HEALTH
Birthing in Challenging Times A midwife can provide safe care for expectant Muslim mothers BY ROMY SHARIEFF
T
he coronavirus pandemic is leading some expectant mothers and their families to consider midwifery care for an out-of-hospital birth, which would help reduce exposure to COVID-19 and other pathogens that can adversely affect the mother and the newborn’s health. Considering the limited availability of data on the potential complications on fetal development if a healthy mother contracts the virus during pregnancy, the Royal College of Obstetricians and Gynecologists (RCOG), has strongly advised expectant mothers to practice social distancing to minimize potential risk (https://www.rcog. org.uk). In the U.S., telehealth is quickly being adopted as an alternative to face-to-face routine care. Yet, a vulnerability exists when health care facilities provide labor and also deliver services simultaneously with care of the sick. Even before the onset of the current pandemic, the U.S. had the worst maternal death rate of any developed nation, where non-Caucasian women are represented disproportionately among the fatality figures (https://www.npr.org, May 12, 2017). One study found that “40 percent of deaths from pregnancy-related complications were potentially preventable, mainly through improved quality of medical care” (https:// www.americashealthrankings.org). That is an alarming conclusion. The World Health Organization (WHO), which designated 2020 as the “Year of the Nurse and Midwife,” is pushing for increased access to midwives as the first line of defense to improve birth outcomes (https://www. cdc.gov/nchs/data/vsrr/vsrr-007-508.pdf). The ability of certified nurse-midwives (CNM) and certified professional midwives (CPM) to reduce maternal morbidity and mortality around the world has finally come 44 ISLAMIC HORIZONS MAY/JUNE 2020
into focus. According to the WHO, “83% of all maternal deaths, stillbirths and newborn deaths could be averted with the full package of midwifery care” (https://www.who.int). Even in the current health crisis, midwifery care is still poised to deliver on that statement.
THE WORLD HEALTH ORGANIZATION (WHO), WHICH DESIGNATED 2020 AS THE “YEAR OF THE NURSE AND MIDWIFE,” IS PUSHING FOR INCREASED ACCESS TO MIDWIVES AS THE FIRST LINE OF DEFENSE TO IMPROVE BIRTH OUTCOMES. The WHO defines midwifery as “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum throughout pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life.” A midwife is trained to handle low-risk pregnancies and various complications that may occur during birth. In a comprehensive study published in 2014, the safety of a planned home birth and freestanding birth centers of a low risk pregnancy with a midwife was indisputably documented (https://onlinelibrary.wiley. com/doi/full/10.1111/jmwh.12172). We also need obstetricians who are trained to handle high-risk pregnancies. However, in areas such as Scandinavia, where midwives are the primary birth attendants, phenomenal
outcomes have been noted when compared to those in the U.S. As more American states continue to recognize midwives, more consumers can legally access the benefits that they provide. Midwifery care also strives to provide holistic care and create an environment that empowers clients. Although there is science in childbirth, there is an even stronger element of trusting intuition, instinct and tradition, for this is perhaps one of the most life altering events a woman experiences as she transitions into motherhood. Islam recognizes and honors that journey so much so that the Arabic word for “womb” — rahm — comes from the same root as al-Rahman, one of God’s attributes. Anecdotal accounts state that a midwife named Shifa’a bint Amr (‘alayha alrahma) attended the Prophet’s (salla Allahu ‘alayhi wa sallam) birth and that midwives also attended his children’s births. But, what does it mean to contemporary
