“Being a midwife is more than catching babies,” Melicia Escobar says. “Through my work as a community midwife in the early years of my career, I developed a community of families that I cared for through some intense times, and I see them and their kids around the neighborhood today. Midwifery has given me the opportunity to provide health care throughout the lifespan and create community.”

Melicia is the Clinical Faculty Director and an instructor at Georgetown University’s Nurse-Midwifery/Women’s Health Nurse Practitioner (WHNP) and WHNP Program in Washington, DC and a midwife with the Special Delivery Unit at Children’s Hospital of Philadelphia (CHOP) in Philadelphia. Chief amongst her concerns are working to ensure that midwives can function at their best—able to practice to their fullest scope as respected and valued members of a collaborative team.

“Midwives are trained to be guardians of the physiologically normal human experience when it comes to pregnancy, birth, and health during and after the reproductive years,” she says. “These can be easily problematized, pathologized, and medicalized in our society. In order to normalize what is inherently normal, a midwife must observe and listen to the person in their care, engaging them in their care. Like other health care providers, midwives collaborate with others in and out of health care as needed to provide the most comprehensive care. Among other issues, devaluing the role of the midwife remains at the core of systemic problems in health care with specific regard to maternal morbidity and mortality.”

Midwifery was not an obvious career choice to her, despite always being interested in “the caring professions.” By the time she was in fifth grade, she decided she would become a doctor. “I wanted to take care of pregnant women like my mom. As the oldest of five kids, my formative years offered a ton of exposure to pregnancy and parenting and visits to doctors’ offices.” Melicia started out at Haverford College on a pre-med track and, thanks to a professor who inspired her to an “holistic and expansive” interest in science, she ultimately majored in anthropology. “I fell in love with the skill set that discipline offered,” she says. “Curiosity, thinking critically, skillful observation, developing relationships, asking questions, reflection, understanding.”

Her plans to become a doctor were upended by a summer labor and delivery externship at Hospital of the University of Pennsylvania. “The experience made me think about the type of care I’d like to give, how I wanted to communicate as a provider, the skills I wanted to obtain, and the outcomes I could possibly effect. I returned from my summer with a college-level existential crisis: maybe being an obstetrician isn’t what I wanted to invest in for my life’s work. My academic advisor helped me reframe and suggested that it sounded like I wanted to be a midwife.”

Melicia earned her BSN from Georgetown University and came to Penn Nursing for her MSN with a Nurse-Midwifery concentration. “I’ve had the good fortune to serve as a midwife across many unique settings—home, birth center, hospital, and in the specialized setting of CHOP’s Special Delivery Unit. Being a midwife is, for me, in tight alignment with my personal mission, vision, and values. I’ve had opportunities to participate in education of future midwives; research and write about my findings; advocate for health equity, reproductive justice, and access to care in Washington DC and in Pennsylvania; and contribute to my professional organization in meaningful ways.”

Her career as a midwife has been punctuated with learning moments while working with her patients, but more recently she attended a Philadelphia City Counsel hearing that furthered her understanding of midwifery. “My colleague, Penn grad Mari-Carmen Farmer, GNu’16, was testifying along with other providers in the city’s obstetric community, birth workers, and citizens. The Counsel sets the agenda and speaking order, and they scheduled obstetricians to lead the testimony. In describing solutions to the horrific maternal mortality and morbidity rates in the city, they were perhaps unknowingly—to them—describing the midwifery model of care, yet it wasn’t acknowledged and the only midwife testifying was placed toward the end of the docket, which also meant that her testimony was abbreviated.”

“That hearing crystallized for me that the midwifery model of care is often undervalued and unrecognized. What’s more, the hearing didn’t completely acknowledge the systemic racism that is a barrier to equitable care. How can we address a problem if we can’t put a name to the solution or to a central component of the problem? This experience has been refueling my work with students and in my local midwifery community.”

She notes, “I believe that people thrive when their humanity, their human rights are respected, valued, and protected—not just our patients, but we as midwives. Inspired by that, doctoral work is definitely in my future. I’m hungry for the tools that doctoral preparation offers. And I hope to continue in education, as I really love being part of the group of midwives locally and nationally that are bringing future leaders to the workforce.”

Random fact: Melicia started to learn how to play the guitar when she was in her thirties. “I don’t really play for audiences—except for my kids,” she says, “and I don’t take lessons anymore. But I turn to YouTube to learn new things and use guitar-playing as a way to unwind. I’ve also added the Uke to my personal bag of tricks to de-stress.”