23 Sarah Swanson

Sarah is a licensed midwife practicing in a small coastal community in Northern California, providing care in both home birth and OB/GYN settings. Her clinical work support clients across the lifespan from preconception through postpartum and into menopause with an emphasis on relationship centered evidenceinformed care. She's a graduate of the midwives college of and is current currently completing her master's degree while serving as a faculty. In her teaching role, she mentors student midwives in developing clinical skills, critical thinking, and professional identity while fostering learning environments that are both supportive and accountable. Her work is grounded in a commitment to strengthening midwifree education culture. She believes in moving away from models that normalize struggle and toward approaches that cultivate growth, connection, and sustainability. Through both clinical practice and teaching, she contributes to a model of midwiffrey that upholds integrity, supports learners, and centers the relational nature of midwiffrey care. So without further ado, over to you Sarah. Thank you so much. Happy to be here. Um, okay. So, we're just going to get started. And I I for I don't know if anybody else found themselves a little bit captivated by the Aremis 2 moon mission as it unfolded, but I did. Um, and for those of you who might not know or maybe didn't follow it, Artemis 2 um is a part of NASA's return to the moon program. It uh this was a mission designed to send a crew of astronauts around the moon and back. um the first time humans have traveled that far before and and this step toward longer term lunar exploration. And there was something about watching it that felt unexpectedly considering it was around the moon grounding. And not because of the milestones or all of the firsts, like the firsts that took place, but because of something that it illuminated for me. Upon returning to Earth, Canadian astronaut Jeremy Hansen made the statement that our purpose as humans is to find joy in lifting each other up by creating solutions together instead of destroying. And when you see Earth from out here, it absolutely affirms that. I thought that was beautiful and I'm going to come back to that at the end. So, put a little pin in that quote from from the astronaut. Um, I want to just take a second to situate myself um to this topic of peer mentorship. Um, as was mentioned, I'm a practicing midwife, an educator, and also a student. I move between clinical care and student learning spaces daily. uh I became a licensed midwife in the US state of California in 2023 and began independently practicing right away. So my experience of being a student and transitioning into practice is still in the grand scheme of things pretty fresh. And because of that I don't just see midwiffery education from the outside looking in. I both remember and know what it feels like to be inside of it. And something that I noticed during my education and training and that has stayed with me as a new midwife is that midwiffery practice in clinical care in that we as midwives center relationship. We center trust and safety and continuity. But in midwiffrey education, those same conditions aren't always or haven't necessarily been built with the same intention. I've seen uh incredibly capable students start to doubt themselves. I've seen how often students and can end up feeling um like they have to figure things out on their own. And I've also seen what can open up when student midwives are supported in real respected relationships. So this project that I'm currently working on as a master's student at the Midwives College of Utah, which I'm sharing with you today, um comes from a pretty simple question. If relationship is central to how we care for midwives, why wouldn't it also be central to how we form midwives? Um, so to get us sort of all oriented in the same direction, I want to start with one of the biggest things I really hope um you'll take away from this, which is mentorship is midwiffery. That's really what this whole project comes back to for me. That mentorship at its core looks a lot like what we as midwives already know how to do. Just stay present with someone in process in their growth in their unfolding. Not doing the work for them, but also not leaving them alone in it. And that's really what can create belonging. Knowing that you're not alone while you're still becoming. Mentorship can be one of the most powerful tools we have to support student midwives. It shapes not only academic success, but how students come to see themselves in the profession and whether they remain in it long term. Mentorship matters because it can impact both individual students and the profession as a whole. At the personal level, the data shows that mentorship can reduce isolation. It can build confidence and it can cultivate a sense a real sense of belonging especially in training environments where the workload is heavy and the stakes they they feel high and and they are high at the professional level. Mentorship supports retention and longterm long-term sustainability in the workforce. Midwives who feel supported are more likely to remain in practice, which directly affects access to care for families and communities. So mentorship matters because it supports students to succeed and it supports midwifery to remain strong or to remain a strong and sustainable profession. At its core, this work is about how relational structures in education can shape whether students feel they belong in midwiffery at all. So this also connects directly to the broader vision of midwifery for all because access to care isn't separate from how we support how we support and sustain the people entering the profession. Mentorship doesn't just influence outcomes. It shapes identity formation. It's it it's part of ident identity formation. It can shape who students begin to believe they're becoming as midwives. Across many midwiffery systems, a a pattern can show up within the hierarchy of learning and training. Um there's also a saying that circulates in some midwifrey communities that midwives midwives eat their young. And this describes the experience of students and new midwives encountering a culture where hardship is reproduced through hierarchy and where struggle becomes normalized as part of becoming and be part of becoming a midwife. That phrase it it it's not going to resonate in every cultural context, but the pattern underneath it it can. We see we we see it across many professional training environments where difficulty gets passed down rather than reflected on and where initiation into a profession becomes something that happens through struggle and isolation rather than support. Um alongside that there there's can be an a spoken and sometimes unspoken belief that midfree is inherently hard. Therefore, training should be hard to and that struggle itself becomes framed as a sort of right of passage. Um, within hierarchal systems, that belief can carry a a whole lot of weight. access, knowledge, and even belonging can start to feel like something that has to be earned through endurance rather than something students are supported into through relationship. And this doesn't come from nowhere, right? This is it develops when within systems um that are under real strain. workforce shortages, limited preceptors, teachers or leaders, time pressure, and then the longstanding hierarchies. When systems are strained, learning can begin to shift from being relational to something that's really guarded. Knowledge um becomes something to protect and hold on to. And the feedback becomes uh more focused on evaluation than on supporting learning and formation. And then belonging can really start to feel conditional, right? Like something you have to prove yourself into rather than something you're welcomed into. How we support students is not separate from the care we're ultimately able to provide as midwives. This is about naming a pattern so we can begin to imagine something different together. But before we move there, I think it's important to consider what this pattern produces. When learning shifts from relational to guarded, it doesn't just shape that moment. It shapes what students carry through their training and into the profession. When learning happens in isolation or through hierarchy, the effects of that can be pretty they can be pretty predictable. Um, we see burnout, we see difficulty asking for help, we see inconsistent confidence. Um there's attrition, but there are these sort of softer or quieter um more subtle maybe impacts too. Students start to believe maybe I don't belong here or everybody gets it but me or um I just don't know if I can do it. And over time that really shapes identity because students aren't just learning skills, right? students are learning who they're allowed to be in this profession. And that doesn't just affect individuals, it affects the workforce. When students leave or disengage, we lose future midwives. Um, and in my studies, what we can see, we see this pattern um, consistently echoed in the literature. But before we actually dive into the research, um, I want to share just a quick story of my experience. my experience with the benefits of successful mentorship because um it's also not it's not just theory and it's not just data it's also anecdotal and so I want to share my story um when I was finishing my undergrad at Midwives College of Utah also known as MCU an MCU alumni and freshly minted licensed midwife um really stepped in for me. She was a sounding board as I tried to figure out what could I realistically handle as I neared the end of my time in school, which classes I might be able to take, how much clinical time I'd need, and and what it would take to get through the program without completely burning out. And this peer, she didn't just tell me, "You'll be fine." She actually sat with me in the messy decisions and challenged me to keep my head down and my eyes forward and really helped me weigh my options with with clear perspective as someone who had just recently navigated the same exact journey. This peer relationship, it didn't end when I when I ultimately graduated. She continued to walk with me through the nitty-gritty that no one really prepares you for. Things like the the paperwork to get my license, signing up with the lab, um getting connected with mandatory state screenings and all of the little details in between on my own. Those step-by-step tasks could have felt so overwhelming and isolating, but through peer mentorship, they became things I totally approached with confidence. That support didn't just help me get things done. It really truly it shaped my professional identity where some preceptors told me, "You'll be you'll you'll have to figure it out on your own. That's just part of becoming a midwife." my peer actually reached out her hand and and carried me while she was climbing and launching her own independent practice. So it it gifted me, but in turn the act of mentoring gave her the opportunity to actually solidify her own learning to reinforce her confidence um as a new midwife and really grow her sense of leadership. Now, I love to say it years later, we continue to work um really close together. We are encouraging and challenging and listening and lifting each other up on a regular on a regular basis, which ultimately led me to create a peer mentorship program. Um, in doing this, I had a few core objectives guiding guiding this work. And, um, those objectives, they really came out of what I experienced firsthand and what it can look like when mentorship is actually relational, intentional, and a key word, reciprocal. Um, because belonging be it isn't a limited resource. It actually grows through relationship. The more we support each other, the more that support becomes normalized. We rise by lifting others, by staying in relationship as we're becoming. And that's really the heart of mentorship, not fixing, but staying present and connected while growth unfolds. And that's what I wanted to intentionally design into something more structured, something that reflects those values in practice. So this led to a develop to the development of a 15week um peer mentorship program and at its core the objectives were to create a meaningful effective peer-to-peer mentorship program to center student voices at this at the at the design of it and to reflect the relational reciprocal and community-based values of midwiffery. So, in um January 2026, just a few months ago, the peer mentorship program was was offered as a course within midwifrey education at the Midwives College of Utah. And it wasn't created informally or haphazardly, but it was really intentionally designed based on research. um this peer mentorship program. It's my current thesis work using a qualitative participatory approach, centering student voices through surveys and focus groups and reflective feedback. That input from students is actively shaping the ongoing design of the program. Which this brings us to what sits beneath all of this. Um because again, it's not just anecdotal. There's strong research behind what we already see in practice. When mentorship's done well, when it's consistent, relational, and grounded in trust, it's associated with improved academic success, stronger professional identity, increased confidence, reduced burnout, better retention, and a greater sense of equity and trust. Mentorship clearly matters, but the way it's structured also matters for success. Most mentorship programs or relationships in midwiffery education still exist within uh the hierarchal systems of training. And hierarchy matters here because it shapes what's possible in the relationship. when there is an evaluative or powerbased structure or power dynamic present um psychological safety can can just sort of shift even when there's supportive intent. Students may filter what they say. They might hold back some questions or avoid vulnerability especially when they're also being assessed or evaluated right within that system that they're working to move forward in. And this is where peer mentorship um can offer something structurally different because peers exist outside of formal evaluation. There's less at stake in being honest and the people who best understand the student experience are other students living it in real time. Um so with that I just want to I think it's important to also name the difference between supervision and mentorship. Supervision is evaluative. It it usually comes from an instructor, a preceptor or a clinical surviv um supervisor. Uh it is structured and it's focused on competency on making sure students are knowledgeable, skilled and safely meeting expectations. And that matters. It is very important but it serves a different purpose. Mentorship on the other hand it's relational. It's non evaluative. It's grounded in trust, reciprocity and connection. And now these aren't opposing approaches. It's not about choosing one o over the other. They they just meet different needs. And when both are present, they're clearly defined rather than blurred together. They can actually work alongside each other in a way that better supports students. Um, and we see this in the research that mentorship is most effective when it's intentional and when there's some structure, but also flexibility and when it's supported and when it feels psychologically safe. When those conditions are present, mentorship can do what supervision alone cannot. But when mentorship becomes constrained by hierarchy or starts to feel like an evaluation, something shifts. And what often begins to erode is a sense of belonging. And that matters because belonging is one of the conditions that allows students to stay engaged, to ask questions, and to remain in the learning process. And yet, we still don't have consistent models that reliably create that kind of balance. And that gap is where this project comes in. Um, first, belonging is not limited, right? It expands through relationship and and over time collaboration and support can become normalized. This is the shift the program is built on that when people are supported in relationship they don't just learn better but they learn differently. They begin to experience belonging as something that is built through um built through connection not earned through endurance. Um so this led to the development of a 15-week mentorship program. This is a structured guided course designed to hold both consistency and flexibility. Participation is voluntary which matters. Students are choosing into relationship from the start which can support authenticity, investment and uh mutuality. And the structure is intentional but it's not rigid. It provides sort of a scaffolding without control and supports connection without expectations or um performance. From the very very start, the program is designed to be relational, not hierarchal. The application process is intentionally reflective. Students consider their own readiness, their communication styles, their boundaries, and their own capacity. Both mentors and mentees reflect on their roles, their motivations and what they hope to both um give and receive. So from the very beginning uh the mentorship is framed as collaborative and reciprocal. Before before launching though those who will be in the role of the mentor participate in a structured orientation and this isn't to make them experts or place them in a position above others or anyone or the mentees, right? but to actually just support clarity, care and um a groundedness in their role. During that orientation, we focused on role clarity, boundaries, supporting without over responsibility and just staying present without becoming directive. Because at the core, mentorship reflects midwifery. And it's about staying in reciprocal relationships while someone is becoming not being above them or in a position of power over them. So, and then at the start of the program, participants meet in a live group session designed for connection. Rather than assigning pairs immediately, students engage in a structured conversation across the group and that can create space for agency and relational choice. After that, then students were invited to privately share who they felt aligned with or not. And then pairings or matches were made with both structure from the application and then participant input. So connection between participants, it's neither random or imposed. It's it's supported and intentional. Um from there, the program unfolds over 15 weeks with guided weekly prompts. Uh they're not assignments, but more like opportunities for reflection and conversation and connection. The topics include communication and feedback, uncertainty, boundaries, identity formation, self-doubt, imposttor syndrome, collaboration, resilience, just to name a few. Um, students, student midwives are not only learning skills, right? They're actively navigating identity, confidence, and relationship in real time. So this space though embedded into the educational system um becomes more than academic it becomes relational and again the structure here is intentional. Research shows that mentorship works best with enough structure to create consistency and enough flexibility to preserve authenticity. Without structure connection can fade. Um but without flexibility it can become performative. So the hope here is uh sort of a rhythm without rigidity um connection without control and sort of depth without a pressure. Um what's being developed here isn't just practice, it's identity. Student midwives are learning how to stay in relationship without having all the answers. how to ask for help without feeling shame and how to support without taking over. Those shifts have real impact because they shape academic success and how students begin to see themselves as midwives. They support students in navigating the dual demands of academic and clinical learning, not by reducing the challenge, but by changing how that challenge is experienced. They build confidence, deepen belonging, and support resilience and persistence over time. Um, they also reduce isolation, which is part of what allows students to stay engaged and continue forward. That over time strengthens peer networks and can contribute the bigger picture to a more sustainable workforce. Um, this isn't peripheral learning. It's what makes sustained learning possible in demanding environments like midwiffrey. If we look at the midwiffrey model of care, we're not only talking about clinical practice. We're talking about relational practice, monitoring well-being, providing individualized support, minimizing unnecessary intervention, and knowing when additional support is needed. These are the tenants of the midwives model of care. These aren't just clinical principles. They are relational ones. And what and that means they don't stop at our clients. They extend into how we learn, how we teach, and how we support one another in the profession. And if we're serious about midwiffery for all, that has to include belonging within the profession, not just access to it. What this work is really pointing toward is not just a program but a cultural shift in how we understand mentorship itself within midwiffrey education from something that's passive or informal to something intentionally designed around support reciprocity and and and um relational continuity. When midwives are supported in relationship, that support carries forward, expanding access to quality midwifery care. This project is ongoing. It continues to evolve through student feedback and qualitative insight. But even right now at its early stages, one thing is is so clear. When peer mentorship is intentionally structured, not just left to chance, it can change how midwiffrey students experience their education and move into the profession. Students are more willing to reach out, more willing to reflect, and more able to stay engaged through challenges academically, clinically, and relation relationally. learning becomes less like a a solitary test. You're out on an island all by yourself and actually more like a shared process. What can emerge from that is something deeper than support. It's belonging. A sense that you don't have to become or be a midwife alone. Um, before I close though, I and I'm getting close, but this program isn't just designed based on theory or research alone, right? It is it's actually being shaped directly by student voices. Their qualitative input from surveys, focus groups, ongoing reflection from student midwives. It it's not what initially created this program, but it is what's now guiding its refinement. Um, it's actively shaping how the structure evolves moving forward. The student voices are informing concrete design decisions from how participants are matched or paired um to how communication is supported, how boundaries and expectations are clarified. And it's also shaping the ethical safeguards built into the program, supporting that emotional safety, protecting student agency, and preventing mentorship become from becoming just another space of pressure or performance. The intention um is to create a mentorship frame that's not only relational but also reciprocal, grounded, and actually feasible within an academic setting. This 15week program um is intended to be more than a single implementation at a single institution. Um, and while it's still evolving, my hope is that it offers an emerging model that can be adapted to other midwifrey education settings using student informed design to strengthen peer mentorship and support more sustainable relational learning cultures across diverse contexts. Um, last month when the Artemis 2 moon mission was unfolding, I became totally obsessed with it. It was it was literally all I wanted to see if I went online. And it brought me so much hope. And if I'm honest, it wasn't because of the incredible exploration pieces. Um, again, all of the milestones, all of the firsts, but because in a time here on Earth when there is so much complexity, so much hurt, separation, and strain in the world, there was something really grounding about hearing astronauts who zoomed way out talk so plainly about human connection and shared purpose. In the beginning of this um seminar, I shared something again Canadian astronaut Jeremy Hansen said after returning from space. He said, "Our purpose as humans is to find the joy in lifting each other up." And that sense of connection was echoed in what his crewmate, US astronaut Christina Cook, described after returning from space when she named their crew as a whole, as being inescapably, beautifully, dutifully linked, and then extended that outward saying, "Planet Earth, you are a crew." Connection isn't optional. It's not optional. It's fundamental. Survival and well-being are not individual. They're collective. We rely on one another. We are shaped by one another. And and we really we can't move through complex human experiences or processes in a sustainable way alone. We need each other. And that is what true midwiffery already understands. We're not built for isolation. We're built for relationship. So I want I want to leave you with a few thoughts. What if we don't just rise by lifting others, but we carry as we climb? What if belonging isn't something we're brought or not not that it isn't? What if belonging is something we are brought into through relationship? What if peer mentorship is not random or happen stance um in in mid in midwifree education if you're lucky you know making some connections but what if it's part of its core structure because ultimately this is not only about how we teach midwives it is about how we sustain them and how we sustain one another. The future of midwiffery doesn't depend on repeating cycles of hardship. It depends on how intentionally we build each other up. And peer mentorship is one of the ways we can actually do that right inside the everyday fabric of how we learn and train and move into and through this profession. And ultimately that is what midwiffery for all requires. not only access to care but access to belonging, support, sustainable entry into the profession and sustainability within it over time. Thank you for having me. Thank you so much Sarah for this you know great presentation talking about pure mentorship an important concept in midwiffrey. Um yeah there are lots of comments and um thoughts any questions anybody would like to ask? Yes. Misy. Yeah. >> Yes. I I I have uh I have a question well about mentorship. So how we can for example if if if if I like midary students for example I'm doing my training in some place in a hospital in center in rural place in in a far place so how can this condition in this environment in this training place can affect the mentorship quality? Yeah, that's a great question. How >> because because here in Morocco we have this this struggling we have a lot of this struggling. So like me like professional and also uh we doing some training for the this midwife midwife students how can I protection them and can um like increase this quality and a good thing not bad thing. >> Yeah I think that is a great question. What we've seen so far is the students in the school where we did the where we did the sort of pilot program, nobody lived near each other. Everybody was in a different location and so it was all virtual connection and it was ultimately um again they them choosing to come and be a part of something knowing that they're at different places doing different things but on the same line. Um, so far what I seen and I'm still going to be going through all the data is that having the structure of different topics to connect ended up providing a platform for the participants to connect and just by connecting in that way even when their experience or environments were totally different, it it created a connection of support and increased the belonging within the profession and just that sort of a buoy almost even though they far apart. >> Thank you so much. Thank you. >> Mhm.