August 4, 2010
Volume 12, Issue 16
Midwifery Today E-News
“Birth Change”
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How do we change birth and how does birth change us?

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How has birth changed over the years? Articles in Midwifery Today Issue 84 (Winter 2007) will answer those questions, as well as teach you about massage and midwifery, ectopic pregnancy, the placenta and more. Authors include Robbie Davis-Floyd, Judy Slome Cohain and Sister MorningStar.
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Midwifery Today Conferences

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.

See the complete program here.


Sister MorningStar ~ Ina May Gaskin ~ Michel Odent

Learn about birth from these great teachers when you attend our conference in Eugene, Oregon, March 30–April 3, 2011. Other confirmed speakers include Elizabeth Davis, Carol Gautschi, Harriette Hartigan, Robbie Davis-Floyd and Gail Hart.

Learn more about the Eugene 2011 conference. To receive a printed program by mail when it becomes available, please e-mail admin@midwiferytoday.com with your name and postal address.


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In This Week’s Issue:


Quote of the Week

“Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience and the passion to reach for the stars to change the world.”

Harriet Tubman


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The Art of Midwifery

There is absolutely no evidence that supports that taking five-minute interval fetal heart tones makes a bit of difference in the outcomes. The simpler you keep the birth process, the fewer mistakes are made.

Gloria Lemay
Excerpted from Sharing Midwifery Knowledge, Tricks of the Trade, Vol. IV
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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.


Send submissions, inquiries, and responses to newsletter items to: mtensubmit@midwiferytoday.com.

Jan’s Corner

Birth Change

Changing birth practices around the world is an important part of my work, and it is probably an important part of your work. Every motherbaby has the right to an optimal pregnancy and birth. When I attended homebirths in the ’70s and ’80s, the uterus had not yet been invaded. During the early 1970s, the US cesarean rate was 6–8%—not the optimum of less than 5%, but certainly more reasonable than today’s numbers. By 2007, the c-section rate in the US had soared to 31.8%. Between 1975 and 1983, the c-section rate in the US increased sharply, doubling from 10% to more than 20%. What accounted for this increase? Was it fetal monitoring or too many drug pushers in the hospital? (Midwifery Today, Issue 95, which comes out in early September, includes an informative article about drug pushing in hospitals.) Regardless of the reason, what we are left with is a humongous amount of change needed in birth practices.

As a pregnant woman, you have the ability to change the outcome of your own birth. The first and best way to ensure a positive outcome is to stay home. You will expose yourself to much less risk by staying out of the hospital. Hospitals are for sick people and you aren’t sick. Find a great midwife who has time for you and who understands that, if she helps you during your prenatal period to work though things that may hold you up in labor, your birth is likely to go well. During our recent midwifery conference in Russia, many of us came to the conclusion that probably 90% of birth takes place in the mind. The mind influences our muscles, so the more you can clear from your mind prenatally, the easier your birth will be. If you do birth outside your home, remember that drugs cause babies to get caught in positions that are not optimal for birth and lead to further interventions, including c-sections, so “just say no” to drugs during your labor! I have been writing about the dangers of ultrasound on my Facebook page, and we have written about it in Midwifery Today magazine, but ultrasound rates continue to climb. Today, US doctors are performing twice as many prenatal ultrasounds as they did just 10 years ago. Question the need for drugs and technology in birth.

While meeting with our sisters in Russia, we developed a “Global Midwifery Council” to tackle the many problems and questions surrounding birth issues around the world. I’ll write more about this global council soon. For now, I have a couple questions: For those of us who know all of this, how do we convince other mothers of these truths? How do we change the world of horrendous birth practices?

When we hold our Midwifery Today conference in Strasbourg, France, September 29 – October 3, 2010 (http://www.midwiferytoday.com/conferences/Strasbourg2010/), we have an excellent opportunity to discuss birth changes. The day before the conference starts, we will host an International MotherBaby Childbirth Organization (IMBCO) meeting. Those who attend will discover how to use IMBCO’s excellent, evidence-based, 10-step International MotherBaby Childbirth Initiative (IMBCI) to improve care throughout the childbearing continuum and enact birth change in your society. Find out more about IMBCI’s 10 Steps at http://www.imbci.org/ShowPage.asp?id=174. Another great site to check out, especially if you live in the US, is http://www.motherfriendly.org/. The job of changing birth practices is up to all of us who are interested in the emotional, spiritual and physical health of motherbaby. There is no reason for mothers to go through their lives traumatized when we know so much about the miracle of birth. Each one teach one!

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
International Alliance of Midwives on Facebook: facebook.com/IAMbirth


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Research

A new study shows that a newborn’s first exposure to bacteria differs according to how that baby is born. Led by researchers from the University of Puerto Rico, the study examined the types of bacteria on newborns and compared c-sectioned babies to those born vaginally.

Babies born vaginally were covered in bacteria similar to that found in their mother’s vagina—bacteria that researchers noted may be useful for protecting the baby against various diseases. The babies born via cesarean section had acquired bacterial colonies commonly found on human skin, primarily the Staphylococcus genus bacteria, which can cause deadly infections.

Researchers noted that their findings “establish an important baseline” for studying how mode of delivery affects an infant’s health.

— M. Dominguez-Bello, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. PNAS early edition, doi:10.1073/pnas.1002601107 Accessed 21 Jun 2010.


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Midwifery Today Short Video Contest Deadline This Week!

video cameraHelp spread the word about good birth!

Enter our short video contest on the theme “Birth Is a Human Rights Issue” and you could win a free five-day conference registration! Entry fee is US$10 per video and you can enter as many times as you want in the three categories: Short Documentary, Make ’em Laugh, and Advertise Optimal Birth. The winning videos will be shown at our conference in Strasbourg, France.

Entry Deadline is August 10, 2010, so get your creative gears spinning! Go here for more information and instructions.


Birthing with Reverence

Midwives can create a spirit of beauty at a birth or they can desecrate it. They can create a sacred space around a birthing woman that drives out fear and inspires the mother’s belief in herself, which ultimately determines the outcome of the birth. Midwives can be a channel of Grace in ways they never imagined and in doing so they create a spirit of reverence. Reverence in these days and times is not a common thing.

As a midwife there were times after births that I was overcome with awe, which is another term for reverence. It seemed appropriate for the sun to stand still in the sky, and the traffic to stop, and the whole universe to pause for a minute of awe in acknowledgement that something astonishing had just happened. It just seemed appropriate that all of creation should have taken notice. Perhaps, in the unseen world, it did.

Unfortunately in America there appears to be little reverence for much, especially not women or birth. This is not surprising given the history of the oppression of midwives, the rise of the medical model and the objectification of women’s bodies. The sacred has not just been drowned out at births but in our lives as a whole. In fact, reverence is not part of our public vocabulary at all. Yet, there are a few things that Americans do revere. Reverence for money comes to mind.

If you follow where the money goes it will reveal the short list of things that Americans do have reverence for. Large amounts of money are funneled into the pornography industry. Women are not revered in that industry. In fact, they are desecrated as an object of fantasy, not to be loved, cherished and honored, but simply to be used and discarded. Therefore, lust is revered, and as a result we have become a pornographic culture in which women are routinely desecrated.

Desecration involves an act in which a sacred thing is pillaged, or dishonored. The opposite of desecration is reverence. Reverence acknowledges and honors the sacred. Women and that which has to do with them, namely birth, are sacred. But they are not sacred at this place and this time. In fact, who among all the industrialized nations are reverent about women and what they do when they give birth?

Midwives have been given a sacred trust and a great honor to stand by as a witness to a miracle. Birth is not a small miracle. It is an extraordinary miracle. We are created for reverence and our work demands it. But when birth became a medical procedure our culture became so far removed from the beauty of it that it became commonplace and unimportant to the larger community. In the process of our irreverence we lost sight of our beauty as human beings.

Caroline Wise
Excerpted from "Birthing with Reverence," Midwifery Today, Issue 82
View table of contents / Order the back issue


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Each quarterly issue of Midwifery Today print magazine is packed full of birth news, insights and information. You'll also get an in-depth look at an important topic, with several articles devoted to the issue theme. Look over the list of available issues, then order the ones you need to help improve your practice. Order yours.



Web Site Update

Visit the Midwifery Today YouTube Channel

Please check out this YouTube video, part of our Birth Essentials series:
Ina May Gaskin on Footling Breech Birth
In this video, Ina May Gaskin of The Farm Midwifery Center teaches in the Breech Birth workshop at the Midwifery Today Conference in Eugene, Oregon, March 2009. She tells the story of a footling breech birth, including information about posterior breech and cord prolapse.

Click below to view, or you may wish to go here to download video and view without streaming interruption.


 

Read this article from Midwifery Today, Issue 94, recently-posted to our Web site:

  • Full Moon Birthing—by April Bailey Weaver
    “It was just the three of us. They wanted absolute privacy. After an hour or so, her water broke and she had a slight urge to push. The baby’s heart tones sounded wonderful. The night was warm and the moon was just on the horizon, yellow and full. She wanted to go to the tide pool.”

Read these reviews from Midwifery Today on our Web site:

  • A Walk to Beautiful—produced by Mary Olive Smith
    “A number of social factors cause so many women to develop fistulas in Ethiopia. First, the women have to do physical labor starting as very young girls. Because of the heavy lifting and carrying water for long distances, and inadequate diet, many of them have stunted growth.”
  • Creating a Life: The Memoir of a Writer and Mom in the Making—by Corbin Lewars
    “The need for women’s health care providers (i.e., obstetricians, gynecologists, doulas and midwives) to be knowledgeable about the impact of sexual abuse and violence on women’s lives and their experience giving birth is critical. We are the ones most likely to encounter these strong feelings, and we are the ones who can offer the space to let healing begin.”

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Question of the Week

Q: Can an inverted uterus cause complications during the third stage of labor?

— Jacqui Basilian


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: We’re looking for interesting postpartum customs from other cultures. Do you know of any? Please share them with us.

— Midwifery Today staff

A: Here in St. Paul, Minnesota, we have a large contingent of immigrants from Southeast Asia who are part of the Hmong culture. The Hmong women follow a strict, traditional diet for six weeks after childbirth: Only hot water, rice and a soup made from chicken and herbs are consumed. Nurses in our hospital have noticed that these women rarely complain of cramping postpartum, and we have wondered if the fact that they only consume warm beverages and foods is responsible for this. Many of our Asian immigrant women from other cultures also follow the custom of avoiding cold food postpartum.

Another custom many Hmong women follow during the postpartum period is the use of an abdominal binder. If the doctor won’t prescribe the stretchy kind the hospital provides, one of the grannies will often fashion one from a shawl or scarf. Women say they like the feeling of support the binder provides.

The Hmong families also show a great deal of support to their new moms. The entire extended family often arrives to visit, packing a dozen or more people into the woman’s small hospital room, including small children and elderly relatives. There is always someone who stays with the new mother to help care for the baby, so she can rest and recover from birth. I love the feeling of warmth and caring these families show their new moms.

— Molly Brom, RN

A: Ayurveda (literally “science of life,” the traditional medicine of India) recommends light massage (abhyanga) with warm sesame oil (more of an oil application than massage) for 42 days after birth. How’s that for nourishing? Ayurveda teaches that the new mother is just as open, sensitive and vulnerable as her newborn during this time, and has an opportunity to heal her whole being in profound ways. The oil and warmth are particularly soothing, grounding, relaxing and binding after childbirth. More ayurvedic postpartum protocols can be found at: http://www.sacredwindow.com

— Andrea Murphy, birth and postpartum ayurvedic doula
Sedona, Arizona

A: Here in Malaysia it is customary for a new mother to hire a “confinement lady” after the birth of the baby. I do not have personal experience with this, but I do know it varies from helper to helper on what is offered and from mom to mom on what they desire. The rules are very different from ethnicity to ethnicity. Read more about the practice of having a “confinement lady” at: http://www.babycenter.com.my/pregnancy/asian-postnatal-practices/confinement-practices/ While I think that, overall, this can be a very good thing, I also know that many moms abuse it (my opinion here) by sending the baby to be fed all night by the helper. I also know moms that felt so very restricted by their helper, by the dietary rules and someone constantly fussing over them.

— Vanessa Beyer

A: Here in Southern Algeria, where I am currently living, there are some postpartum rituals practiced. Everyone here is Muslim, so the postpartum mother is excused from her daily prayers during her lochia period. Also, if she is breastfeeding she is excused from fasting until she feels able to fast, or has weaned her baby. The families—on her side and on her husband’s side—cook and clean for the new mother for at least 40 days. There are special dishes that are cooked just for her, to help her milk come in and to prevent bleeding or pain.

New mothers here also put henna on themselves and on their baby (hands only for the baby, but hands and feet for the mother). The new mother rubs her baby daily with olive oil and puts kohl on the baby’s eyes. She receives guests (women of her family and community) almost every day and everyone helps out.

On the seventh day after a birth, lambs are slaughtered in thanks to God for a new baby, and then the meat is given away to the poor people of the community. The baby’s head is shaved and the weight of the hair, in the form of gold, silver or money, also is given away in charity to the poor.

Having a baby here is almost as social as an engagement or a marriage, and I believe that is why I have yet to see or hear about postpartum blues.

— Jennifer Hebert


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,

I am collecting stories and photos of South African homebirths for a South African Web site dedicated to homebirth. I’m also looking for things to include in a homebirth resource list (e.g., antenatal classes, midwives, doulas, mothers and fathers who have experienced homebirth and are willing to be contacted by people who are thinking about it, good Web sites and books).

Much love,

Ruth Ehrhardt
ruth@derekgripper.com


Dear Midwifery Today,

[This letter is in response to a recent “Trick of the Trade” published in Midwifery Today E-News Issue 12:12 http://www.midwiferytoday.com/enews/enews1212.asp#art, which said babies nurse for longer periods of time and drink more milk when the nursing mother eats garlic two hours before feeding time.]

In the homeopathic world, this is no secret! Homeopathically, garlic, or Allium sativum, in its proving symptoms causes “voracious appetite,” “patients to eat a great deal more than they drink,” “thirst,” and “complaints of those who eat to excess; gluttony.” But it also can cause “dyspepsia,” or “troubles from the least change of diet (like dyspepsia, burning in stomach; derangement of bowels and/or belching)” and so much more. Remember, garlic is a medicine like onions, asparagus, many spices including black pepper and cayenne, coffee, tea, chocolate and vanilla. These substances should be used sparingly while pregnant and nursing as our babies are more affected by these potent substances and usually cannot tell us that they are causing them discomfort in some way (e.g., cranky or irritable, not sleeping, colic, stomach pains, etc.). Many of the symptoms that we mothers drive ourselves crazy trying to remedy could actually be being caused by what we are eating and drinking!

Christina Mueller
Director, The Homeopathic College
Barnardsville, North Carolina


Dear Midwifery Today,

My name is Nick Nguyen and I work for Medical Emergency Relief International (Merlin), an international relief agency that trains midwives in Afghanistan and Liberia. We are looking for US midwives to support the training of midwives all over the world by simply giving your signature to our campaign, “Hands Up for Health Workers.” Our goal is to collect 10,000 signatures by September 2010 to present them in New York at the UN Summit on Millennium Development Goals, one of which is to support maternal and infant health care. Your signature would represent your support in the local training of midwives and other health workers around the world so that they can provide sustainable health care to their own communities.

Merlin specializes in health, saving lives in crisis and helping to rebuild shattered health systems. On-the-job training for health workers, and midwives, is key to all our programs, but in those countries where maternal deaths are among the highest in the world, we've gone even further: we’ve established dedicated midwife training schools.

Support Merlin’s campaign to raise 10,000 signatures by September 2010, when we’ll present a petition to world leaders demanding urgent investment in health workers in crisis countries. Since 2004, Merlin has supported two community midwife training schools in the Takhar and Kunduz provinces in Afghanistan, and has trained more than 155 midwives, benefiting more than 600,000 people. In Liberia, Merlin and Liberia’s Ministry of Health opened a midwife training school in December 2008 and the first class of 45 students will graduate at the end of this year. Visit http://www.handsupforhealthworkers.org and choose a health worker to support, then add your signature. Thank you so much for supporting our global health care campaign.

Sincerely,

Nicholas Nguyen


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.


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Midwifery Today: Each One Teach One!