March 31, 2010
Volume 12, Issue 7
Midwifery Today E-News
“Amish Birth”
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  • Cultural Birthing: Working with Amish Women—Pregnancy and prenatal care are quiet and modest times. Purchase this tape
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Midwifery Today Conferences

A full-day workshop is a great way to learn more about birth.

When you attend our conference in Philadelphia, April 2010, you can choose from a variety of full-day classes, including a two-day class on Traditional Midwifery Skills. There are also single-day classes such as Beginning Midwifery, Herb Workshop, Spanish Language for Birth, Breech Workshop, and First and Second Stage Difficulties.

Learn more about the Philly 2010 conference and get a complete program.


Birth Is a Human Rights Issue

The right to have the most joyous and healthy pregnancy, birth and postpartum possible should be a human right for both mother and baby. Learn how you can help. Come to our conference in Strasbourg, France, September 29 – October 3, 2010. Classes will include Mothers' Birth Rights, Babies' Birth Rights, and Maternal Mortality Is a Pressing Human Rights Concern.

The complete program for the Strasbourg conference this fall is now online! You may view it online or download a PDF. Sign up for your first choice of classes before they fill up! Go here.


Come to a Midwifery Today Conference in Russia!

We're teaming up with Domashniy Rebenok (Home Child magazine) for the “Birthing in Love: Everyone’s Right” conference this June in Moscow. You'll be able to learn from teachers such as Eneyda Spradlin-Ramos, Michel Odent, Katerina Perkhova, Gail Hart, Marina Dadasheva and Elizabeth Davis. This is a great opportunity to learn from Russian midwives and share our knowledge with them, so plan now to attend!

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Quote of the Week

“It is the custom of the Amish to ‘give themselves up’ to what life delivers them because if God didn’t mean it to be, they assume, it wouldn’t have happened…. As they give themselves up, they seem to become both more gentle and more joyful.”

Penny Armstrong, A Midwife’s Story


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The Art of Midwifery

Potato for Hemorrhoids

For hemorrhoids, a sliver of potato can be carved into a suppository and inserted past the anal sphincter. A slice of raw potato can also be placed against the hemorrhoid on the outside. Or, the potato can be grated and applied externally, being held in place by a 4x4 gauze pad and the underwear. The soothing effects begin almost immediately, and even grossly swollen hemorrhoids begin to shrink in a few hours. Potato is especially comfortable if the skin is broken and there is any rawness or bleeding; it does not sting as garlic might.

Lani Rose Jeansdottir, Canoga Park, California
Excerpted from Midwifery Today’s Wisdom of the Midwives, Tricks of the Trade, Volume II
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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.


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Jan’s Corner: Ultrasound and Autism

Amish_buggyWhen I was in Pennsylvania for the last Midwifery Today conference two years ago, I had the privilege of going around Eastern Pennsylvania and visiting Amish and Mennonite midwives with my midwife friend, Carol Gautschi. First we stayed with Diane Gosland, a very experienced and excellent midwife who let me attend a few births with Amish women. She has served the Amish for a couple of decades. It was a very special experience to go to a home farm in the middle of the night, guided only by the glowing light of an oil lamp. A feeling of warm spirituality was present, but then I always feel a deep spirituality at births. At one birth there were a dozen loaves of bread and as many cakes cooling on the counter. There were dozens of baked cookies ready and an unbaked bowl of cookie dough sat on the counter—labor had hit too hard for her to finish baking. I remember shopping with Diane, and seeing all the Amish men and women come up and talk to her about everyday things. Diane’s warm hospitality and open sharing of her practice will always be remembered as a blessing.

We then visited with Mollie Petersheim, an Amish midwife. We picked her up at her home and went with her to visit with Mary Hostetler, a Mennonite midwife and good friend of Mollie’s. I had the privilege of interviewing them about their practices. [See Jan’s editorial in Midwifery Today magazine, Issue 88, Winter 2008] The confidence all these midwives exude about birth is amazing in this fast-paced, over-technologized world.

The next Sunday was Easter and Mary invited Carol and me, complete strangers, to a huge, 80-person, family event. Her hospitality and love of people emanated from this beautiful woman. The memories burned into my heart and mind will last a lifetime. It was one of the best experiences of my life. Carol and I laughed our way around Eastern Pennsylvania, shopping at Amish businesses, making house calls and talking midwifery and birth nonstop.

If you would like the privilege of meeting Amish midwife Mollie Petersheim, come to the Philadelphia conference April 14–19, 2010. Mary Hostetler has a family emergency and can’t attend this conference, but Mary Cooper, who has worked with the Amish, will share her stories with you.

Jan Tritten, mother of Midwifery Today

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

Jan's blog: community.midwiferytoday.com/blogs/jan/default.aspx
Jan on Twitter: twitter.com/jantritten
Midwifery Today on Facebook: facebook.com/midwiferytoday


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Research

Vital Statistics Report Examines Out-of-Hospital Births and Homebirths in US, 1990–2006

A report examining the trends of out-of-hospital and homebirths in the US from 1990–2006 says the popularity of home and birth center births is on the increase, especially among white, married women older than 25, who have had previous children.

“After a gradual decline from 1990 to 2004, the percentage of out-of-hospital births increased by 3% from 0.87% in 2004 to 0.90% in 2005 and 2006,” the report, written for the U.S. Department of Health and Human Services’ National Center for Health Statistics and published in the National Vital Statistics System journal, states. “A similar pattern was found for home births…the percentage of home births increased by 5% to 0.59% in 2005.”

The report shows the percentage of homebirths varying by state, with states like Vermont and Montana having a 2% homebirth rate, compared to states such as Louisiana and Nebraska, which each had a homebirth rate of 0.2% in 2005 and 2006.

In their conclusion, the report’s authors state, “Women may choose home birth for a variety of reasons, including a desire for low-intervention birth in a familiar environment surrounded by family and friends and cultural or religious concerns. Lack of transportation in rural areas and cost factors may also play a role.”

The report points out that the homebirths were “less likely than hospital births to be preterm, low birthweight, or multiple deliveries.”

The majority of the homebirths in this report (61%) were attended by midwives. Of those births, 27% were attended by nurse-midwives and 73% were attended by direct entry midwives.

To read the full report, visit http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_11.pdf.

http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_11.pdf Accessed 9 March 2010.


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Just a Plain Birth

I race out the door, grabbing a drink and a chunk of cheese and eat in the car in lieu of dinner. Once on the road, I call my helper and then ponder what he [Amos, the laboring woman’s husband] could have meant by “feeling poorly.” Is she throwing up, bleeding or just in active labor? I pray that it is the latter. I call to check on my other client to tell her I will be out of my service area (why do all the ones without phones live where I can’t get cell phone service?).

Then I nibble on the cheese, praying for a good birth, until I reach the house, tucked way down a lane, marked only with a plain black mailbox with the name AMOS MILLER on it—not to be confused with the other mailboxes labeled ADAM MILLER, BARRY MILLER, AMOS MARTIN or AMOS BONTRAGER, or the unmarked mailbox of the newly moved couple. I know the house by the pile of gravel and 4x4s and the gleam of Celtex insulation just visible through the trees if the light is right.

As I carry in my equipment, I can smell the residual aroma from their dinner. My stomach growls, aching for the dinner I left on the stove. I hope that my son hasn’t burned it and that someone puts away the leftovers I can eat when I return. (I know that if it gets left out, my son’s dog will claim it for her own and I will be the loser!) Once my equipment is inside, I inquire how Lydia’s doing. He says it has slowed down and she’s taking a rest. Of course, she woke up when the dogs barked on my arrival, not to mention the herd of bleating goats that thought I was coming to feed them. She ambles out of the bedroom to greet me, not looking at all like that woman on TV, in agony at 3 cm.

We go into the bedroom: Her BP is 116/72, fetal heart tones range from 134 to 148, her cervix is 6 cm dilated and she is 80% effaced. I go back toward the kitchen and she follows, settling in a rocking chair by the wood stove, with a gentle, barely rocking motion. Her eyes close. Amos has already taken the children to the neighbors for the night. A row of black jackets, capes, bonnets and straw hats of varying sizes hangs on a rack near the door, a row of galoshes sits on the floor beneath. Dinner dishes are still in the sink. Two pots of water are boiling on the stove. I put my instruments in the smaller one and set a few towels and receiving blankets on the warming shelf, well away from the stovepipe, still remembering the beautiful blanket I scorched several years previous. I pour some of the water from the larger pot over the dishes in the sink and proceed to wash the dishes while my instruments boil. My partner, Jade, arrives; she starts rinsing the dishes while I fill her in on the progress. Amos feeds the horses, brings in more firewood, stokes the stove and settles down to read.

Lydia appears to be asleep, but an astute eye can see a barely perceptible change in facial expression every few minutes. After the dishes are put away, I settle down with my latest issue of Midwifery Today while Jade rummages through the supplies, ensuring that everything is in order and readily available. A slight moan escapes Lydia’s lips. Jade immediately starts applying counter-pressure on her lower back during contractions and massages her shoulders in between. Soon, I remind Lydia to empty her bladder and offer her a sip of juice. A few contractions later, she moves from the bathroom to the bedroom, saying, “I think it’s getting close.”

Lydia’s low moaning is now turning to light grunts. The baby’s heart tones remain good and strong. I go to check her dilation again, but find nothing but a bulging bag of water peeking through her labia. I put some more of the hot water from the big pot into a bowl with a few washcloths, while Jade carries the pot of instruments into the bedroom. Amos brings in the big kerosene lamp from the kitchen and lights the small one in the bathroom.

I apply a hot compress to Lydia’s bottom, while Jade applies counter-pressure to her lower back with one hand while holding her upper leg with the other. We offer sips of herb tea through a bendable straw between contractions so she can drink lying on her side. The water breaks; it is clear. The head crowns; we quickly wipe away a small piece of stool. Jade lays the warmed towels nearby on the bed, while I change the chux pad. The head is born with the cord around the neck. I hold the cord at the perineum, while Amos catches the baby in the towel as it comes through the loop of cord. Jade records the time.

Marlene Waechter
Excerpted from "Just a Plain Birth," Midwifery Today, Issue 85
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Web Site Update

Read this article excerpt from the most recent issue of Midwifery Today (Issue 93, Spring 2010) newly posted to our Web site:

  • The Question of Homebirth—by Sister MorningStar
    “Since when do we need an expert to tell us where we are comfortable? Since when do we need an expert to tell us with whom we feel relaxed and open and able to poop or make love or birth a baby? Since when was there an animal that didn't know how to protect itself—to flee or scratch and bite or growl when it isn't comfortable? Or to protect its young—to hold it close and get it back if it is snatched away and avoid people and places that threaten the ease of living and feeding the newborn? We are an intelligent animal. We know more than we are letting on. We know more than we tell ourselves that we know.”

Read this article from Issue 83 of Midwifery Today newly posted to our Web site:

  • Safer Birth in a Barn?—by Beth Barbeau
    “You’ll see that we’ve removed her halter and lead—you would never restrict the movement of a birthing mare; foals have been lost for less! She must be free to move any way she wants. She’s been in this box stall (when not out to pasture) for weeks, because she must be in a familiar environment to birth smoothly.”

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Question of the Week

Q: With the efficacy and safety of prenatal ultrasound in question, we’ve been wondering how many midwives stick to the traditional fetoscope for prenatal exams and how many have switched over to using a hand-held Doppler. We want midwives to weigh in on this debate. Fetoscope or Doppler for prenatal exams? Which do you prefer and why?

Midwifery Today staff


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.


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Question of the Week Responses

Q: I am currently studying for my midwifery degree at Oxford Brookes University, UK, having been a registered nurse since the early 1990s. During a recent module exploring perineal trauma, I came across an article published in the Winter 2001 issue of Midwifery Today, by Denise Gilpin-Blake and Summer Elliot, titled “A Natural Alternative to Suturing.” Having elected to further explore methods of repair of trauma for my dissertation topic, I conducted a literature search in order to find current evidence for the use of seaweed in perineal repair and came up blank! I e-mailed the Accouche centre in California where this article was based, and despite a very pleasant, prompt reply, no further information was offered apart from the fact that this practice is no longer carried out there.

Do you have any further information regarding the use of seaweed or any insight into why it may no longer be used in this capacity?

— Sarah Brennan, RN, student midwife

A: I learned about the use of seaweed as an alternative to suturing from a Mexican midwife. I never actually witnessed her using the ever present Nori in her birth supplies, because during my apprenticeship with her I only saw either women who didn’t tear at all or those whose tears were bad enough for stitches. The midwife taught me that seaweed can be used for very minor tears, ones that did not quite require stitches but probably would need a little support for optimal healing. However, I did test the method out on my boyfriend’s badly cut finger and it healed up very quickly without leaving any scar!

— Julia Pollard, student midwife

A: When I trained as a doula in Denver, I was also taught about seaweed being an alternative to suturing. I have never used it in childbirth, but I have used seaweed for first aid. I live 45 minutes from the hospital and it can be a long time when an emergency happens. When my son was 3, he slipped and bit through his lip. The lip was dangling. I remembered about the seaweed and applied it to his lip. To my amazement and relief, it held the lip in place and stopped the bleeding. We brought him to the clinic and they stitched it up. There was no way a bandage would have worked on his lip. In another incident, I sliced my finger deeply while I was sharpening a knife. I again used the seaweed to “glue” the cut together. It worked amazingly well.

— Katie Garrity
Fairbanks, Alaska

A: Two drops of rosemary oil are sticky and antibiotic, and [will cause] small tears to close up within 20 minutes. I carried seaweed in my bag for a few years, but never used it. Some [women] don’t like the smell; since it won’t dissolve and if you have to remove it, the cut will open again. Try rosemary oil—works like glue.

— Judy Slome Cohain, CNM
Israel


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


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Letters

Dear Midwifery Today,

Thank you so much for your insightful editorial about where we are as midwives today. I, too, have seen a change in the head space of apprentices and new midwives. I think we strive so hard for the unattainable goal of approval from the system, that we have sold our hearts. It really feels like some kind of disconnect that has cost us the very thing we went into midwifery for—service to birthing women, their babies and their families.

Thank you!

Cheri Jackson
Hardyville, Kentucky


Dear Midwifery Today,

Reading the little note about the woman who danced her baby out [E-News, Issue 12:5] reminded me of my early childbirth classes. At the end of the class I would put on music, turn down the lights and the couples would dance together. I did this for years and the parents loved it. Many said it gave them the habit of doing it at home and at the end of a long day, for both, reminded them to take time for each other.

Donna Harnett


Dear Midwifery Today,

Whenever I see an article about a possible link between ultrasounds and autism (E-News, March 3, 2010, Issue 12:5. Jan’s Corner: Ultrasound and Autism: “Research Shows Women over 40 More Likely to Have Autistic Babies, but What’s Really Going On?”) it catches my eye. It has made sense to me for some time that the two must somehow be related. Recently I have been studying Dr. John Cannell’s Web site, http://www.vitamindcouncil.org/health/autism/, and his ideas about how autism is related to low levels of vitamin D. It fits that ultrasound could be even more damaging to an unborn baby when the mother is vitamin D deficient. This is an important key to the tragic autism epidemic. Vitamin D research is mounting fast and is very eye-opening. It is so convincing that my family and I are now taking extra vitamin D and avoiding use of sunscreen. Looks like all midwives should be checking moms’ vitamin D levels. Home vitamin D tests are available at http://GrassRootsHealth.net.

Jeanne Campise
Fresno, California


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