April 9, 1999
Volume 1, Issue 15
Midwifery Today E-News
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In This Week's Issue:

1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Meeting the Challenge of Infection
5) Food-Borne Hazards
6) Listeriosis and Toxoplasmosis
7) Question of the Month
8) Switchboard
9) Coming E-News Themes


1) Quote of the Week:

"Talk to the elderly people around you. They have a lot of knowledge. That's where most of our knowledge is, and that's how you empower each other. [Then] talk to the children about it, tell everybody about it, and never stop."

- Jeanne Shenandoah, Onondaga Nation midwife


2) The Art of Midwifery


Following birth, mothers may want to take ten to fifteen drops of echinacea tincture twice a day in water as a preventive measure against infection. Some people feel dizzy when taking echinacea. This side effect can be alleviated by preparing it with licorice.

- Robin Lim, After the Baby's Birth... A Woman's Way to Wellness, Celestial Arts 1991

Cabbage Leaves

Because cabbage leaves are used to treat sore nipples, mastitis, and many other kinds of "itis," I tried placing cabbage leaves on top of a maxi pad to treat vaginitis. I experienced complete relief from burning and itching within a couple of hours.

- Christine Mallon, Midwifery Today Wisdom of the Midwives: Tricks of the Trade Volume 2, 1997


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3) News Flashes

Gentian Violet

Gentian violet is an effective topical antifungal, is active against some gram-positive bacteria, and is inexpensively available over the counter. However, treatment with gentian violet for infant thrush may cause ulcerations in the infant's mouth. Oral ulceration of the mucous membrane is thought to be associated with frequent (more than once or twice daily) use and/or prolonged use (longer than three days). A 0.25 percent to 0.5 percent solution is reported to be as effective as, and less irritating than, 1.0 percent to 2.0 percent solutions. It is also recommended that only the thrush lesions be painted with the solution and that the infant be turned face downward after application to minimize the amount that is swallowed.

- Journal of Human Lactation, September 1993



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4) Meeting the Challenge of Infection

Prenatal infection can threaten both mother and baby. The most effective approach a midwife should take will strive for prevention and foster radiant health, which increases overall resistance to disease. Pregnant women should be encouraged to maintain these basic habits:

1. Drink abundant pure water, which provides a medium for removal of metabolic waste. Encourage moms to drink prior to and beyond thirst.

2. Regular fresh-air exercise keeps tissues oxygenated and circulates immunological factors throughout the body. It decreases anxiety, increases energy, and elevates mood. Positive emotions are emerging as one of our most powerful infection fighters.

3. Consistent intake of fresh, minimally processed food, including fiber and ample protein in an easily digested form, is imperative. I emphasize fresh vegetables, whole grains, plant- and sea-based proteins, then fruit, in that order. Delayed intestinal transit time, reduced stomach acids, and diluted enzymes make items like red meat a tough proposition.

4. Top quality supplements, with plenty of vitamin C, bioflavinoids, and minerals, are a must. Ask your client at each visit how she is doing with supplements: Can she swallow them? When does she take them? How many is she taking? Are they staying down? Suggest taking them in the evening, never on an empty stomach, followed by a few bites of food.

5. Intervene early, before a minor infection turns ugly. This requires careful surveillance. Allow plenty of time for prenatal visits. Pay close attention. Get all the details if something doesn't seem right.

- Judy Edmunds, condensed and excerpted from "Wholistically Meeting the Challenge of Infection," The Birthkit Issue No. 14, a Midwifery Today publication


5) Food-Borne Hazards

Certain organisms that exist in food are known to cause late miscarriages, stillbirth and premature labor. The main known dangerous organisms are listeria, a bacteria, and toxoplasma gondii, a parasitic organism.

Listeriosis is usually contracted from meat and dairy products, especially soft-ripened cheeses; cook-chilled, ready-to-eat poultry; pate and other cook-chilled meals. The listeria bacteria is unusual in that it can multiply at the temperature of most refrigerators.

Pregnant women should avoid soft-ripened cheeses such as Camembert, Brie, and blue-veined types, whether made from pasteurized or unpasteurized milk. Ready-cooked poultry should be thoroughly heated. Raw foods and cheeses should be stored away from other foods in the refrigerator. Food should not be reheated more than once, and if reheated, should be heated all the way through. Food that is reheated in the microwave should be allowed to stand as directed by the oven manufacturer.

Toxoplasmosis can cause serious or fatal problems to a baby during pregnancy. To avoid them, pregnant women are advised to wear gloves when changing cat litter trays and while gardening; to wash their hands after changing litter, after gardening and after handling raw meat; and to wash fruit and vegetables thoroughly before eating.

Tests for toxoplasmosis can be carried out during pregnancy to find out whether the mother and baby have been infected. Antibiotics are used to combat the organism, and although damage that has been done cannot be reversed, the baby can be protected from further damage.

- When a Baby Dies, by Nancy Kohner & Alix Henley, Thorsons, 1997


6) Listeriosis and Toxoplasmosis

Listeriosis first presents as a mild infection with upper respiratory complaints, fever and nausea, with occasional severe systemic illness. Within a few days, an intrauterine infection develops with fever, a high white blood count and the onset of labor. Listeria may remain in the mother's genital tract for several weeks after birth.

Diagnosis depends on bacterial culture from tissue or body fluid. Blood antibody tests are not widely available.

Early onset of the disease in the newborn produces classic Granulomatosis infantiseptica, a diffuse sepsis with lung, liver and nervous system complications. These babies are most often premature and have congenital pneumonia with a rash and an enlarged liver and spleen. Mortality rate is around 90 percent. Late onset neonatal listeriosis presents as meningitis. Up to 40 percent die. Those that don't frequently have hydrocephalus and mental retardation.

Adult symptoms of toxoplasmosis gondii are mild and cold-like with swollen glands, muscle and joint pain and fatigue. Those with normal immune systems recover rapidly and develop antibodies; those with suppressed immune systems often die. Maternal recovery is excellent and treatment is not usually recommended since the drugs used may be harmful to the fetus. Only the acute infection can be transmitted to the fetus. This may cause hydrocephaly or microcephaly, jaundice, convulsions, vomiting, diarrhea, a rash, fever or hypothermia. Eye problems, the most common symptom, may appear at birth or in the first weeks or months of life. Isolation is not necessary as the organism does not shed.

A modified indirect fluorescent antibody (IFA) test can be done to distinguish acute neonatal infection from passive antibody transfer due to prior maternal infection. A true positive establishes infection. However, 50 percent of newborns with obvious problems may have negative results. If infection occurred at or near term, the baby will be born antibody negative, with antibodies appearing sometime during the neonatal period.

- Anne Frye, Understanding Diagnostic Tests in the Childbearing Year 4th ed., 1997.


Order Anne Frye's Understanding Diagnostic Tests in the Childbearing Year from Midwifery Today. Just $43 plus shipping. email inquiries@midwiferytoday.com for information on how to order. Please mention code 940.


Learn more from these Midwifery Today Issues:

No.16, Infections & Diseases
No. 29, Unexpected Outcomes
No. 41, Miscarriage & Infertility

Get these back issues for only $6.00 each plus shipping. (Regular price: $7.00) Call 800-743-0974 to order today! Mention code 940 and save $1. Expires May 1, 1999.


7) Question of the Week (repeated from last week): At what rate in your practice do babies pass meconium before birth, not counting breeches? Are your statistics from a homebirth practice or hospital practice? Also tell us how you handle the problem of meconium. Send your response to: mtensubmit@midwiferytoday.com


8) Switchboard

My husband and I are about to begin trying to conceive our first child. I have severe allergies to pollen and I receive weekly allergy shots. I'm trying to find out if these shots are safe for the baby. My allergist says they are, but he thinks it's OK to take medicine during pregnancy! (Needless to say I don't trust him.) Any information you have would be greatly appreciated. I'm also looking for information on safe herbal treatments for allergies during pregnancy.

Thanks for your help!

- Celende

I am loving being part of this community of women and educators--thank you so much for building the foundation.

I would like to share a little information about my posterior labor. While I was laboring with my second child, contractions were a constant five minutes apart and they came in pairs. Boomboom, then five minutes, for the whole labor. I wondered when they would get closer, but they never did. I was afraid the labor was going to go on forever (actually I labored only seven hours--still four hours longer than my first)... then I had the urge to push. It was an easy vaginal birth but the boy knocked my tailbone out of joint on the way out (I used the homeopathic remedy rhus tox to put it back).

I am a full time mom, massage therapist, doula and health educator who is making a living working in a health food store until I get a client base. I am looking for a possible apprenticeship somewhere out there--please respond to my email address:e23forest@hotmail.com. Love and light to you all sisters,

- Elizabeth Forest

All eight of my children were posterior. I had back labor with each one, but no problem at all pushing them out, usually a ten minute second stage. I have a great photograph of my daughter Jade coming out face up! One of the kids was asynclitic and posterior and I had to walk the last forty minutes of my labor to get his head down. But he came out just fine. Babies ranged in size from 6 pounds 7 ounces (number 2) to 9 pounds 15 1/2 ounces (number 7). My sister's four boys were all posterior as well. We just figured it was something about our pelvises and I concluded posterior was normal for me.

- Jana

As a homebirth midwife turned CNM who now works in a hospital, I have to ask you to be cautious when comparing home with hospital. I never realized the differences before I worked in a hospital, but I have to tell you my clientele in a hospital are the other extreme of homebirth clients. They are not even comparable on any physical, emotional and social levels. I now realize how healthy my homebirth clients were. Maybe not all hospitals are the same. I work in a small rural mill town where there is much poverty and many social issues. I often feel in shock.

- Cathy H.

Are you both a survivor of sexual abuse and a mother? If so, please take a moment to read about a project which may be of interest to you:

My name is Mickey Sperlich. I am a practicing midwife in Ann Arbor, Michigan and I have spent the last few years trying to learn as much as I can about sexual abuse issues and how survivors experience childbirth and mothering. I am working on a book primarily written by survivors for survivors. It is an anthology of women's voices, women survivors in various stages of healing, who have experienced birth and the process of becoming a mother. I am circulating surveys to find volunteer participants for this book project.

If you are interested in being part of this project, please contact me at: NewMoonMid@aol.com

I do not have a fax machine; are there other ways to share comments in support of breastfeeding in public? (We eat in public, why can't my child?)

- Amber W.

I have been carrying out some research on the role of stress in failure to progress. I have been using a description of the anatomy and biology of the uterus gleaned from an out of date book. I am concerned that this information may not be accurate or up to date. Can anyone recommend a suitable textbook or be willing to check the added description [see below] and email me?

Thank you.

- Rayner Garner

"Any stress to the mother stimulates the adrenal glands to pour out catecholemines. As a result, muscle sphincters tighten down making uterine contractions less effective and sending blood away from the uterus to the arms and legs because stress and tension prepare the body for fight or flight. All of this prevents an adequate supply of oxygen to the big contracting muscle-the uterus.

There are three muscle layers composing the uterus, the outer muscles contract to push the baby down, through and ultimately out of the uterus. The middle muscles contract to squeeze the blood out of the walls of the uterus and then relax to allow the blood vessels to fill up again with a fresh supply of blood.

But when the inner circular muscles contract they close the outlet, maintaining the uterus in its unemptied shape. Thus, these inner circular muscles must be loose and relaxed when the long muscles contract to open the womb and push the baby out.

If a woman is frightened during labor this inner muscle layer contracts, then the muscles of the uterus and the muscles that hold it closed are working against each other.

Whenever there are two big groups of muscles working against each other they soon begin to hurt and in a short time the pain becomes very severe. We speak of this as the fear-tension-pain-syndrome of childbirth for a woman who is afraid and unconsciously resisting the birth of her baby by tightening the circular uterine fibers which prevents the progress of the birth and increases muscle tension within the walls of the uterus. This causes nearly all of the pains and distresses in otherwise normal labor. Which describes the labor of about ninety five women out of a hundred."

- Grantley Dick-Read, M.D., excerpted from Childbirth Without Fear

Readers: In order to strengthen midwifery, it behooves us to not only educate the public, but to get our names registered so women seeking a midwife in their area can easily find us. Following are two midwifery directories currently available for modest fees. Check them out!

Introducing MidwifeSearch.Com, the site on the Internet to find a midwife quickly and easily. This brand new site is striving to make it easier for consumers to have access to midwives by making it easier to find them. In this day when computers and the Internet are replacing the Yellow Pages, this site will help consumers find you midwives. There is a small charge for listing in order for this database to be maintained and marketed, making it useful and valuable to all! Please access www.MidwifeSearch.Com. Fees are $10 for first year, $7.00 each year for renewals. Different rates for practices: 1-2 members $10 with $7 renew; 3-4 members $25 with $20 renew; 5-6 members $45 with $40 renew; 7 or more, email for quote at listings@midwifesearch.com.

Greg Cryns, editor of Compleat Mother magazine online, is creating a global directory of midwives to meet needs both locally and internationally through a network of people who care about birth. Greg says the following about Midwives.net: "Midwives.net will provide a few good things:

1) a place where parents can go to find a midwife in their immediate locale;

2) a place where parents can learn more about the midwifery profession via important links and selected information;

3) a place where parents might stumble upon the concept of midwifery for the first time, perhaps, via the Web and then learn that midwifery is real and gentle birthing can be attained--and sow some seeds of doubt that what is accepted as the norm "ain't necessarily so" by providing links to midwife sites;

4) a place where midwives can make it known to the world that they are indeed in business and that they seek new clients;

5) a place where aspiring midwives can announce that they are looking for an apprenticeship with an established midwife, and conversely, a place where an established midwife can seek apprentices (right now this is available in the Aspiring Midwives forum http://www.compleatmother.com/aspire.htm); and

6) a place where parents (and midwives) will learn that many countries in the world have similar difficulties accepting the concept that gentle birth is indeed possible.

I don't want Midwives.net to be reflective of any one personal philosophy; I want it simply as a database of midwife contact information. I see Midwives.net as a very long term project. To make all of this happen I will need the cooperation of hundreds/thousands of sites to link to Midwives.net. I will also need help with publicity, since we are operating on a near-zero budget."

To view the Midwives.net main page, go to www.compleatmother.com/midwives/index.htm. Greg can be contacted via e-mail at greg@rsg.org.


9) Letters

I start midwifery training at university in January and your newsletter has proved an excellent starting point. The information I have digested from it has certainly made me very eager to begin my training. Thank you!!

- Karen Hall
Norwich, England


9) Coming E-News Themes

Coming issues of Midwifery Today E-News will carry the following themes. You are enthusiastically invited to write articles, make comments, tell stories, send techniques, ask questions, write letters or news items related to these themes:

- education (April 16)
- tear prevention (April 23)
- International Midwives' Day (April 30)
- CIMS (May 7)
- drugs in labor (May 14)
- premature rupture of membranes (May 21)
- doulas (May 28)
- induction (June 4)
- episiotomy
- epidurals
- breastfeeding
- waterbirth
- breech birth
- homebirth
- nutrition

We look forward to hearing from you very soon! Send your submissions to mtensubmit@midwiferytoday.com. Some themes will be duplicated over time, so your submission may be filed for later use.


This publication is presented by Midwifery Today, Inc., for the sole purpose of disseminating general health information for public benefit. The information contained in or provided through this publication is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment.

Midwifery Today, Inc., does not assume liability for the use of this information in any jurisdiction or for the contents of any external Internet sites referenced, nor does it endorse any commercial product or service mentioned or advertised in this publication. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding any medical condition.

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