A Look at Midwifery:
Back to Natural Birth
Tehmina Islam is Wisconsin’s  first
person of color to be a certified
professional midwife.
By Jonathan Gramling

Part 1 of 2

For the Baby Boom generation and beyond, it may seem that it has always been hospitals
where babies were born, that it is only “natural” that a woman goes to a hospital to give
birth. After all, 99 percent of births in the United States are in hospitals. But at the
beginning of the 20th century, the vast majority of births were done at home under the care
of a general practice physician or a midwife.

As a high school student in Madison, Tehmina Islam first witnessed a birth when her
friend, also a 16-year-old high school student, asked her to be in attendance at her child’s
birth.

“Watching her in the hospital, I was so amazed by the strength with which she birthed her
child, but I was also really in awe with the poor treatment that she received as a teen mom
in the hospital,” said Islam, the first person of color to become a certified professional
midwife in Wisconsin. “After that, I really thought a lot about birth and knew that my skill
set belonged in providing care for women and pregnant women and laboring women.”
a lot of group prenatal education. I also worked with traditional birth attendants in the
community of Kisumu and lived with a host family there. I would work with the traditional birth
attendants to make home visits to a lot of the moms who had recently had children or were
about to and try to provide prenatal and postpartum care for them.”

By the time that she came back from Kenya, Islam had decided to become a certified
professional midwife (CPM), which had now become certifiable and regulated by the Wis.
Dept. of Regulation and Licensing. Islam would have to undergo a rigorous training before she
could become licensed.

“I started volunteering as a doula, which is a woman for labor support through an organization
called Small Miracles, which provides doulas for low-income women, teen moms and women
on BadgerCare,” Islam said. “And through doula care, I learned about a midwifery school in
Chicago out of the National College of Midwifery and started attending classes with a fellow
midwife for two years. As part of your training, you go to school and then you complete an
apprenticeship. My apprenticeship lasted four years. I apprenticed with local home midwives
in Madison and Milwaukee. I also did a six-month internship at the Madison Birth Center. I got
a really nice breadth of apprenticeships.”

Islam apprenticed with CPMs as well as certified nurse midwives (CNM) who are registered
nurses with a certification in midwifery. She also received training in neonatal resuscitation
and adult CPR. Last fall, Islam received her certification and license and established Access
Midwifery LLC and works out of her home just off of Williamson Street.
As she was preparing to further her education after high school, Islam looked into midwifery as an occupation, but was discouraged
because it had an a-legal status in Wisconsin. She opted to attend the University of Wisconsin-Madison to pursue a degree in
international relations.

Yet Islam was still interested in maternal health and chose to complete her senior year in Kenya, Africa and completed an internship
working on maternal health issues in rural areas.

“The year in Kenya was probably the best and hardest year of my life,” Islam said. “I was doing a lot of group, prenatal education on
issues of malaria, domestic violence, alcoholism, malnutrition, anemia and pregnancy and water quality and breast feeding. We did
As a midwife, Islam works with women who are experiencing low-risk pregnancies to have a natural childbirth in their home setting.
If the pregnancy remains low-risk, the woman gives birth at home without a doctor or nurse present and without the administration of
drugs like Pitocin, a labor-inducing drug.

“The midwife’s model of care really advocates for holistic care and looking at a woman during her pregnancy and birth as a holistic
aspect, looking at her psycho-social health, her physical health and her mental well-being,” Islam said. “It is care that minimizes
technological interventions and really allows a space for women to follow their bodies and birth the way they feel most comfortable
and most supported. It’s also vigilant care where you are monitoring that pregnancy and making sure that home birth is safe when you
have low-risk women having home births. It monitors the pregnancy to see when that risk increase and become a high risk
pregnancy. At that point, you refer to obstetrical care or hospital-provided care. I think that’s also a part of midwifery care, to be
vigilant about what is low risk and really maintain that boundary so that home birth stays safe.”

Central to the practice of midwifery is the development of a trusting relationship between midwife and the pregnant woman who
remains in control of her pregnancy.

“I don’t automatically assume that she will listen to what I have to say because of my credentials,” Islam said. “I hope that she will
listen to the recommendations that I make because I have invested in a relationship of trust and integrity.”