GBS Updates from a Homebirth Perspective

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine One of the principles of the midwifery model of care is to provide mothers with individualized education, counseling and prenatal care (Midwives Alliance of North America, 1996). Midwives strive to provide care that is evidence-based, logical and free of fear. Yet, for homebirth midwives in particular, doing so can be difficult because the vast majority of birth research focuses on out-of-home births and/or very low-resource communities. Neither of these populations reflects the contexts in which homebirth midwives typically work in the United States. One way in which this mismatch between existing research and the context of care sets a unique challenge for homebirth midwives is in the case of Group Beta Streptococcus Disease (GBS). An Overview of GBS GBS is an infection of a gram-positive bacterium To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

Helping a Mother with Twins: Choose Your Words Wisely

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine “You mean I get two for the price of one?” (This is often how an Amish dad responds when I tell him his wife is carrying twins.) “Yes,” I say, “you do!” I helped with my first set of twins when I was still in my two-year apprenticeship program. They were born in July 1979 to first-time parents. In fact, out of the first nine sets of twins I helped with, five of the couples were first-time parents. To date, I have helped with 35 sets of twins; almost half of these were born to first-time parents. I believe there is an advantage with primips. Almost every one of these moms told me the same thing, “I’ve never had a baby before, but I know it To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

Twin Birth in Rural Nevada

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine I am a midwife in Las Vegas, Nevada. Since Nevada is a very rural state, it is not unusual for women to come to me from locations many hours away. About 15 years ago I had a client from Tonapah, which is over three hours away from Vegas. This was her sixth pregnancy (I had helped with three of her previous births) and we discovered she was carrying twins. The first baby was in a frank breech position and second baby was head down. The plan was for her to head to Vegas as soon as labor started and to birth at her grandmother’s house. She had never had a fast labor, so neither of us was concerned about her making it to me in time—she To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

The Voice of Reason

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine “Good luck with that cesarean section problem,” said my webmaster as he posted the beautiful home waterbirth photos of mother Kalista and baby Loki with father Trace and sister Sophie immersed in love, joy and newborn water. “It seems we were talking about that problem 30 years ago.” Yep, he’s right. We were. By 2013, ACOG had released their new definitions for gestation, making 40 weeks term and paving the way for inductions at 39 weeks. California-licensed midwives received news of tighter restrictions for homebirth. National and world statistics worsened for infant and maternal mortality making it seem reasonable to move toward higher requirements for birth worker education and tighter control for standards in childbirth. ACOG seems to be the voice of reason. I, however, am To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

The Wonderful World of Twin Birth

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine Whether you wait 16 hours between twins, don’t even realize a twin is coming or have an unexpected position for the second twin, twins can be double the trouble and double the fun! During the past 30+ years, I have attended many twin births. It is my hope that the stories that follow will provide insight into various approaches to twin birth. Transverse Lie A mother with RH sensitization came to me seeking midwifery assistance for a natural homebirth. At her first prenatal visit, she was already measuring much larger than normal for a single baby and we discussed the likelihood of twins. By the next visit, she had grown significantly and continued this pattern throughout her pregnancy. I showed her how to palpate the head To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

Why All the Fuss about Twins?

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine I want to suggest that, in the case of twins, trying to give birth vaginally in an inappropriate environment (e.g., in the presence of a scared doctor or a scared midwife) is a recipe for disaster. We must adapt to our cultural lack of understanding of birth physiology. In 1953–1954, I spent six months as an externe (medical student with minor responsibilities) in the maternity unit of a Paris hospital. At that time, twin birth was not a frequent topic of conversation among midwives. I can only remember occasional word-of-mouth reports by old midwives of locked twins, an exceptionally rare complication when the first twin is breech and the second one is presenting head first. In general there were no discussions, in terms of daily practice, To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

Coming to Twins

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014. Subscribe to Midwifery Today Magazine Forty-four years ago my calling to midwifery was initiated through women who had been abused, the extent of which created a need for individual birth plans. As a traditional homebirth midwife by training and practice, I have gone on to serve every type of community, focusing primarily on college-educated, back-to-the-land families, as well as Plain and farming communities. While the childbearing landscape has changed over the 3400 births I have witnessed, my devotion to individualized care has never faltered. As with my general homebirth practice, my support of over 400 sets of twins (and 4 triplets) has been eclectic, crossing every segment of the population. During the 1960s and early 1970s, my experience was not terribly unlike that of the medical world; twins were often unexpected To access this post, you must purchase: Midwifery Today Website Membership – 12 months, Midwifery Today 1-year Subscription and Website Membership, Midwifery Today Website Membership Student Special – 12 months or Midwifery Today Website Membership – 6 months If you are already a member login here. Read More

In Memory of Marsden Wagner – A Friend to Midwives, 1930–2014

The world lost a treasure earlier this year, but his passion and kindness will forever remain in our hearts. This tribute contains memories, stories and thoughts about Marsden from some of his midwife friends. Read More

Homebirth and the Microbiome

…now I am learning that homebirth is even more important than I ever thought it was. New microbiome research is teaching us that how and where we are born is crucial and even life-altering. Our birth literally sets the foundation for our health and well-being or lack of it. Read More