Building resiliency among pregnant women in vulnerable circumstances through holistic midwifery

Katie Moriarty, PhD, CNM, RN, CAFCI

“To the young it seems no door is closed and as if all hearts are open. Everything is possible. Love comes so easily. I loved my work and the freedom that it brought me. I loved the teeming streets, the families I encountered, and I thought the joy would last forever.”

Personal crisis, inner strength and resilience are amazing qualities that we see in the characters from Episode 4 of Call the Midwife. Shelagh struggles with seeing a way forward from her pain of infertility and works through this by reigniting the community choir. We witness a young woman that bravely faces her labor and with patience and perseverance gives birth to her gorgeous daughter. Sister Winifred moves from being unsteady without joy in her new role of midwifery to a position of inner calm, confidence, and a true sense of purpose and happiness. Mrs. Reuben survived the horror of the holocaust but then had to face an inner prison with her fear of leaving the safety of her home for 12 long years. She commented that being a midwife is truly a wonderful thing—bringing life into the world and seeing everything made new. The midwives and nuns noted her problems when they did their home visitation and connected her with help and provided psychological and emotional support. They truly addressed her mind, body, and her spirit. Mrs. Reuben witnessed the birth of her granddaughter. As her daughter, Leah, walked through a door to motherhood — Mrs. Reuben figuratively and literally walked through her personal pain and out her front door back into the community. Lastly, Jenny’s experienced intense emotional pain after the tragic accident and death of her boyfriend – Alec.

Early in the show Dr. Turner states –“It isn’t the end of the world. It is just the end of a road.” That comment made me think of challenges and the quality of human resilience. As modern day midwifes, we witness the same challenges, struggles and tragedies that we saw in this episode. We see poverty, fear, infertility, losses, and abuse. But we also get to assist women and families to face these challenges and move forward.

We can help build resilience by helping women make connections and having a loving support system; developing goals and then breaking them into achievable steps. This fosters that feeling of success and can lead you to the next step. Visualizing the positive goals—and realizing each day is a new opportunity for us to change. Change is part of life and you can work on the goals that are attainable. Having open communication really assists to determine where someone is and where they want to go. Then you can work on problem-solving skills. Each small success can lead to a more positive view of yourself and your abilities. Helping women get involved in community groups for more social support can help. Addressing our care in a holistic sense—the mind, the body, and the spirit. Strategies can take many forms: keeping a journal, meditating, yoga, exercise, spiritual practices. Connecting women to the resources that are needed! Each mother and each family are different — that is the excitement of being a nurse and being a midwife. The key is to identify the individual and aid them in their personal strategies to foster resilience.

As a nurse-midwife, we work to improve the health of our mothers, babies, families—and ultimately our communities. David Olds, founder of the Nurse-Family Partnership, stated: “There is a magic window during pregnancy…it’s a time when the desire to be a good mother and raise a healthy, happy child creates motivation to overcome incredible obstacles including poverty, instability or abuse with the help of a well-trained nurse.” In Call the Midwife, and with modern day midwives and nurses, women, families, and communities can be empowered with knowledge and resources, helping them reach their short and long term goals.

“You will feel better. Maybe not yet- but you will. …..You just keep living- living until you are alive again.”

Katie Moriarty, PhD, CNM, RN, CAFCI, is director of the Nurse-Family Partnership at the Detroit Wayne County Health Authority. She maintains a midwifery practice and blogs in response to the PBS series Call The Midwife.