While accounting may be considered the stable job choice at the moment, graduate student Kelly Bruhn plans to enter a vocation that has been around for millennia.

Bruhn is studying to be a midwife.

The College of Nursing will hold a nurse-midwifery open house Monday in Clark Hall at 3:30 p.m. to introduce its specialized program to prospective students from nursing and other backgrounds.

Far from an outdated profession, midwifery — a practice that emphasizes non-interventionist birthing strategies — now accounts for one-tenth of all in-hospital births, according to Lisa Hanson, associate professor of nursing.

Although it is only a fraction of the number of "normal births" they would like to take part in, midwives have made a major comeback in recent decades. Normal births are births in which no complications occur.

Their resurgence was led by an at-home birthing trend in the 1960s and 1970s, according to Jan Tritten, editor of Midwifery Today Magazine.

"Midwifery was pretty much eliminated around the turn of the century," Tritten said. "The doctors said 'Let's get rid of them.'"

However, pockets of the midwife culture remained strong among black communities in the South, according to Tritten.

The practice was then revitalized in the 1960s and 1970s, she said, especially on the West Coast.

"A lot of lay women started to become midwives," said Tritten, who counts herself among the ranks of "lay midwives," individuals who have completed a midwife certification course but don't have a nursing degree.

"Midwives have discovered that there's a much better way — the way it was designed in the first place," she said.

This entails "keeping it normal" by limiting the "unnecessary use" of technology and drugs, according to Hanson.

"Research shows that if women are supported in the normal process of birthing, they have better outcomes," she said.

Although some lay midwives, like Tritten, are struggling against medical doctors to remain in practice, many licensed nurse-midwives have been integrated with traditional health care.

Marquette has offered a nurse-midwifery option in conjunction with a Master of Science in Nursing, the only such program in Wisconsin, since 1993.

"The impetus for it is that it's an advanced practice in nursing," Hanson said.

Besides providing birthing and prenatal care, certified nurse-midwives can also provide primary care, gynecological care and family planning services, she said.

The program allows students to take the National Certification Examination of the American College of Nurse-Midwives, which is required to practice midwifery in Wisconsin.

Although only 70 graduates completed Marquette's midwifery program since 1993, they have been influential in expanding the practice throughout Southeastern Wisconsin, Hanson said.

"There are nine new practices in the state of Wisconsin as a result of our program," Hanson said. "Almost all of the hospitals in the metro area are using midwives or are considering it."

But the biggest challenge the age-old profession faces is publicity.

"Patients often don't know how to get access to midwives," Hanson said.

And the ideal way to increase both access and awareness is through increased midwifery training, according to Juliana Fehr, midwifery program director at Shenendoah University in Virginia.

"There is a shortage of midwives — always," Fehr said. "Midwives should do at least 80 percent of all births, ('normal births')."

But this is not the common practice.

"It's backward in America," Fehr said. "Doctors do that many, but they're the experts on abnormal (births)."

"There's not enough midwives in the U.S. to change that statistic," she said. "If we want to increase access to midwifery for women, we have to increase the access to midwifery education."

In an effort to do this, Marquette provides nearly complete online midwifery courses, according to Hanson.

"The goal is to help people have more flexible learning," she said. "Many of our students have jobs and families."

In addition to flexibility, online programs allow students from all over the Midwest to enroll in Marquette's nurse-midwifery program and help to spread the practice.

"We'd like to help them develop practices where they come from," she said.

This article appeared in The Marquette Tribune on Dec. 2 2004.