June 8, 2011
Volume 13, Issue 12
Midwifery Today E-News
“International Edition”
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Quote of the Week

A “no” uttered from the deepest conviction is better and greater than a “yes” merely uttered to please, or what is worse, to avoid trouble.

Mahatma Gandhi


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The Art of Midwifery

When a baby’s shoulders are stuck, have the mom stand up and squat. Usually, just getting up will twist the body enough to readjust the neonate’s body. Ask the mom to lift her shoulders, one side at a time, while an assistant gives suprapubic pressure (cupped hands together, knife-like and standing behind the mom). The midwife catches the baby. Gravity, twisting and suprapubic pressure usually brings the baby out right away.

Faith Heise
Excerpted from Midwifery Today’s Sharing Midwifery Knowledge, Tricks of the Trade, Vol. IV


ALL BIRTH PRACTITIONERS: The techniques you’ve perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to mtensubmit@midwiferytoday.com.


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Jan’s Corner

Global Midwifery Council

I have been blessed with many international connections, as well as the ability to travel around the world for Midwifery Today conferences. As far as midwifery and birth are concerned, the situation everywhere is desperate and deteriorating. It is incredibly important for each one of us to do whatever we can to reverse this trend. Motherbaby deserves better. For the past 25 years, writers for Midwifery Today magazine have shared news and information from all over the world. Through conferences, we have met thousands of excellent but struggling midwives. The possibility of a miracle birth for every motherbaby is the goal. The health, and possibly even the survival, of people depend on what we do or don’t do now. This is why the Global Midwifery Council (GMC) was birthed.

Amazing things happen when we meet in Russia, and it was during the joint Midwifery Today/Domashniy Rebenok conference in Russia last year that GMC was born. We have a great group of women working on goals, definitions and NGO status for the organization. The GMC’s primary goal is to fight for the human rights of every birthing mother and baby. International training, recognition of family-centered midwifery, preserving and encouraging traditional midwifery, separating midwifery from the medical hierarchical model and giving an international voice to those who already work so hard and need recognition are among the GMC’s many other goals. We plan to help the people of every country who ask for help with midwifery or birth.

One of the ideas we are working on is a “situation room.” My mentor, Marion Toepke McLean, put forth that idea when we were having intense GMC meetings during the Eugene conference. In our situation room, probably a virtual one, we will keep files on the situation of midwifery and birth in every country we learn about. In looking at what we have been doing with Midwifery Today, Wanda, our fabulous Web mistress, and I realized that the GMC has a great start with Midwifery Today’s Web site and magazine. We already have links to many countries’ resources and an extensive list of country contacts. If someone is looking for a midwife, traveling and wanting to meet other midwives or has other needs, we may have a point of contact. (We are always looking for more contacts, so please volunteer if you are available and philosophically aligned with us.) Midwifery Today’s International Alliance of Midwives page includes a definition for midwife and goals, as well as a statement on autonomy by Robbie Davis-Floyd (http://www.midwiferytoday.com/iam/).

Our e-mail boxes are filled with ideas and communication as we outline the GMC’s goals. If you have ideas please e-mail me at jan@midwiferytoday.com and share them. We are a fledgling organization but we are strong and determined to change birth for the better!

Jan Tritten, mother of Midwifery Today

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

Jan on Twitter: twitter.com/jantritten
Midwifery Today on Facebook: facebook.com/midwiferytoday
International Alliance of Midwives on Facebook: facebook.com/IAMbirth
Midwifery Education: Caring and Sharing: facebook.com/MidwiferyEducation


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Join Us in August

MANA Region 3/NCMA Conference 08/05/2011 to 08/08/2011 in Cary, NC

Midwives, doulas and childbirth educators from across the region can reunite with old friends, make new ones, and learn information in workshops to enrich their professional practices. Key note speakers are Anne Frye, CPM, and Jan Tedder, FNP (H.U.G. Your Baby). CEUs applied for, MEAC and ACNM.

For more info http://ncmidwife.org/MANARegion3Conf/



News and Research

Midwife Training Reduces Infant Death Rate

A study recently published in the journal Pediatrics concludes that basic training for midwives saves infants’ lives, and is cost-effective.

A Zambian pilot project, costing just over $20,000, taught midwives basic skills such as warming and cleaning a newborn, facilitating breastfeeding, diagnosing common illnesses and newborn resuscitation.

Statistics comparing the infant death rate prior to and after the training found that the first-week death rate of newborns decreased significantly after the training, to nearly half the previous rate. Read the full study here: http://pediatrics.aappublications.org/content/127/5/e1176.abstract

— McNeil, D. Jr. 2010. “Infant deaths drop after midwives undergo inexpensive training.” New York Times. May 9.


Featured Article

International Updates

Editor’s Note: Midwifery Today maintains a list of country contacts who serve as birth and midwifery liaisons in their communities. For this international issue of E-News, we bring you updates from our contacts in Kuwait, Uganda, the Dominican Republic, France and Argentina.


BirthKuwait

It is my pleasure to inform you about the establishment of a new, volunteer-run organization: BirthKuwait. The mission of BirthKuwait is to provide evidence-based information and resources to a) help women in Kuwait have positive, healthy and safe births, b) empower women to advocate for improved maternity services and c) increase transparency in maternity services through the creation of a central, information-based Web site, an online birth survey and new training opportunities for doulas, lactation consultants and childbirth educators.

For a full report on the first meeting of BirthKuwait, visit: http://midwiferyinkuwait.blogspot.com/2011/05/meeting-birth-kuwait-may-5th-2011_09.html

Zuzana Nadova


Birth Control and Male Involvement in Uganda

It has come to everyone’s notice that birth control is one of the most sensitive and difficult issues in Uganda. The country has one of the highest population growth rates in Africa, with an average of over six children per woman. The total population of Uganda is estimated at 32 million, and at the current rate of growth could double in a matter of decades.

There is a deeply embedded attitude that having many children is a good thing. It seems pragmatic—children look after you when you are old, and since some children die, you need plenty to ensure a few outlive you. Producing many children is considered essential to one’s identity.

The White Ribbon Alliance in Uganda, with support from many members, is working tooth and nail to put the message about safe birth across. If we could pull more men aboard the campaign, it would make a difference.

In Uganda, maternal mortality has fallen from 506 to 425 per 100,000 live births. Although there is an outcry for births to be attended by qualified health workers, some women still prefer traditional midwives who are within easy reach. The challenge is that traditional midwives prefer to use local herbs that are not measurable and are dangerous to the fetus. Though it is believed that local herbs ease pain during labour and make birth faster, complications to both the mother and the baby may not be noticed until it is too late.

We have a lot to achieve and the United Nation’s Millennium Development Goals may be left unaccomplished unless we involve male spouses to help prevent unwanted pregnancies and promote safe birth.

Kezaabu Edwidge


Experiences in the Dominican Republic

I am a licensed midwife from the state of South Carolina; I have been bringing student midwives and doulas from my online course (http://midwifetobe.com ), as well as others who want more experience, down to the Dominican Republic a few times a year.

Conditions are difficult and poverty is an issue, but the women sure know how to deliver babies without a lot of fuss! It is a joy to bless the women and hospital staff with sheets, baby packs, birth photos and medical supplies. We don’t hear much at all about midwives in the country. Most women seem able to make it to one of the free hospitals for the general population. The ones who have connections go to smaller, nicer hospitals that can handle preterm babies and other special circumstances.

We work in the poorer hospitals that need help. Spanish is spoken, so translators are needed. We try to teach staff about neonatal resuscitation, kangaroo care for preterm babies, etc. The staff, for the most part, are open to learning new ideas.

Directors of hospitals change often, so we go to numerous hospitals to try and find the place where students can learn the most and where we can be of service. We’ll sometimes help with 20 to 30 births a day. They do let us catch babies if not high risk, but we don’t really manage the births. There are plenty of moms to doula, babies to exam and experiences to be had. I know we have saved lives on numerous occasions. Come join us if you want to bless the poor.

Lisa Aman


France’s Sage Femmes

It’s high time for women, especially les sage femmes (Fr. midwives; literally meaning “the wise women”) of France, to take over! Since 2002, midwives’ wages have thinned down. Of all professionals acting in health care, we have the lowest income, and costs keep going up.

The government is cutting down expenses in every public institution, so that midwives working in hospitals are under pressure: fewer midwives, more births! Therefore, we started our first movement in 2010, a demonstration in black. We were mourning our dying profession. This year we were 3500 (we are around 23,000 in total) strong to demonstrate in the streets of Paris (http://www.youtube.com/watch?v=fINFkmtU42c&feature=related).

Our demands:
One mother, one midwife

  • Birth centers
  • Insurance for homebirth
  • Better income and better working conditions
  • Independent teaching units inside universities (not a part of medicine departments)

The minister of health accorded us an interview with his first secretary. We did not even receive a promise, just a vague “we will think about it.” We foresee continuing to fight for true respect for our job.

Françoise Bardes


A Review of Birth in Argentina

Doulas: Since 2007, an amazing doula movement has been taking place. Prior to 2007, the doula figure was unknown. Now, DAR (Doulas of Argentina) is educating an increasing number of doulas.

Hospitals: As the demand for homebirth and natural birth increases, many hospitals are changing their medicalized way of assistance, becoming slightly more humanized and intervening less. However, many hospital births are still very violent and harmful. An initiative has been proposed to pay doctors more for vaginal births than for c-sections as a way to decrease the epidemic rate of c-section, which is 50–90% in private hospitals and 20–30% in public hospitals. This idea was applied in Brazil with the expected outcomes but, in some cases, doctors became negligent by forcing a vaginal birth when a c-section was needed.

Midwifery: Midwives are still working to pass a law that would update their competencies. This new law aims to legitimize all the tasks and skills midwives currently practice, including suturing episiotomies and tears, assisting births by their own responsibility, using medications and taking care of the newborn in the absence of a pediatrician. The struggle between OBs and midwives is still the same, and has even gotten worse in a medical system where midwives are meant to be the doctors’ assistants.

Midwifery Education: A private training course that promotes community and independent midwifery, and which bases midwifery on the continuity of care and homebirth, has been taking place in the last four years, and has resulted in young midwives establishing their own home offices to provide out-of-hospital care.

The midwifery education programme at Buenos Aires University is interested in developing a new project that would add holistic midwifery to midwifery education to broaden the knowledge base and prepare midwives to satisfy client’s demands. Midwives are often perceived as lacking research-based evidence and skills that provide natural comfort to women during labor. The new training would offer more “hands-off” techniques and preparation for attending out-of-hospital births safely, with equipment and a clear transport protocol. The new training project will be launched as a course for advanced students in June of this year, and if successful, may be included in the curricula in the future.

Birth Centers: All of the initiatives regarding legal, freestanding birth centers run by midwives or medical teams have unfortunately failed. People who feel unsafe birthing at home, uncomfortable and threatened at hospital, as well as people who don’t have a proper place to welcome their child or who live in more remote locations, are driving demand for freestanding birth centers. There are two hospitals that provide natural birth options (no drugs, free movement, no IVs, upright birth positions, freedom to eat and drink), delay shots and decline giving vitamin K to the newborn. One is a private hospital in Buenos Aires Province and the other one is a public hospital in Tucumán Province. It is a good start but there are many things yet to improve.

Birth Activism: In the last three to four years, celebrating World Respected Childbirth Week has been a good strategy to place birth issues on the political and media agendas, and to make the topic a public concern. The Latin American and Caribbean Network for the Humanization of Birth is very active in Argentina and stays in constant contact with Spanish organizations that advocate for childbirth rights.

Marina Lembo
Independent homebirth midwife


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Jan watching clockWeb Site Update

The table of contents for the brand-new issue of Midwifery Today is now online! Go here.

Read this editorial by Jan Tritten from the brand-new issue of Midwifery Today, Summer 2011:

  • Waiting Can Be So Hard
    Excerpt: So what are the main issues regarding second stage? One of the most important issues is the fear it seems to provoke in midwives, often leading them to try to “deliver” the baby as soon as the head emerges instead of waiting for the next contraction and letting the mother deliver her baby on her own time. Fear can lead to some horrendous circumstances.

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Bring resources about homebirth and midwifery to your community.

Does your library have relevant natural birth and midwifery resources? Did you know that as a patron of the library, you can make requests for specific books, magazines and DVDs? If these resources are not available for mothers to find, how will they make educated decisions? Making requests is easy. Go here to learn how.

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Birth Wisdom from the Web

I traveled to Mexico in the winter of 2008/2009 and was blessed to work with traditional midwife Angelina Martinez Miranda and her lovely son, Esteban Garcia Martinez, serving women in the small birth center in front of the family’s house. This past winter I was in Kerala, India, helping start the first birth center in Kerala, called Birth Village, in the heart of Cochin. I served the first three clients of the center, arriving on the due date of the first client!

Kavita Darby Rosepetal, Facebook


Teaching women’s health to 25–30 women, sitting on the floor in mud huts in Bungoma, Kenya, Africa—awesome! Teaching one midwife neonatal resuscitation by drawing in the sand with a stick—priceless!

Andrea Dixon, Facebook


As a researcher it seems to me that the traditional midwives of India are an asset to my country, as in other countries, but they need proper training as far as health and hygiene are concerned. If we made an exchange of ideas using their knowledge and our modern concept of midwifery, it would be very fruitful.

Soma Mukhopadhyay, Facebook


If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to mtensubmit@midwiferytoday.com.


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Jan, Eneyda and KaterinaConference Chatter

Katerina of Russia

We are off to Saint Petersburg, Russia, on June 6, where we will do a two-day event, and then off to Moscow, Russia, where we will hold our next joint conference, “Traditional Midwifery—The Profession, the Art, the Life.”

Katerina Perkhova, the energy behind these events, is an amazing young woman. All of us who have met her know that Russia is in for some great birth changes because of the dedication and hard work of this woman and her family. She started a magazine much like Mothering (Domashniy Rebenok), and does another magazine on eco-friendly homes. Katerina has a special interest in midwifery and birth. She runs an organization named MAMA, for mothers and midwives, and travels around Russia talking with government officials to try to change birth. Did I tell you she and her husband, Phil, have two young children?

Katerina has also been translating Midwifery Today magazine into Russian, helping to share great birth information with Russian-speaking people. Our hope at Midwifery Today is to change birth around the world and this is one way to feed that goal. I asked her once how she does so much with so little and she answered, “I’m the editor, journalist, photo editor, advertising manager and Web designer. Phil is the art director, designer, photographer, publisher and heavy load lifter.” They only have two other staff members! I hope one day you all get to meet this hard-working, sweet husband and wife team; meeting them is an honor.

Jan Tritten


Think about It

We homebirthing mothers love our midwives because they are the first to touch our true love. We love our midwives because they give us life, and life again.

Meredith Winn Excerpted from “The Midwife Bond,” Midwifery Today, Issue 89
View table of contents / Order the back issue


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Letters

Dear Midwifery Today,

A friend recently asked me for advice about choosing to attend midwifery school and I responded with the e-mail that follows. I have realized just how important these words are to those considering midwifery as a profession, so I thought I would share them with E-News readers.

Midwifery school has been the most challenging journey I’ve taken in my entire life. This path has been so incredibly beautiful, sad, amazing, powerful, ecstatic, traumatizing and breathtaking that there is no way in Hades that I could have ever stuck with it if I wasn’t absolutely, 100% positive that there is literally nothing else in the entire world that I can do. For me, there is no choice. I am a midwife and I believe this path was chosen for me before I was born on this earth.
To people who are contemplating midwifery, I say to them this: If you have one ounce of doubt that this path may not be for you, don’t do it. Find your true passion and follow it instead. For those whose passion is not midwifery, this way will only end in heartache. But for those who are born midwives, who accept this challenge and meet it head on, prepare to experience unimaginable joys and a pure, deep peace, the likes of which you’ve never felt before.

Melissa-Marie Marks


Only letters sent to the E-News official e-mail address, mtensubmit@midwiferytoday.com, will be considered for inclusion. Letters sent to ANY OTHER e-mail addresses will not be considered.


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