I am at the Midwifery Today conference in Harrisburg, PA this week/weekend. If you're here too -- hi!!
My observations (and opinions) are as follows......this is my first time at a MT conference, so I am seeing this entire conference through both a new attendee's eyes, a new midwife's eyes, and through a CNM's eyes.
My first impressions where....awesome, amazing, such wisdom to share between such wise women! Meeting and listening to Angelina, a traditional partera (midwife) from Mexico was just...awesome. She brings four generations of traditional midwifery experience and wisdom with her. Granted, the majority of her clients are indigenous Mexican women, who have different body structure than the clients I see, different cultural beliefs, spiritual beliefs, and who have different diets/nutrition than the women I care for, but much of her wisdom is in a general type of knowledge that applies to all women. Care and pampering of the mother, good nutrition, proper alignment of the baby, nurturing the spirit, and assisting women at their births (mostly upright positions, by the way, which is much different than what I see in the hospital). Listening to Angelina tell her stories, share her wisdom, several of us remarked on how she should publish this in a book to share with midwives all across the world. I genuinely hope that Angelina does this. What an amazing legacy to share with women and midwives across the globe! (By the way, Angelina
Gail Hart - lots of wisdom, intelligence and experience from this wonderful woman. She taught a session on shoulder dystocia and malpresentations. Gail presented evidenced-based material, research studies, and a good discussion on how shoulder dystocias occur, and how they can (hopefully) be prevented, (possibly) predicted, and how to resolve them. A great topic, with a thoroughly researched and well presented session.
I didn't get to attend the Spinning Babies session -- sold out :-(
Now, for some of the downsides to bringing many different midwives and birth attendants together........misinformation and plain old wrong information. Gail at least acknowledged that hospitals and medical providers (MDs, peds, NICU, CNMs) are there for a reason -- when things go in an abnormal direction, it's time to transfer. But other presenters....I will not name names at this point....are sharing/teaching some unsafe and wrong information. Now, if anyone can counter my thoughts/opinions on the following, please do. I am always open to learning --- evidenced based please, not anecdotal! --
Mouth to mouth resuscitation on a baby that is newly born and needs resuscitation. No. Standard precautions!!! If it was my baby, or a very close family member, or a dire emergency, and equipment was not available, that would be different. But seriously.....carry a newborn bag/mask and a tank of oxygen with a blender on it.
Only use air for resuscitation of a newborn. Uh, no. See my comment about a bag/mask with an oxygen tank with a blender on it. You start out with 21% oxygen (room air), and increase it if needed, if baby does not respond appropriately. Then you dial down the % of oxygen, until you gradually wean baby off of oxygen. And if baby still needs oxygen....transport to the hospital.
As the midwife/birth attendant, stimulate the baby's ear to get it to breathe. (Seriously...lick the ear, nuzzle it, even put your tongue in the baby's ear.) Once again, this is fine and instinctual if you are the mother doing this to your baby. But this is being told to birth attendants/midwives, to do to your client's baby.
Don't do tactile stimulation to a baby that needs resuscitation. For real? Sorry, but a little bit of gentle tactile stimulation is really going to work to get a baby to take a good breath, or to encourage a baby to continue to breathe.
In a woman with hyperemesis, an enema with electrolytes will fix her dehydration. Oh now, come on, really? H.G. is a true reason to go for IV hydration, IV medications, and even possibly a longer term PICC line. Take her to the hospital. An enema?!?
An example was given of a woman diagnosed with preeclampsia at 35 wks gestation. Not the best nutritional status. The midwife's advice? "You don't really have it (preeclampsia), and I can fix it with good nutrition." Get the ef out of here!!!!! Preeclampsia can not be cured with good nutrition, especially if she is already 35 weeks pregnant! No evidence given to back this up, just anecdotal experiences.
As you can tell, I started out very enamored and excited to be at MT this week, but I am clearly becoming less and less excited about it. NONE of the speakers are CNMs. None are medical/nursing researchers. Yes, there are some very wise LMs/CPMs as speakers, but there are also some that I thought would be good to learn from. No. Giving wrong information to other aspiring midwives is just WRONG.
And now, I am even more firm in my belief that there needs to be a very basic entry level testing/certification/licensure process for ALL midwives in this country. While things are definitely different in poorer countries, third world countries.......we are in the United States. We are NOT a third world country. We are rich with educators, researchers, physicians, certified nurse-midwives, evidence-based practice. This needs to be throughout our country. Yes, there are midwives who serve women in poor communities, in different cultural communities (Old Order Amish, Faith Tabernacle, etc), but we all need to be well educated. We all need to know when we are in over our heads (or heck, let's acknowledge it before we get in over our heads!), and we ALL need to work towards the common goal of good midwifery/medical care for all women and babies.
In the end, I am so glad that I chose Frontier for my education. I could NOT have chosen a better path for becoming a midwife.
