August 27, 2014
Volume 16, Issue 18
Midwifery Today E-News
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A 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more. To order

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In This Week’s Issue

AU conferenceLearn 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.

Learn more about the Byron Bay, Australia, conference.

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.

Lisa Goldstein, excerpted from “Urinary Tract Infections,” Birth Wisdom, Tricks of the Trade, Vol. III, a Midwifery Today book
View table of contents / Order the book

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

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Editor’s Corner

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.

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Featured Article

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).


  • Reid, G. 2001. “Probiotic agents to protect the urogenital tract against infection.” Am J Clin Nutr 73 (suppl): 437S–38S.
  • Reid, G. 2002. “Probiotics for urogenital health.” Nutr Clin Care 5 (1): 3–8.
  • Trenev, N. 1998. Probiotics: Nature’s Internal Healers. New York: Avery Publishing Group.
  • Vora, Sadhna. 2002. “There’s Something in the Water! A Look at Disinfection By-Products in Drinking Water.” J Young Investigators 5(4).

Genevieve Lewis
Excerpted from “Probiotics: A Better Way to Treat Infections during Pregnancy,” Midwifery Today, Issue 79
View table of contents / Order the back issue

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Make sure you get the whole story.
Midwifery Today E-News is only a sample of what you’ll find in Midwifery Today magazine. Subscribe and you’ll receive a 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more. Subscribe. Midwifery Today Magazine

Discover the essentials of supportive touch.
Touch Techniques for Birth

In Touch Techniques for Birth, Leslie Piper, LMT, and Leslie Stager, RN, LMT, show you how to make touch a part of your midwifery practice. You’ll learn about contraindications, acupressure, reflexology, hydrotherapy, general comfort strokes, pain relieving techniques and more. A special feature includes a midwife’s story of the use of belly rub and emotional support to encourage labor. This DVD belongs in your midwifery library! Get the DVD.

Read about the third stage of labor!
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The Third Stage of Labor e-book is packed with information about the umbilical cord, the placenta and natural approaches to this phase of birth. This collection of 15 articles from past issues of Midwifery Today magazine includes “Placenta Accreta by Marion Toepke McLean, “Cord Burning” by Kelly Dunn, “On Meconium at Home and Delayed Cord-cutting” by Naolí Vinaver, “Placenta Rituals and Folklore from Around the World” by Sarah J. Buckley and “The Problem Is Induction, Not Meconium” by Gail Hart. Buy your copy and have it with you at the next birth you attend!

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What is optimal fetal positioning?
Understanding and Teaching Optimal Foetal PositioningWhy is it important and how can you help your clients achieve it? You’ll learn this and more when you read Understanding and Teaching Optimal Foetal Positioning by Jean Sutton and Pauline Scott. Succinct and thorough, this manual includes brief descriptions of the various ways a fetus can present, information on how a fetus can be encouraged to rotate into the optimal position during later pregnancy and postures the mother should use or avoid during actual labor. Optimal Foetal Positioning features numerous black and white line drawings that illustrate and illuminate the information in the text and is a must-own for anyone who works with pregnant women. To order

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Website Update

Read this article excerpt from the Summer issue of Midwifery Today magazine, now on our website:

  • Catharina Schrader: A Midwife of 18th-Century Friesland—by Jane Beal

    Excerpt: “Her path to professional midwifery was not an easy one. When she was 38 years old and the mother of six young children, her first husband died. To support her family, she began to work as a midwife. As she indicates, this was partially because both the doctors and townspeople were urgently pressing her to help them. As the wife of a surgeon, she had apparently assisted at difficult births and complicated situations did not prevent her from acting quickly in emergencies to save the lives of mother and baby whenever possible.”

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Birth Q&A

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?
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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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