April 11, 2012
Volume 14, Issue 8
Midwifery Today E-News
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Plan now to attend our conference in Bad Wildbad, Germany, next October!

Germany conferenceMark your calendars and save the date. This is your chance to learn from teachers such as Elizabeth Davis, Cornelia Enning, Gail Hart, Carol Gautschi and Lisa Goldstein. You can choose from a wide variety of classes, including Essentials of Midwifery, Second Stage of Labor, Techniques from Mexico and Waterbirth.

Learn more about the Germany conference.

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

In This Week’s Issue

Quote of the Week

Hope has two beautiful daughters. Their names are anger and courage; anger at the way things are, and courage to see that they do not remain the way they are.


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The Art of Midwifery

The simple act of lovemaking before or during labor facilitates a quicker birth and can trigger the onset of labor. When a woman is sexually stimulated, oxytocin flows through her system, causing her uterus to contract, either in the form of orgasms or labor contractions.

Marnie Ko
Excerpted from “Natural Alternatives to Induction,” Birth Wisdom, Tricks of the Trade, Vol. III
Order the book

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.

Jan’s Corner


Eneyda Spradlin-Ramos, my conference planning partner, and I just got back from China. Our friend and colleague Dr. Chen invited us to go to Guangzhou because he wanted us to do midwifery training. I had not heard from him since Midwifery Today did a conference there in 2002. It was exciting to hear of his plan because when we were there in 2002 the thinking was, “We have enough doctors—we don’t need midwives.” How exciting it is that the realization that midwives are needed has taken root in China once again. All countries need midwives. They are the force working to keep birth normal and extra special for families.

The hospital in Dr. Chen’s area is very important because it is the main hospital for all the problem cases related to pregnancy and newborns in the province. They care for some very sick mothers and babies there. There is also a whole floor for normal birth, which is Dr. Chen’s area. The midwives are already nurses with training in midwifery but not as many alternative practices have been taught. There is great enthusiasm from the staff at the hospital. I am sure we can have a lot of fun exchanging information and birth stories in the future.

The hospitality extended to us was unparalleled. It seems we never quit eating! I did not recognize what I was eating, but it was always delicious. They took us site-seeing and we visited another hospital a couple of hours away. We were impressed that the family members were in the birth room with the mothers. In one birth, the husband, the mother and a couple of other family members were present—more relatives than are allowed in US hospitals. They don’t seem to suffer from the epidural epidemic since the moms labor naturally. I look forward to more and stronger relationships with the people of China. The eight days we were gone seemed like three weeks because of all that was accomplished!

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.

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News and Research

Breast Cancer Patients Told Pregnancy Is “Safe”

The surge of hormones in pregnancy was thought to increase the chances of cancer returning. Some women have even been advised to have abortions because of this. But researchers are finding that there is no difference in the survival rates of women who have previously had breast cancer and become pregnant compared with women who have not had breast cancer.

Because more and more women are delaying having children until later in life, there has been an increase in the number of women faced with the decision about trying to conceive after having had cancer.

Dr. Hatem Azim, a medical oncologist in Brussels, Belgium, researched women who became pregnant after being diagnosed with breast cancer and said the following, “…we found that patients who became pregnant within two years of breast cancer diagnosis appeared to have a better disease-free survival compared to those who did not become pregnant.”

— Smith, Rebecca. “Breast Cancer Patients Told Pregnancy Is ‘Safe.’” The Telegraph. Mar. 21, 2012. http://www.telegraph.co.uk/health/healthnews/9154925/Breast-cancer-patients-told-pregnancy-is-safe.html

Featured Article

When Love Hormones Become Useless

The Good News: Among the spectacular recent technical advances that will influence the history of childbirth, we must give a pre-eminent place to the modified and simplified cesarean technique. Introduced by Michael Stark, it is often referred to as the “Misgav Ladach cesarean.” A c-section can now be performed in 20 minutes, with minimum blood loss and, therefore, a reduced risk of further adhesions. This new technique is considered by many to be very safe. Although only recently described and evaluated in the medical literature, it is now known and used all over the world.

Evaluation of the safety of the cesarean is difficult via the usual statistical methods, because cesareans are performed for a great diversity of reasons that cannot easily be determined. However, these difficulties may be overcome by looking at a homogenous series of cesareans performed for the same reason. We have at our disposal three huge statistical studies on planned pre-labor cesareans for breech presentations. The most important one looked at all elective cesareans for breech presentation in all of Canada (except Quebec and Manitoba) from 1991 to 2005 (46,766 cases).(1) A Danish statistic looked at 7503 elective cesareans, also for breech presentation.(2) In addition the famous randomized controlled study by Mary Hannah and co-authors about breech presentations at term included 941 elective cesareans.(3) When adding the data provided by these three studies, we find a total of 55,210 cesareans with no maternal death. Such hard data, among others, lead us to conclude that today, in well-organized and well-equipped obstetrics departments, the safety of the cesarean can be compared with the safety of the vaginal route.

Serious reasons lead us to present these technical advances as good news, insofar as our interpretations are exclusively based on conventional criteria: perinatal mortality and morbidity rates, maternal mortality and morbidity rates, and cost effectiveness.

The Bad News: The price of technical advances, such as simplified cesarean techniques, is a lack of motivation for studying the factors that can make the act of birthing easier or more difficult. It is as if, in the current technical context, making efforts to “rediscover” the basic needs of women in labor and of newborn babies is simply not worth the effort. It would be a real “re-discovery” indeed, after thousands of years of culturally controlled childbirth. We have a quasi-cultural lack of understanding of the physiological processes. Medical circles, natural childbirth movements and the general public share this lack of understanding. Understanding the physiological perspective would make possible the necessary steps forward.

The point is that, everywhere in the world, the number of women who can give birth to a baby and the placenta by themselves—which means with their own hormones—is getting smaller and smaller. Of course, the safety of the cesarean is the main factor that makes this operation more and more trivial. We must also keep in mind that most women who give birth by the vaginal route rely on pharmacological substitutes for the hormones that they cannot release in an inappropriate environment: for example, replacing natural oxytocin with drips of synthetic oxytocin and endorphins by epidural anesthesia is easy. These pharmacological substitutes do not have the behavioral effects of the natural hormones, though.

Michel Odent
Excerpted from “When Love Hormones Become Useless,” Midwifery Today, Issue 84
View table of contents / Order the back issue

Michel Odent will be hosting The Mid-Pacific Conference in Honolulu, October 26–28. Below is some information about the event.

For the first time, Ernesto Mesa will present hard data provided by the Malaga study about the side effects of synthetic oxytocin (Syntocinon or Pitocin). This important study has been feasible at the university hospital in Malaga, where there are about 6000 births a year. Thanks to detailed birth records, it is possible to evaluate the doses of synthetic oxytocin received by the parturients during induction, the first, second and third stages of labour or as a uterotonic agent during a cesarean section. The basis of the study has been the first to analyse the 2006 birth records, and then to interview the families in 2011–2012. According to preliminary results, synthetic oxytocin interferes in a negative way with breastfeeding, and there is a dose-response relationship. Furthermore, there are detectable effects on the psychomotor development of the children.

Such results are easily interpreted when considering the enormous concentration of oxytocin in maternal blood during pharmacological assistance. One of the anticipated effects is a desensitization of the oxytocin breast receptors. Let us recall that the milk ejection reflex is under the control of the oxytocin system. Another anticipated effect is on the development of the fetal brain during a critical period, since oxytocin can probably cross the placenta and also the immature blood brain barrier.

While the use of synthetic oxytocin is by far the most common medical intervention in childbirth, it is paradoxical that such a study is unique.

Featured Products

Learn what’s going on during a shoulder dystocia
The Resolving Shoulder Dystocia DVD shows you five types of shoulder dystocia and techniques to address them. A one-hour studio class includes slideshows, birth clips and demos, while the second hour shows systematic and clear demonstrations of techniques using a doll and pelvis. This is an important resource for your birth library.
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Penny Simkin

What is Midwifery Today magazine?

A 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more. Subscribe. Midwifery Today Magazine

If you work with postpartum women…
Nurturing Beginnings

…you need Nurturing Beginnings, MotherLove’s Guide to Postpartum Home Care for Doulas and Outreach Workers. This book is a comprehensive postpartum training manual and includes information from internationally recognized birth experts, doula trainers and doulas. Order the book.

Belly dance and pregnancy: a perfect pair!

Learn how to do it with Dance of the Womb: A Gentle Guide to Belly Dance for Pregnancy & Birth. This 2-disk DVD set includes a 45-minute warm-up and six dance chapters that teach specific movements and their uses during labor. You’ll also see belly dance in practice during labor, as well as a beautifully filmed 50-minute homebirth documentary. To Order

Dance of the Womb book cover

Fill Your Birth Library with Midwifery Today Back Issues

Midwifery Today back issues

Each quarterly issue of Midwifery Today print magazine is packed full of birth news, insights and information. You’ll also get an in-depth look at an important topic, with several articles devoted to the issue theme. Look over the list of available issues, then order the ones you need to help improve your practice. Order yours.

"I am opening up in sweet surrender
to the beautiful baby in my womb."
Of Nature and Birth DVD Slide Show

Watch "Of Nature and Birth"—a DVD slide show by Harriette Hartigan—for a powerful affirmation of how we can and should trust birth. Order this DVD for a beautiful beginning for your presentations to birthing classes. Add it to your lending library as encouragement for a pregnant woman to open as a flower on her birth day. Order the DVD.

Web Site Update

Read these articles from Midwifery Today magazine now available on our Web site:

  • Papatoto: Homebirth from a Father’s Perspective—by Michael Welch
    Excerpt: I’ve always been sort of a “guy’s guy,” steering my life with my will, and often only feel my true feelings later. Even now, more than a month after the birth of our daughter, I still feel as if I’m awakening from a yearlong dream.
  • Mamatoto—by Judy Edmunds
    Excerpt: Mamatoto (motherbaby in Swahili) represents a profound truth about those we are honored to serve. There is a mother, and there is a baby. Two unique DNA matrixes, individual brains, independent heartbeats, marked by separate sets of one-of-a-kind fingerprints on each digit.

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You want to be a midwife, but where do you start?

Are you an aspiring midwife who’s looking for the right school? Or maybe you’re trying to decide if midwifery is the path for you. Visit our Better Birth Education Opportunities page to discover ways to start or continue your education.

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library book stackMake the vision of natural birth available for all to see.

Ask your library to order natural birth and midwifery books for you. When a mother has more information about natural birth available to her, she can make more educated decisions about how she wants to birth her baby. Making requests is easy; here’s how.

Birth Q&A

Q: For moms who have experienced a variety of births, did you notice a difference in bonding with your hospital-birthed baby compared with your homebirthed baby?

— Midwifery Today

A: I’ve had three very different birth experiences and have three very different children. I can proudly say the bonding began long before the birth and I am equally bonded to each of them, though our relationships are all different.

— Sunshine Tomlin

A: I have eleven children. First 5 in the hospital, last 6 at home. Numbers 4 and 5 were twins born via c-section and that was the hardest bonding experience. Thanks to being determined to nurse them no matter what, we did bond, but it was a long, hard road.

— Vicki Davis

A: I had my first in a birthing centre and bonding took a while. My second was born at home and bonding was instant. BUT I don’t know how much of that is due to first baby “shock” vs. second baby “acceptance,” which I experienced. Both births were vaginal, in water, little interference, un-medicated.

— Kathy Reynolds

A: No, I did not, and actually, I feel just as close to the two I bottle fed as I did to their breastfed siblings. They’ve grown up to be two of my very best friends.

— Valarie Nordstrom

A: I have three boys, each born very differently. When I finally held my oldest son, born via cesarean after a failed vacuum extraction, I felt as if I were holding someone else’s baby. That feeling faded after a few weeks, and I assumed everyone felt as shell-shocked after giving birth for the first time. I chose my care provider carefully when I became pregnant again, and he assured me I was an excellent candidate for VBAC. Two weeks before my son was due, the hospital banned VBACs, and there were no other hospitals within 150 miles, who “allowed” them (midwives were also not allowed to legally attend them). I felt forced into a medically unnecessary cesarean, and suffered from posttraumatic stress disorder after my son was surgically extracted. For over a year, I couldn’t even look at him without bursting into tears. Yes, I loved him, but I wasn’t bonded to him, and it showed in his behavior as he entered toddlerhood. He and I have since spent a great deal of time trying to heal that rift, and we’re being very successful, but it will take a little more time. My third son was born at home, in the water. To be honest, I thought very little of him as he grew inside me, but the moment he was born, I could think of nothing else. He will be a year old in a few weeks, and I lack words to describe the level of attachment we have. It’s amazing. I’m so sad I couldn’t so easily experience that level of attachment to my two older sons. A mother’s love should be effortless.

— Heather Barson

Wisdom from the Web

According to Daniel Levitin, author of This Is Your Brain on Music, sex isn’t the only thing that leads to high levels of oxytocin. What’s the other? Singing, particularly singing with other people, causes the brain to produce unusually high levels of oxytocin. Just to double check, I found a study at the National Center for Biotechnology Information that lends credibility to this claim: when people sing together, their brains make oxytocin, and that makes them feel trust, solidarity, and connectedness with the people around them.

— Church Music Blog

Never in a woman’s life is oxytocin higher than in pregnancy and during labor, as well as the moments immediately after birth (when it’s at its all-time peak). Therefore if you think of birth as a sexual event, then you begin to understand how important the setting and the set of people around you really are. It’s not too far afield to say “imagine yourself having sex with a room full of strangers parading in and out of your room.” Could you change positions spontaneously? Could you move and groan and moan and do the things that are natural in birth if you’re being observed?

— Elizabeth Davis, midwife, women’s health care specialist, educator, consultant and author

When the process is uninterrupted, oxytocin is one of nature’s chief tools for creating a mother. Roused by the high levels of estrogen (“female hormone”) during pregnancy, the number of oxytocin receptors in the expecting mother’s brain multiplies dramatically near the end of her pregnancy. This makes the new mother highly responsive to the presence of oxytocin. These receptors increase in the part of her brain that promotes maternal behaviors.

— Linda F. Palmer

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 mtensubmit@midwiferytoday.com.

Conference Chatter

Introducing Jennifer Reeves

By the time you are reading this we will be doing our first day at the Harrisburg conference. If you are within driving distance, you could still join us! If you missed Harrisburg, we a have a great event planned for Bad Wildbad, Germany. Go to the following link for more information: http://www.midwiferytoday.com/conferences/Germany2012/.

We have an exciting announcement to make—we have a new conference coordinator! We are very pleased. She is well organized and as sweet and kind as can be! I’ll let her introduce herself below.

Jan Tritten

Hello! Having recently joined the Midwifery Today team, I want to introduce myself. As Karen Navarro will soon be moving on to other adventures, I will be taking over as the new conference coordinator. By following Karen’s masterful guidance, my aim is to advance Midwifery Today’s mission to “…redefine midwifery as a vital partnership with women,” and continue to bring you amazing conferences in fabulous places with beautiful people.

The Harrisburg conference and the October 17–21, 2012 conference in Bad Wildbad, Germany, “Midwifery: Birth Care for a Global Future,” will be my first opportunities to serve you. Please let me know if there is anything I can do to help—I am so excited and greatly look forward to meeting and working with you. See you at the conferences!

— Warm Regards, Jennifer Reeves
Conference Coordinator


My daughter reached her hand out when I was only a few centimeters dilated and shook hands with the midwife. She pulled her hand back in, and within an hour she was born. She was definitely ready to greet the world!

— Shawn Allyson Barr

Love birth?
You need Midwifery Today magazine!


Dear Midwifery Today,

Regarding the question of what items to include in a birth bag for a resource-deprived midwife, the following are the basic requirements:

  • a clean razor blade
  • a clean thread for the cord
  • a pair of gloves
  • a piece of mackintosh/polythene 6 x 1 m
  • a towel for wrapping the baby
  • a bottle of chlorhexidine
  • a small basin

— Benson Williesham Milimo, Midwifery Today Country Contact for Kenya
Lecturer, Department of Midwifery and Gender
School of Nursing, Moi University
Eldoret, Kenya

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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Midwifery Today: Each One Teach One!