June 9, 2004
Volume 6, Issue 12
Midwifery Today E-News
“Nutrition in Pregnancy”
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Midwifery Today Conferences

What Can you Do with a Placenta?

Did you know that a correctly-stored placenta can be used to prepare baby creams, cream gravidarum or labor-inducing preparations? Attend the full-day "Midwives' Kitchen" class at our conference in Bad Wildbad, Germany, October 20–24, 2004, and learn how easy it is to teach families you care for how to make the most natural remedy from their placenta. Get more information and a full conference program here.


Read Jan Tritten's update on Midwifery Today international conference plans for Germany and Denmark.


Send submissions, inquiries, and responses to newsletter items to: mtensubmit@midwiferytoday.com.

In This Week’s Issue:


Quote of the Week

"It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her."

Judy Slome Cohain


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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.


News Flashes

A University of Toronto study prospectively evaluated 86 children age 15–71 months whose mothers used fluoxetine (Prozac) or a tricyclic antidepressant throughout pregnancy and compared their neurodevelopment with that of 36 unexposed children. The study revealed no differences between the two groups. Results of the study also support previous findings that an uncontrolled depressive disorder in the mother can have an impact on a child's neurodevelopment.

Am. J. Psychiatry 159[11]:1889–95, 2002

The Art of Midwifery

Some things I found helpful for combatting nausea and vomiting during pregnancy:

I found that putting peanut butter on the crackers I ate helped keep them down. If I vomited and then ate plain crackers, my blood sugar spiked and I would vomit again. The problem is the vicious cycle of blood-sugar swings. High blood sugar, vomit, low blood sugar, chills and shaking, food intake (even high-protein shakes, bland chicken, crackers, ginger ale), sugar spike, vomit, chills, etc. all day and night. By the third pregnancy I focused more on comfort measures and submission to the affliction than on remedies.

Comfort measures that most helped included:

  • smelling cut lemons
  • lavender oil
  • ginger tea
  • eating grilled cheese sandwiches with tomatoes (fat allows slower absorption of carbohydrates)
  • chiropractic adjustments
  • cold wash cloths applied to my face
  • warm blankets from the dryer
  • red raspberry leaf tea
  • fresh air
  • sunshine
  • prayer and meditation
  • positive visualization
  • listening to good music

Sometimes I would just lie in the sun and listen to the birds sing even while vomiting.

I turned my bathroom into a shrine with fresh flowers, pillows, blankets, and installed a telephone to call for help if I thought I was going to pass out. During one pregnancy I had a one-year-old lying with me and playing during most of the time I was on the bathroom floor. I focused on my growing baby all the time and that gave me comfort.

I truly take comfort in knowing that morning sickness is a sign that all hormones are working to support a healthy pregnancy. We take our comfort where we can.

Desiree O'Clair, Midwifery Today Forums


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Conference Update

What a delight. Cornelia and I just returned from Bad Wildbad where we went over the details of the conference and planned more joyful activities for midwives. We have been planning some ways to use the wonderful resource of Bad Wildbad, the waters. We thought of doing Tricks of the Trade in one of the beautiful water baths there. All registrants are invited to buy an access card for admittance to all the baths and saunas for the whole five days for only 20 Euros! I think the conference will have competition for your attention as you may play hooky to enjoy "taking the waters." Serious students can go in the waters at lunch and perhaps we will conduct some of the classes in the water. You can also join Cornelia for a post conference day where you will learn about many of the water therapies.

In addition to the waters, Bad Wildbad is such a wonderful place to have a conference because of its beautiful setting. It is a charming little town which is nestled in the mountains of the Black Forest. A tram runs up the mountain to many hiking trails. Registrants who arrive early on Tuesday may be taken on an afternoon orientation of the area led by local midwife named Ursula. We will also try to have another small orientation on Friday at lunch. Conference participants will be able to sample the regional specialties at a dinner on Friday for only 7 Euros. We have also been planning the Saturday night entertainment which will take place in the waters.

Cornelia and I visited with Hella Riedel who will be teaching the midwives' recipes. As we talked about how she will conduct the class, we were treated to a very special breakfast which she prepared incorporating some of the herbs she uses in her work.

If you cannot come to Germany this year perhaps you can join us in Denmark next year. While in Europe, I visited Copenhagen to make plans for our international conference there. The dates for that conference are May 18–23, 2005. In meeting with the Danish midwives, we decided that the theme should be "Reclaiming the Joy of Midwifery and Birth." Sadly, with the horrendous trauma around birth, we have masked the reality of the miracle. Birth does not have to be the way it is now. We can make a difference in birth; indeed, if we do not, who will?

love, jan


Nutrition in Pregnancy

Preeclampsia, toxemia, and eclampsia are all symptomatic degrees of the same disease that Dr. Tom Brewer calls "metabolic toxemia of late pregnancy" (Brewer, Tom [1982]. Metabolic Toxemia of Late Pregnancy). They are evidenced by symptoms of high blood pressure, edema, sudden weight gain, proteinuria, spots before the eyes, headaches, elevated liver enzymes, and in the most severe cases, eclamptic seizures.

The anatomy of eclampsia is complicated, but the basis of Dr. Brewer's research is simple: eat good food and avoid drugs. Working with a poor, malnourished population, he looked at what the women were eating and the high rate of eclampsia and other serious maternal/fetal health problems. Rather than throw complicated, expensive technology and drugs at the problem, he did something logical: he fed them. He asked what they were eating and recommended they eat whatever healthy, whole foods were available to them. Apparently their diets were especially deficient in protein, so he recommended they eat eggs and drink milk because these were not only nourishing, but also inexpensive and easy to come by. Meat was expensive and scarce, but if the women could afford to obtain some, he recommended they add it to their diets too. Contrary to the popular beliefs at the time, he told women to salt their food to taste. This supports an expanding blood volume necessary to support pregnancy and grow a baby. He reduced the rates of eclampsia from 40% to almost nil.

The high-protein diet recommended by Dr. Brewer is not the no-carb/high-protein diet popularly used to lose weight today. When a woman eats a varied, high-quality, whole-food diet, she ends up with anywhere from 75 to 100 grams of protein a day from varied sources. Vegetarians and vegans must be diligent about getting enough variety and vegetable proteins. Meat eaters must add more nuts, seeds, beans, and other vegetable proteins to acquire the proper variety of foods. Powdered protein supplements will not suffice. Recent studies have shown that high-protein diets without sufficient high-complex carbohydrates can cause women to lose weight at a time when they should be gaining in order to build a baby.

The National Institutes of Health refused to publish the results of Dr. Brewer's studies because he couldn't do a clinically controlled study—ethics of course prevents using a starving group of pregnant women as a control.

Excerpted from "Preventing Complications with Nutrition," by Amy V. Haas, BCCE; Midwifery Today Issue 67


The average daily requirement for iron in pregnancy is 30 to 48 mg, due primarily to its poor absorption rate (about 10%). For a pregnant woman to meet the iron requirements of pregnancy, she must choose her foods wisely and/or take supplemental iron. Iron is generally found in red meats (especially organ meats), whole grains, beans, dark green leafy vegetables, nuts and seeds, dark molasses, seaweed, nutritional yeast, and dried fruit.

To get the most of iron from one's diet:

  • Eat high-iron meals with vitamin C or foods high in vitamin C. Taking 200-500 mg nearly doubles iron absorption.
  • Niacin, B1, B2, pantothenic acid, choline, B12, folic acid, calcium, cobalt, and copper are involved in the absorption, assimilation, and utilization of iron.
  • Minimize exposure to cigarette smoke and other air pollutants.
  • Tannic acid, caffeine, and phosphates inhibit iron absorption; avoid them.
  • Avoid antacids; they neutralize stomach acids, which enhance iron absorption.
  • Minimize use of laxatives, which decrease the amount of time the body has to absorb iron.
  • Minimize consumption of refined carbohydrates; they cause the secretion of more-alkaline digestive juices, which decrease the acidity of the stomach.
  • Do not take iron supplements or high-iron meals with dairy products, which neutralizes stomach acidity.
  • Use leavened whole grains; yeast in the fermentation process makes iron available.
  • Do not rely on iron-fortified foods; iron used by manufacturers is often a phosphate compound not soluble in the human digestive tract.
  • Large doses of supplemental zinc or calcium interfere with iron absorption.
  • Cast-iron cookware adds iron to food, especially if the food cooked in it is acidic.
  • Regular aerobic exercise improves iron absorption because of the body's greater need for oxygen-carrying capacity.
  • Choose iron supplements carefully.

Excerpted from "Iron in Pregnancy: Nutrition for Two," by Althea Seaver, nutritionist; Midwifery Today Issue 16


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Midwifery Today Issue 64

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Looking for a good video to show your clients?
Do you need to see what different suturing techniques are like? Check out our selection of birth videos.



Web Site Update

You can view confirmed speakers for our domestic conference in Eugene, Oregon here: www.midwiferytoday.com/conferences/eugene2005/ Visit this page frequently for updates!

Dates for international conferences in Denmark and the Bahamas have been added to the "Looking Ahead" page online: www.midwiferytoday.com/conferences/2000and.asp

Read these articles newly posted to the Midwifery Today Web site:


Forum Talk

After your clients give birth, how do you know when it's time for you to go? What kinds of things do you do in that initial time, and what do you want to be sure is done for the mom before you go? Also, how soon do you usually contact her—next day, several days, etc.?

Anon.


Go to our forums to share your thoughts and experience.


Question of the Week

Q: I felt that my son was having seizures when I was about six months pregnant. My obstetrician said it was rare but sent me to perinatology anyway. They performed an ultrasound, but because the baby was not having seizures during the ultrasound, they could not say yes or no. When my son was five weeks old he began having seizures and was put on two medications four times a day. He is now 21 months old and still on seizure medicine twice a day, though he hasn't had a seizure for almost a year. I am now six months pregnant and am feeling the same movements, but I am afraid to go to the doctor and have them tell me that I am over-worrying. Suggestions?

— Mandie Martin, Vancouver, WA


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.


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Question of the Week Responses

Q: I am undergoing in-vitro fertilization (IVF) and wonder if midwives have noticed any special characteristics with the IVF mother/baby population, and also if they have insights about how to care for moms in this population.

— Leslie K.

A: The rate of medical intervention in post IVF pregnancies is astronomical. The c-section rate is about 50%, in part due to multiple births (most OBs deliver multiples this way) and the rest due to fear—fear of losing the "premium pregnancy," fear of malpractice suits by OBs, and a belief in the medical model by both the doctors and the women who have undergone IVF. They have already learned not to trust their bodies (and in some cases may even be angry with their bodies). There is a strong belief that medicine is the miracle; after all, some women undergoing IVF may not ever have been able to get pregnant without intervention (e.g., those with totally blocked or missing fallopian tubes). But a number of women are pushed into IVF who don't really need that level of intervention (much like childbirth!) because it has been demonstrated to work more quickly than other means of infertility treatment. There begins the slippery slope of medical intervention. I have a dear friend who was having a homebirth after IVF, and her doctor actually said to her that she should be in the hospital because she had used modern medicine to get pregnant! Talk about selling the product!

— Kathy Metzler, R.N.

Re: kidney disease [Issue 6:9]:

A: I have worked with one mom who has persistent kidney disease. She always spilled both blood and protein in her urine during pregnancy and before and after. It is often recommended to cut protein intake, but that simply leads to preeclampsia and more kidney problems. A stable amount, some with every intake of food, is much better. I found that Renatrophin PMG and Renafood from Standard Process were very helpful.

— Judy Jones, CPM

Re: posterior presentation [Issue 6:7]:

A: I can personally attest to the effectiveness of Janie McCoy King's Back Labor No More. I have had severe back pain in each of my three homebirths despite movement and frequent position changes. After the second, I read Ms. King's book. Unfortunately, the brain-fog of labor caused me to forget to use her technique during my next birth. I finally remembered when my midwife decided the baby was posterior after 16 hours of very painful and irregular contractions. My husband and I took a walk, and he held me up while I lifted my abdomen. The pain decreased so much that I was afraid I had stopped my labor. We went home and the baby turned and was born about an hour later.

L.J.

A: I was recently at a birth where the baby seemed posterior, and the mother herself needed to pull up on her belly during the contraction and hold it. She said it helped her with the pain. After some time there seemed to be a shift, and she said she didn't need to do that anymore. Perhaps the baby had turned then.

— Andi, apprentice midwife


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


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Think about It

On May 29 (a weekend day when pregnant or prospective pregnant women would be more likely to be reading the news), the following brief was published in our local newspaper:

Women who gain more than 35 pounds during pregnancy could be more likely to be overweight 15 years later than those who gain less. A study of 2,342 Swedish women found that mothers who gained less during pregnancy were more successful at losing weight afterward and keeping it off. In the West, the healthy amount of weight gain during pregnancy is 26 pounds for the average woman. —from news service reports

E-News invites reader comments!


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 71 of Midwifery Today. In fact, if you send us a response and we use it, we will send you a free copy of the next issue. Responses are subject to editing for space and style. Try to keep the word count at less than 400. E-mail responses, along with your mailing address, to: mgeditor@midwiferytoday.com.

Theme for Issue No. 71: Drugs in Labor
Question of the Quarter: : How do we educate women about the use and effects of drugs in labor?
Deadline for submission: July 1, 2004.

Question of the Quarter is a feature of Midwifery Today magazine, E-News's parent publication. Responses will be printed in Midwifery Today magazine. Subscribe.

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


Feedback

I have found that repeated miscarriage as well as infertility and other menstrual irregularities are very often caused by minimally low thyroid. It often does not show up in blood work. It may also be just low iodine levels since the ovary is the only other organ besides the thyroid that requires iodine. The best treatment I have found is with Standard Process products, Thytrophin PMG and Iodomere. I have helped many women who had repeated miscarriages with this remedy.

Judy Jones, CPM

I am only now getting caught up on my reading and felt compelled to respond to the premature labor discussion [Issues 6:5 and 6:6]. I think the article was accurate only because most women diagnosed as having premature labor really are not having premature labor. That is why the interferences may actually make the situation worse instead of helping it. Contractions that do not cause dilation and effacement are not premature labor. However, there are some cases of true premature labor for significant problems as Erica pointed out. In those true cases some of the things offered are of help. I have always found that bedrest did decrease true problems of premature labor. Another alternative natural thing that I have found very effective is lobelia tincture, 5 drops under the tongue every 15 minutes as long as there are contractions.

I cared for one mother who had three premature deliveries prior to my care. She had a bicornate uterus. Her first baby was born at 34 weeks, and her next pregnancy was twins born at 33 weeks gestation. With her third pregnancy, I was giving her care. She went into premature labor after doing some heavy pushing in an emergency situation. We were able to get the labor stopped with lobelia and bedrest. She carried to 37 weeks and delivered a healthy baby. Her next pregnancy, she also went into premature labor, but again she was able to stop it. She finally learned the extent of activity that she could maintain without starting more premature contractions—contractions that actually result in dilation and effacement. She carried that baby to 38+ weeks. However, her next two babies were born by c-section because of placenta previa, hemorrhage, and premature labor. There is a time for interferences.

Judy Jones, CPM


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.


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