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: Preventing Problems Through Prenatal Care

Prenatal care can detect and treat many problems. Preeclampsia comes to mind. The classic signs of preeclampsia are high blood pressure and protein in the urine. It affects the placenta by reducing the blood flow and, unchecked, can lead to intrauterine growth retardation and fetal demise. Checking blood pressure and urinary protein are routine parts of prenatal care.  Read more…. Marion’s Message: Preventing Problems Through Prenatal Care

International Midwifery/Brought to Earth by Birth

“Brought to earth by birth.” This somewhat enigmatic counterculture midwifery saying is logical and meaningful. And unifying, in a way. All of us, around the world and in so many situations, are developed in the womb, grow during the months of pregnancy, and then the process of birth takes place. This is the same among the world’s many cultures and ways of living.

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Marion’s Message: What is the Fetal Ejection Reflex?

Marion discusses the fetal ejection reflex and an idea for a study comparing it to routine hospital care.

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Marion’s Message: Placenta Accreta Spectrum: A Pregnancy Complication That is Becoming More Common

Placenta accreta is a serious condition of pregnancy that has been increasing worldwide since the 1980s. It can lead to severe hemorrhaging and death. It has been a leading cause of the increasing maternal mortality in the United States in the past few decades.

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Midwifery as a Gift

Midwifery Today needs your help so we can continue to help others become midwives or doulas, provide worldwide birth education, and lead more women to have better births. Read more…. Midwifery as a Gift

Too Little Too Late or Too Much Too Soon? How About Just Right?

Maternal mortality prevention has been a world health goal ever since the conception of the Safe Motherhood Initiative in 1985. Maternal death occurs in pregnancy, childbirth, and the postpartum time.

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 Read more…. Too Little Too Late or Too Much Too Soon? How About Just Right?

Marion’s Message: The Role of the Midwife

The last decade of the WHO Sustainable Development Goals (2015–2030) has been dedicated to nurses and midwives. Cadee and Wicklund stated that, “two million midwives and 22 million nurses make up half of the world’s health workforce and are at the heart of health care everywhere” (Cadee and Wicklund 2020.).

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Marion’s Message: Intervention to Prevent Maternal Mortality

Sub-Saharan Africa has the world’s highest regional maternal mortality rate. I am currently working with African partners in Soroti, Uganda—located in that region—on research to learn why these deaths occur.

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Marion’s Message: The Future of Midwifery

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

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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Marion’s Message: Shoulder Dystocia: Midwifery Care

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

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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 Read more…. Marion’s Message: A Birth Where I Learned a Lot

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