October 29, 2003
Volume 5, Issue 22
Midwifery Today E-News
“Water and Pregnancy, Part II”
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In This Week’s Issue:

Quote of the Week

"Given the opportunity to voice their opinions about what is happening in their labor and how their baby is doing, women will often give you a very accurate account. The key is to listen to them."

Jill Cohen


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The Art of Midwifery

Vulvar Varicosities

Nettle infusions can help because nettle is filled with vitamins and minerals that give veins elasticity. Put a cup of the dried herb in a quart canning jar, pour in boiling water, and let it sit in the dark for 4-8 hours. Strain and refrigerate. For better flavor, add mint and drink it iced.


  • A cloth belly supporter—either commercially made or a 7- to 8-foot-long strip of cloth—helps take weight off the vulva, pelvis, and everything south.
  • Witch hazel sitz baths can soothe vulvar varicosities. Make a strong tea from witch hazel bark rather than use the drugstore kind.
  • Mayan uterine massage can help. Sometimes the womb is malpositioned, putting undue pressure on the pelvis and blocking circulation.

Adrienne, Midwifery Today Forums

News Flashes

Testosterone Levels in Pregnancy and Sex-Typed Behaviors

A University of London study revealed that greater levels of testosterone during mother's pregnancy resulted in an increased likelihood of young girls engaging in "masculine-typical" behavior. The study included data from 13,998 pregnant women in Avon, England, and from 679 of their offspring. Blood samples taken at various stages of the women's pregnancies were analyzed for levels of testosterone and sex hormone binding globulin, which limits the ability of testosterone to act.

A total of 13,998 pregnant women, who represented 90 percent of all pregnancies occurring in the Avon, England, area during an 18-month period, took part in the study. Data from 679 offspring were analyzed. When the female offspring reached age 3-1/2, they were assessed using the Pre-School Activities Inventory (PSAI) to determine degree of engagement in various sex-typed behaviors. Background variables such as maternal education, presence of older brothers or sisters or a male adult in the home, and parental adherence to traditional sex roles were also considered and were eliminated as determining factors in the young girls' behavior.

Child Development, Nov./Dec. 2002

Florida "Grandmother of Midwifery" in Need

Skippy King is a "grandmother" to Midwifery in the State of Florida. She led those responsible for the Midwifery Practice Act established in 1982, which enabled us to enjoy the freedom of practicing as midwives and gave families the option to give birth out of hospitals. She has served many of us for several years. We all love her dearly.

On September 16, 2003 at 12am, Skippy lost her home and all of her personal possessions acquired throughout her life to a fire. There was no insurance to cover this loss. Fortunately, Skippy wasn't physically injured. Skippy will be 79 this November 5th.

After a lifetime of serving and giving of herself to families, midwives, and to all of those who are a part of caring for mothers and babies, Skippy needs the spirit of giving to come back to her at this time. She needs funding for food, medical expenses, cleanup of fire damages, and the basic needs for household comforts.

There is a special account established for her. Skippy needs donations as soon as possible. Please send checks or money orders to: South Trust Bank, Teller Line 729, Cypress Village Blvd., Ruskin, Florida 33573. Make checks payable to: Skippy King. Include with check or money order a statement saying: "This check or money order is to be donated to the special account for Skippy King, 16319099." Donations are not tax deductible.

For more information, you can contact Jeanne Madrid at jeannemadrid@appleisp.net.

Water and Pregnancy, Part II


Preeclampsia is signified by the warning signs of edema, hypertension, and protein in the urine, indicating kidney distress. The best way to treat this condition is to avoid it with the best possible prenatal care, which involves not only eating well, but also eating enough. Pregnant women need a minimum of 2,400 calories daily. Nutrients to pay attention to are potassium, sodium, and calcium. Deficiencies of these three nutrients are associated with preeclampsia. Protein, as well, is an essential component to a healthy prenatal diet and integral to the developing fetus. The recommended daily dose for a singleton pregnancy is 80 grams per day.

The challenge of kidney strain calls us to nourish and reconnect with the water element. A woman faced with preeclampsia can help the natural functions of the kidneys listed [in the previous issue of E-News] as well as with the regular use of the following tea blend:

Kidney-Strengthening Tea

2 parts nettle
2 parts goldenrod
1 part cornsilk
1 part dandelion leaf/flower

When hypertension occurs in the pregnant woman, it is often accompanied by edema and can indicate that kidney stress is also present and likely to manifest in some form. The following botanicals are vasodilators that open the blood vessels to allow freer and easier blood transport:

Garlic (Allium sativa)
Abundant in antimicrobial volatile oils, garlic is a wonderful plant food for the cardiovascular system. It helps reduce high blood pressure, balance cholesterol, and dispel blood clots. Eat it raw and often.

Hawthorne berry (Crataegus oxyacathoides)
This stimulates or relaxes heart function according to what is needed. An infusion made from the dried berries can be taken in sips or spoonfuls throughout the course of one day, with the entire dose not to exceed one cup. The tincture dose is 5 to 10 drops as many as three times a day.

Horse chestnut (Aesculus hippocastanum)
A renowned venal tonic, horse chestnut is specific for restoring and improving vein health and integrity. Use 10 to 20 drops of the tincture three times daily. This nervous system relaxant can be quite helpful where stress and anxiety precipitate hypertension.

From "The Water Element: Why It's Important to Help Mothers Keep Water in Their Diet,"
by Susan Perri, The Birthkit Issue 35

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Web Site Update

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Forum Talk

I heard there are men midwives and I was a little surprised. I don't mean to talk down to men; it's just that birth seems to be kind of a woman's thing/territory. Does anyone else know any men midwives, and what are they like? Mothers, would you be fine with a man midwife?



Question of the Week

Q: It has been 10 years since the last time I gave birth, and now find myself for the first time having to make a decision about getting swabbed for Group B streptococcus infection. Are the concerns that real and scary? This is my fourth pregnancy and I am 36 weeks along. I have not touched antibiotics in more than 15 years and don't care for them.

— Anon.

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.

Question of the Week Responses

Q: It seems I read theory after theory about what causes preeclampsia and how to deal with it and get the mom back on track. What do E-News readers have to say about this problem?

— C.J.

A: I have seen many cases of preeclampsia reversed with a switch to the Brewer diet. It is a simple effective way to reverse the stresses placed on the body by pregnancy. Blood volume increases, and the swelling and blood pressure come down--simple and easy. It is a tragedy that this nutritional information is not being taught in medical school and to pregnant women as a matter of course.

— T.P.

A: As a Bradley Method instructor I am very familiar with the work of Dr. Tom Brewer—in fact, my greatest motivation for becoming an instructor was to help eradicate this illness by teaching his nutritional guidelines, as required by the American Academy of Husband Coached Childbirth. Dr. Brewer maintains a Web site, tireless in his quest to have this simple formula for preventing toxemia, premature rupture of membranes, premature birth, and hypovolemia in the hands of every pregnant woman. In his 20+ years as an obstetrician his clients gave birth to "blue ribbon baby" after "blue ribbon baby"—thus, the name of his Web site—www.blueribbonbaby.org. I find the greatest challenge in getting mothers to follow his recommendations is convincing them of the absolute necessity of adequate protein. So many women fear consuming as much as he insists upon. Also, due to our society's salt-phobia, many are resistant to adding salt to food. Otherwise, his guidelines really are common sense.

— Melissa Leet, affiliated Bradley instructor

Q: Re: Cytotec [See Issues 5:20 and 5:21]

A: I had similar problems which turned out to be endometriosis and a large ovarian cyst. It is quite possible that your bad experience with Cytotec and your current problems are not related. I suggest organizing some scans and blood tests to rule out anything really nasty before you decide on any treatment. My own treatment has been a combination of conventional and complementary.

— Anon.

A: I have another suggestion: Two years ago, after the birth of my second child, I too experienced all these symptoms and more. Blood tests revealed an underactive thyroid (hypothyroidism), and I am now being treated accordingly. Some of the other symptoms I experienced were fatigue, low sex drive, dry skin, constipation, and memory loss, to name a few, many of which can easily be written off to the demands of motherhood. I encourage you to ask your doctor/midwife to check your thyroid levels by getting blood work done, and make sure to ask what your TSH (thyroid stimulating hormone) level is. A normal TSH level is considered to be 0.5 to 5.0, although the American Association of Clinical Endocrinologists has suggested a narrower range of 0.3 to 3.0. This means if your TSH level is higher than 3.0, your symptoms are most likely the result of an underactive thyroid.

— K.Q., New Jersey

After my first child, who was born completely naturally in a birth center, my periods increased in intensity and frequency (I had been very irregular, sometimes going months without a period). After my second (also natural, this time at home) I had all the symptoms you describe with my first few periods: hard cramping, very heavy bleeding, longer duration, nausea, etc. As a doula, I learned that the natural hormone changes in a woman's body can cause these adjustments. I hear women repeatedly report that their cycles change, usually in the ways described, after giving birth. It may have nothing to do with the Cytotec—although I completely agree that administering a dangerous and experimental drug without the full understanding and consent of the patient (and how understanding and consent-giving can a laboring woman be?) is incredibly inappropriate and wrong.

T. Sloan, California

Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to mgeditor@midwiferytoday.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.

Question of the Quarter for Midwifery Today Print Magazine

We hope you'll take a minute to consider the Question of the Quarter for Issue 69 of Midwifery Today. Responses are subject to editing for space and style. Try to keep the word count at less than 400. E-mail your response to: mgeditor@midwiferytoday.com.

Theme for Issue No. 69: Midwifery Knowledge
Question of the Quarter: What do you consider essential midwifery knowledge? What do you consider advanced midwifery knowledge? Who owns the knowledge?
Deadline for submission: December 1, 2003.

Question of the Quarter is a feature of Midwifery Today magazine, E-News's parent publication. Click here to subscribe today!

Write today! (See writer's guidelines.) We love hearing from you!

With Woman

by Gloria Lemay

To Suture or Not

Question: "What is your experience with NOT suturing second degree tears (at least not very deep ones)? What about labial tears?"

Thoughts about suturing tears seem to change as time goes by. Here are some things to think about:

  1. Having a foreign body (suture material) that the body has to fight can interfere with proper healing and produce a lot of pain. Think about having a splinter in your finger. Your finger gets swollen and inflamed in order to surround and push the sliver out. Suture material is an irritant, so consider that before making the decision that a tear needs stitches.
  2. The stitches don't fix the tear, they merely bring the two edges together so the healing can happen—the tissue approximates and knits itself together. I think about ear piercing—you have to wear earrings all the time or the holes will heal over if left empty too long. Therefore, if you have a tear that comes together in a nice match when the woman brings her knees together, it will heal fine with bed rest.
  3. Blood is nature's repair agent for torn tissue, so don't be washing and cleaning too much. Also, in Ayurvedic medicine, urine is used as a treatment for skin abrasions. It could be that nature was pretty smart to make our torn vulvas burn when urine passes over them. Usually that "burning during peeing" only is there for the first 24 hours so the healing happens quite quickly.
  4. If there is a tear where one flap of skin definitely goes off in a direction that it shouldn't, crazy glue (Dermabond) can be used in minute amounts to bring the flap to where it should be for 24 hours. Caution: don't get it anywhere near the anus.

Midwifery teacher Gloria Lemay runs BirthLove's Doula Course. It is free for all site members. See www.birthlove.com/glo_doula.html

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!


My pregnant friend is considering getting a flu shot. She had some serious complications with her last pregnancy and delivery because she had a very bad case of the flu. She is very worried about getting it again with this pregnancy. Her baby is expected to arrive around the end of January/beginning of February. Do readers know where I can find more information about this?

Catheryn Burke

Re: hole in round ligament and possible effects on pregnancy [Issue 5:21]

The broad ligament is a supporting ligament along the outside of the uterus. It is not a part of the myometrium that is responsible for contractions during the birthing process. I assume that if her doctors were concerned about a hole, it would have been fixed on the spot. The fact that it wasn't means they weren't overly concerned.

I know of nothing that says a ligament problem of any kind would affect the outcome of the pregnancy. As long as the baby is healthy as demonstrated by a good sonogram, good fetal movement, etc.; as long as the woman [who wrote to E-News] is receiving good prenatal care, is taking her vitamins, and generally staying healthy; and as long as she doesn't experience similar pain as from 2002, I don't foresee any reason for a hospitalization. I am curious about why she is concerned. If she is concerned that she had bleeding in the first trimester, that would be cause to be worried about a possible miscarriage. But now that she's at five months and presumably all is well, she has mostly surpassed that concern.

I suggest talking very candidly with her midwife. It may also be that her midwife works with or knows of an OB/Gyn who could give a different perspective to her concerns and take the weight from her shoulders. From what I read, she may at most need more-frequent prenatal checks and may be considered higher risk.


I am a nurse in a busy birth center that is part of a hospital. I try hard to work within the system and advocate for patients' rights. One of our MDs and I have been having a friendly argument about his desire for the nurses to give Pitocin before the placenta is delivered. Can anyone guide me to research that shows the pros and cons of this practice?

Carol Gaudey

Editor's Note: 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.


The International School of Traditional Midwifery offers quality education to aspiring and practicing midwives through our onsite, distance learning, A&P, and short course programs. Contact us at 541-488-8254 or www.globalmidwives.org.

Midwives! Students! Doulas! Childbirth Educators! Join us in Portland, Oregon, on November 19 for the Autumn Midwifery Conference and Retreat at Historic Edgefield Hotel! Go to our website www.midwiferyeducation.org for the details. Or phone 503.422.6857.

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