July 17, 2013
Volume 15, Issue 15
Midwifery Today E-News
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Welcome to Midwifery Today E-News !

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Bring breech birth information with you wherever you go!

MT online store

Download Breech Birth, a collection of 15 articles by some of the greatest minds in the natural childbirth world. Articles in this e-book include “Breech Birth from a Primal Health Research Perspective” by Michel Odent, “Instinctual Breech Birth” by Sister MorningStar and “Three Surprise Breeches” by Ina May Gaskin.

Available on Amazon or on Smashwords in a variety of formats.

What is a rebozo and what can you do with it?

Belgium conferenceAttend the full-day class, Rebozo Techniques and Practice, to learn how this traditional Mexican tool is useful in all parts of the childbearing cycle. Thea van Tuyl, Mirjam de Keijzer and Eneyda Spradlin-Ramos will show you simple techniques that promote healthy pregnancy and birth. You will also have time for hands-on practice.

Learn more about the Belgium conference.

Share your passion and joy for midwifery!

Harrisburg conferenceCome to our conference in Harrisburg, Pennsylvania, next April. You’ll meet midwives from around the world while attending classes with teachers such as Jeanne Ohm (pictured), Gail Tully, Sister MorningStar, Elaine Stillerman and Carol Gautschi.

To receive a printed program by mail when it becomes available, please e-mail admin@midwiferytoday.com with your name and postal address. Learn more about the Harrisburg conference.

In This Week’s Issue

Quote of the Week

If the timing is not right, the labor will not happen, and a forced labor ends in greater and greater interventions that put the baby and mother under greater and greater stress.

Sister MorningStar
Excerpted from Sister’s upcoming article, “The Times and Tools of Induction” (Midwifery Today, Issue 107).

Are you enjoying your copy of Midwifery Today E-News? Then show your support and get more content by subscribing to our quarterly print magazine, Midwifery Today. Subscribe here.

The Art of Midwifery

Many women are naïve regarding induction. They don’t realize that induction includes a multitude of possibly unnecessary interventions. Medical induction requires hospitalization, fetal monitoring and often internal uterine monitoring, confinement to bed, IVs and a high rate of obstetrical medication, particularly epidurals.

Sharon Glass Jonquil, excerpted from “Forcing the Issue: The Induction of Labor,” Wisdom of the Midwives: Tricks of the Trade, Vol. II, a Midwifery Today book
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.

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Jan’s Corner


I hope no one is still using this drug for induction. A couple of years ago a man called our office and talked with one of the women here who also works as a doula. The man said his wife and child just died because of a Cytotec induction. This drug is used off label and is a random killer. You never know which case will prove fatal. We as midwives have a responsibility to have good practice, and Cytotec use for induction does not fall into the realm of “good practice,” whether at home or in the hospital. Ina May Gaskin has a quilt with squares for each mother who has died in childbirth; many are the result of a Cytotec induction. She has a great article in the upcoming issue of Midwifery Today on induction and Cytotec use. Don’t miss it. You can subscribe here.

Hemorrhage control is another common off-label usage of Cytotec. I have been trying to get midwives to use what God provides for hemorrhage control: membranes and the cord if the placenta is still inside or a piece of the placenta if it has been born. There are other excellent hemorrhage control herbs, medications and prevention techniques. For a full discussion of all this, get the recent back issue of Midwifery Today, Issue 105. It is packed with information you can use on this very important subject!

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: https://twitter.com/jantritten
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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Learn about midwifery education!

Are you an aspiring midwife who’s looking for the right school? Are you a practicing midwife who would like to learn more? Visit our Education Opportunities page to discover ways to start or continue your education.

Featured Article

Adverse Events Following Misoprostol Induction of Labor

“Off-label” use of misoprostol (Cytotec) for labor induction has been steadily increasing for 10 years, even though this use is approved neither by the U.S. Food and Drug Administration, other national drug regulatory agencies, the pharmaceutical industry, the Cochrane Library nor a number of national obstetric organizations, including the British Royal College of Obstetricians and Gynaecologists. Some obstetricians, particularly in the US, continue to promote induction with misoprostol, even though the available evidence suggests possible serious risks including uterine rupture, maternal mortality and perinatal mortality.

In January 2004, The Cochrane Library commented on the paucity of data on the serious risks of induction with misoprostol and asked for help: “The studies reviewed were not large enough to exclude the possibility of rare but serious adverse events, particularly uterine rupture, which has been reported anecdotally following misoprostol use in women with and without previous caesarean section. The authors request information on cases of uterine rupture known to readers.” This paper addresses this appeal.

In the past eight years, I have consulted on 16 medico-legal cases involving adverse events following misoprostol induction of labor in the US. In every case, I have carefully reviewed all prenatal, intrapartum, postpartum and neonatal medical records, including all electronic fetal monitoring strips; all laboratory results, including maternal ultrasound examinations; non-stress tests; cord blood gases; and the infant EEGs, MRIs and neurological examinations. All cases of uterine hyperstimulation and hypoxic fetal heart rate patterns have been confirmed by thorough review of the electronic fetal monitoring strips. All cases of uterine rupture are not just dehiscence but clear, significant ruptures of 6–18 cm, confirmed by the operative report on the emergency caesarean section done in each case of uterine rupture. All cases of amniotic fluid embolism have been confirmed by the pathologists’ autopsy reports. Finally, all cases of hypoxic ischemic encephalopathy of the infants have been confirmed by EEG, MRI and pediatric neurological examination.

Marsden Wagner
Excerpted from “Adverse Events Following Misoprostol Induction of Labor,” Midwifery Today, Issue 71
View table of contents / Order the back issue

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Born in Water: A Sacred Journey

How would your baby like to be born?
How Will I Be Born? In How Will I Be Born? Jean Sutton explains the principles of optimal fetal positioning in a clear and straightforward manner. Written for expectant parents, this book is packed with helpful advice and information, including an informative chapter on posterior position. A must-read for all pregnant moms and a book for the practitioner’s lending library. Click here.

Learn from the Eugene 2011 conference teachers!

Order this selection of classes on a portable USB drive, then load them onto your computer or into your MP3 player to have them handy whenever you have time to listen. Classes include First and Second Stage Difficulties with Gail Hart and Vicki Penwell, Shoulder Dystocia with Ina May Gaskin and Elizabeth Davis, Third Stage Difficulties with Marion Toepke McLean and Supporting Trauma and Abuse Survivors through Pregnancy and Postpartum with Maryl Smith.


Paths to Becoming a Midwife

Thinking about becoming a midwife?

Do you know someone who is?

Paths to Becoming a Midwife: Getting an Education is just what any aspiring midwife needs and would be a much appreciated gift. The fourth edition of this book includes several new articles on the various midwifery philosophies, new information on becoming an apprentice, dozens of recently updated articles, and a current directory of more than 150 schools, programs and other resources. Order the book.

Do you work with laboring women?
Then you need the sixth edition of Anne Frye’s Healing Passage, A Midwife’s Guide to the Care and Repair of the Tissues Involved in Birth. Even if you have an earlier version, you’ll want this one, which is more than twice as long as the fifth and packed with vital information about the art and science of perineal care and repair. The anatomy section has been completely overhauled, the suturing lessons have been expanded and the information about tear repair has been updated. You’ll also find a completely new pelvic floor model with pattern and instructions in the appendices. To Order Healing Passage

Give the gift of information!
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Birth Q&A

Q: What do you think the dangers of Cytotec are?

— Midwifery Today

A: Cytotec is not meant to be used in pregnant or laboring women. It’s clearly labeled thus on the box! It can cause uterine rupture.

— Alexandria Makley-Martinez

A: I feel a large part of the danger comes from dosage or rather the inability to know exactly how much medication a patient is actually receiving. A 1/4 pill could contain 1/4 medication and fillers and binders, or it could be entirely medication. The second danger is that it’s absorbed, so there is no way to stop the effects once they’ve started.

— Stacey De Almo

A: Uterine rupture, high fevers, fetal heart rate descents leading to a cesarean. The doctor used it on me for a stillbirth—it was horrific.

— Jessica Solberg

A: Cytotec is approved to treat ulcers, but not pregnant women. The only reason hospitals are allowed to use it is through a loophole that allows it to be used experimentally! There is also no recommended manufacturer’s dosage, so doctors choose how much to give on their own. It has been shown to cause uterine rupture, fetal death, maternal death, profuse bleeding and emergency hysterectomies.

— Skyla Walton

A: Once in the blood stream, it can’t be turned off—a disaster waiting to happen! No pregnant woman should be given it without a full detailed explanation of its dangers!

— Susan DiNatale

Craving more birth info?
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Conference Chatter

Conference Sweepstakes

Greetings everyone! I have some exciting news for those of you thinking of coming to our conference on 30 October – 3 November in Blankenberge, Belgium. Midwifery Today is holding its very first conference sweepstakes, and the prize is pretty phenomenal! You can enter to win one three-day pass to the Blankenberge, Belgium, conference (a $425 value). Entry is absolutely free, and there are extra entries for those who promote the conference via social networks. Find out more here. Log into Facebook if necessary, then click "Giveaway" to view sweepstakes information.

The sweepstakes will be running for the rest of the month, so be sure to pop onto our Facebook page and enter. We’re so excited to be able to offer this to all of you. Best of luck in winning!

For more information about the upcoming conference, please visit our website.

If you have any questions about this conference or any conference from past or future, please feel free to drop me a note at conference@midwiferytoday.com, and I’ll be happy to assist you.

— Andrea Goldman, Conference Coordinator

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