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Editor’s note: This article first appeared in Midwifery Today, Issue 132, Winter 2019.Join Midwifery Today Online MembershipThe 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 she… Read more…. All She Wanted Was Her Socks: Bolivia’s First Doula

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

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 MembershipA major global health challenge is the reduction of maternal and newborn deaths. In Nigeria, women of childbearing age face immeasurable hardship, violence, and the prospect of death. This is a huge challenge, with conflict raging across the northern part of the country. We undertook a study to determine whether there were sufficient numbers of midwives working in primary health care (PHC) centres of Northeastern Nigeria. Globally, midwives are working hard to turn around the high maternal and newborn death rate and make good health more than just a wish. Together we can save lives.  Midwives Play an Important Role in Guaranteeing Good Health of Mothers and Babies Women in Nigeria face one of the highest maternal death rates in the world during pregnancy, childbirth, and related complications, with over 800 maternal deaths per 100,000 or about 58,000 deaths in 2015, according to the World Health Organization (WHO 2019). Most deaths involve bleeding (antepartum or postpartum), hypertension (preeclampsia/eclampsia), obstructed labour, and infections (WHO 2019b).  The shortage of midwives contributes to the poor state of maternal and child health care in northeast Nigeria, especially in rural areas. Conflict has also aggravated this situation, with health facilities either destroyed or badly damaged and many health workers being forced to flee. Millions of people have fled their homes and are presently in need of life-saving assistance. The three most affected states in Northeastern Nigeria are Borno, Yobe, and Adamawa. TABLE: Distribution of selected PHC facilities and midwives according to four LGAs in Yobe state LGAs Number of PHC Centres Number of Midwives Damaturu 13 20 Gujba (conflict area) 9 4 Fune 19 6 Gulani Armed conflict zone 1 The United Nations Population Fund (UNFPA) estimated that 1.7… Read more…. Clinical Research and the Shortage of Midwives in Northeastern Nigerian Primary Health Care Centres

 Read more…. Clinical Research and the Shortage of Midwives in Northeastern Nigerian Primary Health Care Centres

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

The author shares her experience after thousands of birth that labor is a continuum rather than being divided into stages. If left undisturbed, women will not even experience a “second stage.”

 Read more…. The Disappearing Second Stage