|July 26, 2000|
Volume 2, Issue 30
|Midwifery Today E-News|
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In This Week's Issue:
1) Quote of the Week
1) Quote of the Week:
"Most midwives espouse the cyclical and flowing model of nature and change. We view the woman's body as normal and healthy in its own right. Our role as midwives is to guard and sanctify the natural process."
- Kate Bowland, CNM
2) The Art of Midwifery
Many midwives have sacrificed their family and other relationships unnecessarily ... and despite all those sacrifices, or perhaps because of their heavy burden, these midwives often burn out and stop practicing midwifery altogether. One way to avoid all this is to prioritize your life's work. You will have to learn to say what is often the hardest word in our midwife vocabulary: No. For example, you may need to tell a good friend, "No, I can't do your birth. I already have four births in April." Each of you will have your own set of priorities. But when you find yourself under too much pressure and heading toward burn-out, look first at your callings. Quite often, you are doing more than you are called to do.
- Jan Trillen, The Birthkit newsletter
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3) News Flashes
The Adverse Childhood Experiences Study of 1,200 women has determined that women exposed to abuse as children or who grew up in dysfunctional households are much more likely to become unintentionally pregnant than women who did not have such adverse experiences. Two out of three of the women who had unintended pregnancies reported at least two childhood exposures to psychological, physical or sexual abuse or household dysfunction, defined as mental illness or substance abuse in the family or abuse to a child's parent by a spouse. The connection was found across all racial and socioeconomic and educational levels. -San Diego Union Tribune, October 1999
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4) Our Mentors
I am a first year student midwife at Wolverhampton University. I would like to sing the praises of my mentor, J. Johnson. During a year of clinical placement she has taught me the stuff you can't read in books. I have eagerly observed whilst she has empowered women in one of the most important aspects of any care: telling them they have the power! I have watched whilst she practices the art of good communication and developing equal relationships in deciding and planning their care. She has developed my thinking. We have had many conversations in which she has learned from me. This has helped my confidence in my practice because I feel we are equal partners and I'm not just there to carry the bags or make the tea--in fact it's very rare for me to make it!
Because you hear so many horror stories, I want to let other students know that there are some great mentor midwifes out there. J. is the most helpful of people in all aspects of my course and my only hope is that I will become half as good a midwife as her. She will influence my practice throughout my professional career.
- Nicola Edwards
I have to thank Nancy Wainer Cohen (now Nancy Wainer) for pointing me in the direction my life has gone. It was 1981; I was an OB/GYN nurse-practitioner and childbirth educator. I had had my first baby eight months prior (c-section for failure to progress: CPD--the usual diagnosis). I got a flyer advertising a VBAC conference in Boston. I was intrigued, so I decided to go learn so I could teach other clients. After all, "my c-section had been necessary." That weekend opened my eyes tremendously to what was going on with birth in the U.S. I networked, learned, cried, shared and laughed with about 50 other women. That weekend we decided to form the National Cesarean Prevention Movement.
I returned to Indianapolis with a mission: lower the cesarean rate, educate women, promote VBAC. Nancy was my mentor. I wrote to her, called her, and visited her at her home in Boston. I remember waking up and hearing her downstairs--by the time I went down, she had already made two casseroles to freeze, fed the kids, cleaned the kitchen---she was a dynamo! I sat in on her VBAC class that night. Remember, this was 1981-82--revolutionary stuff! I became a CNM the following year.
Nancy's book, Silent Knife, is "the Bible of VBAC." I still hand it out to all VBAC clients. I was her groupie for a while--I went to lots of conferences to hear her speak. Of course, I also learned a lot about myself through her and learned how unnecessary my first cesarean was. I went on to have two VBACs after that. I will always be indebted to Nancy for her fire, her dedication, her insistence on treating birth as normal. What a brave woman!
- Patty Brumbaugh CNM
Once upon a time, I worked as a nursing assistant in a small community hospital, the very same one I had been born in twenty-something years earlier. I worked the night shift while I was in college. A high school friend called me one day to tell me one of her sorority sisters from college had been hired in our labor and delivery ward. She told me Leslie was an RN studying to be a nurse-midwife. This interested me because I had never heard of such a path. And to me, midwifery was everything--womanist, humanist, environmentalist, political. I needed to meet this Leslie! Not too much longer I stepped into the hospital elevator while running to the lab, and walked right into Leslie. As soon as I saw her big green eyes, sparkling with stars of encouragement and wisdom, I knew this was the woman my friend had spoken of. She said "Cynthia?" I said "Leslie?" and we giggled. We knew each other as if we had grown up together. She would soon become my midwifery mentor. A few days later, she put "Spiritual Midwifery" into my hands. Inside, Leslie had written, "Each one, teach one." I tried on the idea that I could be a midwife! Leslie and I would often end our shifts at 7 am and spend hours and hours watching videos, reading Midwifery Today magazines and intellectually devouring books. I often say to people nowadays, "It's all Leslie's fault!" Leslie, ever modest, rolls her eyes and asks me not to put her up so high. I remember telling her once how much I liked her hands. "My hands?" she said, wondering.
A few years later, I met a young lady who was interested in becoming a midwife. She began to ask questions about the how-to's. I told her all about avenues toward being a doula, kinds of midwifery education, magazines she could subscribe to, and so forth. To my surprise, she turned to me and said, "I really like your hands." I smiled, got a little misty, and said "Thank you." I understood.
Each One, Teach One: that is how the midwifery tale is told.
- Cynthia Yula
What influenced me? It was the mother who had homebirths in the 1920s and 30s because that was normal. She birthed me in 1948 in the hospital and always said she didn't like it. It was the midwife I met in my eighth month of Montane's pregnancy who made me think and gave me choice. It was the friend who asked for my help because she trusted me. It was my faith in women and our god-given right to choice. In my mind everyone had choice, and if they wanted it and needed my help, I was going to do the best job I could at supporting that choice. But I need to warn all of you: regulation takes that choice away because those in control feel they know more about you than you do. We need to work to support the right to choose rather than our right to practice.
- Ollie Anne Hamilton, CPM, DEM
5) Check It Out!
We are proud to introduce our online Mother/Baby/Environment Friendly Product and Services Directory! Come give us a gander! Shop at the Birth Market!
TELL THE WORLD that you support midwifery-wear one of the
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MIDWIFE IN WAITING? Order Midwifery Today's popular Beginning Midwives' Pack-it's been a winner since 1991! Go to: Beginning Midwives' Pack
Why learn about global midwifery? Find out at Midwifery Today's international conference in New York City in September!
For all the information you'll need:
Thank you to the following businesses for sponsoring the New York conference:
- Mothering magazine: Mothering is in its 24th year of providing inspiration for attachment parenting. Mothering guides, nurtures, and supports while providing the latest on controversial parenting topics.
- Cascade Health Care: Cascade HealthCare Products, Inc. began business in 1979 with the primary goal to provide supplies and equipment for the emerging profession of midwifery. We have developed a complete product line that not only serves midwives, but nurse midwives, childbirth educators, lactation consultants, visiting nurses, birth centers, WIC programs, nurse practitioners, doulas, and professionals dealing with expectant parents, families and women's healthcare.
6) Question of the Week
Q: I am a happy, healthy 39 year old mom with thalessemia minor who is considering a homebirth for my second child. My first was born when I was 37 at a birth center with CNMs. Precautions taken (planned before labor) because of my thalessemia were a heparin lock at the beginning of second stage and a shot of Pitocin in my thigh immediately following labor to help clamp down my uterus. I labored naturally and normally with the exception of third degree vaginal and perineal tears (baby came fast, kicked his way out, and my position was not optimal). My normal hematocrit is between 27 and 30. My pregnant hematocrit just before labor was 25. Three days after it was 23 and back to 30 at six weeks. I believe my platelet count was and is normal. Am I a candidate for homebirth?
Editor's note: There were no responses to last week's question about a torn placenta. If you would still like to respond, see the question in Issues 28 and 29.
Send your responses to firstname.lastname@example.org
7) Question of the Week Responses
Q: A pregnant mother is expecting her fourth child. She says she loses a lot of hair after the birth of each of her babies. She wonders if there is anything she can do or take to prevent this from happening again.
A: This happens because all hairs go through growing and resting phases. During pregnancy more head hairs come into the growth phase due to hormonal stimulus. After pregnancy they all decide to have a rest at once, hence the pronounced shedding that occurs in all women after childbirth usually three to six months later, and more prominently in some women than others.
- Phil Watters, OB
A: This is anecdotal at best, but it has been my experience that this is normal and expected. I have had one child and I experienced a fair bit of hair loss following birth. Almost 2.5 years later my hair is still not as thick as it used to be, but much better than it was! My hairdresser says it is normal too. My mother and sister each had four children and both experienced hair loss. It seems that after the fourth child, their hair never returned to its pre-baby thickness.
- Lisa S., doula
7) For Coming E-News Themes
1. How do you counsel pregnant women about nutrition, especially in these fast-paced days of stress, little time, and junk food? (August 2 issue)
2. In two to four sentences, what is the best advice to give an apprentice or aspiring midwife?
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Are you going to the DONA conference in San Diego this week?
Well, guess who is going to be there? Jennifer Rosenberg, CD
(DONA), design editor for Midwifery Today magazine, and
contributor to Paths to Becoming a Midwife. She's also a
speaker at the conference. She would love to meet doulas
interested in networking and chatting about what doulas do!
Bring your birth zeal and doula energy to eat, drink and be
merry with her on Wednesday, July 26 at 6:30pm at Mimi's
Cafe. (Special dietary needs will be accommodated by the
chef.) 5180 Mission Center Rd. Mission Valley, CA 92108
In response to Carla who complained that she had had a strong urge to push beginning early in labor, then when finally allowed to push seemed to lose the ability to do so well and needed to push 2.5 hours to birth her first baby [Issue 2:29]: She said the way the birth was handled "seemed to contradict the "trust your body to know what it's doing" message. I see many women, especially Hispanic women, who push early in labor. Sometimes it's a cultural thing, and I see women pushing only because family members are encouraging them to do so. In this case I always instruct them not to push but rather to breathe and relax as much as possible through contractions. However, you can tell when a woman is pushing because her body (rather than someone outside it) tells her to do so. These women usually do quite well if left to their own method of birthing. Rather than swelling or damaging the cervix, their pushing seems to "push it away" and they have rapid labors. These women's bodies do know what they're doing, and even though it contradicts everything the caregiver might believe, they work just fine. You know the idea that all women are different and all labors even in the same women can be different? Maybe with your next labor you won't have these "pushing pains," but if you do, consider that your body might know just what it's supposed to do.
- Joyce Jones RNC
Nearly a year ago Elena Ixcot, a Mayan refugee living in Vermont for the past 16 years, invited me to travel with her to her hometown, Concepcion Chirquirchapa, to meet with a community of midwives. The town is located in the Mam speaking area of the Western Highlands near Quetzaltenango. Conveying energy and hope, the midwives told me how they had organized to become more educated, to gain political strength, and to train young midwives to carry on the Maya birth traditions and knowledge of the use of herbs. In addition to attending most women at home they have a small clinic for women's health and a birth center for women who cannot be at home. The area is desperately poor; resources are quite limited.
Out of the deeply personal and moving exchanges in August and again in January grew a project to create some kind of partnership between the co-madronas of the Man area and midwives from the United States. The "partners" project paired 15 midwives from Guatemala with 15 midwives in the States to obtain birth kits and supplies, which were delivered in March. I have received the names of seven more midwives who need partners. In addition, the project is fundraising for a midwifery education and birth center that would be a resource for the whole area and where traditional herbs would be grown and knowledge of their use passed on. Having their own center would help them preserve their autonomy and traditional ways that are threatened, and help them improve their skills and gain the same respect from the government that is accorded them among their people. $14,000 has been raised toward the goal of $20,000 for land and a building. Part of the ongoing project is to have midwives from the United States participate in educational exchanges with the local midwives.
If anyone is interested in being involved in this project through partnering, financial support or material aid, contact me, Judy Luce, CPM, at MidwifeOne@aol.com or 802-476-7056. Donations through the International Mayan League are tax-deductible.
I did a search of PubMed or Medline on induction of labor. There were at the time 941 articles. My survey showed that 665 of them were about techniques of induction: how, where, when, what drug to use, etc.; 50 were about side effects and complications; less than ten were on the experience of induction. Tells you something about priorities doesn't it?
I strongly encourage you all to research this and talk about it with everybody who will listen, particularly girlfriends, daughters, female relatives, anybody. Our female process is being taken from us, and we are letting it happen. Our babies are being injured, taken too soon, not ready to be out in the world yet. Then we lactation professionals have to work so hard to undo the psychic damage and support the basic mechanisms of lactation and infant maturation until mother and baby are ready. I would cheerfully give this up, even if it meant my private practice disappeared. One can refuse routine induction. In fact, if one's heart is not behind it, it will not work because the internal chemistry will work against the technology. Then the technology will be intensified, because after all, that unfavorable cervix must be conquered. If the baby is breathing, and goes home with the mother, then all must be well, right? NOT!!!
- Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, craniosacral therapy practitioner, childbirth educator
I am doing a study on "midwives working at the margins of life: home birth and home death." I've been a home birth midwife for almost 25 years and a hospice volunteer for three years. My sense (an experience) is that home birth and midwives working at home have a unique and rich perspective to contribute to the world of people dying at home. I would like to speak with midwives who are or have worked with people dying at home. Please contact me at MidwifeOne@aol.com or call 802-476-7056 (I'll call you right back).
I live in Greece and I want to study pregnancy massage. I would appreciate if you can recommend relevant books and courses that I could attend in England (in Greece I don't believe there are any).
- Tina Doukas
What causes pain? I ask my dads to think of pushing a whole grapefruit into their mouths. It causes discomfort. Pain is discomfort, just some deal better with it than others. Maintaining relationships is very hard as everyone wants our time. We have to decide what is most important in our life. We just have to decide that ten months ahead of everyone else.
The description from Gail Hart was spot on [meconium aspiration syndrome, Issue 2:29].
- Phil WattersOB
I worked with Amish women having their 10th, 11th, 12th babies, etc. who had huge varicosities, some the size of a small garden hose, and not one caused any problems. This is not to say that it couldn't happen, but none in my experience did. I gave them white oak bark, cayenne capsules, and if I remember right, butchers broom. I also had them eat the white part of oranges. Susun Weed's pregnancy book has some good suggestions for this problem.
For the woman with back labor, a posterior baby, and wanting to push at 3 cm: A book describes a maneuver that may turn posterior babies and is said to help back labor pain and speed up the lengthy labor associated with posterior babies: Back Labor No More. I found it at Amazon.com. I had a similar labor with urges to push at 6 cm and was told to resist the urge until about 9 cm (with the posterior baby cervical lip, of course). My baby ended up getting stuck (4 hours of pushing). He never turned, and I was transferred to the hospital and eventually had a c-section. Needless to say, I don't want any more posterior babies. If anyone else has more ideas, please share.
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Midwifery Today: Each One Teach One!