|August 27, 2014|
Volume 16, Issue 18
|Midwifery Today E-News|
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In This Week’s Issue
Learn about the Anthropology of Reproduction with Robbie Davis-Floyd
Attend this all-day workshop to get an overview of the exciting sub-discipline of the anthropology of reproduction from its early beginnings to its latest findings. The class will concentrate on anthropological studies in four major areas: childbirth, midwifery, the new reproductive technologies, and the politics of reproduction. Robbie’s goal is to provide a stimulating overview of these anthropological subdisciplines for midwives and others who want to know what the social scientists are up to, and to accompany that overview with an extensive annotated bibliography that will provide a helpful template for further exploration and research.
Quote of the Week
To keep the body in good health is a duty, otherwise we shall not be able to keep our mind strong and clear.
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The Art of Midwifery
Cranberry juice has the unique ability to attach itself to bacteria in the urine and pull them out of the bladder. It is a good idea in pregnancy—or if you are unusually prone to UTIs—to drink a quart of cranberry juice a week.
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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The Importance of Midwifery Autonomy
I asked the late Marsden Wagner at a conference two decades ago about what he thought the most important issues facing midwives were at that time. He immediately responded, “Autonomy.” That was a long time ago, yet I think his answer would be the same today. Autonomy is important for midwives because if they do not have it, then they cannot have an unobstructed relationship with the women they serve. Today we have state regulations, licensure requirements, charting and other issues to deal with in our practices that do not have to do with relationship, and yet midwifery is all about relationship. Unfortunately, many of these issues are based on whims and fashion rather than evidence. Often a woman is “risked out” of a homebirth because she has gone 41 or 42 weeks without evidence of increased risk.
I remember talking with an OB about why he was doing so many cesareans. He said that he is not in the birthing room alone, but he is there with insurance companies, pediatricians, anesthesiologists, hospital administrators, nurses, husbands and parents. He implied that he could not just have a good working relationship with the mother. We as midwives have put ourselves in that same situation by getting licensed and certified. If we lose our autonomy, the real loser is the motherbaby.
Birth is a human rights issue and an issue of autonomy. What can we do about this? We need to do something to begin truly serving mother and baby and do it without the threat of going to jail for being a midwife. We are living in unprecedented times. It is going to take some outside-the-box thinking to solve this dilemma.
— 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.
Probiotics: A Better Way to Treat Infections during Pregnancy
Audrey, 27 weeks pregnant, called the midwife with complaints of burning on urination and uncomfortable lower abdominal cramps. A routine dipstick urine check at the midwife’s office showed high nitrates and leukocytes, as well as a little blood. Suspecting E. coli urinary tract infection, the midwife referred her to the backup physician. After a round of antibiotics the infection cleared up and Audrey was feeling much better. Two weeks later, the symptoms returned, along with vaginitis. Would another course of antibiotics lead to a repeating cycle of the same problems?
Urinary tract infection (UTI) in pregnancy is encountered all too frequently, often going hand-in-hand with vaginal yeast or bacterial infections. Worldwide, an estimated one billion women have urogenital infections per year (Reid 2002). These conditions appear to be merely symptoms pointing to a common underlying disorder—a significant reduction or depletion of natural bacteria in the gut and urogenital mucosa. Without this natural immune barrier, pathogenic organisms take over. Studies have shown that the absence or depletion of lactobacilli in the vagina is associated with significantly increased risk for HIV, gonorrhea, chlamydia and herpes simplex virus infections (Reid 2002). Replacement and re-colonization of these “good bacteria” can significantly reduce the incidence of infection and prevent a multitude of complications that follow.
Maintenance of healthy urogenital flora is closely interrelated with healthy gut flora—if the gut flora become depleted, so do the urogenital flora. As long as the friendly natural bacteria dominate, pathogenic bacteria are kept in check. The composition and properties of these dense bacterial biofilms can be easily disturbed by several enemies, including antacids, laxatives, a diet high in fat and red meat, preservatives, antibiotics, lowered estrogen levels, spermicides, chlorinated water and, of course, stress. Chlorine in drinking water not only kills off the natural flora in the gut, but also combines with organic matter and bacteria in the water to form trihalomethanes, which are associated with a significant increase in birth defects and miscarriage, colon and bladder cancer, and other insidious illness (Trenev 1998; Vora 2002). If the microbiotic balance shifts and the pathogens begin to dominate, symptomatic infection results. Asymptomatic bacteriuria is a benign problem in non-pregnant women; but 13–27% of pregnant women with asymptomatic bacteriuria will develop acute pyelonephritis. When this occurs in the third trimester, premature rupture of membranes, premature labor and possibly death of the fetus or the newborn may result (Reid 2001).
Read this article excerpt from the Summer issue of Midwifery Today magazine, now on our website:
Q: Do you recommend probiotics to the women in your practice. Why?
— Midwifery Today
A: As with everything in my service, only when indicated. There is nothing that I do routinely.
— Patricia Edmonds
A: Yes, I do for the Amish women in the area/community where we live. I suggest probiotics because of their diet and the high rate of Candida and vaginal “beasties.” Some Amish communities are better than others.
— Mary Cooper
A: Natural sources such as yogurt, raw milk, kefir, kombucha and fermented vegetables are always preferred over a capsule. If she can’t or won’t eat those foods, then I recommend a probiotic capsule.
— Erika Obert
Craving more birth info?
A: I highly recommend the book, Gulp: Adventures on the Alimentary Canal, by Mary Roach if you want to really learn what goes on in your body when food goes in and about its travels on the way out. It’s a great book; she’s humorous and so thoroughly researched—an easy and fun read. (She’ll explain why probiotics don’t work so well.)
— Margie Dacko
A: I recommend probiotics as well as fermented foods (yogurt, etc.). These boost the immune system as well as battle yeast and GBS. Since having my pregnant mamas incorporate probiotics in some form into their diet, I rarely have a positive GBS test.
— Stacie Smith-Hunt
A: Over the years I have recommended probiotics, but I really have never had the quick results that I have seen with live culture foods—even for topical use.
— Sharon Hodges-Rust
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