Earlier this month, I represented Save the Children at Women Deliver 2019, the world’s largest gender equality conference, to help with overall logistics and to advocate for our main Health and Nutrition objectives at the conference. Like most of our staff who were at the conference, I welcomed participants to the #STOPTHEWARONCHILDREN themed booth, I attended the large plenaries of inspiring speakers, and totally geeked-out over seeing Justin Trudeau. However, what I found most rewarding was being able to attend the smaller sessions on Maternal, Newborn, and Reproductive Health.

Who holds the power in pregnancy?

Most people do not know that in addition to my Health and Nutrition work at Save the Children, I am also a doula, serving to provide educational, physical, and emotional support to pregnant women and their partners over the course of pregnancy, labor, and immediately after the birth. From the perspective of a doula, I understand the health system, the hospital guidelines, the anatomical transformations during childbirth, and the emotional roller coaster that accompanies bringing life into this world. At Women Deliver, Winnie Mwebesa, Associate Vice President of Global Health at Save the Children US, hosted a concurrent session titled “Who Holds the Power in Pregnancy? Overcoming Stigma.” The room was filled with educators, advocates, midwives, obstetricians, nurses, and numerous others. All of them unanimously agreed that as it stands now in our existing health structure, women do not hold the power during their own pregnancies. I believe that power sits with the care-providers and nurses. They have the ability to drastically impact the satisfaction of the laboring woman, the involvement of their partners, and ultimately the environment in which a baby is born. I’ve seen heartwarming un-medicated vaginal deliveries, anxiety-ridden cesarean sections, frustrated inductions, and tragic losses of babies born too soon. In each one of these instances, the care providers and nurses held the power to encourage, show compassion, rush, scare, listen to, disregard, or love the women sitting in front of them. The option they chose drastically shaped the direction of birth and the overall feelings of the woman.

When a woman and her partner feel included in the conversation, listened to, educated on all available options, and respected, they are able to reclaim their power during pregnancy.

The importance of women-centered care

The WHO recently announced that 2020 will be the year of the nurse and midwife due to the integral role these positions play in offering Universal Health Coverage, and improving the quality of care in birth. The American College of Nurse-Midwives reports that “women cared for by certified nurse-midwives compared to women of the same risk status cared for by physicians had lower rates of cesarean birth, lower rates of labor induction and augmentation, significant reduction in the incidence of third and fourth degree perineal tears, and lower use of regional anesthesia,” among many others.

Of course, this is dependent on multiple factors, most namely, the practice in which you chose to provide your primary care. My point in sharing this is to show that providing care in a more compassionate and respectful manner, utilizing alternative options to medical interventions, and engaging the woman and her partner in the process of pregnancy and birth, not only improves maternal and newborn outcomes, but is an easy path to returning power back to women during pregnancy.

Maternal-care is community-care

At Women Deliver, an indigenous midwife in Canada said, “Midwives don’t just catch babies. They are part of the entire health system. And a community that is losing mothers and newborns, is a community that is dying.” To me, this means that investing in women is investing in life.

All of us at Save the Children have the power to bring about change – as individuals and together as a movement. I plan to use my power in my role at Save the Children to advocate for comprehensive education around our maternal, newborn, reproductive health programming and ensure that our technical experts are designing programs that are women-centered and are evidence-based to deliver more desirable outcomes in birth. Save the Children is already doing a lot of this type of work! For example, in Bangladesh, the Strengthening National Midwifery Program (SNMP) provides on-the-job training to student midwives by Clinical Mentors and Nursing Instructors on evidence based routine care. These sessions help student midwives understand critical delivery components, labor support and positioning, companionship, and the positive impact of utilizing non-medical tools to assist women in labor. This program is also helping to raise awareness about the status of local midwives and the essential care they provide to mothers and their newborns. As a doula, I plan to use my power to help women and their partners receive the quality of care they deserve. I will continue to provide childbirth education instruction, overviews of exercises used prenatally and during birth, and guidance on communicating with care providers. Lastly, I will always advocate for the rights and the voice of the woman and her partner. Birth is the most transformational process a woman could go through; and it is at this very moment that she should feel her most empowered and powerful. It is a true honor to help these women bring life into this world and I couldn’t ask for a greater gift.