Marion Toepke McLean

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.

Marion’s Message: The Future of Midwifery

by Marion Toepke McLean September 19, 2021

The good news is that midwives are receiving recognition for our work! The World Health Organization has proclaimed “The Decade of the Midwife” from 2021 to 2030. This will help midwives serve mothers and babies, to the best of our capabilities, to keep them safe in the passage of childbirth.

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Marion’s Message: Tear Prevention from a Retired Midwife

by Marion Toepke McLean June 12, 2021

I graduated from Frontier Nursing School of Midwifery (1) in 1974. At the time episiotomy was widely taught and practiced in obstetrics as the healthiest delivery practice for mom and baby. But we were a midwifery school. We learned to do episiotomies only if it seemed necessary.

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Photo by Aditya Romansa

Marion’s Message: Shoulder Dystocia: Midwifery Care

by Marion Toepke McLean March 18, 2021

Shoulder dystocia (SD) is a complication that is rare, hard to predict, and potentially fatal to the birthing baby. Baby and mother can sustain lasting damage. No wonder it is commonly feared by birth practitioners.

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Marion’s Message: A Birth Where I Learned a Lot

by Marion Toepke McLean December 10, 2020

It was a normal birth in a large room in a small house in a city neighborhood. The modern hospital where I had midwifery privileges was just blocks away. I could transfer care easily and quickly if needed.

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Hemorrhage in Pregnancy, Childbirth, and Postpartum

by Marion Toepke McLean September 15, 2020

Hemorrhage is the number one cause of maternal death worldwide, and in the US as well. In most developed countries it is a less frequent cause. A study of the differences between the US and other developed countries might yield clues to prevention of unnecessary maternal deaths.

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Marion’s Message: Healthy Childbirth Boundaries

by Marion Toepke McLean June 10, 2020

In childbirth, the needs of the one giving birth and the baby—who is transitioning from unborn to born—are primary. The events of the birthing day will affect them for their whole lives. Without their presence, no birth will take place.

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Physiologic Third Stage

by Marion Toepke McLean March 31, 2020

“Physiologic” third stage of labor means that this stage happens on its own—with no interference or treatment whatever—and is within the bounds of normal functioning. Read more…. Physiologic Third Stage

Marion’s Message: The First-time Women’s Health Exam

by Marion Toepke McLean January 23, 2020

Midwives serve women in a variety of ways. Midwife Marion McLean shares how she works with women in their first-time health exams.

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Photo by Apio Rebecca

Saving Women’s Lives in Uganda

by Marion Toepke McLean December 24, 2019

The death of childbearing women is a challenge to health workers worldwide. Why are pregnant and postpartum women so vulnerable to death?

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Photo by Cassidy Rowell

Bimanual Compression of the Uterus: Its Place in Midwifery Practice

by Marion Toepke McLean September 17, 2019

Learn about the hows and whys of this technique to stop postpartum hemorrhage.

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Photo by Annie Spratt

The Pillars of Safe Motherhood

by Marion Toepke McLean June 1, 2019

Read about the essentials of safe motherhood and how they will be the basis for a program in Uganda.

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Photo by Josef Juchem

Interventions in First Stage

by Marion Toepke McLean March 21, 2019

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.

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