24 Hour Virtual International Day of the Midwife Conference

An exciting event has been planned to celebrate International Day of the Midwife. Dr Deborah Davis from the University of Technology (UTS) in Sydney and Sarah Stewart Otago Polytechnic Education Development Centre in NZ have planned and coordinated a fabulous, innovative virtual conference.

 

International Midwives Day Virtual Conference

Presentations, discussions, chat room and webpage discussions, videos and podcasts are all planned to occur on the day.

Conference program

You can have a look at last year's event and explore the presentations there to get a sense of what you can expect this year.

You will learn all about working with a Wiki which is a website where people can create and edit pages about topics/areas that interest them together. Links can be made to resources and further pages.  People can work cooperatively on policy and guidelines development, research and networking on a Wiki. The 24 hour virtual International Day of the Midwife Celebration and Conference is all on a Wiki, with links to events, tools, videos and podcasts provided within the Wiki.

Going to conferences is always fun. I love them, but geography, finances and time zones prevent many midwives meeting on an international level. Online resources and tools such as Second Life, Elluminate and Skype overcome those limitations and enable midwives to meet, communicate, share information and resources in a far more flexible way than face-to-face meetings. This 24 hour virtual celebration of midwifery is a means of providing us with an opportunity to meet at some stage during the day either 'live' in real time meetings or at recorded events at a time that suits us individually.

Elluminate is a virtual meeting room. You can listen, watch, interact in the Elluminate meeting room. You will need to get familiar with Elluminate before the sessions you want to take part in. Sarah Stewart has kindly offered to take you through Elluminate and show you how it functions. Contact Sarah to book a time to do so if you would like that help. I'm certainly going to take her up on her generous offer.

Revamping the Blog

I've had a such a great time tonight, working with Sarah Stewart, the queen of using social media for updating about midwifery and education. Sarah has been wonderful, coaching me on getting the twitter link, the 24 hour virtual International day of the midwife link and putting the tags of my posts on the page.

Sarah's blog is well worth exploring as there are some great tips for anyone who wants to use this medium to get their message across. Sarah Stewart's blog  Sarah also has some timely advice for those of us who use Facebook and Twitter in terms of our professional responsibilities.  I think you will find what she has to say very thought provoking and useful.

I would love your feedback about the new look and any other suggestions you may have for my blog.

Writing Birth: Rainbows in the heart and other matters of importance

When Vicki Chan of Better Birth Workshops put a quote by Carl Sandburg on Facebook, followed up by this beautiful poem (below) written by Sandburg on their discussion page, my thoughts turned to the way that artists and mothers write about birth. 

Being born is important.
You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her.
You who have seen the new wet child dried behind the ears,
swaddled in soft fresh garments,
pursing its lips and sending a groping mouth
toward the nipples where white milk is ready

You who have seen this love's payday of wild toil and sweet agonizing
You know being born is important.
You know nothing else was ever so important to you.
You understand the payday of love is so old,
So involved, so traced with the circles of the moon,
So cunning with the secrets of the salts of the blood
It must be older than the moon, older than the salt.

 

Carl Sandburg at 55 years of age

What an amazing poem and what an amazing man to write so eloquently about birth and how important birth is, not only to women, not only to babies, but all of us.

My thoughts then moved to "Harvest Day" a brilliant piece where writer and journalist, Anna Maria Dell'Oso explored her feelings and experiences about birth and mothering in a column for the Good Weekend Section of the Sydney Morning Herald newspaper. Anna Maria's column and others was published as a book called Cats, Cradles and Chamomile Tea in 1989. I highly recommend the book and in particular this chapter, for mothers, midwives, doulas, fathers, students, everyone.

Anna Maria wrote:

"Being with someone, murmuring along with their heartbeat, breathing with them is a lost art. The true midwives of birth and death, those who keep vigil at the bedposts are rare. They are people whose eyes are accustomed to darkness and light, who stand waiting by  night and by dawn, holding cloaks and soft wrappings at the cross roads and gateways; they stand at the threshold, at the breaking of the paths, watching the lights, the rain and the winds, welcoming and farewelling our journeying souls. The price of such people is above rubies. No machines that go ping can stand in their place. Yet so often that is all we have. Thank God it doesn't happen to me".

Poets and writers show us what's real, what's missing and what's possible. Their words and the images they evoke go straight to our heart and let us know if we are on track or need to change. They teach us if we are willing to listen and see with new eyes those things we adapt to and take for granted. 

A lovely quote by Sandburg, is to be found in engraved lengthwise horizontally in a finished split tree trunk in the lobby of Carl Sandburg Middle School, Neshaminy School District of lower Bucks County.

"MAN IS BORN WITH RAINBOWS IN HIS HEART AND YOU'LL NEVER READ HIM UNLESS YOU CONSIDER RAINBOWS"

As you would be aware, the word "man" was used at the time as the generic term for a human being. Carl Sandburg was obviously referring to all people when he wrote that statement. What does being born with rainbows in our hearts mean? What does it take to consider rainbows?  Our human spirit is ignored in what passes for maternity and newborn 'care' in this country and in most of the so called developed world. Indigenous people understand the rainbow in a person's heart, they consider rainbows and read each other well. 

What will make us wake up to the rainbows?

We are blessed to have the poets, artists and writers. They help us learn to consider rainbows and other signs of real life. They show us why birth is important when we have forgotten. 

Flashmob: Pregnant women breakdancing in London

"If you think this is dangerous, try giving birth in poor countries without a midwife,  hospitals or medicine. This flashmob is one of a series that is happening in Paris, Berlin..."  Oxfam

700,000 more midwives are needed globally. When a trained midwife is in attendance, a woman's chances of surviving childbirth dramatically increase.

Midwives create a clean environment for the delivery and deal with complications during birth. Midwives must be supported with decent, well-equipped hospitals nearby for emergency care.

Oxfam

Caesarean vs VBAC a dramatic difference

This is a very inspirational and moving video by Alexandra Orchard about her birth experiences.


Cesarean vs. VBAC:  A Dramatic Difference from Alexandra Orchard on Vimeo.


There are some very interesting comments on Alexandra's page. Click this link or cut and paste into your browser.

http://vimeo.com/5648654

Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Having positive expectations is good for your immune system functioning and therefore good for your health.

"These results provide the first evidence that changes in optimistic expectancies are accompanied by changes in immunity, as well as the first evidence for a mechanism by which this effect occurs. Changes in expectancies about law school predicted changes in cellular immune function, and this relationship could be partially accounted for by positive but not negative affect. The results support the validity of psychological interventions to improve immunity and health (e.g., Andersen et al., 2007) and suggest that efforts to correct irrationally pessimistic expectancies may be warranted, particularly if these efforts also increase positive affect".

Interestingly, the authors conclude:

"Although optimistic expectancies are associated with both increased positive affect and decreased negative affect, it may be as important for immunological health for people to be happy as it is for them to lack anxiety".

That song "Don't worry, be happy" was on the mark!

Of course, childbearing women do have 'worries' and their anxieties can be alleviated by having a midwife to journey through their experience with.  Midwives can provide a sounding board and provide information and a safe space where worries and fears can be explored; strategies for self management developed and worries dissipated.  In such a supportive environment, women's cell-mediated immunity is obviously improved, which would 'fit' with the reduced numbers of women experiencing pre-eclampsia, gestational diabetes and premature labour that is associated with 1-2-1 midwifery care.


Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Perception of effort, not muscle fatigue, limits endurance performance

"As recently as 2008, scientific research papers were citing the theory that endurance performance is limited by the capacity of the skeletal muscles, heart and lungs and that exhaustion occurs when the active muscles are unable to produce the force or power required by prolonged exercise.
Dr Sam Marcora, an exercise physiologist at Bangor University, has now disproved this for the first time and proposed an alternative - that it is your perception of effort that limits your endurance performance, not the actual capability of your muscles. He showed that the muscles were still able to achieve the power output required by endurance exercise even when the point of perceived exhaustion had been reached".

The idea that the perception of effort limits a person's endurance performance is relevant to any physical activity that requires endurance, not just the sporting arena.

For birthing women, their families and midwives, this information is very important. Perceptions around labour and birth are culturally constructed. Many women are apprehensive about giving birth because of the negativity they are subjected to on a daily basis from well meaning friends, associates and even total strangers. That apprehension that many women feel, coupled with also well meaning but negative, undermining comments when they are in labour, may lead many women to perceive that they are 'at the end of their tether' and unable to go on. Birthing physiology requires the woman to feel safe and loved to work optimally.

Many partners get frightened by the rawness and primal nature of labour and seek to make themselves feel better by sympathising/pitying and/or suggesting pain relief for the labouring woman. An example is regarding one of the couples, several years ago, who came back to an antenatal group to talk about their birth experience six weeks earlier. When they had told their story, the man said "I was so happy when she had the epidural, I couldn't stand it any longer".

Women do look to their partners and caregivers to check how they are 'doing' in labour. Women get feedback that way. Fear-filled or pitying faces trigger mirror neurons to create similar feelings in the women, disrupting their physiological functioning for birthing. Unless the woman's self talk is particularly strong and positively oriented, her mind will be filled with fearful reactive thoughts, further disrupting her birthing physiology.

On the other hand, in a similar way to what happens in sporting situations, when partners/family and midwives provide encouragement, words of praise, smiling faces and a firm belief in the woman's ability, women's self talk changes and they find the inner strength to continue, even getting a 'second wind' as the energy in the room picks up. That's where the analogy to sport ends because with birthing there is no competition. There is no one to beat. The wonder is that there is a beautiful baby and fabulous placenta to welcome into the world.

The recipe for enabling birth, as it is for any physically related endeavor requiring focus and endurance:

• believe you can 'do it'
• prepare yourself
• surround yourself with people who believe in you
• ask your partner/support people to say supportive messages and to smile at you in labour
• tell yourself that you 'can'
• do it

Perception of effort, not muscle fatigue, limits endurance performance

Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

The way that our physiology switches genes on or off in response to environmental circumstances/triggers/cues, a process now studied as 'epigenetics' or 'above the genes' is becoming increasingly understood. The way that stressors impact our lives, our genetic expression and our immune system is becoming more and more recognised and obvious as scientists seek to understand the role of the environment in disease profiles. The significance of the prenatal experience in setting the foundations for health and wellness or disease is now recognised as a reality for humans as well as other animal species.

What scientists are discovering as they study the role of the prenatal environment in health and disease, is that high levels of maternal stress during the prenatal period is associated with impaired immune modulation. This study gives further credence to the Barker hypothesis that the prenatal experience is programming the infant's physiology, including the immune system to respond to the environment it will be born into. In the case of children whose mothers experience chronic and high stress levels, they have immune systems that are more vulnerable and more highly triggered by adverse environmental factors.

"In the Urban Environment and Childhood Asthma Study, the investigators evaluated associations among prenatal maternal stress and cord blood mononuclear cell (CBMC) cytokine responses among 557 families in Boston; Baltimore, Maryland; New York City; St. Louis, Missouri, and other cities. Each child had a parent with history of asthma or allergy".

Cytokines are messenger molecules with a complex range of interweaving, intersecting pro inflammatory and anti inflammatory functions.

"This is the first study in humans to show that increased stress experienced during pregnancy in these urban, largely minority women, is associated with different patterns of cord blood cytokine production to various environmental stimuli, relative to babies born to lower-stressed mothers," lead author Rosalind Wright, MD, MPH, associate physician at Brigham and Women's Hospital in Boston, Massachusetts, said in a news release.

The obvious answer is take care of pregnant women. Reduce the environmental stressors that pregnant women have to negotiate on a day to day basis. Poverty, violence, poor nutrition, unwanted pregnancies, lack of preconceptual care, lack of meaningful, supportive care during pregnancy and birth etc are all environmental risk factors with huge implications for the health and wellbeing of mothers and their babies.

Midwifery care that is provided in a one to one relationship is very beneficial for helping a woman defuse her stress levels. As a woman feels safe with her midwife and as trust builds, discusses her fears, problems and life circumstances, emotional stress is releases and solution generating can begin. Our government needs to heed these studies and provide better care for pregnant women if they truly want better and healthier societies.



Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

Government sold out to the AMA

 "The new regulatory framework includes a request for midwives to form a collaborative relationship with doctors, requiring their sign-off to access Medicare insurance and pharmaceutical benefits"

This bit of legislation has put midwifery under the control of doctors and sold out women's choice to birth at home with her own midwife

 

and is it no wonder when our prime minister, the honourable kevin rudd, at the AMA's union dinner says:

"In particular, tonight I want to acknowledge the hard work of Andrew Pesce as President of the AMA. I've appreciated Andrew's input and his engagement with
the health reform agenda in the meetings that we have had together in recent weeks.

The Government and the AMA are both committed to tackling the long-term challenge of health reform, and we are both committed on the direction we need to take to tackle this challenge - in particular, on the need for stronger clinician leadership within our health system.

In July last year, the AMA told us about the sorts of things that they would like to see in health reform....

Andrew, we heard you."

Date: 10 March 2010
News Type: Speech
Title: Speech to the 2010 AMA Parliamentary Dinner


Senate passes controversial birth bill | Herald Sun

Miracle baby elephant makes public debut

Miracle baby elephant makes public debut

"Miller said the indications were the elephant would have no permanent problems despite being stuck in a position in the womb which experts considered would result in death to both mother and calf in the wild".

Interestingly, the mother gave birth alone, once everyone left her after the pronouncement that the baby elephant was dead in utero.  The experts do that shroud waving thing around birth quite a bit. Even with elephants. Just goes to show that experts are wrong across species. Mothers always know best

British fertility clinic raffling human egg

What do you think of this?

"A British fertility clinic said Sunday it was raffling off a human egg this week to promote its "baby profiling" service, which it insists is legal under UK law".

British fertility clinic raffling human egg

Private practice midwifery

I've been quiet on my blog for a couple of weeks. I've been thinking a lot.

Over the last two weeks, I have been contacted by more and more women wanting one to one midwifery care.

The  women who have contacted me include:
1. Women who live outside the boundary set by publicly funded homebirth services
2. Women who prefer to know their midwife and have one to one care, rather than take 'pot luck' on which midwife will be there at the birth
3. A woman having twins who is apprehensive about all the negativity around having twins and being 'routinely' done to -  you know, induction, epidural... etc. She wants a midwife to go to hospital with her because she doesn't trust the 'system'.
4. A woman who has had three births via caesarean and wants to birth normally.
5. A woman who has had two births via caesarean and wants to birth normally.

To me, this signifies a problem with the 'system' of maternity care in this country. Women's rights are still being ignored. The importance of birth and freedom of choice is still being ignored.

The mountain of research which demonstrates that pregnant women's emotional as well as physical needs must be met to enable optimal health and wellbeing of the mother and her baby is being ignored.

Now is the time to write to the government, the opposition and all your local members talking about these human rights issues. Write your letter. Send it by snail mail. I've been told that a letter from any person is seen as representative of 100 members of the community.  Google the various political parties and all the politicians and their addresses are easily found. Our lives are being over regulated and under serviced. Time for a change. Please make your voice heard.

Study finds genetic link between misery and death

Specifically, Cole analyzed transcription factor binding sequences in a gene called IL6, a molecule that is known to cause inflammation in the body and that contributes to cardiovascular disease, neurodegeneration and some types of cancer.

"The IL6 gene controls immune responses but can also serve as 'fertilizer' for cardiovascular disease and certain kinds of cancer," said Cole, who is also a member of UCLA's Jonsson Comprehensive Cancer Center and UCLA's Molecular Biology Institute. "Our studies were able to trace a biochemical pathway through which adverse life circumstances — fight-or-flight stress responses — can activate the IL6 gene.

Interleukin-6 (IL-6) is a protein that in humans is encoded by the IL6 gene.

IL-6 acts as both a pro-inflammatory and anti-inflammatory cytokine - an immune system messenger molecule. IL-6 is relevant to many disease processes such as diabetes, atherosclerosis, systemic lupus erythematosus, prostate cancer and rheumatoid arthritis. Advanced metastatic cancer patients have higher levels of IL6 in their blood.
Cytokines are regulatory signaling proteins, taking messages from cell to cell and influencing the behaviour and activity of the cells. Their pro-inflammatory behaviour is implicated in many of the processes that plague pregnant women, causing havoc for them and their babies.

This study is very exciting. Such clear linking of stress response and cytokine activation as described by these researchers is essentially providing more evidence that pregnant women need environments which are calm, relaxed, nurturing and supportive. Midwives are the obvious people to support, nurture and ensure calm and relaxed surroundings as they work with women to normalise their experiences of change on the journey to becoming a mother.

1. Kristiansen OP, Mandrup-Poulsen T (December 2005). "Interleukin-6 and diabetes: the good, the bad, or the indifferent?". Diabetes 54 Suppl 2: S114–24. PMID 16306329.
2. Dubiński A, Zdrojewicz Z (April 2007). "[The role of interleukin-6 in development and progression of atherosclerosis]" (in Polish). Pol. Merkur. Lekarski 22 (130): 291–4. PMID 17684929.
3. Tackey E, Lipsky PE, Illei GG (2004). "Rationale for interleukin-6 blockade in systemic lupus erythematosus". Lupus 13 (5): 339–43. PMID 15230289.
4. Smith PC, Hobisch A, Lin DL, Culig Z, Keller ET (March 2001). "Interleukin-6 and prostate cancer progression". Cytokine Growth Factor Rev. 12 (1): 33–40. PMID 11312117.
5. Nishimoto N (May 2006). "Interleukin-6 in rheumatoid arthritis". Curr Opin Rheumatol 18 (3): 277–81. doi:10.1097/01.bor.0000218949.19860.d1. PMID 16582692.
6. "Cancer Patients Typically Have Increased Interleukin-6 Levels". American Society of Clinical Oncology 2006 Annual Meeting, Abstracts 8632 and 8633. Medscape.com. 2006-06-26. http://www.medscape.com/viewarticle/537309.

Study finds genetic link between misery and death

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist

Fascinating read

Richard L. Doty is director of the University of Pennsylvania's Smell and Taste Center. His awards include the US National Institutes of Health's James A. Shannon award (1996), and the Association for Chemoreception Sciences' Max Mozell award for outstanding achievement in the chemical senses (2005). This essay is based on his book, The Great Pheromone Myth (Johns Hopkins University Press)

Richard Doty states:

"All in all, it looks as if "pheromonology" has become a modern-day phrenology, providing simple but false explanations for most chemically mediated social behaviours and endocrine responses, satisfying only those who seek simple answers to complex phenomena. Perhaps once the idea that mammals have pheromones is dispelled, we can work towards an appreciation of the real role chemicals play in their lives".

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist