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Jeanne Howell, a certified nurse-midwife, worked for four weeks at a maternal and children’s health hospital in Saudi Arabia. She’s wearing an abaya and standing on the outskirts of the city of Buraydah, which, she says, looks like any other city. SUBMITTED PHOTO

Alexandria nurse shares ‘best practice’ skills in delivering babies

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Alexandria nurse shares ‘best practice’ skills in delivering babies
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ALEXANDRIA, Minn. -- Like many people in the dawn of their retirement, Jeanne Howell of Alexandria still has more to share with the world.

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She worked 21 years as a local certified nurse-midwife, but an opportunity this fall took her halfway around the world.

“I love to travel, so I thought, ‘I’m going to check this out,’ ” Howell said.

Through the Minnesota International Medicine organization, Howell was part of a four-week medical mission to Saudi Arabia.

MIM has a contract with the Ministry of Health in Saudi Arabia to promote best practices in women’s health, particularly labor and delivery.

On Aug. 31, Howell was part of a six-person team that landed in Buraydah, Al Qasim, Saudi Arabia, to work with nurses, residents and doctors at a maternal and children’s health hospital.

“We would go to the hospital, work eight hours on the labor and delivery floor, basically working side by side with the nurses and (medical) residents, teaching what we call best practices,” Howell explained.

Best practices

Some of those best practices include interpreting fetal monitoring strips, the importance of regular blood pressure checks and documentation, encouraging women in labor to get up and move around, and explaining that episiotomies, surgical incisions used to enlarge the vaginal opening to help deliver a baby, are unnecessary.

Howell explained, “Research has shown us that cutting an episiotomy is not necessary except in rare circumstances, so it should not be a routine practice (as it is now in Saudi Arabia). If a woman tears, it’s easier to stitch up a tear than have to stitch up an episiotomy that cuts through muscle. It heals faster and it’s less painful.”

Howell said one of her most memorable moments was seeing those best practices in action.

“There was a resident who spent some time in the States and we got to know her very well, and I worked with her and I convinced her not to make (an episiotomy) cut and all went well. She believed what I said, practiced what I said and she was pleased with the results.

“The nurses were receptive (to the best practices) … I would guess that it will continue just because the Ministry of Health and director of nurses was very much behind what we were encouraging them to do, so I’m very hopeful it will continue.”

Culture shock

The cultural differences surprised Howell most.

“Saudi Arabia is quite an interesting country,” she said.

As part of the Muslim culture, men and women are often kept separate, and women are not to show any skin in public.

“We pretty much spent our time in the hotel and the hospital. We went to a mall a couple times,” she said.

“(Women), by law, are required to wear an abaya, which is like a long black coat down to the floor, up to your neck and down to your sleeve. And then you have to cover your hair so everyone wears a scarf. In our area, everyone also wore the burqa, which covers the face.

“One day while shopping,” Howell said, “we had on the abaya and scarf, but not the burqa. We were at a public market and I was standing outside waiting for my colleagues to come out, and a Saudi woman came up to me and took my scarf and covered my face. So we went around the corner to another store and bought burqas and put them on. I was not prepared for that,” she said.

Their group was treated to a couple of meals at a resident’s home and that’s where, Howell said, she got a true taste of the culture.

“At their homes, their families are just like us,” she said.

Reflecting on her work in Saudi Arabia, Howell said, “It was satisfying to do it, although you never know if you made an impact. None of us know if we make an impact with anything we do, but I felt that it was a good way to continue to practice the things I believe in. For me, it was a marvelous adventure.”

Amy Chaffins | Forum News Service

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