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Successful Midwifery Experiences in the Caribbean Reduction of C-section and Humanization of Birth by Rosie B Felix RN, CM, MMid(Merit) 4th ICM Regional Conference of the Americas April 23 – 26, 2013, Swissotel, Quito, Equador


INTRODUCTION Everyone who was born in the Caribbean by vaginal delivery with no brain or other injury, or who received maternal and child Health care in the Caribbean and is alive today, wherever they may be now, is an example and evidence of the many successful midwifery experiences of Caribbean Midwives.


Against this backdrop we will look at 1 Caribbean c-section rates 2 How CM keep c-section rates low 3 How CM humanize birth 4 Successful experiences of CM


Map of the Caribbean


English Speaking Caribbean


C-section Rates in the Caribbean


Attitudes to C-section


How midwives influence lower c-section rates


How midwives humanize birth • promote and encourage natural/normal birth with a midwife • educate and prepare the woman and her family for labor and birth • allow family support in labor and birth


How midwives humanize birth con’t

• provide privacy and comfortable environment for labor and birth • encourage early bonding by skin to skin contact between NB and mother


How midwives humanize birth con’t

• establish a therapeutic relationship with the woman • encourage support of spouse or significant other


How midwives humanize birth con’t • give one on one care in labor • remain with women who are near delivery, even if shift is ended • allow women persons of their choice in labor and birth


How midwives humanize birth con’t • promote and encourage natural/normal birth with a midwife • educate the woman and her family on expectations of labor and birth • allow family support in labor and birth


How midwives humanize birth con’t

•make humanized birth a priority •do follow up care in the postnatal period and •deliver the woman in her own home


SUCCESSFUL MIDWIFERY EXPERIENCES • all those of us who were born, received midwives’ care, or give/gave midwives care in the Caribbean • travel by boat, plane to deliver a women, save their lives and those of their preterm and sick NBs


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • midwives correctly diagnose twin pregnancy after the OBGyn said it was a large baby • midwives deliver over 95% of births • midwives give specialized care from conception to post delivery


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • CM boast of low maternal mortality rate • Midwifery led birth centers exist to give women birth setting option • Midwives provide homebirth for women who desire it


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • midwives are responsible for over 95% immunization coverage of children in some of the countries • midwives care for families from birth to death • midwives are educated at masters level


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • Midwives engage in sexual and reproductive health and reduction of mother to child transmission of HIV • Some countries have updated their midwifery curriculums to reflect the ICM competences and 18 program month duration for post basic nurses


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • midwives are celebrating International Day of the Midwife with or without midwifery associations or ICM membership • midwives are engaged in real-time pelvic sonography with accuracy levels greater than physicians


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T

• midwives are successfully educating, training and graduating new midwives for decades • midwives are educating women and families not only one on one and in groups but in publications


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T • CM boast of many midwives associations and the birth of the Caribbean Midwives Association on 21 April, 2012 in Trinidad and Tobago


SUCCESSFUL MIDWIFERY EXPERIENCES CON’T CRMA 2nd Meeting Equador 2013


TO BE MORE SUCCESSFUL MIDWIVES MUST • be more loyal to our midwifery model of care and review our MCH manuals to reflect this • reclaim our autonomy as practitioners • empower women to also advocate for what they want (informed choice)


TO BE MORE SUCCESSFUL WE MUST CON’T • challenge medicalized care without medical justification including • c-section • advocate for birth place of womens’ choice • maintain old competences and learn new competencies


TO BE MORE SUCCESSFUL WE MUST CON’T •engage in continuing education esp by e-learning and pursue higher education in midwifery •practice evidenced based midwifery •ensure that our regulations protect us and our women


TO BE MORE SUCCESSFUL WE MUST CON’T •get involved in policy making and decide the future of midwifery •Be accountable to women and demand accountability from those who hurt them


TO BE MORE SUCCESSFUL WE MUST CON’T •birth midwifery associations where there is none and obtain ICM membership •speak up, be counted, and stand out as midwives


CONCLUSION C-section rates are too high and can be reduced if we empower women by giving them the researched benefits of natural labor and normal birth as well as the risks and disadvantages of unjustified c-section.


CONCLUSION con’t Midwives must humanize birth by keeping the woman and her family at the center of labor and birth while giving her competent, evidenced based, respectful, compassionate and dignified care.


CONCLUSION con’t Indeed midwives are the most successful people – we care for the world from conception to birth registration and until our find their identity and space in each nation. We are the single mothers of the world, no one does it quite like us. We must PUSH to save our lives, our mothers, our babies, our world. YES WE CAN!


THANK YOU FROM CRMA

Dominica sucessful midwifery experiences in the caribbean rduction of c section and humanization of  
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