But something unexpected happened to me…I had to transition to non-student life.

It wasn’t unexpected that I would need to transition, besides, I’ve done this a few times before.  The joke at our house is that I keep graduating because I’m good at it. What was unexpected, at least to me, was how I would balance all the things I had planned to do with all the things I had been putting off while in school.  What was unexpected was that the rhythm of life as a student, and the organizational tools I used as a student, would no longer be effective for me.

For example, each semester I made a list of all the assignments and projects for each class.  I then put them in order by due date because this was when they had to be completed.  But now, I don’t have ANY due dates except the ones I put on myself. These seem somewhat fluid to me, not because they are but because I haven’t put any dates on the calendar.  So for two weeks I tried to work on things without having my normal prioritization scheme – and really only made progress on one project (which actually had an outside deadline, go figure).

Another example, during the semester I have classes at scheduled times of the day.  This gave me natural built-in work times with “breaks” that I had to take.  But now I have lost the outside imposed stop times, and the urgency of getting my work done before class begins is gone.  This has made it very easy to slack off, and over the past two weeks I’ve noticed I waste more time than I actually work.

Added to all these structural changes is the uncertainty of my next step.  We haven’t decided yet if we will stay in Atlanta or if we will move.  We don’t know yet what type of “job” I will look for.  This has made it hard to want to prioritize the certification exams – a step which is priority number one for most graduating midwives. I need to decide which to take first, nurse practitioner or midwife.  And I need to balance this part of my work with updating the website — a task that has been on hold for four years!  And this needs to be balanced with publishing the results of my thesis — a task that is time sensitive due to the nature of research.

You see, I didn’t really plan well for my exit from graduate school. I couldn’t really give advice on how to do this better, some of it may just be the initial “shock” that all students experience during the move from student to worker. But I wanted to be honest about how much more complex this piece of the educational journey is, especially since I had not anticipated graduation would be difficult.

20Dec

Graduation

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This week I completed my last final exam and submitted my last paper.  I have completed all requirements for both degrees and within a few days will be officially graduated.

What a strange feeling – to be done with school but not yet completed.  Before I can work, I need to pass the certifying examinations. At least to work clinically I need to pass the certifying examinations and then wait for the state to license me. I finished my last nursing class and took my final exam in May.  I’m not saying all the information is out of my head, but I am saying a review before the exam would do me well.  If I had only done one program, I would be ready to take boards tomorrow, or at least that is the theory.

So now starts a time of limbo – without a job and without the opportunity to apply until I get a license. It didn’t have to be this way.  Several of my classmates were offered positions at the practice that precept ed them. But I wanted different – I wanted to have as many different experiences as possible.  I think it was a good move – I am incredibly flexible in my skills.  I can work with very few resources and can adjust to different working styles and environments.  I’ve trained in a birth center, public hospital, a private hospital and in two public hospitals in low resource countries. I’m ready and capable.  It just means this first few months will have a shadow of uncertainty about my future.

 

 

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