ALBUQUERQUE, N.M. — In her 14-year career as a midwife, Ruth Kauffman has lived in a mud hut in hot, dry South Sudan, a small town in rural India, on the U.S./Mexico border and, most recently, shared a home with international workers in Lae, the second largest city in Papua New Guinea.
Wherever she lands, Kauffman is a fierce advocate for women’s health.
She has delivered more than 3,000 babies and made it her mission to support women who want to become midwives and nurses. In her international work, she focuses on programs that work with women and children in conflict and connecting issues like reproductive health and gender violence.
|Childbirth and maternal health
Women around the world continue to die unnecessarily during and after childbirth. That includes in the U.S., which spends more on health care than any other nation, yet has a lifetime risk of maternal death higher than 40 countries, according to a 2010 Amnesty International report “Deadly Delivery: The Maternal Health Care Crisis in the U.S.” Women are four times more likely to die during childbirth in the U.S. than in Germany, according to the report.
The maternal mortality rate in the U.S. was 14.5 deaths per 100,000 live births in 2007, according to the Centers for Disease Control and Prevention. Pregnancy-related deaths include the death of a woman while pregnant or within one year of pregnancy termination from causes related to pregnancy or its management.
In New Mexico, the rate was 15.3 from 2007-2010 and 9.6 from 2003-2006, or about 2-5 pregnancy-related deaths each year, according to Michael Landen, acting state epidemiologist for the New Mexico Department of Health.
OBGYNs and midwives are in high demand at Doctors Without Borders’ obstetric projects around the world. More information is available at http://doctorswithoutborders.org/work/field.
Kauffman is motivated to help women through labor and beyond. Not only do women die unnecessarily during childbirth but they are often targets in times of conflict, she says.
Kauffman admits she “naively” believes women can change the world.
“When we can bridge our differences and challenge the accepted roles, and not accept that things must be as they are, then we can change the direction of the world,” she says in an email. “We must.”
This month, Kauffman was set to end her post coordinating a program in Papua New Guinea that works with survivors of sexual and intimate partner violence.
What’s next for Kauffman, a nurse and midwife who still calls Albuquerque home?
Since 2008, when she began working for Medecins Sans Frontiers, a non-governmental humanitarian medical organization known here as Doctors Without Borders, she has taken one job after another with only brief breaks to see family.
Ask Kauffman, 49, if she plans to return home for good and she says she is still debating. But it doesn’t take long for her to admit she will likely return to the developing world.
“There’s such a need for midwives around the world,” she says in a phone interview from Lae.
In the U.S., many midwives fight for the right to practice, she says. But elsewhere, many women are desperate for midwives, often because they are the only ones providing quality care. Obstetricians are often based at urban hospitals, and in places like Sierra Leone there may be only a few. Midwives are more likely to practice in rural communities.
Brain drain is also a problem in many countries.
“With midwives, the more experience they get, the more they’re taken away from their communities,” she says.
About 15 percent of women have life-threatening complications during birth, she says. In international work, the challenge involves getting women to help in time and offering competent care once they arrive.
Working as a midwife in Albuquerque and South Sudan are worlds away but Kauffman has learned many lessons she can bring home. With Doctors Without Borders, midwives see women through a continuum of care – from family planning, safe abortions and HIV prevention to pre- and postnatal care – unlike the U.S., where women’s healthcare is more specialized, she says.
Kauffman began a career in women’s health after working with the Peace Corps in Sierra Leone from 1985-1987. She decided to become a midwife after she saw what an integral role they played in the community.
“They were the birth attendants, the healers, the head farmers, the community organizers,” she writes in an email. “I decided then I wanted this but felt I was too young.”
She worked in the U.S. for 20 years, first as a rape crisis counselor, then as a sexual assault nurse examiner. She then earned a nursing degree and studied midwifery at Maternidad La Luz in El Paso, where she later was associate clinical director. In Albuquerque, she started a birth center and home birth practice and was a labor and delivery nurse at University of New Mexico Hospital.
Friends and colleagues say Kauffman is a passionate advocate for midwifery and women’s health.
“She’s certainly one of my heroes,” says Jaymi McKay, a licensed midwife and registered nurse.
McKay was a charge nurse in labor and delivery at UNM when Kauffman applied for a job. Not only did she hire Kauffman, but McKay spent the next few years “picking her brain” about becoming a home birth midwife.
“Anywhere Ruth works, she is an asset,” she says. “I’m better off having known her.”
Time to go abroad
Newly single at 45, Kauffman decided she was ready to work abroad. She spent a year as a midwife and nurse in India, eight months in South Sudan and stints in Uganda and Indonesia before Papua New Guinea.
Through her work, Kauffman has developed a deeper understanding of the role violence plays in women’s lives and how it affects health.
Whether she is talking to a rape survivor or pregnant woman, her job is to be patient, compassionate and “hold the space” so the woman can get through the experience as well as she can.
“It is important for her, and for myself, to make those connections,” she says.
Her connections span the globe. When Micaela Cadena, campaign and policy coordinator at Young Women United, an Albuquerque advocacy group for women of color, learned she was pregnant, she turned to Kauffman. Six years later, Kauffman has delivered both Cadena’s daughters, as well as her sister Mireya Cadena’s daughter.
As a midwife, Kauffman always went the extra mile, even biking over with tea or flaxseed oil, Cadena says.
When Kauffman learned Mireya Cadena was in labor, she called her from Papua New Guinea with advice that helped her have a healthy home birth, her sister says.
“It brought tears to my eyes,” Micaela Cardena says. “She was literally on the other side of the world calling to help.”