|March 4, 2009|
Volume 11, Issue 5
|Midwifery Today E-News|
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In This Week’s Issue:
Quote of the Week
"Birth is not only about making babies. It's about making mothers—strong, competent, capable mothers who trust themselves and believe in their inner strength."
— Barbara Katz Rothman
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The Art of Midwifery
[With twins,] mom is now eating for three, and must increase her intake. Common complaints of pregnancy multiply due to low blood sugars and lack of adequate caloric intake. Ask her to give a complete diet history weekly. Ask for her family's support in making sure that she is adequately nourished.
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 firstname.lastname@example.org.
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A Boston study analyzed the relationship between maternal vitamin D status and the prevalence of primary cesarean section, because one symptom of vitamin D deficiency is "poor muscular performance." The study included 253 women, 43 of whom had had a primary cesarean. This small study showed that women with vitamin D deficiency had increased odds of having a primary c-section.
— Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2008-1217, published online 23 Dec 2008
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After Twin Birth
This was Sharon's sixth pregnancy and second homebirth, and it would also be her fourth VBAC. This time two of them were in there. All of her babies had been breastfed at least a year. She had a healthy, realistic and informed attitude toward this twin birth.
Because I am a lactation consultant, one of my curious desires was to see twins nurse right after birth. Would the first twin nurse before the second was born? Would they nurse together? Or one at a time? If so, which one would nurse first? As it turned out, Sharon was having some powerful afterbirth contractions and was not ready to bring them to her breast "in the first 30 minutes." The babies were being loved, passed around and photographed. I thoroughly enjoyed preserving these one-of-a-kind memories.
As we lay the newborns together in a towel to take more photos, I thought of Anne Geddes, who might do images like this, but staged and planned ahead of time in her studio. This was natural and spontaneous. The two little brothers were skin-to-skin, naked, bonding, cooing and exploring each other. Just what twins should be allowed to do immediately after birth! I never did see them latch on that night.
One of the midwives correctly pointed out that this immediate twin bonding would never have happened if the birth had occurred in a hospital because each baby would have had different receiving pediatric teams and separate warmers and routines to undergo.
— Denise Punger
Life after the birth of twins is intense because it is difficult for a family to keep up with the needs of two babies. Midwife help in the postpartum period is critical so that the mother can find a little time to eat nutritious food, drink fluids, and rest a bit. With adequate postpartum help, I believe more women would choose to breastfeed their twins, which is undoubtedly better for their twins' long-term health.
I am not surprised that a mother of twins is at greater risk for postpartum depression than a mother caring for one baby. It is utterly demoralizing to feel that you cannot take good care of your child. I found it difficult to reconcile the ways that I had to modify my parenting because there were two. I was fortunate to have very supportive family and friends who gave my boys a lot of loving care, allowing me to nurse them on demand as I did with my single children. It was so much work for everyone but well worth it.
Twin mothers deserve to be supported by those who see her birth as a very special blessing. I believe midwives offer superior care for twin mothers during their pregnancy, birth and postpartum with nutritional counseling, skillful care and confidence in birth.
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Question of the Week
Q: Is fundal massage more routine in deliveries not attended by midwives? How important is it, as opposed to just a fundal check after delivery to make sure the uterus is in fact doing its job of expelling clots, etc.? Is there a huge difference between fundal massage and fundal checks? Are fundal massages possibly damaging to the uterus?
— Stephanie J.
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.
Question of the Week Responses
Q: I am a 28-year-old woman and I've just been told that I have uterine didelphys—with two of everything (cervix, uterus and vaginal canal). According to the gynecologist I saw, I can become pregnant but she said there is a higher risk of premature birth and of a caesarean. Other than this I am perfectly healthy and have had no illnesses or anything.
While I am not planning to get pregnant in the next two years, I would really like to think about my options, to prepare myself when the time is right. I have always planned on having a homebirth with a midwife to assist. I really want the opinion of someone who is not solely from the medical side of things. I know the doctors tell me what they think is the right thing to do but I have always felt that birth is a more natural occurrence than what the majority of the medical society seems to believe.
A: It was really comforting to read the stories about the women with uterine didelphys. I found out at age 15 that I have two uteruses. I only found out because my second cervix was closed off, and as my body was trying to have my period, which it couldn't have because there was no where for the blood to come out. It was very painful, and I had to have surgery to open my cervix. I only have one vagina, but I have two functioning uteruses.
I haven't been pregnant, but my fiance and I want children soon after we are married, and I want to know my options, if (hopefully I can) I get pregnant. I am curious as to whether or not I will be able to find a midwife to do a homebirth or even a center or hospital birth. I would like to find out if the risk is higher because I had a surgical correction, even though it was 10 years ago. I am also afraid that a doctor would push me into a c-section, without good reason. Not that a doctor would do something so unethical as recomending a huge surgical procedure for no reason, or for the reason that he wants to get off work on time! If you have any information that you think will be helpful, please let me know! Thank you so much for your time.
— Jill Ihnken
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.
Think about It
Research shows that for one child, an average family could save upwards of $3000 a year by breastfeeding instead of formula feeding. Multiply that by eight and you're looking at savings of $24,000 in a year.
— Gina Ciagne, Lansinoh
Arielle Greenberg, Citizens for Midwifery's newest Board Member, is working on a book about choosing and having babies with midwives. She is seeking answers to some questions that could provide quotes for this book. You are welcome to forward this e-mail to other individuals and lists. If you are interested, write to Arielle at firstname.lastname@example.org and request the questions.
Sheri Menelli is giving away the electronic version of her book, Journey into Motherhood: Inspirational Stories of Natural Birth. You can find it at http://smenelli.wordpress.com.
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