Marion Toepke McLean

Marion Toepke McLean, CNM, attended her first birth as primary midwife in August 1971. She received her nursing degree from Pacific Lutheran University in 1966 and her midwifery and family nurse practitioner degree from Frontier Nursing Service in 1974. From 1976 through 2001 she did home, clinic and hospital births, while also working as a family nurse practitioner. In 1980 she taught a year-long program for local midwives, returning to Frontier Nursing Service to teach during the summer. She had a homebirth practice until 1985, when she went to work at the Nurse-Midwifery Birthing Service, a freestanding birth center. In June 2000 she completed a BA in International Studies at the University of Oregon, with concentrated studies on Mexico. Since 2002 she has worked in a reproductive health clinic and attended an occasional homebirth. She lives in Eugene, Oregon, and is a contributing editor to Midwifery Today.

A Difficult Breech Birth

Jennifer had once told me, “I don’t do births in Africa,” leaving this to an excellent staff of Ugandan midwives. But on that lucky morning, she got a stuck baby born and saved a life. Read more…. A Difficult Breech Birth

The Midwife and the Partograph

Marion discusses the use of the partograph in developing countries.

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Working in the Safe Motherhood Clinic

Marion shares her experiences as a volunteer in Uganda.

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Does It Matter How We Were Born?

The author argues that midwives need to be aware that it does matter what happens during our birth so they can do the best job possible.

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Marion’s Message: International Midwife Assistance

My introduction to International Midwife Assistance (IMA) came in 2006 when I spent three weeks as a volunteer in their Community Midwife Training Program in Bamiyan province, Afghanistan. IMA offers a high level of people-to-people assistance, with almost no bureaucracy. Our services were direct, personal and highly valued by the recipients.

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Marion’s Message: Plus ça change…

When I was 21 years old and newly graduated from a Bachelor of Science nursing program, I had enough money left in my college fund to go to Europe for a few months. A woman friend and I went to Paris where I studied French at the Sorbonne and lived well on $150 per month. I learned about politics, philosophy and life. Some old sayings seemed more meaningful in French, like, “Plus ça change, plus c’est la même chose.” “The more things change, the more they stay the same.”

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Marion’s Message: The Safest Kind of Breech

Sharing our birth stories is one way of teaching midwives their trade. Marion tells the story of a frank breech presentation, describing the steps in how the birth occurred.

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Marion’s Message: Too Many or Not Enough Cesarean Sections?

Editor’s note: This article first appeared in Midwifery Today, Issue 82, Summer 2007. Join Midwifery Today Online Membership What is the ideal cesarean section rate? That rate associated with the least possible morbidity and mortality for mother/baby. This is the suggestion of Fernando Althabe of the Perinatal Research Unit, Montevideo, Uruguay, and Jose Belizan of the Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina, in their recent article in The Lancet.(1) They acknowledge that the appropriate rate is debatable. One to five percent is a range for the minimum. Fifteen percent, as suggested by WHO (2), is a commonly accepted goal for a maximum rate. Althabe and Belizan are commenting on a study of cesarean rates in developing countries, reported in the same issue of The Lancet.(3) One way to determine whether 1% or more is really a minimum safe cesarean rate, look at three conditions that can be fatal without surgical intervention. The rates of these conditions are variable, depending on the population and other factors. Placenta previa at term occurs in about one in 200 births. However, it is more common in multipara and in older women, occurring in more than 1% of the time, even… Read more…. Marion’s Message: Too Many or Not Enough Cesarean Sections?

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MDG 5: Something We Can Work With

With maternity mortality in childbirth so high around the world, Millenium Development Goal 5, maternal health, is something that we all can work toward.

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Marion’s Message: Cesarean on Maternal Request

Marion critiques the outcome of the NIH’s recent conference on “Cesarean on Maternal Request.”

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Marion’s Message: Working in Afghanistan with Siri

Marion recounts her visit to Afghanistan, arranged by her friend Siri, to volunteer as a teacher and insert IUDs

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Marion’s Message: The Taste of Tears

A contributing editor comments on the Jennifer Williams trial in Indiana, where a homebirth midwife was arrested and charged with practicing medicine and midwifery without a license.

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