Below is a list of available sessions from the 2014 MANA Conference, "The Spirit of Midwifery," St. Louis, Missouri, October 23-26 2014. 

MA1401: President’s Welcome—Marinah Valenzuela Farrell LM CPM

MA1402: Plenary - Undisturbed Birth—Sister Sandra MorningStar CPM

MA1403: Saving Ourselves - Black Midwives and Doulas Impacting Inequities—Sherry Lenore Payne RN MSN CNE IBCLC

This session examines the state of childbearing and maternity care in the African-American community, with a review of the literature, and a subsequent look at successful community-led models around the country driven by the resurgence of Black midwives and doulas and their impact on birth outcomes and breastfeeding rates.

MA1404: Birth and the Primal Brain - Survival of the Species in the Modern World—Sarita Bennett DO CPM

We will explore the hormonal physiology of birth, the hard wiring of the female brain and the importance of understanding its implications for the future of the human species, specifically in the modern world. Sit back and enjoy this spirited explanation of how our mommy brain works. 

MA1405: Midwives as Appropriate First Responders to Disasters Worldwide—Vicki Penwell CPM LM MS MA

Midwives are increasingly being called upon to help in times of national and international disasters. These include natural disasters such as earthquakes, tornadoes, storms and flooding, but also Doctors Without Borders has been recruiting CPM and CNM midwives from the USA to go into war zones. The skills to mount a disaster response are accessible and learnable, but they must be both informed and culturally competent to produce the most good and not hinder the relief efforts at ground zero. This session will discuss the authors own personal experience mounting a large scale midwifery response to the biggest storm ever to make landfall (Super Typhoon Haiyan/Yolanda in Nov of 2013), and the speaker will demonstrate how especially suited out –of-hospital midwife’s are to being first responders to disaster scenes. She will describe how her small team of local and international midwives were able to keep all 10 Steps of the International MotherBaby Childbirth Initiative 10 Steps to Optimal Maternity Care even under duress in a disaster zone.

MA1406: AME PRESENTS: An Exploration of Power Within the Student-Preceptor Relationship—Lisa Maureen Wiley MSM

This session will begin with a presentation of the results of interviews with recently educated midwifery students. The presenter will then discuss a summary of themes that emerged from the interviews that provides insight into the nature of power within this relationship, and as well implications of this dynamic upon the profession. The presenter will further open up the session for questions regarding the study; should there be time and desire from the audience, the presenter will consider facilitating a dialogue regarding how to integrate the findings of this research into an effort to strengthen the profession of midwifery from its educational base.

MA1408: Plenary - Jessica Danforth, Native Youth Sexual Health Network

MA1409: What You Don’t Know Hurts Us: Racism, White Privilege, and Perinatal Health Inequities—Sherry Lenore Payne RN MSN CNE IBCLC

This workshop examines the issue of health inequities in the African-American community and how why white privilege promotes those inequities. We will discuss common barriers to care and health promotion and how practitioners can increase their own awareness of the problem. Finally, we will look at strategies for eliminating disparities through purposeful assessment and examination of beliefs and attitudes and the policies that proceed from them. This workshop offers practical steps that anyone can take to begin to rid themselves of bias in the provision of care.

MA1410: Decoding Legalese: A Hands-on, Holistic Introduction to the Law and How it Impacts You—Indra Lusero MA JD

This session will provide attendees with a solid foundation for understanding the legal system and how they fit within it. Material will be presented in a fun, accessible way; kind of like a legal version of the midwifery model (nurturing, hands-on, trust-based, and confidence building). Instead of treating risk as if it is black and white, this session will provide participants with a framework for understanding legal risk and tools for making individual risk assessments. Just like decisions in health care are effected by culture, resources, gender, age, and more, so too are legal decisions. Similarly, legal issues impact us not only professionally and economically but also emotionally and spiritually. Covered topics will include informed-consent, regulatory, civil and criminal law, your rights and responsibilities within different practice settings, what to do if you’re charged or investigated, when to get an attorney and what to look for in one, and common legal strategies and pitfalls. This session will provide a positive, solutions-focused, holistic view of the law.

M1411: Obstetric Fistula and Illegal Birth Attendants in Eastern Uganda—Bonnie Ruder CPM MPH MA

In Uganda, there are an estimated 200,000 women suffering from obstetric fistula, with 1,900 new cases each year. Overall, the number of women who have skilled attendants with them at the time of delivery is low; only 42 percent of women nationwide, and only 37 percent of rural women, deliver in health care facilities with skilled birth attendants. The majority of Ugandan women deliver with traditional birth attendants and family members. These figures, along with a persistently high maternal mortality rate led the government of Uganda to criminalize traditional birth attendants in 2010. In this presentation, I draw on ethnographic evidence from open-ended, semi-structured interviews with obstetric fistula survivors and traditional birth attendants to describe their experience of obstetric fistula. The lived experience of this devastating morbidity is a vital, yet under-examined, piece of the puzzle needed to reduce rates of obstetric fistula and related mortality, in Uganda and in other low-income nations. In addition, in-depth interviews and participant observation explore the effect criminalization of traditional birth attendants has had on maternal health care in eastern Uganda. Results demonstrate how the reliance on Western-prescribed imported practices has failed to address the root causes of maternal morbidity while simultaneously criminalizing Uganda’s culturally embedded system of birth attendants. Recommendations include increased obstetric fistula treatment facilities with improved communication from medical staff, decriminalization of traditional birth attendants and renewed training programs, and engaging local populations in maternal health discourse to ensure culturally competent programs.

MA1412: The NARM Certification Process - Updates on Recent Changes and Expectations for the Future—Ida Darragh CPM

Discussion of the 2013 changes in eligibility requirements for NARM certification, the 2014 changes in testing procedures and the impact of the US MERA statement on the NARM PEP process.

MA1413: Recognizing Subclinical Hypothyroidism in Pregnant Mothers and Newborns—Erica Peirson ND

There is currently an epidemic of subclinical hypothyroidism in the U.S. that is not being detected or treated by conventional endocrinologists. Hypothryroidism is only treated by conventional doctors based on an elevated TSH and not based on physical symptoms. Physicians are currently trained to treat numbers on a page and not actual patients. This lack of treatment is not only leading to women who are fatigued, in pain and depressed, but also at risk of giving birth to a child with a birth defect or miscarrying. The child is also at increased risk for developing autism. Additionally, nearly 100% of children with Down syndrome (Ds) are at risk of having subclinical hypothyroidism and experience profound effects in all organ systems from inactive thyroid hormone on the cellular level. Recognizing these symptoms as subclinical congenital hypothyroidism and not dismissing them as “normal” for Ds is key to helping children with Ds thrive. The goal of recognizing and treating hypothyroidism in newborns and infants with Ds is not to fix their Down syndrome, but to optimize their health.

MA1414: Keynote Address - Why Midwives Matter to Reproductive Justice—Dorothy Roberts

MA1416: AME Presents - Out of Country Clinical Placements - Calling the Question for MEAC Schools—Wendy M. Gordon CPM LM MPH, Mary Yglesia AND Ida Darragh CPM

Stating it is beyond NARM’s capacity to oversee or assure the quality of clinical training in dozens of world-wide sites, NARM will not accept clinical experiences for PEP applicants in out-of-country clinical sites after June 1, 2014. In light of NARM’s position, MEAC has convened a committee to study clinical placements in out-of-country settings for students in MEAC accredited midwifery programs. Informing this work is a history of participation by students and apprentices in maternity sites, specifically in Africa, Asia and Latin America, where European hegemony created historical, unequal long-standing relationships that have existed for centuries. Coupled with lack of diversity in the CPM community, this fostered a climate where programs which arrange clinical placements for CPM students have been criticized for inappropriate or naïve abuse of power over childbearing women to obtain clinical experiences for certification. These foreign clinical placements may jeopardize human dignity through cultural arrogance and ignorance. The MEAC committee is looking at all facets of out-of-country clinical placements for students in MEAC accredited programs. We will report the committee’s findings and create an opportunity for educators to bring forward important issues for discussion on this topic. For example: Is there value in out-of-country clinical placements for student midwives and birthing women, their families and communities? What is the risk to the women and babies by having students provide their care? What is the risk to students who are ill prepared and possibly inadequately supervised? Can systems be put in place to protect and benefit all involved? 

MA1417: WHY Equity?—Sam Killerman

Social Justice Comedian and Author Sam Killermann talks about his passion for social justice through his own experience in the world of Identity, Gender, and Sexuality. 1CEUs will be applied for from MEAC for this session.

MA1418: Supporting Muslim Families in the Childbearing Year: A Guide for Midwives—Shannon Staloch LM CPM IBCLC and Krystina Friedlander

Like other Americans, Muslim families are increasingly seeking out midwifery care. This session is designed to sensitize midwives to the incredible diversity of religious and cultural preferences that color the childbearing experiences of Muslim women, thus giving midwives the tools to better navigate issues related to working with Muslim families. The session will cover a range of topics, including varying definitions of modesty, the relevance of gender roles, the complex relationship between culture and religion, Muslim comfort with birth control, expectations about circumcision, Islamic traditions around birth and babies, fasting in Ramadan for pregnant and breastfeeding mothers, and more. We also plan to share the results of the first-ever American Muslim Birth Survey. We anticipate that the results will show a community of women who have larger families than average American women as well as higher rates of natural birth and extended breastfeeding. These results, we hope, will inspire midwives to reach out to Muslim women, part of a community that numbers anywhere between 2.5 to 7 million people in the United States. We will share strategies that midwives can use to promote midwifery care to the Muslim families in their local communities. Midwives will leave this session with an increased and more nuanced understanding of Muslim traditions and practices around birth and their implications in midwifery care.

MA1419: Legislative Drafting for Midwifery Advocates—April Blackmore JD

This session will provide midwifery advocates with tools to draft effective legislation and to lobby their state legislatures. We will begin with a short overview of the legislative process or “how a bill becomes a law.” We will discuss how to interpret existing statutes and how to read, write, and understand new legislation, focusing on best practices for effective communication with legislators and their staff. We will review basic grammar and style rules for drafting legislation and best editing practices. Finally, we will discuss the current state of midwifery laws at the state level, including Medicaid reimbursement and legal status of direct-entry midwives. We will also discuss state rules regarding implementation of mandates under the Affordable Care Act. This is a technical session geared toward those who want to create effective form bills and bill analyses that may be presented to any state legislature.

MA1420: Intrahepatic Cholestasis of Pregnancy - What Midwives Need to Know—Sarah Hunter CPM CH

Intrahepatic Cholestasis of Pregnancy is often referred to as a medical “zebra.” However, I argue that it is significantly more prevalent than the research suggests. Does this neglect stem from a lack of education on the part of care-providers? Is institutional racism a part of why cholestasis is missed? In this paper I aim to redress continuing neglect of ICP by providing caregivers a multidimensional understanding of the condition and the tools to deal with it in the field. Using the midwifery model of learning, the session includes both: information from the available medical research  and empirical observations of my own experience with the illness. I will cover common signs and symptoms along with  lesser-known ones, and demonstrate how to differentiate these from similar but unrelated benign complaints that often arise. Participants will learn about the medical histories and ethnic backgrounds that are associated with ICP. We will cover the medical tests that are research based, as well as those that are not. We will cover herbal and other alternative medicines as well as pharmaceuticals for both relief of symptoms and treatment of cholestasis of pregnancy. I will address crucial questions that arise when dealing with ICP: Is your cholestatic client still a homebirth candidate? When is it appropriate to refer, and when is it appropriate to transfer care? What are the implications for the intrapartum period? What about the immediate postpartum and the newborn? With a better understanding of the differential diagnosis of itching during pregnancy and the pathophysiology of ICP we can help improve the lives of mothers and babies.

MA1421: Awards Ceremony

MA1423: The Anti-Shock Garment Training for Midwives—Vicki Penwell CPM, LM, MS, MA

This session will provide critical hands on training in how to use the Non-Inflatable Anti-Shock Garment to treat shock from blood loss in postpartum women. These newly designed NIASG are now on the World Health Organization’s list of measures to prevent death from Post Partum Hemorrhage, still the leading cause of mortality and morbidity surrounding childbirth everywhere in the world.

MA1424: Gestational Diabetes - What Do We Know, What Do We See, What Can We Do—Linda Schutt BS CPM CM and Susan Derby CPM

In this workshop we will present the most recent research on the occurrence and effects of Gestational Diabetes, and the analysis of client history, food journals, risk factors, and diagnostic tests. We will discuss dietary education and recommendations, including the concept of carbohydrate excess, and client-based testing and dietary correction. We will explore potential adverse outcomes in newborns, including several case studies.

MA1426: Midwifery and the Life Continuum - Lessons Drawn from Birth and Death—Amy Wright Glenn MA, CD(DONA)

This session will explore the skills required of caregivers when holding space for both the birthing and the dying; discuss the features that characterize skillful support for individuals and families as they move through both birth and through death, the areas of overlap in the training of birth professionals and hospital/hospice chaplains and how birth workers have much to gain the formal study of how to support people as they die.

MA1427: HOW Equity?—Sam Killermann

Gender is one of those things everyone thinks they understand, but most don’t really understand at all. Kind of like the usage of the word “irony” (isn’t that ironic?) Sam will explain the complexities of gender, highlighting the obstacles with healthcare. He’ll follow up with a discussion to brainstorm strategies for dismantling these barriers. 1CEUs will be applied for from MEAC for this session.

MA1429: Panel - Midwifery in Native American Communities - The Challenge

MA1430: City Dweller Syndrome—Sister Sandra MorningStar CPM

Akin to Nature Deficit Disorder, the effects on wimyn’s reproductive lives by living primarily in the city, removed from nature and daily or direct contact with the Earth’s land, streams, wind, plants and animal life, of which we are a part, has resulted in decreased fertility, dwindling capacity to initiate labor, increased interventions for birth, decreased production of breast milk, interrupted bonding, decreased sense of belonging and capacity to love or show empathy. Female depression and growing sense of isolation despite dense dwelling environments contribute to biological and behavioral dependency on increasing medicalization of all female function. Wimyn living closer to nature experience, as a whole, the absence or diminished symptoms of what I call City Dwellers Syndrome in much the same was as we observe mammals in captivity. Simple changes in early development and prenatal care can have lasting effects in reversing the magnitude of these adverse symptoms and save not only one womyn at a time but perhaps our global society as a whole.

MA1431: ACNM, MANA and NACPM - Working Together to Promote Normal Birth in the United States—Justine Clegg MS LM CPM, Ellie Daniels CPM and Catherine Collins-Fulea MSN CNM FACNM

This session will describe the history of the Normal Birth Task Force, explain the Delphi Process that resulted in the document “Supporting Healthy and Normal Physiologic Childbirth: A Consensus Statement by ACNM, MANA and NACPM”, and use the companion consumer statement “Normal Healthy Childbirth for Women and Families: What you need to know” in client care and consumer education. We will access and use the BirthTOOLS toolkit to promote normal physiologic birth and discuss current national quality initiatives related to normal physiologic birth. We will relate the benefits of collaboration among the national midwifery professional organizations to promote midwifery and normal birth in the US to other initiatives to advance midwifery and improve maternal and child health.

MA1432: Hiding behind the Masks - Eating Disorders and Anxiety Disorders During Pregnancy and the Postpartum Period—Tara Tulley CPM LCSW

Participants will learn about the biological blueprint of the mind of an individual suffering from an eating disorder and learn how anxiety plays a factor into predisposing individuals who suffer. Participants will learn how an individual who has suffered or is currently suffering from an eating disorder may be at higher risk for experiencing pregnancy and postpartum depression and anxiety, body image disturbances, and relapse of eating disordered behaviors. Participants will learn which screening tools are available, how to bring up these issues during prenatal visits, and how to help clients find life saving  treatment. 

MA1433: Basic Disaster Birth Support (BDBS) A Means of Changing the Perception of Birth (Change for the Future)—Ruth C. Walsh MA CPM

This session will present the Basic Disaster Birth Support project. It will review the current national recommendations for pregnant women in times of disaster. This includes March of Dimes, ACNM, White Ribbon Alliance, CDC. It will compare and contrast the recommendations. The session will conclude with a summary of the West Virginia experience with BDBS.

MA1434: Grief Politicized: When Homebirth Becomes Stillbirth—Elizabeth Heineman PhD

Homebirth for low-risk pregnancies attended by qualified midwives has as low an incidence of “bad outcomes” as hospital birth. That doesn’t mean there are NO bad outcomes. Homebirth, like hospital birth, occasionally results in death or lasting complications. Hospital births gone wrong, however, aren’t taken as evidence that hospital-based obstetrics should be shut down. By contrast, homebirths gone wrong become ammunition in the “midwife wars.” In 2008, my homebirth turned into a stillbirth. As I grieved, I learned that people’s sympathy could quickly turn to blame when they learned that I had chosen homebirth. At the same time, I feared exclusion from the gentle-birthing community that had become so important to me: perhaps I was now a political liability. The fact that I was driven to write a memoir about my experience compounded my worries. My stillbirth would not remain private. Yet rather than seeing me as a threat, midwives reached out to me in my grief – and they understood me as a resource. Midwives (and doulas) know they may face a death at some point in their career, and they feel unprepared. Knowing that I wished to speak about my experience, midwives and doulas expressed their hope that I could help them to understand their clients’ needs. Their commitment to radical honesty and compassion trumped a defensive political stance that might have led them to marginalize clients in greatest need of community. My reciprocal commitment (to myself; no midwife tried to influence the content of my book) was to write a memoir that challenges readers’ assumption that homebirth was to blame for my stillbirth. My session will consist of readings from my memoir as well as discussion of midwives’ role in aiding grieving clients and the politics of acknowledging “bad outcomes” in homebirth.

MA1435: Intermittent Auscultation in Labor - Research and Practice Updates—Wendy Gordon CPM, LM, MPH

This session discusses the use of intermittent auscultation (IA) in midwifery practice; Compares the different types of instruments that can be used for IA, the interpretation of auditory vs. visual data, review of current research evidence and identifies information to be included in the documentation of IA in the client’s record.

MA1436: Plenary - Report from Home Birth Consensus - National Collaborative Guidelines on Transport from Home Birth to Hospital—Diane Holzer LM, CPM, PAC and Tami Michelle OB/GYN