Famous Midwives: Part 6

'Famous Midwives' is a Feminist Midwife blog series to bring awareness to the work of midwives, promote the national and international impact of midwifery, and advertise the images of those known to some by name, to few by face, but to midwives as part of our community. Each "Part" of the series includes midwives considered "famous" by the nature of their work, their contribution to the profession, and their presence as motivators and forward-thinkers and change-makers. Five midwives are included in each "Part," with great respect for the diversity of the profession, attention to the past and the present, and ultimate adoration for the variety of capacities midwives fill in their provision of our dedicated model of care. If you know a famous midwife who should be featured on the series, please email feministmidwife@gmail.com.

Holly Powell KennedyYale University School of NursingAmerican College of Nurse Midwives - Past President

Photo Credit: Yale School of Nursing

From her biography on the Yale School of Nursing website:As an internationally known midwifery researcher and leader Dr. Kennedy is the first person to be appointed as the Varney Professor of Midwifery at Yale in 2009. She came to the position with broad experiences as a clinician, researcher, educator, policymaker and leader in a variety of settings. Collectively these experiences have shaped her current vision of academic and clinical scholarship in US maternal-child health care.

She is Past-President of the American College of Nurse-Midwives (ACNM), the professional association representing Certified Nurse-Midwives and Certified Midwives in the US.Dr. Kennedy received a diploma in nursing from Miami Valley Hospital School of Nursing, Dayton, Ohio, a bachelor's degree from Chaminade University, Honolulu, HI, a master's degree as a family nurse practitioner from the Medical College of Georgia, a certificate of midwifery from the Frontier School of Midwifery & Family Nursing, Hyden, KY and a doctorate in nursing from the University of Rhode Island. She has held academic positions at the University of Rhode Island and most recently at the University of California San Francisco. She holds visiting faculty appointments at King's College London and the University of Basel, Switzerland.Dr. Kennedy's program of research is rooted in her clinical and educational experiences during which she was challenged by a prevailing lack of trust in and fear of childbirth. Her research is committed to understand the links between "how" care is provided during pregnancy and birth with clinical and social outcomes. Part of her work has culminated in a conceptual framework of midwifery care reflecting (a) the relationship between the woman and the midwife, (b) orchestration of an environment of care by the midwife to meet the woman's needs, and (c) life journeys, or outcomes for both, that go beyond usual perinatal measures. She has employed mixed methods to examine the provision of care in complex settings and with various models. She has been instrumental in developing the concept of "optimality" in maternity care which strives to achieve the maximal outcome with minimal intervention in the context of the woman's obstetrical, medical, and social background. Her future work will examine cultural issues in applying evidence supporting low-interventive care in complex birth settings and shared decision-making among women and clinicians about birth care.Dr. Kennedy recently worked with the team of writers, researchers, and midwives on The Lancet series on Midwifery.

Asoka "Koko" RoyBeth Israel HospitalTrained Nurses' Association of IndiaNursing Journal of India

Photo Credit: Nightingale Declaration

From her biography on Nightingale Declaration: Asoka Roy was a pioneer nurse-midwife who established this field as a profession in the United States.She began her midwifery career in India, the country of her birth. One of eleven children, Ms. Roy was born on December 10, 1915, the daughter of a high-ranking civil servant.Though she could have lived a leisurely life, not needing to work to support herself, she decided, instead, to become a midwife. After learning about deficiencies in maternity care in India, she realized how much mothers, babies and nurse-midwives of India needed her commitment to them. From this initial decision, Ms. Roy found that she truly loved her midwifery profession. With great energy, she devoted her entire life to the care of mothers and babies, considering each mother-to-be as a sacred individual on a nine-month journey to deliver a miracle.Visiting war-torn villagesHer first job was in a hospital in New Delhi and she later became fully trained in midwifery, earning her master’s degree at the All India Institute of Hygiene and Public Health in Calcutta. During the partition between India and Pakistan, she made several trips to the war-torn villages. During this period, stories are told of her courage when she risked her life to see all her midwives to safety and of her trips to the villages to deliver babies — such as twins in the mud-huts of war-torn India — when medical assistance was nowhere to be found.After the partition, Asoka Roy broke new ground for the cause of Indian nursing, as General Secretary of the Trained Nurses’ Association of India, or TNAI. She was only the second Indian to hold this high-level 'British' national post and the first Indian Editor of the TNAI’s Nursing Journal of India.Then, through her association with TNAI, she traveled to London to earn a midwife’s teaching certificate at the Royal College of Midwives. Before she immigrated to the United States, she was a midwifery tutor in Britain. Ms. Roy always welcomed technology as a valuable complement to the traditional skills she practiced and traveled, also, to Sweden to learn the vacuum-extraction method of delivery.Trained midwivesJust at a time when American women were beginning to seek midwifery services, Ms. Roy earned her nurse-midwife license in New York in 1967. In 1968, she became the first director of Beth Israel Medical Center's midwifery program, which was one of the first of its kind. Ms. Roy also taught midwifery students and medical students at the prestigious Yale University. While there, she drafted the curriculum of a course to train foreign midwives for practice in the United States. In 1983, she obtained midwifery-admitting privileges at St. Vincent’s’ Hospital and, when she retired from delivery practice in 1990, the hospital named her “Midwife Emeritus.” During this time, she became a Fellow of the American College of Nurse-Midwives.Active after her retirement, Ms. Roy attended her last birth, her grand-niece's, at home, at age 82 in 1998. Until nearly the end of her life, she was involved in developing the Beth Israel midwifery archives.Throughout her career, Ms. Roy delivered more than 5,500 babies. In a 1983 article in The New York Times, Ms. Roy explained her approach this way: "I consider that the woman delivers the baby, not a midwife or obstetrician."Koko Roy AwardAffectionately called ‘Koko” by her friends and family, she died on June 22, 2001 at the age of 85. In her memory, “Koko Roy Award” has been instituted to recognize an individual’s contribution to women’s health. Her story is an inspiration to all Indian nurses and to the global nursing and midwifery community.Ms. Asoka Roy was one of those fortunate women of pre-independent India, who had access to the highest education and a life of wealth and privilege. Yet, she used her education to devote her life to the care of mothers and babies and toward the improving her profession and inspiring her students and colleagues.Her New York Times Obituary closes with these words: “Her departure represents a great loss to the international midwifery community. Her spirit will live on for many generations.”

New York University gives an annual "Koko Roy" award, described as follows:

The Koko Roy Award recognizes an individual who has contributed significantly to women’s health as an advocate, one who values community relationships, shows cultural competency, is a visionary who offers a down-to-earth approach and displays creative innovation. Asoka Roy (1915-2001) immigrated to New York City from India in 1959 and was a co-founder of the midwifery program at Beth Israel, serving as its director until 1983. During her midwifery career, she delivered more than 5,500 babies. Roy devoted her life to the care of mothers and babies and toward the improvement of her profession. 

Yeshi NeumannHomestyle MidwiferyMidwives Alliance of North America - Council of Elders

Photo Credit: Birthways

From her biography on the Midwives Alliance of North America, Council of Elders site: Yeshi Neumann has been working as a midwife since 1970. In 2000, she created Homestyle Midwifery, a unique model of care, blending home and hospital birth. In 2006 Homestyle Midwifery received a certificate of honor from Mayor Gavin Newsom, and in July 2007 was voted "Best Way to Have a Baby" by San Francisco magazine.In addition to her work in the United States, Yeshi has taught and learned from nurses and midwives in Mexico, Nicaragua, Guatemala, Trinidad, Tibet, Morocco, India, and China. She is the team leader and principal educator of the maternal-child health project, Jungle Mamas, in the Amazonian rainforest in Ecuador.Yeshi has facilitated hundreds of workshops about women's leadership, diversity, conflict resolution, organizational development, communication and healing family relationships. She brings her passion for women's empowerment and social justice to her work with mothers, grandmothers and community leaders. Yeshi also trains social change leaders from the non-profit, philanthropic, labor and socially responsible business sectors in the Art of Leadership at Rockwood Leadership Institute.Yeshi has developed a relevant and inspiring curriculum for the grandmothers of our time,Conscious Grandmothering Workshops, and is the founder and director of the Conscious Grandmothering Council Network (Conscious Grandmothering Councils).Yeshi is a dedicated student and practitioner of Mindfulness. She teaches Mindfulness-Based Childbirth and Parenting.In addition to being a Certified Nurse-Midwife, Yeshi has a Masters degree in History and a Masters degree in Public Health. She is a regular speaker at national and international conferences.Yeshi is the mother of two daughters and the grandmother of two granddaughters, both of whom were born into her own hands.

Cheryl Tatano BeckPostpartum Support International University of Connecticut

 Photo Credit: University of Connecticut

From her biography on the Postpartum Support International site: Cheryl is a professor at the University of Connecticut, School of Nursing. Her Bachelor of Science degree in Nursing is from Western Connecticut State University. She received her Master’s degree in maternal-newborn nursing from Yale University. Cheryl is a certified nurse-midwife. She received her certificate in nurse-midwifery also from Yale University. Her Doctor of Nursing Science degree is from Boston University.Cheryl is a fellow in the American Academy of Nursing. She has received numerous awards such as the Eastern Nursing Research Society’s Distinguished Researcher Award, the Distinguished Alumna Award from Yale University and the Connecticut Nurses’ Association’s Diamond Jubilee Award for her contribution to nursing research. Currently she serves on the editorial boards of Advances in Nursing Science, Journal of Nursing Education, and Journal of Nursing Measurement. She has been a member of the Board of Trustees of Depression After Delivery-National and on the Executive Board of the Marce International Society. She has been appointed to the President’s Advisory Council of Postpartum Support International.Over the past 20 years Cheryl has focused her research efforts on developing a research program on postpartum mood and anxiety disorders. She has extensively researched these devastating disorders that plague new mothers using both qualitative and quantitative research methods. Based on the findings from her series of qualitative studies, Cheryl has developed the Postpartum Depression Screening Scale (PDSS) which is published by Western Psychological Services.She is a prolific writer who has published over 100 journal articles on such topics as postpartum depression, postpartum onset of panic disorder, birth trauma, PTSD due to childbirth, phenomenology, grounded theory, meta-analysis, instrument development, meta-synthesis, and narrative analysis. Currently Cheryl’s research efforts are focused on (1) the impact of birth trauma on breastfeeding, (2) the effect of DHA on postpartum depression, and (3) assessing the psychometrics of the Postpartum Depression Screening Scale-telephone administration.

Dorothea M LangNew York Cornell Medical CenterAmerican College of Nurse Midwives - Past President

Photo Credit: Albright College

"You don't get what you deserve, you get what you negotiate." Dorothea Lang

From her biography at Albright College:

“Behold the turtle…it makes progress only when it sticks its neck out.”

Dorothea Lang ’56, who had a poster with this sentiment on it hanging in her office for many years, was never afraid to stick out her neck for what she believed.

For nearly 40 years Lang has worked, advocated and legislated to achieve recognition for the practice of midwifery and quality care for women.

Born the second eldest child to missionary parents in Japan, Lang saw a midwife arrive at home to assist her mother’s delivery of her four younger siblings. In the 1930s, 97 percent of women in Japan were delivered at home by midwives. Only those few with complications went to the hospital.

Lang saw the respect that these midwives received in the community. “People had warm feelings towards them,” she said, “the same feelings you would have for a family doctor.” Intrigued, Lang went on to Albright College with the intention to acquire the science foundation for midwifery education.

However, she could find no information on midwifery education in the United States. By 1950, 88 percent of American women were delivered in hospitals by doctors. Home births delivered by midwives were no longer the norm. So, Lang completed a five-year nursing program at Albright and Reading Hospital School of Nursing.

Not long after receiving her bachelor’s degree, Lang discovered a new program that taught midwifery at Johns Hopkins University Hospital. Excited about the opportunity, she applied and completed her educational and clinical requirements to become a certified nurse-midwife (CNM). However, when she went to find a job, she found that there were no clinical practice employment opportunities for midwives. Lang took a job as an obstetrical head nurse and junior instructor at New York Cornell Medical Center in New York City.

But in 1962, an opportunity arose that would not only change Lang’s life, but the future of midwifery in America.

Lang traveled to San Iku Hospital in Tokyo’s East Side as a consultant-mission associate. While in Tokyo her collegial relationships with obstetrical professors, nurses, midwives and other allied health team members introduced her to the modern type of health care – professional midwifery practice in a hospital setting.

“In Tokyo, midwives were delivering 95 percent of the births,” Lang said. “They were doing such a good job with the Japanese women. The doctors were there in the back rooms doing research and writing textbooks, and the midwives were doing all the work. The doctors only saw the patients when there was a problem.” That experience, said Lang, greatly influenced her pioneering work to integrate the American professional midwife into both hospital and public health-based maternity services.

In 1965, after completing a master’s degree in public health at Columbia University, she went to work for the Maternal-Infant Care project in New York City as a nurse educator. Her goal was to introduce midwives into the system and convince the New York City Health Department that midwives were the key to improving and personalizing maternity care. In 1968 Lang was appointed director of midwifery.

Under her administrative guidance, the number of hospitals that employed midwives went from two to 23, and through her efforts the fullest scope of nurse-midwifery practice was demonstrated in urban settings.

Now, across the U.S., more than 40 universities offer midwifery education and more than 10,000 midwives have been educated to provide the “midwifery model of care” to families of all cultural and socio-economic levels.

That missionary trip to Tokyo in the early 60s taught Lang another thing – midwives shouldn’t be required to have a nursing background in order to practice midwifery. “A doctor doesn’t need to be a nurse before they become a doctor, so why should a midwife need to be a nurse first,” she argued. That argument, and her persistence for more than 20 years, led to a Board of Midwifery in New York State that recognizes certified nurse midwives and certified midwives. The law, established in 1992, stated that prerequisites to midwife education may be nursing education or the academic science equivalent, such as psychology, anatomy, physiology, pre-med, etc. For Lang’s pioneering efforts, she was given New York Midwife License Number 000001.

Honored with the Hattie Hemschemeyer Award in 1986, the most prestigious award presented by the American College of Nurse Midwives (ACNM), Lang’s mandate to midwives sums up her philosophy best: “Do not try to go where things are already great. Go where the individual needs of the women arethe greatest.”

In 2002, the Dorothea M. Lang Pioneer Award was established by the American College of Nurse Midwives Foundation to acknowledge those midwives who have demonstrated why midwifery care could and should be on the health care team. “I’d like to think that maybe my work gives courage to other people to reach beyond what’s existing today.”

Lang hasn’t stopped since retiring in 1998. Today, she remains active at both the local and state levels working toward achieving a friendlier mother-baby environment within the health care system. She’s involved in community-based organizations in central Harlem to help improve maternity care there, and she represents the International Confederation of Midwives (ICM) as a nongovernmental organization at the United Nations.

In addition, she continues her pioneering efforts at the State University of New York– Brooklyn where she is working to establish a doctoral program in midwifery, which she hopes will be available within the next 10 years.

“I still have a lot of energy,” she said. “We haven’t won all the battles yet.”

A video interview of Dorothea Lang exists as part of the ACNM Foundation's Living Legacies Project.

During her time as ACNM President, Dorothea Lang fought for reimbursement of midwives in changing health insurance practices in 1975:

Summary

1. The American College of Nurse-Midwives is the professional organization of Certified Nurse-Midwives in the U.S.A. The ACNM is dedicated to the improvement of health care to the mothers and babies of America, through professional midwifery services as provided by the Certified Nurse-Midwife.

2. The Certified Nurse-Midwife is a Registered Nurse who has successfully completed a midwifery educational program and who has passed the examination for Certification given by the ACNM. The CNM practices normal obstetrics, routine gynecology, and infant care within the framework of a medically directed health service.

3. It has been well documented that Certified Nurse-Midwives have contributed for 50 years to quality care for mothers and babies in the U.S.A.

4. ACNM is concerned that the present national health insurance bills do not adequately speak on two issues: 1) The proposed bills do not sufficiently cover the needs for preventive health care services for the mothers and babies of our country; 2) No provision is presently made in any national health insurance bills for recognition of and payment for the services of Certified Nurse-Midwives.

5. Without separate, specific recognition for the Certified Nurse-Midwives' care in any national health insurance bill, the close collaborative services provided by the physician/Certified Nurse-midwife team is less likely to fluorish in our country. This would deny us the possibility of truly improving the health care services to our mothers and babies.

6. The ACNM strongly urges that professional midwifery services, as provided by the Certified Nurse-Midwife, should be identified and listed as a separate reimbursable category in any national health insurance bill being considered.

The International Confederation of Midwives (ICM) offers an annual award in her honor: The Dorothea Lang Award recognized an exceptional midwife who has demonstrated leadership and vision during the course of their work. The 2014 award was presented to Sabera Turkmani from Afghanistan. Sabera has broad expertise in strengthening midwifery education, faculty development, capacity building, grant management, fundraising, as well as management of health advocacy campaigns and events. In her acceptance speech, Sabera said that she was honored to receive an award named after ‘a symbol of leadership and work beyond the limits’, Sabera also talked about midwives in Afghanistan and how they are leaders of change in their own society. ‘Women can and need to be a voice of change! We all have a commitment to bring hope not only to women but to all the humanity over the world’.