|March 16, 2011|
Volume 13, Issue 6
|Midwifery Today E-News|
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In This Week’s Issue:
Quote of the Week
“Offer hugs, not drugs.”
— Adina Lebowitz
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The Art of Midwifery
Students or beginning midwives who are not yet able to accurately interpret what they are feeling during palpation may enhance their mental imagery by using a water soluble marking pen to trace the shapes of fetal parts they are feeling onto the mother’s abdomen. This gives a visual as well as tactile picture of size and position of the baby. Of course, make sure the mother feels comfortable with this procedure.
— Jeriann Fairman
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 firstname.lastname@example.org.
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In Support of Doulas
Doulas have an especially important role in changing birth practices, both one birth at a time and as a presence in the larger birth movement. With the exception of a brave few, midwives have not been able to infiltrate the hospital system. Doulas are reaching many spaces in birth care that we cannot. Doulas help more women have good births and motherbaby needs them.
If a woman hires both a doula and midwife, it is really important that they work together to make sure the mother’s autonomy and needs are put first. It is often difficult to synchronize our care but it is a goal we need to reach for. It’s important to know early in the pregnancy if you have a hands-on doula and hands-off midwife attending the same birth. Midwives are accustomed to forming a strong relationship with a mom during her pregnancy and perhaps doulas need a prolonged relationship with moms as well. Birth is so much about relationships and motherbaby should always be the center of those relationships.
Being a doula is a great stepping stone and a rich profession of its own. Doulas’ enthusiasm for birth often leads them to midwifery, where their experience can compliment further education. In Europe I have had the privilege of meeting so many wonderful doulas. Many of them have the desire to become a midwife but most of the schools they would have to attend are brutal. You do not become a loving birth practitioner through the brutal education that many countries have. We don’t need more cogs in the medicalization of birth. The education that doulas have gleaned put them in the best position to be the world’s next midwives. How can we help them?
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor in chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan on Twitter: twitter.com/jantritten
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Updated Systematic Review of the Effects of Continuous Labor Support
An updated, systematic review of the effects of continuous labor support was recently published in The Cochrane Library. The updated review adds new data to a controlled trial research review on continuous labor support published in 1989. The purpose of the review was to assess the effects of continuous, one-on-one labor support on both mothers and babies.
The review found that women who received continuous support during labor were more likely to have shorter labors and to give birth spontaneously. They were less likely to have a cesarean, give birth with a vacuum extraction or forceps, have analgesia or anesthesia and tended to express less dissatisfaction with their experience. Care providers who were not a part of the birthing mother’s social network, or a part of the hospital staff (in cases of hospital births), seemed to have the most impact on assessed outcomes.
— Childbirth Connection. “Systematic reviews, continuous support for women during childbirth.” Last modified February 16, 2011. http://www.childbirthconnection.org/article.asp?ck=10272
Let Your Monkey Do It—A Doula’s Take on Homebirth
When the time came for Rebecca to push, it wasn’t determined by someone coming in and checking and declaring, “Okay, you are fully dilated. Time to push!” Instead, she transitioned into the birthing tub, moved around and investigated ways that best suited her needs. Soon, the urge to push just appeared. Without instructions, bright lights, counting or commotion, Rebecca found a way to push her beautiful baby girl out into the world.
This particular birth experience revealed to me not only a different side to birthing, but a different perspective of the doula’s role. Normally, a big part of my job is to help the couple negotiate with the hospital staff and explain the basic risks vs. benefits of different interventions. This time that aspect was removed and one of my main contributions was to just watch and be present. I stepped in when Rebecca needed a gentle touch, a hand to hold or a soft voice to remind her she was perfect “as is.” I stepped away when she didn’t need me or when she and her husband needed time together. Rebecca’s primal instinct was our true leader on this journey. And it led her and her baby well.”
Web Site Update
Read this editorial by Jan Tritten from the brand-new issue of Midwifery Today, Spring 2011:
Read these reviews from Midwifery Today, Autumn 2010, newly posted to our Web site:
Question of the Week Responses
Q: How do you facilitate good midwife-doula relationships?
— Jan Tritten
A: As a birth doula in a small city, I’ve often heard stories from my fellow doulas about feeling conflicted around their role at homebirths. Some have felt like the midwife was displeased with the client feeling the need for a doula, or that the midwife expected the doula to perform support tasks that fell outside the doula’s scope of practice. Our local doula networking group arranged for a homebirth midwife to specifically address the role of the doula at a homebirth, and to dialogue about the doula-midwife relationship. It was a fantastic experience where a room full of doulas got to really open up and explore why they may have had troubling experiences in the past, and how to work more proactively with midwives toward a positive experience for everyone. I greatly appreciate when care providers are direct and openly communicate with me about their expectations and how they normally do things. I also make a point to stay in regular contact with our local midwives so that we have a comfortable, ongoing relationship to draw from at a birth. Thank you, midwives, for all that you do!
— Laurel Ripple Carpenter, CD (DONA)
A: I think it is very important for me to go to one prenatal to meet the midwife ahead of time. If I don’t know the midwife already, I see when I can get five or ten minutes to find out her philosophies regarding birth. This may be a phone call at a later time. I think it helps to establish a good rapport.
— Veronica Lacquement
A: I approach working with a midwife the same way as with hospital staff: respect her as a person and as a professional (whether the respect is returned or not). Often with a midwife, you have the opportunity to meet and talk at least briefly (by phone or in person) to get to know each other a bit, share birth philosophies and compare role expectations before the labor begins. This all helps immensely on “birth day.”
— Janelle Repp
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
Model your midwifery and your values. Your apprentice will do what she sees and it’s far more effective than anything you can say. This, more than anything, will keep everyone in the practice of caring for others with consistency and excellence. You can’t demand of her something that she hasn’t seen you treat as important.
— Maryl Smith
The Art of Midwifery in E-News 13:4 had some interesting thoughts on humor from Kate Prendergast. I agree that humor can be a natural medicine but I’ve also found that humor often is acceptable in early and/or prodromal labor, irritating in active labor and “watch out that you don’t get something thrown at you” if you try to use it in transition. Women in transition are often most literal and misunderstand attempts at humor. It seems I’ve spent about as much time translating a doctor’s “humor” (English to English) as I have translating English into Spanish for the Spanish speaker in labor.
— Linda B. Jenkins, RN
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