August 17, 2016
Volume 18, Issue 17
Midwifery Today E-News
“The Fourth Stage of Labor”
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In This Week’s Issue



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Quote of the Week

We’ve got to protect them, because, after all, a person’s a person, no matter how small.

Dr. Seuss


The Art of Midwifery

Considering that in most of the world, women’s lives are difficult and challenging and their work is exhausting and demanding, lasting from predawn into the late night, the postpartum time of rest is a true blessing. The lion’s share of women in my part of the world cook on wood fires, wash all the family clothing by hand, iron with cast iron and hot coals and work in the rice fields. On top of this, many of them must be at their job by 8 am looking tidy and feeling strong and ready to put in eight to ten more hours of hard work. By the time these women give birth, they are so exhausted and low on Qi, essential energy, that once they have had the baby, their bodies find it difficult to muster the Qi to safely deliver the placenta and close the uterus properly. This, and the fact that white rice with nearly no nutritional value is their staple food, is why hemorrhage after childbirth is one of the leading causes of death in the world.

Robin Lim
Excerpted from “The Fourth Stage: Sharing the Asian Way,” Midwifery Today, Issue 102
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Midwifery Today Conferences

Strasbourg conference Join us in Strasbourg, France, this October!

Learn from teachers such as Carol Gautschi (pictured), Fernando Molina, Gail Tully, Michel Odent and Cornelia Enning. Choose from a wide variety of classes, including Midwifery Skills, Breech Skills, Rebozo Techniques and Practice, and Managing Twin Births. Plan now to attend.

Learn more about the Strasbourg, France, conference.



Plan now to attend our conference in Eugene, Oregon, next April!

Eugene conference You will be able to choose from classes such as Using Gentle Tools (Our Hands) for Ideal Positioning, Hemorrhage and Estimating Blood Loss, and Research in Midwifery. There will also be a two-day Midwifery Skills class. Planned teachers include Carol Gray, Carol Gautschi, Gail Hart, Fernando Molina, Sister MorningStar and Penny Simkin. [PHOTO BY PATTI RAMOS]

Learn more about the Eugene, Oregon, conference.



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Editor’s Corner

Fourth Stage

In Issue 102 of Midwifery Today, I wrote, “The fourth stage of labor is defined as the first hour or two after birth. I think we should redefine it as birth to 21 years of age, or maybe for the lifetime of the child. The issues never end once you are a parent. But let’s go back to the first hour or two after birth because this editorial doesn’t have enough space for 21 years!”

We have a tendency to really concentrate on the birth, and we sometimes forget how important that initial interaction is with the new mother and her newborn baby. This is probably the most important time in the life of both. It is our main task to guard this precious time and keep it undisturbed as we diligently watch to make sure no complications, such as hemorrhage, are happening. The midwives skills must be sharp and up to date so she has many ways to handle issues, but her greatest task is to be protector of the birth process.

The thing is, this mother and baby have just this one chance at the most important time for both of them. Their hormones are at their peak time for this very special greeting. The oxytocin emanating from both can fill the room and spread to everyone there. To protect it, midwives or doulas may need to discuss the importance of bonding and keeping calm at the birth. Talk about putting off using the cell phone as well. The cell phone may just be the second biggest disturber of this period. The first is the people present. Help make every third and fourth stage as ideal as possible.

Each one, teach one.

— 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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Conference Chatter

Online Classes

Speaking of newborns…Midwifery Today is giving birth to online classes and webinars! You may be one of the many birth practitioners who do not have the time or resources to attend our inspirational conferences in person. So, Midwifery Today has begun developing online classes in order to bring the essence of our conferences to you. The first online session will be a FREE interview with Gail Hart called, “Midwifery Today presents Midwives Today.” Through a Q&A session lead by Jan Tritten, Gail will be talking about the important issues that affect midwives in the twenty-first century; Gail will also let listeners in on the stumbling blocks she has experienced as a midwife. Then the floor will open up in order to give you a chance to ask your own questions. Stay tuned for dates and times by checking our website or Midwifery Today’s conference page on Facebook.

Mini-Conference Retreat in California, September 9

Another newly born event Midwifery Today is cooing over is our one-day educational getaway. Appropriately called mini-conference retreats, these events allow you to steal at least one day away from your practice in order to refresh, earn CEUs and network with your colleagues. The first retreat was held at the magical McMenamins Edgefield in Troutdale, Oregon, this past March and was very well received. Midwifery Today will be hosting its second retreat in Sebastopol, California, at the picturesque Mamalanda Permaculture Farm and Retreat Center on September 9, 2016. For more information, visit our website.

— Oriona Turner, Conference Coordinator

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Featured Article

Building My Nest

BuildNest1_sm (9K)I think the best place to start is at the beginning of my story.

I was pregnant, a single mother and living in a jungle in Costa Rica. The events leading up to all of the aforementioned facts are, well, complicated. Regardless of my situation, I was going to have a baby! Because I had already given birth to other children and because I had been in birth work for several years already, I was profoundly aware that the first few weeks of a baby’s life are so very fleeting and so very precious. I decided that not only was I going to plan to have a home waterbirth, I was going to plan to stay in my nest for 40 days afterwards. Along with the perfect birth, I wanted a perfect nesting time. As this was the first time out of all of my births that I would be the only adult in the house, I realized fairly quickly that if I wanted to have the experience that I hoped for, I would need to create it myself.

First, let me define what I mean as “nest.” It is a physical space that a new mother and her baby enter into immediately following birth. It is the next stage in the process—a continuation and ultimate completion of the pregnancy and birth. Mama and baby go into this space alone for an extended period of time to share the sacred space that naturally surrounds the two after a birth, optimally for 40 days. It is safe and beautiful. Mom has no other responsibilities other than the nest. Others may visit—but the heart of the space is reserved for just mother and baby.

Within the nest, the new baby first learns about love and life. Because of what scientists call “plasticity of the brain,” we can deduce that it would likely be a beneficial thing if the first few weeks of life were spent in a sacred and safe love nest with a healthy happy mother.

The nest is not only a physical space, but it also includes a protective shield around all aspects of life during the first 40 days following birth. This shield is built by pre-organizing life financially, as well as generally with household issues such as cleaning and laundry, food preparation, other children, etc. The shield then acts as a protection around the new mother and baby, allowing them to enjoy the nest to its fullest. These issues need to be prepared and pre-organized in the same way that the physical space is created.

I’ll tell you how I did it. I began by making lists and I kept these ongoing lists in my journal, adding to them often. One of the first things I realized I needed to do was to purchase a birthing tub before the third trimester. I found a portable hot tub on eBay for $500. The hot tub gave me a welcome, weightless retreat every day leading up to the birth. From there, I designed the room that I would be nesting in and made drawings and lists in order to make that space work for me and my family. For example, I built an addition to my bed and attached it to the wall so my kids would have a separate space to lie down and play and hold the baby that didn’t encroach on mine and my baby’s bed. They could even lie down next to me, but they would still have their own space and wouldn’t bump mine around. I made lists of how I could create enough food—good food—for the 40 days. I realized that I needed a chest freezer and after buying the freezer, I began leisurely making and buying my favorite foods and freezing them. I made enough chocolate cupcakes for myself that I was sure to have at least one every day! I budgeted for a young woman to come to my house for a few hours every morning and clean and do laundry beginning in the third trimester and to continue through the 40 days after the birth. I budgeted for the midwife, a weekly massage, wireless headphones, and lots of pillows and luxurious bed linens. I also budgeted for enough savings to pay for three months’ worth of bills as I obviously wouldn’t be working during the nesting time and would continue staying home for some time afterwards. After I totaled everything up, I had a good idea of how much money I needed to set aside. Miraculously, over the months I was able to save just that amount. It wasn’t cheap, but I realized that this may be one of the most important investments of my life. I sacrificed, I got creative, I sold things and I did whatever I could to make sure I would have the amount that I needed.

I spent months building my nest, going to great lengths to have everything in place so that when the day finally came, I was ready. Since I knew that all the logistics of my household were taken care of for 40 days, I could relax deeper into the birth. After days of on-again, off-again contractions, I woke up one morning knowing that it was the day. I woke up around 5 am to the sound of howler monkeys rustling in the trees in front of my house. The house had screens for walls, and my bed in my nest faced the river and trees where the monkeys were. I said good morning to the monkeys. This was it! I asked the monkeys to stay for the birth—I told them that I would love to have them be there with me. All 22 of them (my daughter counted) would end up staying and coming very, very close to where I was laboring. They even howled along with me during transition later on that night.

Linda Louise Henry
Excerpted from “Building My Nest,” Midwifery Today, Issue 102
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Website Update

Read this article excerpt from Midwifery Today magazine, now on our website:

  • Changing the Language of Childbirth—by Susan Highsmith

    Excerpt: “What is important to realize is that the system that dominates our society has co-opted our thinking. When we take our language for granted, our dialogues are full of words and expressions that keep us trapped in the very system we want to change. Rayna Rapp, in the foreword to Childbirth and Authoritative Knowledge, emphasizes how medical authority is socially constructed. She eloquently describes how women have lost their authority by having it subverted by the authority of a socially constructed institution. ‘Authoritative knowledge isn’t produced simply by access to complex technology, or an abstract will to hierarchy. It is a way of organizing power relations in a room that makes them seem literally unthinkable in any other way’ (Davis-Floyd and Sargent 1997, vi). Our everyday language perpetuates the diminished power and authority of pregnant women in favor of a system designed to do just that.”


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Midwifery Today: Each One Teach One!