Check It Out!
A Web Site Update for E-News Readers
Birth Song Midwifery Workbook
Cost: $24.95 plus shipping and handling
LOOKING FOR A MIDWIFERY WORKBOOK to help you with your studies? The Birth Song Midwifery Workbook has eleven chapters that cover the basics of normal birth and midwifery. Included are exercises, informative line drawings, and a nine-page glossary of midwifery terms.
COMPLETE YOUR LIBRARY of Midwifery Today back issues. Find them at Midwifery Today's Web site storefront.
INTERNATIONAL ALLIANCE OF MIDWIVES
Midwifery Today's Web-based organization that networks international midwives.
ARE YOU A MIDWIFE IN WAITING?
Get our Beginning Midwives' Pack, the package designed with YOU in mind. You'll receive a subscription to Midwifery Today magazine, the 332-page book Paths to Becoming a Midwife: Getting an Education, and four audiotapes about the realities of being a midwife and the art of midwifery.
Midwifery Today's Online Forum
Have any of the midwives [on the Forum] caught a breech baby? I may be facing a breech birth soon and would like some input. - Kelley
To share your thoughts and experience, go to Midwifery Today's Forums. Click on "Births" and "Has anyone caught a breech?"
PLEASE DO NOT SEND YOUR RESPONSES TO E-NEWS!
Question of the Week: Stroke
I have a client who is 24 yrs old and is due March 14 with her first baby. She just had a stroke. It occurred in the right temporal lobe and was caused by a heart defect (atrial septal defect). The woman has had the heart problem all her life and never knew it. She was always into sports, very active, and it was never a problem. Now with the blood increase of pregnancy it became a problem and she threw a blood clot. She is now on blood thinners (Lobinox) and going through rehab. Her left side is paralyzed at this point.
Has anyone ever had a similar case? Doctors are changing their stories constantly. One says he wants her to heal and carry this baby (who is fine at this point) to term so she has time to heal. Another says she needs to be induced (38-40 weeks) and needs Pitocin and epidural because she can't push this baby out - it could cause another stroke and may damage her heart. They may want to use forceps or vacuum extraction. C-sec is out of the question because of the blood thinners. The doctors in this area have never seen this happen before so they don't really know what the limitations or side effects are. The family is going to the Philadelphia area to see about other options. The father is a chiropractor and both dad and mom wanted this to be as natural as possible. What is a realistic expectation? Will natural birth be riskier than the meds and side effects of interventions? What about not pushing the baby out and letting mom let the baby come down with minimal pushing and minimal breath holding?
Send your responses to:
Question of the Week Responses
Q: Would readers please share their experience and information about endometriosis and pregnancy/labour? Our pregnant client has quite severe endometriosis, with nonpregnant symptoms of frequent nausea, very painful cramping premenstrually and during menstruation, heavy bleeding and bleeding from the rectum.
A: My experience is not as a midwife but as a woman who has endometriosis. I am also a nurse in labor and delivery and have a sister-in-law who is a CNM and also has endometriosis. In both my pregnancies I had nausea and vomiting for all nine months. I don't know if that was related to the endometriosis or the hormonal changes. For her pregnancies, my sister-in-law was less sick and for a shorter period of time.
My labor and delivery went well with both children. My sister-in-law's labor went well; delivery was a struggle. Why the difference? The endometrial implants I had were within the uterine cavity and tubes. My sister-in-law's implants were on the bowel, bladder, and outside of the reproductive organs. She had nothing on the tubes and very few implants near the uterus. Pushing was quite problematic because she felt her bladder was being pulled down with each push. She opted for a pudendal block, which relieved the intense pressure and pain.
I think that where the implants are and how extensive the implants have invaded the sites determines not how sick one is but the comfort level during pregnancy, labor and delivery.
- Catherine Mascari
This client's nonpregnant symptoms match mine almost exactly. Before my first pregnancy 18 years ago I had severe menstrual symptoms that began with my very first period. On the first day of any period I would not only bleed heavily but also have very regular cramping. The cramps would get closer and closer together until I would begin vomiting, get very panicky, sweat heavily, have diarrhea-like symptoms and then I would pass a very large clot. Once the clot was passed, the cramps would slowly subside and I would fall into a deep sleep. When I had my first labor it was like having these "cramps" all over again.
A doctor put me on birth control pills, which helped, but after several years I became concerned that all those hormones were not good for me. I was told by four different doctors that I would "never get pregnant" because my endometriosis was so bad. I was off the pill for about four years before I conceived.
The baby came at 34 weeks. The labor was relatively short for a first timer - eight hours. I dilated to 4 cm and stayed there for several hours before progressing to 10 cm within 30 minutes. I hemorrhaged after the birth of the placenta but did not need to be transfused. After my first baby I never had endometriosis symptoms again. The second pregnancy was seven years later. Labor was basically the same, although it lasted five hours and started spontaneously at 40 weeks. Again I "hung" at 4 cm dilation for two hours, went to 10 in 30 minutes, and the rest was pushing (baby was 3 lbs. bigger). I hemorrhaged again, no transfusion. After the first baby I realized my periods were very much like labor - they progressed the same way even with a transition-like stage.
My oldest daughter showed symptoms of endometriosis when she began her periods. However, we used Traditional Chinese Medicine to help her and she has been symptom-free since. She had only one episode of severe cramping with all the other symptoms I had at her age. I wish I had known about TCM when I was her age!
More about pica [Issue 4:6]:
Craving soap is often a result of a lack of trace minerals in the diet, a form of pica. I highly recommend supplementing and my favorite is red raspberry leaf tea because of its high concentration of trace minerals. Three cups of tea a day is good, and more is better. It's very easily assimilated so her pica should improve quickly depending on the amount of tea consumed.
- Connie Banack, CLA/CLD, CPD, CCE, ICAN president
A patient with severe pica may have very low iron stores but still have a normal hemoglobin and hematocrit. Also check her zinc level. The best reference I found about this subject is Ambulatory Obstetrics, 3rd edition, by Star, et al.
I had a similar case recently with a woman who craved soaps, cleaning substances and bleach. I consulted with one of the hematologists in my clinic, and informed him of her low ferritin level and low zinc levels (also associated with pica). He made some recommendations for iron supplementation as well as zinc. These remedies helped somewhat but the cravings continued until birth. The woman said the most important thing was knowing there was a reason for this compulsion.
More about kidney stones [Issues 4: 2, 3, 4]:
There is one other factor about calcium to consider. Calcium does not normally float around freely in the body. It occurs bound with other molecules. The most common form of kidney stone is made of calcium bound up with oxalate, an alkaline compound. Calcium bound with oxalate causes alkaline urine and it sediments out and forms stones more readily. The presence of calcium bound with citrate (which is acidic) in the kidneys prevents this from happening. Calcium stripped from bones is always bound with oxalate. So adding calcium to the diet, reducing caffeine intake and quitting smoking, all of which encourages retention of bone calcium, will reduce the amount of calcium bound with oxalate. In addition to ensuring adequate intake of calcium (and vitamin D required to use the calcium), one must also avoid consuming foods that contain oxalates such as strawberries, rhubarb and especially grapefruit juice. One must also increase intake of citrate to switch the pH balance to acidic. Lemonade is one example of an excellent source of citrate.
It is also important to remember that not all kidney stones are made of calcium oxalate. Some stones are made of other kinds of material and signal a different source for the stone. This is why your doctor wants you to catch and keep any kidney stones you pass. The stone can be tested for content. Different stones require different treatments. No treatment should be used without guidance from your doctor.
- Natalie Bjorklund
More about placental tear [Issue 4:5]:
I am an herbalist in the Chinese Tradition. I studied in China in the OB/GYN department of a large traditional hospital and have practiced with a focus on women's health for 20 years. My teacher, Dr. Qiu, used a special decoction - called Bu Jue Tang or Supplement Certainty Soup for placental tears and early detachment of the placenta - with dramatic results. Below is an excerpt I translated from her book. A case study regarding the use of this formula can be found at www.whitepinehealingarts.com.
Bu Jue Tang, Supplement Certainty Soup
Ren Shen Radix Ginseng (or Dang Shen Radix Codonopsis), 30 g.
Huang Qi Radix Astragalus, 24 g.
Bai Ji Mo Rhizoma Bletillae Striatae Powder, 6 g. Stir in.
Method: Decoct in water
Function: Consolidates qi, absorbs blood, "weeds through the old to bring forth the new," stops bleeding and engenders flesh.
Principle Use: Treats early detachment of the placenta.
Formula Explanation: This prescription contains Huang Qi Radix Astragalus, which has a warm quality and a sweet bland flavor. It can raise yang and supplement qi as well as heal wounds and grow flesh. It also can absorb blood and stop bleeding, consolidating so that the bleeding spontaneously stops. Ren Shen Radix Ginseng, (or Dang Shen Radix Codonopsis) increases strength, supplements the middle, and boosts qi. Bai Ji Rhizoma Bletillae Striatae sticks and pastes, takes in and closes, and repairs damage. Therefore this prescription is called "Supplement Certainty Soup." It has a very good effect for early detachment of the placenta.
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!
I am looking for a midwife in India who can accept me as an apprentice. I do not have any birth experiences or even knowledge, but I feel that midwifery is something I am supposed to be doing this life. In Japan, it is so hard to find someone I can work with and learn from. If you know a midwife in India, would you please let me know? Thank you so much for your time.
Reply directly to: email@example.com
INTERNATIONAL MIDWIVES, please direct your questions, comments, and needs to "International Connections." We're here to help you!
Are you interested in connecting with birth enthusiasts and midwives around the globe? Join IAM!
The International Alliance of Midwives is an online directory of individuals and organizations working to change birth. Only $20 a year!
Dr. Helen Caldicott is again speaking out against nuclear proliferation on earth and in space and supporting women and children against the terrors of a world gone mad for war. If you or your organization is interested in endorsing a grassroots movement of midwives in opposition to the proliferation of nuclear weapons, and/or if you are interested in hearing Dr. Caldicott, please contact me at firstname.lastname@example.org, 503-325-1935.
- Sue Skinner
Bathing baby [Issue 4:6]:
I'm very interested in holistic care. When I had my son, I didn't give him his first bath until he was a month old. He never had skin problems or cradle cap until after I started bathing him. The only reason I started to bathe him was because of pressure from family and friends about "hygiene" and the inference of how bad a mother I was for not bathing him. I'm now expecting baby number two and will definitely wait even longer before the first bath.
- Christine Goodwin, Three Rivers, MI
Frequent miscarriage [Issue 4:6]:
Have this couple had their karyotypes checked to see if one of them has a balanced translocation? Frequent early miscarriages can be caused by many things; one partner with a balanced translocation is one of them. For those who may be unfamiliar with this condition, it occurs when part of a chromosome containing some of the DNA is broken off and moved to another chromosome or part of a chromosome is flipped within itself. The person with a balanced translocation has a full genetic compliment and so is normal. However, when it comes time to reproduce, the changed chromosome cannot line up properly with the partner's chromosome in making the new baby. The resulting embryo does not have the correct DNA compliment and is often lost as an early miscarriage.
Fortunately, a person with a balanced translocation has another unchanged chromosome in the pair so having normal children is still entirely possible. Or they can have a child that is the same as themselves, normal in every way but having this balanced translocation. Such a couple has to have the right combination in each pregnancy to carry to term and have a healthy baby and so may have many miscarriages before that happens.
A trip to a geneticist may be in order to rule out this possibility. In a couple in which one partner has a balanced translocation, one unfortunate outcome can be a baby that makes it to term but has an unbalanced chromosome compliment that causes severe birth defects. Careful prenatal monitoring may be in order for such a couple. Because balanced translocations can travel in families over several generations, if one is found, geneticists will usually offer testing to other family members as well. The clinical geneticists in the department where I work routinely offer karyotyping to any couple who have had three or more miscarriages to rule out a balanced translocation. While they don't find them frequently, they do find them often enough to justify offering the testing.
- Natalie Bjorklund
I had severe heartburn in the entire last trimester of my pregnancy. A few times a week I would get it so bad I would have to make myself throw up to relieve the acid. Can making myself throw up cause the baby to lie transverse? She was transverse from four months until the night I delivered. I was told I had a lot of amniotic fluid at my scan two days before my due date, but they didn't give me measurements.
Honey [Issue 4:4]:
Babies up to age one shouldn't have honey because of the possibility of ingesting botulism spores. Around age one, the gastric lining is mature enough to prevent the toxin from passing into the bloodstream; before then, all bets are off. The mom ingesting honey, either raw or cooked, is not a problem, both while pregnant and nursing. Remember the general rule: If it makes nursing more difficult, it probably isn't necessary.
EDITOR'S NOTE: Only letters sent to the E-News official email address, email@example.com,
will be considered for inclusion.
Letters sent to ANY OTHER email addresses will
not be considered.
Midwifery Today E-News is published electronically every Wednesday. We invite your questions, comments and submissions. We'd love to hear from you!
Write to us at:
Please send submissions in the body of your message and not as attachments.
Click here to subscribe to Midwifery Today E-News
For all other matters contact Midwifery Today: PO Box 2672-940, Eugene OR 97402
Remember to share this newsletter
Need to subscribe, unsubscribe, or otherwise change your E-News subscription?
Then please visit our easy-to-use subscription management page!
On this page you will be able to:
- Subscribe to any of our email newsletters
- Unsubscribe from any of our email newsletters
- Change the version (text or HTML) that you receive
- Change the email address to which newsletters are delivered
If you have difficulty, please send a complete description of the problem, including any error messages, to: firstname.lastname@example.org
Learn even more about birth!
Subscribe to our quarterly print publication, Midwifery Today. Mention code 940
U.S.: $50 1 year $95 2 years
Canada/Mexico: $60 1 year $113 2 years
All other countries: $75 1 year $143 2 years
E-mail email@example.com or call 800-743-0974 for information on how to order.
To order Midwifery Today products mentioned in this issue, send a check or money order to:
Midwifery Today, Inc.
PO Box 2672-940
Eugene OR 97402 USA
To pay by Visa or MasterCard, send your information to: 1-800-743-0974 (orders only)
Fax: 541-344-1422 For other matters, you may call:
541-344-7438 Or email us:
Editorial for E-News:
Editorial for print magazine:
For all other matters:
This publication is presented by Midwifery Today, Inc., for the sole purpose of disseminating general health information for public benefit. The information contained in or provided through this publication is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment.
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.
The content of E-News is copyrighted by Midwifery Today, Inc., and, occasionally, other rights holders. You may forward E-News by e-mail an unlimited number of times, provided you do not alter the content in any way and that you include all applicable notices and disclaimers. You may print a single copy of each issue of E-News for your own personal, noncommercial use only, provided you include all applicable notices and disclaimers. Any other use of the content is strictly prohibited without the prior written permission of Midwifery Today, Inc., and any other applicable rights holders.
© 2002 Midwifery Today, Inc. All Rights Reserved.
Midwifery Today: Each One Teach One!