What a blessing that this young mother and her baby revived and survived.
Mother, baby revived after 'dying' in labor - Heart health- msnbc.com
What I found particularly interesting is that the woman had an epidural minutes before the circulatory collapse. Her husband noticed her colour was blue and when the nurses checked her, she had no pulse.
The fact that an epidural had been administered had not made it into any of the news reports that heralded the story about the miracle of this woman and her baby's survival.
The doctors are at a loss to explain what happened to this young woman.
Yet, there are several possible explanations with the administration of an epidural in labour:
1. The anaesthetic agent could have been inserted into a vein by mistake causing cardiogenic shock
2. The epidural block may have been too high, causing paralysis of the intercostal muscles and respiratory arrest and then cardiac arrest
3. Allergic reaction to the anaesthetic agent
None of these possibilities have been explored in the news. What this story does of course is add to the general fear cascade around 'birth' in western culture. The 'problem' in this story is not with labour, it is with the intervention, the epidural administration. The problem needs to be attributed to where it rightfully belongs. Where most of the problems with birth lie is with the interventions that are 'done to' birthing women. Instead of providing every childbearing woman with one to one midwifery care that enables a woman to feel valued and cared about, work through her feelings about becoming a mother and then supported to give birth in her unique way, according to her own body biorythms, women are fed a steady diet of fear and problems, anaesthetised, poked, prodded and pushed. The way that the normal natural process of birth is tampered with is what leads to the problems that women experience.
Fear is a powerful force for shaping women's experiences of birth. The trouble lies in our cultural conditioning and media portrayals of birth. Fear makes us compliant and anxious. Instead of women perceiving the birth of their babies as something special and transformational, they are encouraged to rush to take 'whatever' modern medicine provides for deadening the feelings associated with the experience.
Unfortunately the 'cure' can often be far worse than the experience itself.
This story should have read " Mother, baby revived after 'dying' post epidural"
Sunday, 3 January 2010
EWG Minority Cord Blood Report Executive Summary | Environmental Working Group
A two-year study involving five independent research laboratories in the United States, Canada and the Netherlands has found up to 232 toxic chemicals in the umbilical cord blood of 10 babies from racial and ethnic minority groups. The findings constitute hard evidence that each child was exposed to a host of dangerous substances while still in its mother’s womb.
Government, academic and independent biomonitoring studies, including those by EWG, have detected up to 358 industrial chemicals, pesticides and pollutants in the cord blood of American infants. Exploring the so-called “additive” effects of possible carcinogens, hormone disrupters and neurotoxins is a new and urgent priority for environmental health scientists. EWG supports this very important work.
But as this science moves forward, we need to act now to reduce exposures that present the greatest health threats based on what we know today, even as scientists struggle to understand how the cocktail of chemicals in the womb could harm current and future generations.
Many of the up to 232 compounds detected in this study have been the target of regulatory action and government controls. As a rule, however, these actions came far too late, well after the environment and the human race were polluted to a degree that has raised serious health concerns. Our failure to act quickly has ensured that these chemicals will continue to pollute future generations for decades, even centuries to come.
EWG Minority Cord Blood Report Executive Summary | Environmental Working Group
Australia's maternity system like 'herding yards'
Mother Care: It's like herding yards
JULIA MEDEW
January 2, 2010
"Chronic shortages in Australia's maternity system have left mothers feeling like cattle being pushed through herding yards that put both their own and their babies' lives at risk.
A survey of 2792 mothers by Fairfax Media found that about half of those who had given birth in the past five years believed the maternity system was not coping well enough with soaring demand".
''There should be more continuity of care. Knowing your carer and trusting your carer removes the fear from childbirth and fear leads to more interventions.''
WHAT MOTHERS SAY
''There is a severe shortage of birth centre places available and in many areas it is not even an option.''
''There are so many time limits imposed on women which completely disregard the natural progression of labour in women's bodies. Doctors are too quick to intervene, too impatient to wait and allow the body to do its job.''
Chronic shortages in Australia's maternity system
A child is born
One to one midwifery care puts the woman at the centre of care and ensures that she feels valued, listened to and cared about. Nicola Roxon needs to listen to what women want and ensure that private midwifery is a viable option for those women who want individualised maternity care. The move to publically funded midwifery models of care is a welcome move, however, those models are unable to provide what a private midwife can provide and all models are needed to meet the individual needs of Australian women.
Solution to killer superbug found in Norway
The World Health Organization says antibiotic resistance is one of the leading public health threats on the planet. A six-month investigation by The Associated Press found overuse and misuse of medicines has led to mutations in once curable diseases like tuberculosis and malaria, making them harder and in some cases impossible to treat.
Antibiotic use in most western countries is widespread. Antibiotics are given as first line of treatment for just about anything you like to mention. In maternity care, antibiotics are poured into pregnant women who test positive for Group B Streptococcus on vaginal swabs and those pregnant and labouring women whose 'waters' (membranes) have been 'broken' for longer than 18 hours. Antibiotics are used as a cure all, even when there is nothing that can be cured by them, even though antibiotic resistence is rising and even though antibiotic use is associated with long term problems for the infant.
However, Norway has taken a radical approach to antibiotic use. Norweigans have stopped pushing antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA), a virulent killer in most hospitals in the west, has been controlled in Norway because Norweigans take less antibiotics.
"Penicillin is not a cough medicine," says the tissue packet on the desk of Norway's MRSA control director, Dr. Petter Elstrom.
"Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Dr John Birger Haug, the infectious disease specialist. And because Norwegian doctors prescribe fewer antibiotics than any other country, people do not have a chance to develop resistance to them.
According to a press release on December 31 st 2009 by Associated Press Writers, MARTHA MENDOZA and MARGIE MASON, Aker University Hospital's pharmacy does not stock the newest, most expensive antibiotics, because as Dr Haug says "because if we have them here, doctors will use them."
I've noticed that doctors, at least in places I've worked, are frightened not to prescribe antibiotics for fear of being sued if 'something goes wrong'. Fear of litigation is a huge issue in our country and common sense goes out the window when this fear is activated. The mantra in mainstream medicine, at least, for those involved with the care of birthing women is the more you do, the safer you are, however, the safety factor is about being protected from litigation NOT what is best for the woman and her baby.
Group B streptococcus (GBS) management is a perfect example of how fear of litigation overtakes common sense. In Norway, women who test postitive for GBS in pregnancy are offered a Chlorhexidine solution vaginal douche in early labour and every six hours to minimise the potential risk of GBS transmission to the fetus/newborn. The use of this douche is dismissed as unscientific in Australia because doctors prefer the 'security' associated with IV administration of antibiotics.
Thank goodness some doctors and health services are more open minded. At John Hunter Hospital, Newcastle, NSW, where routine screening of all pregnant women at 34-36 weeks for GBS colonisation is recommended, while women are advised that antibiotics in labour are the preferred option, they are informed about Chlorhexidine douche. The policy of providing chlorhexidine douche as an option for GBS prophylaxis came about following the visit of a Norweigan Obstetrician who explained their successful approach to GBS management.
When women are given the information about GBS colonisation and risks of infection and a choice of having an IV cannula in their arm and IV antibioitics or a self administered vaginal douche as a prophylaxis for GBS infection, the overwhelming majority of women choose the douche.
Despite the misgivings of the paediatric and some obstetric staff, no baby whose mother has used Chlorhexidine vaginal douche for GBS prophylaxis has been infected with GBS in four years.
Chlorhexidine vaginal douche as prophylaxis for GBS colonisiation is a cheap, easy, benign and effective solution (no pun intended) to the rampant use of antibiotics, and all the long term iatrogenic sequelae, in pregnant and labouring women. The use of a chlorhexidine douche for this common condition will not only be safer for babies long term health, it will help contain antibiotic resistence, ensuring that antibiotics will be effective if ever a person truly needed them.
Solution to killer superbug found in Norway
Antibiotic use in most western countries is widespread. Antibiotics are given as first line of treatment for just about anything you like to mention. In maternity care, antibiotics are poured into pregnant women who test positive for Group B Streptococcus on vaginal swabs and those pregnant and labouring women whose 'waters' (membranes) have been 'broken' for longer than 18 hours. Antibiotics are used as a cure all, even when there is nothing that can be cured by them, even though antibiotic resistence is rising and even though antibiotic use is associated with long term problems for the infant.
However, Norway has taken a radical approach to antibiotic use. Norweigans have stopped pushing antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA), a virulent killer in most hospitals in the west, has been controlled in Norway because Norweigans take less antibiotics.
"Penicillin is not a cough medicine," says the tissue packet on the desk of Norway's MRSA control director, Dr. Petter Elstrom.
"Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Dr John Birger Haug, the infectious disease specialist. And because Norwegian doctors prescribe fewer antibiotics than any other country, people do not have a chance to develop resistance to them.
According to a press release on December 31 st 2009 by Associated Press Writers, MARTHA MENDOZA and MARGIE MASON, Aker University Hospital's pharmacy does not stock the newest, most expensive antibiotics, because as Dr Haug says "because if we have them here, doctors will use them."
I've noticed that doctors, at least in places I've worked, are frightened not to prescribe antibiotics for fear of being sued if 'something goes wrong'. Fear of litigation is a huge issue in our country and common sense goes out the window when this fear is activated. The mantra in mainstream medicine, at least, for those involved with the care of birthing women is the more you do, the safer you are, however, the safety factor is about being protected from litigation NOT what is best for the woman and her baby.
Group B streptococcus (GBS) management is a perfect example of how fear of litigation overtakes common sense. In Norway, women who test postitive for GBS in pregnancy are offered a Chlorhexidine solution vaginal douche in early labour and every six hours to minimise the potential risk of GBS transmission to the fetus/newborn. The use of this douche is dismissed as unscientific in Australia because doctors prefer the 'security' associated with IV administration of antibiotics.
Thank goodness some doctors and health services are more open minded. At John Hunter Hospital, Newcastle, NSW, where routine screening of all pregnant women at 34-36 weeks for GBS colonisation is recommended, while women are advised that antibiotics in labour are the preferred option, they are informed about Chlorhexidine douche. The policy of providing chlorhexidine douche as an option for GBS prophylaxis came about following the visit of a Norweigan Obstetrician who explained their successful approach to GBS management.
When women are given the information about GBS colonisation and risks of infection and a choice of having an IV cannula in their arm and IV antibioitics or a self administered vaginal douche as a prophylaxis for GBS infection, the overwhelming majority of women choose the douche.
Despite the misgivings of the paediatric and some obstetric staff, no baby whose mother has used Chlorhexidine vaginal douche for GBS prophylaxis has been infected with GBS in four years.
Chlorhexidine vaginal douche as prophylaxis for GBS colonisiation is a cheap, easy, benign and effective solution (no pun intended) to the rampant use of antibiotics, and all the long term iatrogenic sequelae, in pregnant and labouring women. The use of a chlorhexidine douche for this common condition will not only be safer for babies long term health, it will help contain antibiotic resistence, ensuring that antibiotics will be effective if ever a person truly needed them.
Solution to killer superbug found in Norway
Wednesday, 23 December 2009
Home-birth boost for expectant mothers
Hospital provided homebirth pilot project
Those of you old enough to remember will remember the fanfare and Commonwealth money dished out to fund midwifery model of care pilot programs following the Shearman report in the late 80's. Many programs were funded in the early 90's. As soon as the money ran out, however, those models fell over and childbearing women across the country were left high and dry, with no midwifery service. The only model to survive those halcyon days was the Community Midwifery practice in Perth, Western Australia. The only reason that model continued was because the state government at the time agreed to fund it.
Time will tell if this is a Wizard of Oz or Emperor's New Clothes situation or not. The government may be sincere in wanting women to have true choice, however true choice means equity for all health professionals, not just those with the most money and the most power.
A disturbing aspect to this pilot project is that the government is hoping that private midwives will want to work in the program and become state funded employees. While that sounds good on the surface, the reality is that along with state funding comes state rules and regulations which is where the problems start for some people. Midwives who work privately do so because they want to work in their full scope of practice and be 'there' for those women who request their services. That means being on call for those women. With state run services there are rules about how many days you can work, how many hours you can work, who you can work with and how you do your work. Depending upon how the project is structured, women may or may not know who will attend them for their birth; they may not know the midwife on the other end of the phone when they ring in labour. Those rules and regulations are designed to protect the institution. Because the rules and regulations are designed for institutional needs, not the birthing woman's needs, they end up creating a 'cookie cutter' approach to maternity care work. A birthing woman does not necessarily fit neatly into a proscribed pattern of care provision. Privately practising midwives I know choose to work as a contracted employee of the woman, within their scope of practice and according to their professional requirements, not contracted by the state to have their working schedule dictated by rules and regulations for government purposes. Private midwives primary focus is on the woman and what her needs and desires for the birth of her baby were. Serving two masters never works.
An article which explored the ethics of caring for nurses in the health care system identified three ways that nurses align themselves. The first way is aligned with the institution, the second, aligned with doctors and the third, aligned with 'patients'. Midwifery ethics, as described by Fay Thompson, are clearly 'with woman'. While some privately practising midwives may be interested in working in state run institutions, others are not going to be interested in working for the state.
Apart from the right to work in way that is aligned with one's ethical and professional values, our profession needs privately practising midwives. Midwives in private practice demonstrate what midwifery care is at its essence and provides an inspirational role model for future midwives. Midwifery knowledge and wisdom, which has, in institutionalised maternity care, been subsumed under the technocratic approach to childbirth of the medical model, is held and passed on by privately practising midwives.
To sum up, this pilot study is welcomed, but this year long program, even if it continues, does not take the place of ensuring there are robust structures in place for the continuation and support of private midwifery and a woman's choice to birth with someone she knows and trusts.
Home-birth boost for expectant mothers
JULIA MEDEWThe provision of state funded homebirth services is a welcome sign of change in attitude towards the normality of birth, at least in the eyes of politicians and health care service bureaucrats. However, this pilot scheme is funded for one year. What happens after that is anyone's guess. The skeptic in me is suspicious that this 'offer' is to mollify the insurgents and designed to keep people quiet. Given the groundswell of support from the community for privately practising midwives to provide homebirth services for women who want to birth at home, that is a reasonable suspicion.
December 23, 2009VICTORIAN women will be able to give birth at home - with hospital back-up for the first time - under a pilot project starting at three hospitals next year.
Health Minister Daniel Andrews said yesterday that the State Government had allocated $400,000 for midwife-led home births through Casey Hospital in Berwick and Sunshine Hospital in Melbourne's west. A regional health service will also participate, but the Government has yet to decide which one.
Those of you old enough to remember will remember the fanfare and Commonwealth money dished out to fund midwifery model of care pilot programs following the Shearman report in the late 80's. Many programs were funded in the early 90's. As soon as the money ran out, however, those models fell over and childbearing women across the country were left high and dry, with no midwifery service. The only model to survive those halcyon days was the Community Midwifery practice in Perth, Western Australia. The only reason that model continued was because the state government at the time agreed to fund it.
Time will tell if this is a Wizard of Oz or Emperor's New Clothes situation or not. The government may be sincere in wanting women to have true choice, however true choice means equity for all health professionals, not just those with the most money and the most power.
A disturbing aspect to this pilot project is that the government is hoping that private midwives will want to work in the program and become state funded employees. While that sounds good on the surface, the reality is that along with state funding comes state rules and regulations which is where the problems start for some people. Midwives who work privately do so because they want to work in their full scope of practice and be 'there' for those women who request their services. That means being on call for those women. With state run services there are rules about how many days you can work, how many hours you can work, who you can work with and how you do your work. Depending upon how the project is structured, women may or may not know who will attend them for their birth; they may not know the midwife on the other end of the phone when they ring in labour. Those rules and regulations are designed to protect the institution. Because the rules and regulations are designed for institutional needs, not the birthing woman's needs, they end up creating a 'cookie cutter' approach to maternity care work. A birthing woman does not necessarily fit neatly into a proscribed pattern of care provision. Privately practising midwives I know choose to work as a contracted employee of the woman, within their scope of practice and according to their professional requirements, not contracted by the state to have their working schedule dictated by rules and regulations for government purposes. Private midwives primary focus is on the woman and what her needs and desires for the birth of her baby were. Serving two masters never works.
An article which explored the ethics of caring for nurses in the health care system identified three ways that nurses align themselves. The first way is aligned with the institution, the second, aligned with doctors and the third, aligned with 'patients'. Midwifery ethics, as described by Fay Thompson, are clearly 'with woman'. While some privately practising midwives may be interested in working in state run institutions, others are not going to be interested in working for the state.
Apart from the right to work in way that is aligned with one's ethical and professional values, our profession needs privately practising midwives. Midwives in private practice demonstrate what midwifery care is at its essence and provides an inspirational role model for future midwives. Midwifery knowledge and wisdom, which has, in institutionalised maternity care, been subsumed under the technocratic approach to childbirth of the medical model, is held and passed on by privately practising midwives.
To sum up, this pilot study is welcomed, but this year long program, even if it continues, does not take the place of ensuring there are robust structures in place for the continuation and support of private midwifery and a woman's choice to birth with someone she knows and trusts.
Home-birth boost for expectant mothers
Tuesday, 22 December 2009
Social construction of Childbirth - how the media works
A new film called "Labouring under an Illusion" shows the way that childbirth is portrayed in the media. The film makers juxapose the often comical, always fear inducing media perspective with normal, healthy, calm birth footage. The presentation of the two points of view provides an excellent reality check.
Here's the trailer for the video
Vicki Elson, a childbirth educator, explains her motivation for making the film during an interview with
"I was doing a workshop for nurse-midwives at a local hospital when a particularly ghastly and unrealistic (and Emmy-winning) episode of “E.R.” came out. The midwives said their phones were ringing off the hooks because moms were scared that they could die like the lady on TV. Meanwhile, Murphy Brown was America’s liberated TV mom who could anchor the news and stand up to Dan Quayle. But in labor, she was wilted and powerless, except when she was strangling men by their neckties. I wanted my kids and their friends to grow up with realistic, nourishing imagery about the power of their bodies to do normal things like have babies. I was working with midwives Rahima Baldwin Dancy and Catherine Stone on a workshop called “Empowering Women in the Childbearing Year,” and we started collecting clips to show childbirth educators what they were up against from the culture. It’s still a struggle to compete with compelling but unrealistic imagery that sticks in people’s minds. I expanded on that project to write my master’s thesis 10 years ago, and when the kids grew up I finally got around to updating the project and putting it on DVD so it’s more useful and accessible.”
Well done Vicki! Resources like this are essential to counter the negative publicity that childbirth is subject to. For more information on the video or to order a copy, visit Birth-Media.com.
Amy Romano on Science and Sensibility blog has an excellent post on Childbirth Literacy that includes this video trailer and information. http://www.scienceandsensibility.org/
Breastfeeding is Normal
The women who made this video said:
"The purpose of our video is to encourage mothers to feed their child, no matter where they are! And to give encouragement to new and expecting mothers that breast is best, and nursing IS normal".
YouTube - NIN CHARLOTTE
"The purpose of our video is to encourage mothers to feed their child, no matter where they are! And to give encouragement to new and expecting mothers that breast is best, and nursing IS normal".
YouTube - NIN CHARLOTTE
Midwifery-led maternity care safe
HSE.ie - Health Service Executive Website - Presentation of the “MidU” study – a major trial comparing midwifery-led and consultant-led maternity care
"The 'MidU' ('Midwifery Unit') study showed that midwifery-led care, as practised in these units, is as safe as consultant-led care but uses less intervention in pregnancy and childbirth".
What's interesting is that the report says midwifery care is as safe as consultant care. My reading of the statistics means that midwifery care is safer than consultant care for that group of women.
"The 'MidU' ('Midwifery Unit') study showed that midwifery-led care, as practised in these units, is as safe as consultant-led care but uses less intervention in pregnancy and childbirth".
What's interesting is that the report says midwifery care is as safe as consultant care. My reading of the statistics means that midwifery care is safer than consultant care for that group of women.
Honoring Embodied Wisdom
I was exploring the peaceful birth project's wall (http://www.thepeacefulbirthproject.com/) on Facebook and came across the article about perineal integrity from Midwifery Today 2005.
Honoring Body Wisdom - by Pamela Hines-Powell
Pamela has some wonderful insights including:
"... there are very few things I personally can do to really prevent tearing in a client, but there are a whole host of situations and instances where I could actually create an environment for perineal tearing".
Our role as midwives is to create the environment where a woman can find her own way, get in touch with her inner power, her inner intelligence and innate guidance system. A woman can find her own way when there is an atmosphere of loving, capacity building trust in the process of birth and the woman's ability that the midwife engenders by having a mindful approach to her role in creating that environment. A mindful approach for the midwife involves awareness of and congruency in her intention, focus, thinking patterns, body language, movement and words. A midwife's mindful approach also includes attention to those aspects of the woman she is working with. Such an environment optimises a woman's birthing psychophysiology. A woman's optimal birthing psychophysiology means her mind, body and spirit are in harmony, her brainwave patterns are in gamma, alpha, theta and delta wavebands (known as a 'flow' state) a relaxed, focussed mode; her brain's attentional networks are focused on her baby and her baby's impending birth; the woman is able to let go of her orienting and alerting brain networks with their beta brain waves. When a woman is able to be in that biobehavioural state, genetic switches are flipped to parasympathetic mode; oxytocin and endorphins flow and the woman is able to respond instinctively to her body cues; labour progresses and birth happens.
Pamela asks a really good question: "As midwives, are we finding ways to support women's instinctive behaviors or do we undermine their instincts by directing them?"
How we look, how we move, everything we do and say has an effect on the labouring woman.
Pamela writes:
"The birthing woman is highly susceptible to suggestion—even if very subtle. For instance, a midwife lays a chux pad on the bed. The message received is "sit here"—many women will follow the placement of the chux and reside wherever it is placed, even if there is no spoken direction by the provider. However, left to her own devices, a woman will rarely lie down to push her baby out".
There is so much wisdom in that information. The first job for a midwife on the learning curve of being 'with woman' is to understand and integrate that truth into their practice.
I'm reminded of the words of the wonderful Nicky Leap, a brilliant midwife. Nicky said "the less we do, the more we give". That 'doing less' has to come from a position of trust in birth, trust in women's innate capacity to give birth well as well as being mindful of what is happening with that woman, her baby and the labour process. 'Doing less' is not about being lazy or lassez faire about women and birth. Doing less, is actively mindful, fully present and conscious in the moment, actively aware of the ebb and flow of labour and birth; being a source of feedback for the woman when required; subtly monitoring the woman, her baby and her experience; ready to support adjustment if needed. 'Giving more' in this context means that a woman who is supported to be instinctive feels powerful, her capacity is strengthened, she emerges from labour and birth feeling amazing. Barbara Katz Rothman says that birth is about building strong, capable mothers as well as welcoming new life into the world.
As midwives, we can create a safe, nurturing, protective environment where a woman can express her individuality, her innate wisdom and feel free to make the changes needed in becoming a mother. We can provide a supportive environment within which a woman can empower herself, find her innate power and utilise it; we can't empower her. We can however, disempower. We can 'pull the rug' from underneath a woman, destabilising her so she doubts herself and loses her confidence.
Pamela's question is a good one. We can extend that question and ask ourselves "am I creating an environment where a woman feels safe to be herself and does she feel better about herself when she leaves my presence?" We need to ask ourselves that frequently. We need to ask the women we work with for feedback about that too.
Honoring Body Wisdom - by Pamela Hines-Powell
Pamela has some wonderful insights including:
"... there are very few things I personally can do to really prevent tearing in a client, but there are a whole host of situations and instances where I could actually create an environment for perineal tearing".
Our role as midwives is to create the environment where a woman can find her own way, get in touch with her inner power, her inner intelligence and innate guidance system. A woman can find her own way when there is an atmosphere of loving, capacity building trust in the process of birth and the woman's ability that the midwife engenders by having a mindful approach to her role in creating that environment. A mindful approach for the midwife involves awareness of and congruency in her intention, focus, thinking patterns, body language, movement and words. A midwife's mindful approach also includes attention to those aspects of the woman she is working with. Such an environment optimises a woman's birthing psychophysiology. A woman's optimal birthing psychophysiology means her mind, body and spirit are in harmony, her brainwave patterns are in gamma, alpha, theta and delta wavebands (known as a 'flow' state) a relaxed, focussed mode; her brain's attentional networks are focused on her baby and her baby's impending birth; the woman is able to let go of her orienting and alerting brain networks with their beta brain waves. When a woman is able to be in that biobehavioural state, genetic switches are flipped to parasympathetic mode; oxytocin and endorphins flow and the woman is able to respond instinctively to her body cues; labour progresses and birth happens.
Pamela asks a really good question: "As midwives, are we finding ways to support women's instinctive behaviors or do we undermine their instincts by directing them?"
How we look, how we move, everything we do and say has an effect on the labouring woman.
Pamela writes:
"The birthing woman is highly susceptible to suggestion—even if very subtle. For instance, a midwife lays a chux pad on the bed. The message received is "sit here"—many women will follow the placement of the chux and reside wherever it is placed, even if there is no spoken direction by the provider. However, left to her own devices, a woman will rarely lie down to push her baby out".
There is so much wisdom in that information. The first job for a midwife on the learning curve of being 'with woman' is to understand and integrate that truth into their practice.
I'm reminded of the words of the wonderful Nicky Leap, a brilliant midwife. Nicky said "the less we do, the more we give". That 'doing less' has to come from a position of trust in birth, trust in women's innate capacity to give birth well as well as being mindful of what is happening with that woman, her baby and the labour process. 'Doing less' is not about being lazy or lassez faire about women and birth. Doing less, is actively mindful, fully present and conscious in the moment, actively aware of the ebb and flow of labour and birth; being a source of feedback for the woman when required; subtly monitoring the woman, her baby and her experience; ready to support adjustment if needed. 'Giving more' in this context means that a woman who is supported to be instinctive feels powerful, her capacity is strengthened, she emerges from labour and birth feeling amazing. Barbara Katz Rothman says that birth is about building strong, capable mothers as well as welcoming new life into the world.
As midwives, we can create a safe, nurturing, protective environment where a woman can express her individuality, her innate wisdom and feel free to make the changes needed in becoming a mother. We can provide a supportive environment within which a woman can empower herself, find her innate power and utilise it; we can't empower her. We can however, disempower. We can 'pull the rug' from underneath a woman, destabilising her so she doubts herself and loses her confidence.
Pamela's question is a good one. We can extend that question and ask ourselves "am I creating an environment where a woman feels safe to be herself and does she feel better about herself when she leaves my presence?" We need to ask ourselves that frequently. We need to ask the women we work with for feedback about that too.
Sunday, 20 December 2009
Mothers held to ransom as breast milk sharks charge $1000 | The Courier-Mail
December 20, 2009 12:00am
A BLACK market in breast milk has developed in Australia as families desperate to feed their babies the natural elixir are being charged up to $1000 a litre on the internet.
Mothers held to ransom as breast milk sharks charge $1000 | The Courier-MailThe news comes after The Sunday Mail revealed last week that the Gold Coast milk bank – which receives no government funding – may have to close in February if it doesn't raise $50,000 through donations or sponsorship to cover the cost of its pasteurisation unit.
RMIT (Royal Melbourne Institute of Technology) lactation expert Dr Jennifer James said she was aware of the growing unregulated black market.
"It is very dangerous because in an unregulated fashion there are no checks and balances, the milk would not have been tested for viruses and bacteria," Dr James said.
"Women are being put in this insidious position because of a lack of breast milk banks nationally.
"They have no option but to look outside the system."
The risky practice has increased with the advent of the internet where women advertise their milk for sale".
Midwifery takes a northern look: UofA program supports Nunavit women to birth at home
U of A program supports Nunavit women to birth at home
"A healthy community has to be one where women can give birth," said O'Brien, who has been travelling to Nunavut for three years to speak with traditional midwives, most in their 80s. They share stories of feeding the best cut of meats to expectant mothers and delivering babies in ice houses, or tents made of furs. That history is informing the new midwifery program"
The aim of the program is to train midwives locally so more Nunavut mothers can give birth in their home communities.
Kango, a traditional midwife who learned her skills from her mother-in-law, sister-in-law and other northern elders, is now sharing her knowledge through Nunavut's first midwifery training program.
"Before colonization", Kango said "there were no doctors or nurses in Nunavut, so men and women stepped forward to be midwives. But in the 1960s and '70s, when western medicine arrived full force, mothers had to leave their homes, husbands and children six to seven months before their delivery to give birth in distant hospitals".
"With this kind of method of hospitals to send the mother out without husband or parents to attend, it was hard for the mother," Kango said. "With increased stressed, they would smoke more, lose their appetite and lose interest in looking after themselves. Oftentimes, health professionals couldn't speak any Inuit languages, leaving the women isolated in pain".
Midwifery takes a northern look
More women choose do-it-yourself births - Pregnancy- msnbc.com
By Linda Carroll
msnbc.com contributor
updated 1:05 p.m. ET Dec. 6, 2009
"Jennifer Margulis thinks birth should be a private party — no doctors or midwives invited. So when her daughter Leone Francesca was born at home last month, only Margulis and her husband, James, were in attendance.
“My husband and I were the only ones there when she was conceived,” says the 40-year-old writer from Ashland, Ore. “I thought we should be the only ones there when she was born.”
Margulis is part of a very small but growing number of women who are choosing to deliver their babies at home without the presence of health professionals. Some choose to have a husband or another family member help, while others opt to deliver their babies completely on their own."
Jennifer Margulis, 40, of Ashland, Ore., gave birth to her daughter Leone Francesca at home Nov. 4 without medical or midwifery help.
I can understand why women would choose to birth on their own or with their loved ones in this modern climate around birth. These women are telling us in the health care industry that they are not happy with what we are doing. If we want to have a place at birth with intelligent, self aware women who understand the process and feel comfortable with their bodies then we have to pay attention to what they want.
I personally love it when I am redundant at birth. When the women are fully present and aware and confident. They manage their labours beautifully, they breathe their babies and their placentas out easily; they and their babies are well and healthy. When I've sat on my hands and enjoyed the process and the woman's sense of self mastery, that's my idea of a good days/nights' work.
Unattended births can be problematic, that's true. So can attended births. The issue, no matter where or with whom women chose to give birth, is how does the woman feel, what does she know, is she well nourished, does she love her partner and how is their relationship, how confident is she in herself and what else is going on?
For women in developing countries it is often a very different situation. The problems for birthing women in developing countries are multifactorial. These women are usually anaemic, have no birth control and therefore too many babies already, they are tired and poorly nourished. They usually work too hard and don't have any support of any kind. These women often don't have the stamina and energetic resources to stay mindful and present to the birthing process to keep safe.
Let's listen to women, find out what they want. Rather than seeking to undermine their confidence to get compliance with our agendas, let's listen and change what we are doing to be more likely to be invited to be part of the most amazing experience on earth.
More women choose do-it-yourself births - Pregnancy- msnbc.com
Saturday, 19 December 2009
Ina May Awarded Honorary Doctorate « Ina May Gaskin
Ina May Awarded Honorary Doctorate « Ina May Gaskin
Ina May's blog tells us that:
"LONDON—Ina May Gaskin, of Summertown, Tennessee, was awarded the title “Honorary Doctor” by the Thames Valley University, London, England, on November 24, 2009. The award was presented by the faculty of the Health and Human Sciences division of the University in recognition of her work in demonstrating through midwifery and natural childbirth that women’s bodies still work as they were designed. Gaskin accepted the award in the Grand Auditorium of Wembley Stadium before an audience of 600.
I came across Spiritual Midwifery when it was released in the 70's. I can't remember how I found out about the book. But I do remember how much the book affected me and my practice. I adored the book and was radicalised by the ideas in it. I carried it everywhere. In the early 80's, I was working on night duty as the relief night manager in a maternity unit. I left the book on the labour ward desk when I did a 'round' of the wards. One of the older obstetricians, known for his difficult and pedantic manner, passed me with his nose deliberately 'up in the air' and said, glancing at me with a twinkle in his eyes "I'm off to do a spiritual caesarean!". I knew he'd been reading my book in the labour ward. I thought to myself that could only be a good thing.
I loved Ina May's gentle loving approach to women and birth. I loved the common sense, practical way she worked with women and incorporated men into the birthing process. Ina May has been the shining light for keeping birth normal and helping midwives to reclaim their place with women. The stories of the Farm midwives and the women's experiences of birth fueled my desire to work one on one with women. I credit Ina May with being a big reason why I finally took the plunge into private midwifery practice with Maralyn Fourer (ex Rowley), together gaining visiting rights in public hospitals at a time when midwives didn't do such a thing. Ina May's Guide to Childbirth is another classic and I find that women today really value this book for the calm, sensible, affirmative approach it takes.
Sincere congratulations to Ina May for her forward thinking, beautifully expressed, deeply held trust in women and their birthing process. You are a legend and you deserve this honour. Thanks for being my mentor (even though you don't know you were/are).
Ina May's blog tells us that:
"LONDON—Ina May Gaskin, of Summertown, Tennessee, was awarded the title “Honorary Doctor” by the Thames Valley University, London, England, on November 24, 2009. The award was presented by the faculty of the Health and Human Sciences division of the University in recognition of her work in demonstrating through midwifery and natural childbirth that women’s bodies still work as they were designed. Gaskin accepted the award in the Grand Auditorium of Wembley Stadium before an audience of 600.
Gaskin, who will turn 70 in March, thanked her mother for not scaring her about childbirth; Dr. Grantly Dick-Read (author of the classic Childbirth Without Fear); her high school biology teacher for teaching her to keep an open mind; her husband, Stephen Gaskin, for allowing 270 young people to accompany him on a lecture tour in the winter of 1970-71; and several physicians for mentoring her during the early years of her career as midwife.
Gaskin also thanked “the little Capuchin monkey who, in 1970, held my hand with an electrifying touch, thereby teaching me in an instant that I could also have touch that powerful if I lived as much in the moment as she did.”
I came across Spiritual Midwifery when it was released in the 70's. I can't remember how I found out about the book. But I do remember how much the book affected me and my practice. I adored the book and was radicalised by the ideas in it. I carried it everywhere. In the early 80's, I was working on night duty as the relief night manager in a maternity unit. I left the book on the labour ward desk when I did a 'round' of the wards. One of the older obstetricians, known for his difficult and pedantic manner, passed me with his nose deliberately 'up in the air' and said, glancing at me with a twinkle in his eyes "I'm off to do a spiritual caesarean!". I knew he'd been reading my book in the labour ward. I thought to myself that could only be a good thing.
I loved Ina May's gentle loving approach to women and birth. I loved the common sense, practical way she worked with women and incorporated men into the birthing process. Ina May has been the shining light for keeping birth normal and helping midwives to reclaim their place with women. The stories of the Farm midwives and the women's experiences of birth fueled my desire to work one on one with women. I credit Ina May with being a big reason why I finally took the plunge into private midwifery practice with Maralyn Fourer (ex Rowley), together gaining visiting rights in public hospitals at a time when midwives didn't do such a thing. Ina May's Guide to Childbirth is another classic and I find that women today really value this book for the calm, sensible, affirmative approach it takes.
Sincere congratulations to Ina May for her forward thinking, beautifully expressed, deeply held trust in women and their birthing process. You are a legend and you deserve this honour. Thanks for being my mentor (even though you don't know you were/are).
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