Sustainable Birth in Disruptive Times (Global Maternal and Child Health)

This contributed volume explores flexible, adaptable, and sustainable solutions to the shockingly high costs of birth across the globe. It presents innovative and collaborative maternity care practices and policies that are intersectional, human rights-based, transdisciplinary, science-driven, and community-based. Each chapter describes participatory and midwifery-oriented care that helps improve maternal and newborn outcomes within minoritized populations. The featured case studies respond to resource constraints and inequities of access by transforming relations between providers and families or by creating more egalitarian relations among diverse providers such as midwives, obstetricians, and nurses that minimize inefficient hierarchies within maternity care. The authors build on a growing awareness that quality and respectful midwifery care has lower costs and improved outcomes for child bearers, newborns, and providers. Topics include: Sustainable collaborations including transfers of care among midwives and obstetricians in India, The Netherlands, Germany, United Kingdom, and Denmark Midwifery-oriented, femifocal, indigenous, and inclusive models of care that counter obstetric violence and gender stereotypes in Mexico, Chile, Guatemala, Argentina, and India Doula care and midwifery care for women of color, previously incarcerated women, indigenous women, and other minoritized groups in the global north and south Practices and metrics for improving quality of newborn and maternal care as well as maternal and newborn outcomes in disruptive times and disaster settings Sustainable Birth in Disruptive Times is an essential and timely resource for providers, policy makers, students, and activists with interests in maternity care, midwifery, medical anthropology, maternal health, newborn health, obstetrics, childbirth, medicine, and global health in disruptive times. Acknowledgments Contents About the Editors and Contributors Editors Contributors List of Acronyms Chapter 1: Introduction: Sustainable Birth in Disruptive Times 1.1 Sustainability and Disruption 1.2 Evidence-Based Consensus on Maternal and Newborn Health 1.3 How the Models in This Volume Promote Maternal Health 1.4 How Our Volume Promotes the Midwifery Model of Care and Supports Marginalized Groups 1.5 How We Promote Newborn Health and Survival 1.6 Counting Maternal and Neonatal Mortality in Our Case Countries 1.7 Conclusion: The Three Sections of Our Volume Appendix: The 7 Foundational Principles and 12 Steps of the International Childbirth Initiative (ICI): Promoting MotherBaby-Family Maternity Care The ICI 12 Steps to Safe and Respectful MotherBaby-Family Maternity Care References Part I: Sustainable Maternity Solutions in High-Income Countries Chapter 2: Sustainable Midwifery 2.1 Three Models of Care: Holistic, Humanistic, and Technocratic 2.2 Midwifery Education and the Three Models of Care: Technocratic, Humanistic, and Holistic 2.3 Practicing Holistic Midwifery Care 2.4 Holistic Care: Oxytocin, Theta, and Trauma 2.5 Holistic Midwifery: A Case Study References Chapter 3: Bringing Back Breech by Reframing the Language of Risk 3.1 Introduction: The Language of Risk vs. the Language of Rights 3.2 Regenerating Focus on the Normal in Breech Birth 3.3 Three Themes, Three Proven Elements, and Three Categories of Sustainable Breech Birth Models 3.3.1 Three Proven Elements of Sustainable Breech Delivery Models 3.3.2 The Three Categories of Vaginal Breech Delivery in Facilities 3.4 Category A: Breeches Managed by the Midwife, Without Obstetricians Required in the Room 3.4.1 The Breech Clinic in the Oxford Radcliffe Hospital, NHS Foundation Trust, Oxford, England, Described by Anita Hedditch 3.4.2 The Breech Clinic in l’Hôpital Montfort, Ottawa, Canada, Described by Betty-Anne Daviss 3.4.3 The Sanctum Natural Birth Center in Hyderabad, India, Described by Vijaya Krishnan 3.4.4 A Hospital in the North of England, Described by Helen Dresner Barnes 3.5 Category B: Breeches Managed by the Midwife, with an Obstetrician Required to Be in the Room 3.5.1 SeeBaby Midwifery, Atlanta, Georgia, Described by Betty-Anne Daviss 3.5.2 Hospital of Southern Denmark in Aabenraa, Denmark, Described by Betty-Anne Daviss 3.6 Category C: Breeches Managed by Obstetricians, with Midwives and/or Doulas as Support 3.6.1 Goethe Klinikum in Frankfurt, Germany, Described by Betty-Anne Daviss 3.7 Conclusion: Changing the Focus on Risk References Chapter 4: From Home to Hospital: Sustainable Transfers of Care in the United States 4.1 Introduction 4.2 Transfers of Maternity Care: Who, When, Why, and to What End? 4.3 A Sustainable and Humanized Approach to Transfers of Care 4.3.1 Maintain the Pregnant Client’s Support Personnel 4.3.2 Avoid Unnecessary Replication of Tests and Procedures 4.3.3 Limit Obstetric Interventions to Those Medically Indicated and Desired by the Pregnant Client 4.3.4 Eliminate the Fragmentation of Care Between Sites and Providers During Transfers of Care 4.4 Further Considerations 4.5 Conclusion References Chapter 5: Structures for Sustainable Collaboration Between Midwives and Obstetricians in the Netherlands: The Obstetric and Midwifery Manual and Perinatal Care Partnerships 5.1 The Collaborative Dynamic Among Midwives and Obstetricians 5.2 Organization of Maternity Care in the Netherlands 5.3 The Dutch Obstetric and Midwifery Manual 5.3.1 The Obstetric Indications List in Everyday Midwifery Practice 5.4 Perinatal Care Partnerships 5.4.1 Two Board Meetings of a Perinatal Care Partnership 5.5 The Dutch Obstetric and Midwifery Manual 5.6 Perinatal Care Partnerships 5.7 Conclusion: Is the Dutch System of Home Birth and Autonomous Midwifery Sustainable? References Chapter 6: Re/Envisioning Birth Work: Community-Based Doula Training for Low-Income and Previously Incarcerated Women in the United States 6.1 Introduction 6.2 Racial Disparities in Birth Outcomes 6.2.1 Doulas and Better Birth Outcomes 6.3 The East Bay Community Birth Support Project 6.4 The Experiences of Doula Trainees and the Impact of Doula Training 6.5 Negotiating Birthing Spaces 6.6 Reflecting on Changes in Network 6.6.1 Empowerment 6.7 Challenges to Sustainability 6.7.1 “This is Where My Heart Lies, but Realistically Speaking I Can’t Do It”: Money as Barrier 6.7.2 “I’m Down for Birth”: Making It Work 6.7.3 “I Could Be Part of the Solution”: Doulas Envisioning Their Role in Systemic Change 6.8 Conclusions: The “Roots of Labor Collective” and Policy Implications 6.8.1 Medicaid Coverage of Doula Care 6.8.2 “A Starter Kit to Your Baby”: Doula Care as an Institutionalized Social Service 6.8.3 Vocational Training for Previously Incarcerated Women References Chapter 7: Sustainable Metrics: Using Measurement-Based Quality Improvement to Improve Maternity Practice While Avoiding Frustration and Pitfalls 7.1 Introduction 7.2 Maternal Care QI: A Recent Focus 7.3 Key Organizations and Advances in Maternal Care Quality Measurement 7.3.1 National Organizations 7.3.2 The State Level 7.3.3 Advances in Maternal Care Quality Measurement 7.4 Design Considerations 7.4.1 Designing an Actionable Problem 7.4.2 Additional Design Considerations for Quality Measures 7.4.3 Data Issues 7.4.4 Clinician Burden 7.5 Identifying and Addressing Common Pitfalls 7.5.1 Infrastructure Pitfalls 7.5.2 Methodological Pitfalls 7.6 Conclusions References Chapter 8: Unsustainable Surrogacy Practices: What We Can Learn from a Comparative Assessment 8.1 Introduction: Questions About Surrogacy 8.2 Methods 8.3 The Regulatory Context 8.4 Elements of Sustainable Surrogacy 8.4.1 Standardization and Regulation of Contracts 8.4.2 Mandated Screening of Intended Parents 8.4.3 The Open Surrogacy Relationship 8.5 Summary and Conclusion: A Call to Rethink US Surrogacy Regulation References Part II: Sustainable Maternity Solutions in Latin America Chapter 9: Childbirth in Chile: Winds of Change 9.1 Childbirth Activism 9.2 Territories of Birth: The Case of La Florida Hospital 9.3 Home Birth 9.4 Final Words References Chapter 10: Humanizing Care at the Maternity Hospital Estela de Carlotto in Buenos Aires: Providers Relearning Their Roles 10.1 Sustainable Birth Principle #1: The Importance of a Name 10.2 Sustainable Birth Principle #2: Reorganizing Complex Childbirth Care 10.3 Sustainable Birth Principle #3: Providers as Protagonists of the Paradigm Shift 10.4 Sustainable Birth Principle #4: Childbirth in a Sexual and Reproductive Healthcare Setting 10.5 Conclusion: A Humanized Model to Deepen and Expand References Chapter 11: Luna Maya Birth Centers in Mexico: A Network for Femifocal Care 11.1 Luna Maya: History and Context 11.2 The Landscape of Maternal Health in Mexico 11.3 Luna Maya Vision and Mission: Empowering Women and Communities 11.4 Creating a Femifocal Model: Beyond Full Spectrum Care 11.4.1 Sustainable Femifocal Care in Action: Case Studies 11.5 Sustainability for Luna Maya 11.6 A Vision Forward: Integrating Birth Centers into a Network References Chapter 12: Reconstructing Referrals: Overcoming Barriers to Quality Obstetric Care for Maya Women in Guatemala Through Care Navigation 12.1 Guatemala and Maternal Mortality 12.2 Methodology 12.3 Telma 12.4 Hospital Bureaucracy and the Failure of Systems of Care 12.5 A Solution: Patient Accompaniment and Care Navigation 12.6 Telma’s Story Retold References Part III: Sustainable Maternity Solutions in Low- and Middle-Income Countries Chapter 13: A Sustainable Model of Assessing Maternal Health Needs and Improving Quality of Care During and After Pregnancy 13.1 Background 13.2 Introduction 13.3 Progress on Improving Maternal Health 13.4 Maternal Health Indicators and Definitions 13.5 Severe Acute Maternal Morbidity 13.6 Maternal Morbidity 13.7 Quality of Maternity Care 13.8 Evidence-Based Care for Mothers and Babies 13.9 A Culture of Quality Within Maternity Care 13.10 Measures for Sustainable Improvements References Chapter 14: Sustainable Maternal and Newborn Care in India: A Case Study from Ladakh 14.1 Excellent Maternal and Newborn Outcomes at Sonam Norboo Memorial Hospital 14.2 Methods 14.3 Maternity Care at SNMH 14.4 Dr. Padma’s Story 14.5 Dr. Spalchen’s Story 14.6 Two Newborn Outcomes in the Special Newborn Care Unit (SNCU) 14.7 Neonatal Care in Ladakh Versus India: Scaling Up 14.8 Neonatal Survival: India and the World 14.9 Conclusion: Sustainable Newborn and Maternal Care References Chapter 15: Giving Birth at Home in Resource-Scarce Regions of India: An Argument for Making the Women-Centric Approach of the Traditional Dais Sustainable 15.1 Introduction 15.2 Methods and Study Areas 15.3 Mother’s Attitudes Towards Homebirths 15.4 Dais’ Skills in Normal Births 15.5 Birth Patterns and Complications 15.6 Newborn Care and Birth Rituals 15.7 Conclusion References Chapter 16: It Takes More Than a Village: Building a Network of Safety in Nepal’s Mountain Communities 16.1 Introduction: Sustainable Maternal Health in Mountain Communities 16.2 The NGO: One Heart Worldwide 16.3 The Network of Safety Model in Nepal 16.4 Building Trust and Local Knowledges 16.5 Conclusion: The Sustainability of OHW’s Network of Safety References Chapter 17: Tranquil Birth: Revising Risk to Sustain Spontaneous Vaginal Birth 17.1 Fearfulness and Institutional Apartheid 17.2 Risky Definitions of Risk 17.3 Sustainable Birth 17.4 Conclusion References Chapter 18: Sustainable Birth Care in Disaster Zones and During Pandemics: Low-Tech, Skilled Touch 18.1 Introduction: Effective Disaster Care as a Critique of Technocratic Birth 18.1.1 Obstetric Disaster Responses: A Brief Note 18.1.2 The International Childbirth Initiative as a Template for Optimal Care 18.2 Bumi Sehat’s Disaster Relief Efforts as Recounted by Founder Ibu Robin Lim 18.2.1 The Aceh Tsunami 2004 18.2.2 Volcanic Eruptions in Bali 2017–2018 18.2.3 Disasters on Lombok and Sulawesi 2018 18.3 Mercy In Action’s Disaster Relief Efforts as Recounted by Founder Vicki Penwell 18.3.1 Mercy in Action’s Disaster Response after Hurricane Haiyan/Yolanda 18.4 The Great Japanese Earthquake of March 11, 2011: Mothers’ Perspectives as Recounted by Tsipy Ivry and Robbie Davis-Floyd 18.5 Global Impacts of COVID-19 on Maternity Care 18.6 Conclusion: Lessons Learned from Disaster Zone Maternity Care References Chapter 19: Sustainable Newborn Care: Helping Babies Breathe and Essential Newborn Care 19.1 Introduction 19.2 Neonatal Resuscitation at Birth and Subsequent Stabilization 19.2.1 Neonatal Resuscitation Program (NRP)® 19.2.2 Helping Babies Breathe (HBB) â 19.3 The Neonatal Period 19.3.1 Essential Care for Every Baby (ECEB) ® 19.3.2 Essential Care for Small Babies (ECSB) ® 19.3.3 Quality Improvement (QI) 19.3.4 The Survive and Thrive Alliance (S&T) ® 19.3.5 Kangaroo Mother Care (KMC)—An Important Intervention 19.4 Conclusion References Chapter 20: Conclusion: Sustainable Maternity Care in Disruptive Times 20.1 Disruptive Times 20.2 Sustainable and Lean Maternity Care 20.3 Perspectives on Sustainable Models of Maternity Care 20.4 Characteristics of Sustainable Maternity Care References Correction to: Introduction: Sustainable Birth in Disruptive Times Index "This contributed volume explores flexible, adaptable, and sustainable solutions to the shockingly high costs of birth across the globe. It presents innovative and collaborative maternity care practices and policies that are intersectional, human rights-based, transdisciplinary, science-driven, and community-based. Each chapter describes participatory and midwifery-oriented care that helps improve maternal and newborn outcomes within minoritized populations. The featured case studies respond to resource constraints and inequities of access by transforming relations between providers and families or by creating more egalitarian relations among diverse providers such as midwives, obstetricians, and nurses that minimize inefficient hierarchies within maternity care. The authors build on a growing awareness that quality and respectful midwifery care has lower costs and improved outcomes for child bearers, newborns, and providers. Topics include: Sustainable collaborations including transfers of care among midwives and obstetricians in India, The Netherlands, Germany, United Kingdom, and Denmark; Midwifery-oriented, femifocal, indigenous, and inclusive models of care that counter obstetric violence and gender stereotypes in Mexico, Chile, Guatemala, Argentina, and India; Doula care and midwifery care for women of color, previously incarcerated women, indigenous women, and other minoritized groups in the global north and south; Practices and metrics for improving quality of newborn and maternal care as well as maternal and newborn outcomes in disruptive times and disaster settings. Sustainable Birth in Disruptive Times is an essential and timely resource for providers, policy makers, students, and activists with interests in maternity care, midwifery, medical anthropology, maternal health, newborn health, obstetrics, childbirth, medicine, and global health in disruptive times"--Back cover