May 9, 2012
Volume 14, Issue 10
Midwifery Today E-News
“Postpartum Depression”
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The Power of WomenSave $5 on any one Motherbaby Press book

Check out our Spring into Savings page to find out how. Choose from The Power of Women, Brought to Earth by Birth, Survivor Moms or Placenta: The Gift of Life. Offer expires June 30, 2012.



Learn more about postpartum…

…when you read Midwifery Today, Issue 61 (Spring 2002). Articles include “The First Hour Following Birth: Don’t Wake the Mother!” by Michel Odent, “How I Overcame Postpartum Depression,” by Joli Furnari, and “Postpartum Psychosis,” by Robin Lim.
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Explore Mexican techniques with Angelina Miranda Martinez

Germany conferenceSign up for this full-day pre-conference class and you’ll learn about remedies, techniques and customs from Mexico. You will also have hands-on practice time to learn how to use the rebozo, a very useful tool in all parts of the childbearing cycle. From the first labor contractions to the first days after birth, you will discover how midwives work with both normal birth and problems that arise. Part of our conference in Bad Wildbad, Germany this October.

Learn more about the Germany conference.

In This Week’s Issue


Quote of the Week

The wisdom and compassion a woman can intuitively experience in childbirth can make her a source of healing and understanding for other women.

Stephen Gaskin


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The Art of Midwifery

Motherwort: This herb has the reputation of being mildly addictive, though most people I’ve seen who use it feel like it was a lifeline for them at a time when they needed it. Under periods of extreme stress, it is an effective nerve soother. In tincture form, take 10–15 drops two to three times daily.

Lisa Goldstein
Excerpted from “Herbs for Emotional States,” Midwifery Today’s, Birth Wisdom, Tricks of the Trade, Vol. III
View table of contents / 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.


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

Jan’s Corner

Facebook: A Great Resource for Networking

I really like Facebook as a resource for discussing midwifery and birth. I have a fairly constant stream of great talks on my profile page. I will ask a question such as, “What are the most important considerations for a midwife or doula to do or not do as soon as the baby is born and breathing,” and then I wait for all of the interesting answers to come streaming in.

My answer to this post was this: “A key to rousing a slow-starting baby is a quick change of elevation. Hold baby up about 12 inches in your hands—put one hand under the head and one hand under the buttocks. Lower your hands with the baby cradled in them—do this twice. Babies have not known gravity so they generally wake right up with a startle. This is only for a really slow-starting baby—do this just before you are ready to try full-on resuscitation. Most babies will start right up and you can hand the once floppy baby to mom. It may sound awful, but it works so, so well (and of course, the cord is still attached!). When needed, this is an excellent trick.”

Marlene Waechter provided another solution, “Jan, I do a slightly different take on your ‘trick.’ I do not raise them up, but (for pale, floppy, non-breathing babies only) lower them below the level of the placenta. This has all the advantages of raising them, plus gives them a little extra blood to work with. This is the only time I don’t put baby right up to breast. I don’t hurry the placenta, but I do want to know its status, before I leave things alone. A detached placenta that remains inside, acts like a stopper on the cervix, causing an occult hemorrhage. If it’s still attached and the fundal height is not rising, I don’t interfere. When I need to, I do. I’d rather prevent a postpartum hemorrhage than treat one! I do believe that God designed our bodies to birth our babies naturally—I’m not one to jump in quickly to control things, but ‘meconium’ happens, and I want to be assured things are really okay before I leave the mom and baby alone. One must find the best balance of leaving things alone and troubleshooting for problems to be a good midwife.”

Sally Kelly said, “She should leave the cord intact. Let mum make the first contact with the infant and sit back and enjoy that amazing moment. We don’t need to interfere at all.”

Sharing from midwives from all over the world happens on the Facebook page. Besides my profile page, you can “like” Jan Tritten’s Birth Page. I started this to slowly transition our talks over to that page since I have no more friend spaces left on my profile page. I also started Gardening Midwives on Facebook to prove we could, once in a while, talk about something besides birth! Midwifery Today’s Facebook page has over 39,000 people liking it. Donna, our marketing director, puts up great articles there. We also have a page for each conference where you can arrange rides together, find roommates or have other conversations. We also have a page for Birth Is a Human Rights Issue. The networking opportunities on Facebook are amazing—it makes the world so much smaller. Please join us in this great opportunity to get to know each other.

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.

Midwifery Today on Facebook: facebook.com/midwiferytoday
Jan on Facebook: facebook.com/JanTrittensBirthPage
International Alliance of Midwives on Facebook: facebook.com/IAMbirth
Birth Is a Human Rights Issue: facebook.com/birthisahumanrightsissue
Midwifery Education: Caring and Sharing: facebook.com/MidwiferyEducation


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News and Research

Postpartum Depression in Dads

Loosely defined, postpartum depression is an episode of depressed mood that occurs in the weeks or months following a birth. What you may not realize, however, is that men can suffer from this disease, too.

Recent studies have shown that around 10% of dads suffer from depression following the birth of a child. For moms, the percentage is around 14%.

Rob Sandler, a father who experienced depression after the birth of his son, said, “You suddenly have no control over what you do. You are totally dependent on what the baby needs and when he needs it. Before, you [were] very in control of your life and time and calendar—all that changes so dramatically when you have a child.”

Research suggests that testosterone levels dip while estrogen and prolactin (a hormone that helps make breast milk in women) levels increase in males before and after a partner gives birth. These hormonal changes in men may be a cause of postpartum depression.

Family health educator, Nikki Wellensiek, says new fathers should seek help if they are still feeling sad and out of sorts one month after the birth of their child.

— “Postpartum depression affects dads too.” The Huffington Post. Last modified May 25, 2011. Accessed April 20, 2012. http://www.huffingtonpost.com/2011/02/14/postpartum-depression-aff_n_822206.html


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Featured Article

Reducing the Risk of Postpartum Depression

Recent media coverage of actress Brooke Shields’ birth experience has brought postpartum depression to the attention of the American public. Although Brooke’s talks have illuminated the reality of postpartum depression, discussion of risk reduction has virtually been ignored.

The focus, instead, has been on treatment, such as medication. While using medication to help stabilize mothers already experiencing severe postpartum depression may be essential to the safety of mother and baby, finding ways to reduce the risk of postpartum depression is a preferable course of action. Risk reduction can avoid the need to stop breastfeeding as well as prevent medication dependency.

What factors contribute to postpartum depression and how can we reduce the risks for both mother and baby? These questions need to be asked and answered by families and health care professionals alike.

Parents need to be educated in topics such as underlying psychological issues, birth trauma, proper postpartum nutrition, household support, cultural pressures and therapeutic massage so they can identify the risks and develop a plan for reducing them.

Many hospital birth attendants overlook the possibility of underlying psychological factors when evaluating and treating postpartum depression. Issues that may have been buried deep within the psyche often surface during labor or postpartum. Physical trauma such as rape, unresolved feelings toward parents or unstable partner relationships may affect how a mother cares for her new child. Uncovering deep-seated fears and resolving hidden feelings may reduce the possibility of postpartum depression. One useful tool in confronting hidden fears is presented in a book called Birthing from Within, by Pam England. England advocates that parents cope with inner fears through different exercises and birth art.

Another contributing factor in postpartum depression may be the mother’s feelings of trauma during her birth experience. She may have had unfamiliar caregivers doing vaginal checks, unfriendly support staff or procedures that were in opposition to her personal beliefs. These include routine episiotomies, early cord-cutting, forced supine positioning and lack of freedom to move around. Birth completes a unique cycle in a woman’s life, and jarring events during this time may have long-lasting effects.

A woman has a unique challenge to face when she must cope with an unexpected c-section. After nine months of anticipating a normal birth, an unforeseen c-section can be a major disappointment for a number of reasons, including being given drugs, having the baby whisked away and facing a longer and more difficult recovery. This birth trauma may cause feelings of inadequacy leading to internal messages that say, “Something is wrong with my body because I was unable to give birth vaginally.” Even though family and friends may reassure her that these messages are not accurate, she may still face her own personal inner critic.

Adarsa Antares
Excerpted from “Reducing the Risk of Postpartum Depression,” Midwifery Today, Issue 76
View table of contents / Order the back issue


Featured Products

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Tear Prevention handbookFind out with Midwifery Today’s The Tear Prevention handbook. This book will also discuss how to heal tears when they do occur, with suggestions ranging from Super Glue to seaweed. Other topics include natural alternatives to suturing, sitz baths, and protecting the upper tissues.

Do you want to be a midwife’s assistant?

The 2-DVD set, Midwife’s Assistant Orientation for the Student Midwife, features a combination of live workshops and demonstrations that will help you prepare for clinical site training and experience. It also includes detailed instructions for many emergencies, as well as role-play of various scenarios such as waterbirth procedures and neonatal resuscitation. If you’re a student midwife or know someone who is, this DVD is a must-have! To order

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Choose from several inspiring mandala art prints by Amy Swagman. Each image is available as a digital print on archival, acid-free artist paper. Take a look, then choose your favorite! These stunning prints also make lovely gifts.
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Five Countries, Six Births, Seven Babies DVDFive Countries, Six Births, Seven Babies showcases homebirths in Guatemala, Costa Rica, France, the USA and Bermuda. Filmed between 1994 and 2010, this DVD’s powerful images of mothers and babies can inspire a woman to learn to embrace birth as a joyful experience. It definitely belongs on any birth professional’s media shelf. Buy the DVD.

Learn from Expert Midwives

Wisdom of the Midwives
Wisdom of the Midwives, the second volume in the Tricks of the Trade series, is packed full of useful ideas and techniques. You’ll learn about counseling as a tool in your birth kit, nutrition and healthy birth, herbs, homeopathy, Chinese medicine, premature rupture of membranes, first stage and more. Order the book.

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Web Site Update

Read this article excerpt from the current issue of Midwifery Today magazine now on our Web site:

Read these articles from past issues of Midwifery Today magazine now on our Web site:

  • Prenatal Care CNM Style—by Sharon Glass Jonquil
    Excerpt: Our clinic day begins at 9 a.m. with “Welcome, how are you?” Smiles may greet us, with excited tales of the baby’s first kicks. Or a stone face may turn away, and our patient questioning of the pregnant mom elicit a story of trouble at home.
  • What Really Matters Is Our Primal Health—by Michel Odent
    Excerpt: The contrast between fetal vulnerability and adult adaptability is a key for understanding the nature of health. What really matters is our “Primal Health,” that is, the basic state of health in which we are at the end of the “primal period.”

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Bring resources about homebirth and midwifery to your community.

Does your library have relevant natural birth and midwifery resources? Did you know that as a patron of the library, you can make requests for specific books, magazines and DVDs? If these resources are not available for mothers to find, how will they make educated decisions? Making requests is easy. Go here to learn how.



Birth Q&A

Q: After giving birth, what specific kind of support did you receive that you most appreciated?

— Midwifery Today

A: Arranged meals were such a blessing and relief! It would have been nice to have help with housekeeping (light), but I was happy with the meals!

— Brandi Monson

A: Moral Support! No matter what, don’t be hard on yourself; being a new mom takes time, and sometimes the bond isn’t instant. Love yourself as a mom, and then you can love your babe.

— Barbara-ann Horner

A: People bringing meals was certainly amazing, but it was also amazing to have people visit and chat and help with the older children. Mostly though, I appreciated the support of my husband and knowing that he was there all hours to help!

— Kendra Rogers

A: I remember sitting on a park bench during a mom’s meeting, so tired I fell asleep sitting straight up. Not one mom offered help. I don’t think they knew what to offer.

— Shannon Mitchell

A: I remember being so envious of the other moms I knew who got meals made, laundry done and felt supported. I remember feeling isolated, depressed and having to accept my unexpectedly huge and foreign post-pregnancy body, which was about 30 lbs heavier than I’d ever been in my life. Having had that experience, I try to reach out to new moms to make sure they don’t go through the same thing.

— Catherine Burns

A: Having people smile at me, listen to me, and not be so quick to give advice when it wasn’t asked for. When dinners were made for me (this may sound silly) I felt like a queen—a champion. I felt like I did something important and that I was worth being taken care of when someone did something as simple as bringing me a drink while I was feeding the baby. I felt like I did something amazing, and the way people reacted reassured me that it really was amazing and that it was important to take care of me. It all validated my own feelings about my experience and how I was feeling (tired but excited, happy and nervous). If someone treated the situation like “this is just life, so, whatever…“ I wouldn’t have dealt as well, I think. The validation of my experience (not just the birth but becoming a mom) was invaluable.

— Michelle Anthony

A: As far as postpartum depression goes, the first time around I started having trouble with this, but I had had my placenta encapsulated—what a lifesaver!

— Laura Walthew

A: I appreciated friends and family bringing food and being careful to observe that we wanted organic food, meats, etc., help with dishes, trusted folks helping with the older children to give Mommy and baby time alone to rest and bond, placenta encapsulation for postpartum depression! I appreciated the support from my midwife, knowing I could call her if something was going on that I needed advice on.

— Summer McCreless


Wisdom from the Web

New mothers need sleep and rest, which is hard to come by with a newborn. The Asian lifestyle is more suited for new mothers to handle these situations since grandmothers and aunts offer help voluntarily. The new mother is pampered and not allowed to do any kind of work for at least a period of two months. This kind of a set-up provides the much needed company and rest that a new mother needs. It also gives her an opportunity to share her fears with someone more experienced.

— Native Remedies
http://www.nativeremedies.com/articles/natural-remedies-postpartum-depression.html


Postpartum depression, also known as postnatal depression, can happen to any new mother, and is not a reflection of her character. According to the Centers for Disease Control, between 11% and 20% of pregnancies result in the mother being diagnosed with postpartum depression, which is about 950,000 moms every year! This statistic is based [on] mothers who self-reported their symptoms.

— Postpartum Living
http://www.postpartum-living.com/


St. John’s wort extract is licensed in Germany and other countries to treat mild to moderate depression, as well as anxiety and sleep disorders. While the exact effect of the herbal extract is unknown, several studies have shown that St. John’s wort works better in trials than a placebo and often gives results that are on par with standard prescription antidepressants. A minimum daily hypericin dosage of 1 mg is recommended. It should be noted that while there is nothing to show that St. John’s wort isn’t safe to take during pregnancy, not much study has been completed in this area.

— Your Days, free information for women
http://www.yourdays.com/articles/postpartum/remedies/natural-cures-for-postpartum-depression.htm


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

Laugh at a Midwifery Today Conference

Midwives laughing: Carol Gautschi on the left, Barbara Harper on the right and Tine Greve in the background
Midwives laughing: Carol Gautschi on the left, Barbara Harper on the right with Tine Greve in the background

Midwifery is maybe one of the most complex, difficult, wonderful, happy, sad callings one can have. You deal with professional issues, the witch-hunt against midwives, births that are euphoric for motherbaby and births that have sad outcomes. It is a loving roller coaster. You must be ready for the next birth on the heels of a possibly difficult one. Your family scene can be in momentary shambles, but you have to go now—she needs you. And yet we love it; we simply love the gift God gave us to help families in this most intimate time.

We need to renew our strength in the many ways we can. You know many ways of taking care of yourself, so you need to balance all of that intense loving you are giving out by doing things for yourself. Midwifery Today conferences will almost always give you that loving lift you need to keep going in your work. Many past registrants have told me that they were ready to quit until they became refilled and re-inspired at a Midwifery Today conference. That always makes us so happy to be doing what we do with Midwifery Today. Maybe you will even attend a conference where someone suggests laugh yoga, or maybe you should suggest it. This photo is from a Midwifery Today conference in Philadelphia. We were doing laugh yoga and a famous midwife wet herself from all the laughter—but it wasn’t me this time!

— Jan Tritten



Stories

Two years ago I had my third child at home. We were hanging out in the bedroom after my midwife arrived, when my then 4-year-old daughter who was playing hostess, offered everyone strawberries from her little tea party plates. She came up to the midwife and offered her a drink of water in a cup she had found empty in the bathroom; a cup with “urine specimen” printed on the side. Um, no thanks!

— O’Keefe Kelly D’Elia


Classified Advertising

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