|July 23 2003|
Volume 5, Issue 15
|Midwifery Today E-News|
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THINKING ABOUT BECOMING A MIDWIFE?
This issue of Midwifery Today E-News is brought to you by:
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Midwifery Today Conferences
Come to the conference in Oaxaca, Mexico Sept. 24–28, 2003. For more information and a complete program, click here.
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In This Week’s Issue:
Quote of the Week
"The current medical backlash in birth is actually the death throes of an outmoded way of thinking and behaving. Men and women, mothers and babies, midwives and doctors—we are all awakening together."
— Sarah Buckley
The Art of Midwifery
For vaginal yeast infection during pregnancy, dilute tea tree oil with either a little olive oil or evening primrose oil (break open a capsule), use a tampon soaked in the mixture, a rolled up gauze pad, or (my favorite) a clean sea sponge. Insert it overnight. Garlic clove peeled and inserted overnight (usually takes three or four nights in row) is also a good remedy. Acidophilous caps inserted vaginally as well as taken orally also are effective. All the usual dietary concerns for yeast are the most important precaution/treatment.
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 firstname.lastname@example.org.
A study to determine if tightening of nuchal cord entanglement is more likely to occur where normal cord coiling is absent and when there is deficient Wharton's jelly included singleton pregnancies with cephalic presentation and spontaneous labor. Placental insertion, nuchal entanglement (tight or loose), length, presence of knots, umbilical coiling index (UCI), and the amount of Wharton's jelly were recorded. Longer cords were more frequent amongst male infants and were predisposed toward entanglement. The study found no significant differences in the amount of Wharton's jelly or in the UCI between tight and loose nuchal cord groups. The only measurement that differed significantly was the total cord length, with shorter cords predisposed toward tightening.
— Acta Obstet Gynecol Scand 2002; 82: 32–37.
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Three beautiful home waterbirths attended by families and friends as mothers catch their own babies underwater.
Shoulder Dystocia: Traditional Midwifery Solutions
The basic premise: To move the baby, move the mother.
When squatting, standing, and the Gaskin Maneuver don't work:
A Running Start
Praying Hands Rotation
Lift the Sacrum
Bring the Posterior Arm Out from the Hands and Knees Position.
Any difficulty getting the posterior arm out now is likely due to the arm's position. The midwife can reach in to find the posterior shoulder and follow down the arm with her fingers. It may be that one or both arms are behind the baby's back! An arm behind the back has to be worked to the chest of the baby before the shoulder can be rotated into the oblique.
— Excerpted from "Shoulder Dystocia: The Basics," by Gail Tully, CPM, Midwifery Today Issue 66
Editor's Note: This article continues to discuss in detail how to extract the posterior arm, lifting the sacrum if needed, working with the baby's joints. It's an excellent read! TO ORDER ISSUE 66, click here.
Products for Birth Professionals
CONFERENCE AUDIOTAPES FOR THIS WEEK'S THEME
What is authentic midwifery? How can we move toward it?
MIDWIFERY TODAY magazine:
Web Site Update
ARTICLES NEWLY POSTED TO OUR WEB SITE:
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I have a client who is being treated for severe mastitis. Her OB put her on Vancamycin. Does anyone know of side effects of this medication? Or could you tell me of a reliable and thorough source (book, website or other) for information on medications and breastfeeding?
— Samantha Searcy, LMT
TO SHARE YOUR THOUGHTS AND EXPERIENCE ABOUT THIS TOPIC, click here. **PLEASE DO NOT SEND YOUR RESPONSES TO E-NEWS!**
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The Frontier School of Midwifery and Family Nursing
The Frontier School of Midwifery and Family Nursing is a private, non-profit, distance-education graduate school offering directed web-based learning certification for nurse-midwifery, family nurse practitioner and OB/GYN nurse practitioner with a 9-credit Master's Degree completion at Frances Payne Bolton School of Nursing Case Western Reserve University. Visit us at www.midwives.org or phone us (606) 672-2312.
Question of the Week (Repeated)
Q: What can be done for endometrial hyperplasia as far as alternative methods of treatment? In my case, it falls under the category of excessive bleeding. Three cycles of progesterone haven't helped, and I don't really want to go the hysterectomy route.
SEND YOUR RESPONSE to email@example.com with "Question of the Week" in the subject line.
Question of the Week ResponsesRe: Broken coccyx [Issue 5:14]
A: Have you considered chiropractic care? Sometimes the coccyx can get displaced during childbirth and can be very easily brought back into alignment with gentle spinal adjustments (yes, even to the coccyx). If x-rays were not taken there is no way to confirm that your coccyx is in fact broken, but many medical doctors often assume that is all it could be. With all the ligament laxity during both pregnancy and childbirth, the pelvic bones can easily become misplaced. Your coccyx (or other pelvic bones) may simply be malpositioned and would likely respond very well to chiropractic.
To find a chiropractor in your area who specializes in pre- and postnatal care, contact the International Chiropractic Pediatric Association at 1-800-670-KIDS, or check out the website www.icpa4kids.com.
— Dr. Melissa Vecchio, DC, FICPA
Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to firstname.lastname@example.org. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
Exclusively on the BirthLove site: Gloria Lemay, celebrated midwife and teacher, is offering advanced online doula education. She covers a vast amount of topics that today's doulas and student midwives need to know: herpes simplex II, medical terminology, pediatric exam of the newborn, prenatal diagnostic tests, business and professionalism, pregnancy-induced hypertension, gestational diabetes and so much more. The course is free for all BirthLove members. Check it out! www.birthlove.com/glo_doula.html
A study of 11,721 British women has concluded that eating seafood rich in omega 3 fatty acids—key building blocks of the brain—may help pregnant women avoid depression before and after childbirth. Read about this study and other comments about the efficacy of omega 3 during pregnancy in Midwifery Today's coming issue, Issue number 67.
I have just finished research for my Masters Thesis in East Timor. Women there sit by the fire for 40 days, a common practice in southeast Asia and some Latin American countries. Do you know if there have been any medical or clinical studies showing whether this practice is harmful or helpful? I have found a number of articles outlining what women do, but I am most interested in knowing whether medical science has a basis for disapproving.
— Vanessa van Schoor
What is the risk of having low amniotic fluid volume, and why must a mom be induced? Is there a natural way to increase fluid so mom can carry full term? Mom is now at 41 weeks gestation; fluid volume is 4.2 liters.
— Angela Stocksdale
I too have experienced blanche nipple pain in exactly the way you describe [Issue 5:14]. My third baby, after a happy homebirth, had not developed a good rhythmic suck at four days, and my milk was slow. I was 42 and had a 15-year gap between baby two and three. I had a very successful breastfeeding history and I have been a practising midwife since 1980. A lactation consultant helped me establish that he had a "bubble palate." Feeding began in earnest; he would *not* receive formula. I used a combination of manual compression during feeds, hand expressing to increase stimulation and to give after a breastfeed, and tried to correct his latch using a cut nipple shield (my husband, using a craft knife, cut out the bottom third of a nipple shield so that baby's tongue had direct contact with my breast but the bubble palate was bridged by the top half of the shield). This prevented my nipple from flipping up into his palate, causing trauma. At about 10 days thrush became evident. I treated it with homeopathic borax, and at two weeks blanche nipple began. I cannot describe the pain as my nipples filled with blood after each feed, they turned white then purple then red and the pain would last up to one hour. Weight gain was adequate, but only just.
If I had been a first-time breastfeeder I am sure I would not have tolerated it, but I knew I could do it. Finally the perseverance paid off and at seven weeks we began feeding without a shield and at 12 weeks he was totally independent again. He continued to feed beautifully right through my next pregnancy. Boy 1 finished his breastfeeding career at three years and boy 2 is still going strong at 26 months. I am now 46 years old and work full-time as a core midwife in a secondary care facility.
— Sue Pace, New Zealand
I was interested to read your main feature article about preventing postpartum hemorrhage [Issue 5:14]. I recently came across a Cochrane review of four trials that were done on active versus expectant management of labour. Their conclusions were the opposite of Margaret Scott's opinion, and while instinctively what she says sounds right, it's difficult to go up against a body of evidence as substantial as a Cochrane review. Since this issue has major implications for practice, I would be interested in getting some feedback.
The abstract follows.
— Robyn Sheldon, student midwife
Date of most recent substantive amendment: 9 March 2000
This review should be cited as: Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour (Cochrane Review). In: The Cochrane Library, Issue 4, 2002. Oxford: Update Software.
Data Collection and Analysis
I just turned 40, and my husband and I are exploring the possiblity of another child. A nurse practitioner has requisitioned a blood test to determine function of my ovaries. I have had previous homebirth.
There seems to be little information out there for older moms. Do readers have helpful suggestions, health-wise, especially about keeping nutrition and energy going if we went ahead with a pregnancy, and about pursuing a pregnancy?
Editor's Note: Only letters sent to the E-News official e-mail address, email@example.com, will be considered for inclusion. Letters sent to ANY OTHER e-mail addresses will not be considered.
Question of the Quarter
We hope you'll take a minute to consider the Question of the Quarter for Issue 68. Responses are subject to editing for space and style. Try to keep the word count under 400. E-mail responses to: firstname.lastname@example.org.
Theme for Issue No. 68: Instinctive Birth
Please submit your response by Sept. 15, 2003 to email@example.com. (All responses are subject to editing for space and style.)
Birthing From Within Level 1 Mentor Training: Learn to teach parents the power of birthing-in-awareness. A multi-sensory process that helps reclaim the spirituality and power of birth. Taught by Pam England. San Francisco August 15–17 www.birthingfromwithin.com Info: firstname.lastname@example.org
Midwives: Free herbs for participation in a study on Shepherd's Purse and Yarrow as a p.p. hemorrhage remedy! More info: email@example.com or (503) 702-5392.
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