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In This Week's Issue:
1) Quote of the Week
2) The Art of Midwifery
3) News Flashes
4) Our Mentors
5) Check It Out!
6) Question of the Week
7) For Coming E-News Themes
1) Quote of the Week:
"Most midwives espouse the cyclical and flowing model of nature and change. We view the woman's body as normal and healthy in its own right. Our role as midwives is to guard and sanctify the natural process."
- Kate Bowland, CNM
2) The Art of Midwifery
Many midwives have sacrificed their family and other
relationships unnecessarily ... and despite all those
sacrifices, or perhaps because of their heavy burden, these
midwives often burn out and stop practicing midwifery
altogether. One way to avoid all this is to prioritize your
life's work. You will have to learn to say what is often the
hardest word in our midwife vocabulary: No. For example, you
may need to tell a good friend, "No, I can't do your birth.
I already have four births in April." Each of you will have
your own set of priorities. But when you find yourself under
too much pressure and heading toward burn-out, look first at
your callings. Quite often, you are doing more than you are
called to do.
- Jan Trillen, The Birthkit newsletter
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3) News Flashes
The Adverse Childhood Experiences Study of 1,200 women has
determined that women exposed to abuse as children or who
grew up in dysfunctional households are much more likely to
become unintentionally pregnant than women who did not have
such adverse experiences. Two out of three of the women who
had unintended pregnancies reported at least two childhood
exposures to psychological, physical or sexual abuse or
household dysfunction, defined as mental illness or
substance abuse in the family or abuse to a child's parent
by a spouse. The connection was found across all racial and
socioeconomic and educational levels. -San Diego Union
Tribune, October 1999
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4) Our Mentors
I am a first year student midwife at Wolverhampton
University. I would like to sing the praises of my mentor,
J. Johnson. During a year of clinical placement she has
taught me the stuff you can't read in books. I have eagerly
observed whilst she has empowered women in one of the most
important aspects of any care: telling them they have the
power! I have watched whilst she practices the art of good
communication and developing equal relationships in deciding
and planning their care. She has developed my thinking. We
have had many conversations in which she has learned from
me. This has helped my confidence in my practice because I
feel we are equal partners and I'm not just there to carry
the bags or make the tea--in fact it's very rare for me to
Because you hear so many horror stories, I want to let other
students know that there are some great mentor midwifes out
there. J. is the most helpful of people in all aspects of my
course and my only hope is that I will become half as good a
midwife as her. She will influence my practice throughout my
- Nicola Edwards
I have to thank Nancy Wainer Cohen (now Nancy Wainer) for
pointing me in the direction my life has gone. It was 1981;
I was an OB/GYN nurse-practitioner and childbirth educator.
I had had my first baby eight months prior (c-section for
failure to progress: CPD--the usual diagnosis). I got a
flyer advertising a VBAC conference in Boston. I was
intrigued, so I decided to go learn so I could teach other
clients. After all, "my c-section had been necessary."
That weekend opened my eyes tremendously to what was going
on with birth in the U.S. I networked, learned, cried,
shared and laughed with about 50 other women. That weekend
we decided to form the National Cesarean Prevention
I returned to Indianapolis with a mission: lower the
cesarean rate, educate women, promote VBAC. Nancy was my
mentor. I wrote to her, called her, and visited her at her
home in Boston. I remember waking up and hearing her
downstairs--by the time I went down, she had already made
two casseroles to freeze, fed the kids, cleaned the
kitchen---she was a dynamo! I sat in on her VBAC class that
night. Remember, this was 1981-82--revolutionary stuff! I
became a CNM the following year.
Nancy's book, Silent Knife, is "the Bible of VBAC." I still
hand it out to all VBAC clients. I was her groupie for a
while--I went to lots of conferences to hear her speak. Of
course, I also learned a lot about myself through her and
learned how unnecessary my first cesarean was. I went on to
have two VBACs after that. I will always be indebted to
Nancy for her fire, her dedication, her insistence on
treating birth as normal. What a brave woman!
- Patty Brumbaugh CNM
Once upon a time, I worked as a nursing assistant in a small
community hospital, the very same one I had been born in
twenty-something years earlier. I worked the night shift
while I was in college. A high school friend called me one
day to tell me one of her sorority sisters from college had
been hired in our labor and delivery ward. She told me
Leslie was an RN studying to be a nurse-midwife. This
interested me because I had never heard of such a path. And
to me, midwifery was everything--womanist, humanist,
environmentalist, political. I needed to meet this Leslie!
Not too much longer I stepped into the hospital elevator
while running to the lab, and walked right into Leslie. As
soon as I saw her big green eyes, sparkling with stars of
encouragement and wisdom, I knew this was the woman my
friend had spoken of. She said "Cynthia?" I said "Leslie?"
and we giggled. We knew each other as if we had grown up
together. She would soon become my midwifery mentor.
A few days later, she put "Spiritual Midwifery" into my
hands. Inside, Leslie had written, "Each one, teach one." I
tried on the idea that I could be a midwife! Leslie and I
would often end our shifts at 7 am and spend hours and hours
watching videos, reading Midwifery Today magazines and
intellectually devouring books. I often say to people
nowadays, "It's all Leslie's fault!" Leslie, ever modest,
rolls her eyes and asks me not to put her up so high. I
remember telling her once how much I liked her hands. "My
hands?" she said, wondering.
A few years later, I met a young lady who was interested in
becoming a midwife. She began to ask questions about the
how-to's. I told her all about avenues toward being a doula,
kinds of midwifery education, magazines she could subscribe to, and so forth. To my surprise, she turned to me and said,
"I really like your hands." I smiled, got a little misty,
and said "Thank you." I understood.
Each One, Teach One: that is how the midwifery tale is told.
- Cynthia Yula
What influenced me? It was the mother who had homebirths in
the 1920s and 30s because that was normal. She birthed me in
1948 in the hospital and always said she didn't like it. It
was the midwife I met in my eighth month of Montane's
pregnancy who made me think and gave me choice. It was the
friend who asked for my help because she trusted me. It was
my faith in women and our god-given right to choice.
In my mind everyone had choice, and if they wanted it and
needed my help, I was going to do the best job I could at
supporting that choice. But I need to warn all of you:
regulation takes that choice away because those in control
feel they know more about you than you do. We need to work
to support the right to choose rather than our right to
- Ollie Anne Hamilton, CPM, DEM
Great Falls, MT
5) Check It Out!
A Web Site Update for E-News Readers
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For all the information you'll need:
Thank you to the following businesses for sponsoring the New York conference:
- 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.
6) Question of the Week
Q: I am a happy, healthy 39 year old mom with thalessemia
minor who is considering a homebirth for my second child. My
first was born when I was 37 at a birth center with CNMs.
Precautions taken (planned before labor) because of my
thalessemia were a heparin lock at the beginning of second
stage and a shot of Pitocin in my thigh immediately
following labor to help clamp down my uterus. I labored
naturally and normally with the exception of third degree
vaginal and perineal tears (baby came fast, kicked his way
out, and my position was not optimal). My normal hematocrit
is between 27 and 30. My pregnant hematocrit just before
labor was 25. Three days after it was 23 and back to 30 at
six weeks. I believe my platelet count was and is normal. Am
I a candidate for homebirth?
Editor's note: There were no responses to last week's
question about a torn placenta. If you would still like to
respond, see the question in Issues 28 and 29.
Send your responses to email@example.com
7) Question of the Week Responses
Q: A pregnant mother is expecting her fourth child. She says
she loses a lot of hair after the birth of each of her
babies. She wonders if there is anything she can do or take
to prevent this from happening again.
A: This happens because all hairs go through growing and
resting phases. During pregnancy more head hairs come into
the growth phase due to hormonal stimulus. After pregnancy
they all decide to have a rest at once, hence the pronounced
shedding that occurs in all women after childbirth usually
three to six months later, and more prominently in some
women than others.
- Phil Watters, OB
A: This is anecdotal at best, but it has been my experience
that this is normal and expected. I have had one child and I
experienced a fair bit of hair loss following birth. Almost
2.5 years later my hair is still not as thick as it used to
be, but much better than it was! My hairdresser says it is
normal too. My mother and sister each had four children and
both experienced hair loss. It seems that after the fourth
child, their hair never returned to its pre-baby thickness.
- Lisa S., doula
7) For Coming E-News Themes
1. How do you counsel pregnant women about nutrition,
especially in these fast-paced days of stress, little time,
and junk food? (August 2 issue)
2. In two to four sentences, what is the best advice to give
an apprentice or aspiring midwife?
**Take part in E-News! Sound Off-Give Advice-Share Your Knowledge!**
Send your responses to firstname.lastname@example.org
Know a strong woman? Helping empower one? If you haven't already done so, please forward this issue of Midwifery Today E-News to one or two of your friends or business associates. Thanks so much!
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Are you going to the DONA conference in San Diego this week?
Well, guess who is going to be there? Jennifer Rosenberg, CD
(DONA), design editor for Midwifery Today magazine, and
contributor to Paths to Becoming a Midwife. She's also a
speaker at the conference. She would love to meet doulas
interested in networking and chatting about what doulas do!
Bring your birth zeal and doula energy to eat, drink and be
merry with her on Wednesday, July 26 at 6:30pm at Mimi's
Cafe. (Special dietary needs will be accommodated by the
chef.) 5180 Mission Center Rd. Mission Valley, CA 92108
Phone: (619) 491-0284
In response to Carla who complained that she had had a
strong urge to push beginning early in labor, then when
finally allowed to push seemed to lose the ability to do so well and needed to push 2.5
hours to birth her first baby [Issue 2:29]: She said the
way the birth was handled "seemed to contradict the "trust
your body to know what it's doing" message.
I see many women, especially Hispanic women, who push early
in labor. Sometimes it's a cultural thing, and I see women
pushing only because family members are encouraging them to
do so. In this case I always instruct them not to push but
rather to breathe and relax as much as possible through
contractions. However, you can tell when a woman is pushing
because her body (rather than someone outside it) tells her
to do so. These women usually do quite well if left to their
own method of birthing. Rather than swelling or damaging the
cervix, their pushing seems to "push it away" and they have
rapid labors. These women's bodies do know what they're
doing, and even though it contradicts everything the
caregiver might believe, they work just fine. You know the
idea that all women are different and all labors even in the
same women can be different? Maybe with your next labor you
won't have these "pushing pains," but if you do, consider
that your body might know just what it's supposed to do.
- Joyce Jones RNC
Nearly a year ago Elena Ixcot, a Mayan refugee living in
Vermont for the past 16 years, invited me to travel with her
to her hometown, Concepcion Chirquirchapa, to meet with a
community of midwives. The town is located in the Mam
speaking area of the Western Highlands near Quetzaltenango.
Conveying energy and hope, the midwives told me how they had
organized to become more educated, to gain political
strength, and to train young midwives to carry on the Maya
birth traditions and knowledge of the use of herbs. In
addition to attending most women at home they have a small
clinic for women's health and a birth center for women who
cannot be at home. The area is desperately poor; resources
are quite limited.
Out of the deeply personal and moving exchanges in August
and again in January grew a project to create some kind of
partnership between the co-madronas of the Man area and
midwives from the United States. The "partners" project
paired 15 midwives from Guatemala with 15 midwives in the
States to obtain birth kits and supplies, which were
delivered in March. I have received the names of seven more
midwives who need partners. In addition, the project is
fundraising for a midwifery education and birth center that
would be a resource for the whole area and where traditional
herbs would be grown and knowledge of their use passed on.
Having their own center would help them preserve their
autonomy and traditional ways that are threatened, and help
them improve their skills and gain the same respect from the
government that is accorded them among their people. $14,000
has been raised toward the goal of $20,000 for land and a
building. Part of the ongoing project is to have midwives
from the United States participate in educational exchanges
with the local midwives.
If anyone is interested in being involved in this project
through partnering, financial support or material aid,
contact me, Judy Luce, CPM, at MidwifeOne@aol.com or
802-476-7056. Donations through the International Mayan
League are tax-deductible.
I did a search of PubMed or Medline on induction of labor.
There were at the time 941 articles. My survey showed that
665 of them were about techniques of induction: how, where,
when, what drug to use, etc.; 50 were about side effects and
complications; less than ten were on the experience of
induction. Tells you something about priorities doesn't it?
- Kato K, Nagata, Furuya K et al. "Programmed induction of labor for primiparous women to ensure daytime delivery." Asia J Oceania J Obstet Gynaecol 1987 13: 405-415. (Doesn't the title alone give you the creeps?)
- McNeil TF, Blennow G. "A prospective study of postpartum psychoses in a high-risk group. Relationship to birth complications and neonatal abnormality." Acta Psychiatr Scand 1988; 78: 478-484. (Sample is only 24, so trends are non-significant. However, induction, fetal distress, instrumental deliveries and offspring abnormality were associated with postpartum psychosis within three weeks of delivery.)
- Wigtron WR and Wolk BM. "Elective and routine induction of labor. A retrospective analysis of 274 cases." J Reprod Med 1994; 39: 21-26. (Basically, the authors say induction is not a problem for anybody except those primips with unfavorable cervices that had twice as many cesareans, and the respiratory distress syndrome in three cases, all secondary to meconium aspiration and all from the elective induction group.)
- Out JJ, Vierhout ME et al. "Elective induction of labor: a prospective clinical study, II: psychological effects." J Perinat Med 1985; 13 :163-170. (Elective induction again not a problem, except that mothers with induced labors were rated as being generally less emotionally involved in the first contact with their newborn than mothers with
spontaneous labor. "Differences not significant." How can one breastfeed if there is less emotional involvement at the first meeting?)
- Xenakis EM et al. "Induction of labor in the nineties: conquering the unfavorable cervix." Obstet Gynecol 1997; 90:235-239. (Nice title, kind of like saying rape is merely
conquering the unfavorable vagina.)
- Smith, Nagourney et al. "Hazards and benefits of elective induction of labor." Am J Obstet Gynecol 1984; 148:579-584. ("For the obstetrician and nursing staff, there has been great value in the concentration of 88% of deliveries to the hours of 9 am and 9 pm on weekdays. The hospital has benefited, not only from better use of staff and reduction of weekend and holiday workloads, but from improved occupancy of beds with the leveling of the peaks and valleys associated with deliveries after spontaneous onset of
I strongly encourage you all to research this and talk about
it with everybody who will listen, particularly girlfriends,
daughters, female relatives, anybody. Our female process is
being taken from us, and we are letting it happen. Our
babies are being injured, taken too soon, not ready to be
out in the world yet. Then we lactation professionals have
to work so hard to undo the psychic damage and support the
basic mechanisms of lactation and infant maturation until
mother and baby are ready. I would cheerfully give this up,
even if it meant my private practice disappeared.
One can refuse routine induction. In fact, if one's heart is
not behind it, it will not work because the internal
chemistry will work against the technology. Then the
technology will be intensified, because after all, that
unfavorable cervix must be conquered. If the baby is
breathing, and goes home with the mother, then all must be
well, right? NOT!!!
- Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, craniosacral therapy practitioner, childbirth educator
I am doing a study on "midwives working at the margins of
life: home birth and home death." I've been a home birth
midwife for almost 25 years and a hospice volunteer for
three years. My sense (an experience) is that home birth and
midwives working at home have a unique and rich perspective
to contribute to the world of people dying at home. I would like to speak with midwives who are or have worked with
people dying at home. Please contact me at
MidwifeOne@aol.com or call 802-476-7056 (I'll call you right
I live in Greece and I want to study pregnancy massage. I would appreciate if you can recommend relevant books and courses that I could attend in England (in Greece I don't believe there are any).
- Tina Doukas
Reply to: email@example.com
What causes pain? I ask my dads to think of pushing a whole
grapefruit into their mouths. It causes discomfort. Pain is
discomfort, just some deal better with it than others.
Maintaining relationships is very hard as everyone wants our
time. We have to decide what is most important in our life.
We just have to decide that ten months ahead of everyone
The description from Gail Hart was spot on [meconium aspiration syndrome, Issue 2:29].
- Phil WattersOB
I worked with Amish women having their 10th, 11th, 12th
babies, etc. who had huge varicosities, some the size of a
small garden hose, and not one caused any problems. This is
not to say that it couldn't happen, but none in my
experience did. I gave them white oak bark, cayenne
capsules, and if I remember right, butchers broom. I also
had them eat the white part of oranges. Susun Weed's
pregnancy book has some good suggestions for this problem.
For the woman with back labor, a posterior baby, and wanting
to push at 3 cm: A book describes a maneuver that may turn
posterior babies and is said to help back labor pain and
speed up the lengthy labor associated with posterior babies:
Back Labor No More. I found it at Amazon.com.
I had a similar labor with urges to push at 6 cm and was
told to resist the urge until about 9 cm (with the posterior
baby cervical lip, of course). My baby ended up getting
stuck (4 hours of pushing). He never turned, and I was
transferred to the hospital and eventually had a c-section.
Needless to say, I don't want any more posterior babies.
If anyone else has more ideas, please share.
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Midwifery Today: Each One Teach One!