July 6, 2016
Volume 18, Issue 14
Midwifery Today E-News
“International Issue”
Print Page

In This Week’s Issue

MT online storeSee how birth should be

nacer con amor cambia el mundo, a 4-disc DVD set from La Primavera Maternidad Clinica, gives you over seven hours of birth footage. Jan Tritten says: “The births shown in this DVD set are the most beautiful births I have ever seen on film. They are so gentle and work so well with nature, they show how birth should be conducted in a very gentle, hands-off kind of way.” The set is in Spanish only, but our shared humanity makes them completely relatable. To order

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Quote of the Week

Be the change you want to see in the world.

Mahatma Gandhi

The Art of Midwifery

The humanization of childbirth is a big house full of doors through which many forms of expression of the phenomenon of birth can circulate. If the walls of this house are maintained strong and steady by the power of an interdisciplinary vision and its connection with evidence-based medicine, the different colors and textures of the humanization movement will be always welcome.

Ricardo Jones
Excerpted from “Birthcraft in Brazil: An Update on the Brazilian Humanization of Birth Movement,” Midwifery Today, Issue 118
View table of contents / Order the back issue

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Editor’s Corner

[Editor’s note: This issue’s guest editorial is by Sister MorningStar.]

I am very aware at present of the need for a paradigm shift toward our community involvement with birthing mothers. People are afraid of birth. Even ER docs and paramedics are afraid of birth. They would rather handle a gunshot wound. Grandmothers have become silent. Friends and family feel ignorant and helpless. We have lost the joy and wonder and celebration of birth that allows a mother to move through pregnancy and labor surrounded by calm loved ones and familiar environments. Indigenous people’s rites, rituals and prayers often don’t work when exposed to unbelievers. The natural mystery of life and birth is often undermined to breed fear rather than curiosity and trust. What to do? Learning more has not helped. Science proves and disproves on a daily basis and keeps everyone reading and confused. Meanwhile, mothers are growing another baby. Maybe the Cherokee can help. Maybe simplicity and sacredness can help. Maybe returning birth to community by way of village prenatals can help. [See MorningStar’s article on village prenatals.] Together, we can circle the earth and start a new wave of hope and joy.

— Sister MorningStar

Sister MorningStar has dedicated a lifetime to the preservation of instinctual birth. She birthed her own daughters at home and has helped thousands of other women find empowerment through instinctual birth. She is the founder of a spiritual retreat center and author of books related to instinctual and spiritual living. She lives as a Cherokee hermitess and Catholic mystic in the Ozark Mountains of Missouri. Visit her at her website.

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Featured Article

The Medicine of the Ukhu Pacha: Andean Sacred Teachings around Pregnancy, Birth and Postpartum

Andean culture and wisdom offer a deep and honoring approach to women’s bodies and their reproductive health, including the time/space around birth and becoming mothers. Birth is considered a rite of passage in itself, where one will no longer be the same. The time of pregnancy and birth is considered to be a chakana (bridge) into maternity and an entrance to another reality: the Ukhu Pacha, where one enters her darkness, her inner world, and finds her strength and her medicine. The Ukhu Pacha is associated with the world of the ancestors, with the dark (from which everything is born), with the feminine generative force, with the periphery and with the unknown. The wisdom present in this can help women understand the different emotions we experience throughout pregnancy, birth and postpartum, which are not only emotional or mental states on the “bright side” but can include also sadness, grief, doubt, deep fears and confusion as we dwell in the waters of the Ukhu Pacha. As we will see, Andean cosmovision doesn’t understand these emotions as negative but as opportunities to better know ourselves, heal in deeper levels and strengthen our personal medicine.

It is starting with conception that the pregnant woman slowly enters this Ukhu Pacha as her pregnancy progresses, reaching its greatest depth at birth. She then slowly emerges from the Ukhu Pacha together with her baby. When we cross the threshold at the time of birth, diving in the deepest waters of the Ukhu Pacha, we experience a paramount transformation and are reborn at different levels of experience. When we cross the threshold of birth, we not only give life to a new being but we give birth to ourselves. We birth ourselves as new women, as we will not be the same again. Thus, according to Andean practices, to incorporate within the world of culture or the Kay Pacha (the here and now reality), the woman and her baby, as beings in transition, make a trance from one state to another, from one world to another, and must enter in the cultural world of norms (Lingán 1995). Thus, special care is given to the new mother by female community members in this rite of passage, as this is understood to be a very vulnerable state, not only physical, but emotional, mental and spiritual, where so much of her experience in the world as a woman is transforming. In a way, a woman in her state as a new mother after birth is weaving again, little by little, her new identity/identities and her place in the world. This personal transformation into becoming a mother must not be taken lightly (by herself and by her community).

The mother and baby during the pacha, or time-space after birth, are still dwelling in the Ukhu Pacha and going out little by little (and incorporating themselves) back to the Kay Pacha, or time-space as we know it, and they sense it normally. Thus, in the Andes, the common cultural practice is to have a one-moon or one-month retreat after the wawa (baby’s birth) to support this transitioning. The new mother stays in her house during the first days after birth just in her room, and she is cared for by close family and female community members. Her husband is a key part of this support circle, and he helps with household chores, as the new mother has to be in absolute repose and isn’t supposed to cook, wash laundry or dishes or clean the house. Although she is “on retreat” and has to follow some cultural norms during her time of seclusion (e.g., a special diet, minimum contact with water), she is not alone and she feels supported in this process. Certain cultural practices are followed by mother and baby to support the containment needed in this vulnerable pacha, such as the Andean practice of walta or walteado (swaddling). It is also advised that the household’s physical environment remains dark, and this is easy to attain as typical Andean houses aren’t illuminated; they resemble dark little wombs.


  • Lingán, M. 1995. “El ritual del parto en los Andes.” Dissertation. University of Nijmegen.

Cynthia Ingar
Excerpted from “The Medicine of the Ukhu Pacha: Andean Sacred Teachings around Pregnancy, Birth and Postpartum,” Midwifery Today, Issue 118
View table of contents / Order the back issue

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Website Update

Read this editorial by Jan Tritten from the newest issue of Midwifery Today, Summer 2016:

  • Core Midwifery Skills

    Excerpt: Where do we learn the most about birth? I think we learn most from the mothers and babies on their journey. Can we separate core midwifery skills from the face-to-face meeting of the mothers and getting to know them and walking on their journey with them? Our core midwifery skills must attach directly to the kind of prenatal care we provide, our attention at births and our encouragement and care postpartum. There is no substitute for experience.

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Country Contact Question of the Quarter

Editor’s Note: Midwifery Today is interested in promoting international networking among childbirth practitioners. Our goal is to strengthen the international community by establishing a country contact in every country of the world. If you would like to become a country contact, please e-mail Jan Tritten. Learn more about Country Contacts.

For this international edition of E-News, we asked Midwifery Today’s country contacts the following questions:

Where does your country stand with regard to human rights in childbirth? Are there hospitals or clinics that are baby-friendly?


In Slovakia, human rights in childbirth is still a very “foreign” concept. Many of the problems our maternity care has are so normalized (e.g., no proper informed consent) that when we start talking about human rights in childbirth, people (both public and medical professionals) will say that “of course, birthing women have their human rights,” but if you look at the individual issues, it turns out that the rights actually are not respected. The normalization of bad practices and the failure to recognize these problems in the first place makes it very difficult to get respectful care in individual cases and achieve system change on a country scale.

About half of the hospitals in Slovakia carry the baby-friendly accreditation, but the actual situation is different. Our organization (NGO Women’s Circles; activists for human rights in childbirth) together with NGO Mamila (lactation consultants) have performed a survey (3000 mothers from all hospitals in Slovakia, including all “baby-friendly hospitals”), which showed that there is no difference in baby-friendly and non-baby-friendly hospitals. Mothers and babies in baby-friendly hospitals do not receive the kind of care that promotes and supports breastfeeding; mothers and babies are not placed skin to skin after birth; separation of mothers and babies is common; and babies are supplemented with bottles of formula for no medical reason. Not a single hospital in our survey met the BFHI criteria.

We are petitioning with WHO and UNICEF and hoping to have the titles removed. The hospitals need to change their practices!

Iveta Jancigova


As far as I know, there is nothing like “human rights in childbirth” in my country of Ghana. Women have no rights when it comes to childbirth; that idea is nonexistent. Nobody talks about women’s rights in relation to childbirth practices.

This year I have been discussing abuses women face during childbirth in my pregnancy classes. One woman shared her experience of how she was fired from work the very day her employer found out she was pregnant. She was not sick and was performing her duties all right. Her employer was a medical doctor and she was a nurse.

I am in the process of securing some time on a television program to talk about human rights abuses women face in Ghana. The silence must be broken. People hate the issue of human rights because when you talk about it, you step on their toes. God have mercy.

Abena Okra

South Africa

Human rights in childbirth is not high on the agenda here in South Africa, but a start was made last year when the first Human Rights in Childbirth Conference in Africa was held in Johannesburg.

South Africa has two streams of maternal care. Firstly, there is the private health care system for those who can afford to pay Medicaid. Here, every effort is made to provide hotel-type surroundings, yet very few private hospitals are mother-baby friendly, and the rate of cesarean section in private health care is between 70–90%. Women are strongly coerced into surgery for various reasons, and most women just comply. This is changing though as women become more aware of their rights through Facebook groups such as “VBAC in SA.” Secondly, the public health care service provides for the majority of people in South Africa and a huge effort has been made to turn most hospitals into baby-friendly units. Breastfeeding is encouraged, and babies are not separated from their mothers unless medically required. Even when the mothers undergo cesareans, babies are popped into the beds right next to or skin to skin with their mothers. Sadly, these government hospitals are not so mother-friendly, and most women are made to give birth on their back or semi reclining. There is a lack of respect shown to women, and verbal and physical bullying is common. The rules change from region to region, and while doulas and husbands may be allowed in some maternity obstetric units/or hospitals, they are not allowed in others. Women are often not aware they have rights, although I think this is slowly changing as women have more access to communication technologies through cell phones, Facebook and other social media sites.

Marianne Littlejohn

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