From Midwife to Millions of Mothers

Howard Schiffer, our founder and president, started out as a midwife in the ‘70s, where he learned of the importance of nutrition during pregnancy. Today as the leader of Vitamin Angels, he’s helping us reach millions of women and save newborn lives on a global scale.

By Elysia Cook

When I was twenty-one, being a midwife was the most amazing thing I could think of doing with my life. Getting to witness the miracle of birth every couple of weeks? I was in. It was the early seventies, a time when names like Treetop, Milkmaid, and Lightning were not all that uncommon.

What was pretty common at the time was undernutrition, anemia, low hemoglobin counts, and iron deficiency among the pregnant women we were seeing. Everyone was vegetarian, but no one had yet figured out how to combine foods, complementary proteins, or how anemia could be life-threatening for the mother and the baby. Our group of lay midwives was on a steep learning curve.

It wasn’t easy. The medical community was against us – they called our work ‘practicing medicine without a license.’ We argued that birth was a natural process and that the woman should have input into how she wanted to deliver her baby. Hospitals fought us saying doctors had to be in control of the entire process. But we knew something was wrong when a mother and baby were separated right after birth, when fathers or partners were not allowed to be with the woman when she was delivering, or when homebirth was considered dangerous and irresponsible, always. (continued below)

So we began educating ourselves and applying our learnings, and the results we saw were amazing. Even nurses who had spent their entire careers in labor and delivery were stunned to see how different a birth could be under soft lights, with music playing, a partner massaging the woman’s back, and close family (or even children) present. The atmosphere in the room after the baby was born felt electric. I was constantly awestruck, even after seeing a woman pregnant for nine months, or in labor for hours, that a new being was actually with us. Staring down at a newborn in her mother’s arms or listening to that first cry, or seeing that natural instinct of a baby to breastfeed took my breath away. More often than not we were all in tears. It was truly a miracle to behold.

What became really clear early on in the home birth movement was how scrupulous we had to be in all aspects of the care we provided. We felt like everyone was watching and waiting for us to make a mistake. So every woman had to have her blood work done. Every woman had to have a doctor as back up (not so easy at the time). And we did rigorous charting of everything from weight gain to urine tests to monitoring and palpating the baby’s growth, to in-depth interviews, and of course nutritional counseling.

We knew that hemoglobin and hematocrit counts were critical to monitor. Hemoglobin was measuring red blood cells and hence your body’s ability to carry oxygen to the baby – obviously very important! Really low hemoglobin causes anemia which can be life-threatening for the mother and baby.

I remember seeing women come back from their doctors in tears. Their hemoglobin counts were critically low, and their doctors were recommending immediate hospitalization and/or iron shots. These women were rightfully scared, but after we started teaching them about which foods were rich in iron, how to combine foods, which supplements their bodies could most easily absorb, and what prenatals were best, things started turning around really quickly.

Women had more energy, felt stronger, were more alert, and when they returned to their doctors for subsequent visits, the doctors were astounded that their hemoglobin counts were back to normal levels. These women went on to have healthy pregnancies and deliveries, and their big babies were a glowing testament to our success. (continued below)

“ These women went on to have healthy pregnancies and deliveries, and their big babies were a glowing testament to our success. ” Howard Schiffer

After I started Vitamin Angels, it was obvious that part of our efforts should focus on supporting the health of mothers and their babies. From the start, I’ve advocated for using a prenatal supplement with multiple micronutrients (vitamins and minerals) for pregnant moms. This is contrary to the standard iron and folic acid recommendation from the World Health Organization and most governments. But I had seen the results for myself, and I knew what a difference they had made.

Globally, the conditions are much worse than anything I had seen as a midwife. The statistics are dire; sometimes as many as one in thirty women die during childbirth. Seven thousand newborns die every day (and 80% from preventable causes!) It was a serious wake-up call for me to realize that in many places around the world the act of giving birth, or even just being a newborn, can be life-threatening.

The women we are reaching are truly the most vulnerable women on the planet today. They’re more affected by the global economy than anyone else. When the price of gas rose years ago, I remember the women in Guatemala telling me that the price of corn had doubled, and as a result, they might only feed their children one or two meals a day instead of three. These women are the most affected by climate change. When crops fail from drought or flooding, they don’t eat – there’s a time of year in Africa that's literally called ‘the hunger season.’ These women are disproportionately affected by malnutrition, lack of access to basic services, poor sanitation, contaminated water, the list goes on. So when they’re pregnant, their situation becomes more untenable. The shocking thing to me is that it doesn’t take that much to start changing things in the most basic way. A healthy baby gives a woman and her family hope. A healthy baby means that population density can decrease (yes it’s true. When infant and child mortality goes down, birth rates decrease as well. When women don’t feel like they have to have ten babies to have four survive, they start having smaller families). And a healthy baby means a chance for a child to do well in school and begin breaking the cycle of poverty.

It would be really difficult to take nine months’ worth of food around the world, to transport it, and store it correctly and deliver it to the woman in need. But, you can take a bottle of prenatal multivitamins in your backpack and deliver it to the most remote region in the world, and completely change a woman and a baby’s life forever. So if you had the chance, how could you not do that?

In Kenya, I saw a woman arrive at a prenatal multivitamin distribution for the first time with a clump of dirt tucked into her purse. She pulled it out and took small bites throughout the day, eating it like a snack. It was the only source of minerals available to her.

When we went to these same villages months later, after the women had been receiving prenatals, the results were remarkable. Women would stand up at our distributions and ‘testify’ to the amazing impact that the ‘Vitamin Angels’ (what they often call our prenatal multivitamins because of our name on the label) had on their pregnancies. Women whose first baby weighed three pounds, would now proudly hold up a six or seven-pound baby. Women who had no energy or were always fatigued early in their pregnancies would talk about working in their gardens all the way up to the day of delivery! And moms whose older children were always sick, would tell us how their new babies were always healthy and never sick!

The amazing thing is that nothing else in these women’s lives has changed. Their economic situation is still the same, their diet isn’t any different, they’re still living in the same place, but just adding a bottle of prenatal multivitamins to the equation has changed everything.

Finally, a few years ago the science started catching up with the stories we’ve heard for years. By comparing iron and folic acid supplements with prenatal multivitamins, researchers showed a 12% reduction in low birth weight babies and a 10% reduction in small for gestational age babies (key indicators for how healthy a baby will be or even if a baby will survive), and a 9% reduction in stillborn births with the women who took the prenatal multivitamins! Then the Lancet study showed that for anemic women who took a prenatal multivitamin (38% of pregnant women globally are anemic!), there was a 29% reduction in infant mortality at six months of age. With credible evidence, I knew it was time for a much bigger prenatal initiative. Knowing what was possible using the same locally sustainable model we’ve created to distribute vitamin A and deworming globally, we came up with the goal to ‘Eliminate newborn mortality around childbirth due to vitamin deficiency diseases by 2030'.

I feel like my life’s work has finally come full circle. Seeing healthy moms give birth to healthy babies, made possible with good nutrition and access to quality basic healthcare, is what I’ve always wanted. As a midwife, it was on a one-on-one basis; now it’s on a global scale.  

I know we can do this. I know by 2030 we can be reaching fifty million women annually. I know we can make an incredible difference in the lives of millions and millions of babies and moms worldwide. And I honestly cannot think of doing anything with my life that would be more worthwhile.

Help us reach these women and join us in our global mission for health for all mothers and children. Donate today.