Celebrating International Midwifery
This is a story of a 9-year-old boy who woke up on the Three Kings' night and got the most beautiful present he could imagine. He witnessed the birth of a baby, his nephew. He saw two strong women, brave, alone. He saw how the mother hugged her daughter and helped her grandson be born. No men were present, just women and two male children -- the newborn and the one who was watching through a crack in the door. The others were not aware of the boy's presence. Nobody saw him, but for the boy that was the best present ever. He saw something magical, secret, unforgettable, something that filled his eyes with awe and admiration. The boy turned away and went to bed, but he couldn't sleep. He thought it would be wonderful to have those feelings forever. He wanted to see babies being born. Time passed and life made that boy's wish become a reality.
This is my story, the reason I assist homebirths. When I assist homebirths, my eyes still keep that boy's look. I'm amazed and full of admiration in the presence of birth. When I assist at a birth, I'm not there as a man but as a human being with the innocence of a child.
- Jésus Sanz
I have fought to save the life of a newborn and lost. I have held a dead infant in my arms and sobbed over the loss of her life. I will never forget the feel of her silky hair or the sound of her mother's anguished cries as we handed her a tiny bundle. I have slid down a wall, pulled my knees to my chest, and wished I was dead.
I have fought to save the life of a newborn and won. I have forced air into tiny lungs, seen her skin turn pink and her limbs flex. I rejoiced to see her lower lip quiver as she gathered her strength to scream in protest. I wrapped her up and gave her to her mother, who reached out for her child, crying with relief. I have fallen to my knees in gratitude, knowing that this life easily could have been taken. I have seen only a fraction of the poverty and suffering that is endured here daily, and it wrecks me. I have felt God's heart for the poor and I know with all that is in me that the love he holds for them is strong, tangible and unwavering.
- Amy, student midwife
Strengthening midwifery for the future will require us to overcome our fears of professionalization. Without it, there would be no hospital-based midwifery care at all. If we want midwives to be available for our grandchildren and their children, we midwives will have to commit to high professional standards, to creating reliable mechanisms by which one can make a living at midwifery, and to being accountable to women for our practices. We will also have to accept responsibility to refer pregnant or laboring women to medical providers when we reach the limit of our expertise. Our goal should be autonomous practice regardless of setting. I would like to see a midwifery practice that is accountable to women and their needs rather than to corporate needs or to the requirements of other professions.
To those who believe gaining professional status means a necessary loss of autonomy, I would say the autonomy some homebirth midwives have now is extremely fragile in those states that have not yet legitimized the practice of direct-entry midwifery. Many midwives are still one fetal death away from discipline, not by their professional colleagues but by the criminal justice system. And when these midwives reach the end of their working years, there are not likely to be replacements for them unless we who are midwives now create the foundations for the future of midwifery. Individuals, regardless of talent and competence, cannot erect such foundations. It must be a cooperative effort.
- Ina May Gaskin
From the West we look to India for what our souls have lost. From here in the East there is a gaze toward the West for what glistens in the name of progress. The two worlds have offerings to make to one another, and from my vantage point of Southeast Asia I see the human spirit here being weakened in the exchange. With regard to childbirth, there are gains in the availability of emergency care, but the traditions around women's fertility and childbearing power are being highly threatened by the trend to give birth in a hospital setting...
There are 700,000 traditional healers and dais (midwives) in India. Seventy percent of the nation's babies are born at home, and the dai's work is a living tradition. Ironically, modern hospitals and public health clinics fully represent allopathic medicine. A precarious balance is being kept here between these paradigms of care. Women are being coerced and convinced by government advertising programs to leave the home and all that is traditional to give birth in environments that suggest safety and promise degradation. It is my feeling that we face a highly critical time here of losing a primal force -- an ancient way -- to a superficial, transient understanding of the birth process.
- Diane Smith
UNICEF began a small-scale program call Cultural Adaptation in Maternal Health. The program trained doctors and midwives to accept that mothers have fewer problems with delivery if they are at home, that the area must be warm and private, that most women prefer female providers and that most women want family members inside the delivery room. The project was able to help the Ministry of Health implement workshops to finally look at birth from the perspective of the mother.
Meanwhile, professional midwives were receptive to the idea of supervised birth, a practice that many midwives have used with great success. In a supervised birth, both the partera and obstetriz are present in the home or health center with the mother during delivery. In ideal circumstances in which there is sufficient trust between the two, the partera would actually attend the birth with the obstetriz present. Experience has shown that most obstetrices who work with parteras are informed early on of pregnant women in the community, thereby improving the chance for early and continued prenatal care. Parteras have much more respect and trust in the community and it behooves obstetrics to work with them. By the third year of the project, the number of reported maternal deaths was down dramatically.
- Ruth Madison
International Midwives Day is May 5
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Midwifery Today's Online Forums: Seeking a German Midwife
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Mothering celebrates the experience of parenthood as worthy of one's best efforts and fosters awareness of the immense importance and value of parenthood and family life in the development of the full human potential. As a readers' magazine, we recognize parents as the experts and wish to provide truly helpful information upon which parents can base informed choices.
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Question of the Week: Aromatherapy and Labor
Q: Will readers please share any tips/experiences for using aromatherapy during labor?
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Question of the Week Responses: Herbs for Hemorrhage
Q: What are your favorite herbs (and amounts) for postpartum hemorrhage? What has not worked? Have you ever felt that you could not keep a hemorrhage under control with herbs and bimanual compression until a mother could be transported to a hospital?
- Amy Kieffer, student midwife
A: The homeopathic remedies that respond to this problem are (almost) all herbs that have been potentized homeopathically and therefore work quickly and effectively. I prefer using homeopathic potencies because the results are immediate, and I don't have to wait for the absorption of the "material dose" to begin to work. Betty Idarius, a midwife and homeopath, wrote a wonderful book, The Homeopathic Childbirth Manual, with a good chapter on postpartum hemorrhage. Another good, modern resource is Sandra J. Perko's book, Homeopathy for the Modern Pregnant Woman and Her Infant. You must learn the general indications for each remedy when you're not in an emergency situation. The following list is only a quick review of the remedies most commonly used to treat hemorrhage.
- Arnica: when the delivery has been long and traumatic
- Aconitum: gushing or spurting of bright red blood; there is tremendous fear (of death) and anxiety
- Belladonna: bright red blood that may also have bright red clots (the blood coagulates quickly); the face may be flushed, pupils dilated; the bleeding may start suddenly and stop suddenly
- Carbo vegetabilis: the woman is worn out, weak; blood is dark, slow from uterine atony; skin is cold and pale although she wants to be fanned; unconscious or nearly so
- Caulophyllum: after long and difficult labor; uterine atony with slow and ineffective contractions; generalized weakness, trembling, nervous exhaustion
- China: hemorrhage from uterine atony leading to shock with buzzing in the ears, dizziness, cold sweat, fainting; the woman is pale, wants to be fanned; very sensitive to external stimulation
- Cimicifuga: contractions stop with hemorrhage; the woman is hysterical with the pains, nervous trembling, perhaps confused; mental and physical symptoms alternate
- Erigeron: profuse, bright red blood after the slightest motion; it begins suddenly and stops
- Hamamelis: in women with varicosites; the flow is dark, steady, slow; the woman shows no anxiety or concern about the hemorrhage; hammering headache; no uterine pains
- Ipecacuanha: persistent nausea with bright red, profuse hemorrhage; the blood gushes with every attempt to vomit, and there is no relief from vomiting; faintness and gasping for breath
- Kali carbonicum: hemorrhage with severe back pain that extends down over the butt into the legs
- Lachesis: the blood is dark, thin, copious; the woman feels better with the gush of blood; the woman is talkative, jumping from one subject to another; sensitive to touch, especially around throat or abdomen
- Millefolium: bright red, copious blood flow of thin, fluid blood that comes suddenly and painlessly; continuous flow; prolonged, obstinate bleeding after a hard labor
- Phosphorous: profuse, bright-red flow which may or may not have clots, especially in tall, slender women with a tendency to easy bleeding or bruising; unquenchable thirst for cold water
- Pulsatilla: in general for sweet, yielding women in whom the character of the hemorrhage is its changeability; hemorrhage alternates with pains; cries easily and is better from reassurance
- Sabina: active, gushing, bright red blood with clots, which may be dark colored; pain from the sacrum to the pubis; worse from the slightest movement, but strangely better by walking; intolerant of warm air
- Secale: passive, continuous trickling with uterine atony; blood is dark, perhaps fetid; there may be violent, irregular contractions or none; skin is cold to touch but the woman complains of burning up
- Sepia: strong bearing-down sensation as if uterus would be expelled from vagina; the woman is chilly, tired and not very attentive to the newborn (perhaps this was an unwanted pregnancy)
- Trillium: hemorrage may be active or passive in obese women with sense as if their hips and back were broken; faintness and dizziness; gushes of blood with least movement; history of hemorrhage
- Ustilago: uterine atony with passive, slow but continuous hemorrhage of dark blood with small clots; dark, clotted blood may form long, black strings; cervix is spongy; woman may weep easily
-Patricia Kay CNM, homeopath
A: We have had very good luck with strong shepherd's purse tea. Two quarts of water and 2 handfuls of shepherd's purse is boiled for about 5 min, left to steep until cool (or until we need it -- whichever comes first), then is strained. We give it to mom only in the case of moderate to severe portpartum bleeding and hemorrhage. It works most of the time.
A: When I apprenticed I learned that the first treatment for a hemorrhage is to say loudly and clearly "STOP BLEEDING." Most women are in an altered state of consciousness, and sometimes this strategy is enough to stop a hemorrhage. I have used it with success. If this treatment doesn't work I've seen black cohosh do the trick. Occasionally a full bladder can cause a woman to bleed, and simply emptying the bladder will work.
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In response to mom's size and ability to birth [Issue 4:17]:
Many years ago before the use of scans we trusted the body to give us information. I must admit I was shocked when I watched a 4'10" woman birth a baby who topped the scales at a very healthy 14 lbs. Admittedly it was her sixth, but she was also lying down. So please in this wonderful age of active birth, ask yourself how "YOU" feel about childbirth, trust your body, keep upright and be positive about your ability.
- Ann Mcleod Taylor
I am a 4'9" woman who gave birth 8 months ago to my first baby. I had a vaginal birth with the aide of my doula using hypnobirthing. I did not have any drugs or episiotomy (but I did tear). My labor was easy, and delivery was very quick. My baby was 8 lbs. 12 oz. and very healthy. I for one believe height has nothing to do with prolonging a vaginal birth. If anything, it quickens it because your birth canal should be shorter (by assumption, not medically speaking). I am a true believer in relaxation! The more relaxed you can be and just let your body do its thing, the easier it will be for your baby to birth and for you to give birth.
How do we think the human species survived all these centuries before the last few decades of medical care? Women in New Guinea and Latin American Indian tribes are most often under five feet, and they must be having babies -- their groups continue to exist! I personally have attended the births of two women under five feet. Both had very nice births, no different than anyone else. One of them has six children, the last five of which were born at home. I've also attended the births of numerous women in the five foot and just-over range; they did fine and so did their babies. I don't see height as a determining factor in birth. It is simply one contributing factor, along with dozens of others.
- DJ Graham
In response to Dr. Parke Hedges [Issue 4:16]:
If you are really looking for resources for collaborative practice for midwifery and medicine, have you checked the ACNM Web site (www.midwife.org)? If you are looking to label those who support and practice the midwives' model of care as extremists, I don't know if you want to collaborate or dominate. The collaborative practice model is one of mutual respect for the different practice styles, sort of a yin to yang. A good collaborative practice would increase your marketability. My father is an ob/gyn, now retired. I'm a CNM. When we practiced together with our hugely divergent practice styles, he said it's like Burger King -- you can have it your way!
- Sara Ferguson, CNM,
Kentucky ACNM chapter chair
In response to physicians doing more c-sections to get paid more [Issue 4:17]:
I know of an OB practice in Kentucky that got sued out of business -- and in the past three months of their practice their c-section rate went up over 50%!
If more obstetricians cared about the well being of women and not money, they would educate their patients about pregnancy and childbirth; they would practice preventative care and teach their patients about proper nutrition during pregnancy; they would teach their patients how to deal with labor through education and relaxation instead of giving them drugs; they would not count on electronic monitoring for assessment of labor, etc. The studies are out there for them to follow, yet they ignore them. Our maternal and infant mortality rates and the increase in low birth weight and premature birth rates certainly speak for themselves. Yes, doctors are practicing defensive medicine because they CHOOSE not to approach pregnancy and birth as a natural event, and they choose to do c-sections on women who do not need them, and yes, they are making more money for it. If doctors took a different approach to pregnancy and childbirth and truly educated women and practiced preventative medicine, they would not have the malpractice claims they do.
- Mandy Wyche Viator, natural childbirth educator, AAHCC
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The International School of Traditional Midwifery in Ashland, Oregon is accepting enrollment for 2002 classes that start in May. For information call 541-488-8273, or go to http://www.globalmidwives.org
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