|February 4, 2015|
Volume 17, Issue 3
|Midwifery Today E-News|
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In This Week’s Issue
Improve your midwifery skills and knowledge
Attend the full-day Midwifery Skills class with Elizabeth Davis, Patricia Edmonds, Gail Hart, Carol Gautschi, Marion Toepke McLean and Sister MorningStar. Planned sessions include Prenatal Care to Prevent Birth Complications, Common Complications of Labor, The First Hour After Birth and Creating Postpartum Plans that Work. Suitable for both beginning and advanced midwives, this class is part of our conference in Eugene, Oregon, March 2015.
Come to Germany this October!
Plan now to attend our conference in Bad Wildbad, Germany, October 2015. You’ll learn from teachers such as Robin Lim (pictured), Elizabeth Davis, Cornelia Enning, Gail Hart, Fernando Molina, Sister MorningStar, and Michel Odent. Choose from a wide variety of classes, including Breech, Mexican Techniques, Shoulder Dystocia, Birth Positions and Organic Midwifery.
Quote of the Week
Have a heart that never hardens, and a temper that never tires and a touch that never hurts.
— Charles Dickens
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The Art of Midwifery
During the labors I attend, I use a lot of touch and massage. As with pregnancy massage, I find that my clients benefit from touch and massage in different ways. One client told me, “Massage eased labor pain in my back immensely. I would have had an epidural without the massage during labor—I’m sure of it! The massage also gave me something to focus on other than the pain of labor.” Another reported that massage made her feel “cared for.” Another said, “Massage definitely reduced stress and anxiety by helping me focus on each stage and get over it.”
— Keri Redding, excerpted from “Touching Lives: Massage in Pregnancy and Labor,” Sharing Midwifery Knowledge, Tricks of the Trade, Vol. IV, a Midwifery Today 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 firstname.lastname@example.org.
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Subscribe to the Web Updates RSS feed to stay on top of what’s new or highlighted on the Midwifery Today website. Be alerted when conference programs go online, new articles are posted and more.
[Editor’s note: This issue’s guest editor is Hermine Hayes-Klein.]
Human Rights in Childbirth (HRiC)
On January 28–31, 2016, Human Rights in Childbirth (HRiC) will host an international conference at the National Law School of India in Bangalore, India. Over four days, attendees will address how maternity care can optimize maternal and infant health outcomes in a respectful, culturally competent, human rights framework. HRiC is an international network of some of the most influential thought leaders in human rights and maternity care—individuals and organizations that work to address global maternal and newborn health issues through the lens of human rights in interdisciplinary and innovative ways. Our organization challenges the professional and political segmentation of women’s and children’s health and advocates for recognition of the full range of human rights at stake in pregnancy, childbirth and postpartum. Midwifery Today has co-hosted two of the three international conferences that HRiC has organized since 2012. We welcome the global network of midwives unified through Midwifery Today to join us in person next year in Bangalore for this important event.
The conference will convene a vibrant and interdisciplinary group of maternity care providers, public health professionals, lawyers, consumer activists, policy makers and reproductive justice advocates. Speakers will represent the front edge of global efforts to eliminate disrespect and abuse in maternity care and to ensure non-discriminatory access to care for every woman and baby. Two days of the conference will be devoted to examining maternity care development and practice around India, convening providers and advocates serving diverse populations from rural villages to slums and urban high rises, to share stories of the realities that women face in childbirth around the nation. The other two days of the conference will draw speakers from around the global community, and in particular the southern hemisphere, to discuss the challenges and successes of maternity care systems in different stages of development.
The Human Rights in Childbirth: India Conference will effectuate a global maternity care policy paradigm shift, from recognition that preventable maternal mortality is a human rights issue to recognition of the full spectrum of human rights at stake in childbirth. Women have a right to survival, but it is not their only human right. This conference will catalyze a critical reorientation of the goals of maternity care development to pursue community-based, non-colonialist maternity care development, respectful collaboration between midwifery and medicine, and a biodiversity of healthy birth support and practices that reflects the resources and knowledge held by midwifery traditions around the world.
More information is available on the HRiC website, including a call for abstracts and registration information.
— Hermine Hayes-Klein is an American lawyer and the director of the Bynkershoek Research Center for Reproductive Rights in The Hague, the Netherlands. In 2012, she organized the Human Rights in Childbirth conference in The Hague. Hermine now lives in Portland, Oregon, with her husband and two young sons, who were born at home in Holland. Her work now focuses on legal issues surrounding childbirth, including the defense of midwives.
Eugene is the home of our next conference and its theme, “Birthing with Love Changes the World,” is, to me, one of my favorite themes. Our many teachers exemplify this idea. Diego Alarcon from Ecuador has a loving waterbirth center; Fernando Molina, originally from Venezuela and now living in Eugene, provides gentle midwifery care and teaches others about natural childbirth; and Sister MorningStar embodies wisdom and love. Sister does a very special class called “Village Prenatals.” It is a class you won’t want to miss. As I look at our teacher list, I feel blessed to be able to bring together so many amazing, loving and knowledgeable teachers.
The classes are a great mix of clinical themes, which are our old favorites, such as Breech Birth, Hemorrhage and Estimating Blood Loss, and Shoulder Dystocia, along with some new classes, such as Essential Oils and Midwives: A Loving Response to Disaster. Besides these, our classes on love, such as Love in Birth vs. Fear in Birth and Newborn Babies Need Love, Microbes and Stress with Michel Odent, give us the promise of a special conference. We hope you will join us. This is going to be an amazing event and it is coming to Eugene, Oregon, March 18–22, 2015.
If you are in Europe in October, you can find us in Bad Wildbad, Germany, 21–25 October 2015, in one of our favorite venues in the world, complete with awesome spas. The theme there is “Pillars of Midwifery: Insight, Information and Intuition,” which promises to be a great conference as well. Robin Lim will be with us at this conference, and we are thrilled to have her.
Toward better birth,
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Teaching Respect for Hands-On Care
One of the greatest challenges before US midwives is teaching the value of hands-on care to birthing women, the midwives who come after us, the medical profession, the nursing profession and the overall culture. Our culture’s love affair with machines, contraptions and gadgets has, unfortunately, blinded literally hundreds of millions of people to the importance of human contact, feeling, experience and judgment in maternity care. Part of what makes our task a challenge is that hands-on care can be difficult to describe, to record in a few short words, to evaluate—even to recognize, especially to people who have never been present continuously through a labor and birth. We midwives have to learn how to excel at this kind of description, and we need to re-legitimize the art and importance of storytelling if our profession is to thrive once again.
If we don’t tell our stories, how are we to teach women that cervical dilatation can reverse itself simply because they go to a hospital or because the wrong person enters the room? How can women re-learn confidence in their bodies unless they hear how well women’s bodies work, given the right atmosphere? How else can we give the woman who has always had pain medication while giving birth the confidence to labor without medication?
When midwifery was “on a roll” during the 1970s and 1980s, many in our movement thought insurance companies and health maintenance organizations (HMOs) would recognize the savings that would follow adoption of the high-touch, low-tech version of midwifery care we wanted for ourselves and those close to us. That was because few understood the intricacies of how services are billed in hospitals, the extent to which women’s health insurance plans would limit their choices of care provider, the medical-legal requirements of hospitals, the close links between insurance companies and hospital corporations or the ease with which judges and juries could be convinced that a yard-long electronic fetal monitor (EFM) strip is equivalent to or better than the notations made by a midwife or nurse providing intermittent auscultation (along with kind words, comfort measures, encouraging stories and loving touch). EFM strips have incredible illusory power; to the uninitiated they make it look as if someone is in the room with the laboring mother and give the impression that knowing the fetal heart rate during contractions is more important than it actually is. (No one has been able to count the unnecessary cesarean sections that have been performed because of low fetal heart rates recorded during contractions simply because of EFM).
It seems to me the only reason the assessment of cervical dilatation is still done by hand in hospitals is that no one has yet invented a set of indwelling calipers that can be installed to do the job mechanically—although some inventors in the early 20th century did try. We may be able to land a spaceship on Mars, but human flesh still doesn’t lend itself to easy measurement as it changes form, consistency and position during the process of labor.
Read this article excerpt from the Winter issue of Midwifery Today magazine, now on our website:
Q: Why is palpation helpful?
— Midwifery Today
A: Learning to trust your hands, and what they tell you, is vital. The day may come when ultrasounds and blood pressure cuffs aren’t available. Midwives will rule the day because we use all our senses!
— Andrea Reynolds
A: It is one of my most valuable tools. Having properly positioned babies makes for more efficient labors without unnecessary discomfort!
— Kate Aseron
A: Palpation involves humanly connecting the mother and baby through your gifted hands.
— Bonnie Weinberg Cowan
A: I like moms to be aware of where the baby is in relation to their own bodies. It seems to help them better prepare for labor. I had a situation where at 33 weeks I could not make heads or tails of baby’s position. The mom was palpated by two more midwives, who still came up blank. So, the mom got an ultrasound (something she originally didn’t want). Turns out the mom was carrying twins. A boy and a girl! The doc scared the mom into having a surgery at 38 weeks.
— Cathi Cogle
A: In many parts of the world, they don’t have high-tech equipment, so the use of hands is essential. Then there are areas where midwives go, such as disaster zones, where you need top-notch hands-on skills. I was shocked the first time I realized that many doctors do not palpate. It is as though they are afraid of touch.
— Jan Tritten
A: I have been horrified at many hospital births where no one—not a nurse, a doctor or a midwife—ever touched the mother. They didn’t shake her hand or comfort her, let alone do palpation. Transducers are strapped to a mother’s belly without even a consideration of where the baby is. It makes me cry when I think of my wonderful teachers, telling us students that our hands were our finest gift and the only “tool” we would always need.
— Andrea Reynolds
Birthing Your Way located in Utah is hiring for a CPM/CNM. Must have CPM/CNM credential, attended at least 75 births. Team environment. Please e-mail resume to firstname.lastname@example.org. Questions: 801-615-1733; Birthing Your Way website
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