February 26, 2014
Volume 16, Issue 5
Midwifery Today E-News
“Undisturbed Birth”
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Learn more about how birth can be.

Watch Giving Birth to discover what’s possible for 95% of all mothers and babies who can birth normally and naturally. This DVD contrasts the medical and midwifery models for birth and explains the risks of routine obstetric practices. You’ll learn about the importance of doulas, see images of a waterbirth, watch a woman give birth in her own home, and learn about epidural anesthesia, cesareans and more. Giving Birth features obstetrician/gynecologist Christiane Northrup, author of the bestselling Women’s Bodies: Women’s Wisdom. Includes a free resource/teaching guide, “Giving Birth: Challenges and Choices.” To order



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In This Week’s Issue


Harrisburg conferenceCome to our conference in Harrisburg, Pennsylvania, this April

You’ll be able to choose from a wide variety of classes including Breech, Optimal Fetal Positioning, Beginning Midwifery, Cultural Aspects of Resuscitation and Midwifery Skills. Teachers include Jeanne Ohm (pictured), Sister MorningStar, Elaine Stillerman, Gail Tully and Carol Gautschi.

Learn more about the Harrisburg conference.



UK conferenceImprove your midwifery skills and knowledge

Attend the full-day Midwifery Skills class with Verena Schmid (pictured), Gail Hart, Amali Lokugamage, Mary Zwart and Eneyda Spradlin-Ramos. Suitable for both beginning and advanced midwives, sessions include Essential Prenatal Care, Complications of Labor and Newborn Complications.

Learn more about the Bury St. Edmunds, UK, conference.



Quote of the Week

When you consider birth as an involuntary process involving old, mammalian structures of the brain, you set aside the assumption that a woman must learn to give birth. It is implicit in the mammalian interpretation that one cannot actively help a woman to give birth. The goal is to avoid disturbing her unnecessarily.

Michel Odent


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The Art of Midwifery

At birth:

  1. Use low light.
  2. Do not disturb the mother with unnecessary interruptions. Limit talking.
  3. Have the mother choose the positions that are best for her.
  4. Make the mother central. Follow her lead and do what she needs or wants. Pay attention to her sounds, body language and expression to determine her needs.
  5. Make sure the room is warm. If mom is comfortable she will birth more easily.
  6. Comfort measures for the mom also help the baby. They are a unit.

Jan Tritten and Jill Cohen
Excerpted from “Tricks of the Trade,” Midwifery Today, Issue 81
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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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Editor’s Corner

UK Midwifery

Midwifery in the UK has a special place in my heart. Many today may not realize the role it has played in the reclamation of midwifery in the US. During the decades when midwives had been outlawed in many of our states, we could look across the Atlantic to the UK where our sisters were not only legal, but an honored part of the medical system!

When told that women did not have the mental or emotional capacity to give birth without medical intervention, we could say, “But they are able to do it in the UK!” When we were told that a doctor’s education was required to deliver babies, we could say, “It isn’t required in the UK.” When told that obstetricians were the standard of care for childbirth, we could say, “They aren’t in the UK.” When told midwives were old-fashioned and unwanted, we could say, “They are popular and very much wanted in the UK.”

For every argument put against us and for every obstacle in our way, we could look to midwifery in the UK and say, “It works there. It can work here, too.”

The UK showed our doubters that midwifery is not only possible, but also normal, accepted and expected. In the UK and around most of the world, childbirth is in the hands of midwives, not doctors.

In the US, we had to fight hard for the recognition, and even legalization, of midwives in many of our states. Though we are still unsuccessful in a few regions, our gains in midwifery could not have been achieved without the UK midwives providing an example of how midwifery can be legal and integrated into normal society.

You in the UK were our standard-bearers. You are part of our history!

— Gail Hart, midwife

Gail Hart graduated from a midwifery training program as a Certified Practical Midwife in 1977. She has held a variety of certifications over the years; she was a Certified Midwife through the Oregon Midwifery Council, and an LDEM in the state of Oregon. She is now semi-retired, and no longer maintains her license, but still keeps active with a small community practice. Gail is strongly interested in ways to holistically incorporate evidence-based medical knowledge with traditional midwifery understanding.

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Conference Chatter

I am so excited to come to the UK Midwifery Today conference. The tourist in me is excited to see the famous gardens and locations I’ve read of in so many books, and the midwife in me is excited to come to the place that was most influential to the revival of midwifery in the US.

The UK still holds a strong central position as midwifery evolves worldwide. The protocols and standards accepted in the UK are likely to become adopted throughout the English-speaking world. The influence of UK midwifery can be felt everywhere. When you make changes there, you precipitate changes elsewhere.

Humanity is at an important moment in our understanding of birth. We are dealing with the balance between physiological birth and technological birth, the integration of the old and new, the recognition of maternal rights and the new discoveries surrounding the profound effect of birth on mother, baby and family.

Midwifery itself is at an important moment as we try to define the role of midwifery. The UK midwives are right in the center of it all!

I am inspired by the potential of midwives in the UK to walk the careful path into the future of midwifery and I look forward to rubbing shoulders with them at this year’s conference.

— Gail Hart

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Featured Article

Knitting Midwives for Drugless Childbirth

I cannot forget the time when a woman could give birth in a small, dimly lit room with nobody around but an experienced and silent midwife, sitting in a corner and knitting. The situation was obviously conducive to easy births (Odent 1996).

It is fruitful to reinterpret such a scene in the scientific context of the twenty-first century. At the April 2004 British Psychological Society conference, Dr. Emily Holmes from Cambridge University presented her studies on the effects of repetitive tasks, such as knitting, in stressful situations. In one study, volunteers were recruited to watch video footage of real car crashes showing dead bodies and a lot of blood. Some participants were given a repetitive task, such as tapping out a complex five-key sequence of numbers on a keypad, to do while they watched. Those who were given such a task experienced fewer flashbacks during the following days than the others. The author concludes from Dr. Holmes’ studies that repetitive tasks are an extremely effective means of reducing tension. Dr. Holmes emphasized that her research was consistent with the actions of notorious French tricoteuses of the French Revolution, such as Madame Defarges, who knitted while watching people being guillotined, apparently never experiencing posttraumatic stress disorder. She also referred to the use of worry beads in many cultures, such as Greece, as a way to cope with stressful situations.

We might translate such findings into physiological language and conclude that when midwives spend hours and hours knitting, their own levels of adrenaline are kept as low as possible. Since high levels of adrenaline are extremely contagious, the progress of labor is to a great extent dependent on the adrenaline levels of those around the laboring woman.

Such considerations are of paramount importance at a time when we must learn to think long-term and to think in terms of civilization. The aim of any futuristic birth strategy should be that as many women as possible give birth vaginally, thanks to an undisturbed flow of love hormones. The future of our civilizations is at stake.

The essential first step is to improve our understanding of birth physiology and to rediscover the basic needs of women in labor. These basic needs are shared by all mammals. All mammals need to feel secure when giving birth: They postpone the delivery if there is a predator around. All mammals need privacy: They have strategies for avoiding observation during the period surrounding birth. After thousands of years of culturally controlled childbirth, decades of industrialized childbirth and a proliferation of methods of natural childbirth (as if the words method and natural were compatible), these basic needs have been forgotten.

Reference:

Michel Odent
Excerpted from “Knitting Midwives for Drugless Childbirth,” Midwifery Today, Issue 71
View table of contents / Order the back issue


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Website Update

Read this article excerpt from Midwifery Today magazine, recently posted to our website:

  • Amniotomy and Cord Prolapse by Judy Slome Cohain

    Excerpt: Research shows that artificially rupturing the amniotic sac (amniotomy) can cause umbilical cord prolapse. Amniotomy became a routine part of obstetrical care with the introduction of active management, without evidence of benefit. In the 30 years since active management was introduced, the rate at which amniotomy causes umbilical cord prolapse has not been directly studied.


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Birth Q&A

Q: To midwives: How do you protect birth from being disturbed?

— Midwifery Today

A: So simple. So sacred. Let’s keep babies in the arms of their mothers and watch peace wash over the face of the earth. Skin-to-skin, delayed cord clamping, uninterrupted breastfeeding and immediate bonding are all ways we can use science to support instinct. The simple actions of lowering one’s voice, moving slowly when approaching, respecting natural lighting, using breath instead of language during contractions, providing warmth, emptying the mind and heart of distraction or fear, nurturing joy, offering plenty to drink and having patience. By observation one can learn to use skills that replace cervical checks, fetal monitoring machines, clocks, tubes that tangle and other things that come from our formal training that do little to improve outcomes, but do lots to disturb birth. The old brain has intelligence that the new brain can learn to trust.

— Sister MorningStar

A: I’m a fly on the wall observing quietly from a corner or even from the next room. I listen for cues that she wants/needs help and then I step up and do a little coaching. If she is doing great, I continue to leave her alone. I try to check FHTs occasionally when she gets up to pee or is changing positions (when she is already out of her “zone” anyway). I use visual or tactile cues before resorting to verbal intrusion. If a mom “loses it,” I bring her back and then I retreat again. If she hasn’t “lost it,” then nothing is needed, and I stay in my corner.

To be fair though, I have found that while some moms are in their hind-brains (as Michel Odent would say), for them, anything that intrudes on their labor land brain is detrimental. But for others, birth is a social affair—they like interaction. There have been times when I notice the mom starting a contraction and so I stop what I was saying midsentence so as not to disturb her, only to be told, “Keep talking. It takes my mind off the pain.” Some women want many hands on, but others need all hands off. I serve my clients, not my agenda. I will be as hands-on or -off as they wish.

— Marlene Waechter

A: To be a good midwife, you have to learn to preserve the sanctity of a laboring woman’s environment. If you allow a woman to birth on her own terms, her birth environment will naturally progress from a social event to a more reverent one. An experienced midwife knows how to recognize what is happening, follow the mom’s lead and hold her space.

— Rachel Curnel Struempf

A: Say nothing, do nothing and suggest nothing unless it is truly needed or asked for. Be aware that absolutely everything you could possibly utter or even think may influence her process!

— Maryn Green


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