Day two of our travels in Nepal was fabulous. We had a chance to walk around some more and work on some MIDSON documents through the afternoon. In the early evening we headed out to Boudhnath Stupa, where one is to walk in circles and spin the prayer wheels to send up blessings for all sentient beings. You always walk with the temple on your right, and then spin the wheels with your right hand. Prayer flags adorned this temple and monks were walking as much as locals and tourists were. The temple itself is white with a gold centre mount, and eyes painted on looking in all four directions. It seems to be a fairly iconic place given that it also graces the cover of my Lonely Planet guidebook!

After our walk, and spinning of prayer wheels, we met up with our trekking guide, Bishnu to discuss plans for our trek and workshops that we’ll be doing in the Upper Mustang region in May. Bishnu was an absolute delight! He speaks perfect English and is obviously a very competent trekking guide. We thoroughly enjoyed every minute, while watching the light fade over the temple. We were so energized by the plans for our trek and workshops en route! It was a very fun night.

By Day three, we were starting to feel a bit laggy. We had a slow morning, complete with delicious breakfast once again and then headed out to visit some more of the movers and shakers in the midwifery world here in Nepal. We met with Sister Rashmi, another instrumental member of MIDSON and birth centre guru. She and another wonderful nurse and Ph.D. candidate, Laxmi spoke to us about midwifery in Nepal, its absence here and a plan for education and improving outcomes. Sister Rashmi talked about the difficulty of having a birth centre in a location where women and families think doctors are the appropriate practitioners for birth, in an area saturated with hospitals. Laxmi spoke of the need for a mindset change amongst the Nepali people to improve birth outcomes here and support the development and growth of midwifery. They made very clear the need, and special focus on reducing intervention and increasing physiologic birth by supporting things as simple as delayed cord clamping. This meeting was an excellent precursor to our upcoming work in Pokhara, as it really helped set the stage for both Rachelle and I as to where midwifery is currently in Nepal and what birth is typically like in hospital here, by comparison with the lovely birth we witnessed at the Teaching Hospital Birth Centre on Sunday.

While at the community birth centre with Sister Rashmi and Laxmi, we also met our very first male midwife, Patrick! He hailed from Sweden and is here for his seventh time. He is working with Laxmi and Sister Rashmi to put data together on the success of the care provided at the community birth centre, to help obtain and maintain funds that support that birth centre. Additionally, he’s also very well-versed on the role of midwives in Sweden. So for quite a while, in Kathmandu, we found ourselves discussing the similarities and differences of the roles of midwives in Sweden versus those in Canada. It made for a very interesting afternoon. Our brains were carefully cataloguing information from the stories we were being told, while our hearts were full from the love and laughter present throughout the afternoon.

This was an incredibly memorable day for both Rachelle and I. After we returned, Cathy was able to help us fill in some of the blanks around the who’s who of midwifery in Nepal. The most important take-home message is that there truly aren’t any midwives in Nepal, there are nurses with midwifery training, but the push is on for direct-entry midwives who practice full scope care in urban and rural settings. And the silver lining is that while there aren’t any “registered midwives” at present, there are wonderful nurses like Sister Rashmi with decades of experience who practice midwifery in its truest form, here in Nepal.