2021 Folklife Apprenticeship Feature: Angelita Nixon and Christine Weirick, Home Birth Midwifery

The West Virginia Folklife Apprenticeship Program offers up to a $3,000 stipend to West Virginia master traditional artists or tradition bearers working with qualified apprentices on a year-long in-depth apprenticeship in their cultural expression or traditional art form. These apprenticeships aim to facilitate the transmission of techniques and artistry of the forms, as well as their histories and traditions.

Christine Weirick and Angy Nixon

Angelita Nixon of Scott Depot in Putnam County is leading an apprenticeship in home birth midwifery with Christine Weirick of Fayetteville. Nixon has been a Certified Nurse-Midwife since 2003 and has been a part of over 400 deliveries and taught multiple students the trade. Weirick is a doula and an apprentice student midwife working towards her certification. Through their apprenticeship, Nixon and Weirick are excited to explore the creative expression and storytelling aspects of community-based midwifery.

Christine preforming her first newborn exam under the guidance of Angy. She is listening to baby’s reparations and heart beat while mom is resting close by and comforting her baby with touch. This is a familiar scene from every homebirth.

Angy Nixon – Mentor Certified Nurse-Midwife

Bio:

Raised in the small city of Wabash in north-central Indiana (born in nearby Marion on October 25, 1967), I was the eldest of three daughters with a broad curiosity for the natural world—animals, plants, minerals, fire, water, and air.  I always knew I wanted to be some kind of healer (perhaps a veterinarian).  My upbringing included an appreciation for physical and intellectual hard work, with the heritage of a family-owned berry farm on my mother’s side and a family business in newspaper publishing on my father’s side.   
 
In my teens I developed a love of travel and a fascination with foreign cultures, so in my 20s I took a Scandinavian urban studies term in Norway during my junior year abroad through Macalester College in St. Paul, Minnesota.  While in Minnesota I was inspired by the confluence of preventive health, patient education, counseling, crisis intervention, activism, self-care, and medicine, which I observed during my internship at a local family planning clinic that was bombed in the 1970s for providing abortion care; it was on the same street where I lived just a few blocks down from my apartment.   
 
Upon finishing my undergraduate degree in psychology with a pre-med concentration, I seriously envisioned myself pursuing a career in women’s health. The only career pathway I knew was medicine, but finally it came to me: the discovery that midwifery was a modern-day health science profession—one which fit my passions, skills and ambitions perfectly. I found my calling, and spent four more years in graduate school at CWRU in Cleveland, OH, earning my master’s degree in nursing in 1998 and becoming a certified nurse-midwife (CNM).   
 
I moved to West Virginia in 1999 and spent my first five years in full-scope practice while attending most births (90%) in one of two hospitals, and about 10% at a freestanding birth center. In 2003 I started my own full-scope midwifery practice and began attending home births so that I could work with a smaller number of clients. I now live in Scott Depot, West Virginia, in a red cedar A-frame at the end of Scenic Drive. 

Christine using a doppler to check fetal heart tones before, during and after a contraction. She is learning how to listen and assess fetal wellbeing during labor.

Description of Art Form/Tradition:

My midwifery education took place in a heavily medicalized setting, which I enjoyed for the most part. We had over a dozen students in my midwifery class, about half of whom were experienced labor and delivery nurses (from the nursing tradition), and the other half were sometimes referred to as the “crunchy” group—we held more to the midwifery traditions. The term certified nurse-midwife (CNM) itself is hyphenated because it is a combination of two distinct and separate professions (nursing and midwifery), in both of which CNMs are trained.   

The CNM credential originated in 1925 and the first training programs were located in Appalachia. Today we have an analogous credential, the Certified Midwife (CM), not requiring prerequisites in nursing. Other midwifery credentials such as the Certified Professional Midwife (CPM) have emerged, with a narrower scope compared to CNM/CMs.  However, the essence of midwifery has existed practically throughout the entirety of human history, around the globe, and even across animal species (dolphins, whales, primates, bats, and domestic dogs and cats are often accompanied by and use midwifery behaviors during birth). Many professions have been invented and become regulated in the US, say over the last 100-200 years, and the scientific basis of each continues to improve. All professions undergo these continuous quality improvements over time, and I can only imagine that quality improvements began from the very start of midwifery way back in the times of the ancients, and will continue on forever. 

Find more details here.

Artist Statement:

The majority of the science of midwifery was taught to me in school, the purpose of which is to prepare newly credentialed CNM/CMs (or CPMs) for entry-level full-scope practice. I had an awareness of the art of midwifery, but to reach a sense of mastery took me about three solid years (sometimes in 80-hour work weeks), and by five years I felt confident enough to begin practicing independently.   
 
There are a lot of aspects of midwifery that to me represent the art of midwifery, and this side of it sometimes even appears to be on somewhat of a spiritual plane. This is where the relationship matters, where the learning edge and curiosity remain fresh, where knowledge turns to wisdom that can be passed along, where the work moves from effort to second-nature, where we learn to trust our intuition, where our ultimate accountability is with the families in our care, and where accountability to our colleagues is more like a code of honor. In this context our duty is very personal, to serve the client rather than an employer or some system or hierarchy.   
 
In midwifery the art and the science are almost inseparable.  Both the art and the science are accessible to clients, usually through a combination of modeling, teaching basic preventive health and wellness concepts, and storytelling.  
 
Exploring the world in my travels and studies abroad prepared me well for coming to Appalachia to accept my first midwifery position with a group of seasoned CNMs and an obstetrician-gynecologist in 1999. I came to West Virginia to grow roots, and I look forward to working with families over multiple generations. Over the 20+ years since, I have built strong collaborative networks in the communities around me, on a foundation of quality and service. I know I thrive best under conditions of deep connection with people and places. This apprenticeship helps ensure that the knowledge and skills, the art and the science, remain under continuous quality improvement, and carry forward with the next generation of future midwives. 
 
Find more details on Core Competencies here.

Students Staysha Quintrell and Christine Weirick practicing and becoming recertified in neonatal resuscitation. These practice days ensure their confident and calm while moving through the steps of providing a baby with breaths.

Christine Weirick – Apprentice

Bio:

Christine Weirick was born in Charleston, West Virginia, May 23, 1990. She lives just outside of Fayetteville, West Virginia, serving people as they navigate pregnancy, birth and the postpartum time. She has been attending home births as a student midwife under Angy Nixon’s guidance. As a birth worker in her community Christine supports families emotionally, physically and educationally.

This work has felt like a calling to Christine. Her interest in birth and babies started very young and the passion for supporting families only grew with time. In 2015, after having her own midwife-led home birth, Christine felt inspired to begin her education as a doula or birth coach. Since then she has attended many more trainings and lectures, building on her knowledge and understanding surrounding birth and reproductive justice. In 2018 Christine began apprenticing under Angy Nixon, a home birth midwife based out of Scott Depot, West Virginia. This apprenticeship allowed Christine to marry the art of supporting birthing people with the science of midwifery.

During 2019 Christine began the Portfolio Evaluation Process (PEP) to become a Certified Professional Midwife through the North American Registry of Midwives. Recently she entered the second of four phases of the PEP, entitled “Assistant Under Supervision.” Now Christine is learning how to assess fetal heart tones, sterilize equipment, preform newborn exams and check vital signs for both birther and baby, amongst other skills.

Christine using a doppler to listen to fetal heart tones while parents labor in the tub. She says, “There is an art to assessing fetal wellbeing without disturbing the birthing person and mood in the room. It takes practice placing the doppler probe in the right place on the belly without being able to see where I’m reaching. I don’t like to take too long searching for heart tone as that can be distressing. The more births I attend the more natural this skill has become for me. When I take heart tones I’m listening and assessing the baby as well as sharing this info with the team and family. Knowing how baby is managing during labor helps keep everyone at peace with the process.”

Description of Art Form/Tradition:

During this apprenticeship Christine is learning the art and science of midwifery. Under the watchful eye of her preceptor, Angy Nixon, she is taking the time to increase her skill level, attend births in this region of West Virginia, and learn to care for birthing families both prenatally and during the postpartum time. Like many women before her, Christine felt drawn to a more deep understanding of birth after bringing her own children into the world.

Midwifery has a long global history. From the very beginning women have been helping each other give birth. For most of human existence it has been the midwife, not the physician, who has attended births. In modern-day Norway, the Netherlands, Denmark, Germany, and Sweden midwives attend 70% of births. Midwife-led care is still the norm in these six countries which also lead the world with the lowest maternal and infant mother/baby mortality rates. In comparison, in the United States midwives attend only 5-12% of births, mostly due to low numbers of midwives, accompanied by political and regulatory constraints. With such low utilization of midwives, the U.S. ranks alarmingly high in loss of life for both baby (30th internationally) and birther (42nd internationally).  

 Not so long ago there were midwives in every community through the United States, and hundreds throughout the state of West Virginia. Records indicate that at its peak, there were 558 midwives registered in the state; today there are fewer than 70. Historically, West Virginia midwives primarily learned how to serve families by learning from someone more experienced and giving birth themselves. Today, there are several routes to midwifery education, one of which preserves the mentor/apprentice model of learning; it’s called the Portfolio Evaluation Process (PEP) and it is administered by the North American Registry of Midwives. When Christine completes this process (which usually takes 2-5 years from start to finish) she will become a Certified Professional Midwife.

Christine taking vitals on a newborn less than an hour old.

Artist Statement:

As a young adult I was first introduced to the Midwifery Model of Care when my mother found a midwife to provide me well woman care. She had gone about this by asking her friends and coworkers who they would recommend. Repeatedly a particular midwife in Charleston, West Virginia was suggested and that’s who I saw. The care I received was personalized and tender. I am grateful for my mother who turned to her community for guidance.

Before becoming pregnant with my first baby I started absorbing stories from other families in my community. The stories that were filled with respect, attentive care and autonomy came from women who chose to give birth at home, with midwives. When the time came I chose that, too. Both of my birth experiences were deeply transformative and I have the stories I heard from other women to thank for that. This is the power of stories in our community.

With this apprenticeship project I will be exploring the influence that storytelling has on birth in West Virginia through video. I have interviewed families and midwives and as I sat with this project, I began to see storytelling in many aspect of midwifery: From mother to mother, the sharing of birth stories and breastfeeding advice. From midwife to family, the teaching of how to nourish their growing bodies and how to trust their intuition. From midwife to student or midwife to midwife, the passing along of knowledge and wisdom that comes with years of witnessing birth. From student to student, sharing stories and information further solidifying our education as we find words for what we are learning.

Storytelling is a vital part of the education I am receiving and with the support of the West Virginia Folklife Apprenticeship Program I will be creating short film capturing the power of storytelling in midwifery.

Note: Any views, findings, conclusions or recommendations of the collected submissions do not necessarily represent those of the West Virginia Folklife Program/West Virginia Humanities Council. All photo subjects pictured have given permission for their photo to be posted in this context.

The apprenticeship program grants are administered by the West Virginia Folklife Program at the West Virginia Humanities Council in Charleston and are supported in part by an Art Works grant from the National Endowment for the Arts. West Virginia Folklife is dedicated to the documentation, preservation, presentation, and support of West Virginia’s vibrant cultural heritage and living traditions.