|September 14, 2011|
Volume 13, Issue 19
|Midwifery Today E-News|
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In This Week’s Issue
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Quote of the Week
A calm, watchful, loving presence protects the fragile harmony of birth; frantic coaching has never been part of nature’s plan.
— Pam England
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The Art of Midwifery
Put mother’s milk in the baby’s eye to cure infections. Put it on the cord to help the cord fall off faster. Mother’s milk contains lysozyme, an enzyme that kills bacteria and is abundant in a number of secretions, such as tears and saliva, and is also found in egg whites.
— Judy Slome Cohain
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Toward Trust in Birth
I was talking with my conference planning partner, Eneyda Spradlin-Ramos, the other day about the importance of the mom trusting birth and trusting her body during birth.
As Eneyda and I discussed a class I’ve been asked to teach in Turkey called Positions for Birth, she said, “That is exactly what I am trying to get everyone to understand. Get the mom out of that semi-sitting position where she is on her coccyx and into any other position she chooses.” As a massage therapist, Eneyda understands the body well. She went on to quickly recount a recent hospital birth that went so well that the baby moved right down and out. Eneyda told the staff midwife, who commented on how well the birth went, that when you get the mom off her coccyx the baby can and will move out much easier, and without damaging mother or baby. It occurred to me that birthing more babies this way would leave the craniosacral therapists with fewer damaged babies to help, but I’m sure they would be very happy about it!
If you trust in your body and in your baby, the birth journey changes. And this trust must also be placed in a non-interventionist environment. In fear, a rush of hormones can really slow the process of birth down. The best place to facilitate both the hormones and the trust is at home. To me, homebirth is the gold standard. This doesn’t mean hospitals cannot facilitate a normal oxytocin high during birth, they just don’t. It would take a revamping of everything they do, including a retraining of all personnel.
I visited a hospital in Poland many years ago that had a maverick doctor who changed everything in the hospital. She revamped her hospital to be like a birth center and retrained all of her staff in supportive natural birth and waterbirth practices. It was an oasis in a desert of birth destruction. It was a small hospital and she had complete control of how it was run, but her work does show it can be done. Though it would be very hard to achieve something similar in huge hospitals so common today, that doesn’t mean we shouldn’t keep trying to change birth practices. Toward Better Birth! Toward Trust in Birth!
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan on Twitter: twitter.com/jantritten
News and Research
Drop in US Birth Rate
New research confirms that the US birth rate has dropped around 10% since its peak in 2007. States with the largest decline in income have had the fewest number of births in recent years, while states with more income growth have had high birth rates. Many women cite economic uncertainly as a primary factor in the decision to delay childbearing, and “since 2007, the rate of women of childbearing age who had three or more children also fell 5%.”
— Dickler, Jessica. “Anti-baby boom: why US birth rate keeps falling” CNNMoney, August 16 2011. http://money.cnn.com/2011/08/11/pf/recession_birth_rate/index.htm.
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Second-guessing an Unexpected Outcome
We were 20 days postdates with an average size baby who was active and had good heart tones. The mother, a nurse, listened daily to her baby and kept careful track of daily fetal movement counts (FMC). In fact, until the labor, this baby seemed totally fine.
Labor began spontaneously. The first indication that there might be a problem was a severe dip in heart tones, down to the 40s, at 3 cm. I put the mother on oxygen and monitored her closely. Everything seemed to resolve. I weaned her off the oxygen to find yet another severe dip in heart tones. I put her on oxygen again and we transported to the hospital.
There, the monitor did not pick up another dip for more than an hour but the monitor line did reveal a moderately depressed baby—a definite concern.
The doctor decided to break the bag of waters to see the color of fluid. It was thick pea soup-colored meconium. An amnioinfusion was suggested and accepted. Pitocin was offered, but refused because she was progressing nicely. Within one hour, she was complete and pushing began.
The baby was born an hour later—naturally, no episiotomy, in severe distress. Within twenty minutes, the baby was put on a respirator and airlifted to a hospital with more sophisticated equipment. There, she fought for her life. We watched and waited as this child took one step forward for every three steps backward.
It was two weeks before she began to rapidly improve with the help of much technology, much love and much spiritual care. Doctors, midwives and healers agreed unanimously that all those forces working together had healed this child.
What happened here? Why was this baby compromised? What can we learn? First, from everything I have learned this baby was fine until labor. This baby started having problems during labor. Because she was in distress she started swallowing amniotic fluid, trying to breathe, until she passed meconium, and then started swallowing meconium. No amount of suctioning or intubation could have saved her from this serious aspiration.
What we think happened, and what is most likely, is that the placenta sustained this child through her postdates but could not sustain her through labor. I saw the placenta; it had no integrity and was in pieces. The baby, however, did not look like a typical postdates baby. There was no weight loss, she was not too big, and there weren’t a lot of wrinkles. Due to daily monitoring of heart tones and good movement counts, we did not opt to do a non-stress test/biophysical profile. Could this have made a difference? We aren’t so sure. However, when a diagnostic test is offered to assess potential problems in high risk situations, one cannot help but question decisions after a traumatic outcome—food for thought in a world full of options.
As a lay midwife, I feel good about informing parents of their options and swaying the way that best meets the family’s needs. This baby’s total recovery was a truly unexpected outcome. I am thankful every day for all of our options and for this baby who worked so hard to be here and be whole.
— Jill Cohen
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Birth Wisdom from the Web
The training is an opportunity for midwives and paramedics to learn more about each other’s scope of practice…. Paramedics and midwives are the only two professions that need obstetrical skills outside of a hospital setting, so it makes sense for midwives to provide this kind of training. The feedback has been positive and it’s been a fun day for both the midwives and the paramedics.
— Judy Rogers, registered midwife, on midwife-led training of paramedics in the Toronto area. http://www.hospitalnews.com/modules/magazines/mag.asp?ID=3&IID=157&AID=1973.
In present day Kerala, 99 per cent of the delivery cases are institutionalised with 80 per cent of the births being done by c-section. A “back to natural way” with the assistance of midwives is what I am advocating owing to the immense health benefits for the mother and her baby such as fewer post partum complications, lowered stress levels as well as the intense emotional bond between the mother, father and the baby.
— Priyanka Idiculla, of Birth Village, a Southern Indian birth center that follows the midwifery model of care.
I would have become a nurse but I didn’t like the fact that nurses had to treat people with wounds and that is the reason I resolved to become a midwife.
— Ugandan midwife Aidah Nalule Semukutu, known locally as Musawo, on her 60 years as a midwife.
If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to firstname.lastname@example.org.
Conference Chatter: Upcoming Conference and Country Contacts
It is exciting to see where all the registrants for the Germany conference are coming from. We just had 13 midwives from Finland register. It will be fun to meet them. Our diverse registrants make me think that it would be great for Midwifery Today to have even more country contacts.
Our country contacts help us in many ways. It is our goal to have a contact in as many countries as we can. A contact basically lets us know what is going on in midwifery and birth in her country so that we can let our readers know. She also lets midwives in her area know about Midwifery Today projects. Sometimes women are looking for a midwife and sometimes midwives are looking to meet other birth workers in a particular country, so our country contacts are a great resource.
Maybe you’d like to be a country contact? You do not have to go to a conference to join this part of our team, but it helps if you know a bit about Midwifery Today, and conferences are a great opportunity to connect with our contacts from other countries.
Our country contacts are housed on the International Alliance of Midwives (IAM) page on the Midwifery Today Web site http://www.midwiferytoday.com/iam/ . The IAM is a good page to explore, especially if you are interested in international midwifery. If you would like to be a country contact, please visit our Web site at http://www.midwiferytoday.com/iam/countrycontacts.htm to learn more about what we’re looking for in a country contact. We hope to meet you in Germany, at another Midwifery Today conference or somewhere else in the birth world.
— Jan Tritten
Think about It
The effects of birth traumas are far reaching and mostly unrecognized in our culture. An infant who has suffered birth anguish may seem withdrawn. She or he may have trouble bonding or making eye contact. A traumatized infant may wish to be held all the time or not at all…. As midwives, it is important we do all we can to prevent birth trauma and know how to heal it when it does occur.
Periglow, the best to support the perineum after birth. Periglow is a ready-to-use Swiss compress to promote healing the first weeks after giving birth. As a soak or bath. www.periglow.com
Metamorphosis helps pregnant women and families with a gentle touch approach to easing unconscious tension so each family member can contribute more positively. Classes great for midwives doulas, and parents. Classes nationwide, book, DVD. http://www.MetamorphosisCenter.com
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