Developing confidence to practice midwifery according to its underlying philosophy and hallmarks is an important aspect of midwifery education. Midwifery students at Georgetown University gather for labor and birth skills simulations prior to beginning their first labor and birth clinical rotation. Students are asked about their hopes and fears for their learning. Common themes and unique emotions are expressed; these inform faculty development of learning activities. Students then have authentic experiences providing midwifery care under the supervision of their clinical preceptor over the 15 week term. How does the lived experience of learning to practice midwifery influence the hopes, fears, and confidence of beginning midwifery students? This is of interest given the differences between midwifery culture and mainstream medical culture in the United States. Georgetown midwifery students will share reflections on their initial experiences providing labor and birth care to women and how this shapes their learning goals going forward.