May 30, 2001
Volume 3, Issue 22
Midwifery Today E-News
“Omnium Gatherum”
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THIS WEEK'S ISSUE

Contents:

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OB STARE

Why OB STARE? In Latin, it means "to be by the side." We are beside the mother, the father, and of course beside the baby. OB STARE is a magazine about Motherhood and Childhood. It is aimed at midwives, parents and institutions. All ideas are welcome. OB STARE is a Spanish language journal.

Quote of the Week:

"A sort of chemical 'combination lock' starts labor. Everything has to be lined up just right to 'unlock' a good labor pattern. When we interfere with that, it can be as frustrating as using the wrong combination of numbers to open a locked safe."

- Gail Hart


The Art of Midwifery

I have seen wonderful results with using oil of oregano for yeast infections--no harmful drug effects on the liver that may result from using Diflucan, no stains like those that result from using gentian violet, and no gassy babies from using Nystatin. Most moms use it internally and externally and most report that within a day nipple soreness is gone. Use about two drops under the tongue three times a day. Mix two drops in a tablespoon of olive oil to rub on baby's feet and directly on nipples after feeds. It can be applied with a swab to spots of yeast in the baby's mouth. Refer to the book "The Cure is in the Cupboard" for more uses.

- PJ Jacobsen, BCLC, CD, aspiring midwife
Bothell, WA

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Midwifery Today Magazine

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News Flashes

Factors of ectopic pregnancy: 1) Fallopian tube or damage to cilia compromises their function. 2) Pregnancy after sterilization: if the tube is not completely ligated, sperm may be able to pass through. The fertilized ovum is much larger and cannot pass back through to the uterus. 3) Intrauterine contraceptive devices: when the device makes the uterus hostile to the fertilized ovum, the ovum may instead implant in the fallopian tube. 4) Progestin-only pill, which works by slowing down the wafting activity of the cilia that ordinarily move the egg to the uterus. 5) Infertility treatments.

- Nursing Times, Vol. 6 No. 17


WITH THE GOAL OF BIRTH RENAISSANCE IN MIND, Midwifery Today brings you our newest baby: the International Alliance of Midwives (IAM). IAM is an online directory of birth activists from around the world who network with each other. All practitioners and activists interested in birth change and international midwifery are welcome to join. Click here for more information.

Food for Thought

Mr. Jack Petch
Chairperson of the Board of Directors
St Michael's Hospital
30 Bond Street
Toronto, ON M2B 1W8

Dear Mr. Petch,

The Infant Feeding Action Coalition (INFACT) Canada wishes to bring to your attention a matter concerning research and conflict of interest relating to a press release issued on April 3, 2001 from St. Michael's Hospital. The press release entitled: Researchers find peanut allergens can pass into breastmilk, reported in a study conducted at St. Michael's by Dr. Peter Vadas published in the Journal of the American Medical Association. [See E-News Issue 3:15]

Of major concern is the fact that the press release did not declare the competing interests of the financial sponsors of this research. On reading the original study, published in JAMA, one notes that a funder of the study is Nestle Canada. Nestle is the world's biggest manufacturer and distributor of infant formulas and a major violator of the World Health Organization International Code of Marketing of Breastmilk Substitutes both in Canada and internationally. The World Health Organization and UNICEF estimate that one and a half million babies die every year because they were not breastfed.

Although the research, which tested the milk of 23 lactating women who consumed a half cup of peanuts after a fast, found that only 11 showed peanut protein spillage into the breastmilk and that the peanut proteins cleared from the breastmilk after only a few hours, the implication of the press release was that breastfeeding can sensitize children to peanut allergies. There is no evidence in Dr.Vadas' research to support such an association, yet this is how it was suggested to the media. In fact there is much research to show that breastfed infants and children suffer less from allergies, asthma and atopic eczema because of the vast array of complex and interrelating immunological substances found in breastmilk.

Additionally there was no mention in the press release that infant formulas are manufactured with peanut ingredients and therefore might be a cause of rising peanut allergies in the general population. Yet this research found its way to the front pages of both national newspapers.

In future, in the interest of optimal health for infants, children and their mothers, we request that St Michael's institutes research policies in the area of infant and young child nutrition that require funding sources to be independent of competing interests as obligated by the World Health Organization's International Code and subsequent resolutions of the World Health Assembly. I look forward to your response on this important matter.

- Elisabeth Sterken, nutritionist
National Director INFACT Canada/IBFAN North America

[Editor's note: Thanks to E-News reader Lisa Caron for submitting the above letter. E-News readers are always encouraged to bring to light information such as the above, especially if the information in question has been published in an E-News issue.]


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Question of the Week

Q: I am going to give birth for the second time in just a few weeks. I've suffered from hemorrhoids since my first baby's birth when I used that eye-popping Valsalva pushing. I won't do that again! I want to keep the hemorrhoids from being such a distraction during my labor. Any good ideas, treatments, positions? Would laboring in water help? I love the squatting position but it doesn't work well during pregnancy when the hemorrhoids are swollen. I'd appreciate any advice.

- Anon.

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DONA (Doulas of North America) 7th International Conference
July 26th-29th

Milwaukee, Wisconsin, Four Points Sheraton. Early-Bird Registration by June 9th. Also offered;DoulaTraining, Doula Teacher Training, and Pre-Conference Seminar-Bereavement and the Doula. Speakers include Phillip Hall, Katherine Shister Harrod, Barbara Harper, John Kennell, Marshall Klaus, Phyllis Klaus, Jack Newman, Penny Simkin, Leona Van deVusse. Friday night on the town.

Register on our website www.dona.org


Question of the Week Responses

Q: One of my women is suffering from acute glomerulonephritis. She is dumping large amounts of protein; as yet, hypertension hasn't developed. I wanted to help her prevent it and suggested taking calcium, magnesium, and potassium supplements, but then thinking it over, I decided that it was bad advice because of the kidney damage. Does anyone have advice?

- Jordana

A: I have assisted a mother with kidney disease through two homebirths. After the first I insisted she have an evaluation by a kidney specialist. The specialist was amazed that she did not have severe toxemia due to kidney problems. The two best things we did were to have her drink plenty of fluids and also take Renatrophin PMG from Standard Process Labs. We kept her protein intake high even though protein is hard on the kidneys.

- Judy

A: What does her diet look like? If she is a vegan or mostly vegan she may not be getting enough protein! Make sure she is getting 80-100 g per day. You can contact Tom Brewer, MD via Kalico.net and he may be able to help you. It is worth a shot and I have his personal number if you need it. His life's work has centered around women who are pregnant and have toxemia. If she is early toxemic or borderline, this diet may turn her around in as little as 2 weeks but she MUST eat the recommended 80-100 g protein/day. It sounds simple, but it is the truth. My clients who ate less than 80 g per day all ended up with borderline toxemia and/or horrible birth outcomes (medicated, forceps, vacuum, c-secs).

- Jill McDanal
Birthmama@att.net


Question of the Quarter for Midwifery Today Magazine

Theme for Issue No. 59: Prenatal

Question(s) of the Quarter: What are the essential elements of good prenatal care? How does prenatal care create better birth? As a midwife/doula, what do you hope to accomplish in the prenatal period with a pregnant woman?

Please submit your response by June 30, 2001 to editorial@midwiferytoday.com


In Celebration of Doulas

I have attended two births--one resulted in a c-section and the other in a vaginal birth. In retrospect it seems I am both at the beginning of a long journey with birth work and am also immersed and knowledgeable. Being with a laboring woman resonates within me. To comfort and laugh and sit by the side of a woman is so ancient.
My mind is not on the essential oil or the rolling pin, although I would reach for whatever tool "felt" right. As grounded as I am, while at a birth I don't think in the ways I usually do. I'm on standby, and my intuition is humming and swimming on that wave.
Being a doula is being fully a woman and becoming a woman in the presence of another who is in a primal place. Mythically she goes to the other side of the veil, glimpsing its wonders and its unimaginable dimensions and bringing back life--renewed, fierce, resolute, confident and triumphant. As a doula I get to witness and celebrate this passage each time. My legs are firmly in this world with my hand in hers as she ventures into the other, and sometimes I guide her on her return with her treasure to this one. What an honor.

- Heather Morrison

Every woman is entitled to a safe and memorable birth experience. I also believe that young women with low incomes who are potentially at higher risk in pregnancy need the support of women in their community. Because my children are little and I can't be on call for numerous clients, I find great comfort volunteering as a doula for women in the Healthy Moms Healthy Babies program in Canmore, Alberta. There's no doubt that the extra care these women receive reduces the risk of postpartum depression. One of my main goals as a doula is to ensure that women are treated with integrity and respect while they give birth in the hospital setting. I see the work of doulas as an excellent way to alleviate stress for mothers to be.

- Julia Lynx
Canmore, AB, Canada

Interested in becoming a doula? Check out the Doula Audio Tape Packages and learn from the greats like Penny Simkin and Sara Wickham!


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Switchboard

International Connections

~*~*~*~*

I am coordinating a doula service at the International College of Spiritual Midwifery in Melbourne, Australia. Our philosophy is to provide a continuum of care prior to labour, during labour and postnatally. Our support is emotional, physical and informational; we do not provide clinical care. Our qualities are compassion, patience and an ability to be totally present with the woman giving birth. I would love to hear from other doulas in Australia.

- Sunderai Felich
Reply to: ssmfelic@web.solutions.net.au

We are two student midwives in our final year at Bournemouth University in England. As part of our training we would like to experience midwifery in a culture different to our own. The trip will be self-funded and for a period of about two weeks in August or September 2001. We would be grateful for suggestions of where we could go.

- Melanie and Lisa

I am moving to Turkey soon and have no clue on what to do about a midwife. I will be five months pregnant when I get there and I will be on an Air Force Base. I do not want to do a hospital birth again. Does anybody know a midwife or any information I could get about one who practices in Turkey or one who would like to go to Turkey?

- Brianna Ybarra
Reply to: jlybarra@earthlink.net

INTERNATIONAL MIDWIVES, please direct your questions, comments, and needs to "International Connections." We're here to help you!

To make more "International Connections" join IAM (International Alliance of Midwives)! All birth enthusiasts are encouraged to join. IAM is an online directory.

~*~*~*~*

In response to the Switchboard comment on a prolonged labor that was induced with castor oil at 42+ weeks [Issue 3:21]: I have seen a lot of labors that were artificially induced via so-called natural agents result in the same kind of lack of progress as well as regression during labor. In my 10 or so odd years in the midwifery community I have been stumped by how we midwives are willing to use means we call "natural" to artificially bring on a labor. Many times I have seen the exact same scenario with contractions, progression, then nothing. The body is not ready for labor. The feedback loop is not naturally present. We see this happen with Pitocin all the time.

My husband is an obstetrician and when we reviewed ACOG (American College of Obstetrics and Gynecology) standards for what is truly considered a post-term pregnancy, we found 42 completed weeks (first day of the 43rd week) is considered post-term. This is when the risk of continuing the pregnancy is markedly increased. I feel that midwives' responsibility is to encourage women to allow their bodies to go into labor on their own.

- Anya Wait
Madison, WI

In response to questions about using herbs to support healthy pregnancies and labor [Issue 3:20 and 21]: I have a viewpoint I hope is helpful. I am a homeopath and resting midwife. In homeopathy, a substance is "proven" by giving minute doses to a healthy person to see what effects the substance has on the person's physical, mental and emotional states. These symptoms become part of a catalog (called a materia medica) that tells us about the actions of herbs, minerals, animals in the human realm. Since homeopathy is based on the premise that "likes cure likes," a remedy prepared from these substances is given to a person who has the same symptoms that they provoke in a healthy person. For example, we all know the effect of chopping an onion: our eyes water and burn and our noses can run with a watery discharge; we may even sneeze. So if a person has a cold in which these are the predominant symptoms, i.e., burning eyes with a lot of watering and runny nose and sneezing, and this person takes Allium cepa (onion) in homeopathic potency, the remedy will somehow push the body into healing faster and alleviate or "cancel out" the symptoms.

When an herb is taken over and over, we can cause a homeopathic "proving" if the person doesn't really need the herb. In other words, we provoke the symptoms in a healthy person that the same herb will help cure in a person who has a weakness that could benefit by the support of the herb's properties. So, if a woman with a "weak" uterus, prone to reactivity and premature contractions, takes raspberry leaf tea to strengthen and tone the uterus, this is very appropriate. However, if a healthy woman with a strong uterus takes the tea over and over, she could provoke the symptoms she is trying to avoid. Her body is telling her she doesn't need the tea. So, in deciding whether to give (or take) a substance, it is wise to listen to the body and give it what it needs instead of using a blanket formula. All women don't benefit from raspberry leaf tea (or peppermint or nutmeg, etc.) just because they are pregnant, and some benefit greatly.

- Patricia Kay, CPM, Olympia, WA

I am noticing a number of newborns having seizures and cardiac arrest before they even get home from the hospital. While I suspect there is a correlation to the high-tech birthing process, I don't know where to get the information to support it. Can you help?

- Rochelle

More on suturing/not suturing [Issue 3:21]:

No rule is true forever for all places and in all conditions. Sometimes rarely suturing gives horrible results too.

- Anon.

I believe a healthy blood flow through the area is essential for optimal healing and sutures do interfere with healthy tissue development. However, most mothers are unable to keep as still as is required for the healing of anything more serious than a first-degree tear. Staying off the area is also not always possible as it makes latching baby to the breast difficult. I have chosen to align the skin and apply surgical super glue in a crisscross pattern to hold tissues in place so they are allowed to heal quickly and blood flow is not affected. The glue may be reapplied if necessary. This, along with pelvic floor exercise, is a fail-safe method for treating tears less than fourth degree.

- Anon.

In reply to the question about bathing/not bathing baby soon after birth:

It is my understanding that the smell and taste of amniotic fluid on the baby's body and hands helps the baby find its own way from mother's belly to mother's breast and to latch and begin nursing, if baby is placed there after a little drying and covered with a warm blanket. I forget the authors of the study (but Kennell and Klaus undoubtedly reference it) who showed that if you washed a baby's hands before placing him/her on mom's belly he/she had more difficulty locating and reaching the breast. I wouldn't be at all surprised if the reverse is also true in some way: that the smell of the unwashed baby stimulates oxytocin and/or prolactin production in the mother, assisting both in breastfeeding and bonding.

I think the general theme of not bathing the baby for a while has to do with our more recent understanding that nature has an exquisitely designed program for moms and babies to get to know each other and for babies to adjust to life outside the womb. The less we interfere with this design the better for all concerned. A year or so ago there was a lengthy discussion on a doula list about the first bath, and many women who posted were enthusing with passion about the smell of their unwashed newborns' heads.

A final justification for not bathing a baby soon after birth is that in many hospitals such procedures are performed by nursing staff rather than parents, and the current thinking is that (both for health and bonding's sake) it is more beneficial for the family if the parents do as much as possible or all of the handling of the newborn in the first day or two to help baby adjust to the world and attach to its parents, and because the more the baby is cared for by hospital "professionals" the less confidence new parents have in their own skills.

- Claire Winstone, pre- and perinatal psychology educator

While I don't think there's any particular guideline prevailing in my area, there may be good reasons to delay a first bath. My first baby, born at home, who had mild asymmetric IUGR and very red skin (a marker for blood sugar problems, I've since learned) really screamed through his first bath (12 hours after birth) despite a very warm room. He experienced a blood sugar crash right after. His blood sugar became very volatile and he wound up spending 10 days in an NICU. When my second was born I delayed his bath a full 36 hours with the support of our midwife, and while he also had "off" blood sugar levels in the first 48 hours, he did much better than my first. My midwife also recommended a deep-immersion bath with him (baby and mom in the bath skin-to-skin, with the baby in up to his neck).

- Nora

I am a 22-year-old aspiring midwife who after trying different jobs, considering different careers, and going in and out of college sees very clearly that midwifery is my calling. My concern is that I won't be taken seriously because I haven't had any children and don't really think I will have any. I am happy with this decision because it would let me be free to throw myself into being a midwife. Do you think I would still be taken seriously as a midwife even though I have not given birth?

- Andrea
Sacramento, CA

In reply to teen mom/adoption [Issue 3:21]:

I don't know if her book is available in the US but Mavis Kirkham (professor of midwifery at the University of Sheffield, United Kingdom) has edited an excellent book called The Midwife-Mother Relationship. She makes reference in her own chapter "How Can We Relate" to personal experiences, one including dealing with a young single mother who was giving her baby up for adoption. This book is excellent and I would recommend it to anyone working with pregnant women. It contains several chapters, written by different authors, that look at the various relationship issues with pregnant/ birthing women, including midwives without children, homebirth, three-way relationships with midwives working through interpreters and being with woman who are economically without. Well worth a read!

- Anon.

I was adopted at 6 weeks old, and all I know of my mother is that she was a teenager and could not keep me. If anyone is blessed to attend the birth of a lady who knows she's going to immediately give her child to someone else to love and raise, let her know how *truly* brave, strong, giving and loving she is. Support her and remind her of the beautiful gift she is giving, and help her recognize what gifts of strength she might receive.

- Gail

As a doula I've worked with women who wanted to let their babies be adopted. Because she is having a hospital birth, I would contact social services at the hospital; they will be able to refer her for counseling and give her reading material, legal information, etc. You may also need to make sure the hospital staff understand her wishes. I had one troubling case in which a client (untreated schizophrenic really not capable of coping with a child) had decided to let her baby be adopted, and a nurse--without looking at the chart--tried to browbeat her into keeping the baby.

- Sharon DeJoy, doula


Connections

Looking for a Labor Doula in Atlanta GA, who is trying to get certified and would consider helping me for a minimal fee. This is my first child - DD: July 7, 2001.
Please contact Phyllis @ 770-457-9455 OR email pmaslia@intermedia.com


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