María is a mother, midwife and International Board Certified Lactation Consultant. After qualifying as a Midwife in Ireland in 2012 and a Lactation Consultant in 2015 she returned to her home town of Valencia. Maria now works in a public maternity hospital and also offers private lactation support and midwifery care, tailored to meet each woman’s individual needs. Maria is passionate about holistic family-centred continuity of care. She works with women both in-person and online.
You had a successful career as a nurse working in Spain, Italy and Ireland. What made you decide to train as a midwife?
It’s something I always knew I wanted to become since I was undertaking my Nursing Degree. Being with women, advocating for them, empowering them in something so unique as their pregnancies and childbirth. I fell in love with this job since my Nursing Clinical Placements in the Maternity Department. At that time, it wasn’t easy to get access to Midwifery Studies in Spain without several years of nursing experience behind you. As travelling is one of my passions, my best option was working abroad.
Why did you decide to undertake midwifery training in Ireland?
When I decided to move to Dublin, I knew some places where to undertake Midwifery Studies, so I worked hard to get a place in one of them. In the meantime, I met a few newly qualified Spanish midwives who had trained in Dublin. And what is more, they were delighted with the experience! They talked about the different attitude to midwifery in Ireland compared to Spain. While in Dublin humanised childbirth was the norm, excessive delivery interventions happened in Spain. Although it took me a few years to get my English Exam passed before I was accepted, it was worth it. Living in Ireland opened my mind, filled me with so many life-changing experiences and facilitated my dream of becoming a midwife.
A couple of years later, you became an International Board Certified Lactation Consultant (IBCLC). Do all midwives become lactation consultants as well?
No, not really. All midwives get some sort of breastfeeding studies during their training. In Ireland it is quite common to become an IBCLC, while in Spain is still quite rare. To have some numbers, in Ireland there are 322 IBCLCs and 1,400 midwives, whereas in Spain we are 244 IBCLCs and more than 8,500 midwives. What is more, an IBCLC is not required to be a midwife. They can be any other healthcare professional or just have some health studies before qualifying for the certification exam.
After working and training abroad, what made you decide to return to Spain?
Homesickness, definitely. A year in Italy, a decade in Ireland, more than a year in other Spanish cities, I felt it was enough. I felt it was the time to return home, to be able to hug my family every week.
What advice would you give to a woman hoping for a natural birth in Spain?
First of all, to choose her place of birth. Home birth midwifery teams are present in most Spanish regions. If their preference is a hospital birth, I would recommend to choose carefully as not every hospital has a natural birth delivery room, or low-intervention labour policies. Antenatal classes facilitated by a midwife with a focus on natural birth are essential. During pregnancy, women hoping for a natural birth need to connect with their power to birth. Their partners will find out their role too. Mum, partner and baby will work as a team on the Big Day. These are the main goals in antenatal education classes.
What are your top tips for a positive birth experience?
My best recommendations for a positive birth experience are: antenatal education by a midwife for both mum and partner, a personalised birth plan, and identifying and working out their fears during pregnancy so that at the time of labour, they are well able to trust nature, let it happen and enjoy their unique experience. Society has lost trust in women’s ability to give birth naturally. When a woman has a positive birth experience, postpartum weeks and breastfeeding tend to just flow.
From your experience, what are the most common concerns for foreign women giving birth in Spain?
The most common concern is the language barrier, fear of not being able to communicate properly and “connect” with the healthcare professional who is looking after them. I always advise them to look for an English-speaking professional team, in some cities it is possible. During antenatal education we always work out some useful Spanish vocabulary and sentences to make them feel more in control during labour and birth.
What are the most common reasons for a new mum to need the help and advice of a lactation consultant?
Most women come with nipple pain and damage during breastfeeding and/or low milk supply. Together we search for the cause, and design a care plan to correct it. A single consultation could be enough, while a follow up visit may be required in some cases. In either case week-long follow-ups via WhatsApp is included.
Some women approach me during pregnancy because they had a hard time with breastfeeding other babies. In these cases, we first debrief the past experience and design together the action plan. I usually see them again after the baby is born. The same if the woman is expecting twins or a condition is suspected which which may affect breastfeeding, such as cleft lip/palate, preterm baby or congenital. Women with diabetes also benefit from this prenatal visit.
Pregnancy and birth are intense physical experiences – how is it possible to work online with women during this period of their lives?
Obviously birth is not assisted online. And yes, you are right, pregnancy and postpartum are quite delicate and sensitive periods in women’s lives. It’s usually a roller coaster of emotions. Some time ago, the screen seemed to me a barrier for communication, we all looked more distant from each other. Those were my thoughts but during the last few years, I have been amazed to see how we all adapt ourselves to new tendencies. Nowadays families are used to new technologies, to videoconference with family and friends, most families don’t find it so bizarre. But it is true, there are some limitations. For example, in an online consultation I explain to mum how to latch her baby on, I can show her with a dummy or any other tools I have. I will never be able to put my hand on her hand to guide her how to do it. I have to say, I also miss the hug, the touch. That’s the reason why I always offer in-person visits first, but every family’s situation is different.
How would you describe your work in 3 words?
Passionate, vocational and empowering.
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