June 22, 2011
Volume 13, Issue 13
Midwifery Today E-News
“Midwifing Moms with Disabilities”
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Learn about birth and disability with Midwifery Today Issue 27.

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You’ll be able to read about substance abuse and how it affects childbearing, how a woman with an inverted uterus had a successful birth experience, cerebral palsy and more. This issue also includes Guidelines for Serving Disabled Women. Just $7 plus shipping!
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Brush up on your midwifery skills!

Germany conference

Attend one or both days of the two-day Traditional Midwifery Skills pre-conference class at our conference in Bad Wildbad, Germany, this October. You’ll learn from teachers such as Elizabeth Davis, Carol Gautschi and Ina May Gaskin. Topics covered include Essentials for a Normal Birth, Preventing Complications with Prenatal Care, Labor and Birth Complications, Holistic Complete Exam, Helping the Slow-starting Baby and Suturing Overview.

Learn more about the Germany conference.

In This Week’s Issue

Quote of the Week

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure.

Marianne Williamson

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The Art of Midwifery

In late labor, women are often miserably hot and sweaty, even in air-conditioned environments. Hospitals usually don’t allow the use of electric fans and rural homebirth clients may not even have electricity. I always carry a folding metal and paper fan. This small, simple tool can provide real comfort to a hard-working woman—plus, it can give a nervous family member a useful job.

— Excerpted from Midwifery Today’s Second Stage Handbook

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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Jan’s Corner

A Holy Calling

What is normal birth? I believe that almost all women have within them the capacity to birth in power, sacredness and trust. It is the job of the midwife in the prenatal course to help guide women to become physically, emotionally and spiritually healthy. It is the belief of many midwives, including myself, that if mothers and midwives do the work in prenatal care, the birth will go well. Though birth itself may be normal, no two births are alike and there is nothing normal about a miracle.

Think of what a detour birth has taken from the way it was designed by our creator to be. I recently asked on my Facebook page, “Could it be we lost birth when we took the sacredness out of it? At a birth or in a prenatal or postpartum visit you are standing on Holy Ground.” Indeed, when you are dealing with pregnant and birthing women you are in the presence of one who is carrying the future.

All birth practitioners who are “with women” are called to a holy place, a place where true giftedness is needed. As midwives, we must always be ready to learn, grow and give. The abilities we need to cultivate will take a lifetime of humble learning. I don’t know of a profession that calls for more giving but also returns so much. Most midwives love their work. I hope you are one of those blessed practitioners! Keep up the good work for motherbaby. The world needs you. Remember also to treat each other with the love and respect you give to birthing women—doing so really can change the world!

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
Midwifery Today on Facebook: facebook.com/midwiferytoday
International Alliance of Midwives on Facebook: facebook.com/IAMbirth
Midwifery Education: Caring and Sharing: facebook.com/MidwiferyEducation

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News and Research

The Mothers’ Index

The international nonprofit group Save the Children recently released its annual Mothers’ Index, which analyzed data and information on maternal and child well-being from 164 countries.

Considering maternal and child mortality rates, life expectancy and a host of other indicators, the report ranked Norway as the best place in the world to be a mom and Afghanistan as the worst. The US ranked 31, due largely to its maternal mortality rate, one of the highest among industrialized nations. Download the full report at: http://www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.6748295/k.BE47/State_of_the_Worlds_Mothers_2011_Statistics_and_Facts.htm

The Mothers’ Index. Accessed May 12, 2011. http://www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.6748295/k.BE47/State_of_the_Worlds_Mothers_2011_Statistics_and_Facts.htm

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Join Us in August

MANA Region 3/NCMA Conference 08/05/2011 to 08/08/2011 in Cary, NC

Midwives, doulas and childbirth educators from across the region can reunite with old friends, make new ones, and learn information in workshops to enrich their professional practices. Key note speakers are Anne Frye, CPM, and Jan Tedder, FNP (H.U.G. Your Baby). CEUs applied for, MEAC and ACNM.

For more info http://ncmidwife.org/MANARegion3Conf/

Featured Article

Guidelines for Serving Disabled Women

Pregnancy can be a time of disequilibrium for any woman. Women with disabling conditions may experience a double dose of it. The normal feelings of ambivalence that accompany early pregnancy may be prolonged for women who are unsure of both their physical ability and their emotional responses. They often need more time and opportunity to talk about the impact of pregnancy than “able-bodied” women do. On the other hand, some women are so excited about being able to carry out a “normal” function like childbirth that they move on very quickly in their acceptance of pregnancy.

The fatigue of early pregnancy can be severe for women with rheumatoid arthritis, multiple sclerosis or chronic fatigue syndrome. And the feelings of dependence that so often accompany pregnancy, those feelings that allow the woman to contemplate herself and her body, are often difficult for women with disabilities. They have spent so much of their lives striving for independence that it is often very difficult for them to allow others to take care of them.

A discussion about the woman’s feelings about her changing body shape will reveal whether she views those changes positively or negatively. Her response will depend largely on her comfort level with herself prior to the pregnancy and on the effects of pregnancy on her comfort. For example, women with cerebral palsy or quadriplegia may have increased spasms and difficulty maintaining their posture in the wheelchair. A wider chair may provide greater physical comfort.

Physical examination may be difficult for the woman with a disability such as vision or hearing loss, chronic illness or cerebral palsy. The midwife should do as much of the exam as possible with the woman in the position which is most comfortable for her, or in her wheelchair, if she wishes. She should be asked to bring a companion with her to the exam, one who is familiar with her transfer techniques. If the midwife is assisting the woman with transfers, time must be taken to learn the ways that are most comfortable for the woman. Braces, crutches and wheelchairs should be left close by.

Like most women, she many feel vulnerable during a breast or pelvic exam. Determine in advance what kind of draping, if any, she would prefer. The traditional lithotomy position is apt to be difficult for a woman with limited mobility. After determining the extent of a woman’s abilities with respect to positioning, consider doing the pelvic exam in any of the following positions: knee chest, diamond shaped (on back with legs in diamond shape, no stirrups), side lying, or modifications of these positions. If a spasm should occur during the pelvic exam, the midwife should support the limb or area in spasm until the spasm has gone away before proceeding. Spasms can be exaggerated if the woman is feeling anxious. A close presence, and thorough explanations, can decrease feelings of uncertainty.

Elaine Carty, Tali Conine, Angela Holbrook and Lenore Riddell
Excerpted from “Guidelines for Serving Disabled Women,” Midwifery Today, Issue 27
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Learn how sexual abuse affects women during pregnancy and childbirth and what you can do to help.

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Web Site Update

Visit the Midwifery Today YouTube Channel

Please check out this YouTube video series:
Come to Conference! ~ Euphoria in Eugene
Come to a Midwifery Today Conference! After studying hard in workshops for several days, attendees at the 2009 conference in Eugene, Oregon, dance enthusiastically to the exciting sounds of Zimbabwean marimba music played by Jenaguru Full Moon marimba ensemble. "We work hard ~ we play hard!" Come to conference!

Click below to view, or you may wish to go here to download video and view without streaming interruption.


Read this article excerpt from the Summer 2011 issue of Midwifery Today newly posted to our Web site:

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Reach a targeted international market by advertising at Midwifery Today’s conference in Bad Wildbad, Germany: “Preserving Our Traditions, Improving Our Skills”, October 19–23, 2011. By advertising at this exciting conference you will reach an audience passionate about birth. Space is very limited so contact us soon. [ Learn More ]

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Make the vision of natural birth available for all to see.

Ask your library to order natural birth and midwifery books for you. When a mother has more information about natural birth available to her, she can make more educated decisions about how she wants to birth her baby. Making requests is easy; here’s how.

Birth Wisdom from the Web

As I reflect on the last 11 years, the good and the bad, I know, WITHOUT A DOUBT, that I would do it all again. Even if I knew what was to happen, I would travel our road. Katy has been the best thing to happen to me…”
Al Hayes, reflecting on his love for his wife, Katy, who had a quadruple amputation upon developing a life-threatening Streptococcal A infection after a normal homebirth.

The use of water as an option, a choice, a way of receiving comfort in labor, has always been for me, a platform upon which I stand to have a conversation about birth—all aspects of birth. I don’t really care what pool one uses, or where that birth happens, as long as the birth AND the baby are respected.
Barbara Harper, Facebook, on the FDA’s efforts to seize incoming shipments of birth pools.

Midwives are qualified to manage a variety of medical complications, and any good midwife knows when transport to a hospital is necessary (as occurred with my first birth). Midwives can stop hemorrhaging, midwives unwrap umbilical cords from around necks and torsos (as happened to my little bundle of joy), and midwives do not need electronic fetal monitors to know the baby’s heart rate, position in the birth canal, or when the next contraction is coming (any un-medicated mother will make that abundantly clear). If we stop viewing birth as an emergency waiting to happen—it’s NOT—then we can stop imposing anxiety on women about birth.
Mayim Bialik, actress, lactation educator and homebirth mom, in defense of homebirth.

If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to mtensubmit@midwiferytoday.com.

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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.

Conference Chatter

Harrisburg, Pennsylvania, Conference

We found a beautiful conference venue for our 2012 East Coast Conference, which will take place in Harrisburg, Pennsylvania, April 11–15. It has an open and welcoming foyer. The indoor pool and hot tub will be perfect for networking, mentoring, telling birth stories and learning from our teachers and each other about the many birth ideas and cultures represented in our amazing group of teachers and registrants.

The theme for the conference is Midwifery: Skill, Wisdom, Culture, Love. We will learn about birth in many cultures and make plans for change because “every motherbaby has the right to be treated with reverence and respect during the birth process, including pregnancy and beyond.”

Teachers will include Stephen Gaskin and Ina May Gaskin from The Farm, Marcos Leite, an amazingly gentle physician from Brazil, and Betty-Anne Daviss, who has worked in Guatemala, Haiti and Afghanistan, and helped establish Inuit midwifery in Canada. Many Amish and Mennonite midwives will join us in Harrisburg, along with Eneyda Spradlin-Ramos, who hails from Nicaragua, Tine Greve, a midwife from Norway, and Mabel Dzata, originally from Ghana, who has done thousands of births in a number of settings.

Debra Pascali-Bonaro, who has been all over the world training doulas, will help with the doula and labor comfort classes. Robbie Davis-Floyd will share her powerful teachings on culture, and Carol Gautschi and Diane Goslin will take us into the world of working with complications. (Or shall we call twins, breech and VBAC births simply variations of normal?) Michel Odent will share on many topics, from Primal Health to ideas for the birth room, and Naolí Vinaver will teach Spanish and Mexican techniques. More teachers will be announced in the coming months. Come listen, learn, share and have fun! View highlights here.

Jan Tritten

Think about It

Nurses, who are usually very technocratically trained, can be as hard to convince as doctors to change childbirth. Yet no social movement to humanize birth can succeed without the involvement of nurses, at both individual and organizational levels…. The autonomy of hospital-based midwives and their degree of failure or success is highly dependent on the nurses with whom they work.

Robbie Floyd-Davis
Excerpted from “Changing Childbirth: The Latin American Example,” Midwifery Today, Issue 84
View table of contents / Order the back issue

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