We Can Change the World of Birth
When we look at the international situation of birth, it looks fairly hopeless. However, with so many dedicated people around the world working on it, we can have hope. At the last Eugene, Oregon Midwifery Today conference, my long-time mentor and Midwifery Today columnist, Marion Toepke McLean, suggested that we keep a “Birth Situation Room.” The White House in the United States has a situation room about what is going on in countries around the world. We wanted to expand on this theme because of the parallels between birth processes and societies’ health. We need good births around the world, everywhere!
Wanda Walker, our Web person, and I got the Birth Situation Room up and running; you can take a look at it here. You will also find links to other international work we have done and are in the process of working on. If you have any reports to add about the situation of birth and midwifery in your country, please send them to us. The Birth Situation Room is an important link in our process toward better birth. We are expecting some good reports soon!
I was even thinking about keeping a way to grade what is going on in the world of birth. Marsden Wagner used to do this in his talks at our conferences before he retired. Right now, it seems that Iceland, New Zealand and the Netherlands have fairly good situations for mothers and babies. However, my contacts in the Netherlands are concerned about losing homebirth. Even though the percentage of homebirth is falling in the Netherlands, it is still the highest homebirth rate in the Western world.
It is important that we work on these issues together. It is only with each of us doing own part that we will make important changes. The Global Midwifery Council (GMC) is working hard toward change. We are working on midwifery education, traditional midwifery, letter writing to offending nations and many other projects. Do consider joining us to help change the world of birth. GMC has a new and evolving Web site that you can use to keep up with our projects: http://globalmidwiferycouncil.org/ Together we can reach our goals. Now, more than ever, we have research that confirms that undisturbed birth is best for motherbaby—more on this topic in the next issue!
— 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.
Midwifery Today on Facebook: facebook.com/midwiferytoday
Jan on Facebook: facebook.com/JanTrittensBirthPage
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Midwifery Education: Caring and Sharing: facebook.com/MidwiferyEducation
An analysis of South Asian studies showed that the use of clean delivery kits during homebirths could help reduce neonatal deaths in rural areas where there is a limited access to health care.
These birthkits included soap, a razor for cutting the umbilical cord, clean string for tying the cord and a plastic sheet. According to Nadine Seward of University College London, the kits were associated with a 48% decrease in newborn deaths within the first 28 days.
It is estimated that each year 3.3 million newborns around the world die within a month of birth. Nearly all of these deaths occur in low- and middle-income countries where up to 15% of the deaths are related to sepsis.
One way to combat these high neonatal mortality rates is to use clean delivery kits and implement other clean delivery practices.
— Neale, Todd. “Delivery Kits for Homebirth May Up Survival.” MedPage Today. March 02, 2012. http://www.medpagetoday.com/OBGYN/Pregnancy/31457
Learn about midwifery education!
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Country Contact Reports
Editor’s Note: For this international edition of E-News, we asked Midwifery Today’s country contacts the following question: What items would you include in a birth bag for a resource-deprived midwife?
Thank you for your request for what materials should be included in the delivery kit for midwives in resource deprived areas. As I myself am from one of the resource limited areas, I feel the following are equally important and to be ranked as #1:
- cord ties (2)
- soap (1)
- clean towels (2)
- surgical gloves (1–2 pairs)
- scissors or razor blade (1)
- packed gauzes (2–3 packs)
The following can be ranked as #2:
- kidney dishes (2)
- bulb syringe (1)
- ambu bag (1)
— Gebresilasea Gendisha
I would probably suggest having at least (as a bare minimum) the following:
- hemorrhage remedies (herbs, homeopathics, drugs)
- tools for clean cord clamping (strings, clamps, etc.), scissors
- gloves, antiseptic solution (whatever is available for infection control)
- suturing equipment (provided the midwife knows how to suture)
If possible, also:
- resuscitation bag and mask or at least a pocket mask, especially in countries with high STD occurrence (midwives need to be trained in CPR)
- clean cloths to create clean surfaces for baby
— Nandu Noll
Here is the list of the most important items I would put in my birthkit:
- a few receiving blankets
- flashlight and candles
- hemorrhage medicine (Chinese herbs, Shepherd’s Purse tincture, Pitocin injection, syringes, Methergin pills)
- fetoscope or Doppler/gel
- small bottle of honey
- some wash cloths
- water to drink or coconut water (for mom)
- sterile scissors to cut cord
- cord clamp
- suturing stuff
- sterile gauze
- sterile gloves
- blood pressure cuff
- baby caps
- big pot to boil water
- bowl to catch placenta
Of course I carry many more items but these would be the ones I would not like to be without.
— Uva Meiner
Great idea; here are my thoughts:
- a few under pads (for a clean field)
- cord clamps or dental floss for trying cord
- bulb suction
- scissors for cord or clean razor blade that is wrapped up for one-time use
- alcohol wipes for cord and cleaning scissors
- a very simple emergency childbirth picture book
Also, the main cause of maternal death is poor nutrition and postpartum hemorrhage, so perhaps Cytotec in every birthkit or herbs for this.
Please send me a consensus as I, too, teach here in Belize and will want to make up emergency kits for the volunteer village health care workers.
— Gail Johnson
What items would I include in a birthkit for a resource-deprived midwife?
- stethoscope and blood pressure testing instrument
- clean cloth diaper and napkins
- clean cord scissors
- cord clamp or tape
- glove or plastic bag
- plastic sheet
- drinking water
- Methergin and injection set
— Meena Sobsamai
Read more country reports and full-length articles on international topics in the 100th issue of Midwifery Today magazine, now available here.
How can you normalize the breech delivery?
If you attend pregnant women, you need basic knowledge of the breech delivery. In Normalizing the Breech Delivery, Midwives Valerie El Halta and Rahima Baldwin Dancy share their expertise in a clear, detailed manner. You’ll learn a Breech Scoring System to help evaluate risk, various positions for the mother in delivering a breech baby, the key points for diagnosing and delivering a frank breech and more. Perfect for midwifery training programs and self-study by both student and experienced midwives, Normalizing the Breech Delivery is a must-have for every birth library. Order the video.
Put the gift of beautiful birth in her hands.
Give Brought to Earth by Birth, a collection of black and white photographs by Harriette Hartigan, one of the world’s master birth photographers. It makes a beautiful gift for your midwife or doula, for expectant or new moms, for grandmothers and for anyone who loves babies and birth. And remember to order a copy for yourself!
Order the book.
How would your baby like to be born?
In How Will I Be Born? Jean Sutton explains the principles of optimal fetal positioning in a clear and straightforward matter. Written for expectant parents, this book is packed with helpful advice and information, including an informative chapter on posterior position. A must-read for all pregnant moms and a book for the practitioner’s lending library.
Learn about being a midwife’s assistant
The 2-DVD set, Midwife’s Assistant Orientation for the Student Midwife, features a combination of live workshops and demonstrations that will help you prepare for clinical site training and experience. It also includes detailed instructions for many emergencies, as well as role-play of various scenarios such as waterbirth procedures and neonatal resuscitation. If you’re a student midwife or know someone who is, this DVD is a must-have! To order
Discover The Power of Women!
When you read this book by Sister MorningStar, you’ll discover how healing words and empowering stories help women listen to their instincts during childbirth. Filled with inspiring, moving stories, The Power of Women will lift the veils from your eyes and let you view the world in a new way. Give it to the pregnant women you know. Help them see the power that resides within them.
Order the book.
Make sure you get the whole story.
|Midwifery Today E-News is only a sample of what you’ll find in Midwifery Today magazine. Subscribe and you’ll receive a 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more. Subscribe.
Read these articles from Midwifery Today magazine now on our Web site:
- Building Sacred Traditions in Birth—by Whapio Diane Bartlett, traditional midwife
Excerpt: During the past 18 years, my apprenticeship with birth has challenged me to redefine my concept of boundaries, trust, fear and responsibility. Today, if I could make one statement about building a birthing community it would be this—build on what you know and believe is sacred.
- The Doula’s Contribution to Mamatoto—by Gail Tully, BS, CD (DONA), CPM
Excerpt: Even as midwives we can underestimate the long-term grace brought through the presence of a doula at a mother’s side. This is a curious blind spot in our maternity care. As a homebirth parent and midwife, I came to this realization slowly, even though I was a doula myself!
- Fathers: Those Engrossing First Minutes—by Richard Reed, PhD
Excerpt: Midwives, fathers and mothers all agree that dads should participate in childbirth. They are less clear, however, about why dads should be there. Do fathers really ease birthing for mothers? Is there a moral obligation to accompany mothers on their passage?
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The CDC identified a 29% increase in homebirth rates from 2004 to 2009 in the United States, a finding that angers people who view homebirth as a child-endangering scourge. But recent large studies suggest that the experience and training of birth attendants and proximity of emergency intervention are more relevant to safety than birth location, while the birth environment is important to the level of stress the mother and infant experience.
— Emily Willingham, developmental biologist
Studies of doulas (professional labor assistants) have found that when a doula is used, the need for medication and surgical birth techniques decreases by as much as 65%.
— Birthing Naturally, a free source of information about pregnancy and birth
By the time you are about 28 weeks pregnant, your body will have made 50% more blood! This extra blood allows your baby and placenta to grow, so that there is enough blood to bathe the placenta, without neglecting your needs as well. The catch is this: your body can only manufacture this extra blood with enough protein and calories. That’s about 2,500 calories a day (yes, really!) and anywhere between 70–100 grams of protein daily.
— Indie Birth, a Web site dedicated to providing “intellectual fuel for free-thinking mamas”
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 email@example.com.
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.
Stork Hat and Factbytes
If you want to see Tine Greve, Gail Hart and me in a beautiful but silly stork hat, you will have to come to the Harrisburg conference April 11–14. We are instituting a new piece to conference called “factbytes.” The idea of factbytes is to share a very quick fact at moments in the conference so that every attendee will be exposed to bits of information each day. These are tidbits of information which really need to get into midwifery but are often missed. The stork hat on one of the teachers will alert you that a factbyte is coming. It is just a couple of sentences, quick, thought-provoking and something that will stay in your mind—like a 15–30 second public service announcement.
Here is a sneak preview of a factbyte: “Did you know that if the cord is left intact, at about the third minute after birth there is a massive transfer of stem cells to the baby?” This factbyte will help you understand that 30 seconds is NOT delayed cord cutting. I am sure most of you know 30 seconds is not delayed cord cutting, but this piece of information can help you help hospital-based people understand this insight. I think factbytes are going to be an especially rich piece of the conference, and if I were you, I would take notes! (Factbyte by Gail Hart)
We hope you can join us for the factbyte fun, great classes, swimming and Karaoke as we hang out telling birth stories in Harrisburg.
— Jan Tritten
I had to tell a Hispanic couple they were having twins after the first baby was born. They spoke no English, and I spoke no Spanish other than being able to inform them “dos niños” to which both mother and father replied, “No.” I repeated, “Si, dos niños” and held up two fingers to emphasize the fact. A few minutes later, baby number two emerged, and indeed, we had dos niños. This was prior to routine ultrasounds, and if I remember, mom had little prenatal care when she presented in active labor. Nevertheless, both babes were born naturally and drug-free in a birthing room in a community hospital.
— Christine Posler Domask
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