The personal reason this superwoman has dedicated her life to Indigenous midwifery

This blog post was originally posted on Upworthy.com as part of a project with Girls’ Globe, Upworthy and Johnson & Johnson.

Claire Dion Fletcher was taking a class in Women’s Studies as part of her undergraduate program when she first realized she wanted to become a midwife.

She was writing a paper on the decline of midwifery and the medicalization of birth in Ontario, when she started thinking about whether or not midwifery was even practiced anymore. It didn’t take long before Claire found that the answer was ‘yes’ along with a lot more information on the subject from the Association of Ontario Midwives and the Ryerson Midwifery Education programme.

The more she read, the more confident she became about wanting to become a midwife herself. She had always been interested in health care, and especially women taking an active role in their health, so midwifery seemed like the perfect fit.

But it wasn’t just an academic interest — Claire also had a personal connection to health care and midwifery.

Claire is Potawatomi-Lenape, and she wanted to help Indigenous women like herself take an active role in their health care. She thinks that Indigenous women should have access to an Indigenous midwife if they want, because their Aboriginal identity is something that “cannot be replicated or taught”.

Despite the differences in experiences of Indigenous people, Claire explains that they share an ongoing experience of assimilation. Indigenous people also typically don’t have access to as comprehensive health care as other groups in Canada.

But one of the biggest challenges Indigenous people face is that “[they] have the poorest health outcomes compared to any other group in Canada”, Claire explains.

And there are studies to support Claire’s claim. In a report by the National Collaboration for Aboriginal Health, health indicators show a higher burden of disease or health disparities among Indigenous people than among non-Aboriginal Canadians. And there isn’t just a gap in health outcomes, there is also a gap in data which makes it more difficult to address the situation.

What’s more, women often get the shortest end of the proverbial stick, “due to the intersecting effects of colonization, race, sex and gender,” notes Claire.

This is why people like her are so important — Claire recognizes that there’s a lot about the state of maternal health that needs to change.

“Our families deserve Indigenous midwifery care that meets all their health needs, our people deserve access to health care in a place where they feel safe and respected, where they will be listened to and their concerns taken seriously.”

Thankfully, Claire found a way to actively work towards that change – she became a registered midwife who specifically caters to Indigenous women.

Claire Dion-Fletcher receiving the Iewirokwas Cape Award for Midwifery Heroes from the Toronto Birth Centre on February 16. Photo via Ryerson University.
But she does much more than deliver babies.Claire holds several other positions that help propel her mission forward.

She sits on the core leadership of the National Aboriginal Council of Midwives, where she works on several projects to expand Indigenous midwifery and enhance midwifery education. She also supports increased access to culturally safe educational opportunities through her role as an Aboriginal student coordinator at the Ryerson Midwifery Education Program, which is also where she got her midwifery certificate.

And Claire’s constantly researching decolonized health care and Indigenous midwifery, too. One of her most interesting findings so far is the unique approach that Indigenous midwives bring to health care.

“Indigenous midwifery provides clinically excellent care that incorporates an Indigenous understanding of health and world view,” writes Claire.

Ultimately her mission is to recover Indigenous practices while trying to improve overall health and wellbeing of Indigenous people and fight against the ongoing impacts of colonization and assimilation.

Photo by Claire Dion Fletcher @cgdionfletch

And Claire and the National Aboriginal Council of Midwives share another important goal — to have at least one Aboriginal midwife in each Aboriginal community.

That’s why she lobbies for the expansion of Indigenous content in university programs and the growth of Indigenous midwifery in Ontario.

“I see all of these as a part of Indigenous midwifery and part of our responsibility as Indigenous midwives to serve our communities,” she notes.

Since she’s involved  with so many projects, it’s impressive that Claire finds the energy to keep up her work, but the strength and resiliency of her Indigenous clients help her stay motivated.

And her goal for the future of Indigenous health care in Canada is a powerful motivator as well.

She wants to help build a health care system that is focused on the clients, in order to meet the needs of the people actually using the system. She also wants to make Indigenous midwifery is more accessible, and make it easier for Indigenous people to become midwives themselves.

To achieve this, she will keep lobbying for a fairer health care system and increased recognition for Indigenous midwifery. She hopes her research will also provide her with more tools to improve the situation and spread information about the most pressing issues associated with Indigenous health today.

There’s still a long way to go before we see the necessary changes in place, but with people like Claire in the mix, the chances are good that they’ll happen a lot sooner.

Tilde Holm co-authored this post with Ally Hirschlag.

What it’s like to be Fancy: Midwifery in Uganda

This post is a tribute to a young midwife named Fancy in south eastern Uganda.

Fancy is the newest addition to the Mama and Family Project, funded by Swedish Organization for Global Health (SOGH) in partnership with the Uganda Development and Health Associates, to provide effective support to women and infants during pregnancy and after childbirth.

The World Health Organization (WHO) defines midwifery as the “care of women during pregnancy, labour, and the postpartum period, as well as care of the newborn”. However, the reasons midwives are needed and the ways in which they work around the world differ. The definition is universal, but the circumstances are not.

To celebrate this month’s observance of International Day of the Midwife, I had the honor of speaking with an incredible woman named Fancy. After fiddling with inevitable technical difficulties, we finally connected over Whatsapp. 

Fancy the midwife outside the Maina Clinic in Uganda. Photo credit: Moses Kyangwa

A day in Fancy’s life begins with morning tea (sometimes coffee). She arrives at the Maina Clinic and checks her list of patients to visit that day – some at home and some at the center.

It was Fancy’s aunt, also a healthcare worker, who inspired her to become a midwife. Fancy knew as a child this was what she wanted to do. After two and a half years of education and internships, she felt prepared to join the workforce as a midwife.

Fancy has a passion for her work, and keeps always in mind the mantra ‘serve two lives’ – the mother and the baby. This is sometimes difficult when there are resources missing, like gloves, machinery, light, or doctors. Making sure clean water is available during birth is also a concern and a leading reason for birth-related complications in Uganda. Fancy tells me that helping mothers deliver is difficult during the night when the sunlight is gone if there is no electricity.

Fancy mostly provides care for young women and mothers – which makes sense since Uganda has one of the largest youth populations and highest adolescent fertility rates in the world. It is not uncommon for her to “see eighteen year olds with three children already”.

Before the call, I had researched Uganda’s legal status of abortion and contraception. Though abortion is legal in certain circumstances (such as a danger to the mother’s health), many healthcare workers and citizens default to recognizing it as illegal. Fancy told me that abortion is not legal, and that women still do get abortions but illegally and unsafely. She also shared insights into why she believes supporting the work done by local people in their own communities is a necessity for any development program.

Perhaps the loudest and clearest words of the entire call came toward the end of our time together when Fancy told me: “a good midwife should respect and treat all mothers equally – with no discrimination.

Before our conversation ended, I spoke with the health center Executive Director, Moses. He said that midwives are taught to “be submissive” and simply accept their working conditions (like salary, rights, and status). This prevents midwives from speaking out about their struggles. If given the chance, Moses explained, midwives would voice their sadness about how mothers and babies they care for are sometimes failed by cycles of systemic failure – resources, doctoral care, education.

There is much the health AND finance ministries can and should do to improve things (and this includes international governments) – starting with empowering midwives to speak out and increase awareness of women’s health issues in all areas of Uganda.

Being Fancy in Uganda means having a passion for your work, an embedded resiliency, and the drive to continue serving women and girls in extremely vulnerable states. Midwifery is a difficult job, with many challenges. It requires knowledge, skill, passion, empathy, bravery, resourcefulness, multi-tasking, quick problem-solving, and grit.

Uganda, and the entire world, is fortunate to have people like Fancy – midwives who have chosen to use their hearts, minds, and skills for the terrifying and beautiful cycle of life.

#13 – Midwives Providing Safe Birth in Humanitarian Settings

 

“(Midwives) give support to women whether they are in labour or not, they are social solidarity players in the local communities, not only the providers of health services for women & newborns.” – Mohamed Afifi, UNFPA

Welcome back to The Mom Pod! In this episode Julia Wiklander connects us with midwives and advocates about maternal and newborn health in humanitarian settings, at the 31st ICM Triennial Congress in Toronto, Canada. The midwives that we meet work in Mexico, Somalia and Afghanistan and share experiences from their work and talk about the challenges they face to deliver care.

With a world in constant political change and with the largest number of displaced people in history, ensuring that every mother and every child has access to a midwife during pregnancy and birth, is a difficult promise to keep. The world needs more midwives.

“They’re not refugees, they are not citizens – they are migrants. We need to start to name this as a public health issue.” – Cristina Alonso, Midwife working in Mexico

Our conversation is also broadened by UNFPA Reproductive Health Specialist for the Arab States, Mohammed Afifi, who tells us that in the region, midwives is the cadre of health professionals that are committing to delivering care, despite conflicts that push away many of their colleagues.

Safe Birth Even Here is a Campaign run by UNFPA to raise awareness of the high rate of maternal deaths in emergency situations and increase support for services to protect the rights of the women and girls living in humanitarian and fragile settings. Johnson & Johnson is one of the partners supporting the campaign, and has committed to supporting health professionals at the frontlines of care. We speak to Joy Marini at Johnson & Johnson about why the company is investing in the health of women & children in humanitarian settings and what they are doing to ensure that midwives receive support in their important work. 

In this episode, Young Midwife Leader, Massoma Jafari from Afghanistan, interviews Jane Philpott, the Canadian Minister of Health and asks her what action Canada is taking to support midwives in Afghanistan. Philpott gives the young midwife advice and promises new connections. A meeting that hopefully sparks further engagement by the Canadian government to invest in midwives. 

Listen to the full episode here.

During the ICM Congress, Johnson & Johnson launched their new initative – the GenH Challenge. This exciting opportunity hopes to encourage midwives to see themselves as innovators with the power to help to create the healthiest generation in human history – “GenH”. The GenH Challenge is looking to discover brand new ideas from the front lines of care that can change the trajectory of health. If this sounds daunting, don’t worry! The competition welcomes ideas in their earliest stages, and it welcomes small ideas that have the potential to create great impact. You can apply any time until 4 October 2017. Full guidelines are available at www.genhchallenge.com.

See all of the Girls’ Globe LIVE coverage from the 31st ICM Triennial Congress in Toronto, Canada here

Midwives: Innovators on the Front Lines of Care

With simple but resounding words, Frances Day-Stirk, President of the International Confederation of Midwives, reminded 4,200 people gathered in Toronto that midwives are the engine of creativity and care that can deliver for mothers, babies, and families around the world.

Always aiming to best serve mothers, babies, and their communities, midwives’ human-centered approach to delivering care drives them to find ever-new ways to improve, adjust, and improvise when needed. Innovation is fundamental to midwifery. Enabling that ingenuity is fundamental to how Johnson & Johnson supports and champions midwives and others on the front lines of care as they improve the trajectory of health for humanity.

This week marked the launch of the GenH Challenge, a social venture competition designed to accelerate everyday solutions to health challenges. We were honored to launch the GenH Challenge at the world’s largest gathering of midwives, the International Confederation of Midwives (ICM) Triennial Congress. But of course, championing innovation on the front lines means not only fueling innovation within midwifery – it also means bringing midwives to the table with health innovators and entrepreneurs as they design new approaches to health care.

Samara Ferrara, a participant in Johnson & Johnson and ICM’s Young Midwife Leader program, as well as an Aspen Ideas Festival “Spotlight Health Scholar,” has had the opportunity of being part of both sides of this conversation. Samara has been a practicing midwife for eight years, and plays a leading role in redefining what it means to be a modern-day midwife in Mexico. As ICM wrapped, and in anticipation of Spotlight Health, we spoke with Samara about this unique intersection.

Zack Langway (ZL) What does leadership mean to you, and what would you say is your leadership style? 

Samara Ferrara (SF): A leader is someone who leads by example – someone who inspires and touches other people to act, do, or think in new ways. I try to lead by example by bringing the community and midwives together, and by sharing information so people can better understand what midwives do, not just in Mexico, but around the world. I want people to understand that it’s not enough to survive birth, and that the experience of the family during the birth has a large impact on that human being for the rest of their life. I also share moments and stories from births I witness with inclusive language so that everyone, whether they currently understand midwifery or not, can see themselves or someone they know in the story.

ZL: How do you use your role as a midwifery leader to identify community needs, and come up with innovative ways to solve them?

SF: I create opportunities for dialogue between midwives and other decision-makers in my region. For example, I recently organized a regional conference for midwives, government representatives, medical schools including nurses and doctors, as well as non-profit organizations, to bring all sorts of different perspectives together on the role of midwifery in improving the health of our women and children. The definition of what it means to be a midwife is still unclear in Mexico, and because of the conference, I am now engaged in a discussion with government representatives about midwifery law and what it will take to open a midwifery school.

Creating these links with the community and decision makers is incredibly important to establish that midwifery is an option for quality care. Whether through a conference, or smaller classes, I try to continuously offer educational opportunities for my fellow midwives to reinforce the importance of continuous education and participating in advocacy efforts. It’s not a new profession, but we are pioneering new areas that have not been defined in the community and country.

ZL: What are some of the little, everyday things that have made a big difference in the community you serve?

SF: I’m working hard to give new meaning to what midwifery is nowadays, because there are many misunderstandings around what it means to be a midwife, like the planning and support we provide women and their families during, before, and after pregnancy. I’ve also started partnerships with a pediatrician and a gynecologist which have been very successful. People sometimes think that midwives and doctors are adversaries, but working together, we can offer families the best of both worlds and the clients can really have a choice in how they receive care. So, something as little as a partnership that builds new relationships can have a big difference for families and health.

ZL: As Frances emphasized, how can midwives be the pioneers developing new approaches and methods to provide the best possible care for mom and baby?

SF: We need to put women first. We can start by asking them directly what they need so innovations based on their ideas will be rooted in their needs as the “end user.” As midwives, we also need to push ourselves beyond our comfort zones. We need to expand our education beyond midwifery and learn new skills that can help us better advocate for our profession and demand change from our leaders. As midwives, we need to take on many different roles in our communities – care provider, counselor, leader, advocate, innovator – and we need to be prepared to do so with the highest level of quality.

I also want to encourage my fellow midwives to take part in competitions like the GenH Challenge because our ideas are the fastest roads to innovation in our countries. I definitely plan to regroup with my team back home, as well as the women of my community, to hear their voices and determine the best innovation we can submit to the GenH Challenge.

ZL: What is do you enjoy most about attending conferences like the ICM Triennial Congress and Aspen Ideas Festival?

SF: I look forward to connecting with new people and creating alliances on shared goals. I also love to learn about the latest innovative ideas and information out there and think through how that might apply to my work. We need innovation so we can change and create new possibilities in my community and my country.

Zack Langway is senior manager of experiential philanthropy in social innovation for Global Community Impact at Johnson & Johnson. Prior to joining Johnson & Johnson, Zack led the global development team at Fenton, the social change agency. He has served as a consultant and in-house digital strategist for organizations including the United Nations Foundation, Save the Children, and Bread for the World. 

This blog post was originally published on the Healthy Newborn Network.