|June 22, 2011|
Volume 13, Issue 13
|Midwifery Today E-News|
“Midwifing Moms with Disabilities”
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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 email@example.com.
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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
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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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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
Web Site Update
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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…”
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.
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.
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 email@example.com.
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.
Periglow, the best to support the perineum after birth. Periglow is a ready-to-use Swiss compress to promote healing the first weeks after giving birth. As a soak or bath. http://www.periglow.com
Florida School of Traditional Midwifery in Gainesville is hiring a part-time Managing Director, a position that will eventually transition into a full-time Executive Director. Details at http://www.midwiferyschool.org. Send letter and resume to firstname.lastname@example.org
Metamorphosis helps families function better by easing unconscious tension using a non-verbal gentle touch approach. Help your family grow instead of trying to change or discipline. Helps pregnant women relax. Classes, book, DVD. Cdsilver11@gmail.com http://www.MetamorphosisCenter.com
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