July 3, 2013
Volume 15, Issue 14
Midwifery Today E-News
“Natural Hemorrhage Control”
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Learn about Hemorrhage

The Hemorrhage Handbook is filled with great stories told by expert midwives that give you superb insight into bleeding problems that may occur during the prenatal period, the birth or postpartum. Topics include the importance of good nutrition, how the bloodstream works, herbs to use, emotional factors and Chinese remedies. To order MT online store


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Learn about breech birth with Cornelia Enning, Carol Gautschi and Gail Tully

Belgium conferenceYou will spend the morning with Cornelia as she shows you how to work with breeches in water and explains the advantages of waterbirth for breech presentation. In the afternoon, Carol and Gail (pictured) will show you how to turn breech babies and discuss what to do if the baby won’t turn. The class covers palpation skills, estimating fetal weight, amniotic fluid, how to communicate with the baby with touch and words and much more. This full-day class is part of our conference in Belgium 30 October – 3 November. Learn more


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In This Week’s Issue


Quote of the Week

Women’s bodies have their own wisdom, and a system of birth refined over 100,000 generations is not so easily overpowered.

Sarah Buckley


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The Art of Midwifery

For the new mother, the third stage is a time of reaping the rewards of labour. Mother Nature provides peak levels of oxytocin, the hormone of love, and endorphins, hormones of pleasure, for both mother and baby. Skin-to-skin contact and the baby’s first attempts to breastfeed further augment maternal oxytocin levels, strengthening the uterine contractions that will help the placenta to separate and the uterus to contract down. In this way, oxytocin acts to prevent haemorrhage, as well as to establish, in concert with the other hormones, the close bond that will ensure a mother’s care and protection, and thus her baby’s survival.

Sarah Buckley
Excerpted from “A Natural Approach to the Third Stage of Labour: A Look at Early Cord Clamping, Cord Blood Harvesting and other Medical Interference,” The Third Stage of Labor, a Midwifery Today e-book. View table of contents / Order


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.

Jan’s Corner

Natural Ways to Control Bleeding

In answer to a question on hemorrhage, Gail Hart said, “Use your hands because those are the fastest and most effective tool! Act quickly. Don’t wait and watch while mom bleeds. The body is primed to stop the bleeding. There are natural mechanisms which usually work, and when they don’t we can use our hands. Fortunately, most of us are able to get medications in the rare times when we need more help.” Gail also says, “With cord still intact, you can reach membranes at the introitus and use that. They should be right there.”

I have been trying to get midwives to use what they already have readily available when controlling excessive bleeding: the membranes, cord and placenta. These are loaded with the perfect chemical components to stop bleeding. The potential dangers of synthetic oxytocin are avoided as well. We can observe mammals that eat their placentas (and don’t have human interference); they do not hemorrhage. Let’s take a lesson from God, who is so smart to create such a process. I believe if this knowledge had been known and used over the past few centuries, there would be millions of mothers who would not have died in childbirth, since hemorrhage is the biggest killer of women in childbirth worldwide. Will you please join me in this effort to get the word out about using what we have on hand to stop hemorrhage? Let’s tell the whole world of midwives!

My other concern is that when synthetic drugs are given after the birth, they may disturb the mother’s own oxytocin-bonding love hormone. I say may disturb because we know it certainly does disturb natural oxytocin in labor and if it does a similar action after the baby is born, it could reduce or completely replace natural oxytocin. Research has not been done on this yet as far as I know. As always, we must be vigilant and protective of the natural process that we know works almost all the time!

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.

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Featured Article

Preventing Postpartum Haemorrhage

The prevention of postpartum haemorrhage is an ideal topic to illustrate the usual discrepancy between the perspective of modern physiology and the legacy of tradition.

According to the physiological perspective, the delivery of the placenta is a result of the peak of oxytocin a woman is supposed to release after the birth of the baby. A Swedish team headed by Kerstin Uvnas-Moberg has demonstrated that immediately after giving birth, a mother has the capacity to reach a level of oxytocin that is still higher than for the delivery itself (Nissen et al. 1995).

Knowing the vulnerability of oxytocin release, which is highly dependent on a great number of factors, particularly environmental factors, we must wonder what kind of environment can influence this special hormonal peak just after the birth of the baby. This is, in the current scientific context, a way to phrase the right questions regarding the delivery of the placenta and its possible complications. To answer these questions I am influenced by the lessons of clinical observation, which are supported by the lessons of modern physiology. The first positive factor is that the mother has given birth to the baby through an authentic fetus ejection reflex, rather than a second stage of labor associated with the need for voluntary movements (Odent 1987). After the birth, one of the conditions is that the mother is not cold. Regina Lederman found that the level of adrenaline can return to normal as early as 3 minutes after birth (Lederman et al. 1985). She has therefore demonstrated how crucial this short period of time is and confirmed what can be learned from practical experience. When asked what to prepare for a homebirth, I only talk about electric radiators and extension cords, so that warm blankets or towels are constantly available. If a woman is shivering just after the birth of the baby, it simply means that she is not warm enough.

Another condition is that the mother is not distracted when discovering her baby. The mother needs to feel the contact with the baby’s skin, to look at the baby’s eyes and to smell the odor of her baby. Any distraction can bring her “back to our planet” and inhibit the hormonal peak. One cannot make a list of the countless distractions that can interfere during this phase of labor. Some of them are special to our society. For example, a woman has forgotten the rest of the world while discovering her baby. Suddenly a telephone rings. The mother will come back to our planet and will not release her vital peak of oxytocin. Other distractions are quasi universal, such as cord cutting before the delivery of the placenta. In general, one can claim that, according to modern physiology, the newborn baby needs its mother, particularly during the critical minutes following birth, while the mother needs the baby. It is an interaction between the two obligatory actors during the period surrounding birth.

References:

  • Nissen, E, et al. 1995. “Elevation of Oxytocin Levels Early Postpartum in Women.” Acta Obstet Gynecol Scand 74 (7): 530–33.
  • Odent, M. 1987. “The Fetus Ejection Reflex.” Birth 14 (2): 104–05.
  • Lederman, RP, et al. 1985. “Anxiety and Epinephrine in Multiparous Women in Labor: Relationship to Duration of Labor and Fetal Heart Rate Pattern.” Am J Obstet Gynecol 153:870–78.

Michel Odent
Excerpted from “Preventing Postpartum Haemorrhage,” Midwifery Today, Issue 105
View table of contents / Order the back issue


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Midwifery Today Back Issues have the information you need!

Midwifery Today back issuesFrom second stage and prematurity to birth change and natural remedies, back issues of Midwifery Today print magazine are packed with informative articles that will help you improve your practice. You’ll also find inspiring birth stories, birth news, poetry and stunning black and white photography. Choose from these available back issues.


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Suitable for both parents and practitioners, the Breastfeeding e-book is filled with insights into various aspects of this important topic. This collection of 15 articles from Midwifery Today magazine includes “The Role of the Shy Hormone in Breastfeeding” by Michel Odent, “Milk Supply: You Have Enough” by Lina Duncan, “Supporting Mothers in Long-term Breastfeeding” by Janell E. Robisch and “The Four Pillars of Safe Breast Milk Sharing” by Shell Walker and Maria Armstrong.

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Website Update

Read this article excerpt from the newest issue of Midwifery Today, Summer 2012:

Babies Are Born Where They Are Born: A Conversation with a Midwife about Not Handing Babies to Their Mothers by Mary Esther Malloy

This article is a wonderful argument about the importance of not disrupting the first moments after birth, but allowing the mother to meet her new baby in her own way and on her own time.


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Birth Q&A

Q: How do you handle a hemorrhage?

— Midwifery Today

A: I use angelica if the placenta hasn’t come and shepherd’s purse if it has.

— Amy Miceli

A: Remember the four Ts! Tone, Trauma, Tissue and Thrombin. The important thing is to first establish where the haemorrhage is coming from. Tone: Is the uterus contracted (70% of bleeds)? Trauma: Is there a tear that’s bleeding (20% of bleeds)? Tissue: Is there something left inside the woman, like membranes or a piece of placenta (10% of bleeds)? Thrombin: Is this a clotting issue (less than 1% of bleeds)? Understanding why the woman is bleeding will help you decide how to manage the bleeding. If it’s a tear, then an oxytocic isn’t going to help.

— Samantha Rouse

A: I use Hemhalt by TriLight herbs. I have seen it stop a hemorrhage faster than Pitocin. As soon as it is given to mom, use uterine stimulation and get the baby to nurse.

— Christy Birthkeeper Fiscer

A: If the placenta has been born, giving the mama a small piece of it to suck on will often stop the hemorrhage.

— Jeanice Barcelo

A: Giving mom oxygen will constrict blood vessels in the uterus and can temporarily slow bleeding down. (Think about this if you were taught that oxygen is useful for a distressed baby!) Oxygen can slow bleeding for a bit, but not because it is strengthening the uterus. The uterus needs glycogen/glucose and it will likely not contract until it gets it. You can give mom Pitocin, but if the uterus is tired it won’t fix the problem. Sweet is the key in this situation: honey on a spoon, sweet tea, sweet juice, etc. In some regions, apricot nectar or a few dates are traditionally used for prevention and treatment of hemorrhage. In others, it’s sweet hot chocolate.

— Gail Hart


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Conference Chatter

Hemorrhage Classes at Conference

As conference coordinator, my job requirements often keep me very busy at conference. It’s a treat for me to get to pop my head into the classes. At our Eugene conference this past April, one of the classes I was able to sit in on was a class on hemorrhage co-taught by the amazing Gail Hart. I felt so lucky to be able to do so, as her lecture on the subject was extremely informative and inspiring. At this next conference we’re holding in Blankenberge, Belgium, Gail Hart is once again teaching a class on this subject, called “Hemorrhage: Prevention and Management” during the Saturday program. Please come join us and learn skills to help prevent and treat hemorrhage from an evidence-based and holistic perspective, taught by an expert midwife.

To learn more about this class and the other classes that will be at our October conference, please visit go here.

If you have any questions about this conference or any conference from the past or future, please feel free to drop me a note at conference@midwiferytoday.com, and I’ll be happy to assist you.

— Andrea Goldman


Stories

After laboring all night and day, I was begging to get in the tub in my bedroom. As I let my body sink in I exclaimed, “Oh good, I might do this again someday!” I had been thinking about how I really didn’t want an only child, but I was never doing this again. The tub was a wonderful relief, and I demanded on getting in it much earlier during my next labor, 23 months later.

— Stacy Gould


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