September 17, 2003
Volume 5, Issue 19
Midwifery Today E-News
“Global Midwifery”
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Send submissions, inquiries, and responses to newsletter items to: mtensubmit@midwiferytoday.com.


ALL BIRTH PRACTITIONERS: The techniques you've perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to mtensubmit@midwiferytoday.com.

In This Week’s Issue:


Quote of the Week

"Having seen everything that can go wrong at least a few times doesn't shake my confidence in the essential beauty and miracle of birth."

Maggie Ramsey


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The Art of Midwifery

A postpartum hemorrhage (PPH) can be most frightening, but can be avoided for following pregnancies. Blue cohosh and capsicum, taken together daily, can help strengthen the uterus. I also use another treatment, what I call a "Bloody Shame": Cut into small pieces 2 oz. raw liver, preferably calf's liver, place in a blender with 6 oz. of tomato or V8 juice. Add juice of 1/2 lemon and dash of Worcestershire sauce or steak sauce. Have the mom drink this twice weekly. It is a natural blood builder, it replenishes nutrients lost in a PPH, and it is a natural blood transfusion through the intestines. If the thought of raw liver is abhorrent, another blood builder—not as effective, but an acceptable substitute—is 4 oz. pure grape juice, 4 oz. coconut milk. Mix together and drink three times per week.

I know this works! For example, four other midwives and I were present at a birth as observer when the birth mother went into PPH. Her blood pressure (BP) dropped to 60/40. She refused an IV because it was against her religious belief. I ran into the kitchen and made up a Bloody Shame. She drank it, and ten minutes later her BP was 115/70. We gave her another Bloody Shame an hour later and one a day during the next week. She recuperated swiftly.

Joan Dolan, Midwifery Today Forums


Editor's Note: It's always wise to be careful when eating raw meat which may cause illness.


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News Flashes

Designer Drug

Rat pups that had been exposed to MDMA (3,4-methylenedioxymethamphetamine, commonly called Ecstasy) in the womb in a time frame analogous to the first trimester of human pregnancy showed significant brain chemistry changes compared with control animals. During the Rush Presbyterian-St. Luke's Medical Center in Chicago study, eight pregnant rats were injected twice daily with MDMA from day 14 through day 20 of pregnancy, and saline was injected twice daily during the same period in a control group of eight pregnant rats. The drug-exposed rat pups' brain tissue was examined when they were 21 days old "an age roughly equivalent to a 2- to 6-year-old human child. The MDMA group had a 502% increase in the number of dopamine neuron fibers in the frontal cortex and a small decrease in dopamine metabolism in some brain structures. Dopamine transmits messages between nerve cells and helps determine various motivated behaviors, and the frontal cortex has to do with planning, impulse control, and attention. The rats also showed a reduction in serotonin metabolism. Male, but not female, pups showed reductions in dopamine and serotonin metabolism in the nucleus accumbens, suggesting gender-based differences in vulnerability to fetal exposure. The rat pups also exhibited behavioral changes.

Journal of Neurotoxicology and Teratology, August 29, 2003


Midwifery Survival Guide

A group of us on the midwivestrial yahoogroups list are creating a legal manual for midwives to be titled: "From Calling to Courtroom: A Midwifery Survival Guide." Because we believe this information is so important for every midwife, this book will be available for FREE online upon its completion, and at cost for those who wish a hard copy. The outline of the book looks like this:

  1. Why you aren't safe!
  2. Preparing Ahead of Time: What you Need to Know and Do
  3. Understanding the Legal System
  4. Finding and Working with a Lawyer
  5. After the Dust Settles

Once completed, this project will find its home on the MANA website, as well as the Birthwithlove site. Please consider contributing to its success in the following ways:

  1. We still need input from persecuted/prosecuted midwives. What do you wish you had known? What do you wish you had done? What would you do differently? Your experience can be of tremendous help to midwives who are may be prosecuted in the future.
  2. We are in GREAT NEED of people who can help compile a resource list! This need not take a lot of your time, but please put your internet skills to work to help track down and verify the resources needed by persecuted/prosecuted midwives!

If you are able to contribute in any way, please let us know!

Valerie, filerook@aol.com


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Global Midwifery

Editor's Note: Midwifery Today supports the strengthening of midwifery and goodbirth around the world. From time to time, E-News likes to remind its readers about sister/brother practitioners and mothers working and birthing in other cultures. Here are some excerpts to give you a sense of our connectedness and responsibility for each other.

Nigeria: I became a midwife after an eight-year apprenticeship in the 1960s with my grandmother, a renowned traditional midwife in our community, Edo. In the early days of my midwifery training, my grandmother had me collect certain herbs from the nearby bush that I would prepare on her instruction for the pregnant women to bathe with or drink.

I started an organization, GBECN, to help couples have the best possible transition into parenthood by providing a qualitative birth education and information that will enable them to make informed choices about their babies and place of birth. GBECN also promotes waterbirth. My experience at Yoseftal Hospital in Israel showed me the positive effects waterbirth had on women such as reducing labour pain and lowering high blood pressure. Currently we have two waterbirth pools in Benin City, "the first of their kind in Nigeria."

We encourage couples to attend birth classes and we make necessary arrangements for midwives and nurses to attend births at hospital and homes. GBECN has successfully encouraged lots of people to discover the joy and satisfaction of a gentle birth followed by gentle parenting. Our centre was founded to show people what happens when homebirth is considered the standard of normal birth and midwifery care is the standard of care for birthing women. We encourage the training of traditional midwives and birth supporters.

—Excerpted from "Improving Birth in Nigeria," by Andrew I. Ewere, Midwifery Today Issue 65

Costa Rica: Dona Miriam, or abuelita (grandmother) as she is called by most, was the midwife who helped bring almost the whole town of 2000 inhabitants of Tres Equis, Costa Rica, into the world. She grew up observing and assisting her mother, who encouraged her to "watch, listen, and remember." She is well-known for her special use of the traditional Costa Rican massage technique "sobada." At every visit, she oils her hands with cooking oil or lard and gently passes them over the uterus to encourage optimal fetal positioning. She checks whether the mother's umbilicus is crooked or pulled in one direction and helps move the baby to a more central and balanced position. She emphasizes keeping the baby well-positioned, and suggests that women alternate sleeping sides and tie a cloth around the belly for support during the day. This will help with leg cramps and back pain and make the birth go more quickly. At prenatal visits she mainly spends time talking and telling jokes and stories with the woman. "If the woman sees that you have confidence in her, she'll have confidence in you."

—Excerpted from "Lessons from One of the Last Tica Midwives," by Rebecca Turecky, Midwifery Today Issue 65

Australia: In Australia there is only one type of officially-recognized midwife—one who has trained as a nurse, then as a midwife and who is registered by one of the state nursing councils. Most states have legislation forbidding anyone but a registered midwife from attending a woman in childbirth. There are lay midwives in every state, with most practicing "underground," even though national homebirth statistics collected from 1985–1990 vindicated the safety of their practices. The situation is dire, but the crisis has created opportunities. All around Australia, consumer groups have become impassioned and are now pushing for implementation of the National Maternity Action Plan, which calls for continuity of care with a known midwife as a choice for all pregnant women Australia-wide, whether birthing in home or hospital.

—Excerpted from "Homebirth in Australia: The Personal and the Political," by Sarah Buckley, Midwifery Today Issue 66

China: By seeking out secluded hamlets where foreigners perhaps had never before ventured, I was able to locate "jie sheng po" (translation: old woman who comes close to life). One young mother who was assisted in her home by the midwife explained that during birth she felt cared for and safe. She was pleased to have avoided the inconvenience and discomfort of the hospital. She smiled shyly and spoke with confidence and joy about the birth of her child.

Traditional midwifery does continue with dignity and respect in some areas, but my overwhelming experience is that it is in jeopardy in China. When I located a midwife in a different area, I was confronted by police who were concerned by my interest in midwifery. I pressed on and found a local midwife who lived at the top of a mountain, a long and muddy hike down to the closest village clinic. She had not practiced midwifery since 1999, when the government told her to stop. I asked her if she had ever lost a mother or a baby; she said no. On a later visit to the clinic, I discovered the facilities included little more than a bed, an IV pole, and a broken ultrasound machine. The doctor on duty had been educated in a high school vocational program and most likely had not attended any continuing education. The claim that higher rates of delivery in clinics had resulted in a decreased rate of maternal and infant mortality was obviously not based on scientific evidence.

—Excerpted from "The Jie Sheng Po of China," by Travis Anna Harvey, Midwifery Today Issue 66

Bolivia: At a project workshop, videos were shown of childbirth in Japanese birthing houses: women giving birth on all fours, lying on their side, and so forth. Afterward, an obstetrician of the La Paz Hospital asked a young Japanese midwife to come to the labor room where five women were waiting to give birth. The midwife who had been working as a volunteer in Bolivia's highland area took care of one of the birthing women, who was having her first child. While the obstetrician performed a cesarean section on another woman, the birth of the Aymara woman progressed. The Japanese midwife asked for a mattress and vinyl sheet to be spread on the floor of the delivery room. The woman walked to the delivery room and gave birth on her knees on the mattress.

By this time, the obstetrician had returned. When the baby came out without the mother making much pushing effort, the whole obstetric team applauded. The doctor said, "This is what we need to learn!" An auxiliary nurse said, "This is how they do it at home; they always did."

—Excerpted from "Humanization of Childbirth in Bolivia," by Daisuke Onuki, Midwifery Today Issue 64

A final word:

Real change begins when people are exposed to others' ways, whether we think they are "right" or not. Let's broaden our worldview and tear down barriers. This concept can echo in our local communities as well, where we struggle to find unity among a diverse sisterhood of midwives. There is a beautiful recognition that passes between eyes when moments of common experience are discovered. This is the start of an ongoing globalization of midwifery. We are too connected as a world community to focus on differences. What I took back from India—confidence in the birth process and a lifelong commitment to celebrate mothers and babies—is universal at its core.

—Excerpted from "Journeys through Old and New in South India," by Sarah Pontell, Midwifery Today Issue 64


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Web Site Update

Read these articles recently posted to the web site:


Forum Talk

I am an Israeli midwife, working in a hospital in Afula. I am interested in traveling outside of Israel in order to participate in homebirths and community midwifery. I will take care of all of my own expenses. I am interested in spending approximately four weeks with a homebirth midwife who would be willing to host me and learn a little bit about Israel in the process.


TO SHARE YOUR THOUGHTS AND EXPERIENCE ABOUT THIS TOPIC, click here.
**PLEASE DO NOT SEND YOUR RESPONSES TO E-NEWS!**


Question of the Week (Repeated)

Q: We have a client who in her first birth had a retained placenta. Retrieving was complicated by a vagal response. She ended up needing to be transported, and the placenta was removed while she was under anesthesia. We are trying to collect data about incidence of repeat retained placentas and any suggestions for reducing its incidence. We are aware of the possible role of vitamin E, and she is minimizing her intake in this pregnancy.

— SC


SEND YOUR RESPONSE to mtensubmit@midwiferytoday.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.


Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to mgeditor@midwiferytoday.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.


Exclusively on the BirthLove Site

Gloria Lemay, celebrated midwife and teacher, is offering advanced online doula education. She covers a vast amount of topics that today's doulas and student midwives need to know: herpes simplex II, medical terminology, pediatric exam of the newborn, prenatal diagnostic tests, business and professionalism, pregnancy-induced hypertension, gestational diabetes and so much more. The course is free for all BirthLove members. Check it out!


Question of the Quarter for Midwifery Today Print Magazine

Question of the Quarter: What does "instinctive birth" mean to you? How do you facilitate it?

Our favorite responses will be published in Midwifery Today magazine, December 2003. E-mail your response to: mgeditor@midwiferytoday.com. Responses are subject to editing for space and style. Try to keep the word count under 400.
Deadline for submission: Oct. 1, 2003.

Question of the Quarter is a feature of Midwifery Today magazine, E-News's parent publication. Click here to subscribe today!

Write today! (See writer's guidelines.) We love hearing from you!


With Woman

A cervix isn't made "ripe" by induction drugs or Foley catheters.

I recommend using caution with language and question the use of the word "ripening" to describe the process of irritating the mother's body by inserting a foreign object. This should properly and descriptively be called "Foley catheter invasion and irritation." Prostaglandin gels applied to the cervix should be more honestly described as "chemically altering the consistency of the cervix." No ripening is happening with either of these methods!

Midwives have used the term ripening to describe a natural process of the cervical changes of late pregnancy. We take a word from the plant kingdom because it is similar to the slow, harmonious process that happens to a plum as it turns from green and hard to darker and darker purple, soft, mushy and sweet. If one puts a whole bunch of plums in a box when they are green and hard and sprays them with chemicals, it is possible that in a few days they will look like dark purple ripe fruit. However, one taste will tell you that Nature had nothing to do with the end product.

Let's not fool ourselves in birth either. Whatever area we work in, we can call these invasions by their proper names—irritation and chemical altering. Lying about what's going on perpetuates the practice.


Feedback

Two weeks ago I found out I was pregnant with my first child. I am worried because last year I got genital herpes. I went to get a Pap smear about a month and a half ago. They called me back saying I might have cells on my cervix and that I needed to come back in for another Pap to make sure it wasn't human papilloma virus. I take supplements such as L-lysine, garlic, and Buried Treasures liquid prenatal vitamins with DHA and folic acid. What else can I take to make sure my baby will be OK? Will it be OK to go through with this pregnancy?

Chloe


I'm with ALACE and found out that their tape series about breathing and relaxation for labor and delivery is no longer available. I was looking for Rahima Baldwin's series. Mine are just too old. Do you know anyone who might have those or where I could get something like it?

Francoise Souverville


"Williams Obstetrics" says the only difficulty with pregnancy at advanced maternal ages is that older moms tend to be less healthy (suffering from the effects of age) than younger moms. But of course some individual older people are a lot healthier than some young people. Some individuals have already outlived some younger people! The real reason for most tests is to make money. (If you don't believe me, ask the nurse-practitioner what information she hopes to gain from this test and what she plans to do with the information once she gets it. And what studies confirm its efficacy. And what the false positives/false negatives for it are. Ask her if it's her office's or her hospital's protocol to "offer" this test to older moms, whether or not they'll support you if you refuse, and how much they bill your insurance company for it. They wouldn't offer it unless you have insurance—unless, of course, Medicaid covers it.) Wouldn't the easiest way to test ovarian function be to get pregnant?

Anon.


Thank you tearfully and emotionally for using my quote in E-News [Quote of the Week, Issue 5:17]. You may never fully realize how your words of support and encouragement for traditional midwives are deeply appreciated. I live in Illinois, a state where the only midwives recognized are certified nurse midwives. CNMs do not even acknowledge traditional midwives. We are either ignored or slandered. Thank you for caring.

Samantha Clemens


Editor's Note: Only letters sent to the E-News official e-mail address, mtensubmit@midwiferytoday.com, will be considered for inclusion. Letters sent to ANY OTHER e-mail addresses will not be considered.


Classified

Beechwood Midwifery, a homebirth practice in Rutland, VT, is offering preceptorships for students desiring a midwifery education through National College of Midwifery. See www.beechwoodmidwifery.com and www.midwiferycollege.org for more info and/or call (802) 786-0740.


Oregon Coastal Conference, September 26–28. Accommodations (yurts and meals) included in price. Visit www.globalmidwives.org or call 541-488-8254 for details. See you on the beach!


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