Afghan Midwifery Training

This was passed along through one of the Bay Area birth doula groups. Please donate if you're able and spread the word about this amazing organization!



Dear Friends,

I try not to send these requests out too often, and appreciate you reading this! As president of Afghans4Tomorrow, and especially when I have an opportunity to help the women and babies in Afghanistan, I hope you won't mind if I tell you about it, and ask for your help too.

We want to provide training for several women who live in Wardak Province (just southwest of Kabul, and heavily controlled by the Taliban) to become Skilled Birthing Attendants in their respective villages. There are no female obstetric doctors in this region, and due to Taliban influence, we are no longer able to find female doctors living in Kabul willing to travel to Wardak to practice. Some women will not go to male doctors, if they are even available. Many instead rely too often on old wives tales, and receive no prenatal care nor have the birth attended by a doctor or midwife or anyone with any training at all.

Afghanistan is one of the most dangerous places to be born, or give birth. A woman dies in childbirth every 27 minutes in Afghanistan, that is 1 in 8 women who give birth. One in five children die before they reach the age of 5.

The formal Midwife Training program in the country is a two-year program that requires the women to live in Kabul for the entire time. We have already trained two midwives and will likely fund more as we find women able to live in Kabul for the two years, which is not so easy.

This program is a way to help bring more skills to the region to help provide safer childbirth and baby checkups to the region now, while we wait and hope for more calm encouraging more doctors to move to the area and while more fully trained Midwives and doctors become available. Our Skilled Birthing Attendant training starts with an intensive 4-week program (to be held in December) conducted by a volunteer American doctor, and is in conjunction with another organization; Mountain to Mountain, who is funding some of the expenses for this training as well as ongoing financial and training for the next three years for the group of women.

Afghans4Tomorrow's responsibility in this program is $20,000, of which we have already raised about $8000. I know things are rough for many of you out there, but if you can't help with a donation yourself, maybe you know someone who would be excited about helping such a program, or know people involved in the Midwife movement that might we willing to share with their friends?

I have attached the actual proposal for those who are interested. I will have more info in the next several days, but feel free to reach out with any questions, and feel free to share this email with anyone you think might be interested in learning about our efforts in helping women to deliver healthy babies in Wardak Afghanistan.

Thanks everyone for taking the time to read this far!

And for those celebrating Ramadan-- Eid Mubarak!

Cheers,Kim

Kimberly O'ConnorPresidentAfghans4TomorrowP: +1 415.282.8281M: +1 415.608.1260Skype: kiminsanfranciscokim@afghans4tomorrow.orgkimoco@mac.comwww.Afghans4Tomorrow.org

First Lady on Breastfeeding

First Lady Michelle Obama spoke to the NAACP a few weeks back on the "obesity epidemic". In it she mentions the low rate of breastfeeding amongst African-American women:

And finally, it’s one thing we can think about, is working to make sure that our kids get a healthy start from the beginning, by promoting breastfeeding in our communities.  (Applause.)  One thing we do know is that babies that are breastfed are less likely to be obese as children, but 40 percent of African American babies are never breastfed at all, not even during the first weeks of their lives. 

And we know this isn’t possible or practical for some moms, but we’ve got a WIC program that’s providing new support to low-income moms who want to try so that they get the support they need.

And under the new health care legislation, businesses will now have to accommodate mothers who want to continue breastfeeding once they get back to work.  (Applause.)  Now, the men, you may not understand how important that is.  (Laughter.)  But trust me, it’s important to have a place to go.  

Breastfeeding has been linked with lower risk of obesity along with several other health factors. 

Hilarious Pregnancy/Motherhood Blogs

Check out The League of Maternal Justice. Pretty hilarious and all-around awesome. Maybe they'll let me join their squad?

Blacktating is another fun read.

Enjoy!

A doctor's take on touch

From the New York Times:

A new patient comes to my office, a healthy middle-aged woman. The medical assistant has already documented her normal blood pressure. Of our allotted 15 minutes, I spend more than two-thirds talking with her.

I ask about her personal medical history, her family medical history. I inquire about her lifestyle: what kind of work she does, whether she smokes, how much she exercises, whether she eats five servings of fruits and vegetables each day. I review her “health maintenance”: whether she’s up to date with her mammogram, Pap smear, vaccinations.

I press into the remaining minutes, counseling about calcium, sunscreen, seat belts. I screen for depression, domestic violence. I remind her about flu shots and colonoscopies. I pull out brochures about healthy diet and exercise, and we talk about ways to squeeze in exercise during her sedentary job.

And then I compliment myself on a job well done. I’ve covered all the relevant screening topics. I’ve touched all the bases of preventative medicine for a healthy woman. And I’ve even managed to finish on time, so I won’t have to keep the next patient waiting.

But my patient has a quizzical look on her face. Is that all there is, she seems to be asking.

In fact, through our extensive discussion (and the initial blood pressure check), we have fulfilled all of the medical interventions that scientific evidence has validated as helpful for a healthy patient. But my patient is clearly dissatisfied. A doctor’s visit is not a doctor’s visit until a stethoscope has probed the inner rhythms of the heart, and a set of medical hands has palpated the belly. Research has shown that patients expect a physical exam.

But is there any research to show that a physical exam — in a healthy person — is of any benefit? Despite a long and storied tradition, a physical exam is more a habit than a clinically proven method of picking up disease in asymptomatic people. There is scant evidence to suggest that routinely listening to every healthy person’s lungs, or pressing on every normal person’s liver, will find a disease that wasn’t suggested by the patient’s history. For a healthy person, an “abnormal finding” on physical exam is more likely to be a false positive than a real sign of illness.

Moreover, a normal physical exam cannot reassure a patient that there is no disease lurking in the shadows.

But does the physical exam serve any other purpose? The doctor-patient relationship is fundamentally different from, say, the accountant-client relationship. The laying on of hands sets medical practitioners apart from their counterparts in the business world. Despite the inroads of evidence-based medicine, M.R.I.s, angiograms and PET scanners, there is clearly something special, perhaps even healing, about touch. There is a warmth of connection that supersedes anything intellectual, and that connection goes both ways in the doctor-patient relationship.

We only have a few minutes left to our visit, but I gesture her up to the exam table. I place my hand on her shoulder and slide my stethoscope over her ribs. As I listen to the thrum of airflow that I’m 99.9 percent sure is perfectly normal, I feel both of our bodies relax ever so slightly.

I ease the bell of the stethoscope around to her heart, and though I know that there is only a small chance that I will hear anything to indicate serious illness, the familiar rhythms are comforting to my ear. As I examine her abdomen, we continue to talk, but there is a perceptible shift in the tenor of our interaction.

The polite but businesslike nature of our initial conversation has melted. No matter how we’ve come to this room, to these postures, to this connection, we are now more intimate. Even if our initial conversation had been marked by frustration or anger, the timbre of our interaction would have softened. It is almost impossible to be annoyed or curt when skin is touching skin.

Perhaps that is the crux. Touch is inherently humanizing, and for a doctor-patient relationship to have meaning beyond that of a business interaction, there needs to be trust — on both ends. As has been proved in newborn nurseries, and intuited by most doctors, nurses and patients, one of the most basic ways to establish trust is to touch.

I cringe whenever our hospital administration refers to the doctors and nurses as “health care providers.” That term always makes me feel like a soft-drink dispenser at Burger King. I’m not a “provider”; I’m a person, a doctor. And my patient is not a “customer” or a “client.” We are not transacting business.

Which is why a doctor’s visit never feels complete without a physical exam. It is a crucial part of the doctor-patient relationship that cannot be underestimated. One doesn’t need a scientific study to prove that.

Dr. Danielle Ofri is an internist in New York City. Her newest book is “Medicine in Translation: Journeys With My Patients.”

Happy World Breastfeeding Week!

Article with great links and fun facts up @The Examiner

Someone give this lady a UN post, already!

From NYMag:

Gisele thinks breastfeeding should be mandatory
The genetically blessed Gisele told Harper's Bazaar it was breast-feeding that helped her maintain her super-hot post-baby figure.

"Some people [in the United States] think they don't have to breastfeed, and I think 'Are you going to give chemical food to your child when they are so little?' I think there should be a worldwide law, in my opinion, that mothers should breastfeed their babies for six months."

Although she claimed her eight-hour labor “didn’t hurt in the slightest,” Gisele prepared herself for the event by meditating and adhering to a strict exercise plan.

“You want to go into the most intense physical experience of your life unprepared? That doesn't make any sense to me. I was ready and I thought OK, let's get to work'. I wasn't expecting someone else to get the baby out of me … I did kung fu up until two weeks before Benjamin was born, and yoga three days a week.'

Ah, so that’s how she did it! Approach your pregnancy with a drill-sergeant-like focus, and you, too, can model swimwear six weeks after giving birth.


After some backlash for the previous comments, this was posted on Gisele's blog:
Since Gisele became mother, the Top model has been outspoken when expressing her feelings about motherhood and life. In a recent interview for the September issue of Harper’s Bazaar UK, Gisele talked about the importance of breastfeeding in the first months of a child’s life. Now, Gisele writes first-hand on the impact caused by the comment.
My intention in making a comment about the importance of breastfeeding has nothing to do with the law. It comes from my passion and beliefs about children. Becoming a new mom has brought a lot of questions, I feel like I am in a constant search for answers on what might be the best for my child. It’s unfortunate that in an interview sometimes things can seem so black and white. I am sure if I would just be sitting talking about my experiences with other mothers, we would just be sharing opinions. I understand that everyone has their own experience and opinions and I am not here to judge. I believe that bringing a life into this world is the single most important thing a person can undertake and it can also be the most challenging. I think as mothers we are all just trying our best.

One more reason not to induce

From the New York Times:

Babies born six weeks prematurely are 40 times as likely as full-term infants to suffer respiratory distress syndrome, a new study reports.

Ten percent of the premature infants experienced the syndrome, the study found, compared with less than half of 1 percent of full-term babies.

In respiratory distress syndrome, the tiny air sacs of the infant’s lungs do not fully open because of a lack of surface lubricant, making breathing difficult. It is one of the most common complications of late preterm deliveries, defined as those that take place after 34 weeks and before 37 weeks of gestation.

The risk of respiratory problems decreased with each additional week of pregnancy, the researchers also found.

Babies born after 36 weeks were only nine times as likely as full-term babies to develop the syndrome, while those born at 37 weeks were at three times the risk. The study, published in The Journal of the American Medical Association last week, is one of the largest and most current to examine respiratory problems associated with late preterm births.

“The pulmonary system is the last system to develop in the fetus,” said Dr. Judith U. Hibbard of the University of Illinois and the paper’s lead author. “Obstetricians need to make every effort not to deliver a baby until 39 weeks unless there is a good medical reason.”