What kind of midwife?

I'm really struggling to figure out my next step after I finish school this spring. Obviously, I want a job, I want benefits, I want a PAYCHECK! But there are some options to what kind of job, and that comes attached to what kind of benefits & paycheck. Here are two options:

1. Out of hospital birth, aka OOH. This involves working with women very intimately during their pregnancy, being with them for hours and hours during the birth, and then caring for them postpartum. The clinic where you see them for visits is homey, comfortable, and no stirrips are present for any type of exam, whether it be for a pap smear or a cervical check. Prenatal and postpartum visits, alike, last 60 minutes. It is incredibly time consuming and wonderfully fulfilling. You create relationships that can last through several more babies, and sometimes even turn into friendships. When you sleep at night (when you can), you feel great about the work you do. On call 10 days per month, where you can be at home if no-one is laboring, or at a labor for hours and hours until that baby is born and mom & baby are safely out of the scary transition period after birth. And the pay is about $60K. Some benefits included. (Sounds great, right? I never made that much as a teacher!!!)

Or

2. Hospital birth. This involves working in a practice with a group, usually between 5-7 other providers. You see patients in typical clinic rooms for their prenatal visits, and depending on your schedule, their schedule, and other factors, you may or may not see the same patients over and over. Their visits are 20 minutes long. You may be on call at the hospital when they arrive in labor, or you may take over their care when your shift begins. Your shift is 24 hours long, not longer, not shorter. You leave when your patient is undelivered, possibly leaving her with a provider with different values about care, even though you are in the same group, and that doc is really a very nice person. And leaving a laboring woman can wreck havoc on her labor, causing a stress response, which can slow down labor, or cause it to even stop sometimes. (Of course, sometimes there is no change at all, but you never know!). Relationships with patients are good, the job is fulfilling, but the intensity and lifelong relationship just isn't there. With this job, there are 5 days on call for 24 hours each per month. 4 weeks of vacation, benefits, and $90K.

Yikes! More sleep and $30K more money!!! What's the decision, right?

Well, as you know, if you know me, I'm a smart cookie who spent her first "life" being a teacher. Enjoying work every day (or at least most of them). But NOT making a lot of money. I could have quit teaching and made tons more money. But I chose to be a role model for children instead. Middle school ones. I must be crazy, right? So I guess I'm a sucker for punishment. I like feeling great about my job, instead of just having lots of money.

But, you say, you'll have 40-50K of debt when you finish school. Don't you want to pay that off?

Great thought. Yes, I do. As soon as humanly possible. So again, it seems like a no-brainer.

And still I struggle with the decision. What kind of care do I want to provide to women?? Where will I make the most difference?? Where will I feel more fulfilled?? Where will I be able to balance my life and my work most effectively??

I guess I have some time to figure it out. Until then, I guess I won't close any doors . . .