|May 7, 2008|
Volume 10, Issue 10
|Midwifery Today E-News|
“Midwifery and Chiropractic”
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In This Week’s Issue:
Quote of the Week
"You never know how far reaching something you think, say or do today will affect the lives of millions tomorrow."
— B.J. Palmer
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The Art of Midwifery
A chiropractor in Eugene, Oregon, recommends the following technique for relaxation and ease of back labor. With the woman positioned on hands and knees, or in any forward-leaning position she finds comfortable, the midwife stands next to her at the waist, cephlad to pelvis (facing away from the woman's head). She puts pressure with the heel of her hand on the posterior aspect of (behind) the sacrum and applies downward pressure to the sacrum in a caudad direction (away from the woman's head). He states that from a chiropractic and neurologic view, this technique is more beneficial than applying pressure to the sacrum in an upward or directly inward direction while positioned behind the woman.
— Douglas Carlstrom
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Research to Remember
An unknown American Medical Association (AMA) study showed that pregnant women under chiropractic care have an easier pregnancy and delivery. The study, by Irvin Hendryson, MD, revealed that pregnant women who received chiropractic adjustments in their third trimester were able to carry to term more frequently and deliver children with more comfort. This information was never revealed to the public and the AMA continued to attack chiropractic as "useless and dangerous."
— Active Balance Chiropractic Newsletter, citing American Medical Association records released in 1987 during trial in US District Court Northern Illinois Eastern Division, No. 76C 3777 (the Wilk trial). http://www.activb.com
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Midwifery and Chiropractic
Midwives and chiropractors offer care that is personal to each individual and specific to every case. Midwives and chiropractors share the unique ability to assess a patient's status with their own hands, and both professions are blessed with the privilege of touching others to bring about a greater quality of life.
These common bonds establish life-long supportive relationships between our two professions. However, there is another cause for alliance and reciprocity between us. It is a specific chiropractic adjustment called the Webster Technique. Developed by Dr. Larry Webster and formerly called the Webster Breech Turning Technique, this particular chiropractic adjustment was previously used during the seventh through ninth months of pregnancy. It was primarily focused on women whose babies were presenting breech or transverse.
Since discovery of the Webster Technique, its protocol has been revised to include women of all stages of pregnancy. Doctors of chiropractic reported a greater than 85% success rate in the technique's ability to balance pelvic structures and remove constraint to the woman's uterus, thereby allowing the baby to turn into the vertex position. The Webster technique is therefore becoming an important part of prenatal care for all women looking to optimize their potential for more natural deliveries.
Midwives around the country are hearing about the technique and seeking chiropractors trained in its use. The two groups are forming alliances in communities, sparing mothers and babies the irreparable damage caused by the growing number of cesarean sections. Midwives are referring patients to chiropractors even before malpresentations are evident; and their practices are reaping the benefits of easier, safer deliveries for both mother and baby.
The International Chiropractic Pediatric Association (ICPA) responded to the growing demand for this skill and began a marathon of classes to train chiropractors in the correct application and use of this adjustment. Today, the association maintains the only database available of chiropractors who have been tested and are proficient in the Webster Technique.
ICPA-trained doctors of chiropractic have learned how to apply this specific adjustment, along with other chiropractic techniques, to benefit the mother and baby throughout pregnancy. The need for "crisis care" in the last months of pregnancy is eliminated as more and more midwives refer their women to trained doctors of chiropractic.
As a doctor of chiropractic, I know that one of our greatest objectives is to eliminate as many variables that lead to traumatic birth and potential injury to the newborn's spine, cranium and nervous system as possible. To achieve this goal, we need the help of midwives! We need your valuable services and care for the women in our communities. Our growing support of midwifery will fulfill both groups' mission for natural birthing.
Specific chiropractic care helps to provide an environment for safer, easier, faster deliveries. Midwifery care is known to do so as well. Thus, ICPA encourages all chiropractors to make the effort to meet with and educate the midwives in their areas about their valuable services and show support and enthusiasm for midwives' important care of women and babies. Together we will restore the sanctity and right of natural childbirth.
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Question of the Week
Q: I've been researching natural care practices for c-section recovery, but have come up short in both Midwifery Today and Mothering magazines.
Thus, I have both a comment and a question. First, I am an advocate for homebirths. I planned one for myself with a midwife and a doula, but I ended up having a c-section—my son was 2-1/2 weeks late, my cervix was very firm and did not respond to the castor oil or even Cervitol, and my placenta was calcifying. I am sure that my scenario could have played out differently, but it didn't and I am saddened that all I ever read are negative things about c-sections as if we all elect to have them for vain or fear-driven reasons. It would be great to also find articles that inform women on how to care for themselves after undergoing such a surgical experience. So on that note, do you have articles, suggestions for key word searches or Web information that provide information for women who want natural remedies (herbal, food, homeopathic, aromatherapy) for caring for their bodies/mind/spirit after a c-section? Your suggestions would be greatly appreciated.
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Question of the Week Responses
Q: In a recent episode of "Baby Story," a mom in labor was offered Ambien, a hypnotic, so she could sleep until she went into hard labor. Does anyone have experience with this or other drugs in its class being used during labor? Does it pass into the baby? Isn't this just going back to the era of twilight sleep (scopolamine—a hypnotic—and morphine)?
A: Ambien is a mild sleeping pill with a short half-life. It is considered Pregnancy Category C, which means that we really do not have adequate studies to evaluate whether it is safe or unsafe. Some providers will prescribe it for a short time at the end of pregnancy to enable the mother to get some rest. It is not considered appropriate for use during labor. I can assure you that it is not strong enough to cause the loss of conscious awareness that was associated with "twilight sleep" during labor that was induced by using scopolamine in the past. However it has been associated with some bizarre side-effects including "sleep driving" and binge eating while sleeping. I would recommend natural approaches to relaxation first (warm milk or "Sleepy Time" Tea, warm bath, back rub, soothing music, listening to relaxation tapes), with prescription drugs as a last resort. If a mother chooses to take Ambien, she should take it very carefully and for as short a period of time as possible.
— Anita Jaynes, CNM
A: I have had two doula clients who used Ambien.
The first was because she had the flu for three weeks and the fundal height for her twins had not changed in two weeks despite being 37 weeks pregnant. She had lost weight, and hadn't gone a day without vomiting or gotten a good night's sleep in all that time. She was also mildly dehydrated. She was offered Ambien to help her rest overnight while doing a gel induction to be followed by Pitocin induction in the morning. This mother had major hallucinations for over 12 hours in response to the medication and did not have any memories of the births of her babies despite being technically conscious.
The second was offered it because she had been in "prodromal hell" for four days and was still closed tightly without any effacement. She took the Ambien, got four hours of sleep and went into full blown labor. While she had memory of the birth, she was very groggy and "out of sorts" for the whole labor and birth.
— Rachel Silber, IBCLC, CCE, CD, CD (DONA), CLE, CPD
Responses to any Question of the Week may be sent to E-News at any time. Write to firstname.lastname@example.org. 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
Debbie Miller, CNM, passed away on February 9, 2008, after a car accident. She worked at Coney Island Hospital in Brooklyn in the 1980s, where she assisted in births of women of many nationalities. Her next position was as a midwife at Columbia-Presbyterian Hospital from 1985–1994, while she finished her MPH at Columbia University. From there she moved to work in a birthing center and ended her career in her home state, Vermont, in the midwifery service at Dartmouth-Hitchcock Medical Center.
Deb possessed a global vision for maternity and women's health. You can help to honor her passion for the people of Africa and for the cause of providing quality health services to those in need by donating in her name to the LWALA Community Alliance. Their current project is the creation of a maternity clinic and health service in Lwala, Kenya, to be commemorated in her name. [LCA, P.O. Box 722, Hanover NH 03755 (email@example.com).]
Exciting news! On May 16, "20/20," the acclaimed ABC-TV news show is dedicating its show to Orgasmic Birth as part of its Mother's Day program. Debra Pascali-Bonaro, producer/director of the new film Orgasmic Birth, will be interviewed, as will women's health advocate Christiane Northrup, MD, (Mother-Daughter Wisdom and Women's Bodies, Women's Wisdom), and Amber Hartnell, whose orgasmic birth is featured on Birth As We Know It and Orgasmic Birth.
— April Bailey Weaver
I just read the article by Cheryl Smith in E-News 10:8 about malaria in pregnancy. I am not a midwife but I am a Chinese Herbalist and have practiced this for 25 years. I lived and studied in China with a teacher who was both a gynecologist and an obstetrician. She used both western and Chinese herbs in her 50 year practice with an emphasis on traditional medicine. Because of the labor-inducing effect of quinine type drugs and the prevalence of malaria in her practice, she was skilled at the use of herbs to treat this. She has case studies and writings on this very topic. There are very effective ways to treat this but these methods are virtually unknown in the west. I have translated some of this material myself. Any suggestions on how to offer up this precious knowledge?
— Sharon Weizenbaum
A couple of important notes from my experience with malaria. Bear in mind that this experience is in West Africa, where we've had no way to do lab work, no oxygen, no advanced support or even basic support in some areas.
First, malaria is caused by parasites that inhabit the red blood cells. After the initial episode, they often "hide" in the liver (for obvious reasons), and when the person is sick, stressed or pregnant, the parasites become active. In pregnant women, they congregate in the placenta. Understanding that it is a parasite, rather than a bacterium or virus, helps you understand its behavior. Also, there are four major types of malaria, which vary in symptoms and severity of the attacks.
Second, as women are susceptible to first attacks and relapses during pregnancy, the babies are affected by the high fevers as well as lack of red blood cells. The babies are often anemic and very slow to breathe. If we can get them breathing, we still lose a number of them in the first 12 hours or so.
— Trish Ross
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MIDWIFE TO BE correspondence program. Pay as you go. Optional 2 week clinicals/catches in the Dominican Republic and skills weekends in S.C. every few months (open to others, too). www.midwifetobe.com
Natural Child Magazine: green, healthy living from pregnancy through birth and early childhood. Intelligent, trustworthy information and inspiration for combining parenthood and planethood! Home birth, cosleeping, breastfeeding, organics and more. Visit www.NaturalChildMagazine.com
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