July 7, 2004
Volume 6, Issue 14
Midwifery Today E-News
“Herbs and Natural Remedies”
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DOULA AUDIOTAPE PACKAGES, Two groups of audiotapes chosen especially for educating and supporting doulas:

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In This Week’s Issue:


Quote of the Week

"Trusting in birth is the best shelter to offer your pregnant and birthing women and the best tool you can pull out of your birth kit."

Jan Tritten


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The Art of Midwifery

I have seen an inflatable waterbirth tub get punctured, so keep duct tape handy!

Marlene Waechter, Midwifery Today Forums


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.

News Flashes

A University of Pittsburgh study of 124 women and their past pregnancies included 36 who had had preeclampsia, 33 women who had had hypertension, and 24 who had had gestational diabetes during pregnancy; 31 women were controls. One to three years postpartum, those who had had preeclampsia or diabetes had a four- to six-fold chance of being insulin resistant, which often leads to diabetes and heart disease. Those with gestational diabetes were 12.5% more likely to have high blood pressure. Women with preeclampsia or hypertension were 25% more likely to have high blood pressure.

newsbureau.upmc.com


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Herbs and Natural Remedies

Many of pregnancy's discomforts are alleviated by the use of alfalfa tablets, including morning sickness, heartburn, constipation and anemia. Alfalfa tablets raise the vitamin K level of pregnant women, reducing postpartum bleeding in both quantity and duration, and they increase the vitamin K stores in newborns, reducing bleeding problems for them as well. They support success in lactation because they help increase and sustain milk supply. They frequently help alleviate nausea, almost always relieve constipation, and they bring up red blood counts in a beneficial way. They also seem to help reduce swelling and improve erratic blood sugar levels.

Because alfalfa tablets are very high in vitamin K, they could be dangerous to take for anyone who needs to be on blood thinners such as Heparin. Their use should be stopped temporarily if one gets a urinary tract infection and cut back, at least temporarily, if one gets diarrhea.

People who have very poor bowel flora may have temporary bouts of gas the first week or so when they start taking them, so they should start at a more gradual pace. I have postpartum moms take a few right after the birth to help with blood loss and bowel movements, then not take any more until the fourth or fifth postpartum day, gradually building back up to about four to eight a day depending on diet and need. They can use oat bran tablets if they need to for bowel function in the meantime. The reason for this course is twofold: the degree to which alfalfa promotes lactation can be too much for comfort until engorgement subsides, and newborn jaundice takes longer to go away if the mom is taking alfalfa tablets.

Excerpted from "The Amazing Alfalfa," by Lisa Goldstein, CPM, CNM; in Birth Wisdom: Tricks of the Trade Vol III (a Midwifery Today book)


Postpartum Perineum Fomentation

  • Calendula flowers (Calendula officinalis): used for their vulnerary and anti-inflammatory action.
  • Comfrey root (Symphytum officinalis): the plant contains a substance that increases cell proliferation, leading to increased tissue repair and growth. It also acts as an astringent, emollient, and anti-inflammatory.
  • Yarrow flowers: a very effective botanical anti-inflamatory, astringent, antimicrobial, and vulnerary. The volatile oil is an important active constituent in these actions.
  • Rosemary leaves: the actions of antiseptic, astringent and circulatory stimulant make this herb a useful addition to this medicated wash.
  • Lavender flowers: the flowers contain large amounts of volatile oils, which act as antiseptics, antimicrobials and analgesics. A clinical trial has shown lavender oil as a bath additive to be most effective between the third and fifth days of the postpartum period.

Mix together all of the above ingredients in a jar: use one handful to a pint of boiling water, cover and steep until warm. Use as a sitz bath or in a peri bottle as a perineal wash for cleaning after urination or in sutured areas.

Excerpted from "Herbs for Use in Pregnancy, Birth and Postpartum," by Mary Bove, ND, LM; in Birth Wisdom: Tricks of the Trade Vol. III (a Midwifery Today book)


Arnica is often like an answer to prayer for muscle, joint pain, bruising, and any kind of tissue trauma. Try it during perineal massage, both prenatally and during birth. Some say do not use arnica oil on broken skin, but I have had no problems with it during a birth. Because oil may weaken latex gloves, change to new ones if using arnica longer than 10 minutes, to reduce chances of breakdown.

I also want to mention arnica solution, a homeopathic form of arnica. If you don't have arnica solution already made up at a birth, you can make up a quick form by dissolving some pellets in clean water in a jar or an unused perineal squirt bottle. Dribble a little of it in the center of the absorbent side of six peri-pads (if using the regular solution first dampen with two or three teaspoons of water and then drop about eight drops of the arnica solution on this area). Put these pads in the freezer (damp side up, or they'll stick). Use them as the first pads for after birth. They will make a huge difference in comfort and work magic on swelling. The next morning, mom is usually swollen again, so make another one or two pads in advance for her to use then. Mom can use a few drops (or pellets) in the peri bottle for rinsing during urination if she has any pain during the process.

Arnica applied to 4 x 4 gauze squares are helpful on the sore little baby bottoms of breech-birth babies.

Excerpted from "Bottoms and Birth," by Lisa Goldstein, CPM, CNM; in Birth Wisdom: Tricks of the Trade Vol. III (a Midwifery Today book)


Sheperd's Purse
Latin: Capsella bursa-pastoris
Pinyin: ji cai
Category: Blood Stanching
Taste: Pungent, sweet
Property: Cool
Direction: Contracting

Blood stanching medicinals comprise a category of herbs used for what is called "branch of root" and "branch treatment" in Traditional Chinese Medicine. This means that instead of treating a root cause of a disorder, the manifestation of the disorder is seen as so urgent that it is treated first. Hemorrhage is one of those situations where the emergency need of stopping bleeding becomes paramount in the treatment.

Shepherd's purse is well-known in the East and West for its ability to stop bleeding. Many serious bleeds may have some element of heat in the blood, and the cooling properties of shepherd's purse may address the need to eliminate heat.

If a tincture is given, effective doses may be up to 30 ml. As an infusion, one-half ounce of dry herb infused for 15 minutes in one cup of water is effective. Do not give shepherd's purse as a preventative. In normal childbirth some bleeding should occur because it discharges "old blood" that might otherwise create problems in the postpartum period or later. To give someone a blood-stanching herb in the absence of need could create problems where none existed before.

Excerpted from "Traditional Chinese Medicine for Hemorrhage," by Valerie Hobbs, midwife, doctor of Chinese Medicine; in Birth Wisdom: Tricks of the Trade Vol. III (a Midwifery Today book)


To order BIRTH WISDOM: TRICKS OF THE TRADE VOL. III, go here. This book is packed with tips, tricks, techniques of all kinds!


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Read this press release newly posted to our Web site:
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Forum Talk

Should a mother with controlled (with medication, Aldomet 250- mgs 2x daily) chronic (as in, before pregnancy) hypertension automatically be selected-out of a homebirth? She started having problems with some higher readings only after a sudden death in the family five months ago and they were originally attributed to anxiety stemming from the stress of the death. Readings have persisted in the 140–150/88–100 range until starting medication. Now the readings are normal.

Jennifer


Share your thoughts and experience about this topic.
**Please do not send your responses to E-NEWS!**


Question of the Week

Q: I recently had a friend who dilated to 10 centimeters in eight hours. She then pushed for 18 hours at the encouragement of her midwife. The parents then insisted on going to the hospital, where a c-section was performed. I have two questions. How long is too long to push, and are there criteria we follow as homebirth midwives?

— Anon.


SEND YOUR RESPONSE to mtensubmit@midwiferytoday.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.


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Question of the Week Responses

Q: I have a friend who is presently going to a physical therapist because of injuries caused by forced contortions of her body during second stage. Her hips were injured as she could not feel the pain from the extreme position they had her (unnaturally) pushing in. Does anyone have any information on this subject or suggestions for helping her heal physically? The physical therapist is at a loss.

— Amy V. Haas, BCCE

P.S. (two weeks later): My apologies - I should have mentioned that the woman in question had an epidural, which is why she could not feel the pain from the forced position.

Amy

A: She might want to consider seeing a chiropractor or osteopath who specializes in treating pregnant women. They should evaluate not only her spine, sacrum, and hips, but also her pubic symphysis (PS) as well. Some women have the PS joint damaged during birth (diastasis symphysis pubis, or DSP) from extreme positions, etc. and have found great help afterward with knowledgeable chiropractic care.

However, some chiropractors tend to ignore the importance of the pubic symphysis joint, so it's important for her to ask for that area to be evaluated along with the other areas. Sometimes the pain feels like it's in the hips, but the pain is being referred there from elsewhere, or there are multiple sources of problems that all must be addressed before good relief can occur.

This was the case for me; I had pain in my back and hips postpartum. I saw a chiropractor who adjusted my sacrum and spine. It brought partial relief, but the hip pain and inflexibility remained. It was when we discovered and treated the pubic symphysis alignment that the hip problems resolved.

— kmom

A: Send her to a principled chiropractor to set those hips.

— Dr. Jeff

A: Consultation with a massage therapist and/or Feldenkrist practitioner may help. My physical therapist fortunately took Feldenkrist workshops and could incorporate both modalities into my care (the problem was not a birth-related injury). My first physical therapist was not able to provide much hands-on help. My yoga teacher had a deep muscle pushing injury (prior to her career as a yoga teacher, I believe) and credits yoga with her ability to get relief from and maintain freedom from pain.

— Linda Stinnet, CNM, MSN

A: I suggest seeing an osteopath, a medical doctor (a DO) who practices classical osteopathic manipulation and does so at least 90% of their medical practice. Keep in mind, not all DOs practice this. Unlike physical therapy and chiropractic techniques, osteopathic manipulation releases the trauma to the fascia, allowing the body to heal. Our family osteopath can even tell us what position or movement caused our injury.

— Beth J. Keil, BSN, CH, CHBE


Regarding seizures [Issue 6:13]:

A: I read an article a few months ago about aspartame in diet drinks as well as other processed foods that say "sugar free" on the labels. Aspartame turns into straight arsenic when it is heated above 90 degrees F. Our body temperature is on average around 98.6 degrees, which is more than enough to change the chemistry of this substance. Diabetics use it frequently as a sugar substitute, but more of them have died from using the product because it does something to their insulin level to the point where even the doctors in the emergency room can't help them. They give them a shot of insulin to help get their blood sugar level back to normal, and it doesn't work when it's due to aspartame intake. The patient ends up going into a coma and dies. Autopsies have shown they had aspartame in their systems.

Many children have also had seizures as a result of drinking diet sodas and other processed foods with aspartame. Anything that says "sugar free" is bad news. If this concerned mom is eating or drinking anything that says "sugar free" or "diet" on the label, she should eliminate it from her diet immediately and cut it out of her son's diet as well before it ends up killing him or her new baby. This stuff is no joke.

The soldiers in Desert Storm came home sick because soda companies donated massive loads of diet soda that were sitting in the 120-degree desert all day; the soldiers consumed large quantities of it on a daily basis. They're having massive health problems now as a result.

I don't know how this mom would feel about investigating also the affects of dairy products, but there is a Web site I learned about a couple of months ago, www.nomilk.com.

— Susan Gallant, Lewiston, Maine


Editor's Note: Responses to any Question of the Week may be sent to E-News at any time. Write to mtensubmit@midwiferytoday.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.


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Think about It

Response to midwives and public relations [Issue 6:13]:

While I completely agree that midwifery really needs a good publicity campaign, I don't think the idea of midwives charging more is necessarily the answer. As a doula, when I lead clients in the direction of midwifery care the number one reason they end up not choosing it is the prohibitive cost involved. What I hear ALL THE TIME is, "I really want a midwife/homebirth but my insurance won't cover it and I just can't afford it out of pocket." Raising the cost of services so drastically would only make it harder for women to choose expensive midwifery care over insurance-covered obstetric care, and ultimately lower clientele.

If midwives want to really get the publicity campaign off the ground perhaps they should be working toward making sure insurance companies are obliged to pay them just like any other legitimate practitioner. This change would serve several purposes. For one thing, the public puts a lot of stock in what is and is not covered by insurance. It seems people are under the impression that if an insurance company covers it, it must be safe/good. Second, it would give midwives more pay (which we all know they deserve) and increase their clientele because more women would opt for midwifery care if it were covered. Perhaps then midwives could opt to contribute to this fund and also encourage their clients who have benefited from insurance coverage to contribute as well.

Anon.


Feedback

I'm a certified doula, childbirth educator, and a fan of your Web site.

It's now protocol at Duke Medical Center and Chapel Hill's stand-alone birthing center to administer a shot of Pitocin to all moms as soon as the baby's anterior shoulder has birthed. I'm sure it's just a matter of time until this is the case at all our area hospitals. I've encouraged my latest Duke client to state on her birth plan that she does not want this routinely, but only if she's bleeding too much. The doctor who first read this at her last appointment had a problem with this and proceeded to scare my client.

It seems I did hear about a study about delayed cord clamping that compared active management of third stage (including immediate clamping, Pitocin, and tugging to remove placenta timely) with not doing these things and found significantly less hemorrhaging in the active-management group. I'm guessing this is what this new protocol is based on. I can't believe that was a good study. Does anyone know anything about this? I've searched your Web site for articles about this protocol but found nothing. It seems a shame for a mom to avoid Pitocin only to have to have it postpartum even if it doesn't look like she needs it. My current Duke client may be assertive enough to refuse, but I'd like something more to stand on. Please help.

Sheryl Mika, Durham, NC


Editor's Note: Only letters sent to the E-News official e-mail address, mtensubmit@midwiferytoday.com, will be considered for inclusion. Letters sent to ANY OTHER e-mail addresses will not be considered.


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