- Email: [email protected]
Reducing maternal mortality is a matter of social justice
International news International day of the midwife Member Associations of the International Confederation of Midwives marked May 5th in many different ways in 1998. The theme of the day was 'Equity for Women'. The New Zealand College of Midwives campaigned for paid maternity leave and presented the mother of every baby born that day with an announcement card that the baby was born on the International Day of the Midwife. The New Zealand College of Midwives also launched its website on that day (midwives.org.nz). The website promotes midwives as health professionals who support consumer choice and provides information to women. Many of the midwives and places for birth also took out pages of advertisements in the media. The midwives of Germany involved their students in planning leaflets and midwives were visible in shopping malls all over the country explaining the role and work of midwives. After hearing about the day and its significance the midwives of Vietnam proceeded to develop a competition. A Jazz concert, held in Lucern was a feature of the day for the Swiss Midwives' Association.
Reports received by International Confederation of Midwives
Website for Safe Motherhood The Safe Motherhood Inter-Agency Group now has a site on the worldwide web. The address is: http://safemotherhood.org
Safe Motherhood, Issue 25, 1998 (1)
Reducing maternal mortality is a matter of social justice Pregnancy and childbirth are special events in women's lives, and, indeed, in the lives of their families. This can be a time of great hope and joyful anticipation. It can also be a time of fear, suffering and even death. Although pregnancy is not a disease, but a normal physiological process, it is associated with certain risks to health and survival for both the woman and the baby she bears. These risks are present in every society and in every setting. In developed countries they have been largely overcome because women are in better health when commencing pregnancy, and every pregnant woman Midwifery(1998) 14,
190-193
© 1998 Harcourt Brace & Co. Ltd
has access to special care during pregnancy and childbirth. This is not the case in many developing countries, where each pregnancy represents a journey into the unknown from which all too many women never return. This situation cannot be allowed to continue. The interventions that make motherhood safe are known and the resources needed are obtainable. The necessary services are neither sophisticated nor very expensive, and reducing maternal mortality is one of the most cost-effective strategies available in the area of public health. Access to family planning information and services can help reduce unwanted pregnancies and their adverse consequences. Access to health care, particularly at the critical time of birth, can help ensure that childbirth is a joyful event. It must be recognised that the reduction of maternal mortality is not only a matter of effective health care, but also one of social justice. The risks that women face in bringing a life into the world are not mere misfortunes or unavoidable natural disadvantages, but injustices that societies have a duty to remedy through their political, health and legal systems.
Safe Motherhood Newsletter, Issue 25, 1998 (1) Extract from the 1998 World Health Day Message of WHO's Director General Dr Hiroshima Nakijima
New government study reveals ways to lower mortality rates All singleton, vaginal births, occurring between 35 and 43 weeks' gestation, attended by either physicians or certified nurse-midwives (CNMs), which occurred in the USA in 1991 were examined in a study. The results of this study found that the risk of infant death was 19% lower for births attended by CNMs when compared with those attended by physicians. The risk of neonatal mortality was 33% lower and the risk of delivering a baby with low birthweight was 31% lower. In addition, the mean birthweight was 37g heavier for births attended by CNMs. The findings of the study were consistent even after controlling for a number of socio-demographic and medical risk factors. The findings were also that CNMs cared for a greater number of women at higher risk for poor birth outcomes. CNMs were shown to spend more time with women during antenatal visits and provide a personal approach during labour. Counselling, education and minimising interventions were all included in the care provided by midwives. There are 5500 CNMs in the USA and they attend around 6% of the nation's births.
Press Release, American College of Nurse-Midwives, June 8, 1998
Research points way ahead for Tunisia's midwives Ms Atf Gherissi, a midwife in the Ministry of Health in Tunisia, has undertaken a study of all midwives in the country to ascertain if the midwives are meeting the needs of the population. There are almost seven midwives for every 10000 women of reproductive age in Tunisia. Three hundred and eighty-one questionnaires were completed by midwives, their employers, trainers and clients. All were agreed on the important role of midwives in perinatal care, family planning advice and reproductive health education. There were varied opinions as to the level of responsibility midwives should take. The researchers urge that the responsibilities of midwives in Tunisia should be more clearly defined and their basic training focus more directly on the competencies that they need to fulfil their role, and that goals be developed for the further education of midwives.
Safe Motherhood Newsletter, Issue 25, 1998 (I)
Update on regulation of midwifery In the USA, nurse-midwives practice legally in all 50 states and in the District of Columbia. In some 19 states, midwifery is a regulated profession and no registered nurse credential is required. In 11 more states, midwifery practice by non-nurses is legal but unregulated. In at least seven states, the legal stares of midwives, other than certified nurse-midwives (CNMs), is in dispute. Finally, in 15 states, a registered nurse credential is essential to legally practice as a midwife. The scope for midwives without a nursing credential is frequently more limited than that for nurse-midwives. The American College of Nurse-Midwives' recent decision to certify midwives whose education does not include nursing is consistent with the expanding interest, at state level, to providing students with alternative paths to qualification as a midwife, and increasing consumer choice of the type of midwife and place of birth (see Roberts 1998).
REFERENCE Roberts J 1998 Current developments in midwifery in the USA (editorial). Midwifery 14 (3): 129-130
Quickening, Volume 29, number 2, March / April 1998 In Canada, the ten provinces are at different stages of development in recognising and regulating midwifery practice. Ontario, with approximately 125 registered midwives in practice, has had regulation since
Reports received by International Confederation of Midwives
Website for Safe Motherhood The Safe Motherhood Inter-Agency Group now has a site on the worldwide web. The address is: http://safemotherhood.org
Safe Motherhood, Issue 25, 1998 (1)
Reducing maternal mortality is a matter of social justice Pregnancy and childbirth are special events in women's lives, and, indeed, in the lives of their families. This can be a time of great hope and joyful anticipation. It can also be a time of fear, suffering and even death. Although pregnancy is not a disease, but a normal physiological process, it is associated with certain risks to health and survival for both the woman and the baby she bears. These risks are present in every society and in every setting. In developed countries they have been largely overcome because women are in better health when commencing pregnancy, and every pregnant woman Midwifery(1998) 14,
190-193
© 1998 Harcourt Brace & Co. Ltd
has access to special care during pregnancy and childbirth. This is not the case in many developing countries, where each pregnancy represents a journey into the unknown from which all too many women never return. This situation cannot be allowed to continue. The interventions that make motherhood safe are known and the resources needed are obtainable. The necessary services are neither sophisticated nor very expensive, and reducing maternal mortality is one of the most cost-effective strategies available in the area of public health. Access to family planning information and services can help reduce unwanted pregnancies and their adverse consequences. Access to health care, particularly at the critical time of birth, can help ensure that childbirth is a joyful event. It must be recognised that the reduction of maternal mortality is not only a matter of effective health care, but also one of social justice. The risks that women face in bringing a life into the world are not mere misfortunes or unavoidable natural disadvantages, but injustices that societies have a duty to remedy through their political, health and legal systems.
Safe Motherhood Newsletter, Issue 25, 1998 (1) Extract from the 1998 World Health Day Message of WHO's Director General Dr Hiroshima Nakijima
New government study reveals ways to lower mortality rates All singleton, vaginal births, occurring between 35 and 43 weeks' gestation, attended by either physicians or certified nurse-midwives (CNMs), which occurred in the USA in 1991 were examined in a study. The results of this study found that the risk of infant death was 19% lower for births attended by CNMs when compared with those attended by physicians. The risk of neonatal mortality was 33% lower and the risk of delivering a baby with low birthweight was 31% lower. In addition, the mean birthweight was 37g heavier for births attended by CNMs. The findings of the study were consistent even after controlling for a number of socio-demographic and medical risk factors. The findings were also that CNMs cared for a greater number of women at higher risk for poor birth outcomes. CNMs were shown to spend more time with women during antenatal visits and provide a personal approach during labour. Counselling, education and minimising interventions were all included in the care provided by midwives. There are 5500 CNMs in the USA and they attend around 6% of the nation's births.
Press Release, American College of Nurse-Midwives, June 8, 1998
Research points way ahead for Tunisia's midwives Ms Atf Gherissi, a midwife in the Ministry of Health in Tunisia, has undertaken a study of all midwives in the country to ascertain if the midwives are meeting the needs of the population. There are almost seven midwives for every 10000 women of reproductive age in Tunisia. Three hundred and eighty-one questionnaires were completed by midwives, their employers, trainers and clients. All were agreed on the important role of midwives in perinatal care, family planning advice and reproductive health education. There were varied opinions as to the level of responsibility midwives should take. The researchers urge that the responsibilities of midwives in Tunisia should be more clearly defined and their basic training focus more directly on the competencies that they need to fulfil their role, and that goals be developed for the further education of midwives.
Safe Motherhood Newsletter, Issue 25, 1998 (I)
Update on regulation of midwifery In the USA, nurse-midwives practice legally in all 50 states and in the District of Columbia. In some 19 states, midwifery is a regulated profession and no registered nurse credential is required. In 11 more states, midwifery practice by non-nurses is legal but unregulated. In at least seven states, the legal stares of midwives, other than certified nurse-midwives (CNMs), is in dispute. Finally, in 15 states, a registered nurse credential is essential to legally practice as a midwife. The scope for midwives without a nursing credential is frequently more limited than that for nurse-midwives. The American College of Nurse-Midwives' recent decision to certify midwives whose education does not include nursing is consistent with the expanding interest, at state level, to providing students with alternative paths to qualification as a midwife, and increasing consumer choice of the type of midwife and place of birth (see Roberts 1998).
REFERENCE Roberts J 1998 Current developments in midwifery in the USA (editorial). Midwifery 14 (3): 129-130
Quickening, Volume 29, number 2, March / April 1998 In Canada, the ten provinces are at different stages of development in recognising and regulating midwifery practice. Ontario, with approximately 125 registered midwives in practice, has had regulation since