”All midwives here know when it’s time to breathe and when it’s time to push. This is our time to push!”
Franka Cadée, the new President of the International Confederation of Midwives closed the 31st Triennial Congress by addressing midwives from around the world with the main message that it is time to “humanize midwifery care – together”. She mentioned that many women across the world are at risk of receiving care too little too late or too much too soon.
Young Midwifery Leader, Samara Ferrara, from Mexico had the opportunity to speak with Franka Cadée prior to the end of the Congress. She asked how the new president is planning to continue the work to ensure universal access to maternal, newborn and child health care, as well as, how she will support midwives in Mexico to have improved quality education. Franka Cadée also sends her key message to midwives as they return home to their communities. See the two videos below.
Women in OECD countries spend, on average, 4.5 hours per day doing unpaid work such as cooking and caring for children. This compares to about 2 hours for men. Even if the division of unpaid labor has become more equal over the years, women are still doing more, and this results in unequal health outcomes for everyone.
“Women, even full-time working women, spend fewer hours on average doing paid work than their husbands or partners do. That may be due in part to the fact that there’s this expectation or default arrangement where they are doing more of the child care or housework.” – Kim Parker, Pew Research Center
In this year’s International Confederation of Midwives (ICM) Congress, I was pleased to see that Fisher was invited to a plenary session on women’s rights where he spoke about engaging fathers in maternal and newborn health, and the impact this has on advancing gender equality. Because, as Fisher put it, “the unequal sharing of caring roles is a major global driver of gender inequality”. And we know for sure that gender inequality damages both the physical and mental health of millions of women and girls worldwide.
Fathers are interested, they want information and they do want to be close to their children. Why then are women still the ones taking on the majority of the responsibility, and what consequences does this have? According to Fisher, there is a lack of public information and services directed at the fathers. They simply don’t know about all the benefits of engaging in caring for their children.
The evidence is out there – and it’s abundant!
Everyone wins when fathers engage, both in the short and long-term:
a father’s testosterone levels drop after the baby is born if he is physically present with the baby (i.e. cuddling!)
his oxytocin levels rise and so does the baby’s
breastfeeding rates increase
maternal mortality rates reduce
the mental health of mother and child improves
access to services improve
violence and abuse decrease
Fisher spoke about the neurobiological impact involvement has not only on the father’s brain, but also the mother’s. Caring for babies changes the brains of both parents, and the change lasts for the rest of their lives. And the more a parent cares for their baby, the more their brain changes. As if this wasn’t evidence enough: the more the parents’ brain changes, the better the child’s social skills are when they reach school.
Fisher also stressed the importance of midwives in fathers’ engagement, and said that midwives play an imperative role in encouraging fathers to cuddle skin-to-skin with their babies within the first few hours of life, and in informing men of the benefits of their involvement.
The unequal division of the responsibility of caring for, managing and educating children is unsustainable, and it undeniably affects mothers’ and babies’ health. Mothers should not be solely responsible for caring for their families – fathers must engage in order for us to achieve optimal health for women and children, as well as gender equality.
I am certain that the redistribution and reduction of unpaid care work and improved gender equality at home will improve quality of life, not only for women, but also for children and men. It most certainly is a win-win situation.
Family Initiative UK have launched an online course delivered by midwives and trainers which explores these issues. If you’re present in Toronto at this year’s ICM Congress, make sure to visit Family Initiative UK’s booth and learn more about the course!
Girls’ Globe is at the 31st ICM Triennial Congress in Toronto, Canada. See all of the Girls’ Globe LIVE coverage here.
Midwives on the front lines of care have made a major impact, ensuring that more women experience a healthy pregnancy and childbirth, and that more newborns survive and thrive. How can we build on progress already made, and strengthen the ability of midwives to ensure even healthier families and communities?
Every year, more than 14 million women around the world experience post-partum haemorrhage. Skilled midwives, trained to deal with complications that arise after childbirth, can intervene to avert many of these deaths, even in low-resource settings.
In celebration of midwives worldwide, Kupona Foundation colleague, Dorcas – a midwife trainer at our sister organization, CCBRT – shares how her team is ensuring mothers and babies in the Dar es Salaam region survive and thrive.
Being a Midwife is Something Precious
“For the past 37 years, being a midwife has meant doing everything I can to save the lives of mothers and babies in Tanzania’s largest city, Dar es Salaam.
Tanzania has one of the highest maternal mortality rates in the world. Approximately 22 women die every day from mostly preventable complications in pregnancy or childbirth1. For the last 6 years, my team and I have worked to strengthen the quality of care provided in 23 health facilities in the Dar es Salaam region with the ultimate goal of seeing that mortality statistic reduced to zero.
As the Senior Midwife Trainer for CCBRT’s Maternal and Newborn Health Capacity Building Team, I train medical teams in all 23 of our partner facilities. I work to empower the maternal health teams already in those facilities with the mentoring, training and resources they need to save more lives. Last year, we learned maternal mortality had reduced by 40% in the Dar es Salaam region thanks to our efforts, partnerships, and the support of the Government of Tanzania.”
High Quality Maternal Health Care for Every Woman
“I divide my time between three regional hospitals, smaller dispensaries, and health centers. The volume of patients at each facility varies depending on the day, but the goal is the same: provide the best care possible to mothers and babies. And that’s why I’m here.
One of these facilities serves 70,000 people, and hosts monthly antenatal care clinics for over 700 pregnant women. CCBRT has supported this hospital since 2011. We began by performing an SBMR (Standards Based Management and Recognition)2 assessment to identify the facility’s quality of care. This facility scored 2% (perfection is a score of 100%). While staff were dedicated to helping mothers and babies, they did not have the equipment, tools, and skills to provide high-quality care to their patients.
We began by working with staff to collect data on current operations, find the gaps in equipment and skills, and identify the key issues. We then hosted training to address the root cause of the problem and teach the intervention needed to solve it.
In November 2015, the facility’s quality of care had improved to 87% on the SBMR assessment. I was so proud. In 2011, the facility delivered 406 babies. As the skills and confidence of their service providers increased, so did the number of babies they delivered. In 2015, the hardworking staff surpassed this goal and assisted with 1,386 deliveries, with zero maternal deaths.
When I go back to the facility, I see the entire team is busy attending to patients. The matron is managing her team efficiently, and it has been fantastic to witness her growth as a leader over the years. As soon as a new staff member joins the team, they receive an orientation of the SBMR tool so that they understand the metrics we use. I see staff members, once young and inexperienced, assisting in the labor ward, performing their tasks expertly and respectfully.
I always say, it’s a long journey. But in this long journey, you cannot go by yourself. You need to have people around you. Collaborate with them. Do things together, work together to serve one goal. I’m proud to say that this is what we do with our partner facilities, each and every day, on the CCBRT Capacity Building team.”
Kupona Foundation empowers people and communities in Tanzania by improving their access to quality healthcare. 100% of our resources are dedicated to the continuation and sustainable growth of our sister organization in Tanzania, CCBRT. Since 2009, Kupona has raised over $3 million to support treatment, training, capital projects and organizational development at CCBRT. In that time, CCBRT has provided over 75,000 life changing surgeries for correctable impairments, over 570,000 clinical consultations, and, through training and capacity building efforts, has supported the safe delivery of over 550,000 babies. Learn more at kuponfoundation.org.
Tanzania Demographic and Health Survey (TDHS) 2010, National Bureau of Statistics, Tanzania, April 2011, Dar es Salaam
Measured by Standards-Based Management and Recognition (SBMR) assessments, developed by Jhpiego, an affiliate of Johns Hopkins University.