April 7, 2000
Volume 2, Issue 14
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In This Week's Issue:

1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Kangaroo Care: Why Does It Work?
5) Check It Out!
6) Question of the Week
7) Question of the Week Responses
8) Switchboard
9) Why I Became a Doula
10) Classified Advertising

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1) Quote of the Week:

"In my dream, all parties choose to reject the kind of rigid and hierarchical thinking that assumes there can be only one standard, so that if there are two, that has to mean that one is better and the other is worse. There is more than one good way to do something good!" [on setting standards for midwifery]

- Robbie Davis-Floyd

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2) The Art of Midwifery

In order to prevent loss of calories and weight in the premature baby, I advise the mother to keep her baby swaddled snugly to prevent his overexertion.... he should be given an external environment which closely resembles the womb. I encourage parents to do "kangaroo care...." It can be a challenge to maintain the baby's temperature because he has less body fat than the term baby and cannot self regulate his temperature. Also, the preemie will sleep almost all of the time until his actual due date, which makes preventing weight loss difficult as well.

One trick I use is the "squeeze, squeeze, suck, suck" technique. Because the baby expends more calories in sucking effort than can be obtained, we have the mother express her milk into the baby's mouth each time he has suckled two or three times.

- Valeria El Halta, Midwifery Today Issue 36

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Comments? Send them to mtensubmit@midwiferytoday.com

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3) News Flashes

Kangaroo care of the premature infant (extensive skin to skin holding) carries a reduced risk of overheating in the infant because when the baby reaches 98.6 degrees F (37 degrees C), any excess heat will be passed to the mother. Even moderate heat stress can lead to breathing problems. A research team found that after four hours, 90 percent of babies who received kangaroo care had regained normal body temperature. This compares to 60 percent of babies placed in incubators.

- BBC News, Oct. 11, 1998

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4) Kangaroo Care: Why Does It Work? by Holly Richardson

By the early 1980s, the mortality rate for premature infants in Bogota, Colombia was 70 percent. The babies were dying of infections and respiratory problems as well as lack of attention paid to them by a bonded parent. "Kangaroo care" for these infants evolved out of necessity. Mothers of premature infants were given their babies to hold twenty-four hours a day--they slept with them and tucked them under their clothing as if in a kangaroo's pouch. If a baby needed oxygen, it was administered under an oxygen hood placed on the mother's chest.

Doctors who conducted a concurrent study of the kangaroo care noticed a precipitous drop in neonatal mortality. Babies were not only surviving, they were thriving. Currently in Bogota, babies who are born as early as ten weeks before their due date are going home within twenty-four hours! The criteria for these babies is that they be alive, able to breathe on their own, are pink and able to suck. However, their weight is followed closely, and they can be gavage-fed if necessary.

Dr. Susan Ludington is one of the people who have been most instrumental in bringing kangaroo care to the United States. She has been intimately involved in many research projects, and her work is having a powerful, positive impact on premature babies and their families. In the United States, the few hospitals that regularly use kangaroo care protocols have mothers or fathers "wear" their babies for two to three hours per day, skin-to-skin. The baby is naked except for a diaper, and something must cover his or her back--either the parent's clothing or a receiving blanket folded in fourths. The baby is in a mostly upright position against the parent's chest.

The benefits of kangaroo care are numerous: The baby has a stable heart rate (no bradycardia), more regular breathing (a 75 percent decrease in apneic episodes), improved oxygen saturation levels, no cold stress, longer periods of sleep, more rapid weight gain, more rapid brain development, reduction of "purposeless" activity, decreased crying, longer periods of alertness, more successful breastfeeding episodes, and earlier hospital discharge. Benefits to the parents include "closure" over having a baby in NICU; feeling close to their babies (earlier bonding); having confidence that they can care for their baby, even better than hospital staff; gaining confidence that their baby is well cared for; and feeling in control--not to mention significantly decreased cost!

Read why and how kangaroo care works! The entire article can be found on Midwifery Today's web site:
www.midwiferytoday.com/Library/articles/kangaroocare.htm
To read more about Midwifery Today Issue 44 in which this article appears, go to
www.midwiferytoday.com/mt/publications/mtmagissues.html#44

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5) Check It Out!

~~~WWW.MIDWIFERYTODAY.COM~~~
A Web Site Update for E-News Readers

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Coming Soon to the Midwifery Today Website!
Pictures, poems and other mementos from Midwifery Today's recent
Philadelphia conference. Stay tuned!

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New Articles Continue to Go Up! Check them out at

http://www.midwiferytoday.com/Library/articles.htm

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Midwifery Today's Product and Services Directory--The Birth Market--has opened its doors for birth practitioners to join! We are asked every day for help locating birth practitioners of all kinds--here is Midwifery Today's savvy solution!
ON SALE: For the cost of $25 and a static banner on your web page, you may join our listing. This means if you have a web page that is EXCLUSIVELY about your practice and DOES NOT SELL A PRODUCT, you may add our banner to your site and pay a $25.00 registration fee to be included in the Birth Market. This is a special price to you--a regular entry to the Birth Market costs $150.00 for businesses/websites that sell products. See
www.midwiferytoday.com/ads/bannertrade.htm. If you don't have a web page, call or e-mail Cynthia the WebGirl@midwiferytoday.com
You may also read more details at
www.midwiferytoday.com/birthmarket

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Birthing From Within
by Pam England, CNM and Rob Horowitz, PhD
www.midwiferytoday.com/Library/Reviews/template5.html

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Are you a birth enthusiast? You need a web page! After all, isn't a picture worth a thousand words? Have a web page created that you can hotlink from Midwifesearch.com, Midwife Link and Midwifery Today as well as your paper marketing! We even register your site into search engines! Contact Cynthia the WebGirl@midwiferytoday.com for more details.

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Ancient Art Midwifery Institute: The Standard of Excellence in Midwifery Education since 1981. The first at-a-distance program for midwives. With online support and the exclusive AAMI online study group for our students, be a part of the best program available for your dollar. E-mail AnctArtMI@aol.com or phone 818-902-0449.

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6) Question of the Week

I have a one year old baby and recently found out I am expecting another wonder gift from God. I had a c-section (no choice of mine) with the first baby. My doctor said that a c-section is definite with this one. I had my mind set on a natural labor. First, is this true that I don't have a choice in the matter? Second, If not then I would love nothing more than to have my baby at home. Is this possible?

- Elena Moreno

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Send your responses to mtensubmit@midwiferytoday.com

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Well-established board-certified female ob/gyn in southern Atlanta suburb looking for an experienced energetic CNM, willing to grow with the practice. GYN experience preferable. Goal of the practice is to keep it small, with personal attention, a total of two physicians, two-three midwives in 2-5 years. Competitive salary, vacation, benefits negotiable. Serious candidates fax resume to 770-389-3848 or email to satyars@hotmail.com

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7) Question of the Week Responses

Q: I did a search on varicose veins and came up with only a brief reference to a connection between them and a diet high in sugar and meat, and living at a high elevation. I am 23 weeks pregnant with my third child, and this is my second experience with this, only it has become apparent much sooner in the pregnancy. Does anyone have any insights into causes, or have helpful suggestions? Herbs, diet, exercise, support garments? And just how common is my complaint, anyway? In all the lay literature I've read, vulval varicosities have only been mentioned a couple of times.

- Cathy Killough

A: I currently have a client in my midwifery practice who has vulvar varicosities that even extend into the lower buttocks and posterior upper thighs. She has obtained a lot of relief from acupuncture from a reputable practitioner. She also has taken care to avoid constipation, and is taking extra vitamins E and C.

- Debbie Wolfe, CNM

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Q: Does anyone know of any natural remedies for blocked fallopian tubes? The woman in question has already had two children and is not aware of having had an infection that could have caused this.

- Julia Duthie

A: A neighbor lady who had two children ages 8 and 10 who was not able to conceive since those births had gone from doctor to doctor to find the cause. *Finally*, after thousands and thousands of dollars were spent trying to find a solution, one compasionate local doctor explained to her that her tubes had been tied. She was shocked as she had never requested such a procedure.

He then revealed to her, though said he would have to deny that he had exposed this information, that in our state, as in many others, if a woman shows any reason--mental, physical, emotional or financial--for not being able to bear any more children, based upon the doctor's assessment, he could tie her tubes without consent or disclosure, and that it was his civic duty. It's problematic, but bears checking out.

If yours is "natural" caused, dehydration will cause the tubes to be blocked simply because the body does not have sufficient fluids to keep up what is supposed to be a continually available tubal mucus flow. Even eight glasses of water in a low water content type of food regimen is not sufficient. You may want to read the book "Your Body's Many Cries for Water--You Are Not Sick, You Are Thirsty" by Dr. Batmangeheilidji (or spelled something like that!)

- Cyndee

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A: My husband is a naturopath and I am a midwife. We have been successful using mineral water in a douche for cleaning out excess left over waste material within the tubes. As it is an astringent, it draws out foreign matter that has been obstructive. This can be done on a slant board using about two ounces and retained for ten minutes. It can be done a couple of times a day for about a week. The mineral water is used by itself in the douche. This may not be all that is causing the problem as infection can swell and obstruct as well as scar tissue. The use of bromaline (derived from fresh pineapple) in the diet has been used to reduce scar tissue if sued over a long period of time. Also if mother is using suppository napkins (you know the brand names) this is not good as it can block the flow of blood, forcing endometrial tissue and old blood back u[p into the fallopian tubes which can cause toxic shock and eventually possibly endometriosis.
This information is to be used by you at your own discretion and is not to be considered medical advice.

- R.

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A: I have a friend who went to an osteopath for this condition and the osteopath worked on freeing the "scarred tissue." She ended up conceiving a baby afterward. She preferred to try this instead of having surgery.

- Helene Vadeboncoeur

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Also: Reiki, Herbs, Birth Companion training, other womanly healing arts.
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resourcing@earthlink.net
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NEW! Homeopathy & Midwifery Course - June 19-21, 2000

- In the National Center for Homeopathy's Summer Program at Johns Hopkins University (Baltimore, MD).

Learn which homeopathic remedies are useful during * pregnancy * birth * post-partum and related conditions/problems.

Instructor: M.J. Hanafin, RN, CNM, NP, CHom, DHom.
Tuition: $230+room & board.

Please click www.homeopathic.org/ss00.htm for more information or to register. Space is limited, so visit soon!

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8) Switchboard

Regarding comments by Kenya Yopp [Issue 2:13]:

Though I acknowledge childraising, personal growth and wisewoman tradition are essential for becoming a midwife, I feel it pertinent that the aspiring midwife, woman or man, acknowledges the benefits of globality of human experience which includes, among other things, a university education.

Ina May Gaskin has not only the wealth of human experience but also a university education. Her lay approach to midwifery began with little success because she lacked practical as well as medical knowledge (re: the early times in her book "Spiritual Midwifery"). Fortunately she found help from professionals who helped her learn what she needed to--though not everyone today can reap the benefits of an experienced doctor sympathetic to midwifery traditions!

As a mother of two children and aspiring midwife, I recognize there are many paths to becoming a midwife and I see the richness in each one.

- Tracy Deborah Robinson
Baie St-Paul, Quebec

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In Jeanne Batacan's response to the woman who had an ectopic pregnancy (Issue 2:12) she states, "In the case of ectopic pregnancy, that is a moot point. Immediate surgery to save the life of the mother is always the treatment. "Surgery is not always necessary in cases of unruptured ectopic pregnancies diagnosed early. If the gestational sac measures 4 cm or less on transvaginal ultrasound, medical treatment with Methotrexate is a good option. Check out the review article by Carson SA & Buster JE Ectopic Pregnancy, NEJM, Vol. 329 No. 16, Oct 14, 1993, 1174-1181.

- Amy Britton
Houston, TX

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A 22 year old primip who is 37 weeks pregnant just came to me wanting a home birth. Docs say she has small bones and they want to cut. She is taking a medication called Atenalol to control tachycardia. Has anyone heard of this med? She really wants to have her baby at home. I'm inclined not to do it at home because of the tach., but told her I would check around for other opinions.

- I.D.

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I am currently working on my PhD in sociology and am considering doing my dissertation research on issues related to teen moms and natural childbirth. I am thinking of collecting birth stories to compare how these stories are told by teen moms vs. older moms, and moms who used a doctor vs. those who used a midwife. Do teen moms tell their birth stories any differently? Do moms who used midwives tell their stories differently? How does story telling influence society's perception of birth, and vice versa? Does anyone know of research that has been done related to these questions? Research on teen moms and natural childbirth, or birth stories? I would love to hear from you! Please send responses to: broetje@earthlink.com

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I am a registered nurse working in Uganda. I am working in the area of maternal child healthcare and education. I was a member of ICEA and am a certified childbirth educator through them but due to various things I was not able to maintain my membership with them. I am now trying to get recertified and I need to get contact hours for it. I hope to travel to Seattle during end of May so wonder if any readers would be able to inform me of any workships, conferences, etc. which may be going on during that time in the Seattle area, The Pacific Northwest or even the West Coast which I could attend while I am there.
Aniko Juhasz
Reply to: anikojuhasz@yahoo.com

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I am trying to find out which states have had May 5th proclaimed as "International Midwives' Day" by the governor. May 5th is quickly approaching and I would like to have this information by then.

- Michelle Bartlett
Reply to: themidwife@hotmail.com

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I have the maternal antibodies Anti D & Anti C. I have just had my second baby who was exposed to these and delivered early due to her increase in liver size (as seen on scan). If any other anti-D or C-positive mothers want to know more about what I experienced and how my pregnancy was managed here in New Zealand, please contact me.

- Kirsten
Reply to: kirst@xtra.co.nz

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"Paths to Becoming a Midwife: Getting an Education," compiled, edited and published by Midwifery Today, Inc., can help you fully understand what midwifery is, what kinds of midwifery are practiced in the U.S. and the kinds of education and training each path requires. It lists and describes resources, schools, programs, standards; it charts programs and the state by state legal status of midwifery; and it includes a comprehensive chart of midwifery schools and programs. No other book has ever been published that can give you all the answers about how and why to become a midwife, from the philosophies to the realities to the training.

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

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9) Why I Became a Doula, by Raverna Wynn Stahl

I am a doula. I love supporting birthing women and their loved ones as they make families. I love supporting and giving to others in this work, and receiving life-giving love and encouragement from them, too. Doulas do help provide happy memories, which just might be the key to the best parenting. Doulas empower women; foster maternal-infant bonding for the strength and health of coming generations as well as birthing families; nurture and support breastfeeding mothers toward health, nutrition and nurture of their young; foster maternal/parental fulfillment so that every time a mother (and fathers too) looks into the eyes of her precious offspring her deepest memories are strong loving ones. That deep seated bias rightly formed from the beginning goes a long, long way during the toughest challenges of raising the young to give and receive love themselves, with confidence and courage in this most profound life here on the planet.
With warmest love and respect for you all,

- Raverna Wynn Stahl
Seattle, Washington

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How did you become a birth practitioner? Or why do you aspire to become one? Share your thoughts and experiences with E-News readers! Send your submission to mtensubmit@midwiferytoday.com

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10) Classified Advertising

Need your article, thesis, essay or book edited and/or proofread? I have worked with pregnancy, birth and midwifery related manuscripts for thirteen and a half years and know the field well. Sliding scale.
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