July 8, 2009
Volume 11, Issue 14
Midwifery Today E-News
“Birth Stories”
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Comfort Measures for ChildbirthNow on DVD: Penny Simkin's Comfort Measures for Childbirth!

Watch this DVD and practice along with expecting guest couples as they learn more than 40 different comfort measures for women in labor. Penny shows you exactly how and when to use the techniques in each of the DVD's four sections:

  • Basic relaxation and rhythmic breathing
  • Comfort measures, devices, and positions
  • Techniques to help with back pain and labor progress
  • Positions and techniques for pushing and birth

Comfort Measures for Childbirth is must-viewing for expecting parents and for anyone who works with women in labor.
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A full-day workshop is a great way to learn more about birth.

When you attend our conference in Philadelphia, April 2010, you can choose from a variety of full-day classes, including a two-day class on Traditional Midwifery Skills. There are also single-day classes such as Beginning Midwifery, Herb Workshop, Spanish Language for Birth, Breech Workshop and First and Second Stage Difficulties.

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In This Week’s Issue:

Quote of the Week

"I believe that the...most important thing you can do for mothers, babies, fathers and society is to keep walking forward in your calling. Changing our birth ways will take all of us doing what we are called to do."

Jan Tritten

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The Art of Midwifery

Podcasts are homemade radio shows that can be shared through services like iTunes. Podcasts can be downloaded onto computers or MP3 players, to be listened to at any time. There are hundreds of family-based podcasts, where couples share their experiences of having a midwife visit, of giving birth and of being new parents. Podcasts can be a powerful audio tool for educating about birth and parenting.

Sharon Craig

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.

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

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A study of 361 men being evaluated for infertility in Ohio looked at effects of cell phone use on sperm. Men with chronic conditions associated with impaired spermatogenesis were excluded.

The study separated men into four groups based on cell phone use: no use; <2 hours; 2–4 hours; and >4 hours (per day). Results showed that sperm quality decreased with increased cell phone use. Certain factors that might have affected sperm quality were not considered, so further studies are necessary to provide a definitive answer to whether a connection really exists.

Fertil Steril (89): 124, 2008

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Another Beautiful Birth Story

I want to share this wonderful birth experience with all of you. While I know that not every birth works out like this one, it would be sad if we couldn't share the joyous ones for fear of offending, because another woman's birth went in a different direction. In this case, the parents had one of the "other birth" experiences previously with their little five-year-old, so they were ready for something different. Mom wasn't too sure about waterbirth, or homebirth, and how do you find a midwife?

This couple was having their second child and while the first birth was "okay" in hospital, with an epidural, other interventions, slowed labor and eventually birthing after two days, mom was exhausted and stressed and baby was removed from mother for its first hours. So the second birth approached and they found me. I was training with Gloria Lemay, and referred them to her as their midwife because I believed that they would appreciate her approach to birth—gentle, calm and little interference.

Gloria held a "Blessing Way" for a second child at their place with four grandmothers and the small family. It was a lovely celebration attended by the local ravens. That was ten days before the call at 5:38 am from dad: Baby was on her way!

I traveled the short distance in the early August morning, arriving at 6:45 am. Midwives were there, the tub was filling and everything was ready. Mom was in her bathtub working through each of the surges just as she had practiced for months! She looked at me and said, "Kathy, I'd have had an epidural two hours ago if I was in hospital." Another surge was moving through her, and it was now time to really focus! Her tummy was becoming the flat "mesa" I had seen so many times—which meant baby was on her way down—and her back and bum were tightening across her tummy. Mom was in great spirits and ready to do it. I suggested to her it was okay to just go within and stay there; she didn't have to keep coming out anymore and she could connect to baby.

Gloria was delighted with mom's presence and her ability to manage her body, breath and emotions. The surges were starting to string out together with little space between them. She was doing great, remaining calm, relaxed and using her deep breathing to stay in touch with baby and her body. Her wonderful rolling whale songs reminded me of a few of the other births I've attended—a gentle, calm sound that went through the water, which I'm sure called and comforted baby, too!

Candles glowed in the early morning light, dad took up his position beside her and they were in union the rest of the journey!

At 8:30 am mom came out of the tub, but felt the need to get back into the tub, so we relocated her to the big tub in the dining room. She had another surge and her loving husband lifted her like a feather—baby, mother and all into the warmth of the tub. We all were touched as we witnessed the great love between them. Dad remained close to her and then two strong surges occurred as baby moved down and began to crown. I suggested to both mom and dad that they "see" baby leaving her body and making her way out into the world. Gloria announced shortly later that the baby's head was there.

Another surge and baby was emerging and dad moved to catch the little being in the water. Baby was born fully enclosed in her "sack"—a beautiful Caul Birth. Another surge and baby emerged completely, mom relaxed in the water, and we moved her around and baby up onto her chest.

It was complete! Mom was grinning ear to ear! She'd done it. She felt her feminine power, her faith in herself and her body in her ability as a woman, to birth her child! She was delighted and we could see the grinning pleasure on her face as she looked up at us! Baby was in her arms, it was completed!

Her husband suggested that was "easy" and she said "No, not easy, and not [ecstatic] either; however, better." Different, strengthening, no fear, lack of panic, feeling in charge of her body and her adventure into birth, knowing what to do, allowing her body, allowing her baby.

In what seemed a few minutes the placenta easily slipped into the water, and there was no bleeding at all. Gloria placed the placenta into a bowl and floated it in the water, allowing all the baby's blood to transfer into the little one. Mom and dad were bright, alert and delighted with their little daughter.

Baby was bright pink in seconds, and later we helped mom up and out of the tub, and into her bedroom, where she rested quietly for about two hours. This allowed the uterus in the mom to slowly contract as baby nursed and we left mom, dad and baby to bond and connect in the early morning. It was so lovely while the midwives and I did some laundry, made tea for mom, and cut fruit for parents, leaving them to be with each other and the early intimacy between parents and their new born.

Gloria explained to us that these first hours for the little one allow her to gently unfold in the world. "Baby would be aware, awake, nursing and getting to know her parents—finding them and being in their warmth and love." She encouraged mom and dad to smell their infant, touch her and let her get used to them both. She said in about two hours baby would go into a deep sleep for about six hours, restoring herself next to her mother and father. Then she would begin the ritual of feeding every two hours. Baby weighed 7 lb 2 oz and was just beautiful.

Dad cut the cord about three hours later, and baby released the organ that truly belongs to her—the placenta. As one midwife told me once, "It's considered baby's tree of life." Barbara Harper refers to it as baby's connection to its consciousness.

The midwives examined the placenta, and a little later they did the quick review of the mom and found her perineum intact, as they knew it would be. Not a suture was needed and swelling was going down already, just a few hours after the birth! No pain medication passed through mom or baby. In a few short hours, the birth was complete, with baby receiving the special gift of being born at home, in water, with just her loving parents welcoming her and falling in love with her. After a time, it seemed her father could not resist kissing her little cheeks, while mom laughed and said "You'd better get used to that."

Another beautiful birth experience in under a few hours of gentle, focused breathing.

Kathy Welter, NLP Practitioner

To read more about the placenta or find recipes using the dried placenta, Placenta: The Gift of Life can be purchased here.

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Web Site Update

Read this article excerpt from the most recent issue of Midwifery Today newly posted to our Web site:

“One of the authors of the book, When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women, describes many of the ways early abuse or trauma may negatively affect the survivors' later experiences with childbearing and offers some tips for midwives….”

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Question of the Week

Q: What do you think is the primary fact that causes women to fear, or not trust, birth?

— Anonymous

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: We use Eldon cards for blood typing and [were] told by a doctor that the Eldon cards are only 80% correct for newborns. In the minimal time I have had to research this, I have not found that to be true. What are midwives out there using at home?

I do not like offering to take blood to the lab at the hospital for Rh negative moms due to the cost, and parents are opting to just receive the RhoGAM instead of paying for the blood typing of the infant. I trust the opinion of experienced midwives, can you help me?

— Donna Reicks

A: I think they are 95% accurate, but anything less than 100% accurate is worthless. We give RhoGAM to all Rh negative mothers and don't test the baby's blood type.

— Judy

A: With regard to Eldon cards, I would not trust this method of blood typing when it came to RhoGAM administration. I've used these and ended up with different results than the lab did on three different occasions—even when executing the process per instructions.

Eldon cards are sold by a company that specializes in educational science products and [I] believe they are not sold to type blood for medical purposes (Carolina Biological—www.carolina.com ), but I would check with the manufacturing company to be sure.

At my local hospital, there is a charge of $11 for ABO/Rh typing. I think it's much nicer to not only have the lab run it for accuracy, but also to have a community-recognized standard typing method in case something should come up later.

— Pamela Hines-Powell, Midwife
Salem, Oregon

A: We use Eldon cards to type baby's blood, typically drawing blood from a vessel on the fetal side of the placenta with a syringe. That seems the easiest way to do it without interfering with our immediate post-delivery time with the mom and baby.

The information packet that comes with Eldon cards indicates a 4% error rate. While low, this would be significant to the mom whose baby was erroneously diagnosed as RH negative. So we also collect a cord blood sample at every birth. If baby is Rh positive on the Eldon card, mom gets the immunoglobulin. If baby is RH negative, we send the cord blood sample into the lab to confirm the Eldon Card results so that we don't miss those in the 4%. This way, only the Rh negative result potentially generates cost for a follow-up test. Of course we always offer to run the cord blood through the lab, even on RH positive moms, and we leave that choice to the parents.

In 26 years I have never seen the Eldon card results be wrong. I do not know if newborn blood cells produce a greater percentage of inaccurate Eldon card results, but I have never seen it happen in my years as a midwife. I do wonder whether the posted 4% error rate is usually due to human error in carrying out the test. I am also wondering if the 20% error rate mentioned by the doc is relative to cord blood collection that is contaminated with maternal blood. This is a real problem that happens when maternal blood is not wiped off a cord before a sample is taken, or when maternal blood runs down the cord and into the tube. Using a placental vein when the surface has been well-cleaned before needle puncture prevents that problem.

I don't think the solution is to give all mothers immunoglobulin regardless of the newborn test results, as is sometimes done in hospitals. This is not only a gross misuse of an expensive, limited resource, but to inject another person with human blood products unnecessarily (no matter how safe they are deemed to be) is a terrible solution. No product of this kind is completely without risk. I hope my two bits is helpful.

— Maryl Smith

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.

Think about It

According to an Institute of Medicine report, "Women today are heavier; a greater percentage of them are entering pregnancy overweight or obese, and many are gaining too much weight during pregnancy." To see the full report, go here: http://www.iom.edu/Object.File/Master/68/110/Report Brief - Weight Gain During Pregnancy.pdf

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