November 12, 1999
Volume 1, Issue 46
Midwifery Today E-News
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Broaden your education in Jamaica and Philadelphia, Pennsylvania!

Make plans now to attend one or both these conferences:

* Ocho Rios, Jamaica, December 2-6, 1999
Birth Without Borders--Weaving a Global Future

Get your program online at Midwifery Today's new website:
Sponsored by:

- Mothering magazine: Mothering is in its 24th year of providing inspiration for attachment parenting. Mothering guides, nurtures, and supports while providing the latest on controversial parenting topics.

- Cascade Health Care: Cascade HealthCare Products, Inc. began business in 1979 with the primary goal to provide supplies and equipment for the emerging profession of midwifery. We have developed a complete product line that not only serves midwives, but nurse midwives, childbirth educators, lactation consultants, visiting nurses, birth centers, WIC programs, nurse practitioners, doulas, and professionals dealing with expectant parents, families and women's healthcare.

* Philadelphia, Pennsylvania, March 23-27, 2000
Mainstreaming the Midwifery Model

This conference highlights the many educational paths to midwifery. Students and educators, plan to attend the day-long education day seminar on the pre-conference day and choose the education track of classes during the regular conference.

Our only U.S. conference in 2000!
Program is now available. For your copy of the printed programs, send your full name and postal address to Please mention code 940.


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This issue of Midwifery Today E-News is sponsored by:

- Childbirth And Postpartum Professional Association (CAPPA)
- Waterbirth Website

Look for their ads below!


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In This Week's Issue:

1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Question of the Week
5) Why I Aspire to Become a Midwife
6) Switchboard
7) Midwifery Today Conference Notes
8) Coming E-News Themes


1) Quote of the Week:

"Doctors in all countries except perhaps Holland need to hear over and over again that a woman has the right to choose where and with whom she wants to birth. A woman's autonomy must be respected."

- Henny Ligtermoet


2) The Art of Midwifery

In my hospital when I have an RH negative woman, I am required to send her blood for type and RH and Coombs after the birth, in addition to the baby's cord blood. As most of my births are non-interventive my moms don't usually have hep locks or IVs so I don't take their blood. I also hate to have to stick them after the birth and to turn such a natural birth into a medical business. So my less interventive way to get the blood is to use the outer part of a sterile 20 cc syringe after I have discarded the inner plunger, and place it at the entroitus. When I place my other hand on her fundus to check if it is well contracted, usually I can catch a spurt of at least 2-5 cc of mother's blood which I then transfer to a test tube and send off to lab. Of course I have a finger on the hole at the bottom of the syringe so the blood doesn't run off. I've been using this trick for years instead of pricking the mom. It works great--try it!

- I. S.


Midwifery Today magazine's Tricks of the Trade column has kept practitioners informed for years. Join the forum by subscribing to the magazine! Mention code 940 and receive $5.00 off a one-year subscription. Call 1-800-743-0974 to order. Offer expires Dec. 3, 1999.


Share your midwifery arts with E-News readers! Send your favorite tricks to


3) News Flashes

An increase in the hormone relaxin results in looser joints during pregnancy. New research has shown that joints may remain looser for up to four months after delivery. New mothers should start post-pregnancy exercise programs slowly, being careful not to overstretch, and should stick to activities that don't require a lot of quick, explosive moves during the first few months after delivery.

- Journal of Orthopaedic and Sports Physical Therapy, July 1997


Childbirth And Postpartum Professional Association (CAPPA)offers expert training and certification programs worldwide to childbirth educators,labor doulas and pospartum doulas. We also assist families in finding these professionals in their area. Please visit or call us toll free at 1-888-548-3672 for more information.


4) Question of the Week: I would like to know how to treat pregnancy induced carpal tunnel and what causes some pregnant women to get it.

- Anon.

Send your responses to


Visit the multiple award-winning WATERBIRTH WEBSITE for the most complete waterbirth information available on the net!
Includes a Photo Gallery, over 50 firsthand waterbirth stories from moms, dads and waterbirth practitioners, a tutorial, information on great products you can order, and lots more. Special Offer to E-News readers: Enjoy a 10% discount on your purchase of the "WATER BABY" video. Regular price is $59.95 + $7.50 p/h. Your discount price is just $53.95 + p/h. Full ordering details are at


5) Why I Aspire to Become a Midwife

I am fifteen years old and I became interested in midwifery when I was thirteen. I began to read books about the subject and before long it was all I could think about. I started to fall behind in school and knew I could not let that happen so I decided I would finish high school, then do my studying. I still read anything I can find on midwifery.

In Issue 43 of E-News Jill Earl told about her theory [of why she became a midwife] and I wondered if it could be true. I am one of twins; my mom delivered us two months early. My sister's lungs were not developed fully and we had to stay in the hospital for two months prior to being born. My mom had to have a c-section which she said was very painful. Mom barely got to see us when we were first born so it was a very difficult time for her.

I have had friends tell me that I have the ability to comfort people so hope if that is true that one day when I become a birth practitioner I can use that gift.

- Briana Stodden

Editor's Note: Readers, E-News invites you to respond to Briana with
thoughts, advice, encouragement and support. Here is a young woman who will
be carrying on your work. Please give her a hand up! Send your messages to and all will be forwarded to Briana.


6) Switchboard

My compliments for your excellent newsletter. I enjoy reading it every week. But I missed seeing mention of a very important survey in the waterbirth issue [45]: Perinatal mortality and morbidity among babies delivered in water by Ruth E Gilbert and Pat A Tookey, August 1999 BMJ. The full text can be found at or search the site for the term "waterbirth" in article text. This survey among >4000 waterbirths in England and Wales concludes that waterbirth is as safe for babies as conventional birth. Which we all knew of course, but now it has been scientifically proven!

- Lucy-Anne de Vletter
The Netherlands


In response to Jane, whose sister in law has a history of miscarriage, ovarian cycsts, placenta that 'breaks up' and fibroids, and whose doctor wants to do a hysterectomy [Issue 45]:

I will offer two things that she might want to look into. This comes with a prayer for hope and encouragement from someone who has been down that road of suffering also.

First, if her miscarriages are in early pregnancy, she may have a progesterone deficiency, also known as luteal phase defect (LPD). With low progesterone levels, the growing placenta never builds up enough to nourish the growing baby. There is literally not enough oxygen or nutrition getting to the baby for it to survive. A simple prescription of natural progesterone supplements (oral, or vaginal suppositories) during the first trimester may make all the difference in the world. (It has for me! I have had three healthy babies after losing three.)

An endometrial biopsy can help diagnose LPD, but it is also helpful to know when ovulation takes place in relation to onset of menses. A short post-ovulatory phase (i.e., less than 14 days from ovulation to menses) would be suspect, especially if the post-ovulatory phase were typically 9-10 days. Several months of record keeping using a "fertility awareness" approach, such as the Creighton or Billings model, will be especially helpful in confirming such a diagnosis. In my personal experience, all of my medical tests came back "normal" but the Creighton model charting showed my LPD quite clearly: a typical 9-10 day post-ovulatory phase.

The second issue I want to mention is nutrition. I have worked extensively with Dr. Tom Brewer in recent months putting together a web site that reflects his years of research and experience with nutrition in pregnancy. I would venture to guess that his first question to Annie would be about her diet. Some women seem able to get pregnant despite terrible nutrition; yet there are some who, in spite of a pretty good diet, find that eating better really does make a difference. Dr. Brewer has said that during times of stress the body doesn't assimilate the good food we eat as well, and assuming Annie is under stress over this issue (and I'm speaking from personal experience), it could put her at risk even if she is eating a good diet.

According to Dr. Brewer, the placenta is like all other organs in that it needs adequate nutrition to survive and thrive. In his practice he virtually eliminated placental abrubtions (among other problems) simply by counseling women on what to eat during pregnancy. So if the placenta is not functioning well and there is no medical reason to indicate why not, then it may be that it isn't being nourished well enough, and of course the baby is not getting enough nourishment either.

With or without a medical reason for her losses, it certainly can't hurt for her to be eating the best possible diet during this time. If nothing else, it's a proactive step she can take, and she can rest assured that she's doing all that she is able to do. Dr. Brewer's simple diet ensures that a woman gets all the protein, calories, vitamins and minerals that she and her baby need, in perfect balance, throughout pregnancy and breastfeeding.

You can find Dr. Brewer's Blue Ribbon Baby pages at The diet is available there to print and distribute freely.

One final resource Annie may appreciate and one that helped me so much is the book I'll Hold You In Heaven by Jack Hayford. This touching little book offers support and reassurance for those who have lost a child through stillbirth, miscarriage, abortion, or SIDS.

- Marci


I think she would benefit from reading The Hysterectomy Hoax by Dr. West. It's written for the laywoman and gives treatment options instead of hysterectomy as well as the drawbacks of hysterectomy (which are usually downplayed).

I agree, she needs to find out what the underlying problem is, not give up so totally on her reproductive years by yanking out her uterus. Even if she decided to quit trying for children, that's no reason to take out her uterus.

- Debby S.


There are some amazing all-natural herbal products that could help her tremendously and possibly reverse the need for a hysterectomy. Please email me at for more information. I can put her in touch with professionals in the medical field if she so desires.


I recently underwent a new procedure for advanced uterine fibroids called arterial uterine embolization. My fibroids were over 18 weeks size and had been resistant to extensive alternative treatments. Basically, this procedure blocks the blood flow to the arteries. Without blood supply the fibroid dies, shrinks and either disappears through reabsorption or is passed. There have been cases documented where women went on to give birth to healthy babies, although post-procedural fertility is not guaranteed. However, where there is a healthy uterus (as mine now is) there is at least hope. Have your sister-in-law find a facility that does this new procedure. It is much safer than surgical options but it's newness means it is not available everywhere.

- Cynthia Gerard, CPM, LM


There is some good current research about immune issues that can cause placental failure and subsequent miscarriage. She may want to check out some of the resources at: and

- Ronnie


Jane Responds:
Aren't women wonderful? I am so pleased with the responses so far. I will be sending all the information to Annie. She'll be so proud and touched that women all over the world are thinking of her and are willing to share their experiences and knowledge.

Thank you at Midwifery Today for this wonderful forum in which to air concerns and queries without fear or embarrassment. Thanks also go to those who have been interested enough to respond so quickly.


In response to "Anon.," Issue 45: I am saddened to hear your resistance to midwives of color creating their own forum for conversation. There are already many "sections" of midwifery. These sections, such as Christian midwives, do not divide the midwifery effort. Instead they have some essential purposes. One is that they will further the scope of midwifery to communities where the option of having a midwife is not known about. They will try to create a dialogue amongst midwives of color in order to find out the particular race and ethnicity issues regarding childbirth within theses groups. They will attempt to raise awareness within these groups so mothers-to-be will know their other options and also will hopefully recruit more women in their communities to study midwifery.

Please do not feel threatened or worried by this kind of coalition. There are differences between us, and we must honor them. Perhaps when these women can point out issues that are different to women of color regarding birth, then all of us can learn something and have more respect for those women.

I am a white-skinned Middle Easterner. I wholeheartedly support the effort of women of color to organize and discuss their issues. And I know that these same women share their discussions with the midwifery community and will make the movement extremely richer.

- Sheeva Hariri


I think the request for literature on midwives of color is an appropriate one. Most people do not know that the majority of children in the South were delivered by black slaves. Most medical doctors found childbirth unseemly and left it for the black midwives to do. Not only were the majority of white babies delivered by black midwives, but all the black children on the plantations. This mother-daughter tradition continued in the United States until at least the 1960s. Many black women did not trust the medical establishment (i.e. Tuskegee Institute syphilis medical testing, for example) to deliver their babies. The women either did not receive adequate care or the doctors would refuse treatment.

There needs to be more information about African American midwives, because if one would look even superficially it would be obvious that the extinction of black midwives was racist. But don't take my word on it, research this for yourselves. I am also interested in finding out how the episiotomy was started. One story I heard was that a white doctor-plantation owner experimented on a female slave until he got it right and by then she was dead. Has anyone else heard the same?

- Tendai Phiri


To Ilana Shemesh [Issue 45]: In my practice, I wrote protocols for intermittent fetal heart monitoring based on the ACOG recommendations:

  • FHT are recorded for 30 min. by EFM upon the mother's arrival to the hospital. NST is performed at the same time.
  • If the FHR is reactive, the mother may be taken off the monitor and intermittent monitoring may be done thereafter.
  • When performing intermittent FHM, the FHT are auscultated during a minimum of one uterine contraction and the 30 seconds interval following a uterine contraction.
  • The preferred method is to begin auscultating midway between two contractions through the next contraction and the 30 seconds following this contraction.
  • During the first stage of labor, during the latent phase, FHR is done every hour, and during the active phase, every 30 minutes, and during the second stage of labor, every 15 minutes.

These protocols are for low risk mothers. FHR will also be done prior to labor events, such as AROM, following AROM, and as indicated.

- Ronnie R.


The statement in Issue 45, "A certified professional midwife (CPM) has gone to a non-nursing midwifery school," is not true. A CPM has a documented and approved education course. That may include a midwifery school, self-study, nursing school or apprenticeship. I am a CPM and did not attend a midwifery school.

- Cynthia Gerard, CPM, LM


I'm seeking information about the birth scene in Switzerland because my family may be moving there next year. Any and all info is most welcome, and in particular, names of midwives I might be able to contact directly.

- Laura B
Brooklyn, NY,


Does anyone know of a "health food" infant formula? I know many frustrated parents who've adopted who have had to rely on conventional infant formula for their baby's sole nourishment. They ask my advise on a brand or a recipe to make their own but I'm at a loss. When my own daughter was an infant I wanted to have a can of backup formula just in case I was detained at a birth and the baby sitter spilled the last of the breast milk. I studied all the labels and found most brands contain cottonseed oil (cotton is heavily sprayed with pesticides as it's not considered a food!!), not to mention the other junk. Or does anyone know an entrepreneur who'd like to capitalize on this consumer niche? Believe me, I'm not advocating for formula feeding over breast, but an organic, non-bovine growth hormone, non-artificial additive formula could serve a lot of babies well.

- Nan


I am working on a waterbirth project and would like insights, stories, helpful suggestions for preparation, execution and cleanup for a water labor or birth from the viewpoint of medical caregivers, doulas, moms, dads, etc. Your input will be acknowledged.

- Judith Halek
Reply to:


Unless otherwise noted, share your responses to Switchboard letters with E-News readers! Send them to If an e-mail address is included with the letter, feel free to respond directly.


7) Midwifery Today Conference Notes

Philadelphian Birth Enthusiasts!
If you are interested in bringing Midwifery Today Conference flyers to a meeting with LLL Leaders, CBEs , nurses, doulas, doctors, parents, etc. contact:

Mothering Mommies Doula Service
Enterprise Building
4548 Market Street
Philadelphia, PA 19139


8) Coming E-News Themes

The coming issue of Midwifery Today E-News will carry the following theme. You are enthusiastically invited to write articles, make comments, tell stories, send techniques, ask questions, write letters or news items related to this theme:

- Gestational Diabetes (Nov. 19)

We look forward to hearing from you very soon! Send your submissions to


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Midwifery Today, Inc., does not assume liability for the use of this information in any jurisdiction or for the contents of any external Internet sites referenced, nor does it endorse any commercial product or service mentioned or advertised in this publication. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding any medical condition.

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Midwifery Today: Each One Teach One!