February 6, 2002
Volume 4, Issue 6
Midwifery Today E-News
“Midwives' Autonomy”
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UPCOMING CONFERENCES

Guangzhou, Guangdong, CHINA, "Healthy Birth": June 7-9, 2002
http://www.midwiferytoday.com/Conferences/china/
Get the full program online:
http://www.midwiferytoday.com/Conferences/china/program.asp
The three-day conference will have components of Midwifery Today conferences as well as the presentation of several papers. Chinese doctors have been asked to arrange for midwives to be present as well as doctors, and it has been noted that we are interested in Chinese medicine. A hospital focused on the practice of Chinese medicine is located across the street from Shamin Island, where our venue is located.

The Hague, THE NETHERLANDS, "Revitalizing Midwifery": November 13-17, 2002
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A two-day midwifery education conference precedes three days of international conferencing.

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Send submissions, inquiries, and responses to newsletter items to mtensubmit@midwiferytoday.com

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In This Week's Issue:

1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Midwives' Autonomy
5) Check It Out!
6) Midwifery Today Online Forum: Fears
7) Question of the Week: Endometriosis
8) Question of the Week Responses: Cravings
9) Midwifery Today Question of the Quarter: Postpartum care
10) Switchboard

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1) Quote of the Week

"I think of midwifery as a seed full of potential - a seed that will grow into a lush, blossoming tree with green branches and plenty of ripe fruit for nurturing women, babies, and families."

- Marina Alzugaray

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2) The Art of Midwifery

I have had success with B vitamin supplementation for reducing swelling of hemorrhoids. Also, grated potatoes and slices of cucumbers placed directly on the hemorrhoid help reduce swelling. Exercise is important as well.

- Jennifer Crowley, CBE, doula, midwifery student

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3) News Flashes

Researchers studied Filipina women at about 30 weeks gestation and their 22,026 children, following them from their births in the early 1980s through adolescence. The study focused on blood pressure, an important marker of cardiovascular health. Results were controlled for adolescent age, height, and body mass index. Their diet, socioeconomic class, and activity levels were considered. The study revealed that maternal protein intake affected the level of blood pressure for boys: the higher the protein intake reported by the mothers, the lower their adolescent sons' systolic blood pressures. The blood pressures of the girls were affected not by protein, but by fat intake: the higher the mother's intake of calories from fat, the lower the diastolic and systolic blood pressures in their teenage daughters. The level of total caloric intake of the women did not have a significant effect on the adolescents' blood pressures.

- Circulation, 2001, 104:1034-39

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4) Midwives' Autonomy

We have been pulled into the profession of midwifery from so many different avenues, yet in our community of midwives we all recognize our profession is more than a course of study, more than a learned art, more than a medical practice. It is an honor and a privilege to sit by a laboring woman's side and often be the first hands that touch a new soul entering this mysterious wonder of life .... We have become mentally technical in our struggle to be recognized as a legitimate professional group. We have created three-year courses of midwifery studies - during which students may not be attending birth, where real learning occurs - to prove our competency. So now, in our eager quest for recognition, we become stupid in medical terms, hieroglyphics of the birth rites, legal status of the individual states.

We have legitimized ourselves. We have legalized a spiritual path, a calling. We have stepped into the arena of the medical establishment in our desire to serve women. Yet in the process we are creating a division among ourselves as sister midwives, disallowing and minimizing those midwives who refuse - for political, spiritual, or personal reasons - to fall in line with licensure. We have turned on our own. We verbally and politically discount any midwife who refuses to be counted. More and more states where midwifery legislation is being passed are excluding the unlicensed midwife. Instead, they are accepting only the certified professional midwife as the criterion, the only midwife who can facilitate births, use the term "midwife," and accept financial restitution for time and service.

Have we forgotten so easily that God/Goddess is behind, between, and in all aspects of life? That birth works? Have we lost our state of innocence, and in our desire to be recognized have we fallen from the garden of trust and do we now look toward the medical establishment for approval?

Are we beginning to replace our innocence with fear - fear of competition, fear of bad statistics, fear of loss of income, fear of sliding backward after so much hard work? Have we gone so far now as to approach legislatures in alegal states to create laws that will be more restrictive than those we have, laws that are to give us permission to practice a divine calling to which spirit has called us equally?

Why is our right to choose how we practice separating us from each other as midwives? We need all of us to weave the tapestry of the midwives' world. We must be available to all women everywhere. Let us be aware, as we professionalize ourselves, that many in our community of midwives are once again standing outside the law but stand firmly in the light of their consciences and in the light of those souls who choose them to attend their births.

- excerpted from "The Calling" by Miriam Medicine Prayer, Midwifery Today Issue 60

Go here to order this issue:
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5) Check It Out!

~~~WWW.MIDWIFERYTODAY.COM~~~
A Web Site Update for E-News Readers

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AUDIOTAPES FOR THIS ISSUE'S THEME
The Pursuit of Excellence: Autonomy is a Must
http://www.midwiferytoday.com/products/991T926.htm

Keeping Autonomous Midwifery Alive and Growing
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Autonomy in Midwifery: An Introduction (2-tape set)
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MIDWIFERY TODAY ISSUE 42: Several thought-provoking, action-inspiring articles about autonomy:
http://www.midwiferytoday.com/products/MT42.htm

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HAVING A BABY TODAY: Quarterly newsletter giving you positive information for staying healthy through pregnancy, birth, and postpartum.

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6) Midwifery Today's Online Forums

What are your biggest fears about being a midwife?

- Crystal

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TO SHARE YOUR THOUGHTS AND EXPERIENCE ON THIS TOPIC, go to
http://www.midwiferytoday.com/forums/topic.asp?TOPIC_ID=1547
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7) Question of the Week

Q: Would readers please share their experience and information about endometriosis and pregnancy/labour? Our pregnant client has quite severe endometriosis, with nonpregnant symptoms of frequent nausea, very painful cramping premenstrually and during menstruation, heavy bleeding, and bleeding from the rectum.

- Anon.

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SEND YOUR RESPONSE to mtensubmit@midwiferytoday.com with "Question of the Week" in the subject line.

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8) Question of the Week Responses

Q: A woman who is about 25 weeks along is experiencing almost overwhelming cravings for soap. She says the cravings have increased with each pregnancy. Her labs are all fine - no evidence of anemia. Suggestions?

- Anne Walters CNM

A: I had this in my first pregnancy. A local granny claimed she recognised it and she made me a "spring soup" using many bitter fresh leafy greens. She suggested I eat lots of the bitter greens in salads. Soap is bitter. Greens that have high amounts of many wonderful things like folate are bitter too. I would suggest trying any safe-to-eat green that is also bitter such as endive, the strong outer leaves of romaine lettuce, parsley, beet tops, spinach and fresh herbs if you can't find a granny to make "spring soup." I never had the cravings for soap in my subsequent pregnancies but I couldn't get enough spinach and endive salads.

- Natalie Bjorklund

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A: Soap tends to be alkaline so I wonder if maybe she is experiencing some slight ketosis. Another possibility is some sort of parasite that has not been cleared out of the gut. I would be cautious about trying to remove parasites during pregnancy as any medication or herbs will most likely be cold and tend to move the energy downward - the opposite of what holds the pregnancy. Try adding more alkaline-forming foods into her diet and reducing the acidic ones.

- Colleen

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A: My guess would be the relationship between soap cravings and diet would have something to do with fat content. Soap has fat in it to create an emulsion. She may be lacking adequate amounts of dietary fat and this may account for the cravings.

- Anon.

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9) Question of the Quarter for Midwifery Today Issue 62

Q: Tell of a birth situation where the woman/couple were able to get in touch with the sexual aspect of birth. How did this enrich the
experience?

Responses are subject to editing for style, space and content. Maximum word count 400. If we print your response, you'll receive a free issue.

Please submit responses by March 31, 2002, to editorial@midwiferytoday.com. Include your postal address.

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10) Switchboard

We have tried everything we know how to do to raise money for the BirthLove website, but for the most part our efforts have been met with silence. Now, we are facing our Internet service being cut off. If my work has been of value to you - my writing, putting up stories, generating activism, supporting women and babies around the world, my experiences and sharing, and if my husband Bill's work has been of value to you - his creation of the site itself, buying and maintaining all the computers and servers, creating the forums, running the site year in and out - please donate $5 or $10 to the website. We have a PayPal account.

We really need people who love the site to give back to it or there simply won't be a site anymore - not in the way it exists now. It needs to be run by us, on our own servers for it to be the strength that it is - all 800+ pages.

I must keep my work alive and keep women and babies around the world safe from needless harm in their births. Please forward this to anyone who you think cares about safe, gentle birth.

- Leilah McCracken, www.birthlove.com

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I am a determined supporter of Gloria Lemay. I find it dismaying to the extreme that registered BC midwives would so grossly misunderstand what her practice means to women who do not desire the presence of a registered midwife at their births. I have not found Ms. Lemay to be a "healthcare professional" in the sense used in your responses. I believe that she is a birth attendant whose first and foremost desire is to follow the wishes of the client and assist her as she births. She brings no belief that birth must be managed or that it is an illness of any kind. With this in mind, clients are well informed as to their choices, and this includes the use of Vitamin K or any other substance. Both of the responses [Issue 4:5] seem to indicate that if Ms. Lemay's clients were informed they would, of course, choose Vit K for their infants. This is far from the truth. And this is exactly the kind of belief system that drives birthing women away from registered midwives. Well-informed women choose to birth in a safe atmosphere, one in which they are safe not only from management by a health professional but one in which their choices are clearly respected. The midwife who presupposes that a client who chooses not to give Vitamin K to her infant is ignorant of the facts is exactly the midwife I do not want near me as I birth. So to whom do I go? In BC there seems to be only the way legislated by the government with no room for my personal, informed choice.

I am spending more and more time with women who have birthed with registered midwives and for subsequent births seek an alternative. Their choice is based not on a dislike of registered midwives, but simply on the realization that registered midwifery has not provided the care they desired. Many of these women, in the absence of a traditional birth attendant, are choosing unassisted birth instead - a glorious choice for some, being forced into a corner for others. It is sad indeed that the BC College of Midwives is working so hard to eliminate choice of attendant for women like these. It is a shame that the very institution and its members who proposed to provide gentle, respectful care to birthing women should so quickly decide that only they are capable of providing it whether the birthing family agrees or not. There was a time when we all were united in working with families for joyful birth. It appears that time has passed.

- Mary-Tim Hare

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It concerns me that some BC midwives are questioning if Gloria Lemay is, indeed, "offering informed decision-making to her clients." I'm quite certain she is. I would imagine that women who choose Ms. Lemay do a lot of decision-making before they even become pregnant. As we all know, there is huge variety regarding what women desire from a caregiver. There are many wise, educated women who choose to believe that whichever course nature takes is the right one; they accept the challenges and conceive, grow, deliver, and raise their children on their own, in their way, finding guided support and professional assistance where and when they need it. These kinds of women need to have the option of being attended by women like Gloria Lemay. This is the real issue. If women are choosing to be cared for by Gloria, then Gloria's services are wonderful and necessary.

- Searching for someone like her in Ontario

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My 34-1/2 year old sister just had her fifth miscarriage. She miscarries about six weeks into pregnancy. We suspect trisomy, and this was identified in one of the previous pregnancies. She has no apparent uterine abnormalities, no infections, and lab work indicates she is not allergic to her husband's sperm, has good mucus, etc. She has an autoimmune disorder called ITP but it is not implicated in the miscarriages. ITP women carry babies to term and are often healthier during their pregnancies. Her doctor just told her to try again in two months. Is two months really an optimum recovery period? In the past two and half years, my sister has been pregnant, is miscarrying, or trying to conceive.

Does this deplete women? How can she optimize her chances of conceiving a healthy baby and carrying it to term?

- Anon.

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Re vaginismus [Issue 4:5]: Yes women with vaginismus can have a vaginal birth. These women just have trouble accepting things going into them. During birth the traffic is going the other direction. It is important to stay off vaginal exams as much as possible, preferably all together. One can observe progress quite well usually by just watching the woman's behaviour, the labouring positions, she engages in, frequency and strength of the contractions, foetal heart tones, colour of the amniotic fluid, maybe abdominal palpation, amount of blood loss, and bulging of the anal sphincter at the final stage. When the pushing stage is started in the standing position the woman may take up a variety of positions after that, acting on her instincts. Here in The Netherlands we refer our client to the gynaecologist if the active pushing stage is expected to take longer than 2 hours. One can have a good idea of progress after 1 to 1-1/4 hour of pushing in the presence of good contractions.

- Gre Keijzer, certified midwife

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Does anyone have written information that will support the premise that preemie twins should be kept together for the duration of their hospital stay? I know I read an article a while back to support the fact that the weaker of the twins is more likely to thrive and survive if the sibling twin is kept close and not sent home before both twins can be released together.

- Jeanne Engle, director, Imagery Birthing Center

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Has anyone an article to recommend about not bathing babies considering that the baby needs to build up his/her normal bacteria ground, thus preventing infections and perhaps allergies later?

- Diane Sjogren, midwife
Sweden

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I have learned that kidney stones are not a result of too much calcium in the diet. They are formed when the body is getting too little calcium in the diet and therefore begins to break down bones and other structures in the body to obtain the calcium it needs for nutritional use. This breakdown of the body's store of calcium is what forms kidney stones. To avoid kidney stones, one must increase calcium intake.

- Jennifer Weed
Indianapolis, IN

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CORRECTION: Notes about turning posterior babies [Issue 4:5] should have included, "One hospital reduced its epidural rate from 80% to 12%" not "by 80%".

- Amy Haas

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EDITOR'S NOTE: Only letters sent to the E-News official email address, mtensubmit@midwiferytoday.com, will be considered for inclusion. Letters sent to ANY OTHER email addresses will not be considered.

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