Sunday, January 31, 2010

Hospital Births May Finally Get It - You Needn't Starve and Be Thirsty During Labor

The medical community may be reversing itself on a practice that came about after the rise of hospital births but which has long been unnecessary. Women who give birth in hospital are routinely denied food and water when in labor, and only allowed to suck on ice chips.  The justification for this policy is that a woman might need to have an emergency c-section (perhaps 1-2% of current births) in which there wouldn't be time for regional anaesthesia, requiring the use of general anaesthesia, and in such cases there can be a rare but potentially fatal complication (which is why you have to fast before you have any surgery). But recent studies are showing no difference in outcome, which may lead to a reversal of this long standing policy that is based on birth and anaesthesia procedures dating back nearly 70 years. Some hospitals are (gasp) now permitting clear fluids for women in labor. The midwife/home birth community has long known that this restriction is ridiculous, and unnecessarily adds to a woman's discomfort and stress. Maybe in another year or so the world of hospital births will catch up and allow women to eat, and drink, or not, as they desire, during labor.

Saturday, January 23, 2010

Haiti's Women, After the Quake

I've been trying to think about what to write here regarding Haiti. It's been so much on my mind, and probably on yours, but this is a blog about Fertility Awareness and related issues, and there didn't seem to be much link. But then today I was reading today about three Haitian leaders who died as a result of the earthquake, and I want to draw your attention to them. I do so because these women did so much for the women of Haiti, and also because (as you may know) I believe that Fertility Awareness should encompass women's issues that result from our biological status as women, such as rape, domestic violence, and female genital mutilation. And I suspect that many of you don't know about how women suffer in the wake of a disaster, in a different and more acute way than men often do.

The names of the women who died were Magalie Marcelin, Myriam Merlet, and Anne Marie Coriolan.

Haiti's troubles were innumerable even before the earthquake, and in countries (and societies) where poverty is as endemic as it is in Haiti, women often suffer the extra burden of violence and sexual exploitation. A recent study by Kay Fanm, a women's rights organizations founded by Magalie Marcelin, found that 72% of women surveyed had been raped, and at least 40% had suffered domestic abuse. Spousal rape is not recognized as a crime in Haiti. Sexual harassment is not specifically outlawed. There are 523 maternal deaths per 100,000 births (vs. 12 in the US). This situation is only likely to worsen as a result of the quake. It's well known that women are at greater risk after major disasters. Rape and domestic violence become more common, women may not be able to gain access to emergency food aid, human/sexual trafficking may increase, and women's maternal health care needs go unmet.

This piece in the Huffington post by Taina Bien-Aime, the director of Equality Now, discusses both the remarkable women who died, as well as the precarious situation of women following this disaster:
"Haiti's Women in the Aftermath of Disaster"

You can read more about these women in this piece by Jessica Ravitz, for CNN:
"Women's Movement Mourns Death of 3 Haitian Leaders"

Here is an elegy to Myriam Merlet on the V-Day website. Myriam approached Eve Ensler in 2001, as she wanted to bring V-Day to Haiti. Together, they established a safe house for women in Port-au-Prince.
V-Day Mourns Myriam Merlet

The Haitian recovery will be going on for years. Even if you have already donated, I hope that you will consider donating, either now or in the future, to some of the organizations that will continue to fight for the rights and safety of Haitian women. Some of them are listed below. There is a Haitian saying, "When the women dish out the food, everyone eats." Help fill the pots of Haitian women so that all Haitians can be fed.

Dwa Fanm

Kay Fanm

V-Day Haiti Sorority Safe House


Madre (Madre also has a piece about how women are uniquely vulnerable after disasters, and how their model of relief puts women front & center, which you can read HERE, and there is also a nice piece about the midwives and maternal health care practitioners they helped send to Haiti, to assist the 37,000 pregnant women estimated to be among the survivors of the quake. You can read that HERE.)

Tuesday, January 12, 2010

More re Kenya Experience

As I indicated in my last post, the work I signed up to do in Kenya and the work I ended up doing turned out to be rather different. The title of the project was, and I quote, "Impact of harmful cultural practices - Female Genital Mutilation (FGM) and Early Marriages for the Girl Child." So you can imagine my surprise and disappointment when I got to the project site and learned that the project actually had nothing to do with that topic, and that the primary activity would be making bricks out of mud. Now mind you, brick-making is very important in Kenya. Nothing gets built until the bricks are made. The community group with which we were working, the Mowankwe Women Group, has a long-term goal of building a health clinic, as there is none nearby and most people go without any type of medical care except for major emergencies (and even then it's not always possible). Many women birth at home, unattended, and while I'm all in favor of home birth here, in rural Africa it often leads to very unfortunate outcomes, including mother to child transmission of HIV.

So brick making is an important activity, but not what I had signed up for, and definitely not one for which I'm particularly well-suited. (The fact that I had recently had surgery for a broken and dislocated thumb did not help matters.) But as several friends with development experience had told me before I left, when attempting to do any kind of development work in Africa, it is very important not to have fixed expectations, and to go where the flow takes you. That advice served me well. They wanted bricks; we would make bricks. We managed to make a few thousand of them, despite the daily rain. (It was the rainy season, arguably not the best time to make bricks out of mud.) It was unclear when we left whether the bricks would be sold, to raise income for the community, or whether they would be used to expand the one room building that currently serves as church, school, and community meeting place.

Mudmaking photos lifted from my friend Malcomb's Facebook page. Here you can see mudpit at rear, and Hitomi and Oska transferring bricks from mold onto ground.

In this photo I'm on the left. Mineshi (center) and I are trying to mix the mud that Oska is making, with
our legs. Way harder than a Stairmaster.

But I had done a ton of preparation regarding FGM, and here I was in Kuria, an area with an extremely high prevalence rate of FGM, so the Mowankwe group and I decided that I would give a presentation, during the last of our 3 weeks there. Mind you, this community has no electricity and no running water, so although I had been told that I would be able to show a dvd (Africa Rising), I was truly astonished when I saw that they had in fact procured a generator, a dvd player, and a tv. They even had a chalkboard and chalk. So with the help of 2 translators, I was able to give a presentation about FGM.

When one is a white person talking about FGM in Africa, one needs to be very cognizant of the complexity of the issue, including the history of it. Attempts to eradicate FGM have largely come from outside Africa, and from outside the cultures which practice it. A lot of resistance to change centers on this fact. I structured my talk in such a way that I left room for arguments in support of the practice. My intention was to have a discussion, not to give a lecture. I used the term Female Circumcision, rather than Female Genital Mutilation, so as to leave open as fully as possible the doors to dialogue. I was fully expecting to encounter the Cultural Imperialism argument. In the end, I encountered no resistance whatsoever. The women (and men) who attended my presentation expressed a pretty uniform opposition to FGM. I think this is because these women are activists within their community, working together to improve their own lives and those of their families. They are poor and in many cases of limited education, but they are engaged. Although most of them had themselves been circumcised, they seemed committed to not inflicting the same damage on their daughters. They lamented the lack of sexual desire/pleasure and were aware of the health risks. I realize that the people continuing the practice were not at the presentation, but it was heartening to see that the tide is in fact turning in Kenya, and to know that these women who are working to bring about change in their community are set against FGM. I hope that they will spread the message to their fellow villagers and lend them, especially the girls, the support they need to resist the tradition.

Btw, the video Africa Rising had been donated to me by the makers of the film, and I left it with the Mowankwe group. Thanks to EQUALITY NOW for the support.

Me, teaching.

Carol and Oska translating for me. They are laughing, despite the serious subject matter, because they are NOT used to saying these words out loud! And that of course made me laugh.

Watching the video Africa Rising.