Research to Remember
A Magee Women's Research Institute study was undertaken to determine the degree of antibiotic resistance after women used either clindamycin or metronidazole to treat bacteria vaginosis, a common infection that affects as many as 50% of women in some populations. The 99 women aged 18 to 45 who took part in the study were tested for concentrations of vaginal microbes before and after a course of treatment using either antibiotic. Ten different groups of bacteria were examined. Results of the study showed that women treated with clindamycin had more-frequent increases in bacterial concentrations of E. coli than those who were treated with metronidazole. Fewer than 1% of bacteria samples showed resistance to metronidazole, whereas resistance to clindamycin was 12% baseline and 53% after treatment with the drug. Resistant bacteria persisted at a rate as high as 80% for as long as 90 days after treatment with clindamycin. Increased colonization of protective lactobacillus bacteria increased during the first week after treatment with metronidazole.
— American Journal of Obstetrics and Gynecology, October 2004
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Effects of Mercury Administered during Pregnancy
A reader named "Donna" contacted Midwifery Today E-News with an informal study she conducted of mothers who were "injected" with mercury while pregnant. She started with her own story:
I had RhoGAM when I was six months pregnant. My son has progressive microcephaly, CP, lennox gastaut (severe seizures), is nonverbal and profoundly mentally retarded. I had his six-month-old baby hair tested for mercury; the results showed 13.78 mcg. The only exposure to mercury was from my RhoGAM and his vaccines. A new study of amount of heavy metals in vaccines showed one that contained nine times more aluminum. There is no telling how much mercury was in the RhoGAM injections I had. The older RhoGAM contained 35 mcg of mercury. We are told to limit "ingesting" mercury to 0.1 mcg. What should the number be for "injecting" it?
- Janet: RhoGAM during pregnancy; her child is 21 and has ADD and a learning disability. She had RhoGAM during one of her other pregnancies but doesn't know which one; one child has ADD and the other child has Down syndrome.
- Kris O.: RhoGAM during pregnancy; has a child with deafness, autism, developmental delays, mild CP.
- Norma W.: Had RhoGAM during pregnancy; has a disabled child [type unknown].
- Colleen F.: Flu shot during pregnancy; son has CP and bipolar disorder.
- Gracie M.: RhoGAM during pregnancy; did not vaccinate son. Boy developed severe eczema at four months old, has lots of allergies, a yeast overgrowth and a depressed immune system.
- Kathy G.: RhoGAM during pregnancy; has a four-year-old daughter with angelman syndrome.
- Barbara W.: RhoGAM during pregnancy; has 10-year-old child with angelman syndrome.
- Ilana S.: Sister had flu vaccine during pregnancy; she has a daughter with Retts. Her hair was tested for mercury; results were 14.8. She also has a friend who had a RhoGAM injection during pregnancy and lost the child a month later.
- Julia A.: Flu vaccine during pregnancy; daughter diagnosed with petiventricular leukomalacia (a type of brain damage).
- Lauree L.: RhoGAM during pregnancy; child is developmentally delayed, in a special-education class with one-on-one aide. Lennox Gastaut syndrome.
- Anon: Four children; had a RhoGAM injection both during and after pregnancy. My oldest son is now 16; he is a very well behaved child and does well in school. However, he has ADD and is on medication. My second child has some major psych/neuro issues; although his IQ is 129, his behavior is horrible and he is on major psych-neuro drugs and has been in and out of institutions and under the care of doctors for several years. My third child is normal. My fourth child has Rett syndrome confirmed at Baylor through the MECP DNA test last year. Prior to this, her doctors thought she had CP. She has seizures, she does not walk or talk, she is now 10-1/2 and functions at the three-month-old level. My first child is by one husband, my second a different husband and the third is my present husband's. So while they all have neuro issues, the gene pool is different. It makes you wonder if an exterior factor such as thimerosol accounts for these kinds of outcomes.
- Lisa T: I have had seven pregnancies; one was a miscarriage. 1981 at age 15 got RhoGAM shot during pregnancy; daughter was born with severe learning disabilities and ADD. RhoGAM after birth. 1985, RhoGAM shot after birth, son has ADHD and ODD, depression (bipolar?). 1988, miscarriage with RhoGAM given after. 1990, daughter with ADD and mild deafness, RhoGAM after birth. 1996, daughter with possible ADD, RhoGAM after birth. 1998, daughter with possible ADD, RhoGAM after birth. 2001, daughter with angelman syndrome, had flu shot in 2000 and got pregnant about one week later; had RhoGAM during pregnancy and after birth.
- Eve: RhoGAM during pregnancy, has 12-year-old girl with Quad CP.
- Jamie B.: RhoGAM during all of her pregnancies; first son has learning disabilities (severe CAPD and PDD nos); second, a daughter, is dyslexic; third, a son, has ADHD.
At a DAN! conference 53.7% of the mothers present who had ASD children were Rh negative. Other studies show 37% of ASD children have Rh-neg. mothers, although the incidence of RH neg. is estimated at only 3% to 7% of the female population.
In the past, RH-neg. mothers were not given the RhoGAM shot until after the baby was born, but now RH neg. mothers often receive the shot between the 16th to 20th week. Most RH shots contain thimerosal.
RhoGAM, a human gamma globulin, is administered against the Rh positive factor of blood; it is given to Rh-negative mothers who birth Rh-positive babies. It is administered to prevent the mothers from becoming sensitized to the baby's Rh-positive blood. If she is sensitized, her immune system may destroy the red blood cells of a subsequent child.
The risk of hemolytic disease of the newborn (HDN) in a subsequent child if the mother receives RhoGAM after the baby's birth is approximately 1% to 2%. If RhoGAM is administered during pregnancy, the risk is reduced by less than 1%.
Hair analysis of unvaccinated children born to mothers who received a RhoGAM injection during pregnancy indicate the presence of mercury in their system that results from the mercury-derived preservative in RhoGAM called thimerosol. Elevated mercury levels can dispose the children to serious neurological compromise. Until 2001, each RhoGAM injection typically contained 25 micrograms of mercury.
Indications for an Rh-negative pregnant woman to receive a larger dose of RhoGAM include fetal-maternal hemorrhage early in pregnancy, a fetal-maternal hemorrhage greater than 15 mL of Rh-positive red cells and an Rh-positive transfusion. Total dosage of mercury can be calculated by multiplying the number of injections by 10.5 micrograms.
Mothers have the option of demanding a mercury-free RhoGAM product. Such a product is available from Bayer Pharmaceuticals; the product is called BayRoh-D. The product has been available since 1996. WinRho SDF, made by the Cangene Corp., is a freeze-dried product that contains no preservatives.
— Information from www.vaccinetruth.org/rhogam.htm
Northern New Mexico Midwifery Center—Midwifery Training Program
Northern New Mexico Midwifery Center is accepting applications for midwifery training program to start April 1, 2005. Learn in a unique practice in the beautiful mountainous town of Taos. Obtain your degree through a MEAC-accredited program and graduate ready to become a CPM. Deadline for application, including a 3-day visit, is February 1, 2005. Visit www.midwiferycenter.org for details.
Products for Birth Professionals
Improve your practice with advice from experts.
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- Nutrition and Herbs
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Order "Tricks IV."
Surprise your midwife or doula with a pair of Crowning Earrings—she'll appreciate how that all-important moment is captured in these classic silver earrings by Russell Wray. They also make a thoughtful gift for a new midwife.
Mother's Love Pendant
If she's a mom, she'll love the Mother's Love Pendant, a delicate sterling silver heart that celebrates the bond between mother and child.
Membership in the International Alliance of Midwives is now free!
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Web Site Update
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Where do educators work? Do you have your own classes that you hold in a rented room or your home? Do you work in a hospital? How often do you hold your classes? Is the length of your class governed by where you got your certification from? I want to get a range of answers for my own curiosity.
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Reader Response Solicitation for Midwifery Today Print Magazine
What Do You Do When…?
Midwives: We need to hear from you! The theme of Midwifery Today, Issue 73, is "Changing Protocols." We want to know what changes you have witnessed in protocols for the following areas of practice:
- Gestational Diabetes
- Prolonged Labor
Choose one or more of the above and describe the former protocol, the current one and any practice that has been standard in between. Do you think the change you describe is a positive one or not? Do you have any recommendations for future practice in this area?
E-mail your responses to email@example.com by Dec. 8, 2004. If we print your reply (of 300 words or more) we will send you this issue of the magazine.
Question of the Week
Q: What do you do when you don't have a last menstrual period to track the conception date? I had a tubal pregnancy. After a D&C it was determined that I would need either tubal surgery or Methotrexate. I chose Methotrexate because I didn't want to have part of my tube removed. Subsequent to the Methotrexate, I was getting blood samples taken to confirm that the HCG levels were going down, and they were.
While waiting for my period so that I could start oral contraceptives, the condom broke, and I've been waiting for my period. It's late—I think. I was just getting my cycle back from 10 months breastfeeding so it wasn't regular. If I'm pregnant, what do I do? How can I determine my due date?
— Catherine Sutton
SEND YOUR RESPONSE to firstname.lastname@example.org with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.
Childbirth without Fear
This timely reissue of Grantly Dick-Read's natural childbirth classic is now available from amazon.com and direct from the publishers. Original and unabridged, it is an essential read for midwives, childbirth educators, obstetricians and other health professionals. "Every pregnant mother should read it," says Janet Balaskas—Author of New Active Birth.
For more details or to order visit:
Question of the Week Responses
Regarding postpartum acne [Issue 6:23]:
Q: While experiencing adult acne with many exacerbations due to hormonal changes, (though mine personally did not include during pregnancy), I found that a set of products sold in an infomercial actually worked. I will not use the name, but there is usually a celebrity who opens the commercial, and the set includes a cleansing lotion, toner and repairing lotion. After years of struggle, my skin is completely clear. It is less of an expense than it might seem, as the products last a long time. Not much is needed per use to be effective.
A: A friend of mine is a clinical herbalist and had been working with a pregnant mom suffering from acne during her pregnancy. He makes a syrup that includes vitex, which helps with hormonal imbalance. Within a few weeks of using this syrup, her acne had cleared up. The product is called Mama's Morning Vitex (I think).
— Lisbeth Eyrich-Fischer
Regarding excessive postpartum bleeding [Issue 6:23]:
A: I am a mother of seven and a midwife. I took Nature's Sunshine liquid chlorophyll during the whole pregnancy, during labor, and after the birth, faithfully. I doubled the suggested dose—at least. I always bleed after and sometimes before the placenta. Not this time—even with my 10-pound baby! I have several clients with previous bleeding history take this stuff as I did and so far not one had a bad bleed! It's not scientific, I know, but it has worked for me and my clients. It has also significantly helped the ladies with bad veins.
A: I had excessive bleeding with my first three births, ranging anywhere from 500 to 1000 milliliters of blood loss. I received Pitocin several hours following my second birth because of continued blood loss. Early in my fourth pregnancy a midwife at a BirthWorks conference told me that in her birth center they had been studying the effects of delayed cord clamping. An unexpected result was that the longer the cord was left unclamped, the less blood the mothers lost. She claimed that if cord clamping was delayed until after the placenta delivered, the mothers did not bleed at all. I was skeptical but support delayed cord clamping because of benefits to the newborn (www.cordclamping.com). At my first three births the cord had been clamped earlier than I would have liked.
With my fourth birth I was adamant about waiting for the placenta, even though it took 30 minutes. Almost immediately after the birth my midwife wanted to cut the cord because my baby wasn't breathing and she wanted to give him oxygen. I've since learned that delayed breathing is normal because the baby is still exchanging gasses through the cord, particularly in waterbirths like mine where the cord is in warm water rather than cold air (and it was 80 degrees in the room). I refused, insisting that she bring the oxygen to the baby, not the baby to the oxygen. And true to what that midwife had told me, I had *no bleeding* prior to delivery of the placenta. My lochia was significantly lighter than it had ever been, and stopped sooner. I'm a huge fan of delayed cord clamping now.
— Jenn Riedy, BCCE, CPS
Regarding posterior position [ongoing discussion]:
A: Some babies turn, others don't. The Pink Kit Method for birthing better (www.birthingbetter.com) gives us, pregnant women and our partners, the ways to relax our internal soft tissue and keep our pelvis mobile, particularly the sacrum. All the information in the resources comes from us, pregnant women and our partners, and is time tested for more than 30 years. Posterior babies have not been a problem when we know how to "map our pelvis," keep ourselves in positions that keep us open, learn to use the pelvic clock, hip lift, Kate's Cat, sit bone spread and most important…have done the internal work. What we need is a change in focus. Instead of just trying to change something, we can work with what we have. We can only do this by taking the responsibility of preparing ourselves. We need you, as midwives, to tell us we need to physically prepare for childbirth by knowing our birthing body. As stupid as it might sound, birth is an exercise in plumbing. Object must come out of container through tube, diaphragm must open and then aperture. Each pregnant woman can learn, as we have, to know her container and how to work through the process. Posterior babies have not been a problem.
— Alicia Hannen, Nelson, New Zealand
Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to email@example.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
Radical Midwives' Homepage—http://www.radmid.demon.co.uk/
Cesarean fails to improve long-term breech outcome
American Journal of Obstetrics and Gynecology
2004; 191: 864–71
In women with breech presentation at term, elective cesarean may not reduce the risk of death or neurodevelopmental delay in the resulting infants at 2 years of age, study findings indicate.
"Some analyses of observational studies have found that delivery by elective cesarean reduces the risk of long-term adverse outcomes for children born at term in breech presentation," note Hilary Whyte (Hospital for Sick Children, Toronto, Canada) and colleagues.
To investigate further, they followed up 923 such infants to at least two years of age, when they screened them for abnormalities with the Ages and Stages Questionnaire. Those children who scored abnormally on this questionnaire underwent a neurodevelopmental assessment.
The researchers found that the risk of death or neurodevelopmental delay at this time point in children delivered by elective cesarean (3.1%) was not statistically different from that for children delivered by planned vaginal birth (2.8%).
This result was unexpected as it contrasted with their earlier report that documented "a marked reduction" in the incidence of perinatal and neonatal death and serious neonatal morbidity with a policy of planned cesarean birth. "One reason for the lack of effect may have been that our study was underpowered," the authors suggest.
— Amy V. Haas, BCCE
My son was diagnosed with cerebral palsey at 14 months. He was born at 41 weeks by c-section because he was frank breech. When the doctor tried to pull him out he startled the baby, so on the way out his head and shoulder got stuck. The doctor used incredible force with his hands. Both my husband and I were in shock. At last he cut me more in order to get the baby out. I was incredibly sore even with all the morphine; to this day I can remember my left side throbbing like crazy. My son went home with me; he breastfed and although he had had a rough birth he seemed to be fine. His records show, however, that he had been a very floppy baby. I have always been suspicious that his injury was in his neck, but MRI to the brain and spine showed nothing. I believe he was injured at the spine because of his ability to do so much from his neck up. His speech is intact; in fact it came very early. His movement from the neck up—his tongue and facial expressions—indicated to me that his injury had to be at the neck and not in the brain, as doctors suggest.
Recently I read on the Midwifery Today Web site that doctors can injure babies through the incision. This is what I had always suspected but never had read about before. The article also suggests that babies who are breech already are more likely to develop some kind of problem. I wonder if you can point me in the right direction where I can do more research about birth. I would really like to know how my baby got hurt.
— Denise Allen
I like your new format. I haven't analyzed it to figure out what's different, but it is much easier to read. Thanks.
Editor's Note: The text version of E-News received a new design with the last issue.
I received the following request: "I am Japanese childbirth educator Ritsuko Toda. I [would like to] ask a great favor. Through a friend, I have seen two photos titled "Baby in Museum." The image is beyond words! I instantly fell in love with them and hoped that the photos could appear in the book which I am working on at the moment. Do you know how I can get in touch with the person who took the photos so that I can obtain permission for using them in my book?"
I remember seeing this photo—someone had sent it to me in an e-mail, but I no longer have it, and I can't remember who sent it to me. If any of you have seen this photo (it's a baby reaching out to the breast on a sculpture of a naked woman) and know how Ms. Toda can reach the photographer to ask permission to use it in her book, please send me an e-mail: firstname.lastname@example.org or you may write directly to her: email@example.com
Thanks for your help.
— Patricia Kay
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