Delivering babies is usual for this Minneapolis nurse midwife, but it’s far from her whole job

Andrea Engdahl remembers the first time she said the words, 25 years ago.

“I want to be a midwife.”

She was pregnant with her first child at the time and exploring her health care options. A nurse midwife, she discovered, was a registered nurse who delivers babies and cares for women from puberty through menopause.

Eighteen years later — after leaving her early childhood family education job, raising her kids and eventually earning a nursing degree to work as an RN, including in obstetrics — Engdahl graduated from midwifery school.

Now 49, Engdahl sees patients at M Health Fairview Clinic-Riverside and delivers babies at Masonic Children’s Hospital.

In an interview edited for clarity and length, Engdahl shares what it’s like to be in her shoes.

We are not surgeons, first of all, and we are specialists in low-risk pregnancy. But in addition to pregnancy, we do full, well-woman care similar to what a women’s health nurse practitioner would do. We care for women from puberty through menopause, which I think is surprising to a lot of folks. They think that they can come and have their babies with us, and then they’re like, “OK, well, I’m never going to see you again, because I’m not having babies.” And we’re like, “No, no, please come back! We can take care of you.”

I work in the clinic, and that’s just a regular 8-4 day where I am seeing patients for prenatal visits, for annual exams, for gynecology visits.

And then I also have a call day. Most midwives work either 12-hour call shifts or 24 — we actually prefer 24 in my practice — but a call day is kind of a wild card.

We’re seeing the postpartum patients. So we go, and we round on our patients that had babies in the previous 12 to 72 hours to set them up and get them ready to go home. And then we are also, of course, triaging patients. So preterm labor patients who come into the hospital with severe nausea and vomiting and then also patients that are in labor.

I worked night shift for many years, so being awake for 24 hours was not something new to me when I came to this job. But there’s a lot of continuity of care for patients when you’re with them for a full 24 hours. If we have downtime, we can be in our own quiet space and take a nap or work on whatever projects we have going on.

Normally, we’re not on our feet, patient-facing, for 24 hours. I have had days like that, and they’re tough, but they’re pretty few and far between. But also, you’re working on adrenaline at that point, and you’re just emotionally invested in your patients and the things that are happening. It’s amazing how quickly 24 hours can go when you are actually working for the full 24 hours.

We have seven midwives on our team, and we take turns doing 24-hour call shifts. We encourage our patients to try to meet everyone throughout their pregnancy so that when they come to have their baby, they’ve got a familiar face there with them. It’s pretty rare that I go into birth with a patient that I haven’t met before. It does occasionally happen, and those days, I get to work really hard at relationship-building in a very short amount of time.

We just have fewer patients in our care, so we’re able to spend more time educating and getting to know our patients really well. Not that OB-GYNs don’t do that: We work with a lot of amazing OB-GYNs who are able to really do that in a short amount of time.

You’ll find a midwife at the bedside more often, and we don’t run in at the end, normally, to just catch the baby. We are generally there with our patients through much of their active labor and are just able to be more present.

Having worked as a high-risk nurse, it was really important to me that I learned to trust normal, physiologic births.

I want my patients to trust themselves and trust their body, but I needed to really learn that, as well, as a midwife — that truly, it is possible to have an uncomplicated pregnancy and birth.

Also, just the power and the resilience of birthing people is so amazing. From teenagers through women in their later birthing years, it’s amazing to me, always, how even when people don’t think they can do it, they step up, and they are amazing.

I always say, if I ever stop being amazed at this process, I would need to find a new job.

I would guess it’s several hundred at this point, but I don’t keep a count. It’s something I always said I would do, and it just — at the end of the day, you just want to go to sleep sometimes.

In Their Shoes is an occasional series highlighting Minnesotans at work. If there’s a type of job you want us to profile — or if you have someone who would be a good candidate — email us at InTheirShoes@startribune.com.