The following list provides a glimpse of various opportunities for careers in women's reproductive health. It is meant as a starting point for your further research.
If you're interested in my personal career path story, read My Exploration of Careers in Reproductive Health. My hope is that for every option I have discarded, there will be someone inspired to take what I learned and run with it.
Midwife
Your Role: Medical care for normal pregnancy and birth, consulting with obstetricians and perinatologists when needed for complications
Variations: Certified Nurse Midwife (CNM), Certified Midwife (CM), Certified Professional Midwife (CPM), Direct-Entry Midwife
Becoming a Midwife
Doula
Your Role: See What is a Doula and Why Do I Want One?
Variations: Birth doula, postpartum doula
Becoming a Doula
- Since doulas are not state-licensed, no national certifying bodies like ACNM or NARM exist for doulas. However, doula certification by a national organization like DONA or ALACE might be worthwhile if there is a chance you will move out of your current community. Also, look for an organization that has a process for continuing education or maintaining certification, as well as a requirement to be a doula for a certain number of births and receive written evaluations from clients and health care providers.
- Other doula-training bodies include Birthing From Within and Supported Birth.
- If possible, acquire some extra training by attending a midwifery workshop at The Farm or volunteering at a birthing center.
OB/GYN-Midwife
Your Role: Full range of reproductive medical care for women. We need ob/gyns who use the midwifery model of care now more than ever. Be an ally for your clients and forge collaborative relationships with midwives who practice both in and out of the hospital. Use your credential to create change and empower women – both in birth and in other aspects of reproductive health. Use your clout to influence hospital policies (e.g., get hospitals to sign on to the Baby-Friendly Hospital Initiative).
Becoming an OB/GYN-Midwife
- Maximize your chances of getting into medical school by doing well in math and science in high school and college. If this doesn’t happen, then do a post-bacc. At a bare minimum, you need one year of chemistry, organic chemistry, biology and physics with labs.
- Train as a doula
- Volunteer in a hospital or in another health care setting
- My personal recommendation is that every OB/GYN should have some hands-on midwifery training. Spend at least a few weeks at The Farm, or at Maternidad de la Luz, study with Dr. Michel Odent, etc. You will not get this training in medical school. You need to know what normal, undisturbed birth looks like before you can handle the spectrum from normal through emergency complications.
- You should also seek out residency programs where residents are taught by CNMs, and/or where there is also a strong training program for CNMs. UCSF is known for its strong midwifery program. If neither of these options exists at your top school, find a hospital that is affilitated with your school that allows CNMs to attend births, and ask a CNM if you can shadow her. Since midwives are generally more protective of their clients than doctors, this may be a hard sell, even at a teaching hospital. Here, it would be helpful if you have already been trained as a doula and attended births in this capacity. Then you can volunteer to help when you are a medical student. As a resident, you can probably ask to learn from midwives (this will be unusual, so there is every reason to suspect that they will see you as an ally and be happy to help). In NYC, Bellevue has a midwifery practice, so NYU medical students can seek out training. All of this is a lot to add to any medical student or resident’s plate, so perhaps it is possible to gain exposure to midwifery as an elective during medical school (you’ll probably be the only one asking to do this) or if you can incorporate it into a lighter phase of your residency (e.g. when you’re doing office gynecology and well-woman care, perhaps you could be on-call to attend births with midwives).
Childbirth Educator
Your Role: Teaching group and/or private classes to educate families about childbirth
Becoming a Childbirth Educator
- Read about childbirth educator certification on childbirth.org, which lists several options
- Regional certification programs may be necessary to enter the field in certain geographic areas. These can be rigorous (in NYC it is a 2-year program).
Lactation Consultant
Your role: Medical care for mothers during breastfeeding
Variations: International Board Certified Lactation Consultant (IBCLC), Lactation Educator
Becoming a Lactation Consultant
- The IBCLC credential is the "gold standard" in the field. Certification is easier for health professionals because clinical training is a key component; it can be difficult for non-professionals to acquire the clinical hours necessary.
- Lactation Educator programs are available at selected institutions, such as UCLA Extension School. There is a shortened clinical requirement, but the credential carries much less weight than IBCLC.
- Becoming a La Leche League Leader is a wonderful way to give back to one's community by helping other breastfeeding mothers. It is also the main path to becoming an IBCLC for those who are not health professionals
Nurse Practitioner in Women's Health
Your role: Seeing patients in an office setting, working in a group practice with physicians; in many states, Nurse-Practitioners can write prescriptions.
- Becoming a Nurse Practioner in Women's Health requires an undergraduate BSN, followed by an MSN. This is a rigorous, multi-year program, which may be rewarding for those who already have a nursing degree; if you're starting from scratch, there is no reason not to go to medical school.
Women's Health Physician Assistant
Your Role: Seeing patients in a clinic or office setting, always working under the supervision of a physician
- Becoming a PA takes only two years. The brevity makes it attractive, but there is little autonomy.
- I learned of one PA who has a private practice in NYC doing gynecology care, but I believe this is a rare exception.
Fertility Educator/Counselor
Your Role: Teach classes and provide individual counseling for women and couples using fertility awareness
Becoming a Fertility Educator
- Training programs are unstandardized; an apprenticeship is usually required, so you have to find a practicing fertilty instructor willing to take you on as a student.
- Justisse offers certification as a Holistic Reproductive Health Practitioner, an 18-24 month course
Master of Public Health (MPH) in Reproductive, Maternal and Child Health
Your Role: Working within non-profit and government agencies, advocating and creating policies affecting women and children
- Most major institutions offer the MPH, which takes 1-2 years. The downside is that you may be constrained by government policies that could run counter to what’s best for women and children, such as a public "Don't Sleep With Your Baby" campaign that does not bother to each about safe co-sleeping.
Psychologist or counselor specializing in women’s health, pre- and perinatal psychology
Your Role: Working with clients focusing on fhe deep-seeddemotional issues surrounding reproductive health, birth, parenting, attachment
Variations: Psychologist (PhD or PsyD), Licensed Clinical Professional Counselor (LCPC), Marriage and Family Therapist (MFT) or Licensed Clinical Social Worker (LCSW).
Becoming a psychologist, therapist or counselor
- Psychology PhD or PsyD programs are difficult to get into and sometimes require a Master's degree.
- Most states license Master's-level LCPCs, MFTs or LCSWs.
For further exploration, see the Association of Reproductive Health Professionals.
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