100 Things I’ve Learned in 100 Births

100 Births blog post
So, my 100th birth happened last week, just before midnight on the 12th.

100 births since 2008. 44 doula births. The other 56 births were as a midwifery assistant and student. Those began January 29th, 2014–my late father’s birthday. The birth of a new life, and the birth of my midwifery journey. A significant day for me. Among these are two unplanned home births, in which I discovered I have what it takes to stay calm in unexpected situations.

100 births. Not counting the ones I missed by as little as a minute. I’m not sure how many of those there are, but there aren’t very many.

There is so much I have learned since I attended my very first birth as a doula in 2008. And there is still so much I need to learn. I am delighted, honored, and sobered at the distance I have traveled. Still more so at the distance I have left to cover.

How do I do it? The same way you do your life: One step at a time, one day at a time, to the best of my ability, with the help of others who have gone before, and the ones who walk it with me.

I will not turn away.

100 Things I Have Learned in 100 Births

  1. Just when you think you know birth, you are proved wrong.
  2. If it could go wrong, it probably won’t.
  3. But you should still keep your eyes peeled.
  4. Women are truly amazing. Every one of them.
  5. Babies are people too.
  6. And they deserve the same human dignity and respect as their mothers.
  7. Affirmations work.
  8. But they look different for everyone.
  9. The circumstances of birth don’t matter as much as how the mother is treated.
  10. Empowered women are formidable creatures.
  11. Midwifery isn’t for wimps.
  12. Being on-call is stressful for my family.
  13. I must be mindful of my priorities in ways many others don’t have to be.
  14. It does take a village.
  15. You have to choose your village wisely.
  16. My village kicks arse. Especially that portion made up by my husband and children.
  17. My husband and children have given me more grace than I deserve on this journey.
  18. Pay yourself first.
  19. You can’t control for what baby decides to do on the way out.
  20. Sometimes, perineal tears happen in spite of everything you try.
  21. A birth pool really is the Midwife’s Epidural.
  22. This job isn’t “fun.”
  23. Three o’clock in the morning midwife humor is fun, though.
  24. People will text you at six in the morning to ask why the sky is blue.
  25. You really have to know your “Why” for doing birth work.
  26. Your family has to know and believe in your “Why” as much as you do, or it won’t work. It just won’t.
  27. I want to be known as a praying midwife.
  28. As a doula, my bag of tools got lighter with every birth.
  29. Sometimes, my hands, my voice, or my presence were all that was needed.
  30. I am enough.
  31. Hard things are worth it.
  32. There is nearly always a learning curve to breastfeeding, even if you’ve done it before.
  33. VBAC is incredible.
  34. The medical reasons for interventions are real, and should be respected.
  35. The health reasons for natural, physiologic, unhindered birth are real, and should be respected.
  36. It’s okay to speak the truth in love instead of just saying “Whatever you want, dearie.”
  37. Healthy mom, healthy baby needs a new definition in this country.
  38. A healthy baby is not all that matters.
  39. How we birth matters. A lot. I didn’t realize how much until I began this work.
  40. Decisions based in fear are never good decisions.
  41. It’s not consent if you’re afraid to say “No.”
  42. I am stronger and smarter than I thought I was.
  43. But I still have a lot to learn.
  44. The day I lose my sense of awe and sacredness in the birth space, I need to quit.
  45. The day I think I have arrived, and have nothing more to learn, I need to quit
  46. Making cesareans more humane is good.
  47. Reducing the number of unnecessary cesareans is better.
  48. Formula is a medicine.
  49. Breast is not best, it’s normal.
  50. Boobs are not for sex, though they do help it along.
  51. Boobs are not fully developed until they have lactated.
  52. Breakfast is always appropriate.
  53. Humility is central to this work.
  54. Being teachable is absolutely necessary.
  55. Thinking outside the box is a skill that should be developed to its fullest.
  56. Becoming a midwife is hard.
  57. Like, really hard.
  58. And expensive.
  59. As it should be.
  60. Midwifery is an artisanal skill.
  61. It should never be allowed to disappear.
  62. When you hire a midwife, you hire her whole tribe.
  63. When you hire a midwife, you are choosing to birth local.
  64. When you hire a midwife, you are choosing to be responsible for your own care.
  65. Prenatal care is what happens between your appointments.
  66. Nutrition matters a lot more than we ever thought.
  67. Midwives have known this forever.
  68. Birth is made up of strong women doing very vulnerable things.
  69. Meconium happens.
  70. And sometimes, it really sucks.
  71. I have seen the worst, and I still want this.
  72. Midwifery isn’t a career.
  73. Midwifery is a calling, deep, strong, and undeniable.
  74. If I weren’t studying midwifery, I would want to be a hospice nurse.
  75. The end of life is very much like the beginning of life.
  76. Sometimes, the thing that shouldn’t work, does.
  77. You don’t always have to understand why or how something works, as long as it works.
  78. Pulsatilla is awesome.
  79. I love seeing a family hear their baby’s heart tones for the first time.
  80. I love watching men become fathers.
  81. Gentle loving touch is a big part of what’s missing from modern obstetric care.
  82. I don’t notice nudity anymore.
  83. Placentas are not always appropriate topics of conversation in mixed company.
  84. Circumcision is a rarely justifiable elective surgery. Look it up.
  85. Methods don’t work, except for a select few women.
  86. Anyone who says differently is selling something.
  87. Flexibility is everything.
  88. Never hesitate to speak out of fear of looking a fool.
  89. If the zombie apocalypse happens, I’ll still have a job.
  90. Birth is much safer now because of two things:
  91. Infection management.
  92. Hemorrhage management.
  93. Midwives know both. Really really well.
  94. Knowing your clients gives you good instincts.
  95. Your heart knows as much as your head, even if your head is late to the party.
  96. Sometimes, the only legitimate basis for a hard call is your gut. You have to trust it.
  97. Finding heart tones takes practice and patience.
  98. If I know what needs to be done, and how to do it, I should not hesitate.
  99. Midwifery is who you are, not what you do. You either have it or you don’t.
  100. I am a midwife.

There is so much more I could add, but I wanted this to be off-the-cuff, and not over-thought. It was important to me that it be in my brain’s real-time, and not artificially cooked up to be more or better than what I actually am.  It’s just very random thoughts off the surface of my brain. Some deeper than others, but all true.

What about you? How many births have you had or attended? What have you learned about yourself or about birth through them?

Grace & Peace,


  1. Aubre on February 15, 2016 at 11:48 am


    • Tiff Miller on February 15, 2016 at 1:29 pm

      Thank you so much!

  2. Becky on February 15, 2016 at 12:56 pm

    And the corollary to #76, the thing that should work, doesnt:(
    Also, I love watching a newly born babe turn it’s head when hearing it’s dad’s voice for the first time exutero.
    Great list! I love every one:)

    • Tiff Miller on February 15, 2016 at 1:27 pm

      You are so right! I love that too!

  3. jennymbennett on February 16, 2016 at 12:46 pm

    This was a great list and I loved it, but #85 and 86 did give me a little pause. As a Hypnobabies teacher, yes, it’s true that I’m selling something. But it’s also true that I couldn’t live with myself if I sold something that wasn’t done in service to the birthing families and that wasn’t designed to empower them. (I have no idea if our class is what you meant by a method, only guessing.) I think it’s important to understand that self-hypnosis does work for many people for many different applications, including childbirth, and it’s up to them to decide if that’s the right approach for them. In your professional profile you state, “Most of all, I believe that women should be trusted to make the best decision for their situation, and should expect to be fully supported by her caregivers.” Amen to that. I believe that statement can and should encompass methods, too. “She believed she could, and so she did.”

    • Tiff Miller on February 16, 2016 at 11:09 pm

      Thank you so much for your thoughtful reply! I know many HypnoBirthing and HypnoBabies instructors, and have genuine respect for the service they provide.

      Yes, I thought of your concern as I was writing it, but in the interest of brevity, chose not to elaborate. My experience with methods is that they are excellent tools, but can be too narrow for most women. I think, generally speaking, it’s wise to have a comprehensive childbirth education, covering a wide range of coping mechanisms and tools, and add specific tools (such as hypnosis) as needed. I have actually recommended hypnosis methods to several clients and students, because I got the sense that hypnosis could be a good fit for them. Ultimately, what I have often seen is that, if a method does not work for a woman, and she has to use other tools she didn’t expect (such as an epidural), she often blames herself. She doesn’t even think that perhaps the method didn’t work for her, or wasn’t what she needed. Instead, she looks for the mistakes she made.

      I don’t tell clients to stay away from certain childbirth methods, but I encourage them to experience a wide range of techniques, based on a fundamental understanding of how labor works, and how different tools work in different circumstances, including hypnosis. It’s about equipping her with the confidence in herself–not in a method.

      • jennymbennett on February 22, 2016 at 11:35 am

        I definitely hear what you’re saying and appreciate that you recommend it to those for whom it seems to be a really good fit. I definitely agree with you that equipping the person with confidence in herself is key! That’s actually exactly what we do in Hypnobabies classes: empower them with tools and information. (The partners, too.) Our class is very much a comprehensive childbirth education. (And I realize there are many other great choices in that regard. I agree with you that women who gravitate towards Birthing From Within, for example, should take Birthing From Within!)

        The topics we cover are too numerous to include here, but here’s a sampling: tools for overcoming fear which is fed to us about birth in our culture; mindfulness for pregnancy and birth; the mind/body connection; ways to stay healthy and low-risk; birthing choices: during pregnancy, during birth, during pushing, in the immediate postpartum time; the stages and signs of birth; creating an optimal birthing environment – home or hospital; creating optimal space for a baby who may be ready to turn and engage; solutions for a slow/stalled birthing; the posterior challenge; birth partner tools & confidence; creating an alliance of trust with nurses and care providers; a change of plans (special script); physiological cord clamping; creating newborn care preferences; basic breastfeeding and creating a postpartum care plan.

        And this says nothing of the tools the mother creates for herself (with our guidance) for harnessing that mind-body connection and allowing it to work in a powerful way.

        So while again, I totally get where you’re coming from with encouraging them to experience a wide range of techniques, I also think it’s important to understand that for those who choose self-hypnosis need full ability to focus on just that. There’s nothing to fall back on so to speak, because a mom who has gotten temporarily off track can get back on with the proper guidance from a hypno-doula or another dedicated partner who attended classes with her. Does this mean we don’t need complementary comfort measures? (Water birth, counter pressure, intracutaneous sterile water, aromatherapy, etc.) Absolutely not. Does this mean epidurals never have their place? Absolutely not, and we talk about the concept of a therapeutic epidural in class. But at the same time, we must be careful not to distract the mother from concentrating on the self-hypnosis she’s been diligently working on by using counterproductive language or instructions not related to a medical necessity.

        Am I making sense?

        With the proper commitment level, language, environment and support, self-hypnosis can become an incredible tool for self-empowerment.

        Thanks for your time and consideration!

  4. gospelisosceles on February 16, 2016 at 1:15 pm

    I agree on #27. I also love #80. At my daughter’s home birth this moment when I saw my husband fall in love with her, was the highlight of the whole birth experience, if not our marriage so far. Feel free to read the story if you have a chance. https://gospelisosceles.wordpress.com/2016/01/19/a-daughters-birth-a-familys-birth/

    • Tiff Miller on February 16, 2016 at 8:22 pm

      Thank you so much!

      • gospelisosceles on February 17, 2016 at 11:36 am

        And thank you for what you and fellow midwives do:)

  5. Kim Woodard Osterholzer, CPM, RM on February 16, 2016 at 4:45 pm

    I love this! I’ve been a homebirth midwife for thirteen years. I’ve witnessed the births of 504 priceless souls over the last twenty-four years, including the birth of my granddaughter (and her mom is a midwife too).

    “If I weren’t studying midwifery, I would want to be a hospice nurse. The end of life is very much like the beginning of life.” This resonates with me, as I’ve attended a few deaths as well. Thanks for sharing!

    • Tiff Miller on February 16, 2016 at 8:23 pm

      So glad it resonated with you! Thank you for commenting!

  6. Amber on February 16, 2016 at 5:46 pm

    So I have a question I’ve had to give birth via c-section 3 times. I’ve not been able do a normal birth but I really want to for my next baby. Is their a possible way for that to happen even though I’ve done 3 c-sections?

  7. Maggie Barry on February 16, 2016 at 6:21 pm

    Thanks. Most of what you posted is so true. I think it is important to separate ourselves from our profession. It is part of giving up the ego. We are who we are. Midwifery is something we “practice or do for a living or for some other reason…”. It doesn’t mean that our heart can’t be in whatever we choose to do.

    • Tiff Miller on February 16, 2016 at 8:24 pm

      Yes, that separation can help with sanity for sure. Thanks for commenting!

  8. Becka on February 17, 2016 at 7:30 am

    #74 and #75 – yes!! Before and during midwifery school, I’ve worked as an ICU nurse, and we do a lot of ‘withdrawing of support’ and ‘comfort care’ as we work to create a peaceful and respectful environment for the end of a life. I’ve been asked how I could do that part of my job, especially wanting to be in birth work, which is ‘so much happier’? My answer is always that being present at someone’s beginning and someone’s end is an honor! I’m grateful for the opportunity to help create an environment that is supportive of that persons wishes, whether its at a beginning or an end. Thank you for your wonderful post!

    • Tiff Miller on February 17, 2016 at 8:41 am

      Exactly! Thank you for what you do, and thank you for sharing!

  9. […] list: 100 things I’ve learned in 100 births I kind of wish I had thought to write one myself. Maybe one day I […]

  10. BayAreaBirthSupport on February 17, 2016 at 2:04 pm

    I found myself agreeing with so much of this! As a doula and student midwife, I found myself nodding with so many of these. Especially #23. 🙂
    ~Tabitha Ames

    • Tiff Miller on February 17, 2016 at 3:10 pm

      I’m so glad! Thanks for sharing!

  11. Birthing With Sani on February 17, 2016 at 2:27 pm

    I love this! Read this during my first birth as a student doula last night and it really encouraged me. This would be so cool to incorporate into a “doula/midwife/birth professional calendar” of some sort or something where we can flip to a card for a quick encouragement once a day or so. I’ll definitely be looking back at this for encouragement often!

    • Tiff Miller on February 17, 2016 at 3:11 pm

      Wow! What an honor that you would come back to this and be encouraged! I’m so glad it was helpful to you. Thank you for sharing!

  12. Natalie on February 18, 2016 at 5:47 pm

    I’m not exactly sure how many births I attended as a doula. It’s been nearly 17 years. I rarely go to birthe now. I went to school to study midwifery but had a traumatic spinal cord injury the day before my first midwifery patient delivered. Without getting out my records I would say somewhere around 30 or so (I had a number of times when I did back up for people). I have never been the doulas with a huge bag of tricks. I too sit on my hands. I watch. I witness. I am the rock to cling to in the storm, because there have been some big storms. I really love your list. Good job.

  13. Patricia on February 19, 2016 at 1:39 am

    I gave Birth in a Hospital in a little town that is now a Huge city. It was over 40 years ago. My Doctor was really into natural child birth. I will Forever be Thankful. She was very much like a Doula/Midwife. I was doing self hypnosis and when the nurses came in and asked did I need anything she replied no she is in her zone and I will catch. I had the most amazing birth.
    I Love that you are practicing the way you do. My Beautiful niece gave birth with a Doula and my Amazing Friend is now in in Training to become one.
    I tried to pick the numbers in the 100 messages that hit me the most. I could not. Each and everyone I could relate to as a Mom and as a Grandma. Thanks for all you do. You have learned Well.
    Female Daughter Girlfriend Wife Mother Grandmother Friend Patricia

    • Tiff Miller on February 19, 2016 at 7:37 am

      What a beautiful story! Thank you for taking the time to share!

  14. […] got inspired to write this after coming across an article entitled 100 Things I’ve Learned in 100 Births.  What I unquestionably know is that we have so much work to do.  There are so many more things […]