A study of 154 mothers and babies in Guadalajara, Mexico, found that babies who are mainly breastfed for the first six months of life were less likely to have gastrointestinal (GI) problems than those babies that were mainly formula-fed (18% versus 33%). The bad news is that they also have more likelihood of having iron deficiency, putting them at risk of anemia. If the mothers had high iron stores, the babies were at less risk; unfortunately, 28% of Mexican women have low iron stores and anemia.
One of the researchers pointed out that prior studies have found that "breastfed babies don't become anemic if their cords are not cut too soon." Delaying the cut for as little as two minutes can help improve the baby's iron status and confer other benefits.
— Medline Plus, http://www.nlm.nih.gov/medlineplus/news/fullstory_67142.html, accessed 18 Jul 2008
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Midwifery and Birthing in Peru
Within Andean traditional culture, the conception of the body is different from that of Western biomedicine. The body is not understood as a machine, but as an integrated whole, with all of its parts interrelated. The body and its kawsay (vital energy in the Quechua language) are in communion with nature, the deities and other human beings; everything is connected to everything. Therefore, good living is based on living in balance.
This conception is made manifest in the practices of Andean traditional midwives, who have a holistic vision of pregnancy and birth. According to their tradition, birth is in itself a ritual, where different aspects of Andean culture and tradition take form, especially the sacredness of fertility and the abundance generated by the complementarity between the feminine and the masculine. Therefore, birth takes place in the intimacy of home, with the presence of the midwife and close relatives only. Natural birth in a vertical position is encouraged so that the baby is received close to Pachamama or Mother Earth. Other rituals are also present, for example, the burying or burning of the placenta. The relationship between the traditional midwife and the birthing woman is horizontal. The midwife serves as a guide and supports the woman in trusting her own body to accomplish this task.
Most Andean women prefer to die at home when complications arise, rather than going to the health post or hospital. They know they will be discriminated against and mistreated, they won't feel comfortable and they will be blamed (along with their midwives) for having been attended at home with these traditional midwives. This is also what impedes these midwives from referring their birthing women to the local health centers or hospitals, in cases of emergency. Also, in most cases the local community health centers don't provide Emergency Obstetric Care (EmOC), which should be available to all Peruvian women if complications arise during labor. Both cultural barriers and lack of access to EmOC together explain why we have one of the highest maternal mortality rates in South America—185 maternal deaths for each 100,000 babies born alive. The nutritional condition of most of these women (many of whom have anemia) also makes them more vulnerable to complications.
As I witnessed with a group at the community of Huillcarpay at Cusco, Andean women long for the traditional medical knowledge that is being lost, especially knowledge of healing plants and Andean traditional midwifery practices. They feel very uncomfortable at the "cold hospitals, where they have to give birth lying down, and where they aren't treated as equals," where their power over themselves and their bodies is diminished. Now they have no choice, because their midwives have passed away.
— Cynthia Ingar
Excerpted from "Midwifery and Birthing: Women in Peru," Midwifery Today, Issue 85
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Conception, Pregnancy & Birth—the journey that shapes our lives
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Read Let Birth Be Born Again for information that will help you restore birth to its rightful place as a safe, simple and exciting family event. Author Jean Sutton says, "Most women, mothers and midwives have deep inside them the 'women's wisdom' of generations gone before. It tells us that what is happening is not right, and makes us uncomfortable as we carry out the protocols laid down for us." This book helps us rediscover this hidden wisdom.
What is MIDWIFERY TODAY magazine? A 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more.
Don't miss the story of midwives as surgeons in Mozambique on Wide Angle, a program by PBS, which can be viewed in its entirety online here. According to the Web site, "'Birth of a Surgeon' travels to Mozambique where, for the first time, midwives are being trained in advanced life-saving surgery. Suffering from an acute shortage of doctors, Mozambique has launched bold grassroots initiatives that have cut the maternal death rate in half."
This amazing documentary shows a very different take, hopefully a trend, on how to deal with maternal and fetal mortality in a developing country. Rather than rule them out, with language such as "traditional birth attendant" and claims that they cannot be trained, Mozambique is further training nurses and midwives to make a difference.
"Living and Dying in a Long-Term Care Facility: Notes from a Nursing Home Doctor"
Author Gilah Silber is a geriatrician who birthed her babies at home despite pressures and preconceptions of her own profession. The book gives a riveting and eye-opening account of life at its other end—the nursing home. A must-read for anyone who believes in choice and personal responsibility. Buy it on Amazon.
Web Site Update
Read this article excerpt from the most recent issue of Midwifery Today newly posted to our Web site:
The "Rule of 10" Versus Women's Primal Wisdom—by Lydi Owen
"There is a rule of labor that forbids a woman to push with contractions until her cervix is completely dilated to 10 cm. Women are warned that to push before this doorway is completely open and out of the way will result in a swollen and/or torn cervix. … If this is indeed the truth, then why do most women during labor have an irresistible urge to begin bearing down before dilation is complete?"
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Question of the Week
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Question of the Week Responses
Q: I have always checked my patients with a rim or anterior lip, allowed laboring down as much as possible and then made a two push attempt to reduce the lip. Is this wrong? I have been practicing labor and delivery nursing for 18 years. It was explained to me that this was not an acceptable practice and, although I had a fabulous outcome, I was severely reprimanded because administration could find nothing to support this practice. HELP! Any ideas on how to support myself?
— Deborah Belty, RN, MS in Maternal/Child
A: I have studied and am a practicing nurse-midwife in Israel for the last 26 years. The common way to deal here with an anterior lip of cervix is to push it behind the head in between contractions and hold it during the contraction while the woman is asked to push. Usually it works and the baby will be born soon after, unless the lip is due to a posterior or asynclitic presentation. Then it will probably come back again until the baby gets into a better position. It can often save a woman half an hour to an hour of a painful transition if you succeed in passing the lip. I have never had any problems with this procedure and although painful for the woman, it seems worth it as it really speeds up the birth.
— Ilana Shemesh
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.
Think about It
Transparency in Maternity Care Project of the Coalition for Improving Maternity Services (CIMS):
The Birth Survey, the brainchild of CIMS' Grassroots Advocates Committee, is poised to transform the way in which women identify and choose their maternity care providers and birthing facilities. Through The Birth Survey, women share feedback on their maternity care providers and birthing institutions with other women in their communities to help them to make informed choices about childbirth. Already, women have reviewed more than 1000 New York City physicians and midwives, and 24 hospitals and birthing centers. Starting Aug. 1, 2008, The Birth Survey will be available to women nationally to review their providers and birthing institutions. Become a The Birth Survey Ambassador to help spread the word and/or collect data by e-mailing email@example.com.
Because misoprostol ("miso," "Cytotec") is being used more and more—without informed consent and without being FDA-approved for use on pregnant women, a mother, Maddy Oden—who lost her daughter and grand-daughter because of this drug—has developed this Web site for us all.
Maddy started the Tatia Oden French Memorial Foundation after her daughter, Tatia, and Tatia's daughter, Zorah, died after being given Cytotec. The foundation is dedicated to empowering woman, specifically in the area of childbirth. The Web site is www.tatia.org and the e-mail is firstname.lastname@example.org.
Please keep this site in mind and refer your friends and clients to it.
— Jeannie B
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