'mothering the mother'
In Hart County, Kentucky, midwife Amanda Poteet-Woolen works around the clock to deliver babies into the world. In her work, she finds herself acting as a mother not only to her three daughters but to the women in her care.
part one
On Call, In Motion
"When I had my first baby, I left the hospital being like, 'Good God, what were we missing?' And we were missing a doula. We were missing an advocate."
Midwife Amanda Poteet-Woolen prepares her equipment to listen to the heartbeat of client Saloma's yet-unborn daughter as Saloma's young son, Kyle, watches on curiously. Saloma is affiliated with the New Order Amish in Hart County, Kentucky. Amish clients--from those like Saloma to members of the Swartzentruber Amish, the United States' most conservative subgroup of Amish--often prefer home birth over hospital births, and thus make up about half of Amanda's work base. Amanda spends multiple hours driving most days to visit these clients in their homes.
Each morning, Amanda Poteet-Woolen wakes up at 4:00 to review the countless notes and papers in her files, send her kids and husband (a teacher) off to school, and prepare for the day at hand. Ahead of her, she'll have an hour's commute to Munfordville, the seat of Hart County, to the northeast of Bowling Green. Each day is different--she may open by serving an English client with a blood draw at ten, then check an Amish client's baby's heartbeat at twelve. The evening might entail an hour's round trip for a tongue tie. All told, she's often up early and home late.
"Life as a midwife can get really crazy," she says, "and when you get those rare off moments, you just want to use it to take a breath."
Her work, though, is nothing short of critical. The March of Dimes grades Kentucky a D-minus state in prenatal care (only recently having escaped the F tier held primarily by southern rural states), with 14.2% of mothers receiving inadequate prenatal care in 2021. Southcentral Kentucky, where Amanda works, fairs particularly poorly in maternity care access. Hart County, along with half of Kentucky's other counties, is considered a maternity care desert, defined by zero providers or hospitals in the county offering obstetric care.
"Life as a midwife can get really crazy," she says, "and when you get those rare off moments, you just want to use it to take a breath."
Her work, though, is nothing short of critical. The March of Dimes grades Kentucky a D-minus state in prenatal care (only recently having escaped the F tier held primarily by southern rural states), with 14.2% of mothers receiving inadequate prenatal care in 2021. Southcentral Kentucky, where Amanda works, fairs particularly poorly in maternity care access. Hart County, along with half of Kentucky's other counties, is considered a maternity care desert, defined by zero providers or hospitals in the county offering obstetric care.
Maternal care deserts in Kentucky, according to the March of Dimes, 2024.
Some of the populations that Amanda serves fall into the category of those unaccounted for in statistics about birth. For the Swartzentruber subgroup of Amish in Hart County, for example, one of the most technologically conservative Amish subgroups in the United States, natural remedies tend to be preferred over medicine. Amanda is likely the only medical provider that they will see in their lifetime--and that places the burden of a great deal of care in her hands.
Amanda fields a call from an Amish client about an injured leg. Because some Amish subgroups do not frequently see doctors, Amanda is sometimes the first or even the sole medical professional they will come to for advice. As such, she often serves the role of directing medical concerns to home remedies or other professionals who can better help. "I try to be supportive in a way that's in my scope of practice and gets them resources," she says. She recalls a statement from a Bowling Green-area midwife that trained her, saying “When you see Amish clients, you have to look closely at all of them—the whole family, not just the woman.”
"It'd have been easy to stay in Bowling Green, but we don't need midwives in Bowling Green. We don't have any midwives in Hart County or Hardyville or E-Town. We don't have any midwives to fill the gaps."
Jackie Wilde gazes at her one-day-old daughter Phoenix as Amanda returns a day after Wilde's home birth for a 24-hour visit. "(The birth) was so easy this time. Everything was perfect," Wilde said.
Amanda makes sets of footprints from Jackie Wilde's newborn daughter, Phoenix. "This will be one of the first sets on my office wall!" she exclaims.
Amanda examines one-day-old Phoenix Wilde near a window in the Wilde family bedroom.
part two
"Welcome Earthside..."
"A birth will humble you so quickly. So, so quickly will it take you to your knees."
Infant medical dolls are seen next to Saloma's husband's hat and bags on the night of their child's birth.
Amanda checks Saloma's baby's heartbeat while Saloma waits for a birthing pool to be filled with water.
"Even in the hospital, the goal is to have a healthy, happy baby and a healthy, happy mom. But I think that sometimes we forget that there's room for a healthy, happy experience, too."
Just past midnight on April 9, 2025, Amanda finds herself wrapping up what has become a 12+-hour day in her office. She's been getting ready for this day periodically over the last several weeks. Saloma, a new-order Amish client who she's come to know well, called her in the morning to report that the child she's been expecting could arrive that night. The building is quiet; Amanda watches over Saloma and her husband while her assistant, Hannah, reads a book on the floor.
"Midwifery care is, you know, very different than the hospital model of care," Amanda explains. "Midwifery care, especially community midwifery, is far more personal. It's a space where we go into people's homes. We see them in their hidey holes; we see them in their natural space."
Though birth work was a lifelong interest for Amanda, her own experience with her first birth in the hospital is, she says, part of what led her to start working toward establishing a midwifery practice. While she agrees that hospitals can be supportive environments in childbirth, her own first birth was filled with experiences that she specifically sought to avoid--pitocin, an epidural, and students working with complex aspects of the birth.
"After that experience, I didn't ever want to do birth again," she recounts.
"Even in the hospital, the goal is to have a healthy, happy baby and a healthy, happy mom. But I think that sometimes we forget that there's room for a healthy, happy experience, too."
Midwifery care has been slowly growing in popularity as an alternative to hospital birth. Despite the need for midwives, however, since the state of Kentucky established the Certified Professional Midwife license in 2020, only 30 or so midwives in the commonwealth have achieved licensure. Finding qualified midwives remains an obstacle for many throughout the state.
"Midwifery care is, you know, very different than the hospital model of care," Amanda explains. "Midwifery care, especially community midwifery, is far more personal. It's a space where we go into people's homes. We see them in their hidey holes; we see them in their natural space."
Though birth work was a lifelong interest for Amanda, her own experience with her first birth in the hospital is, she says, part of what led her to start working toward establishing a midwifery practice. While she agrees that hospitals can be supportive environments in childbirth, her own first birth was filled with experiences that she specifically sought to avoid--pitocin, an epidural, and students working with complex aspects of the birth.
"After that experience, I didn't ever want to do birth again," she recounts.
"Even in the hospital, the goal is to have a healthy, happy baby and a healthy, happy mom. But I think that sometimes we forget that there's room for a healthy, happy experience, too."
Midwifery care has been slowly growing in popularity as an alternative to hospital birth. Despite the need for midwives, however, since the state of Kentucky established the Certified Professional Midwife license in 2020, only 30 or so midwives in the commonwealth have achieved licensure. Finding qualified midwives remains an obstacle for many throughout the state.
Saloma covers with a blanket and breathes through contractions as Amanda and assistant Hannah prepare a birthing pool.
Amanda waits outside of the room in her office where Saloma is in labor, listening to the sounds of running water and breathing. Amanda takes care to ensure that, unlike hospital births, births in her office (and at her clients' homes) can be as long or slow, or loud or quiet, as her clients experience naturally. In the period of labor before the birth, the hours are marked by reading, quiet observation, and checking of Saloma's child's heartbeat.
"The day that this does get old, I'm probably done. Because this is something that should drag the emotion out of you every time."
"Thank you, Jesus," says Saloma as she brings her newborn child, Ida Mae, up out of the birthing pool's water and to her chest. Ida Mae was born at 1:12 a.m. on April 9, 2025 after three hours of labor--a much shorter time period than Saloma's previous birth, which clocked in at twelve hours.
Amanda pulls a hat onto the head of Saloma's newborn daughter Ida Mae during a newborn examination in the early morning hours of April 9, 2025. Ida Mae was born with a boneless sixth finger, an approximately one-in-one-thousand-cases abnormality that is typically removed by doctors.
Amanda and Hannah check Ida Mae's pulse as a tired but happy Saloma rests watching her baby.
part three
Attached at the Hip
"I kind of figured out what it means to be a mom with (Layla). I've healed so much of me through that attachment with my children."
Amanda and eldest daughter Layla share a moment after a long day of appointments that ended in making placenta chocolates for a client together.
Amanda's passion for birth work comes from deep roots. Amanda's parents were young teenagers when her mother gave birth to her; both were 14 at the time. That fact wasn't unusual for Hart County. The region has historically dealt with high rates of teenage pregnancies, with nearly 5% of teenage girls aged 15-19 becoming pregnant from 2015-2017. That number has since fallen dramatically in just the last several years alone, leveling out with the state average rate, which itself has been falling steadily. Still, education on pregnancy and family planning can leave much to be desired in some parts of the county. Part of Amanda's goals, she says, is to educate people in her home county on these matters--and to heal herself and her own family history in the process.
"Generational trauma and pain, that stuff slides right downhill," she said. "And there's no telling how long it had been sliding downhill in my family until it hit me."
"Over these years I have just learned and loved a little deeper with every person that I've served, because just like I see my daughters in some of these women, I also see my mom."
"Generational trauma and pain, that stuff slides right downhill," she said. "And there's no telling how long it had been sliding downhill in my family until it hit me."
"Over these years I have just learned and loved a little deeper with every person that I've served, because just like I see my daughters in some of these women, I also see my mom."
Amanda prepares 7-year-old Valery and 10-year-old Vivian to leave the house after making crocheted bracelets together.
Vivian and Valery practice resuscitation on infant medical models as Amanda instructs them on the proper methods of giving CPR to infants.
Amanda and her children laugh together as they play with a toy stethoscope.
Amanda holds two dolls--one made for her by an Amish client and another purchased from an English-run store--as she crochets friendship bracelets for her children.
Vivian embraces Amanda before leaving for her grandparents' house on the golf cart she and her siblings arrived in.
"It's a little bit (exhausting), but it's a labor of love. I wake up giddy to come to work. This is a calling far more than it is a job."