Changing the World
Sister MorningStar tells us, “What one woman can do, all women can do.” I wonder if this can apply to countries. Do we just need the will to change? Carol Gautschi, a homebirth midwife and Midwifery Today teacher, is flying with me to China to do midwifery training in two locations. We will be in Qingdao for a week doing a day and a half of midwife training, and we will be with our sponsoring province of Guangdong for a five-day training, which is in the city of Guangzhou. Get out a map and find us! We have been preparing for weeks and our excitement for the project is intense. We have been invited to a total of three different places in China already to do three-month long trainings. Chinese hospitals are waking up to the needs of motherbaby. Are US hospitals waking up? How is the rest of the world doing? Here is an excerpt from a letter received detailing their goals for China:
The health level of women and children is an important indicator to assess national and regional socioeconomics, as well as maternal and child health levels. With the maternal changes in demand, a higher demand for quality midwifery services creates the need for highly qualified personnel. We therefore need to pay more and more attention to capacity building of midwifery services. From June 25–29, 2012, the Guangdong Provincial Health Department commissioned the Nursing Education Center of Guangdong Province and the Third Affiliated Hospital of Guangzhou Medical University jointly organizing “the Guangdong Province midwives continuing education advanced training courses.” Guangdong province is now enrolling new students, and we welcome all to come.
We hope to train students in professional midwifery perspective and technique. We hope to improve cognitive knowledge and practical skills on pregnancy, birth and postpartum. To reduce the rate of cesarean section, we seek to promote natural childbirth and improve maternal and child health by introducing concepts and models of international midwifery services that are in continuity with humane midwifery services, such as the involvement of doulas and accompanying relatives.
What one country can do, all countries can do. What one hospital can do, all hospitals can do. We need the will and the heart to put motherbaby first; first over money, insurance companies and doctor’s golf games. The emotional and physical health of the world depends on it. If China is doing it, that means approximately 20% of the world’s population will have a good start to life.
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
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News and Research
Most Moms Hope to Breastfeed for Three Months, Only One-Third Do
Like many women, Tamara Clarke of Marietta, Georgia, felt “duped” by the hospital staff after her son was born. She was told her 8 lb son should be supplemented with formula after he lost 9% of his body weight within the first three days.
Unfortunately for Clarke, her son experienced “nipple confusion” and could not latch on properly at the breast.
“Around four weeks of age, he started latching on again and now he feeds from the breast like a pro,” said Clarke. “It was an uphill battle getting back there. I still pump and bottle feed him breast milk as well as supplement with formula at night. Although, he’s getting my breast milk now, I still look back on that experience and feel duped.”
The Centers for Disease Control and Prevention say that, for a variety of reasons, only about one-third of new moms are able to breastfeed their newborns exclusively for the first three months.
A survey of nearly 1500 pregnant women and their plans for exclusive breastfeeding after their babies were born was conducted by CDC researchers. The results showed that 85% of mothers planned to breastfeed exclusively for at least three months, but only about 32% were able to do so for the intended amount of time.
One CDC researcher said many hospitals might be thwarting breastfeeding efforts. In the study, 15% of the women’s babies had already been given some sort of supplement to their breast milk before even leaving the hospital. This can lead to nipple confusion and make it difficult to continue breastfeeding.
The American Academy of Pediatrics and the World Health Organization recommend that all women exclusively breastfeed for the first six months of babies’ lives.
— “Most Moms Hope to Breastfeed for Three Months, Only One-Third Do.” ABC News. Last modified June 4, 2012. Accessed June 14, 2012. http://abcnews.go.com/Health/moms-hope-breastfeed-exclusively-months/story?id=16475911#.T9o2BbXHmW8
British mothers are among the most reluctant in Europe to breastfeed their babies. In 1995, only 66 percent of babies were breastfed at birth, with rates dropping by 20 percent only two weeks later (Foster et al. 1997:24). The reasons mothers give up breastfeeding include insufficient milk (or the baby seems hungry) and sore nipples or painful breasts. Mothers’ dissatisfaction with breastfeeding may be linked to the crippling effects of Breastfeeding Nemesis.
Nemesis was the Greek goddess of just distribution. In Greek mythology, lesser gods were often the personification of an abstract concept or emotion. Nemesis represented the concept of revenge and divine response to Hubris, another minor deity, who personified arrogance. Nemesis lurked in the lairs of Hubris ready to work the wrath of the gods and punish any mortal who dared to trespass the measure of man.
The concept of revenge applied to medical technology likely would have remained in oblivion had it not been for theologian/philosopher Ivan Illich, who wrote a fierce critique of the impact of technology on everyday life and the dangers of the medicalisation of the life span. Central to Illich’s ideology is the ever-increasing number of therapeutic side effects caused by iatrogenesis. Iatrogenesis, from the Greek words for physician (iatros) and origin (genesis), is defined as any disorder or condition caused by medical personnel or procedures or through exposure to the environment of a health care facility. The significance of Illich’s work is in the recognition and analysis of what he terms the “expropriation of health.” In Illich’s words: “The so-called health professionals have an even deeper, structurally health-denying effect insofar as they destroy the potential of people to deal with their human weakness, vulnerability and uniqueness in a personal and autonomous way” (Illich 1975:26).
Illich’s work explores the divide between the activities of daily living normally accomplished alone or through experience, and mimicry or help from friends and family as opposed to those activities of daily living that require professional advice.
Illich highlights the irony of a political and industrial take-over that engineers a so-called “better health” through fixed systems of technology, creating a three-tiered “clinical, social and structural” iatrogenesis. This results in the total suppression of healthy response to suffering. Instead, the “defenseless patient” suffers the consequences of undesirable and retributive side effects, i.e., the punishment of Nemesis.
Oddly, there is a conspicuous absence of any allusion to birth, breastfeeding and reproductive technologies in Illich’s work. Pioneering obstetrician Michel Odent attempted to make up for this oversight. Illich’s ideology, along with Leboyer’s poetry, has shaped much of Odent’s practice. He pursued the work of Illich in his first book (1976), which recounted his personal experience of the demedicalisation of childbirth. Odent was one of the first obstetricians to critically examine the role of the “obstetrical technician” and focus attention upon the sometimes devastating consequences of “obstetrical hubris.” In sharp contrast to Illich’s style of scathing contempt, Odent’s style is descriptive. As a medical practitioner, he set out to demonstrate what was potentially possible to achieve in a state-run maternity unit just by changing attitudes and priorities.
In this essay the medicalisation of breastfeeding will be examined in an attempt to clarify how nursing a baby became a complicated observable behavioural science. In one short century, breast milk has been transformed into “a human biological product” (Rothman 1986:186). At best, the act of breastfeeding now requires midwifery supervision and instruction, or more extremely, expert medical advice as soon as it is deemed to have deviated from the norms dictated by the technological experts. This fixed system has created Breastfeeding Nemesis.
— Suzanne Colson
Excerpted from “Breastfeeding Nemesis,” Midwifery Today, Issue 48
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Q: Please share your experience of how breastfeeding was truly a nutrition lifesaver for your baby.
— Midwifery Today
A: My daughter had strep throat a month before she turned two. Breast milk was all she could keep down for five days. I’m sure she would have been admitted to the hospital for dehydration if she hadn’t still been nursing.
— Lyndsey Smith
A: My daughter was born at 27 weeks via emergency cesarean due to placental abruption and footling breech presentation. Fortunately for us, our hospital and its NICU were fabulously supportive of breastfeeding. My midwives checked on us daily in NICU, lactation consultants were happy to help and answer any questions we had and every single one of the nurses my daughter had in NICU were supportive and also able to help and answer questions. I firmly believe that the combination of kangaroo care and breastfeeding (including expressing when she was too weak to nurse) are the biggest reasons that she’s had so few issues in spite of her early arrival. Three years later (and, yes, still breastfeeding), I can’t imagine doing it any other way with such excellent results.
— Cat Pinson
A: Our second daughter was born in Abu Dhabi. My wife and kids were on visitor’s visas for two years. During that time they had to exit the country and travel to Turkey, India, Thailand, Ecuador, etc. I have photos of my wife nursing all over the world, and we never had to worry about food for our youngest.
— James Pendleton
A: My son developed a horrible lung infection at nine months that took him in and out of the hospital for over seven months. At 13 months, he got so sick that he stopped eating entirely. He gave up on any form of solids for over a month. Doctors told me my breast milk was the only reason he wasn’t hospitalized in the ICU. Eventually he started eating solids again, but it was the breast milk that saved him!
— Andrée-Anne Gagnon
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Wisdom from the Web
Breastfeeding helps with brain development. Breastfed babies score an average of six points higher on IQ tests than formula fed babies.
— Breastmilk.com, your breastfeeding community…created by nursing mothers for nursing mothers
Each nipple has 15 to 20 openings for milk to flow. When your baby nurses, the action of baby’s jaw and tongue pressing down on the milk sinuses creates suction. This causes the milk to flow out of your breast and into your baby’s mouth.
— Sutter Health, with you for life
Even though the iron levels are fairly low in breast milk, iron is absorbed 50% more efficiently than in commercial cow’s milk formula. Babies have a high reserve of iron from their life inside the uterus, and the combination of Vitamin C and lactose in breast milk help babies digest iron better. The calcium-phosphorus ratio is 2 to 1 in breast milk, the perfect balance to grow healthy bones.
If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to email@example.com.
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Conference: Anthropology and Personality
One of my favorite cultural experiences at a conference took place in Eugene many conferences ago. We were doing a theme of cultural practices in midwifery; there were midwives from many different countries and cultures present. Our midwives from Mexico were talking about how important warmth is for mothers before, during and after birth. They even make sure mothers eat warm foods. I found out that this idea of warmth is also important in many other cultures. I looked at the two Inuit midwives who were present and asked them how they like to have their women eat their food when they are pregnant. One looked at me, paused for a few seconds and then said, “We like it frozen!” What an amazing answer that gives a great example of anthropological differences; my professor in college would have loved it.
To me, one of the elements I love about conference is that each event has its own personality, which results in a great experience for all involved. The conference personality is formed by the blending of the teachers, registrants and the theme of the conference, as well as the location. Though retreat centers and towns are wonderful, it is the interactions, insights and knowledge shared that truly matters. We have had some fantastic experiences in hotels like the Hilton here in Eugene, Oregon, and we have had amazing experiences in Bad Wildbad, Germany, our favorite venue with its spas and small mountain town atmosphere.
Learn more about our upcoming conferences.
— Jan Tritten
A mom was in labor and the baby went into distress. I called the local hospital and proceeded to transport the laboring mom in my first ever brand new car. The baby was born in the backseat before we could pull out of the parking lot!
— Sue Turner
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Midwifery Today: Each One Teach One!