January 20, 2010
Volume 12, Issue 2
Midwifery Today E-News
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The Hemorrhage Handbook

The Hemorrhage Handbook is filled with great stories told by expert midwives that give you superb insight into bleeding problems that may occur during the prenatal period, the birth or postpartum. Topics include the importance of good nutrition, how the bloodstream works, herbs to use, the RhoGAM controversy and Chinese remedies.
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Midwifery Today Conferences

Ina May Gaskin ~ Michel Odent ~ Elizabeth Davis

These are just three of the teachers you'll learn from at our conference in Philadelphia, April 2010. Other confirmed teachers include Gail Hart, Marsden Wagner, Naolí Vinaver, Carol Gautschi and Elaine Stillerman. Plan now to attend!

Learn more about the Philly 2010 conference and get a complete program.

Birth Is a Human Rights Issue

The right to have the most joyous and healthy pregnancy, birth and postpartum possible should be a human right for both mother and baby. Learn how you can help. Come to our conference in Strasbourg, France, September 29 – October 3, 2010. Classes will include Mothers' Birth Rights, Babies' Birth Rights and Maternal Mortality Is a Pressing Human Rights Concern.

Learn more about the Strasbourg conference and get a complete program.

Come to Moscow! Learn about birth!

Plan now to attend the “Birthing in Love: Everyone’s Right” conference this June in Moscow, Russia. You'll be able to choose from classes such as Russian Method of Waterbirth, Traditional Birth Practices from Russia, Midwifery Education Possibilities for Russia, The First Hour after Birth and Prolonged Labor. There will also be a full-day Hands-on Skills Workshop, as well as full-day classes on Shoulder Dystocia, Breech Birth in Water and Improving Your Practice with Research, Insights and Realities.

Learn more about the Russia conference and view complete program.

In This Week’s Issue:

Quote of the Week

"Women's bodies have their own wisdom, and a system of birth refined over 100,000 generations is not so easily overpowered."

Sarah Buckley

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The Art of Midwifery

Check the Fundus

Be sure to measure where the top of the fundus is if placenta isn't delivered. The uterus can fill up with blood while the placenta acts as a plug over the cervix, thus allowing no blood to escape while your woman is still hemorrhaging.

Midwifery Today staff, CPM
From Midwifery Today's Tricks of the Trade, Volume I

Vol. I is out of print. The other Tricks of the Trade volumes may be ordered here.

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.

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A study published in the Canadian Medical Association Journal shows that homebirths attended by a registered midwife have very low and comparable rates of perinatal death and a significantly lower risk of obstetric interventions, assisted vaginal deliveries, cesarean sections, hemorrhage and infection than hospital births attended by a midwife or physician.

The study included all planned homebirths attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in British Columbia, Canada, as well as all planned hospital births attended by the same cohort of midwives, and a sample of planned, physician-attended hospital births.

The rate of perinatal death per 1000 births was .35 for the homebirth group, .57 for those with midwife-attended hospital births and .64 for those attended by a physician in a hospital setting.

CMAJ, 2009-Sep, 181 (issue 6–7): pp. 377–83

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Pathways Magazine: Your resource for family wellness

Pathways Magazine provides vital resources for family wellness. Our articles give parents the necessary information to actively participate in their families' natural health choices. Geared towards new parenting, there are always articles on birth and pregnancy from the vitalistic, midwifery perspective. A must have for holistic education in your practice.


News Flash—Two Options to Assist Earthquake Survivors in Haiti

Bumi Sehat Team, Haiti

Ibu Robin Lim and three other members of Bumi Sehat Clinic of Indonesia will spend a month in Haiti, January 25 – February 25, setting up a clinic as they did in Aceh, following the tsunami in 2004. The goal is to set up a clinic that will attract other NGOs and local community members to help their own people, to be managed by locals after the Bumi Sehat team has left. They will be going into Haiti and looking for a rural location to set up a small clinic for immediate health care. This clinic will be helping women with a safe place to birth and immediate mental and physical trauma. They hope to link up with another organization to have a transport vehicle to transport patients with more serious health needs to a larger facility. Here is the bank that you can direct deposit funds into or pass on the info to others: US BANK, Acct. name Dragonfly, routing # 1230002200, acct.# 153690811358. "We WILL USE ALL funds that are deposited for supplies for the Haitian people."

Circle of Health International (COHI)

Help Our Sisters in Haiti—We've all seen the photos by now of the loss, despair, leveled infrastructure, etc. in Haiti. Sadly, we know that such unrest and chaos are extremely dangerous times for women already living in the most impoverished nation in the western hemisphere. Circle of Health International (COHI) will most likely be sending a clinical field team including midwives, trauma specialists and perhaps an ob/gyn or two from the US. They will be collecting donations of equipment and supplies once the emergency needs are known. As per COHI's practice, they will find a local, women-focused organization to partner with, and will seek funds and assistance from larger institutions. The objectives of such a trip will be to address the issues around the emergency, safe motherhood and gender-based violence. Please send this information on to everyone and anyone you know who might be interested in joining the team, or supporting COHI financially in this effort. All inquiries and responses should be sent directly to Leilani Johnson, COHI's director, at leilani@cohintl.org, or you may call COHI at 517-517-3220. Individuals may give directly through COHI's Web site at www.cohintl.org. Download press release [Word document]: http://www.midwiferytoday.com/news/COHI_Haiti_press_rel.doc

Putting an End to Women’s Global Slaughter: Bleeding to Death

Over the years I have come to the conclusion that postpartum haemorrhages are almost always related to inappropriate interference. Postpartum haemorrhage would be extremely rare if a small number of simple rules was understood and observed….

During the hour following birth, I remain as silent as possible and keep a low profile. I either sit down in a corner behind mother and baby or disappear, if there is an experienced doula present who has had a personal experience of this situation. Minutes after birth many mothers are no longer comfortable in an upright position. This is most likely the time when the level of adrenaline is decreasing and when the mother feels the contractions associated with the separation of the placenta. Then the birth attendant may have to hold the baby for some seconds, in order for the mother to find a comfortable position, almost always lying down on one side. After that there is no excuse to interfere with the interaction between mother and baby.

I don't approach the cord and placenta for an hour. Clamping and cutting the cord before the delivery of the placenta is a dangerous distraction. Suggesting a position to the mother is another unneeded distraction. Her position is the consequence of her level of adrenaline. When the level of adrenaline is low and the mother feels the need to lie down, it would be unkind and unphysiological to suggest an upright position.

It is only when an hour has passed after the birth—if the placenta is not yet delivered—that I dare to disturb the mother in order to check that the placenta is at least separated from the uterus. With the mother on her back, I press the abdominal wall just above the pubic bone with my fingertips: if the cord does not move, it means the placenta has separated. In practice, the placenta is always either delivered or separated an hour after birth, and bleeding is minimal, if the third stage has not been "managed." I have never had to inject a uterotonic drug to control the bleeding.

Michel Odent
Excerpted from "Putting an End to Women's Global Slaughter: Bleeding to Death," Midwifery Today, Issue 74
View table of contents / Order the back issue

This article first appeared in Primal Health Research, Autumn 2004, Vol. 12, No. 2. http://www.birthworks.org/primalhealth

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Library Pack!—perfect for an aspiring midwife.

Anyone planning to become a midwife will appreciate the books in this package: Wisdom of the Midwives (Tricks of the Trade, Volume II), Birth Wisdom (Tricks of the Trade, Volume III), Sharing Midwifery Knowledge (Tricks of the Trade, Volume IV) and Paths to Becoming a Midwife. The Package also includes one free Midwifery Today back issue, your choice of 45, 49, 50, 54 or 60. And all for the low price of just $89. Get the Library Pack!

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Learn more about how birth can be

Giving Birth

Watch Giving Birth to discover what's possible for 95% of all mothers and babies who can birth normally and naturally. This DVD contrasts the medical and midwifery models for birth and explains the risks of routine obstetric practices. You'll learn about the importance of doulas, see images of a waterbirth, watch a woman give birth in her own home, learn about epidural anesthesia, cesareans and more. Giving Birth features obstetrician/gynecologist Christiane Northrup, author of the bestselling Women's Bodies: Women's Wisdom. You may also purchase an optional resource/teaching guide, "Giving Birth: Challenges and Choices," available with the DVD.To Order

Placenta rituals, remedies and recipes…

Placenta: The Gift of Life

…are what you'll find in Placenta: The Gift of Life. Read this book to discover the various ways placentas have been used by people around the world and throughout the ages. You'll also find 15 recipes that will show you how to use the placenta in ointments, essences and other remedies for a variety of ailments. Placenta: The Gift of Life is a book from Motherbaby Press, an imprint of Midwifery Today. Get the book.

Celebrate the Power of Birthing Women!
Epic Women DVD Slide Show

The Epic Women DVD Slide Show by Harriette Hartigan is a powerful affirmation of woman's ability to give birth naturally. Choreographed to Bette Midler singing "The Rose," the 31 still photographs give witness to the strength and grace of women as they work to bring their babies into the world. Order the DVD.

Web Site Update

Read this article from the most recent issue of Midwifery Today newly posted to our Web site:

  • A Difficult Breech Birth—by Marion Toepke McLean
    “Jennifer Braun, Colorado midwife and director of International Midwife Assistance and the Teso Safe Motherhood Clinic, was at her desk in the clinic in Soroti, Uganda, one morning, focused on paperwork. Jennifer had once told me, ‘I don’t do births in Africa,’ leaving this to an excellent staff of Ugandan midwives. But on that lucky morning, she got a stuck baby born and saved a life.”

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Question of the Week

Q: I have a question about fibroids in pregnancy.

I am currently 5-1/2 months pregnant with my first baby. At 16 weeks, an ultrasound showed that I have three large fibroids in my uterus, ranging in size from 4–6 cm. The 6 cm fibroid is located directly in the center of my placenta (which is at the top of my uterus), and the placenta is attached to this fibroid. Additionally, both edges of my placenta seemed to have separated some. Also, the two other fibroids (4 cm and 5 cm) are located on either side of my cervix; so unless they shrink or move, I am told that I will have to deliver by c-section. My midwife screened me out for a homebirth. There is also concern about me hemorrhaging at birth because of the fibroids, and of the placenta not delivering properly because it is attached to the placenta.

Is there anything I can do to facilitate a more natural birth—hopefully not a c-section—and to avoid hemorrhaging and placental delivery problems? I am drinking 2–3 cups of raspberry leaf/nettle tea a day, and I am working hard to build up my iron levels with green leafy vegetables and yellow dock tincture.

— Jackie Ladomato, Grand Rapids, Michigan

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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Learn about midwifery education!

Are you an aspiring midwife who's looking for the right school? Are you a practicing midwife who would like learn more? Visit our Education Opportunities page to discover ways to start or continue your education.

Think about It

For some birthing mothers, the abrupt withdrawal of attention from them to the baby or elsewhere creates a psychological void, which may exacerbate underlying physical problems. If the mother is disappointed with how her birth went, saddened by conflicts with her mate or grieving over an adverse outcome, she may manifest this physically by giving herself over to a "weeping" hemorrhage.

Although this is difficult to classify objectively, I have nevertheless seen it happen on a number of occasions. Although the midwife must not neglect physical interventions, the most important and successful treatment for this is love.

Judy Edmunds, CPM
Excerpted from "Stay Close and Pay Attention to Your Mother," Midwifery Today, Issue 48
View table of contents / Order the back issue

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Midwifery practice in South London under threat

The Albany midwifery practice which provides true one-to-one care for women in a disadvantaged area of South London is under threat, forced to close down its birth service at home and to limit its continuity of care.

The practice is unique in having a contract with the local NHS Trust to provide care for about 200 women a year. Although they are employed by the Local Hospital Trust, they are self managed and hence truly autonomous practitioners and therefore able to provide for the needs of each woman that they care for.

The practice has amazing statistics with fewer babies dying than on average in the UK, low caesarean rates and high breastfeeding rates, but also very satisfied, confident and happy mothers.

We really must fight what is happening here, this is the gold standard of midwifery and if this practice is destroyed then standard of midwifery around the country (or, indeed, around the world) stands little hope of improvement and there is a great chance that it will deteriorate further. Even if you do not plan to have more children yourself, this issue is important for your children and your grandchildren.

For more information about the Albany practice, to be kept up to date on what is happening, to sign the petition or to make a donation to support the campaign and provide legal support for the midwives, visit: http://www.savethealbany.org.uk

Beverley Lawrence Beech, chairperson, Association for Improvements in the Maternity Services (AIMS)

IMBCO International Day
Austin, Texas, February 25, 2010

The International MotherBaby Childbirth Organization is delighted to announce our International Day as a pre-conference event to be held the day before the Coalition for Improving Maternity Services (CIMS) Forum. This day-long event is an opportunity to learn and share what is happening around the world with the International MotherBaby Childbirth Initiative. The CIMS Forum on February 26–27 will feature Ricki Lake, Judy Norsigian, Rima Jolivet, Penny Simkin and others.

Our International Day agenda includes:

  • Putting the International MotherBaby Childbirth Initiative to work
  • Recognition of demonstration site applicants, country representatives, and MBnets
  • Introducing the IMBCI 10 Step Guides with Helene Vadeboncoeur, Quebec, Canada
  • Being a change agent with Mayri Sagady-Leslie
  • Country reports on the three most important steps for their communities
  • Global Doulas with Debra Pascali-Bonaro
  • Workgroups—sharing resources and networking
  • International bazaar—participating countries will have items for sale to support their participation at CIMS.

The registration fee is $45. For more information, or to register for this event, visit: http://www.motherfriendly.org/registration.php

Debra Pascali-Bonaro, Co-chairperson International MotherBaby Childbirth Organization, IMBCO

Deadline to apply for DONA International Doula Trainer Workshop Fellowship Program is March 22, 2010

The Doulas of North America (DONA) International Doula Trainer Workshop Fellowship Program is a unique effort to identify women outside of the United States who would train to become DONA International approved birth or postpartum doula trainers.

Childbirth educators, doulas, midwives, lactation professionals and physicians are eligible to apply. All applicants must submit their documents electronically via e-mail to the DONA Director of International Development and by postal mail to the DONA International home office. The application must reach the office, via e-mail or mail, no later than March 22, 2010.

To view the complete list of requirements and application process, visit http://www.dona.org/Website/PDF/DONATrainerFellowshipProgram_2010.pdf

Nicole Heidbreder, DONA Director of International Development

The Mid-Atlantic Conference on Birth and Primal Health
Las Palmas de Gran Canaria, February 26–28, 2010

What is the future of a world born by caesarean? This is the question we need to ask now that, thanks in particular to the work of Michael Stark, the c-section has become easier, faster, and safer than ever before. In this conference we will not only focus on technical advances, though…. We will also constantly make reference to recent scientific advances which suggest we should apply new criteria in order to evaluate practices within midwifery and obstetrics. For example, thanks to a large amount of data provided by developing disciplines as diverse as ethology, bacteriology, epidemiology and hormonology, it has recently been possible to confirm scientifically that…a human newborn baby needs his or her mother. After thousands of years of beliefs and rituals which have disturbed or prevented first mother-newborn interaction, modern science now has the power to reverse our deep-rooted conditioning.

We welcome all of you, participants from the five continents. We want to thank Prof. Garcia Hernandez and our friends in Las Palmas for suggesting the Canary Islands Convention Centre as a venue for this conference held under the auspices of the Goddess of Love…the Goddess born from the foam of the waves.

Dr. Michel Odent, President, and Heloisa Lessa, Executive Secretary

For more information and to register: http://www.wombecology.com/conference

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