|December 9, 2009|
Volume 11, Issue 25
|Midwifery Today E-News|
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Happy holidays from everyone at Midwifery Today!
Look for your next issue of Midwifery Today E-News on January 6, 2010.
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Midwifery Today Conferences
You'll find classes for seasoned midwives, childbirth educators, doulas and activists, and for those aspiring or just beginning in the birth field. Come to the conference to expand your knowledge and your network and to renew and rejuvenate your heart. Planned teachers include Ina May Gaskin, Marsden Wagner, Michel Odent and Elizabeth Davis.
Learn about birth from these great teachers when you attend our conference in Strasbourg, France, September 29 - October 3, 2010. Planned classes include Prolonged Pregnancy, Prolonged Labor, Managing Hemorrhage, Posterior Position and Preventing and Managing Birth Complications at Home.
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In This Week’s Issue:
Quote of the Week
"You are a midwife. You are assisting at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must, take the lead. Lead so that the mother is helped, yet still free and in charge. When the babe is born the mother will rightly say, 'We did it ourselves.'"
— Lao Tzu, in Tao Te Ching
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The Art of Midwifery
This technique is called a "Piskacheck," after the Russian obstetrician who started using it. An important thing to note is that classical midwifery classifies labor into more steps than modern midwifery does. Classical midwifery divides second stage into two steps: descent and expulsion. Midwives in Russia understand that once a woman is 10 cm dilated that doesn't mean that she has to start pushing; they wait until the head is on the pelvic floor before encouraging women to push. This means that mother and baby don't get exhausted, and pushing only lasts for an average of 10 minutes.
The Piskacheck technique is an assessment tool to tell where the fetal presenting part is, in order to know in which part of second stage the labor is. The midwife usually uses a piece of cloth or drape and, holding it in her dominant hand, she presses it with her index and middle finger on the outer side of the labia majora. If something firm is felt through the labia, then the presenting part is low! If nothing is felt, then the patient is encouraged to rest and breathe until the baby is lower in the vagina.
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.
Send submissions, inquiries, and responses to newsletter items to: email@example.com.
Keep in touch with the international birth community!
Scientists at the University of Werzburg in Germany have discovered that parents' language patterns are evident in a baby's cries at even just a few days of age. Researchers analyzed the cries of 60 newborns (30 born to German-speaking parents and 30 to French-speaking parents), recorded when the babies were three to five days old. They found that the "melodies" of the babies' cries distinctly followed the patterns of each child's mother tongue, suggesting that babies begin picking up language patterns while in the womb (far earlier than previously thought).
The full report of this study was published in the November 5 issue of Current Biology.
— http://www.msnbc.msn.com/id/33656622/ns/health-kids_and_parenting/, Accessed 20 Nov 2009.
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Thesis Project: Administrating International Volunteer Programs
In my journey to become a midwife I had the privilege of working on a project that would increase the satisfaction of birth center administrators and volunteers at the Yayasan Bumi Sehat clinic in Bali, Indonesia. This was a rewarding experience for me but, more importantly, the program is now reporting much higher volunteer and paid staff satisfaction.
Like many students, I needed to fulfill the rest of my "primary under supervisions" in order to complete my schooling. In January of 2007, I traveled to Bali, Indonesia, to serve at the Yayasan Bumi Sehat clinic at the feet of Robin Lim. I learned so much about sisterhood and midwifery but also a great deal about myself during my time at the clinic. While there, I was a fairly typical volunteer: cocky, intense, serious, open; wanting to learn anything I could.
I did fulfill my education requirements during my time at the clinic. My time there was a great success. I returned home with a strong desire to help the clinic in any way that I could. As a student seeking a master's degree at the Midwives College of Utah, I also needed to do a thesis project or paper. I decided to blend my two desires and work on the volunteer program. The clinic functioned well before I went and would continue to do so without the project that I was to undertake. However, the volunteer program, or the portion of it that trained midwives, was suffering. Not the training, to be clear, that was fantastic and thorough. It was the logistical and organizational portion of the program that was lacking a level of administrative systems. I certainly got what I needed out of my time at the clinic, but I could see that there were great challenges for the staff and volunteers related to the functional aspects of the program. With the help of a few key participants I created, designed and implemented procedures of application and orientation, and instituted a set fee for services provided to student volunteers working at the clinic. Some of the areas that I addressed were cultural sensitivity, expectations of volunteers, procedures for arrival at the clinic and clear expectations of volunteers and staff. This program has benefited administrative staff, clinic staff and volunteers by including a clear application procedure, scheduling of volunteer shifts, clear expectations, etc.
While these procedures and forms were created initially to help the Yayasan Bumi Sehat clinic, I have made them available to birth centers worldwide for their use and implementation. They are available for download on my Web site at www.earthmothermidwife.com under the Thesis Project Forms tab. Please feel free to view and copy them for your use. In return I ask that you e-mail me at firstname.lastname@example.org with notification of your intent to use them, as well as the short- and long-term outcome of the implementation of the procedures or use of the forms at your clinic.
— Erin Kaspar-Frett, CPM, LM, MSM, CD
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Web Site Update
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Please check out our first Tricks of the Trade YouTube video, part of our Birth Essentials series:
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Question of the Week
Q: I just read the article, "Questions about Prenatal Ultrasound and the Alarming Increase in Autism," by Caroline Rodgers, in Midwifery Today, Issue 80, Winter 2006. I have long felt that ultrasound is not as safe as the medical industry believes or states it to be. I am desperately looking for more current studies, information on changes in ultrasound practices or technology, and statistics on autism and other possible birth defects which may be caused by overuse of ultrasound.
I recently had a miscarriage and I think I may be pregnant again. Unfortunately, I had no menstrual period between the miscarriage and the new pregnancy, so it may be more difficult to determine a due date. Because of this and complications experienced in my last pregnancy, I am afraid that my doctor will be adamant about having ultrasounds, and I feel that I need the most current information available to hold to my determination to not endanger my baby.
Please let me know if there is any other well-documented information.
— Tami C.
Editor's Note: See the Midwifery Today article, "Ultrasound: Weighing the Propaganda Against the Facts," by Beverly Lawrence Beech.
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: How do you prevent postpartum hemorrhage?
— Midwifery Today E-News Staff
— Marlene, CPM
Q: (From E-News Issue 11:10) My 21-year-old daughter has been advised to have a LEEP (loop electrosurgical excision procedure) for moderate dysplasia due to HPV. I know this may leave scarring on the cervix or possibly pose a small risk of preterm labor when she becomes pregnant. My midwife said she would be put on a preterm labor protocol. What experiences have midwives had with this situation?
Have you seen cervical scarring or preterm labor after a LEEP? Does scarring lead to slower dilation or "stalls" in dilation? Does she have any alternatives for treatment other than the LEEP? What is your advice regarding pregnancy? Would this preclude her from using a midwife?
A: I've worked with lots of women who have had a LEEP and average birth experiences. When I was in a group practice, anytime any of us had ladies with LEEP we simply noted it on the "to know" list.
— Makeda Kamara, CNM, DEM
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
A clinic in the rural Santillana district, in the Ayacucho region of Peru, has attracted more women to using its birth facilities by taking the novel step of asking the community about traditional birth practices and for feedback on the clinic's performance. Very few local women were coming to the clinic for their births (despite high rates of childbirth-related deaths, due at least in part to birth helpers not having the means to treat complications such as hemorrhage or infection), and workers wanted to know why. Among the responses: workers did not speak the local language; husbands and relatives were not allowed in delivery rooms; women were forced to wear hospital gowns and to give birth lying down rather than squatting; workers threw away the women's placentas instead of giving them to the families to bury.
In response, members of the nongovernmental organization Health Unlimited worked with the local community to make changes in the way the clinic was run. Delivery rooms were set up to allow women to give birth in a squatting position, husbands and relatives were allowed to be present during labor and birth, and workers made sure that the local language was spoken.
The results? In 2007, 83 percent of births took place in the clinic (where women have access to life-saving medical supplies, along with workers trained in their use)—up from only six percent in 1999.
A full report on this project was published in the September 2009 issue of the Bulletin of the World Health Organization; the report can be viewed online at: www.who.int/bulletin/volumes/87/9/08-057794/en/index.html
— New York Times, 8 Sep 2009
Thanks for the flu issue [Midwifery Today E-News 11:22]. As a midwife whose phone is ringing off the hook to the pregnant daughter I am caring for, [receiving] good, clear, logical information is refreshing!
— Patricia Edmonds
Editors Note: The Midwifery Today E-News issue Patricia refers to contains excerpts from an article on the H1N1 virus and pregnancy. The full article can be found here: http://www.midwiferytoday.com/articles/preg_H1N1fluvirus.asp
Be sure to look for our brand new article on the same subject, with more information to share with clients, which will be up on our Web site within the next few days here: http://www.midwiferytoday.com/articles/preg_H1N1primer.asp
The Shanti Uganda Society improves the physical, emotional and spiritual well-being of communities impacted by poverty, HIV/AIDS and war in Uganda. Our programs include organic farming initiatives, income-generating initiatives for HIV-positive women, teen girls' groups, a birthkit project and the creation of safe and empowering birth spaces.
In December 2009, we begin building the Shanti Uganda Birth House and Learning Centre. In partnership with a natural building organization, the birth house is being built with and for the local community using local materials and is designed to honour the needs of women in the community. It will be a safe and empowering place for women to birth, supported by midwives, that is similar to a home environment. Design includes an outdoor garden compound and plans for an herb garden. We hope to be complete by Spring 2010.
How to Get Involved
If you are a midwife, doula, prenatal educator, homeopathic practitioner, herbalist or have other skills that you feel may benefit the work we do in Uganda, please contact us. Currently our volunteer midwives work in the labour ward at the local clinic we support. There are roughly 50 births a month at the clinic and it is staffed by local midwives and doctors, and has a room for c-sections. While the Shanti Uganda Birth House is being built, we will also be looking for volunteer midwives to help in the planning and training of local midwives and traditional birth attendants in the area. Once built, volunteers can work both at the clinic, which will be our transfer location, as well as at our eco-birth house.
Ways to Give
Sponsor A Midwife: Either for one month (http://www.shantiuganda.org/products/sponsor-a-midwife), or by joining together with the midwives and other birth practitioners you know to support a midwife for one year (http://www.shantiuganda.org/pages/workplace-giving).
Improve Maternal and Infant Health: Make a contribution towards reducing maternal and infant mortality rates in Luwero District, Uganda. Provide much-needed supplies at the Shanti Uganda Birth House, help educate midwives and traditional birth attendants and support prenatal education (http://www.shantiuganda.org/products/gifts-of-action).
Birthkits: The Shanti Uganda birthkits decrease the risk of infection and bleeding for both mother and baby. They are filled with the basic supplies a woman needs to have her baby with safety and health in mind and include a reusable fabric menstrual pad for the birthing mother to take home (http://www.shantiuganda.org/products/birth-kit).
Donate birth and midwifery supplies, prenatal education tools, receiving blankets, onesies, reusable menstrual pads: Mail to: 1900 Bowman Ave., Coquitlam, BC, V3J 6E3, Canada.
— Natalie Angell
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