Nathan Zahra Piscopo has made Malta's history by becoming the first man in Malta to graduate in the midwifery course, also becoming the country's first male midwife, in a field traditionally dominated by women.

He describes himself, however, as just one of the many midwives supporting women through pregnancy, birth and postpartum; he just happens to be a man.

When Zahra Piscopo quietly applied to the University of Malta's midwifery course four years ago, he told almost no one, except a few friends.

He said that he is the eldest from all siblings and cousins in his family, and was quite exposed to the journey of pregnancy and midwives being in the scene.

"I always wanted to pursue a profession which was related to healthcare and pregnancy and I used to be in awe of pregnancy, so I always wanted something along those lines," Zahra Piscopo said.

As he looked more into midwifery, Zahra Piscopo realised that he prefers it over an obstetrician or a doctor, for example.

"I felt that the relationship you can build with couples and women is much closer. You become a part of their lives, they will remember you forever. It becomes like a partnership more than a client and someone who is giving a service," he said.

He said he did not tell his family, as the course is only limited to 14 students, which has now increased to 18.

"I thought I would not tell anyone until I knew I got into the course, to save myself from the embarrassment," Zahra Piscopo said in comments to The Malta Independent on Sunday.

When the results came out and he placed second on the entry list, everything changed.

"My mum was the one who took it the best," Zahra Piscopo recalled.

"She told me she knew how caring I am, especially with my siblings. She had just had a baby a few months before, and she saw how much I was already preparing myself to get into it," he said.

Reactions from family and friends were overwhelmingly supportive as well, he said.

"They were not shocked, more surprised. My friends were ecstatic. They were happier than I was," he said.

The road to qualification was not easy, as the midwifery course combines 2,400 hours of clinical practice with 240 hours of theoretical learning, Zahra Piscopo said.

"You're on placements in winter, summer, day and night. I saw friends going out in the summer, and I couldn't because of work," he said.

"It took a toll on me at first, but it gets easier. By the second year, you are given more freedom to perform skills, and it becomes more rewarding," he said.

Third year of studies was the most intense, with students required to assist in 40 deliveries to qualify.

"You need to do extra shifts, I worked during Christmas, even on New Year's Day," he said.

"However, even if the situation is not ideal, when someone feels a bit better by the end of your shift, that is enough. You forget the pressure," Zahra Piscopo said.

He also spent two months on Erasmus at Dublin's Rotunda Hospital, where practices were more obstetrician-led. "It made me appreciate what we have here in Malta," he said.

Zahra Piscopo admitted he felt pressure throughout his studies, not from lecturers or mentors, but internally.

"Deep down, I felt I needed to prove myself. That I deserved to be there like everyone else," he said.

"Now that I'm qualified, I'm just one of many midwives. It's just that I'm a man," Zahra Piscopo added.

Still, being Malta's first male midwife carried the weight of visibility, he said.

"It felt like all eyes were on me," he said. "However, someone always has to be the first. It just happened to be me," he continued.

Asked whether his gender ever posed a challenge, Zahra Piscopo said such instances were rare, and people's cultural background also came into play.

"There were cases where I was not the best person to provide care, and there are so many hardworking midwives who can," he said.

"Those situations were in the minority, however, as once I introduce myself, the patient usually sees that there is nothing different," Zahra Piscopo said.

In fact, his presence often sparked open conversations with patients about men in the profession.

"I am transparent with them, and that builds trust. I have not had any terrible experiences; overall, it's been very pleasant and rewarding," he said.

Since graduating, Zahra Piscopo has received messages from other men who had considered midwifery but had not applied because of the stigma.

"If they were to apply now, it would be a different story. Being the first gives me hope that others might follow," he said.

For him, gender should never define a midwife, as to be a midwife is to have compassion, care and respect.

"If you have the right attitude and values, that is what makes a midwife. How you speak to and respect your client is the foundation, the bedrock of midwifery," Zahra Piscopo said.

Asked about his future goals, Zahra Piscopo said that a very big part of the midwifery profession is advocating for women.

"I believe that that is a part that every midwife should obviously take great pride in doing, and I do try, as much as possible, to advocate for my clients and for women," he said.

Now, Zahra Piscopo said he will be starting a Master's degree, and will work part-time as a midwife until he completes it, after which he will work full-time as a midwife at the hospital.

Zahra Piscopo's long-term goal is to work full-time in the delivery suite.

"It is the most rewarding place, you get to see pregnancy, labour and postpartum care all in one," he said.

"A big part of our job is standing up for women. Even if they are not pregnant, we are there for them. That is something I hold dearly to my heart," Zahra Piscopo said.