Every month we feature a new midwife to share her story with us. Young or old, seasoned or green, midwives are natural storytellers and listeners, and we welcome [ nominations ] for this feature from you.

Carol Leonard, BS, NHCM (New Hampshire Certified Midwife)

Hopkinton, NH

Carol Leonard has been a dynamic leader in the midwifery community for thirty years. Even if she hadn’t helped co–found the Midwives Alliance of North America and served as a past president, she would be well known in the midwifery community for her imposing stature and willingness to laugh and speak her mind. Carol published a memoir, Lady’s Hands, Lion’s Heart, in 2008 that chronicles her midwifery career, which Mothers Naturally awarded an award of excellence for “Outstanding Book”.

What was your path of midwifery education?

I started training with a wonderful old country doctor, Dr. Francis Brown in 1975. He was the only MD in New Hampshire who did home births. Dr. Brown was a General Practitioner who was trained in Chicago by the renowned Dr. Joseph De Lee. I got the benefit of apprenticing with one of the last of the true old-timey MDs who used to do EVERYTHING in the home...forceps deliveries, twins, breeches, fourth degree repairs.

When was the influential moment that identified midwifery as your vocation?

My calling chose ME when my hands were strapped down for the (unmedicated) hospital birth of my son in 1975.

What are the greatest occupational hazards of being a midwife?

Sleep deprivation, partner relationship suffering, getting dissed by the medical community...all for birthing a new baby in the world. Your social life suffers. No one calls you after a while because you never show up to things.

What type of self–care works best for you with these hazards?

Self–care doesn’t happen, and it just gets worse when you are older. Even if you have better judgment about your limits, you still burn the candle at both ends. The most significant change for me was not being on call at night. All midwives should set up an equal partnership with another midwife they really trust. A solo practitioner spells burnout, and you don’t even know when you are burnt out.

What is it like to observe so many different female energies at such a primitive time?

Each woman has to find the mother tiger within her. It is my job to help her find it. My role is let the woman give me direction so my job is to try to follow her without directing her. Each woman has her own story, her own style.

I have seen a really high–powered professional woman with perfect makeup and hair come into our first meeting. We knew this was a woman used to being in control and used to a high performance level in her life. My partner anticipated she wouldn’t have a baby until she was on all fours, in a place where her body would finally “let go”, and sure enough, that is exactly what happened.

I have seen a very quiet and unassuming woman chant and scream like a Buddhist monk with incredible volume, the antithesis of who she is. As her midwife, I have to make enough space for who she is and what she needs.

What progress have you seen in the midwifery profession that is most impressive to you?

The fact that the midwives have an address in Washington DC is amazing. We have come that far. MANA getting a vote into the International Confederation of Midwives was a big deal. We have been savvier than we ever thought we could be–and some of it could have been an accident–but I am so proud.

If given absolute power for a day, what three changes would you make to improve maternity care in the United States?

1 Have midwives be the FIRST choice for all routine maternity care...leaving obstetricians more time to deal with complications, true high–risk cases and GYN surgery. This would be more cost effective, would KEEP routine cases just that...uncomplicated and nurtured, and would create a safer world by protecting the experience of entering it.

2 Have ALL pregnant women in the US have access to midwifery–based maternity health insurance (There are only two nations in the whole world that do not pay for their pregnant women’s health care...the US and South Africa).

3 Make sure that all inductions are truly medically warranted...i.e., have all “post–dates” inductions have a REAL medical indicator instead of just being “40+2 days”. This would probably reduce the current c–section rate by about 50%.

What would your advice be to women considering becoming midwives?

It is not a part–time job, it is a life commitment, and if you are not ready to have it take over your entire life, you should not consider it.

There have been such a number of Doulas showing up at my book–signing events for Lady’s Hands, Lion’s Heart; at first I thought these young women were committing to birth just short of the midwife–level of engagement. But I now think the Doula movement is a direct response to the interventions in birth culture now, and it isn’t even conscious. The pendulum has swung so far one way, and these young women are responding to what is happening in childbirth right now. I am very excited about the energy they are generating, and they are swinging the pendulum back to a more reasonable place for birth. They are the bellwethers and they have arrived on time!

What is the one concept you wish every OBGYN fully understood before practicing?

Sitting on their hands. Doing nothing is the hardest thing of all. Wait for the next contraction, take a deep breath and wait to see what happens before intervening.

And your best advice for working with doctors?

Outlive the bastards.