How do I handle leading a midwife practice instead of delivering babies?

You went into this to catch babies and hold families through the biggest moments of their lives. Now you run a practice, and the politics and paperwork crowd out the births. The thing that called you feels like it is happening around you instead of through you. The practice you keep running is what lets those births happen at all. Every schedule you fight for, every conflict you smooth, protects the space where families are held. You are still in the room, in a sense, just standing further back and keeping the walls up. That is love too, even when it does not feel like it. But do not let the calling starve. Keep a caseload, even a small one. Stay on call for some of the births. The politics will always ask for more of you; the babies will not wait. Guard the hands-on work on purpose, because it is the reason all the rest exists.