Each year hundreds of midwives go overseas or cross borders to attempt to improve the dire crisis of maternity care in developing countries, disaster and war zones, and refugee camps. Some of these efforts have better outcomes than others and foreign aid is often seen by the local people as a mix of help, potential harm, and cultural misunderstandings. One of the biggest concerns we hear is that the well-meaning people who volunteer are not prepared or educated on what local people feel they need and do not take the time to learn about their unique burdens.

 Read more…. Mercy In Action’s Diploma in International Midwifery and Maternal/Child Health

Editor’s note: This article first appeared in Midwifery Today, Issue 132, Winter 2019.Join Midwifery Today Online Membership The United States’ use of doulas during childbirth is on the rise. A 2012 survey conducted by Evidence Based Births indicated that 6% of the births in the US are conducted with the assistance of a doula, up from 3% in a 2006 national survey (Declercq et al. 2007; Declercq et al. 2013). This growing acceptance of doulas is not shared in countries like Bolivia where Canadian expat, Vanessa Sykes, delivered her daughter, Isabella, four years ago. She says, “I wanted a vaginal birth and to women outside Bolivia this seems like a given; but in Bolivia, women are kept out of the birthing process.” Sykes refused to be excluded. This refusal led her into a journey that resulted in her becoming the first registered doula in Bolivia, as well as forming Vanessa Sykes Birthing Services in Santa Cruz de la Tierra, Bolivia. Vanessa Sykes Birthing Services is a first in Santa Cruz de la Tierra—one of the fastest growing cities in the world. Services include an array of doula care ranging from prenatal to postpartum care. They also offer some of the only Lamaze classes and lactation counseling in Bolivia. Sykes is always adding to the services. She said, “Last year I went to Brazil to learn about Spinning Babies, which includes different exercises women can introduce while pregnant to help with the birthing process.” She hopes these services provide the care she did not receive when she gave birth to Isabella. “I had a difficult time finding a professional that could help me,” Sykes said, “I didn’t want to have any interventions. I wanted to be able to do what I wanted to do when birthing my baby.”  The first obstetrician… Read more…. All She Wanted Was Her Socks: Bolivia’s First Doula

 Read more…. All She Wanted Was Her Socks: Bolivia’s First Doula

In my first and second articles in this series, I mentioned that in Thailand, they have an expression that translates in English to “same same but different.” As is true with pregnancy and labor and delivery, so it is true of caring for the newborn, as well. There are unique aspects to newborn care in a low-resource setting and, while many elements of caring for a newborn baby in the six weeks following birth are universal, the midwife needs to be aware of how best practices can be different according to the setting. The International Confederation of Midwives (ICM) has created global standards, competencies, and guidelines to ensure that midwives in all countries have effective education and skills (ICM 2018). When working in developing countries where newborn mortality is high in the neonatal period, the midwife should possess advanced skills and be humble about the high-risk population in which she may find herself. Business as usual will not be adequate or even ethical in these situations.

 Read more…. Newborn Care in the Context of a Developing Country

Hospital delivery is the dominant mode for pregnant women in China, and women are advised to go to hospital when labor starts. There is often a time gap during which women in labor wonder whether they should go to hospital or stay at home. Usually they go too early and end up waiting in the hospital for days—especially women in their first labor. This can cause increasing anxiety with the passing time, and the normal labor process will be interrupted by complex hospital protocols. But staying at home also brings anxiety because women and family members worry about the process of labor. There are several ways to resolve pre-labor anxiety: birth education, a maternity waiting home near hospital, and a center for normal birth will work in different ways to relieve the anxiety and help women have a natural birth.

 Read more…. Bridging the Gap between Home and Hospital: Pre-labor Doula Service in Hayi