Leah Marinelli has heard a lot of misinformation in the 20 years she has been a certified nurse midwife. She started holding occasional small workshops on health topics at home to educate patients who had gaps in their knowledge. Yutta Engel is also a midwife in the Monsey area who organizes workshops for patients at her home on related health topics. Both were thinking about how to reach women beyond their living rooms and started talking about holding a larger event together. Soon the two were hard at work planning a comprehensive day-long conference with speakers, a panel discussion and vendors from the community. Others joined in with their own areas of expertise.
Devoiry Steinberg, an events planner, came on board to handle logistics. Leah Tikvah Rosen, a community health educator and experienced doula (labor support coach), joined the group and contributed the knowledge she has gained from hosting numerous workshops and events like the first global preventive women’s health teleconference. The result was The Jewish Women’s Health Symposium, held on Sunday, July 8, at the Atrium in Monsey. About 200 women joined to hear a varied set of speakers, including a radiologist, nutritionist, physical therapist, osteopath, endocrinologist and social worker. There were also panel discussions with midwives and doulas.
Marinelli said she and Engel chose the speakers based on the issues they see frequently in the community. “We identified a few needs like nutrition, emotional health and physical therapy,” she explained in a pre-event interview with The Jewish Link. “For example, people realize that they should be eating healthy food but they have to learn what that means. Some women are rebelling against kiddush cholent and kugel, thinking this stuff is toxic. It’s not healthy on a regular basis but women are going to the extreme. Cleansing diets are dangerous for nursing and expectant women. An obese woman at risk for gestational diabetes is still healthier than women on a low-calorie cleansing diet that can cause severe nutritional deficiencies.”
Too often Marinelli sees women suffering in silence when they have physical and emotional pain, unaware that help is available, and the pain doesn’t just go away. Marinelli is often the “first front” women come to when they have postpartum depression, obsessive compulsive disorder (OCD) or an eating disorder. “I can’t treat these issues, but I recognize them and can refer women to the proper providers,” Marinelli said. Rivki Jungreis, a therapist who spoke at the conference, shared a list of mental health facilities.
The symposium addressed women’s health over their lifecycle. Marinelli said that she sees 15- year-olds who are having irregular cycles, or none at all, kallahs coming for their initial exam and women going through menopause. She brought in an endocrinologist to speak on these issues as well as thyroid disorders and diabetes. Physical therapist Tova Lehmann explained how poor posture as a young girl can cause back problems in later life. A visual presentation showed how pregnancies put pressure on the pelvic floor, pushing it down, which can lead to incontinence. Post-menopausal women are at risk of fractures when they develop osteoporosis, a thinning of the bones. Lehmann showed a picture of healthy bone, which looks like a sponge, and then a bone with osteoporosis that looks more like lace. That made it easy to see how it could collapse under the pressure of daily activity. Lehmann explained how specific exercises and treatment can help these conditions.
The importance of screening for medical abnormalities was discussed by radiologist Dr. Daniel Cohen, who spoke specifically about how ultrasound technology can detect problems in pregnant women and newborns that can be treated when found early. Dr. Cohen noted that insurance companies can be very strict about the tests they cover, and some of the newer ones may not qualify, despite the potential for lives saved and complications averted. Marinelli advised women to treasure their health even when that means saving up for treatment or tests recommended by their doctor that have to be paid for out of pocket.
The finale of the program was a panel discussion about midwifery. In most of the world outside the United States, babies are delivered by midwives; pregnant women see obstetricians only if they are high-risk or a problem develops. Marinelli said she only delivers babies for women who are healthy and deemed low-risk, following an evaluation.
Midwives are allied health care professionals, Marinelli said. She holds a nursing degree, BS in women’s health, MS in midwifery and certificate in nurse-midwifery. She said women entering the profession now also have the option of pursuing a PhD.
Midwives practice in home and hospital settings and work in conjunction with medical professionals. “We bring the home into the hospital and the hospital into the home,” she said. “We make sure the wonderful parts of midwifery care and life-saving equipment are both available.”
Marinelli said there are multiple advantages to delivery with a midwife. “You get personal attention and birth is treated as normal. You have choices. There are protocols but you are not bossed around with someone else controlling every step. There is less medical intervention: only if necessary, not for convenience.” When Marinelli delivers in a hospital, she tries to create a home-birth experience and only goes to hospitals that are comfortable with her methods. “Midwifery is a medical modality. It is a complementary art to traditional medicine and based in science.”
Yutta Engel went to midwifery school after her childbearing years. “I got my calling when I assisted at the birth of my oldest grandchild,” she said in a pre-event interview with The Jewish Link. She began as a doula, a combination birth coach and assistant who helps the mother giving birth with support and comfort, before going for midwifery training. She has been delivering babies at home for 10 years.
“Home birth is still the minority but there is growing awareness,” said Engel. “Many women choose home birth after having done their research and hearing from friends and family that a home birth was an exciting, beautiful and safe experience. And when an unforeseen problem arises, hospitals are nearby.”
Rivky R., a woman from Spring Valley who agreed to speak with The Jewish Link, said she attended the symposium because she is passionate about women’s health and home birth is a family tradition; her mother and sister had babies delivered at home with Marinelli. That was her goal when she was pregnant with her first child. However, her labor wasn’t progressing smoothly so she was transferred to a hospital where midwife Lonnie Morris delivered the baby. She had twins with her next pregnancy so home birth was not an option. But she’s hoping for a home birth in the future.
Engel and Marinelli would like to make the Jewish Women’s Health Symposium an annual event. If plans work out, this will be the nucleus of a new organization to enhance women’s health awareness and provide appropriate referrals.
“A woman is the core of the family. If she will not take care of herself, things will deteriorate.” Engel said. “Women need to recognize the importance of who they are in the family. When she is strong, the family is strong and there is a strong community.”
By Bracha Schwartz
