Maternity Service Care is Changing Across China and the world.

Irene Chain Kalinowski; Meng Xue.

21 July 2017

Meng Xue invited me to speak at conference in China. She founded the Chinese confederation of midwives and the training school. Meng had pioneered incredible changes across the country with face to face training 7 years before I arrived in China... 

The Huikang Nurse Training School (Linyi) Shandong province welcomed me for the first time in 2015. I had never met anyone so passionate for midwifery since the late Joan Donley from New Zealand. I could see exactly why Meng Xue is adored by the 80,000 members of the Chinese confederation of midwives. . She gave out oxytocin at every conference and she created it in every hospital environment. If it wasn’t there at the beginning of training there was an abundance of it surrounding everyone at the end of it. .

I traveled the fast trains and aeroplanes across China. It’s about three hours to the train station. Not like the 15 minute walk from my home in Henderson west Auckland. They took me to and lecture and do some face to face training at hospitals across China between Harbin in the north east to Chengdu Central China some 2573 km. New Zealand is pretty tiny with its 1600km from north to south. The hospitality and welcome was unbelievable. I met Hospital leaders, obstetricians, Paediatricians, Midwives and anaesthetists, and many red carpets. Photographs, I posed for hundreds of them. At the end of the visit I felt a great Honour to be awarded the role of visiting professor to the training school. I gave my word to support Meng Xue, the School and the confederation of midwives.

The passion of the Chinese nurses, midwives and obstetricians inspired me. They were eager to learn about delivering woman and baby centred care. They were keen to learn about New Zealand midwifery. I was passionate about wanting to share what New Zealand taught me. What the women taught me throughout my 20 years of providing one to one continuity of care and share the triumphs of my homeopathic and holistic practices. I came away enriched with more knowledge about acupressure, massage and traditional Chinese medicines. The confidence of those practicing the ancient traditions was just amazing.

I remember lecturing to 10-20 midwives at a time in New Zealand, but in China there were more than a hundred obstetricians and midwives eager to listen to what I had to say. Everything in front of me was very pink as the colour for women’s health care in china is pink. But the olive Asian skin looked so beautifully pretty in pink.

My stay was just a week. It’s the only time I could arrange to leave my practice in New Zealand and I was very grateful to the midwives in west Auckland who covered for me. One of the hardest things for a case loading midwife is to tell women that you won’t be there to birth their babies.

I returned to New Zealand with my Foreign Expert Visiting professor certificate and upheld a promise uphold my new voluntary position and support Meng Xue and help open up more international pathways.  

It was at this time I managed to open links between New Zealand and China; the introduction of New Zealand Obstetricians, and Midwives. Their participation and contributions to the Chinese Confederation of midwives annual conference has been a great success. We introduced the New Zealand health software team at Solutions plus who has played a major role in developing the China Mat Plus software system launched in China recently. Homeopathic Pharmacist from Simillium Homeopathic Pharmacy Wellington supporting the introduction of Homeopathy and NZ Natural products. . I was growing my own global links too following the release of my books The Heart and Soul of midwifery, My Body My Baby, With Woman with Midwife with Me and the magical tale of “Three Blind mice A Midwives tale”. It’s an honour that my books are being used by midwifery tutors in many countries. Brazil, the Middle East and Gulf States, Australia, America and Europe.

I never planned to leave the country I loved and stayed in for 20 years. Yet somehow I knew China was to become part of my future. It had to be. My surname is Chain – an anagram of China. My brother pointed that out to me. The openness and the freedom to tell things as they really are were motivating me and my passion to be a part of change was growing with intensity.

 “You go beyond the role of a midwife.’ My midwifery peers would keep reminding me.  In my mind I was not going beyond the role of a midwife for I was a midwife. A midwife trained with the safe use of simple skills in holistic practices to prevent complications of pregnancy with the New Zealand College of Midwives philosophy ingrained in my heart. ‘Of course there was a voice echoing in my ears, the wonderful late Joan Donley, New Zealand’s midwifery Martyr. My grandmother’s voice too, her  inheritance... she was the baby catcher in the villages of Poland. I had the “The traditional midwife skills” enhanced with homeopathic training and training in other holistic skills. I considered myself lucky to be able to integrate them with my medical knowledge and the physiological changes that occur to mother and baby.  Which accounted for my 90-95% uncomplicated birth rates when left New Zealand.

A drive to change things soared through me because I knew that to truly support the New Zealand college of Midwives midwifery philosophy, midwifery service Systems, Regulatory bodies, government policies and education would need to change. “Midwifery is changing. Healthcare is changing, Women and baby centred care on the horizon. The woman’s whole being is placed before policies, protocols and structure Now changing that is somewhat perplexing and even more challenging to make the changes here in China.…

It’s rare that you would get midwives and obstetricians in the same classroom in western countries. Here in China the main workforce are female obstetricians. Supported by obstetric nurses or midwives who are medically Controlled or protocol/system controlled. Many hospital directors are doctors. It was clear that obstetric training had delivered very fixed and structured mind sets. This happened when the dominance of childbirth became medicalised and American obstetrics came to China in 1929 sort of the beginning of the global epidemic that took control from women. 

The one symptom fix; focused upon the ultrasound; the blood test; monitoring the baby and the lack of insight to that there was actually a woman carrying a baby sitting right in front of them….No different to many medical controlled environments that occur globally.   This was evident not only in China, but in most areas of practice that I had experienced the health professionals demonstrate a clear inability to communicate with women or give clear answers to their questions or hold any pathways to get to the root cause of their problems. 

How can you prevent problems without a holistic mind? How can you prevent problems if you don’t know how to prevent them? How can you prevent problems if you don’t know how to care for you own body or even listen to it? Life is much more than doing exercise and eating healthy foods.

 As I traveled across China I saw a great opportunity to develop training workshops that deliver midwife thinking and even more so deliver a homeopathic mind set where rational can reach to the root of a problem and often fix them with simple solutions for homeopathy is much more than prescribing a single magical remedy as many people assume. The modern homeopath uses integrated many T&CM approaches to restore emotional, physical, spiritual well being in mom and baby.

 Holistic complimentary approaches that incorporate the valuable medical knowledge and skills that saves lives. It’s a challenge moving the 100 years model where rational relies upon tasks, investigations, and treating singular symptoms into becoming one that can look at the entire individual situation, (the mind body connection).

‘How do you get the messages through to health professionals that they need to consider the implications of technology use, invasive investigations and protocols and their effects upon the woman or baby’s psychological state.”

“How do you get them to relinquish the 100 year control over a woman’s care?”

 More so a mind that gives up control and allows the woman to make the ultimate decision about what happens to her.

I adored my midwifery practice in New Zealand and the women I cared for. I carry New Zealand midwifery philosophy in my heart and everywhere I go I fly the New Zealand midwifery flag. There wasn’t a day in my life that I didn’t support a colleague, take students with open arms. The 20 years of case loading midwife and I was a very important part of a community. It was heart breaking to close practice and it was heart breaking for the families I had cared for so long. But I was grateful for the words bestowed upon me. “You go beyond the role of what is expected of a midwife” 

That gave me more determination to show that what I do is what midwives and other maternity service care providers should be doing. I felt like an Irish race horse pacing slowly behind the front runners in a failing system of maternity service care. For I could only see a clear role of the midwife or any health care provider. To support and promote “Emotional, Mental , Physical, Spiritual Wellbeing, and celebrated births with an ultimate goal of reducing the Psychological trauma inflicted upon women and their babies through interventions, tasks and procedures that don’t involve the woman or take into account the psychological impact that they may have.

That left me with another question. “How do you get a woman to take responsibility and provide self- care?” “How do you move the control from the caregiver to the woman?”

I had the answers because my practice was holistic and I had been doing that for 20 years. This would not have been possible without the New Zealand College of midwife’s philosophy or the opportunity to provide one to one care. New Zealand LMC midwives have evolved quickly to put women first but the systems were not prepared for this huge leap into giving “women control of their experience.” When you give women control you need to be flexible, something that systems find to be a little too challenging and the midwives putting women first are often challenged by the systems. It was clear to see where bullying came from and dare I say the Witch hunt where great midwives are driven out of systems. Yes midwives like me leave and sell real estate…midwives deserve better support from governments and systems.

I took all of the negativity thrown at me and turned it into positive energy forces driving change. “Come to China” Meng Called me.

I took up Meng’s offer and I thought I had already had a pretty amazing journey but this one is surreal yet with many challenges. For me I had only lectured homeopathy across New Zealand. Taken Midwives through one to one training, provided one to one holistic midwifery care and prenatal education. The last time I developed in-service training and up-skilling was some 30 years ago in the Middle East. However I am thankful of that I completed a post graduate course in health professional education at the Auckland University of Technology. The certificate came in very useful. I was 40 years old but my life skills and experience from a very young age play most part in implementing the realities of practice. I was just 24 years old when I was involved in developing in-service training and commissioning new hospitals.

My First lectures here in China were quite a stumbling block. I didn’t know what Chinese Midwives and obstetricians knew. There was little opportunity to read about it. Or find course content. It’s a huge vast country. There were difficulties with translation and somehow I felt like this robot churning out evidence based practices. What to do and what not to do. My translator could only translate word for word and I was too scared to move from the power point presentation In case the translator didn’t understand me…Terminology is difficult to translate because there are often no translatable words for the ever increasing vocabulary that many western researchers, health professionals and academics create for themselves.  A new learning for me was to keep things simple and meaningful.

 “We are not children…We need to know how to do it… why to do it and how to apply it…” A student’s comment.

“What’s wrong with it, this was the way I had been trained?” I would sit down with Meng “There were times I cried and thought it would be impossible to find a way to bring my work to life.

I looked back at the video recordings of the sessions. “Yes how dull and how boring”

“Tell it like you do to the women in your care, like you write your books” Meng was so supportive and although we could only communicate through a translator at that time we knew we had the same mind sets. With meditation and reflection I looked back at my case loading practice.

What became evident was that in New Zealand I had educated women in a simple language with one to one care and I was endowed with communication skills knowledge, experience and life skills where I could hold natural conversations with women. Meng could see all of that and she wanted me to bring it out. The skills of the LMC Case loading midwife…Decision making… Being with woman; implementing skills that come with a homeopathic mind that gets deep into the root of the problem and the skills to give choices to women. 

The midwives and obstetricians here want to lean those skills. The holistic integrated skills how to really prevent things happening get things back on track if they move from the normal. Learn to see and identify problems through observation. There was a great hunger for it.

‘Don’t do what you were taught to do yesterday, prepare it for tomorrow the next century. You are in China now it is very different here.” Meng would throw out her Chinese wisdom at me “You have so much knowledge and experience and it needs to come out your way. What holds you back?” 

“Was it an over regulated system”.  Attacking midwives from all directions. “Was it because we were expected do it this way or take the high way? “Was it just I was simply afraid to say how it really is?” It was all of it and I had to clear out the garbage. One thing for sure here in China everyone’s opinion is respected. Experience is respected. No one is offended.

“You are right it must change” Poor Meng, we had so many stale power points translated. 

So I threw away my old gloves, habits and the garbage. I put life and creativity into the presentations. The results are just amazing. I have not looked back. I have performed on stage, put creativity and art into education. Learning is fun especially taking evidence (Much of which is quite limited as it lacks art) applying it, or most of the time questioning it and implanting new ideas for holistic midwifery research. … Of course you do need some structure. There are tests at the end of the training and we grow from feedback. The most important is that the health professionals feel like they are the woman going through the childbirth experience.

It’s been quite a rollercoaster ride. We spent Two months in Henan a remote hospital doing 11,000 births a year. Face to Face training, Consulting, Prenatal education and even redesigning the hospital to make it more woman friendly and with an ability to provide continuity of care, and of course utilise staff and well what hospital doesn’t want to save money? I found myself sketching out the ideal maternity floor plans.

I will say there have been many times I have cried when I have observed that women’s rights have been denied but we can’t blame the health professionals. They are wonderful people who leave home every morning, to do a job that they believe they do well. We must be careful not to be judgemental but to change the education that made childbirth practices this way. We need to go back to 1929.when all of this started and ask why we let it happen. Because up to that time and for a short time afterwards many women in China gave birth at home in their communities. Fortunately China’s families are familiar with stories of homebirth, The C- section epidemic reached a peak and is on the decline although like many other countries far too many of them. There are many things China can teach us. Like the importance of post-partum care, massage for mother and baby. The role of Chinese traditional medicine and the amazing effects of acupressure to promote physical wellness are priceless and combine that with the homeopathic mind that treats emotions, the use of meditation and we have the perfect recipe for delivering emotional, physical and spiritual wellbeing.

Meng and I have developed several projects with our team of international experts. We look back and raise a glass and toast campai.

An enhanced Modern Maternity and Midwifery System, managing systems that are consumer driven, upskilling and education in an enhanced holistic way. I find myself Director of Operations for The My Body My baby Enhanced Prenatal Education project.

Which is now global and I have 7 teams of holistically minded obstetricians and midwives translating to suit the culture of each country. Brazil, Italy, Poland, The Middle East and Gulf States, North and South Africa, and more coming forwards. I am so grateful to the teams that put their free time and efforts into making this project. Teams will be acknowledged and part monies raised will go to the teams to support midwifery and women in each country. Hopefully the English version will be ready towards the end or the beginning of next year. There will be on line education and enhanced prenatal education certificates for midwives, doulas and health care providers available in many countries.  Plus an affordable course available for pregnant moms and their support. It’s exciting with fun with Animation, Story Telling and much more.

Now Midwifery Advisor to the International Academy of homeopathy in New York.

We have created a safe homeopathic online program for midwives, natural health care providers. This education is where it should be, in an international academy and will be supported by Homeopathic Obstetricians and midwives and holistic health care providers across the globe. I know it will innovate research in the future putting science and art together.

We are busy getting ready for the annual conference here in Guilin. We are very excited

Meng and I are two intelligent and creative monkeys. We were born in the Chinese year of the monkey. Two monkeys passionate about midwifery and women and we are destined to drive positive changes and support the return of the control of childbirth back to the women who own birth. Psychological trauma from childbirth experiences can be prevented. That will only happen when systems, governments, educational establishments change attitudes and deliver enhanced integrated systems in every country.

Meng Xue

Born in 1968， Midwifery profession, Founder of China Midwifery Alliance, Founder of China Midwifery website, President of Qingdao Huikang Nursing Training School, Cochairman of China Maternal and Child Health Care Action Coalition, Director of China Medical Council for Promotion Modern Maternity Science and Technology Development. Awarded the “Top Ten Midwifery Angle” in China from 2014 to 2015, Mengxue enjoys a higher reputation in midwifery circles in China, highly respected by the midwifery colleagues. She developed her own distinctive midwifery management system, team training methods, maternity service modes, and held more than 300 lectures across China with high recognition.

Mengxue, with more than 30 years of clinical working experience, leads the revolution and regeneration of modern maternity service in China. Starting from 2006，she undertook a  journey of learning and investigation about midwifery education, midwifery technique and maternity service across New Zealand, America, Canada, German, Netherlands, Japan, UAE etc. Extremely obsessed with midwifery profession, she has accumulated extensive experience and resources, and studied midwifery technology and obstetric service model with a unique perspective.

Irene Chain Kalinowski (1956)

Midwife; Always with Woman and her family; Homeopath; Nurse; Author; The Heart and Soul Of Midwifery, My Body My Baby, With Woman With Midwife With Me. Three Blind Mice- A Midwife’s tale (www.wordfp.com) Lecturer; Foreign Expert Maternity Service and Midwifery advisor to Modern Maternity and Midwifery Systems and Education (China); Director of operations My Body My Baby Enhanced Prenatal global education project. Homeopathic Midwifery Advisor to the New York Academy of Homeopathy….and much more…

I’ve practiced midwifery for 38 years and cared for more than 1000 women as a case loading midwife in New Zealand. Most of my knowledge and expertise came from observing and being with the women and families that I’ve cared for. My homeopathic mind is my greatest asset. I was medically trained in the 1970’s. My midwifery training was not what I expected it to be. Mothers and babies were separated. Birth was not calm or peaceful. It was not the stories from my grandmother who was a baby catcher in the villages of Poland and who birthed 13 children at home. Nor was it anything like the home birth stories of my mothers or my sisters. I’ve spent my entire life observing systems and learning more wonderful ways to deliver care and be connected with women.

“I have lowered intervention rates. I have hardly seen a woman depressed after birth under my care and I am definitely human”.

Women who are educated and learn to connect with their body and their baby; learn to understand and trust the entire process; use traditional and complimentary therapies celebrated birth in quiet calm environments. “Babies, mothers fathers and family are confident healthy and happy.”