I am in my final days of packing for a journey to Senegal. I am getting prepared to spend three weeks working in three birth centers where I will deliver an average of 30 babies. Not the kind of midwifery I am accustom to! A woman, Kaya Skye, started a program in Senegal a while back, where midwives and midwives in training can go and teach and learn.
Here is some information about the program and how you can help!
It is our experience that there is a real crisis of education among the matrons in Sénégal, who deliver the vast majority of babies. They spend six months in practical training in a local clinic and are then often posted to more rural outposts. During this time they follow and learn from the other matrons and sage-femmes, but they have no academic component to their education. The result is generally an unclear understanding of the anatomy and physiology involved in birth. They are taught “protocol”, which is based on outdated Western medical practices such as extreme fundal pressure, supine delivery positions with stirrups, standard pitocin drips, placental extractions and routine postpartum methergine shots. They are not taught problem solving techniques that facilitate good management decisions or allowed to incorporate traditional methods or alternative positions. There is currently no system of peer review in place, and they do not use charts to document the woman’s labor progress or communicate with other matrons. The sage-femme who heads the clinic is responsible for all the women who come in and is on call 24 hours a day for complications. She has very little time to train the new matrons in special skills or theory. The cumulative effect is that Senegal has one of the highest infant mortality rates in the world: 79 deaths per 1000 live births (World Bank 2002).
African Birth Collective has been able to counter the Western obstetric model that has been handed down through post-colonial education with an alternative view. We support women to walk around during labor, deliver in non-supine positions, and support the perineum to allow for slow restitution of the head and prevent tears. We have also been able to learn effective techniques commonly practiced in Sénégal, such as the “milking” of the cord and inverted resuscitation methods.
Together we are able to understand a wider perspective with which midwifery knowledge can be seen as something always growing and changing, drawing on traditions as well as new experiences. In this light, “protocol” must always be reevaluated to determine if it is both useful and appropriate.
To address the need for a larger transformation of the matrones’ education, African Birth Collective is seeking funding for ENDA Santé to translate “A Book for Midwives” (Hesperian Foundation) into French to use as a teaching tool and reference. We are seeking to develop a closer relationship with the Association des Sages-Femmes Senegalaises, to work together to provide resources and opportunities for rural matrons to expand their knowledge, understanding and respect for birth. We sincerely encourage the appropriate use of both traditional and modern knowledge within this model.
We welcome all midwives, midwifery students and those interested in supporting safe birth in Africa! Your support and love makes all of this possible. Please contact us to find out how you can help. Donations of baby blankets, hats, socks and newborn “onesies” [I think onsies might be a trade name so I would use the quotation marks, at least] are put together in ziplocs for new mothers. Any amount of financial donations will be put toward the purchase of needed supplies or go into our ambulance fund. Local birth centers and hospitals often have expired meds and other supplies that might get thrown away. These will be gladly taken to Sénégal and shared with rural clinics that often have no latex gloves or suture, lidocaine or basic instruments. African Birth Collective has 501(c)(3) status and tax deductions can be taken for all donations. Thank you!
African Birth Collective (a Not for Profit Corp.)
595 Weller Ln.
Ashland, OR 97520