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Nurse-midwives are heartened by recent change in state law



Even before the global pandemic pushed healthcare into the limelight, the world was increasingly blinded by the advancement of medical technology and treatments. Except in the delivery room, where one of the oldest forms of medicine – the midwife – is becoming increasingly popular.

The midwife is also making legal progress in Arkansas.

During the recent General Assembly, lawmakers passed Law 607, which gives certified midwifery nurses full authority to practice in gynecological, antenatal, obstetric, postnatal and reproductive health cases. The law changes the longstanding requirement that a midwife must be employed under the supervision of a doctor.

Lawyers had sought this leeway for years, arguing that the extensive training of certified midwifery nurses – those of advanced practicing nurses – qualifies them for broader medical authority. In addition, CNMs are equated with other classifications of midwives who are not legally required to work under medical supervision.

“This is a huge win for women, children, and midwives in the state,” said Brennan Straka, a certified midwife who is now an associate faculty at the University of Arkansas, Fayetteville. “CNMs want to work in collaboration with other health care providers within the health system, not under their supervision.”

“I’m thrilled to have Arkansas join the 27 other states that already have full practice authority for certified midwives,” said Samantha Crouch, a certified nurse midwife at the Creekside Center for Women in Springdale. “This legislation will allow CNMs to fully practice our training, which in turn will give Arkansas women more choices in their obstetric and gynecological care.”

Rep. Mary Bentley, R-Perryville, campaigned for the original House Act 1215. The mother of four, who gave birth to two of her babies through a midwife, said the new law will also help reduce the number of women’s health deserts in Arkansas.

“37 of our 75 counties have absolutely no obstetrician or gynecologist. Another 10 have only one,” Bentley said. “We have some women who don’t even want to go to the gynecologist for maternal care, but only to the gynecologist. You have to wait a year to get your first appointment. It’s that bad in some parts of our state.

“Just among my constituents, some women have to drive an hour or more to get to midwifery. If you’re a poor working mother trying to work every day and finding the time for those antenatal visits, it’s quite difficult.” I think this is a big factor in our low infant birth weight … I think increasing access to care of certified midwives will have a big impact on that. “

■ ■ ■

Midwives have been around almost as long as human pregnancy. Prior to the advent of medical schools, women were often assisted in childbirth by other women in the community, according to However, misunderstandings persist about what midwife is and the training required to perform it professionally, particularly in Arkansas, where there are far fewer midwives than other states.

Samantha Crouch, a certified midwife at the Creekside Center for Women in Springdale, says the state’s new midwifery law will allow certified midwives to “practice the full extent of our training.” (Courtesy photo by Samantha Crouch)

“When things are underrepresented, they are often misunderstood. It takes numbers to be more visible,” said Crouch. “I’ve seen really tremendous growth in my own practice in the three and a half years I’ve been practicing, and I think word of mouth follows when people talk about their experiences.”

Straka found that the number of nursing students entering the field continues to grow.

“When I was in college, I didn’t even know what a midwife was. I had all the misunderstandings, ”she said. “Now I get calls from people who are considering becoming a midwife. For me, this means that more and more young people, mostly young women, are interested in it.”

Virtually every ancient civilization – from Egypt and Rome to China – speaks of midwives who routinely bring new life to the world at all levels of society. The physical and metaphysical often intertwine in such births, according to an article on the midwife story by Phyllis Brodsky in the Journal of Perinatal Education.

“Midwives were empiricists and were good at their craft. Home was the place of birth, and there were generally several women present … who were adept at helping the woman giving birth through comfort, nourishment, and care, ”Brodsky wrote. “This network of female companions patiently waited for nature to take its course without undue interference … Magic played a spiritual role, calming and comforting the woman and ensuring a safe passage for her baby.”

Crouch said that even today, a major reason women see a midwife is for the convenience of connectedness.

“When it comes to midwifery care, the real hallmark is that women are at the center of their care,” she said. “It’s about involving them in decisions throughout their treatment and seeing them as a whole experience they are having, not just a medical event that we treat and then move on.

“In practice, it looks to me like I spend a lot of time talking to women and hearing about their fears and fears. I spend a lot of time just listening and that’s what women want. They just want to be heard. “

It was not until the 19th century that doctors began to wrest control of labor and delivery away from midwives in favor of institutionalized medicine. In 1900, half of US births were attended by midwives; Midwifery births were less than 20% in the 1930s and were rapidly declining, according to the National Association of Certified Professional Midwives. At the end of World War II, less than 5% of births were attended by midwives.

The decline in midwifery during this period had to do with both social forces and improved medical outcomes. The Washington Post reported in May 2020 that health officials are dismissing midwives as a last resort for racist and ethnic “undesirables” while midwives continue to serve black and immigrant mothers.

“New York City Health Commissioner Thomas Darlington stated in 1911,” We generally know that the midwife is widely employed in this country by the Negro and foreign population, as well as many natives of foreign descent. “” Post reported. “Reports conclusively show that, with very few exceptions across the country, the midwife is filthy, ignorant, and utterly incapable of doing the jobs she is doing.”

According to the regional association, the midwife survived within the very narrow limits of obstetrics until the middle of the 20th century and served women mainly for religious and cultural reasons or in communities that received no hospital care due to race or poverty. The women’s rights movement of the 1970s brought with it formal training degrees and admissions, increasing the number of doctors and midwife-led home births, albeit tiny compared to hospital births.

Yet the practice continued, kept alive by practitioners who hold firm in their belief that they are on the right side of medicine and history.

“It’s really becoming a human rights issue,” said Kim Jacob, certified professional midwife and owner of the Kim Jacob Homebirth Service in Conway. “It’s about how we respect the mothers who can respect babies when they are born and [ensure] that we do not use habits that are not rooted in some kind of evidence. All of which go a long way towards making families healthier and happier. “

■ ■ ■

Gaining acceptance in the United States means slowly breaking stereotypes. Today, for example, not all midwives are women, but most of them are. Not all give birth at home; Depending on their qualifications, many give birth to babies in hospitals or specialist clinics such as Creekside, which, among other options, also offers midwives for low-risk pregnancies.

Contrary to the perception that, in Straka’s words, midwife is “towel and prayer”, the training and admission programs for midwives are demanding. Certified midwives are trained nurses who have to acquire at least a master’s degree prior to specialist training, while certified professional midwives complete extensive training in addition to a strict certification process. They may also have acquired additional professional qualifications and skills in a midwifery program or school, according to

In Arkansas, a third designation – Licensed Lay Midwife – is overseen by the Arkansas Department of Health. LLMs usually learn their craft through training with a qualified midwife and must also complete a certification process. According to information on the Department of Health’s website under Licensed Lay Midwife (see, LLMs are typically the home birth of choice, trained in prenatal care, labor and delivery, postpartum care, and neonatal care.

The midwives have also gained mileage due to the health results. According to studies by the American College of Nurse-Midwives, deliveries by certified midwives consistently result in fewer first caesarean sections, fewer procedures and inductions, and far better breastfeeding induction compared to medically directed protocols. estimates that 10.3% of births in the United States are attended by midwives, but a little over 1% in Arkansas. Given the new law and widely available information about the benefits of the midwife, practitioners hope that awareness will increase.

“As far as [midwifery] I feel like there has been more acceptance since my training in 2001, ”said Jacob. Now, over 10 years later, you mention home birth and people say, ‘Oh, so water birth?’ People have this notion that anyone who has a home birth will have a water birth, which is not true, but at least it’s there as an idea more than 10 years ago.

Brennan Straka, a certified nurse-midwife and associate faculty member at the University of Arkansas, says wider access to midwives would dramatically improve health outcomes.  (Courtesy photo by Brennan Straka)

Brennan Straka, a certified nurse-midwife and associate faculty member at the University of Arkansas, says wider access to midwives would dramatically improve health outcomes. (Courtesy photo by Brennan Straka)

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Women’s Health

The latest 6 winners of ‘MI Shot To Win’ COVID-19 vaccine lottery



Six more Michigandans, including two from Oakland Counties and the first from the Upper Peninsula and Thumb areas, will burn tens of thousands more dollars as the newest winners of the MI Shot To Win COVID-19 vaccine sweepstakes.

The Protect Michigan Commission announced the latest winners of the $ 50,000 daily prizes on Wednesday. The latest winners and their vaccination dates are:

  • Debbie Cameron from Port Huron, July 14th
  • Brianna Hrejsa from Grand Rapids, July 18th
  • Brian Louissa of West Bloomfield, July 19th
  • Diedre Malloy, from Kincheloe in the UP, July 20
  • Joshua Long, of Grand Rapids, July 21st
  • Joel Cotton, South Lyon, July 22nd

They join 16 other Michiganders who won $ 50,000 daily in draws in the sweepstakes after receiving their first doses of the COVID vaccine last month. Grand Blanc’s LaTonda Anderson won the $ 1 million award.

Repetition: Next round of the winners of the vaccine competition “MI Shot To Win”

The nine four-year college scholarship winners and other winners of the day will be announced on August 11th. The grand prize winner of $ 2 million will be announced on August 18th.

The Director of the Protect Michigan Commission, Kerry Ebersole Singh, and the President of the Small Business Association of Michigan and former Michigan Lt. Gov. Brian Calley announced the fourth round winners.

Malloy, 66, manager of a welding and manufacturing company, gave an emotional video message. The wife and mother of one son said she intended to get the COVID vaccine earlier this year but was diagnosed with esophageal cancer in December.

She had to choose between the vaccine or cancer treatment and choose treatment.

Once her doctor gave her the OK and her immune system was strong enough to get the vaccine, Malloy said she had an appointment with Sault Ste. Marie tribe of the Chippewa Indians.

“It took a load off me,” Malloy said when he got the first dose of the vaccine.

She said her husband and son both received the vaccine earlier this year to protect them from the virus.

More:10 More Winners Richer by $ 50,000 in MI Shot To Win COVID-19 Vaccine Lottery

Malloy said she had Medicare Part A but no other insurance. She said the tribe picked up many of her bills but there is still a financial burden as she is being treated for cancer in Traverse City, about a three-hour drive from her home.

She said winning $ 50,000 in the vaccine sweepstakes was “just real sunshine.” She said she saw a light at the end of the tunnel – “and in this case I know it’s not a train.”

She said COVID-19 was a concern for everyone and especially scary for them with their cancer diagnosis. She said she had difficulty breathing, could not eat, and was weak. She said that if she had contracted the coronavirus, “it would have killed me. I have no doubt of that.”

More:COVID-19 delta variant that leaves a cascade of events

More:COVID-19 Delta Variant, Vaccination Regulations, and Masks: Answers to Your Biggest Questions

Malloy and other winners expressed concern about the Delta variant of the virus, the highly transmissible and predominant mutation that is currently spreading in the United States.

“People need to understand that this won’t just go away unless we do something about it,” Malloy said, adding, “It’s worth it if we can just cut our numbers. So that we can go back to some kind of normalcy. What a blessing it would be for everyone. “

Hrejsa, a respiratory therapist in Greenville, Michigan, said she was reluctant to get the COVID vaccine because it didn’t have full approval from the U.S. Food and Drug Administration.

She said her partner is immunocompromised and she works in direct patient care. She continued researching and decided to get vaccinated to protect herself, her partner, and her community.

Hrejsa said that for so many online articles that provide information, as many “spit out misinformation”. She said the vaccine was an opportunity to get back to normal.

“I’m tired of worrying about getting sick,” she said.

Hrejsa said she plans to use her profits this semester to buy textbooks to complete her second degree, but will save most of it and possibly use some of it on a down payment for a house.

Cameron said she was working at a local hospital and seeing what happened to COVID patients; and she doesn’t want this to happen to her loved ones. She will use the money to pay medical bills as she is unemployed and has little income.

Louissa, a broker, said his daughter encouraged him to get the vaccine. He had the virus “pretty bad” in late November / early December, but recovered. He said his daughter plans to have a family and spend time with them and doesn’t want him to get sick again.

He was previously on the fence, but not for political reasons. He said he thought he had antibodies that would protect him, but these couldn’t last, so he decided to get the injection.

More:Detroit 3 employees must mask themselves regardless of COVID-19 vaccination status

Long, who works in the construction and supply industry, told officials he did not plan on getting vaccinated but kept hearing about the sweepstakes. His decision coincided with his wife’s decision, Calley said.

Long said the family did not want to run the risk of their children becoming infected with the Delta variant between the ages of 2 and 6. He told officials he planned to use the money to pay a deposit on a new house.

Cotton, who works at Ford Motor Co. and is a small business owner, said after following the data, he and his wife decided to schedule their vaccinations. You have three young daughters and plan to use part of the profit towards a down payment for a new home.

“I wanted to protect myself, my family and my community,” Cotton said, adding that he and his family were not harmed by COVID-19, but some of his employees were affected by the virus.

Protect Michigan Commission officials said data from the state Department of Health shows that COVID vaccinations rose week by week during the sweepstakes, which began July 1 and ended on Tuesday. Here is the breakdown of the first doses given each week in July:

  • 28,770 first doses administered from July 4th to 10th
  • 30,502 first cans dispensed July 11-17
  • 35,952 first doses administered July 18-24
  • 41,150 first cans dispensed July 25-30

Singh said that about 158,000 Michigandans received the first-dose shots in July.

“We’re pleased with the progress we’ve made,” she said, adding that vaccination rates are typically low in the summer; and the sweepstakes was a way to keep the COVID vaccinations going this summer.

Calley said he was “more impressed with 40,000 firearms last week than I was with 400,000 in May” because July is probably the toughest month to get vaccinations and it’s getting harder and harder to reach people through that vaccine.

“It’s a heavier elevator than anything that came before,” he said. “I know the work ahead is even harder.”

More:Experts say Michigan’s COVID-19 vaccine lottery might attract some, but not all, to be shot

As of Monday, more than 2.4 million people have signed up for the chance to win the $ 2 million prize, and nearly 105,000 young Michiganers ages 12 to 17 have signed up for the scholarship prizes.

The prizes are part of nearly $ 5 million in cash prizes and college scholarships in a sweepstakes to incentivize Michigandians to get a COVID vaccine and to meet state and national goals of a 70% vaccination rate for those ages 16 and older to achieve.

Governor Gretchen Whitmer will speak about the COVID-19 vaccine sweepstakes in Michigan on Thursday, July 1, 2021.

According to the state’s vaccine dashboard, as of Tuesday, more than 5.1 million Michigandans, or 63.8% of the population 16 and older, received at least one dose of COVID vaccine.

More than 504,000 Michiganers ages 16 and older still need an initial dose of the vaccine to meet the 70 percent goal, according to state data. According to the U.S. Centers for Disease Control and Prevention’s COVID-19 tracker, the U.S. has hit the 70% mark for Americans 18 and older who received a first dose this week.

As of Tuesday, 58.5% of Michigan residents ages 12 and older had received at least one dose of vaccine and 54.1% were fully vaccinated, according to the state’s dashboard.

More:Analysis: Michigan’s next COVID-19 surge is imminent. Whitmer says her hands are tied

More:Beaumont 2nd Michigan Health System in One Day to Prescribe COVID-19 Vaccines for Workers

Dr. Richard Leach, chairman of the Henry Ford Health System’s Women’s Health Service, said Wednesday it is recommended that pregnant women get the COVID vaccine and that it be safe for the first, second, or third trimester.

He said there could be serious, life-threatening complications for the mother and fetus if the pregnant mother contracted the virus. He said studies have shown vaccinated pregnant women pass antibodies to their fetus that could protect them after birth.

The sweepstakes is one of several ways officials are trying to increase vaccination rates for people 12 and older, as the Delta variant, a mutation native to India, has become the dominant strain in the country.

Last week, the CDC recommended that people fully vaccinated against the virus wear a mask indoors in parts of the country that are COVID-19 hotspots. But this is starting to become a lot of the US

Singh has said officials are closely following the Delta variant in Michigan and are starting to hear about the Delta Plus variant.

The state health department said Tuesday 233 cases of the Delta variant had been identified in 39 counties – nearly half the counties in the state – as well as in the city of Detroit. Sixteen cases concern foreign residents.

The Washington Post reported that at least two cases of the Delta Plus variant have been recorded by officials in South Korea. This variant, first identified in Europe in March and known as B.1.617.2.1 or AY.1, has been discovered in the UK, the US and India, according to the newspaper.

The newspaper’s report said that some experts believe the variant is more transferable than the delta variant.STILL

Contact Christina Hall: Follow her on Twitter: @challreporter.

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Women’s Health

SisterLove Inc Founder Dázon Dixon Diallo on Why She Took on the Anti-AIDS Establishment



Dázon Dixon Diallo, MPH, is the founder and president of SisterLove Inc, in Atlanta, Georgia, an organization for rights and justice in sexual reproductive health with a focus on HIV and sexually transmitted infections at the interface with other sexual reproductive challenges Women’s health and wellbeing -being.


What made you decide to found SisterLove Inc?

The main reason we started was that when Rock Hudson went public with his diagnosis of AIDS in 1985, there was very, very little, if any, information about the impact of the burgeoning epidemic on women’s lives. And for some reason, this announcement caught the attention or interest of women. And the local AIDS services, which up until that point were mostly almost 100% only looking after gay and bisexual men because the epidemic had only been going on for 4 years, had no idea what to say to these women who called – some panicked , some curious, some wanted to know if this condition or experience they were having was actually AIDS – they didn’t know what to tell them. And they thought of calling us at the Feminist Women’s Health Center where I worked to see what we were doing, what we knew, and how we could help them better serve these people.

We were working on the phones that day and I was really curious about it. So, together with a colleague of mine, I became a volunteer because we said it was of interest to us. At that time, she was also working on setting up a lesbian-focused donor semination program in the clinic. So working in the LGBTQ area was her thing, my thing was working in the sexual health clinic for Black Women and being involved in our services. And so we started volunteering. We helped them develop a prevention program for women along with a few other women with whom we coordinated. And after a while they go through their changes, they have dropped women’s work, and so we convinced my organization to take them on. We picked that up for a couple of years.

Here’s the curious part. In 1988 the Democratic National Convention comes to Atlanta. And that year it was also the year in which Randall Terry and a number of extremists from the right-wing conservative movement, the anti-abortion movement, the anti-election movement were besieging Atlanta. All local abortion clinics were besieged for almost a year after the Democratic Party Conference. Congress left and the protesters stayed, and that put a real strain on our organization.

It was at a time when President Reagan not only was not talking about HIV, but he was doubling the Hyde and Helms amendments [originally passed in 1976 and 1973, respectively]. So there wouldn’t be any federal funding at all to do HIV prevention work for us because we were doing abortions – so we had no way of getting those resources. And that was the most important source of funding for HIV or AIDS prevention at the time. So it was a financial burden to do AIDS work, but also because honestly we were mostly white feminists at the time; older women, not young like me – I was the youngest employee; I started working there when I was 18 so I’m 20 now – and it really doesn’t look good for your AIDS support because it just didn’t go together; it was irrelevant to her and many of the women [they] served. But it was relevant to most of the women we served who were young and black and tan.

And like many people start organizations, most of the time it’s either out of anger because something isn’t being done when it should, or simply because at that time someone has to do something because no one else is doing it. Both of these were the reasons I started working with SisterLove, as I was leaving the clinic at that time when they finished my women’s prevention program for the second time. So I said, okay, someone has to do that, and we did that.

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Women’s Health

Plant-based food consumption associated with lower CVD risk



August 04, 2021

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Choi does not report any relevant financial information. Glenn reports that she has received grants from the Banting & Best Diabetes Center Tamarack Graduate Award in Diabetes Research, the Nora Martin Fellowship in Nutritional Sciences, the Ontario Graduate Scholarship, and the Peterborough KM Hunter Charitable Foundation Graduate Award; Consulting fees from Solo GI Nutrition; and fees from the Soy Nutrition Institute. Please refer to the study for all relevant financial information from the other authors.


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According to two studies published in the Journal of the American Heart Association, a more plant-centered diet was associated with a lower risk of cardiovascular disease in both young adults and postmenopausal women.

“Previous research has focused on individual nutrients or individual foods, but there is little data on a plant-centered diet and long-term risk of cardiovascular disease.” Yuni Choi, PhD, Postdoctoral fellow in the Department of Epidemiology and Community Health and the Department of Food Science and Nutrition at the School of Public Health at the University of Minnesota, Minneapolis, said in a press release.

a bowl of lettuce and chickpeas

Source: Adobe Stock

Young adults

The multicenter, prospective cohort study by Choi and colleagues included 4,946 adults, initially 18 to 30 years of age, without CVD. All participants were observed through 2018 and their diets were assessed using a validated nutritional history conducted through interviews. The quality of a plant-centered diet was assessed by the A Priori Diet Quality Score, with higher values ​​indicating higher consumption of nutrient-rich plant foods and lower consumption of high-fat meat products and less healthy plant foods.

The researchers observed 289 cases of CVD during the 32-year follow-up. A lower risk of cardiovascular disease was associated with long-term consumption and a switch to a plant-based diet. Those in the highest quintile of the time-varying mean diet scores had a reduced incidence of CVD compared to the lowest quintile (HR = 0.48; 95% CI 0.28-0.81). In the following 12 years in analysis of changes, an increase in diet scores over 13 years was also associated with a lower risk of CVD (HR = 0.33; 95% CI, 0.16-0.68).

Compared to the lowest quintile, the highest quintile of the 13-year diet change was associated with a 61% lower subsequent 12-year risk of CVD (HR = 0.39; 95% CI, 0.19-0.81). In addition, the researchers found strong inverse associations for CHD (HR = 0.21; 95% CI, 0.06-0.75) and CVD-related to hypertension (HR = 0.34; 95% CI, 0.16-0.75) , 74) with a time-varying average or diet change firmly favor those with a healthy plant-centered diet.

“A nutritious, plant-centered diet is beneficial for cardiovascular health. A plant-centered diet is not necessarily vegetarian, ”Choi said in the press release. “People can choose between plant-based foods that are as natural as possible and not heavily processed. We believe that from time to time individuals may ingest in moderation animal products such as unroasted poultry, unroasted fish, eggs, and low-fat dairy products. “

Post menopausal women

In another study, Andrea J. Glenn, MSc, from the University of Toronto’s Department of Nutrition Sciences, the Clinical Nutrition and Risk Factor Modification Center, and the Toronto 3D Knowledge Synthesis and Clinical Trials Unit, and colleagues prospectively followed a cohort of 123,330 postmenopausal women without CVD from the Women’s Health Initiative from 1993 to 2017 Participants were evaluated to assess the relationship between compliance with a portfolio diet score and CVD scores.

The primary endpoints were CVD, CHD, and total stroke, and secondary endpoints included HF and atrial fibrillation.

The researchers observed a total of 13,365 CVD events, 5,640 CAD events, 4,440 stroke events, 1,907 HF events, and 929 AF events during a mean follow-up of 15.3 years.

There was an association between women adhering to the Portfolio Diet Score and a lower risk of CVD (HR = 0.89; 95% CI, 0.83-0.94), CHD (HR = 0 , 86; 95% CI, 0.78-0.95) and HF (HR = 0.83; 95% CI, 0.71-0.99 when comparing the highest quartile of adherence to the lowest. Es however, there was no association between adherence to the portfolio diet score and stroke (HR = 0.97; 95% CI 0.87-1.08) or AF (HR = 1.1; 95% CI 0.87) -1.38).

These results remained statistically significant even after several sensitivity analyzes.

“These results provide the strongest evidence yet of the long-term benefit of portfolio dieting in primary prevention of CVD, although our portfolio diet score in other cohorts / populations must be assessed to confirm these results,” the researchers wrote.

According to the researchers, the results of the PortfolioEX study, which looked at the effects of the Portfolio Diet plus exercise on a surrogate marker of atherosclerotic CVD risk, are ongoing.



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