In My Mother's House

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Increasing women’s access to quality midwifery services has become a focus of global efforts to realize the right of every woman to the best possible health care during pregnancy and childbirth.

This report from UNFPA aims to provide up-to-date information about midwifery services for women and newborns, focusing on 58 countries with high rates of maternal, foetal and newborn mortality. According to the report, each year 358,000 women die while pregnant or giving birth, some two million newborns die within the first 24 hours of life and there are 2.6 million stillbirths, all because of inadequate or insufficient health care. Unless an additional 112,000 midwives are trained, deployed and retained in supportive environments, 38 of those countries surveyed might not meet the Millennium Development Goal target to achieve 95% coverage of births by skilled attendants by 2015.

The report adds that up to 90% of maternal deaths could be prevented if midwives were in place and could refer the most severe complications to specialised care. The UNFPA website has more information on reproductive health services and safe motherhood. Comments (0) | Trackbacks (0) | Permalink

  
Mrs. Koroma will be arriving at Commonsense Childbirth School of Midwifery in Winter Garden, FL on March 14th for a week long emergency skills training , sharing and resource development. Her dogged determination against all odds is deeply appreciated and admired. Please support this cause - donate @ developmentforafrica.org/donate or info@developmentforafrica.org.

Thank you! 

Tour dates announced for AAPDEP’s "Stop the Hemorrhaging!" Tour

Black History Month is not only an opportunity to remember people and events shaping our past, but also a time to reflect on—and challenge—the current contradictions facing African communities.

 

The disproportionately high death rates amongst African mothers and babies makes infant and maternal health one of the most critical threats to the future of African families the world over.

 

The All African People’s Development and Empowerment Project (AAPDEP) is holding a tour during Black History Month to increase awareness of this neglected issue, while also generating resources for a clinic in Sierra Leone, which suffers from the highest global rates of maternal mortality.

 

The statistics are shocking and indisputable, yet often remain unreported.

 

Women in sub-Saharan Africa face a maternal mortality rate a hundred times greater than that of “developed” countries and nearly one in ten infants will not to live to the age of one year.

And black women in the US are four times more likely to die of pregnancy related complications than their white counterparts, with black babies dying at more than twice the rate of white infants.

Headlining the tour will be Nurse Mary Koroma. Nurse Mary has dedicated her life to saving those of mothers and babies in her native Sierra Leone.

 

She is a certified Nurse Midwife who stepped down from her secure position in a government hospital to work within the communities most in need.

 

With few able to even afford what passes as government healthcare, she witnessed expectant women and infants senselessly dying and suffering, as the massive wealth of Sierra Leone that could provide quality health care is looted.

 

As a nurse midwife, whose job it is to save lives and bring new life into the world, she could no longer be a part of an apparatus that contributed to the deaths of thousands of women and children. Read More

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Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that physical activity may prevent gestational diabetes (diabetes that develops during pregnancy), relieve stress, and build more stamina needed for labor and delivery.

If you were physically active before your pregnancy, you should be able to continue your activity in moderation. Don't try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact. Do not let your heart rate exceed 140 beats per minute.

The pregnant competitive athlete should be closely followed by an obstetrician.

If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication.

Who Should Not Exercise During Pregnancy?

If you have a medical problem, such as asthma, heart disease, or diabetes, exercise may not be advisable. Exercise may also be harmful if you have a pregnancy-related condition such as:

• Bleeding or spotting
• Low placenta
• Threatened or recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your health care provider before beginning an exercise program. Your health care provider can also give you personal exercise guidelines, based on your medical history.

What Exercises Are Safe During Pregnancy?

Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

Tennis and racquetball are generally safe activities, but changes in balance during pregnancy may affect rapid movements. Other activities such as jogging can be done in moderation, especially if you were doing them before your pregnancy. You may want to choose exercises or activities that do not require great balance or coordination, especially later in pregnancy.

To learn strength and toning exercises that are safe to do during pregnancy, see Sample Exercises.

What Exercises Should Be Avoided During Pregnancy?

There are certain exercises and activities that can be harmful if performed during pregnancy. They include:

• Holding your breath during any activity.
• Activities where falling is likely (such as skiing and horseback riding).
• Contact sports such as softball, football, basketball, and volleyball.
• Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
• Activities that require extensive jumping, hopping, skipping, bouncing, or running.
• Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.
• Bouncing while stretching.
• Waist-twisting movements while standing.
• Heavy exercise spurts followed by long periods of no activity.
• Exercise in hot, humid weather.

What Should a Pregnancy Exercise Program Consist Of?

For total fitness, a pregnancy exercise program should strengthen and condition your muscles.

Always begin by warming up for five minutes and stretching for five minutes. Include at least fifteen minutes of cardiovascular activity. Measure your heart rate at times of peak activity. Follow aerobic activity with five to ten minutes of gradually slower exercise that ends with gentle stretching.

Here are some basic exercise guidelines for pregnant women:

• Wear loose fitting, comfortable clothes as well as a good support bra.
• Choose shoes that are designed for the type of exercise you do. Proper shoes are your best protection against injury.
• Exercise on a flat, level surface to prevent injury.
• Consume enough calories to meet the needs of your pregnancy (300 more calories per day than before you were pregnant) as well as your exercise program.
• Finish eating at least one hour before exercising.
• Drink water before, during, and after your workout.
• After doing floor exercises, get up slowly and gradually to prevent dizziness.
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over-exerting yourself and should slow down your activity.

What Pregnancy Changes May Affect Exercise?

Physical changes during pregnancy create extra demands on your body. Keeping in mind the changes listed below, remember that you need to listen to your body and adjust your activities or exercise routine as necessary.

• Your developing baby and other internal changes require more oxygen and energy.
• Hormones produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight shift your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area and makes it easier for you to lose your balance.

Warning for Pregnant Women

Stop exercising and consult your health care provider if you:

• Feel chest pain.
• Have abdominal pain, pelvic pain, or persistent contractions.
• Have a headache.
• Notice an absence or decrease in fetal movement.
• Feel faint, dizzy, nauseous, or light-headed.
• Feel cold or clammy.
• Have vaginal bleeding.
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily.
• Notice an irregular or rapid heartbeat.
• Have sudden swelling in your ankles, hands, face, or calf pain.
• Are short of breath.
• Have difficulty walking.
• Have muscle weakness.

How Soon Can I Exercise After Delivery?

It is best to ask your health care provider how soon you can begin your exercise routine after delivering your baby.

Although you may be eager to get in shape quickly, return to your pre-pregnancy fitness routines gradually. Follow your health care provider's exercise recommendations.

Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it.

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A GLOBAL CALL TO ACTION: STRENGTHEN MIDWIFERY TO SAVE LIVES AND 

PROMOTE HEALTH OF WOMEN AND NEWBORNS

Maternal Mortality: Still the greatest health and gender inequity in the world

We, midwives and other health professionals of the world and development partners, gathered here on the occasion of the Women Deliver Conference in Washington DC, June 2010, share the view that bold and unprecedented action is required to achieve Millennium Development Goal (MDG) 5: Improve Maternal Health and the newborn component of MDG4: Reduce child mortality.

Today 99 per cent of maternal and newborn deaths occur in developing countries. Each year more than two million women and newborns die needlessly due to preventable causes related to pregnancy, childbirth and post-partum conditions.

Millions more suffer disabilities. When a woman dies, her children are less likely to receive nutritious food and education. Saving women's lives and improving their health are key to achieving all of the MDGs.

We know what to do - it is a cost-effective investment

There is international consensus on the set of evidence-based and cost-effective solutions required to ensure that every pregnancy is wanted, every birth is safe and every newborn is healthy. Central to these interventions is a high quality workforce supported by a functioning health system. Midwives, as part of this workforce, provide the continuum of care needed by pregnant women and their newborns from the community to the hospital level.

Midwives and midwifery services save lives and promote health

Up to 90 per cent of maternal deaths can be prevented when midwives and personnel with midwifery skills are authorized and supported by the health system to practice their full set of competencies, including basic emergency obstetric and newborn care. In addition midwives improve the sexual and reproductive health of individuals and couples, including adolescents, by providing family planning services and counseling, and HIV prevention, including the prevention of mother-to-child transmission of HIV. According to the World Health Organization (WHO), some 334,000 midwives are needed to fill the gaps in high-mortality countries by 2015.

A Call to Action to strengthen midwifery services

We pledge to join forces with governments, civil society, and other partners to continue supporting implementation of World Health Assembly Resolution 59.27 on Strengthening nursing and midwifery and initiating a global movement to strengthen midwifery services. This will ensure rapid progress in achieving MDG 5 and contribute to the achievement of MDGs 4 and 6 (to reduce child mortality; and combat HIV/AIDS, malaria, and other diseases). In response to the UN Secretary General's Joint Action Plan for Women's and Children's Health, we call on all governments to increase investments in midwifery services now and to make this a high priority at the UN Summit on the Millennium Development Goals in September 2010 and beyond.

We call on governments to address the following vital areas:

1. Education and training-Provide education and training in the essential competencies for basic midwifery practice. Build institutional capacity, including strengthened clinical training, post-graduate programs and research. Increase South-South collaboration to expand the production of midwives with evidence-based quality training.
2. Legislation and Regulation-Strengthen legislative and regulatory frameworks to ensure midwives have appropriate standards of practice and are regulated to practice their full set of competencies as defined by the WHO and the International Confederation of Midwives (ICM). Also, ensure immediate notification of maternal deaths.
3. Recruitment, retention and deployment-Implement national, costed health workfoorce plans and strengthen management capacities of Ministries of Health regarding training, recruitment, retention and deployment of the midwifery workforce, as per The 2008 Kampala Declaration and Agenda for Global Action on Health Workers and which is vital to increasing access to midwifery services for poor and marginalized women.
4. Association-Strengthen national professional midwifery associations to promote the profession, improve standards of care, participate in policy making at regional and national levels, and establish closer collaboration with other professional organizations, especially obstetric and pediatric societies.

Finally, we call on development partners - particularly the G8 and G20 - to provide long-term support to countries seeking to strengthen midwifery services by investing in a midwifery workforce as a fundamental step towards a functioning primary healthcare system that can deliver for women and newborns, fostering a healthier future for all.

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International Confederation of Midwives

Laan van Meerdervoort 70

2517AN The Hague

Tel. +31 70 3060520

Fax +3170 355 5651

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