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Introducing MANA's New President: Marinah Valenzuela Farrell

Posted by Midwives Alliance on March 6th, 2014

MANA has begun a new era!

Introduction by Geradine Simkins, DEM, CNM, MSN is MANA's executive director. You can learn more about her here.

Three years ago when I recruited Marinah Farrell to be on the MANA board, little did I know I would be introducing her to you today as your new President. I am thrilled to say that with her Presidency MANA has begun a new era in at least two important ways. First, Marinah is the first President who is not from the "Founding Mother" generation of MANA. She stands on the shoulders of the cadre of seasoned MANA leaders who will work hand in hand with her. And second, Marinah is the first midwife of color to be president of MANA, a milestone of serious significance for MANA. Welcome to your new position, Madame President, the torch has been passed to you. Shine on!

Marinah's Story

by Marinah Valenzuela Farrell

I can never think about my story without invoking the history and spirits of my ancestors. My grandfathers and grandmothers were fiercely elegant even amidst the poverty that surrounded them. I conjure memories of my grandfather's blue eagle-eyed silence as we rode his horse into the mountains of Mexico, an explorer of the wild and lover of herbal medicine. This knowledge he passed down to my mother, who passed it down to me.

My parents met in El Paso Texas, and I grew up in a place between the U.S. and Mexican borders. I grew to awareness that it was important to work for vulnerable populations because both of my parents were devoted to missionary work their entire lives. Much was given, and therefore, I have always felt much was expected. Thus, I work for many non-profit organizations here in Arizona and abroad. Everyday, I give thanks for the gift of midwifery and for the communities who invite me into their lives.

My first MANA convention (doesn't everyone have a story of their first MANA convention?!) was in Arizona. Ina May Gaskin and Marsden Wagner were there, as well as all types of midwives and birth workers and advocates. Being at MANA was a "coming home" and an all-star event of unforgettable individuals. From that time forward, I have loved MANA.

With the advent of technology, the aging of our tireless founding mentors, the explosion of maternal health organizations and the fast American pace of life, our board had to look hard at our grassroots style and wonder how in the world we would be able to keep up. We reject becoming pathologically "corporate," but also realize we need to adhere to business policies and practices in order to meet the accelerating demands of our organization. We want to remain an organization that honors all midwives, can professionally represent our members, can still be groovy and, more importantly, will be compassionately progressive.

Our learning curve became a slope. We prioritized trainings in organizational and cultural humility and how to be more supportive of gender freedoms. We created better systems of communications for the "virtual" demands of social and electronic media. We amplified our voice at International and National meetings because midwives are more supported than ever in some ways and yet more vulnerable to hostility because of it. Our Division of Research, whose Coordinating Council are pioneers each and every one, is an essential contribution we make to the midwifery profession. It facilitates us understanding what the big picture looks like in maternal and child health, and for everyone "out there" to understand the important role midwives play in that picture.

The founders of MANA packed into cars with their babies on a shoestring budget and met in hotel rooms to write bylaws and to be recognized as a profession. MANA was founded on a love of midwives and, ultimately, the families they serve, and this remains our core foundation. Looking towards the next 30 years, MANA is evolving to embrace the "new" tools of technology, social media and research. My vision is for every MANA member to have equal access to the profession and our organization because every community and every woman needs a midwife that best represents their own values and cultures. And, ultimately, MANA wishes to welcome a new generation of leaders into the movement to carry on this always hard, always beautiful, "groovy" work.

Peace, health and love to you, Marinah

To learn more about MANA's recent projects and strategic priorities, visit our new e-zine here.

Happy IBCLC Day from MANA!

Posted by MANA Community Manager on March 5th, 2014

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Today is IBCLC Day! 

This year, the International Lactation Consultant Association (ILCA) is honoring the day by “taking this opportunity to thank the International Board Certified Lactation Consultants (IBCLCs) that have made a difference in our lives.”

We know that many aspects of the midwifery model of care result in very high breastfeeding rates among midwifery clients. The recent study by the Journal of Midwifery and Women’s Health found that women who intended to give birth at home had exceptional breastfeeding outcomes. At six weeks postpartum, more than 97% of newborns were at least partially breastfed and 86% were exclusively breastfed.

Despite the many practices of midwives that encourage breastfeeding, some women still experience breastfeeding challenges. This can be the result of anatomical issues (like tongue tie, flat or inverted nipples, or previous breast surgeries), medical issues (premature infants, infants with disabilities, or mothers with illness or disabilities), or just the process of learning a new skill.

For example, Treesa McLean, a Licensed Midwife in California, works in consultation with an IBCLC in her community if a baby has special needs. “Premature infants or babies with disabilities may need extra breastfeeding help. I trust our IBCLCs to support moms who need it.”

Other times, a midwife might have the knowledge base to provide a family with support, but time limitations. “If I am at a birth and a mother needs immediate help, I’ll refer her to a local IBCLC,” said Washington State-based midwife Louisa Wales, LM, CPM.. “Or if I think she’s going to need ongoing care that would be better provided by someone who focuses exclusively on breastfeeding.”

Most midwives have stories to tell about how International Board Certified Lactation Consultants have helped improve outcomes for families. Take today to thank IBCLCs in your community! Share your story of working with IBCLCs in the Facebook post here. You can also show your gratitude by clicking share and posting on the Facebook “wall” of an IBCLC that has helped you and the families with whom you work.

 

Black History Month 2014 Is Ending, But Health Disparities Continue

Posted by Midwives Alliance on February 25th, 2014

Opportunities to make change year round

During the month of February, MANA has been highlighting birth workers of color and their role in improving outcomes for mothers and babies.

Although Black History Month ends this week, the impacts of health disparities in the U.S. continue year round.

MANA would like to bring attention to one national effort to create health equity: scholarships for birth workers of color.

The Birth Workers of Color Scholarship "Grand Challenge" is asking every midwifery program in the U.S. to offer one scholarship per year to women of color. As the site says:

"A midwife for every woman. That is our grand ideal. But what if you are a woman of color in America, where is your midwife from your unique culture?"

If you operate a midwifery training organization, please consider adding a scholarship today. For all of us there are many ways to get involved:

  • Raise awareness. Share the site widely and call on the organization that trained you to offer a scholarship.
  • Offer your assistance as a mentor or preceptor.
  • Offer scholarships for workshops or other trainings you provide.

This project is being spearheaded by Claudia Booker, CPM, Jennie Joseph, CPM, LM and Vicki Penwell, CPM, LM. Learn more at the Birth Workers of Color Scholarship site here.

Educate yourself and your community on maternal child health disparity in the U.S.

When the Bough Breaks free viewings extended for 2014.

To honor Black History Month in 2013 MANA created the opportunity for members, friends, and the community at large to have free access to When The Bough Breaks, a groundbreaking documentary that explores why black babies in the U.S. are more than twice as likely to die, be born too soon, or too small.

MANA has extended this opportunity for 2014. To learn more, email socialjustice@mana.org today.

Presenting and Honoring: Fatima Muhammad, MPH, of Phoenix, AZ

Posted by Midwives Alliance on February 24th, 2014

Celebrating Black History Month

Fatima Muhammad, MPH, is the Director of the new Tanner Community Development Corporation’s Birthing Project, based in Phoenix, Arizona. The mission of the TCDC Birthing Project is: "To empower our families with quality education, skills, and support that promote conscious conception, positive birth experiences and outcomes, resulting in healthy and nurturing parenting practices." Fatima began her journey in Maternal and Child Health as a doula in Tucson, AZ. A few months later she was offered a position at the Phoenix Birthing Project. While there, she worked to decrease high infant mortality rates in the African American community through training Arizona’s first group of Community based doulas, facilitating parenting classes and providing psychosocial support to African American pregnant and parenting families.

In addition to being the Director of TCDC's Birthing Project, Fatima continues her maternal and child health work as a midwifery student. "Becoming a midwife allows me the opportunity to provide quality healthcare services to our families. I believe getting back to our traditional birth practices is key to empowering, preserving and strengthening our community. I plan on practicing the best possible midwifery on all levels; mentally, physically, spiritually and skillfully, resulting in optimal birth outcomes," said Fatima. "My biggest challenges in this work thus far have been funding and finishing my midwifery license. These are no longer obstacles. I realize we are the ones we have been waiting for and no one can serve our community better than we can to improve our state of health."

When asked who her heroes are, Fatima responded, "My 'shero' is my mother. She knew how to make a way out of no way. Her love was so nurturing that it surpassed all of our hardships. My mother always reminded me that I could be or do anything! She taught me about strength, my power, and to value the gifts the Creator has given me as well to help others through the use of my gifts."

For more information on how to assist the TCDC Birthing Project please visit www.tcdccorp.org, or call 602.253.6904.

Home Birth Research Q & A

Posted by MANA Community Manager on February 7th, 2014

We’ve had lots of questions from families, midwives, and others about the recent release of two articles that were based on the Midwives Alliance of North America dataset (MANA Stats). Here are answers to some common questions, along with a roundup of some of the coverage.

Numbers are useful, but only if they can be compared to something. What outcomes can we compare to the Cheyney article’s findings?

In the study, the authors compare the findings to the best available observational studies of planned home births and birth center births. For low-risk women, the authors find similar rates of both positive and negative outcomes for mothers and babies as nearly every other large, well-designed study.

Some of these well-designed studies are able to compare to hospital rates (which is difficult to do in the U.S.). For example, the Hutton et al (2009) study found no difference in risks to babies between home and hospital in Ontario, Canada. While it is reassuring that the Hutton study had comparable rates of mortality at home as the Cheyney study and it found no difference in risk between home and hospital, more research will be needed to compare U.S. home birth and hospital birth rates.

Why doesn’t the Cheyney study compare home birth to hospital birth mortality rates?

It makes sense to want to draw these comparisons. However, hospital rates in the U.S. are derived from vital statistics data (birth certificates and/or death certificates). A number of organizations, including the American College of Nurse Midwives and Citizens for Midwifery have spelled out the limitations, which include a failure to capture the intended place of birth and inaccurate reporting of some outcomes.

Also, the MANA Stats data captures three kinds of mortality outcomes:
Intrapartum = a baby that was alive at the onset of labor, but died prior to birth
Early neonatal = a baby that was born alive, but died during the first week of life
Late neonatal = a baby that was born alive, but died between 7 and 28 days of life

Vital Statistics data report only two: early and late neonatal deaths. You may have participated in discussions that attempt to make these comparisons. Many have confused the combined rate (intrapartum+early+late neonatal) with rates that include only one or two of these outcomes. When attempting to compare rates, we encourage you to ask whether the rate is for intrapartum, early, or late neonatal, and to ask for the source of their data.

How could the findings of this research be so different from findings that suggest home birth has a greater risk than hospital births?

Those studies primarily rely on Vital Statistics data. For a helpful fact sheet on how to assess the quality of articles based on medical records - the “gold standard” for research and the basis of MANA Stats - against those based on Vital Statistics, see this in-depth look at Citizens for Midwifery.

I’m looking for unbiased analyses of this article and home birth evidence to share with families, policy makers, and others.

Here’s a few we’ve found:
Evidence-Based Birth summary on Facebook. Rebecca Dekker is known for her thoughtful and unbiased approaches to the literature.
Judith Lothian’s review at Science and Sensibility.
ACNM’s preliminary review of the Chervenak/Grunebaum findings. This includes a comment on MANA Stats.
Citizens For Midwifery's summary of the findings.

NEW TODAY:

The Daily Beast’s look at how “alarmist studies . . . from data pulled from vital-statistics data” are getting in the way of ensuring safety for mothers and babies, from the Daily Beast. 

Citations:
Hutton EK, Reitsma AH, Kaufman K. (2009). Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth 36(3):180-9.

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