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In This Week's Issue:
1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Nausea in Pregnancy
5) Check It Out!
6) Midwifery Today Online Forum
7) Question of the Week
8) Question of the Week Responses
9) For Coming E-News Themes
11) Classified Advertising
1) Quote of the Week:
"The ways in which we deal with childbirth and how we treat our babies, both in the womb and in the first year after birth, intimately affect us all, not only as individuals, but our culture and the planet as well."
- Suzanne Arms
2) The Art of Midwifery
I distributed a flier in my neighborhood asking to meet
other pregnant women with a close due date and similar
lifestyle. We became a group of five that supported each
other throughout our pregnancies and into newborn care. We
also worked together on childproofing our homes. Although we
are now spread out over the country, we still maintain our
support of each other.
- Sandra Dickson, Wisdom of the Midwives: Tricks of the Trade Vol. 2, a Midwifery Today Book
To order Wisdom of the Midwives, go to
Share your midwifery arts with E-News readers! Send your favorite tricks to email@example.com
3) News Flashes
Women smokers are at higher risk of having an ectopic or
tubal pregnancy, according to a recent study. In women who
smoked around the time of conception this risk was found to
be three and a half times greater. One possible explanation
is that the chemicals in cigarettes hinder the effectiveness
of cilia, which sweep the egg from the ovary down the
fallopian tube to the uterus.
- Pregnancy & Birth, October 1998
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4) Nausea in Pregnancy
Researchers are looking at stimulation of the nei kuan
acupressure point as a way to relieve nausea and vomiting in pregnancy (NVP). A study tested acupressure wristbands,
designed to stimulate the nei kual, for their effect on both
NVP and the emotional state of early pregnancy. This study
pointed out the correlation between nausea and vomiting and
psychological problems such as anxiety, depression, and
hostility--that persistent nausea leads to these
psychological problems, and not the other way around. Study
subjects showed significant improvements in both physical
and mental status after brief use of the acupressure
wristbands, and some whose nausea was not relieved still
found their emotional state much improved.
If a woman is capable of moving at all, have her try
moderate exercise. Be sure she keeps her exertions within
reasonable limits. Vigorous exercise may leave a woman
exhausted, dehydrated, and overheated--conditions likely to
Two women interviewed by the author report that singing was
one of their most effective weapons against nausea.
Breathing exercises or reading aloud may produce the same
Aside from the effectiveness of hypnotherapy, a
self-hypnosis routine that incorporates feelings and goals
is effective in helping a woman feel calmer and more in
control of her body. The fact that hypnosis can assuage
nausea or control vomiting does not mean that NVP is all in
a woman's head. People undergo dental work and even surgery
under hypnosis, and no one would presume to suggest that the
pain of being drilled or cut open is produced by a bad
attitude. Hypnosis is also used to help chemotherapy
patients overcome nausea and vomiting. The mind is a
powerful force that can override the physical sensations
within the body. -Virgina Hege Tobiassen, The Birthkit Issue 26
E-News readers share their experiences and remedies for nausea
I correspond online with a number of women suffering from
nausea in pregnancy through the Pregnancy and Childbirth
Topic Area at Suite101.com. (www.suite101.com/welcome.cfm/pregnancy_childbirth)
Here are some personal tips that reflect much research over
the years, personal experience, professional experience and
correspondence with my readers at Suite101.com:
1. Manage nausea with food when you are able to do so. Read
the book, "No More Morning Sickness" by Miriam Erick, RD,
who specializes in working with women with nausea and
vomiting in pregnancy (NVP). The book gives numerous ideas
on foods to try instead of the same old saltine crackers and
2. Try small frequent meals and not eating and drinking at
the same time. If you must drink, take tiny sips to just
wash your food down. Don't gulp. Overfilling your stomach
can trigger nausea and may cause you to vomit.
3. Try chewable prenatal vitamins, taken at lunchtime. I
took NataChews, prescribed by my doctor. (I once took the
advice of a well-meaning nurse to take them with orange
juice in the morning. I never did that again!)
4. ReliefBand is a battery-operated wristband that gently
stimulates nerves in the wrist. The impulses put out by the
band interfere with the normal process of nausea and
vomiting, allowing the stomach to return to its normal
rhythm. It requires a prescription from your doctor or
midwife. You can read more about it at the website
5. Stock your pantry and refrigerator with sick-day foods.
Lemonade and orange Gatorade, push ups and juice bars,
cantaloupe and honeydew melon and chicken flavored
dehydrated noodle soup mix kept me going and kept me
hydrated on really sick days. Did I mention potato chips?
6. Get plenty of rest. Take a nap if you can. Don't keep an
immaculate home. Since you are having kids, there's no
better time than the present to get used to a less than tidy
house! If you can afford to, consider cutting back on your
7. Finally, I very much believe there is a psychological
component to nausea and pregnancy. Do not discount the
stress in the pregnant woman's life. I'm not saying nausea
is all in a woman's head. However, as I talk to other women
who have had debilitating nausea in pregnancy, they relate
some of the same beliefs I have about stress and nausea in pregnancy. Some have had undiagnosed mental illnesses like
anxiety and depression. Some stressors others have had early
in their pregnancies are decisions to keep or terminate the
pregnancy, abuse issues, abandonment by their partners,
financial concerns, marital trouble, family discord, work-
or school-related problems, trouble with the law and so on.
Help these women find the support they need, whether it be
family, friends or a good therapist to work through these
issues because they can continue to affect the pregnancy and
These and other tips are posted at the Suite101.com website
in a format better suited for pregnant women. Go to:
If the tips are reproduced, please make sure credit is given
to the author.
Perhaps someone can elaborate on the belief that the baby's
gender affects the degree of nausea in pregnancy. I look
forward to seeing what others have to contribute to this
- Maurenne Griese, RNC
I vomited several times a day from 6/40 until around 18/40,
and continued to experience occasional bouts until term.
Nausea never left me until my son was born. I found sipping
lemonade and tonic water helpful when I couldn't tolerate
food. I finally consulted a naturopath at 12-13/40
gestation. She urged me to change my diet to wheat and
dairy-free. I also drank lots of water when I was able to
tolerate it. Almost overnight I felt like a different woman.
I didn't vomit and only felt nauseous when I diverted from
the diet. I would love to have another baby, but the thought
of nine months of nausea and sickness is not attractive. I
hope I can prevent the same from happening next time with
the advice of my naturopath.
- Kellie, midwife
I had nausea in my first and only (thus far) pregnancy.
Smelling a freshly cut lemon worked for me.
- Do soda crackers really work? Yes! Leave a package on your bedside table and eat a few before you get up in the morning. Keep some small packages of crackers in your purse
in case nausea strikes while you are away from the house.
- Chew on licorice-tasting fennel seeds to calm queasiness.
- Fresh grated ginger and fennel seeds make a comforting tea to settle your stomach. Ginger can be purchased at your grocery store in the fresh vegetable section.
- Try eating your favorite foods from childhood, like ginger ale, Jell-O, or whatever your mother fed you when you weren't feeling well.
- Always get up slowly in the morning and take small breaks throughout the day with your feet elevated.
- Hot teas may help, especially spearmint or peppermint which is known to be good for indigestion, or try the excellent "women's tea" known as red raspberry leaf tea. If cold is more appealing, make popsicles or ice chips with the teas.
- Take short walks in the fresh air whenever possible.
- Drink bottled or purified water to flush your system. Try increasing your water intake to six glasses a day.
- If you feel as though your stomach is not digesting food well, increase your consumption of raw, enzyme-rich foods. Fresh cantaloupe, papaya and pineapple have the highest naturally occurring enzymes of all foods and help a great deal with digestion.
- Make sure you are napping at least once a day to allow your body to recharge. Even a short nap can help you to feel stronger.
- Some health professionals are recommending one 50 mg to 100 mg tablet of Vitamin B6 taken before bed. Single B vitamins should only be used for short periods of time. Switch to a B complex vitamin after a two-week period.
- There is a strong connection between nausea during pregnancy and low blood sugar levels. Make sure you are eating small meals throughout the day to keep your blood sugar level up throughout the day and evening.
- A high-protein snack before bed can help to alleviate some symptoms.
- Try powdered ginger root in capsules three capsules a day.
- Slippery elm is a soothing and strengthening herb for the stomach. It has as much nutrition as oatmeal and is so gentle that it can be retained by the most sensitive stomach. It can be taken in powdered form in capsules or made into a gruel.
- Carry raisins, raw almonds, rice cakes or whole wheat crackers with you so you can keep your blood sugar level up.
- Blue green algae, such as spirulina, is very high in protein and very easy to digest. Spirulina powder can be mixed with mashed bananas or other fruit and provides excellent nutritional support. It can be taken in tablet form as well.
- Consult a midwife or homeopath if you find your morning sickness is not alleviated by the above remedies. Reasons for nausea can be many and varied and getting at the cause can give better direction to the remedy.
- New information is showing that morning sickness may be a nutritional deficiency. Lack of calcium alone causes over 180 diseases in modern man. Pregnancy draws calcium from all of your stores. Many common pregnancy problems like intense food cravings, high blood pressure, bleeding gums, muscle cramping, morning sickness, low blood sugar, chronic lower-back pain and other discomforts are caused by a lack of calcium, selenium, chromium, copper and the fifty other minerals that are just as important as vitamin supplements during pregnancy. Proper mineral nutritional support can include a liquid form of minerals known as colloidal minerals. These liquid minerals are over 98% absorbable by you and your baby.
- Gail J. Dahl, Childbirth Researcher, author of national bestselling "Pregnancy & Childbirth Tips," and executive director of The Canadian Childbirth Association. International Toll-Free Order Line 1-888-999-2080; www.pregnancytips.com.
Many excellent homeopathic remedies work for nausea. Ipecacuanha in a 200C potency is for persistent, constant nausea. Nothing relieves this woman; even vomiting does not make her feel better. As soon as she vomits she feels the need to vomit again. Nausea lasts all day and is worse from lying down. This remedy is for the most severe cases when the woman has to be hospitalized due to weight loss and dehydration. Give a single dose (2 pellets) before getting out of bed in the morning.
- Piper Martin, B.Ed., DS Hom.Med
5) Check It Out!
A Web Site Update for E-News Readers
NEW WATERBIRTH ARTICLES have been added to Midwifery Today's website! Go to these sites:
VISIT THE BIRTH MARKET! Search the Midwifery Today directory of products and services, including Find a Midwife and Find a Doula. www.midwiferytoday.com/birthmarket
MIDWIFERYTODAY INTERNATIONAL CONFERENCES: Join us around the world!
6) Midwifery Today's Online Forum
I would like to know alternative treatment to Trichomoniasis
in pregnancy. I would also like to hear any success stories,
complications or just any tidbit you might think would be
To share your thoughts and experience, go to Midwifery Today's bulletin board:
www.midwiferytoday.com/forums. Click on "Midwife
7) Question of the Week
I am interested in hearing about successful protocols for
lactation without pregnancy. Please describe the method
including duration or dose or other appropriate units.
Send your responses to firstname.lastname@example.org
8) Question of the Week Responses
Q: I am a student midwife and have a client who is a
Hepatitis B carrier. I am interested in hearing from other
providers who have been in similar situations, and what they
have done about being vaccinated or not for Hepatitis B. I
am concerned about not contracting it, but also concerned
about the risks/side effects of the vaccine. Any information
would be helpful.
A: Anyone who is involved in labour and delivery care who is
not Hep B immunised is a danger to themselves and their
- Phil Watters
A: The vaccine has been shown to be highly effective with
minimal side effects. I am a healthcare provider, pursuing
midwifery licensure. The risk of contracting Hepatitis B
while providing care for people/patients has far outweighed
the risk of side effects for me. My school-age children
received the three-part series last spring and experienced
no side effects.
A: Like you, I certainly do not want to contract Hep B. But
for me, the bigger issue would arise if I contracted it
without knowing it and then passed it on to my clients or
their babies. I would never forgive myself if that happened.
So yes, I am vaccinated, and I feel that any risk of doing
so is more than compensated for by my peace of mind. Same
with malpractice insurance--I do it for my clients, not
myself. If heaven forbid I should ever make a mistake that
means a mom or baby needs care that I cannot afford to pay
for, I want to make sure that there is a way they will get
the care they need.
- Cynthia Flynn, CNM, PhD
A few years ago I read a statistic that 600 healthcare
workers DIE annually of Hep B. This was several years after
routine vaccination of healthcare workers became the norm,
so perhaps the numbers were old, the vaccine isn't very
effective, or lots of workers chose not to be vaccinated.
Hep B is terribly contagious and although usually the
disease course is relatively innocuous (stomach flu-like),
it can become chronic (I think I remember it's something
like 20% of cases), which is where the mortality comes in,
with chronic liver disease and liver cancer.
I am not comfortable giving this vaccine to little babies or
young children, but I am glad to have received it myself,
since I am in a high-risk line of work. Even family members
of those considered at high risk of exposure are encouraged
to be vaccinated, again because it is so contagious and
lives a long time on surfaces. I mention this just to point
out that you are not the only one placed at risk due to your
potential for professional exposure.
Out of my nursing school class of ten, one of us developed
arthralgia for six months during and following the vaccine
series for Hep B. After the fact, she attributed this to the
vaccine. The joint pain interfered with her tennis-playing
during that time, but did resolve completely.
- Jennifer Seymour CNM
9) For Coming E-News Themes
1. FETAL HEART TONES: How would you explain to a student
midwife how to learn to listen to fetal heart tones?
2. PRENATAL CARE consists of everything a woman does for
herself during pregnancy, punctuated by a series of visits
with you," says midwife and author Anne Frye. Any comments?
**Take part in E-News! Sound Off-Give Advice-Share Your Knowledge!**
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Know a strong woman? Helping empower one? If you haven't already done so, please forward this issue of Midwifery Today E-News to one or two of your friends or business associates. Thanks so much!
I am currently 39 weeks pregnant with my first child. I have
had severe nausea and vomiting throughout my pregnancy and
from about four months on started taking Diclectin
(antihistamine and B6 tablet available in Canada). I was
vomiting from 10-30 times a day and had tried everything I
could think of or read about, from ginger tea to
chiropractic. I am a firm believer in trusting my body to
grow and birth my baby in the best way, but my life of
vomiting had gotten so miserable that I was desperate for
relief or a miscarriage. I have just recently tried to come
off the Diclectin again and am feeling gaggy and nauseous
Does anyone know why this happens? I can only believe that
there are toxins my body desperately wants to get rid of for
the baby's sake. Have I done my baby harm by taking the
Diclectin? Is it better to be on the pills and keeping down
nutritious food or not to be able to keep down food or drink
There are some very positive results from the vomiting
however, that I think are worth sharing: First, my stomach
and back muscles are stronger than they've ever been. My
midwife at times has difficulty telling how my baby is lying
due to the strength of these muscles and my massage
therapist says that he has never seen such strong back
muscles in a pregnant woman this far along. Also, during
massages I've noticed that my nose is no longer stuffy at
all. Apparently stuffiness is related to the release of
toxins into the blood after deep muscle manipulation. Any
International Conference on the Humanization of Childbirth
November 2nd, 3rd and 4th, 2000
Fortaleza, Ceara, Brazil
Throughout the 20th Century, advances in science and
technology have affected every aspect of our lives,
including the way we are born. In many parts of the world,
quick and arbitrary changes in maternity care have often
resulted in the excessive use of perinatal technology, a
loss of community-based models of care and an overcrowding
of large hospitals.
The International Conference on the Humanization of
Childbirth will take place in tropical Fortaleza, Ceara,
where Project Luz, a humanization project currently being
implemented, is based. The objective is to bring the
international community together in order to deepen our
understanding of the global situation of maternal and
perinatal health, thus strengthening the humanized approach
in the new millennium.
Goal: To promote humanized maternity care leading to healthy
Participants: Those interested in maternity care and
childbirth, including: midwives, nurses, obstetricians,
pediatricians, consumer groups, women's groups,
epidemiologists, social scientists, health administrators,
policy makers, journalists and pregnant women and their
families are invited.
For a complete listing of seminars, instructors, events,
cost, etc.: Secretariat Eventuall Promocoes & Assessoria,
Rua Dr. Gilberto Studart, 369, Papicu, CEP: 60190-750,
Fortaleza, Ceara, Brazil; tel. (55) (85) 265 4022; fax (55)
(85) 265 4009; e-mail: firstname.lastname@example.org; web site
More on Cytotec:
Cytotec is used in very small quantities--micrograms (mcg) and not 'mg' or milligrams as stated in the article published last week. The difference between micrograms and milligrams is one thousand fold.
- Lisa Betina Uncles, RN, student midwife
I have heard from several different sources in the last two months that Cytotec has been causing ruptured uteruses in unscarred women during early first and second trimester inductions for fetal demise. This may be because larger doses are used in these circumstances. Here are some comments I've heard:
- A mulitparous patient at 16 weeks gestational age received numerous intravaginal doses of misoprostil for termination of pregnancy due to fetal anomalies. She received about 600 micrograms every six hours, with a total of about six rounds of treatment. Her uterus ruptured, and she got a hysterectomy.
- We have had a case of a ruptured uterus using misoprostol for mid-trimester evacuation for FDIU (not yet published).
- Briefly, A 36 year old woman with one previous caesarean section and one vaginal delivery requested termination of pregnancy at eight weeks (gestation confirmed by ultrasound scan). She was given 800 microgram of misoprostol to prepare the cervix before surgical evacuation. After two and a half hours she had severe lower abdominal pain and profuse vaginal bleeding. Laparotomy found that the scar had ruptured with division of both the uterine arteries. A subtotal hysterectomy resulted.
- We have had at least four patients at our institution who were between 26 and 32 weeks pregnant, with intra-uterine deaths, who were induced with Cytotec and subsequently
suffered uterine rupture. I wonder whether there is any evidence that Cytotec could be the culprit?
- Phillips K., Berry c., Mathers AM., Uterine rupture during second trimester termination of pregnancy using mifepristone and a prostaglandin. Eur-J-Obstet-Gynecol-Reprod-Biol. 1996 Apr:65(2): 175-6.
- Thong KJ., Lynch P., Baird DT., Uterine rupture during therapeutic abortion in the second trimester using mifepristone and prostaglandin (letter; comment) Br-J-Obstet-Gynaecol. 1995 Oct; 102(10): 844-5.
- Norman JE., Uterine rupture during therapeutic abortion in the second trimester using mifepristone and prostaglandin. Br-J-Obstet-Gynaecol. 1995 Apr; 102(4): 332-3.
I have a feeling that there are a great many more ruptures that we are not hearing about.
- Angela Cross
I can't understand the sudden interest and desire to induce
that midwives seem to have developed! Whatever happened to
our strong belief in "mom's body knows best"? What has
happened in our belief that patience and nature's timing are
still the safest, best way? What is going to be the benefit
of having a baby at home if we give them "all the comforts
of the hospital." I thought one of the biggest reasons to
birth at home with a midwife is because parents believe we
are PROTECTORS of the healthy, natural, functions of birth
the way God planned it. They are trusting us to be
different, to be honest and to be protectors. If our client
couples are requesting induction, it is an excellent sign
that we midwives have NOT done our jobs throughout pregnancy
or that we have forgotten what our jobs are! If we let
parents talk us into unsafe, unhealthy procedures for the
sake of convenience, what makes us different than the
medical way? Why would anyone even in the hospital use
Cytotec, when there is so much information about it that
shows its dangers? Do midwives out there not know or are we
refusing to admit to the dangers of things like induction
and Cytotec? What is happening to us? Let's start sitting on
our hands and get back to watchful waiting while we protect
those who trust us! Let's get back to trusting a mom's body
to do its intended job, one it is very capable of doing
safely and joyfully.
It is becoming increasingly difficult to find midwives who
have not heard of or touched Cytotec. Consumers today have
to be very savvy in their interviews of midwives to
determine which ones practice true midwifery and are not
I offer myself as an example. I had read about midwifery
from "Open Season," "Gentle Birth Choices," "Immaculate
Deception II," "Spiritual Midwifery," and others. Imagine my
surprise when I ended up induced with Cytotec, alley-ooped,
fundal pressure applied and my baby "torqued" out, not to
mention the vacuum that was shown to me before labor even
begun. All this in the name of midwifery and natural
childbirth. Because I was attended by two homebirth
midwives, I thought all those things must be necessary. I
figured I must have been a rare case for all that to be used
at home. Sadly enough, I'm finding other women who have
experienced similar births.
What scares me most is the thought of more innocent women
being used as guinea pigs for the newest drug of choice in
childbirth. What saddens me more is the widespread use of
this newest drug in homebirths and free-standing birth
centers, places that are supposed to be havens of natural
I've been told stories of women who've had Cytotec inserted
unknowingly during "routine" exams. Women have been given
Cytotec orally under the guise of a homeopathic remedy.
Women have been told that this drug is "perfectly safe." All
this, from midwives.
It seems the paradigm of midwifery is beginning to shift so
that the lines between midwife and medwife are blurring. One
cannot lecture about normal, natural childbirth and stash a
supply of Cytotec nearby.
Let's stop bringing the field of obstetrics into midwifery.
If we continue on the same route we're going now, there will
be no need to go to medical school. People will be signing
up for midwifery school instead.
- Karen Putz
I'm eternally grateful for my "purist" training with
traditional midwives! Childbirth is not disease management,
something to be conquered with drugs. Midwives are guardians
of normal birth. We are highly skilled in the art of
prevention. If we forget, "First do no harm," we should no
longer be a part of this sacred process.
I appreciate your strong convictions against the use of
Cytotec in birth. There sure are a lot of non-dangerous but
highly effective alternatives that cannot be found with a
drug manufacturer's label on them. Let us keep studying
together, ladies and gents.
- Julia Swart
More on herbs:
Not all packagers of echinacea (purple cone flower) say it
shouldn't be take by pregnant women. This information was
not on the label when I purchased it, and the health store,
when asked if it was OK to be taken by a pregnant women,
found no evidence it was harmful. I bought it because my
daughter had a cold, and she did not want it to get worse,
so we tried it. Almost immediately, after she took only two
sips of that tea, she fainted. We thought it might be a
coincidence, that she was just over-tired in her 7th month.
Later in the afternoon she again fainted.
I have since studied more on echinacea, and it appears it
has a quality similar to penicillin. Are there allergy risks
of this herb or risks to those who are sensitive to penicillin?
The Association for Research on Mothering (ARM) seeks
submissions for its upcoming conferences and next journal
issue. ARM is committed to maternal scholarship from a
feminist, multicultural perspective.
Calls and deadlines:
- Journal of the Association for Research on Mothering Vol 3.1 on "Becoming a Mother" (spring/summer 2001). Deadline: Nov. 1, 2000. Mothering, Sex, and Sexuality Conference (March 3, 2001, York University, Toronto); Deadline: Sept. 15, 2000 (late submissions accepted up to Jan.1, 2001)
- Mothering: Power/Oppression Conference (July 7-8th, 2001, The University of Queensland, Brisbane, Queensland, Australia); Deadline: Jan. 15th, 2001
- Mothering, Literature, Popular Culture and the Arts Conference (October 12-14, 2001 York University, Toronto); Deadline: March 15, 2001. For information, please contact: ARM, 726 Atkinson, York University, 4700 Keele Street, Toronto, Ontario, Canada, M3J 1P3; Phone:(416)736-2100 x.60366; e-mail: email@example.com Website: www.yorku.ca/crm
I am a social sciences student entering my third year at Teesside Uni. I hope to study midwifery after it. I would like to do my dissertation on midwifery but I don't really have an idea for a question or research. Would any midwife out there like to suggest a research topic I could use to help midwives in the future?
- Claire Russell
(Editor's note: Readers, here is a great opportunity to give a future midwife a "hand up," and at the same time educate the public! Send your one-sentence ideas to E-News--we could have fun with this!)
I read with interest the comments from Nigel, a male midwife [Issue 2:37]. I wonder if there are any male midwives out there and how they have been received? Do traditional female midwives feel they are invading? I think it is great that a man would want to participate in birth in a more natural capacity!
- L.S. from Guam
My husband and I have received an offer to buy acreage in Maine. Can you tell me where to look for the status of midwives in that state? I believe it is one of the few states that allow direct entry midwifery. The farm is a three-mile walk to Canada. How can I find out about midwifery in that area?
- Leslie Siat
Reply to: firstname.lastname@example.orgMo
11) Classified Advertising
Southern Oregon Midwifery Conference, October 7 & 8.
Midwives, Doctors, Naturopaths. Featuring Anne Frye. Info:
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