A calling born from loss

Scroll through the Remember Her Project website, and you’ll see a lot of faces.

They’re young mothers, daughters, and loved ones. As you click on each one, you’ll read the story of a full life lived—and the date each woman died, too early, either in pregnancy, during childbirth, or soon after. They came from different places and cultures, their lives varied wildly, but they shared one somber attribute: their deaths should have been prevented by modern medicine.

For Rebecca Smith GS’16, Ph.D., two of those faces are impossible to forget. There’s Whitney, a fellow nurse-midwife and friend who died just hours after giving birth in 2018; and *Emily, a patient Smith lost years later (*name has been changed to respect patient privacy). For Smith, their stories transformed maternal mortality from an abstract public health issue into a deeply personal calling.

Today, that calling shapes every part of Smith’s work—from caring for patients and leading research in women’s health at Mayo Clinic to teaching future nurse-midwives at Bethel. Whether she’s investigating better ways to predict pregnancy complications, walking alongside women through miscarriage, or preparing the next generation of clinicians, she’s driven by one conviction: women deserve to be seen, cared for, and remembered with the same fervor as the babies they bring into the world. 

Finding her way to Bethel

Smith was an intensive care nurse who actually dropped out of her first nurse-midwifery program. As she dealt with fertility issues in her own life, including four miscarriages, she realized she felt a deep-seated resentment toward women for whom pregnancy seemed easy. She kept feeling drawn to graduate school, so she tried a family nurse practitioner master’s program, but it never felt right. She felt an inexplicable draw toward women’s health.

“At my postpartum visit after I had my son, I asked my midwife, ‘Do you think maybe I could be a midwife?’” Smith remembers. “She looked at me and said, ‘You’d be an amazing midwife.’”

Newborn in tow, she heard about an online nurse-midwifery program launching at Bethel. She loved the idea of integrating her faith more closely with her work, and she knew from experience that Bethel had an outstanding reputation in the nursing field. 

"A new grad from Bethel was worth two years of experience,” she says of the hiring she did for her ICU team at Mayo Clinic at the time. “Bethel nurses are impressive.”

Smith’s mom volunteered to watch her young son, and she enrolled. During the application process, she realized she was one of the few applicants with a nursing background outside obstetrics. When asked why she’d make a good midwife, she answered, straight-faced, that nursing in an ICU had made her “bomb-proof” and pretty much not scared of anything. And as a mom of an infant, she could function on very little sleep. All joking aside, though her resume wasn’t the norm, she brought lots of practical experience, innate curiosity, and grit to the program. And she clicked immediately with the faculty and her student peers.

As Smith continued to heal from her fertility journey, she gained clarity about what came next. “Bethel felt like home from the very beginning,” she says. “I just knew, ‘Oh yeah, this is what I’m supposed to do.’” 

Smith came to see her journey toward motherhood—and the many roles she carried at home—as invaluable preparation for caring for women. Motherhood didn't simply change her life. It clarified her calling and deepened her sense of purpose and compassion. 

Developing her niche

Soon after Smith completed her master’s in nurse-midwifery at Bethel, she continued on to a doctor of philosophy (Ph.D.) program in nursing. She’s quick to explain the difference between a Ph.D. and a Doctor of Nursing Practice (DNP), the more common terminal degree within the profession. 

“If someone comes across medical literature and says, ‘Oh my gosh, I can’t wait to change how we practice because of this,’ that's DNP,” Smith says. “If somebody says, ‘Oh my gosh, there is no literature. I need to fix that.’ That’s a Ph.D. There’s a little segment of us who are constantly noticing when there isn’t the research for something, then asking why there isn’t the research. And then deciding we’re going to do the research.”

Smith focused her own dissertation on the relationship between social determinants of health and severe maternal morbidity. In other words, how is a woman’s likelihood of dying in pregnancy or childbirth impacted by her location, her wealth, her age, race, or whether she’s experiencing domestic violence? 

Smith has always noticed alarming disparities, both in how women were served differently depending on their demographics and circumstances—but also in the amount of data itself. Women’s health research receives far less funding than men’s, and some sub-groups of women are far less likely to be studied. That leads to subpar care.

Today, Smith is a certified nurse-midwife at Mayo Clinic in Rochester, Minnesota. She leads Mayo’s Early Pregnancy Care Clinic, where her team cares for women experiencing bleeding, miscarriages, and ectopic and other nonviable pregnancies. She and her team—most of whom are women who’ve also experienced pregnancy loss—provide excellent medical care and a compassionate presence when it’s needed most. 

“We can truly say, ‘I’ve done this. You’re not alone. We’re going to be with you through this whole thing.’” Smith says.

It’s been successful, and Smith and her colleagues even published an article in the Journal of Midwifery and Women’s Health about their observations. They’ve outlined how other medical systems can create similar environments for women in early pregnancy. 

Smith continues to research trends surrounding pregnancy and childbirth. Recently, she’s covered everything from molar pregnancies to perineal lacerations—and how social and relational factors impact the likelihood of those outcomes. 

“It’s all about risk prediction, creating an atmosphere where women and their providers can make informed decisions based on the most likely outcomes for their situations,” Smith says. Once risk factors are identified, she hopes more providers have clear best-care practices to follow, for the good of the women they serve. 

Responding to the climate

Women’s care today isn’t just underfunded and underemphasized. It is also increasingly complex, as healthcare laws and policies vary across the country. In some regions, those differences can affect how providers respond to complicated pregnancies, pregnancy loss, and situations in which a mother’s health is at risk.

For Smith, it is another reminder of why women’s healthcare must be grounded in strong evidence, compassionate care, and a clear understanding of each patient’s circumstances. "Women are getting reduced to statistics,” Smith says.

The climate is part of the reason Smith returned to Bethel as an adjunct instructor in the nurse-midwifery program in 2021. She isn’t just serving her own patients or improving care on her own through research. She’s multiplying her impact by building up future nurse-midwives. 

She teaches Reproductive Physiology, something she calls a drinking-from-a-firehose-type class that helps students determine whether they really want to be nurse-midwives. And in Evidence Translation for Practice, her students learn to analyze literature and address advanced practice nursing questions through research and evidence-based decision making. Smith inspires even the most reluctant researchers to grapple with the facts and use evidence and data to support their approach to practice. 

Just as she had faculty praying for her and challenging her to be her best as a Bethel nurse-midwifery student, she’s doing the same for today’s students.

"Teaching at Bethel is a balm for my soul. Coming into this warmth and care from the faculty—knowing that they’re praying for you and the students—it’s such a different environment from the harshness of the OB world right now,” Smith says. "Bethel is making an impact in women's health by producing exceptionally excellent nurse-midwives who never back down from what they know is right. And I’m glad to be a part of it.” 

Become a Bethel nurse-midwife

At Bethel, you'll learn from practicing experts—clinicians, researchers, and educators who are advancing women's healthcare while preparing students to do the same. Through rigorous academics, hands-on clinical experiences, and Christ-centered mentorship, Bethel's nurse-midwifery program equips graduates to provide compassionate, evidence-based care for women and families at every stage of life.

Explore Bethel’s nurse-midwifery program