summer travels

Above is a picture from the Pro-Vita International women's clinic where we celebrated our colleague, Anda's birthday shortly before we left for the U.S.

The blog has not stopped because of our recent move from Bucharest, Romania to Seattle, Washington.... in fact I have found that there are quite a few Romanians in Seattle due to the local Microsoft staff. Nate and I have been from Bucharest to London to Boston to Columbia to California. We are looking forward to settling into our new home in Seattle, Washington where I will be finishing my nurse midwifery internship.
Romania is still pulling on our heartstrings... I have included a recent article from a local English newspaper indicating that with the increasing economic and social crisis Romanians are looking back to Communism with longing eyes.

I am praying for God's direction for HPR. I would like to be involved in bringing country-wide change to Romania's women's healthcare system but am searching for tangible ways to produce lasting change. This is a question in my mind that only God can answer!


41% of Romanians declared that they would vote former dictator Nicolae Ceausescu as President of the country

de AC HotNews.ro
Luni, 26 iulie 2010, 21:39 English | Top News

Almost two thirds of the Romanians believe that they were better off before 1989 in Communism, and 41% of those interviewed said that if former Communist dictator Nicolae Ceausescu would run for President they would vote him, an IRES survey reveals.

If almost one of two Romanians believe that Nicolae Ceausescu was a good leader, 67% of the respondents say that his wife, Elena, was a bad leader. 87% of those interviewed heard about the decision of the heirs to exhume the remains of the couple.

71% believe that Ceausescu did not deserve the punishment and 23% agree with the way his dictatorship ended. 63% of the respondeds said that they were better off in the Communism, 9% said they were just the same and 23% said that life was tougher in Communism.

First Annual Midwifery Conference

On May 29th I had the honor of attending the first annual midwifery conference in Romania. There were some beautiful people present and several lovely presentations. I felt overjoyed to be a part of this movement... there was also room for improvement. Above is the picture that Irina took when I was speaking. I was able to share for about fifteen minutes regarding my dreams for the future of Romanian midwifery and hopes implementing the International Motherbaby Childbirth Coalition's ten steps towards a better maternal child healthcare system.

Overview
Positives
- attending the conference with midwife student Irina Popescu
- meeting Lamaze activist Oana Moraru once again
- Bianca' Brad's heart wrenching and personal presentation regarding the experience of a mother when her child dies.
- great attendance
- the meeting was initiated by the nurses' and midwives' association president (for Bucharest)
- an excellent presentation on the progress and normalcy of midwifery care in Western Europe

Room for Improvement
- I was shocked when at the university hospital, where the conference took place, there was no soap in the bathrooms (also no toilet paper etc.). When I asked the housekeeper she said, "There is an economic crisis, what can we do? If there is no soap, there is no soap." I thought, well, cutting soap out of the budget is not where I would have started.
- Several cord blood banking organizations paid for advertising and spoke at the conference. It was frustrating because in a country where state hospitals do not have soap, we are promoting this 'advanced' technology. What if we didn't have routine episiotomies and didn't systematically apply fundal pressure to women's uteruses when they were actively pushing.... what if we had soap and washed our hands....and then we talked about cord blood banking?
- Midwives were not able to share 'tricks of the trade' or present a clinical piece of information because of their limited professional role in the country's capital.
- Many midwives present told me they really didn't see the 'big issues' in current clinical practice and were overall satisfied with the care being provided.

But, really and truly, Bianca's presentation made the entire day worth it! I think we need more mothers like Bianca to break through to midwives and reconnect midwives with their emotions, their hearts. Bianca is also a local celebrity and well spoken in German and English. Feel free to check out her website http://www.organizatiaemma.ro/

bioethics in Romania

Above is a picture I snapped on the way to a meeting with the president of the Bucharest Nurse & Midwives Association... thought it was ironic that the virgin Mary was overlooking the 'old' trash cans that were ripped up- maybe this time the trash cans they install will be able to be emptied in a more efficient way than pulling out all the trash by hand... hmm...

This Saturday I got to attend the first annual midwifery conference in Romania. I will post more on that later. For the moment I thought you readers might enjoy a link to this article about bioethics in the Romanian healthcare system. The lead question asks "Is a bioethical analysis of the Romanian healthcare system necessary?" Yes! I would answer and YES again! The system continues to spiral into uncontrollable corruption and the citizens continue to suffer....

http://eng.bioetica.ro/atdoc/RRBv8n1_2010_Editorial_EN.pdf

20 billion euro loan... and promise of increasing neonatal mortality.

In addition to the austerity cuts promised by the government...taxes are expected to increase. This will increase the financial stress for parents and healthcare providers. Critics are speculating that due to these austerity cuts and the poor state-run health system that healthcare providers will now attempt to leave the country more than ever.

Excerpted from "The Common Man News"
http://themancommon.blogspot.com/2010/05/imf-dictates-shock-program-to-romania.html

"Coming out of talks with an International Monetary Front delegation last week, Romanian Prime Minister Emil Boc unveiled an austerity package that is the precondition for the country receiving the next outlay of a 20 billion euro loan package. Even though cuts were expected, the ferocity of the planned attack sent ripples of shock and anger through the population. [...]
Romania has been a target of the IMF. Previous IMF dictates were observed by the notorious “anti-communist” CDR coalition government of 1998-2000, a government that is best remembered for the shameful role it played in the attack on Serbia by NATO forces in 1999, its destruction of the mining sector and huge privatization programs. But the scale of the new attacks is unprecedented even by these infamous standards. Among the population there is increasingly the feeling that the political establishment has this time bitten off more than it can chew. [...]
The dramatic drop in living standards is accompanied by the decay of the public healthcare system. The 25 percent cut to child benefits will certainly affect the infant mortality rate, which is already the highest in Europe. Many of these infant mortalities happen in the first year of life and are caused by treatable infections and malnutrition. {...]
Hospitals have been left in a state of decomposition for years, with patients and health workers buying medication and medical materials themselves due to the almost total lack of funding. The situation reached a critical point in April and May of this year, when more and more managers, including in the capital Bucharest, reported that their hospitals can no longer perform surgeries or receive emergency cases."

Loredana

In her cozy studio apartment we sipped tea and Loredana told me about her traumatic birth experience. She smiled but her voice betrayed her true feeling of frustration and sadness with her birth. “To summarize,” she said, “It was quite an awful experience.”
Loredana shared about how her doctor had been out of the country and how she then labored alone because no one had ‘orders’ to take care of her since her doctor was not present. Loredana expressed her anger at then being rushed into an ‘emergency’ cesarean section for a breech positioned baby that she was aware of since pregnancy. She had repeatedly told her care providers of the breech diagnosis since she had arrived seven hours before in labor but no one had listened.
Loredana also explained that she was forced to walk to the nursery, after having a cesarean section, three times a day and in the evening to nurse. Baby Marius, though healthy, was not allowed to stay with her in the room. The breastfeeding problems began almost immediately from lack of contact between mother and baby!I was impressed with Loredana’s perseverant spirit. She continued to pump and breastfeed through her difficult hospital stay and at home... as a result Baby Marius is a healthy and smiley baby!
These lactation visits, postpartum visits and simple conversations that I have been having with friends and clients continue to impress me with the need for current information to be taught, women to be empowered instead of degraded through their birth experiences, and the GREAT NEED for a birth center in Bucharest.

New York Midwives lose right to catch babies in homes

Picture from the Guardian article.

An article worth reading...

http://www.guardian.co.uk/lifeandstyle/2010/may/14/home-births-new-york-midwives

Availability of birth place options and the possibility for women to choose her place of birth indicates a nation/community's view of women... In Romania we find ourselves like the women of New York... wanting more options and demanding more choices!

Doula training course is a success!

I drew from my experiences at my own doula training workshop and the Midwifery Today conference as I lit candles, arranged birth books, made coffee for the doula workshop participants last Saturday morning. I recalled the warmth of the instructors and the intuitive workshop spaces that promoted dialogue among its eager students. This would be a day like no other because I was about to embark on eight hours of teaching in Romanian about a concept only recently pioneered in the country: doulas.

The eight women who came were brilliant, each with a fascinating career and a passion for women. Included in the group were: a midwife student, two psychologists, a doctor (who is also an expectant mom), a philosopher, a physical therapist, a nurse and a secretary. We were able to discuss scenarios and engage in learning activities from multiple unique perspectives! They also were very kind in offering me grace in my grammar and occasional lack of words in Romanian!

We divided the day between didactic sessions, group 'jigsaw' teaching, hands-on practice, and question/answer sessions. The biggest request on the evaluation was for more hands-on experience in future workshops. In addition, several of the women were interested in starting the certification process with DONA International to become midwives. God-willing I will attempt to get certified to be a doula instructor in Seattle so that when we return I can provide 'certifying' workshops for local women. The top two items mentioned as 'practical things we will take away' were: rebozo (birth scarf) techniques and hip squeeze/pelvic opening labor support methods.

One of the day's participants summed the day up this way, "Thank you for reminding us that what we are doing is important, that we are not crazy and that we can bring change for the women of this country."

Thank you to Clinica Pro-Vita International who graciously allowed us to host the entire day in their beautiful facility!