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President’s Message

Spring has definitely arrived in N. Idaho, which means longer days, warmer temperatures and every possible kind of weather happening in the same day.  It is green and moist in our world with signs of new life everywhere!

And oh what a winter it has been!  It was a real roller coaster ride through the legislative process with a steep learning curve full of frustrations, new connections, successes and lessons.  See a full report elsewhere in this newsletter.  I am so proud of us for all we accomplished and how we represented ourselves’ and our profession.  We opened many eyes, ears and hearts to the wonderful work we do and the people we serve in Idaho.  There are so many people to thank and I will never be able to mention them all, however I must mention a few of them here:

Many thanks to Pat Holmberg who lobbied for us, guided and taught us the process.  Thanks to Senator Shawn Keough who sponsored our bill and assisted us in getting the bill to its final form, printed and introduced in to the Health & Welfare committee.  Thanks to Senator Heinrich and Senator McKague for co-sponsoring.  Thanks to the IMC board for the many, many hours spent in internet meetings, phone calls and all the time it took to organize and communicate our needs.  Thank you to CaraLee Anderton and the Idahoans for Midwives for your efforts organizing and mobilizing our supporters.  Thank you to all the midwives and their clients and friends who wrote letters, sent post cards and emails or made phone calls to the legislators in support of the bill.  And my heartfelt personal thanks to Michelle Bartlett for her lobbying efforts and all the work she have done over the past 3 years, and to Paula Wiens for stepping in when I couldn’t be there.  The list goes on and on.  Thanks to everyone for whatever part you played, no matter how large or small because it is all important.

We are wiser now.  We know where our work lies and what the opposition is like.  The legislative committee continues to meet weekly to keep the momentum going, explore options, do research and answer questions.  We are putting together a small working group with the IPP so we can sit down and hammer out our differences with the intention of introducing a bill in Jan. ’08 that everyone will support.  I believe this is possible. 

If you are interested you can read the minutes of the H&W Senate committee hearing at:: http://legislature.idaho.gov/sessioninfo/2007/StandingCommittees/shelmin.pdf

In the event the link doesn't work, if you go to the page above, then click on the date of the meeting, which was February 26, 2007.

The board has accepted the resignations of 2 valued members.  Sherry Riener of Cottonwood has served as Reg. 2 representative and vice president.  We thank you Sherry, for your many years of service and your dedication to the IMC.  Coleen Goodwin of Meridian was the Reg. 3 representative and has made many generous donations to the IMC’s efforts this past year.  You will both be missed on the board and we appreciate your continued support and involvement as we move forward.  Our best wishes to you both for continued good health and excellent births.

We are excited to welcome 3 new board members.  Jo Nelson from Blackfoot has agreed to become the IMC secretary, Jean Boone of McCall is our new Region 3 representative and Nancy Draznin will join us as the new Region 2 representative.  Please note their contact information in the directory and contact any of us with your needs, news, questions, issues, concerns, stories or for anything we can help you with.  We are all here to serve the midwives of Idaho.  We meet via internet the last Friday of each month, before the annual conference and whenever else necessary.

I urge everyone to continue (or begin) to send the birth announcement postcards to your legislators (they really get their attention), make appointments to visit with them in person while they are at home to educate them about who you are and who you serve (take clients too).  If you are not already on it, join the  Idaho_Midwives@yahoogroups.com to stay connected and get or send information quickly.  Collect and build your database of clients and supporters, send it to Idahoans for Midwives and join that group.  I hope you will get involved and help us to protect midwifery and home birth in Idaho. 

Before the next newsletter you will receive a Fall Conference brochure.  In the meantime, mark September 14, 15, & 16 on your calendar and begin telling those new clients that you will be on Lake Coeur d’Alene those days.  If you have a workshop you would like to offer or suggestions of what you would like learn, please let us know asap.

It is an honor and a blessing to be part of such an amazing group of midwives, students, doulas and educators.  Thanks for being here.

Barbara Rawlings, CPM
IMC President

Upcoming Events

     May 5^th   International Day of the Midwife & Idaho Midwives’ Day
(look for a proclamation signed by Governor Otter proclaiming May 5^th as Idaho Midwives’ Day)

           June 22-24^th     ALACE labor assistant workshop in Moscow     
     (Nancy Draznin 208.310.3252)

                August 24-26^th ALACE labor assistant workshop in Twin Falls  
      (Trisha Blizzard  208.404.1652)

        September 14-16^th   IMC Conference in Coeur d’Alene  (look for a brochure!)

News & Notes 

Kenya  (from Denise Midstokke of Sandpoint)

Dear Idaho Midwives,

I have been in Africa for 4 months now and enjoy it more every day.  I can get around easy enough and find what I want to make my life comfortable. It is amazing how adaptable we are. I can never complain about the weather here and don't mind missing one Idaho winter!

I continue to work at the Sagalla Health Center but have not found much to do in the way of say...medicine. The care is fairly streamlined just for about 7 different diseases, malaria, typhoid, asthma, upper respiratory infections, septic wounds, and worms!  We do occasional check for AIDS and often those are positive but the people get sent off to the hospital for treatment unless they have an apparent opportunistic disease and then they are given the all power full  "Septra".  I have seen so much Malaria it seems like no big deal now. I want a study to get done on why so many Africans have upper respiratory infections and asthma but do remember, we all cook in unventilated rooms with coal, kerosene and wood. (our home has a chimney). 

So many interesting things I have seen..... A man in maybe his 40's, nobody knows their age and it is registered as either child or adult every where. An adult is an estimated age of over 12.  Well, this man came in with a septic wound at about 24 hours post from a thorn. It was quite infected and he was treated with 3 days of IM penicillin.  On day 3 he had gangrene and was entirely septic. His hand was black (blacker then usual) and swollen but most noticeably it leaked copious amounts of fetid black discharge. He got half his hand cut off at the Voi hospital. I happened to see him this morning and it's healed pretty good except where one of his bones projects out of the wound... 

Last week I did an emergency run to a young man cut into the wrist bone with a chain saw. It took them so long getting to the surgery that the muscles and ligaments retracted and they are not sure if they were able to suture them correctly. I saw him after a week He had NO movement or feeling in his hand...  I also transferred by car a 50 year old teacher, a women for pain with swallowing, chest burning sensation, swollen lymph nodes under right arm and swelling with severe pain over her right breast. We asked this village woman to undress a bit so we could view the painful area. She undid her Kanga, a strip of cloth around her chest and it was hard to not laugh as I saw one of the prettiest sexiest black bras I had ever seen. We have an Austrian doctor with us now and she and I were definitely getting the giggles as this seemed SO out of place!!  By the way, we never heard what her diagnosis was and she was unable to explain the diagnosis to even the village nurse. She did stay 2 days in the hospital.

We see really big wounds from pangs, a knife-like tool that everyone works with. Wounds get septic in hours here. We also see many abscesses and the other day saw one from an injection sight in the totally the wrong part of the buttocks!  We give lots of penicillin injections – we will be able to do a study on antibiotic resistance to penicillin here in another few years.

I help in the baby room occasionally. I saw a 2 year old that was born with cranial stenosis and could have used an early surgery. We immunize and weigh. I hang out in the wound treatment area to talk to my friend Esther from Holland and see interesting sores plus not a few knife fight cuts. I help with hard OB cases and women's health issues, helping with IUCD's (our IUD's) and attend births when they ask!

Birth in Sagalla!  We have a women's ward with grey, rusty steel beds, old curtains over broken windows, dusty blue bedside tables and disgustingly dirty mattresses. One pillow. The other day I found a pillowcase! Moms come with a few other women when they are in labor. It is quite a wonderful procession to see them walking up the hill. The women carry a basket of birth items as they have to provide cotton, kanga and cord string. They also have to have food for them all for the stay. They stop every few minutes to allow for the contractions and then start on their way again.  They will have an initial vaginal exam and fetal heart check only to be sure they get a beat. They don't believe in doing more then one vaginal exam every 4 hours no matter what (I cheat a bit but I only use one finger). The woman is then left to labor with what ever women have accompanied her, no male partners. The women rarely receive what we call actual labor support and are not really encouraged to eat or drink. The nurses I work with I think are nicer then other African nurses; they are not warm and fuzzy.  As birth seems to near the women will get up on this stupid high plastic covered exam table.  They have on a kanga and put it under them and it gets everything on it.  They are usually naked whether they want to be or not and any of  the staff is allowed in to view the progress of the birth and give the women advice, even the cleaning lady!  The nurses are called by the family when the head can be seen at the intoitus (If I'm attending I call too late). From the moment the head is seen until the baby is out becomes a huge panic!  Perineal support is pushing the tissue back down over the baby’s head with all of your might.  The women are ordered to push non stop and told they are not doing it right or hard enough. When the baby makes its entrance it is 
picked up by its feet and spanked after which any African people around (usually at this point all the support people are in another room) make a beautiful African welcoming sound. The baby is swaddled in one kanga (I got in trouble once for using one to dry and the other to wrap) and just set on the scale. The mother is given IM methergine and told to push the placenta out. If torn she is sutured (we haven't had to suture one of my births) and within ten minutes a piece of cotton is put between her legs and she, unescorted, walks to the women's ward. The baby only gets weighed and, if they remember, eye ointment. There are no postpartum or nursing instructions given. The women will rest for awhile and then walk home several miles.  If I attend the birth, girls often get named Denise.

Next time I write I will tell you about some positive changes we have been able to make, and my interviews with the Traditional Birth Attendants that start next week!

I send greetings to you all and really enjoyed the stories in the last newsletter!!

Mazungu Denise

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