Marion Toepke McLean, CNM, attended her first birth as primary midwife in August 1971. She received her nursing degree from Pacific Lutheran University in 1966 and her midwifery and family nurse practitioner degree from Frontier Nursing Service in 1974. From 1976 through 2001 she did home, clinic and hospital births, while also working as a family nurse practitioner. In 1980 she taught a year-long program for local midwives, returning to Frontier Nursing Service to teach during the summer. She had a homebirth practice until 1985, when she went to work at the Nurse-Midwifery Birthing Service, a freestanding birth center. In June 2000 she completed a BA in International Studies at the University of Oregon, with concentrated studies on Mexico. Since 2002 she has worked in a reproductive health clinic and attended an occasional homebirth. She lives in Eugene, Oregon, and is a contributing editor to Midwifery Today.
Read about the essentials of safe motherhood and how they will be the basis for a program in Uganda.
Childbirth. Straightforward, simple; complex, and variable. Essentially stated, it is the mammalian way to continue life down through the generations.
Years ago the “Four Pillars of Safe Motherhood” were developed. They are antenatal care, birth in a clean safe place with skilled attendant, access to emergency obstetrical care, and family planning.
Complications of childbirth are frightening for moms-to-be—yet they exist. Luckily, in our present day and age, there are effective treatments for most. Learning to deal with complications—to bring moms and babies through safely—is an important part of a midwife’s learning.
Marion’s Message
Labor can be long or short—it’s all normal. Organizations that make policy regarding birth are finally beginning to come to terms with that fact.
Shalon Irving died on January 28, 2017, from complications of high blood pressure and heart problems. She left behind a four-week-old baby girl. Shalon, 36 years old, was an epidemiologist and commissioned officer in the US Public Health Service (USPHS) at the Centers for Disease Control and Prevention (CDC).
In May 2017, Pro Publica and National Public Radio (NPR) published a story entitled “The Last Person You’d Expect to Die in Childbirth” (Martin and Montagne 2017).
The current research-based recommendation for screening in the US is a Pap smear every three years, starting at age 21, then Pap and high-risk HPV DNA screening every five years, starting at age 30.
The microbiome is a virtual swarm of micro-organisms which live in, on and around the human body. The Human Microbiome Project, launched by the National Institutes of Health (NIH) in 2008, was a five-year project which analyzed the genetic code of the microbes living in and on the human body, with the ultimate goal of finding how changes in the human microbiome are associated with health and disease. Despite the generation of massive amounts of data, this issue is currently not well understood.
