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Top Ten Reasons To Become A MANA Member

Posted by Midwives Alliance on August 26th, 2014

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1) Help families find you! All midwife members of MANA are eligible to be listed at Mothers Naturally "Find a Midwife."

2) Continuing education. Being a member also means discounted access to the MANA conference, which provides continuing education focused specifically on home birth and birth center practices.

3) Keep up-to-date on the latest research and practice guidelines. Our website, blog, and social media sites provide up-to-the-minute news and research.

4) Find your midwifery community. At the conference, on our social media sites, and our emails, MANA connects you to the midwives and birth professionals in your community.

5) Track your outcomes. Your MANA membership supports the MANAstats project. If you become a MANAstats contributor, you’ll get data you can use to track and compare your practice’s outcomes to nationwide benchmarks.

6) Support groundbreaking home birth research. MANAstats data is available to researchers worldwide, a critical tool in understanding what home birth practices lead to positive outcomes for families.

7) Get the tools you need to run your practice. At the MANA conference, in our email blasts, and on our blog and website, you’ll learn about the latest research, meet the people with groundbreaking models for care, and connect with others who are solving the same challenges you are.

8) Support your profession. MANA provides key education and advocacy for preserving the art and science of midwifery, advocating for maternity care policy reform, supporting and unifying midwives, endorsing a woman-centered maternity care model and preserving normal birth practices. Without your membership support, none of this work is possible.

9) Educate families about the value of midwifery. MANA creates tools you can use to educate families about midwifery care, including the I am a Midwife series, blog content tailored to educating families, and other visuals and content. We encourage all MANA members to use our content on your websites, Facebook pages, and other promotional materials.

10) Get your midwifery gear. The MANA marketplace offers books, t-shirts, and bumper stickers you can use to show your pride in midwifery.

But most importantly . . . because you care about your profession!

MANA is making it easy to take advantage of the many benefits of membership! Join now during the August membership special: $100 for one year.

Help us spread the word *and* win some MANA swag. Share this article *anywhere* where midwives are online. Leave a comment below with where you shared. We’ll pick one of you to win a MANA tshirt! Thank you!

Preview: Lancet Special Series On Midwifery

Posted by Midwives Alliance on June 20th, 2014

"Women should be at the heart of planning maternity services."
— Mary Renfrew, on the findings of the upcoming
Lancet Special Series on Midwifery

Midwives know from lived experience the value midwifery care has for birthing families, their communities, and the world. Next week, the evidence base for the impact of midwifery care will be significantly expanded.

At the recent International Confederation of Midwives meeting in Prague, upcoming publication of the Lancet Special Series on Midwifery was announced. What is this research about and why is this release so important?

The Lancet, considered to be one of the world's leading medical journals, is devoting an entire series to bringing together all of the available information about midwifery care in one place. It comes at a critical time when policy crafters are making decisions in the U.S. and worldwide about how to fill the growing gaps in the maternal health care system.

According to the series coordinator, Petra ten Hoope-Bender, the series will include six papers (read her full description of each paper here).

  • Midwifery and Quality of Care
  • Impact of Scaling Up Midwifery
  • Deploying Midwives in High Burden Maternal Mortality Countries
  • Improving Maternal and Newborn Health through Midwifery
  • Human Rights and Midwifery
  • the Research Agenda

According to the Healthy Newborn Network, the series will "Go a long way to helping make the case that investment in midwifery is a highly effective way of improving a nation's health, as well as just the right thing to do from a woman's perspective."

The series will also be multidisciplinary: ". . . It unites midwives with statisticians, epidemiologists, economists, and other disciplines," according to the Maternal Health Task Force.

The rollout will run Monday June 23rd through September and will be free and available online at the Lancet. Watch here and on Facebook and Twitter for updates, and be sure to join the conversation at #LancetMidwifery.

Nine Tips To Help Midwives and Doulas Work Together

Posted by Midwives Alliance on May 21st, 2014

Guest Post by Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE

Editor's Note: Tech issues as we updated the MANA site meant this post couldn't run during the month of May. However, this content remains relevant year round, not just during International Doula Month! 

International Doula Month, celebrated every year in May, is a great time to examine the issue of doulas and midwives working together to support birthing families. While the roles of both birth doulas and home birth midwives are clearly defined, it is not hard to imagine that along with the desire to offer the best professional service to a family, the professionals serving in these capacities might find themselves feeling a bit awkward with each other. There even may be some "jockeying" for position as the midwife and the doula strive to best serve the client and the client's family. Remember that not all home births have a doula presence, so the doula's presence may require some adaptations.

According to DONA International, birth doulas are trained to provide emotional, physical and informational support during labor, birth and the immediate postpartum period. The word "doula" comes from the Greek language and means "woman who serves," though there are both men and women serving in the doula role today. The typical birth doula will meet with his/her client once or twice prenatally to understand their preferences for labor and birth and how the doula can best support them and their family. They also explore any worries or concerns that the pregnant person may have. The doula will attend the birth and then close the professional relationship with a final postpartum meeting or two. The doula is a source of information for the family from the time of hire through the first weeks postpartum. (Postpartum doulas can be hired to provide services after the birth, including newborn care, meal preparation, light housekeeping, and family support.)

The midwife is a trained health care professional who provides clinical care along with information and emotional support during the pregnancy through six weeks postpartum. The term "midwife" means "with woman." Over the course of the pregnancy, a person will see their midwife 15-20 times for pre- and postnatal appointments, where the midwife will assess the client and baby and share information, along with benefits, risks and alternative of procedures, tests and assessments.

Here are nine tips for making the most of what doulas and midwives have to offer while working together:

1. Midwives support healthy, low risk birth and doulas help improve birth outcomes

Midwives are appropriate health care providers for healthy, low risk pregnancy. They are well suited to providing a safe and satisfying birth experience for their clients. Evidence shows that outcomes are good and families are very satisfied with the care they receive.

There is ample research on the benefits of doulas at births. (Hodnett, 2013) When the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) released their groundbreaking "Safe Prevention of the Primary Cesarean Delivery" Obstetric Care Consensus Statement in February 2014, one of their key recommendations to reduce the primary cesarean rate in the USA was the continuous presence of a doula at a birth. (Caughey, 2014)

By working with a midwife/doula team, families reap the benefits of both models of care.

2. Doulas work within their scope of practice

When doulas stay within the scope of their practice, they best serve their clients and are more likely to be a welcomed member of the birth team. Many doulas may be pursuing the path to midwifery. Some doulas may also be a trained midwife or birth assistant, working in that capacity with other clients. But in the doula role, emotional support, physical support and helping a client and the family to find their voice is key.

3. Respect pre-existing relationships

The midwife has an emotional relationship with the client, developed over time. The midwife has also been trained in providing physical support and promoting a normal labor. The midwife is the only one responsible for providing clinical assessments and providing medical advice. The client can make optimal use of both their doula and their midwife. Everyone at the birth has the same goal - healthy family and a healthy birth.

The midwife shares the responsibility of emotionally supporting the client with the birth doula, and recognizes the value of the doula-client relationship. Having a birth doula in attendance allows the midwife to take care of clinical tasks and documentation, and also rest to conserve her energy for the actual birth, when s/he needs to be on the top of their game and ready to respond to unexpected situations. The client views the two professionals differently, but relies on support from both of them. Midwives and doulas are both experts in providing emotional support and physical comfort measures at births.

4. Support in early labor

Often times, a doula will support a client prior to the arrival of the midwife. This early labor support helps the client to gain confidence in their coping abilities, feel supported and promote normal, physiological birth staying hydrated, nourished and changing into positions that promote progress. Sometimes, they arrive together and the midwife can feel confident that the client is supported emotionally while the midwife clinically assesses the situation and sets up birth equipment.

5. Two heads are better than one to promote progress

Having a doula present at a home birth often means that two heads are better than one when it comes to suggesting coping strategies and offering comfort techniques that allow the labor to progress. I always learn something from every midwife I work with; a new position, a different coping strategy. Frequently, the midwife may learn something from me. As a birth doula, I have the chance to work with a wide variety of midwives (and doctors and nurses) and I bring those diverse experiences to all my births.

6. Transfer support

One of the midwife's responsibilities is to provide medical information and assessments and make recommendations for care, prenatally, intrapartum and after birth. The midwife and client make the decision when it becomes necessary to transfer. The doula can help the client to receive all the information that is needed in order for the client to feel comfortable with their choices. The client may choose to transfer and the doula can help the client's voice to be heard.

If a transfer becomes necessary, the doula will stay with the client at the hospital until after the baby is born. Some midwives stay as well, after transferring care to the hospital health care provider. If the midwife leaves, the client will still have continuous support from the doula.

7. Twice as many postpartum visits

Both doulas and midwives have scheduled postpartum visits with the new family. Having separate visits from both professionals means more support for the family on breastfeeding and adapting to caring for and parenting a newborn.

8. Celebrate the different roles

Midwives and doulas serve different but valuable roles during the pregnancy, labor, birth and postpartum period. Working with a midwife should not preclude the benefits of working with a doula and having a doula attend the birth should not interfere with or minimize the trusting working relationship that the midwife has with his/her clients.

9. Collaboration is key

Working together, midwives and doulas are able to create a win-win situation that clearly supports healthy births, healthy parents and healthy babies. When doulas and midwives collaborate, the families reap the benefits. Unfortunately though, subtle (or not so subtle?) areas of conflict can arise, between midwives and doulas, as both strive to serve their clients in the best way possible. When all the professionals attending a birth work together and avoid conflict, the end result is exponentially more positive for all.

Summary

Doulas and midwives should recognize that each professional brings different skills to the birth, along with some overlapping, but not competing abilities. Working together, respectful of the boundaries of the other, will benefit the client and their experience, create a collaborative situation that builds on everyone's strengths and supports the best outcomes for parents and baby. There is no reason to feel territorial or defensive. Open communication between midwives and doulas, mutual respect and a clear definition of each other's scopes of practice create the optimum circumstances to welcome a new human being into the world.

Photo credit: ©2014 Patti Ramos Photography
www.pattiramos.com

References
  • Caughey, A. B., Cahill, A. G., Guise, J. M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology, 210(3), 179-193.
  • Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5.

About the author

Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE is a birth doula and teaches independent Lamaze childbirth classes in the Seattle area, including "VBAC YOUR Way", "Cesarean YOUR Way" and "Labor YOUR Way" classes along with a home birth series for Penny Simkin. Sharon is a birth doula trainer on the faculty at the Simkin Center at Bastyr University. She is the Community Manager for Lamaze International's Science & Sensibility blog for birth professionals and serves as a co-leader of the Seattle Chapter of the International Cesarean Awareness Network. Sharon has served on the board of several local birth organizations and frequently speaks at international conferences. Visit Sharon's website to contact her or learn more.

Rewriting Your Birth Story

Posted by Midwives Alliance on May 13th, 2014

There are many defining moments in a woman's life, but few carry more weight than the day she is born into motherhood. Seeing her child for the first time after the nine months the baby has grown inside her body is elating, and it changes her- whether she's experiencing it for the first time or the seventh time. No birth story is ever the same, and each is unique and compelling.

There are times, however, when the expectations of what labor and birth should have been like, do not come close to what actually happened. This can be at the very least disappointing, and worse, emotionally and physically traumatic. Perhaps it was a natural birth that ended up in unwanted or unnecessary interventions, a complicated c-section, or lack of concern toward the laboring mom's frame of mind. It could be one person, one word, one action that changes everything for that mother, and finding emotional healing is not always easy.

We invite you to listen to The Longest Shortest Time's podcast, "Rewriting Your Birth Story," as Hillary Frank, writer and radio producer, explores the trauma she felt in her own birth story. With her are the midwife who participated in the birth of her baby daughter, as well as maternal care researcher Saraswathi Vedam.

We welcome your thoughts on how we can help mothers who are feeling trapped by negative emotions surrounding their birth stories find their road towards emotional healing. Please share your insights with us.

Stepping Down & Stepping into a New Adventure

Posted by Midwives Alliance on April 29th, 2014

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Embracing my lifelong career in midwifery began not as a conscious intention, but rather, as Destiny. In 1976, I was a twenty-something back-to-the-land hippie in rural northern Michigan when I caught my first baby for a first-time mother. I was also pregnant with my own first child. I wasn't doing it for the money. I was doing it for "the movement" to take birth back. I figured I'd be catching babies long enough to help my girlfriends have their births the way they wanted them, and for me to have mine. After that, I'd move on to my "real job."

Thirty-eight years later, it turns out catching babies was not only my real job, but moving midwifery forward in the United States was my real calling in life. For nearly four decades I have answered my calling fully and wholeheartedly. My midwifery journey has taken me to assorted destinations from community-based homebirth, to clinic-based healthcare for underserved populations, to co-founding a freestanding birth center with a team of DEMs and CNMs. I have caught babies at home, in birth centers and in hospitals. Even in sailboats and under apple trees. I have been educated through multiple pathways including self-taught lay midwifery, competency-based direct-entry midwifery (DEM), and university-based nurse-midwifery (CNM) with an accompanying Master's degree. Each pathway contributed to my expertise in a unique and valuable way. But my early homebirth roots—when our nurslings and toddlers accompanied us and stood wide-eyed and open-mouthed as they witnessed everyday miracles in the birth bed—laid the unflappable foundation for it all.

In the 1970s in my local neighborhood, I blazed a trail for a liberated and personalized way to give birth. In my state in the 1980s, I joined with likeminded peers to organize and co-found a vibrant professional midwifery organization that thrives to this day. In the mid-1990s, after specializing in normal physiological home birth for almost two decades, I went back to school and became a nurse-midwife so I could serve a broader range of women and their families.

It has been a gift and a pleasure to work for two populations different from my own. First I served Hispanic migrant farmworkers who traveled from Texas, Mexico and Central America to harvest fruits and vegetables in Northern Michigan, and then, numerous Tribal communities in the Upper Midwest. It has been a privilege to learn about traditions, health practices, languages, and beliefs unlike mine. For it is only through being immersed in a culture distinctly different from one's own that we learn to think outside of our narrow lens on the world. It is then that the doors of true compassion and understanding can open wider. When I moved into the realm of national midwifery leadership, advocacy to affect U.S. maternity care policies, and international midwifery initiatives, I was able to bring the numerous lessons I'd learned from people, cultures and politics. I became fiercely dedicated to issues of access, equity and respect for women's self-determination and for their right to make decisions about their health and that of their unborn and newborn infants.

In the late 1990s I made a transition from MANA member-at-large to a member of the MANA leadership team. For more than 15 years I have been deeply embedded in that team, first in three different roles on the Board of Directors, including President for two terms, and more recently as MANA's first Executive Director. Throughout those years, it has been my pleasure and privilege to work with many talented, passionate, and dedicated people, very few of whom are paid, and most of whom volunteer their precious time and energy to MANA and the midwifery movement. Gratitude, gratitude to each of you.

As I stand on the cusp of this transition, it is stunning how swiftly all of the years have flown by. During those times when I patiently waited for a breech baby to be born or feverishly worked to get a stuck baby out, the moments were inordinately slow. In fact, at those moments, time stood still. But earlier this month, as I worked amongst colleagues at the historic national meeting of the US MERA Work Group, it was odd to hear these words coming out of my mouth..."I am retiring."  A voice inside me whispered, "Already, really?"

But indeed, I am retiring. I heard my calling. I answered it with a lifetime of service. And now, I am entering into a period of rest and renewal.

As many of you know, after more than 20 years of living as a single, self-employed midwife and mother of three kids, seven months ago I married Fred, my old friend and lover. And as many of you also know—life is short! I intend to jump deeply and fully into this new adventure. Fred has a sailboat, and who knows what destination you might be hearing from me next.

A new and intriguing era for MANA has begun...and I wish you many blessings. May you be confident that MANA is in good hands with the next generation of leaders that are taking the helm and with the generation of Founding Mothers standing side-by-side to guide them. May you be generous in supporting the vision for the future articulated by your new and inspiring President, Marinah Farrell. May you be patient with the leadership team as MANA makes its next evolutionary leap into unchartered territory. And may you find a comfortable and welcoming home in MANA and a satisfying place just right for you to contribute your unique talents to the U.S. midwifery movement.

I leave you all with my spirit-arms wrapped steadfastly around you in camaraderie. Thank you for the honor of serving you all these years, for the many extraordinary and memorable adventures, and for the love you have shown me.

In gratitude,