Population Health Blog

Population Health Blog

Why It Matters

Yesterday, today: Watching midwives from the past, reflecting on the present

On Sunday, March 29, we’ll celebrate the premiere of Season 4 of the PBS series Call the Midwife.  To honor the day, we’re celebrating midwifery in Detroit. The Health Authority, together with the Wayne State University Physician Group, Certified Nurse-Midwife Service (WSUPG CNM Service) and Detroit Public Television are co-sponsoring a pre-screening of the first episode.  At the same time, we’ll celebrate as the DPTV Modern Day Midwives blog moves to the national PBS site, and the birth of our new nurse midwifery service.  Just like the Nonnatus House nurses, nuns, and midwives, certified nurse-midwives (CNMs) will deliver community-based midwifery care while the Detroit Nurse-Family Partnership home visitors will counsel clients in their homes.

When I first brought up the potential for this event I had two interesting questions: “What is a midwife and for that matter—what does it mean to be a ‘Modern Day Midwife’?”  The second question was surprising to me– “What is a blog?!!”

So here goes….. “midwife” means “with woman,” but each culture and country may have a different name or term.  This past weekend I was in Quebec City, Canada. When I asked how many midwives practiced at the hospital we were passing by they just gave me a blank stare.  I remembered the French name for midwife is sage-femme which means “wise woman.” A Danish midwife told me the name for her profession is jordmoder which means “earth mother.”  Some may find it interesting to learn that the term obstetric is actually from the Latin term for “midwife,” obstetrix. The word obstetrix has its beginnings from obstare, because the midwife was to stand by or in front of the woman while she was assisting her during childbirth.

As a midwife we do “catch babies,” but we do much more.  As a certified nurse-midwife (CNM) here in the USA we provide primary care and maternity care services to help women of all ages throughout the entire life cycle.  We help women through life events and approach these life transitions as physiologic changes not a state of disease.  We partner with the entire health care team, women, families, and our community but women are the center of our care.  As a Modern Day Midwife and blogger we will take people into our current practices and share experiences from our personal lens.  I try to showcase scientific evidence (and share resource links in case people want further exploration).  I told my friend that blogs are posts that are on the World Wide Web and have been around since the early 1990s.  I have seen blogs from just one individual or from a group like our trio of Modern Day Midwives bloggers.

I hope you will join us on the Season 4 journey as our Call the Midwives characters provide the poorest women in the East End of London with the best possible care.  We will watch each episode reflecting on the experiences of Modern Day Midwives as we face the worst infant mortality in the nation and one of the worst maternal mortality rates.

Katie Moriarty, PhD, CNM, CAFCI, RN is director of the Detroit Nurse Family Partnership and a practicing certified nurse midwife.








Lost Lunch Hour: A New Population Health Issue?

If you’re like me the idea of “lunch hour” is limited to occasional business lunches, and more often sandwiched by demands on either side, forcing you to arrive late or leave early, and otherwise order a salad or other quick, light course that can be consumed and you can be on with your day. The very idea of having an hour for lunch has become a luxury, with a half hour being sufficient for shoveling down an deli salad or sandwich, eaten at your design with one eye on your computer or mobile device.

And that assumes you eat at all.

Lunch still is a defined benefit for many workers, but less so than ever. And that is becoming a health problem for a growing segment of the population that is tied to computers or running like crazy.

National Public Radio’s Hear&Now program http://hereandnow.wbur.org/2015/03/03/no-lunch-hour recently featured an interview with professor Kimberly Elsbach of the University of California Graduate School of Management and Yen Ha, co-host of the Lunch Studio blog http://www.lunchstudio.com/p/lunch-manifesto.html.  Professor Elsbach summaries, “The work day runs now from much earlier in the morning to late at night, and it’s also not a standard 9 to 5, so for people, when you eat or when you take a break to get some sustenance, it’s not going to be the same. Also, there’s just this demand to be forever available, so people are reluctant to leave their desk in case they miss something.”

Lunch isn’t just about eating; it’s about getting away to another realm – if only another room. “We know that creativity and innovation happen when people change their environment, and especially when they expose themselves to a natural environment,” Elsbach says. “Staying inside, in the same location, is really detrimental to creative thinking. It’s also detrimental to doing that rumination that’s needed for ideas to percolate and gestate and allow a person to arrive at an ‘aha’ moment.”

In a small way, it’s a food-critical moment. For those who really try to follow the recommendation for five portions of fruit and vegetables each day, not luncheon puts a lot of pressure on breakfast and dinner. Of course, you’re not likely to compensate for the lost consumption midday.

Yen Ha has politicized this phenomenon with “A Lunch Manifesto:” Refueling the body with good stuff is “just the side benefits for the true raison d’etre of having lunch every day,” Ha says in the manifesto. “The real reason we have lunch every day boils down to the fact that we love the physical act of eating… Devouring, contemplating, ruminating and purely enjoying what you eat is an undertaking that should be freely and daily exercised.”

Carpe Diem. Have an apple.

Dennis Archambault is director of Public Affairs at Detroit Wayne County Health Authority.