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You're Invited to Midwifery Today's New Community Site

February 3rd, 2009 (11:41 am)

current mood: accomplished

You're Invited to Midwifery Today's New Community Site

I know a lot of you have been waiting for our forums to go back up. They went live yesterday afternoon, as part of our new Community Site, so please join us for a lot of good birth conversation!

Since the site also includes blogs, this will be my final post on LiveJournal. From now on you can read my blog here. The posts from LiveJournal will also be pulled into this blog.


Midwifery Today Covers - A Slide Show

February 3rd, 2009 (09:40 am)

Here is a lovely slide show of some of the more recent covers of Midwifery Today magazine.

Here's a link back to this post on LiveJournal in case you're viewing this someplace that doesn't show the slide show.


The Best Way to Keep Your Baby Warm

February 2nd, 2009 (07:22 am)

I just saw a piece in the New York Times last month that talked about Bulgaria being starved of Russian natural gas because the pipeline going to the Ukraine through Eastern Europe had been closed. The article included a photo of a newborn baby in a "warmer," with no heat. How about putting the baby with her mom where she belongs in the first place. How did the world get so ignorant of the obvious?

Motherbaby = Do not separate.

Jan Tritten
Midwifery Today

Midwifery in Uganda - Report from Marion Toepke McLean

January 31st, 2009 (01:38 pm)

Marion, who you read about in my previous blog post, has shared this little picture of Uganda with us and also a lovely birth story. Midwifery Today sent Marion with a Doppler which was the piece of equipment the midwives wanted most. -Jan

I'm greeting you from Soroti, Uganda, here on the high savannah. It has rained a bit lately and brightened things up, and I have been realizing what an incredibly beautiful, livable landscape this is! So green, such a variety of vegetation.

There have been maybe six births since I've been here, at the birth center, that is. We also do a lot of care for women who deliver in the villages, and in the hospital. I have attended two of the births. One very special woman, by the name of Ediso, had a bit of a harder labor than she has had with previous children. She is 38 and has three girls and a boy at home. (She says she's done!) Anyway, we went outside and sat in the shade for a long time. Not sharing a language, we just shared the time and the space, chickens and little piglets scuffling around the clinic compound.

Ediso hadn't eaten through the night, but I persuaded her to slowly chew a roll and drink a cup of tea. The way we make tea here is, put some dry tea leaves in a cup, add sugar, then pour steaming water out of a thermos. It's very good! Uganda produces a lot of tea, so it's very fresh. The way Ediso made her tea was to put about 1/4 tsp. of tea leaves in the cup and add about six tsp. of sugar! That was probably what gave her the energy to go on! She went inside and bathed, then we spent some more time out in the shade.

About 1 pm we went inside again. There is a shared maternity room with three single beds (one already occupied by the mother of a boy) and further inside, a small birthing room. Her contractions, which for a while were quite spaced out, were coming on strong. She made a couple little moans with the pains. Then she drew her legs apart just a bit, and I noticed the glistening waterbag peeping from the vulva. Things went fast from there. She birthed very spontaneously, just opened her legs and let the uterus do the pushing. The bag bulged more, broke, and the fluid was clear. The new doppler from Midwifery Today registered steady strong fetal heart tones, and some dark curly hair started to show. Within minutes, a strong, 3-1/2 kilo baby boy was born.

Here at the Safe Motherhood Clinic, we follow the WHO guidelines for active management of the third stage. This is because the mothers have low hemaglobins and, despite their big gardens and the bags of beans and rice that are given out on each prenatal visit, are somewhat malnourished. A hemaglobin of 9 or above is considered good. But we do give pitocin IM directly after the birth, and that's what I did with Ediso. Boy, do those placentas deliver neatly! Ediso lost maybe 120 cc's of blood. I also had made sure to have misoprostol on hand. It's used only for postpartum hemorrhage, for which it can be lifesaving. This mom did not need it.

Ediso wondered what my name was. She said she wanted to name her son after me. I told her my name, and said that, luckily, Marion can be either a girl's name or a boy's. So that's how a small African man came to be named after me.

Twice, walking back to the guest house from the clinic, on the pathways with the brownish red dust and hard packed earth, I have met Ediso's husband. He always greets me and tells me the baby is fine. He speaks a little more English than she does. They are very unassuming, kindly people.

More later! The midwives say thanks for the gift; they are very excited about it. They don't all have watches, so the digital display of the FHR is very reassuring to them.

Love to all, Marion

Marion Toepke McLean, Certified Nurse Midwife

January 24th, 2009 (09:22 pm)

"Marion delivered her first baby in Africa." Her husband, Fergus, called me to announce this touching news. Marion has volunteered in Afghanistan and now in Uganda. She is my very special mentor and a faithful writer for Midwifery Today from before its birth. It was in 1976 that I was touched by the calling to midwifery. At this time Marion, a Certified Nurse Midwife (CNM), began teaching midwifery classes to a small group of us. She has been my friend and mentor ever since. She has been faithful in writing her column and a number of other articles for us for the past 22+ years from issue Number 1 and before that in planning what Midwifery Today would look like. As she is such a good teacher we quickly brought her into teaching at our conferences. This gives you the opportunity to experience her in two ways, her writing and her conference teaching.

Marion joined our midwifery practices for a year while she was teaching us didactic classes. Before and after that we could always call her from a birth, even if it was 3 am, to confer. This saved several transports as she would help us ascertain if things were within the realm of normal. For us it was like having a very knowledge- and heart-filled CNM at every birth. She was so humble, she told us she learned as much from us as we did from her. Since she taught us all the midwifery we knew, we were sure this couldn't be true, but it shows how very sweet and unassuming Marion is.

What I hope for each of you is that you have a Marion in your midwife, doula or childbirth education life. There is nothing more valuable.

Jan Tritten
Midwifery Today

Read these two articles by Marion:

Marion Toepke McLean, CNM, attended her first birth as primary midwife in August 1971. She received her nursing degree from Pacific Lutheran University in 1966 and her midwifery and family nurse practitioner degree from Frontier Nursing Service in 1974. From 1976 through 2001 she did clinic, hospital and homebirths, while also working as a family nurse practitioner. In 1980 she taught a year-long program for local midwives, returning to Frontier Nursing Service to teach during the summer. In June 2000 she completed a BA in International Studies at the University of Oregon, with concentrated studies on Mexico. Since 2002 she has worked in a reproductive health clinic and attended an occasional homebirth. She lives in Eugene, Oregon, and is a contributing editor to Midwifery Today.

Birth and Bio-Physical Profile

January 20th, 2009 (02:10 pm)

My friend, who is a homebirth and birth center midwife, just had a round of Bio-Physical Profile problems. That is, some of her clients decided to step on the medical intervention train and have one, "just to see if their baby was all right." What that invariably does is start them on the, "Oh, your baby is in danger, you need to be induced" track.

I hate seeing women get duped at what should be their most beautiful and powerful time in their lives, at their births. So I e-mailed my friend Gloria Lemay because I know her information is clearer than my rant and she quickly wrote back: "Well, the best article on the Suspect Diagnosis of Biophysical Profiling was actually published by Midwifery Today. Love, Gloria." And guess what--it is by Gloria!

After nearly 23 years of doing Midwifery Today Magazine I lose track of the great articles we have published. I used to remember almost all of them but such goes life 23 years into publishing! To quote a bit of what Gloria wrote: "An unusually large number of diagnoses seem to be made that 'there is not enough amniotic fluid.' This seems to be the factor in this outline that is most often used as an excuse for induction. It is important for parents to know that this is likely an inaccurate assessment."

Read Gloria's article: Suspect Diagnoses Come with Biophysical Profiling

Jan Tritten
Midwifery Today

Becoming a Midwife with a Young Family

January 17th, 2009 (11:10 pm)

From Kimbrah: I was going through my Google Reader today (only 776 entries in there!) and I came across your post entitled "Becoming a Midwife." It's kind of funny that I read it today because I have been thinking and praying all day about whether to pursue my dreams or wait. I really do have a desire to become a certified homeopath and also to become certified as a doula, with the intention of eventually becoming a permanent assistant midwife.

I have four small boys right now ages 5, 3, 1, and 5 weeks. I feel silly for even wanting to pursue anything when I have such small children. I am very committed to being a stay-at-home mom (or work-at-home mom) and homeschooling my boys, but I still want to give back to other women and their children. I was able to "play" doula for my brother and his wife for their hospital birth, and I was born for it! She had the birth experience she really wanted and felt empowered, which helped me feel empowered, too.

I am writing because I wanted some encouragement or direction, or maybe I just felt led to because it seemed too much of a coincidence to read the words you wrote on the exact day that I have been seeking guidance about my future. I appreciate your time and look forward to your reply, when you have time.

Answer: This is a great question because it is often the energy and enthusiasm we get from our births that puts that fire in our belly. Your children do come first and are your most important calling right now. That doesn't mean you can't pursue your studies slowly as family commitments allow. For example, I think having your own children and breastfeeding them is the ideal preparation for becoming a midwife. (You can still be a good midwife if you have not had your own children. My mentor, Marion Toepke McLean, who has written an article for Midwifery Today magazine since I started it 22 years ago, doesn't have her own children and is the best midwife imaginable.)

I did find a passion to be a midwife that was unrelenting after I had my first homebirth following a first bad birth in the hospital. I could barely think of anything else, so I know what you are feeling. This was the 70s, though, and we were helping moms who were going to have homebirths no matter what. There were few legal homebirth midwives at this time.

Marion taught us about hemorrhage, shoulder dystocia, and other birth challenges; we invariably experienced that issue with a mom within a very short time. I know there is a divine hand in midwifery. I don't know about self-study for becoming a homeopath, but I imagine there are online courses. You can use this time to study. I would suggest you form a study group in your area. Use this vast resource that is the Internet. You can glean so much information.

At Midwifery Today we maintain a huge Web site with hundreds of articles from past issues, and you can sign up and receive our free twice-monthly newsletter. We also have a section on becoming a midwife.

Other things you can do now:

  • Attend a series of La Leche League meetings if you haven't already.
  • Make yourself available to your friends for information as you learn it and also to be with them as a doula. You might not attend a lot of births, but you will get a lot out of those you do attend.
  • Join local groups that promote midwifery, childbirth education or doula activities.
  • Go to a conference when the children are a little older, if you get the opportunity. It can help you fine-tune the direction you want to go. For example, at Midwifery Today conferences we concentrate on Beginning Midwifery by offering a full-day class in it. We offer two to three great conferences each year.
  • If you get the opportunity, volunteer at a midwife or doula practice. You might consider it when the children a little older, if you have good support at home. I was really blessed because when I went to a birth my mom would come and take over so the household kept running smoothly.

Be sure to use this time when your passion is high to do as much self study as is practical considering your busy life. Midwifery Today has a book you may be interested in called "Paths to Becoming a Midwife: Getting an Education." It may help you get focus. God bless you in your efforts.

Jan Tritten
Midwifery Today

Paths to Becoming a Midwife: Getting an Education

Say It Again: Cesareans, a Cause of Prematurity

January 14th, 2009 (01:57 pm)

My roommate came in to tell me about a news report on ABC about cesareans leading to premature deliveries. Knowing that I work at Midwifery Today, he was sure I would be interested and reported that prematurity causes a number of problems for babies, because various functions such as immune system, lungs and brain have not had time to develop.

Then he went on to repeat the woman-blaming mantra about how cesareans are being requested--by them for convenience--something that undoubtedly occurs, but not at the level that the media would have us believe. Of course, that sent me off on a rant. Aren't obstetricians the professionals? If a person requested any other surgery that was not necessary and caused a risk to life, would the doctor just merrily go about it? Surely, the obstetricians don't go to their patients for advice on how to do their job?

But I digress. My point regarding this news report is: How is this news?

I went to the New York Times Web site to try to find the article/study that had led to this shocking conclusion, but instead I found many other articles, going back at least 30 years. That's right. On March 8, 1978, Jane Brody's well-known column was about how cesareans increase the rate of prematurity because often the baby is born too early. And intermittently, throughout the intervening years, the same news has been repeated again and again. Yet we all know that the cesarean rate continued to climb anyway, to the point that it is now 1/3 of births in the US!

All of this proves the point that I recently read in a submission to Midwifery Today: Once an obstetric procedure becomes usual practice, it is often hard to stop, even when research proves that it is ineffective or even dangerous.

I hope that obstetricians will take heed of this latest study and change their practice of doing cesareans before the babies are ready to be born. It undoubtedly will reduce health care costs--by keeping babies out of the NICU, decrease the number of cesareans--when babies come of their own volition before an operation can be scheduled, and prevent some cases of postpartum depression and failure to bond--by causing the natural release of oxytocin that labor brings.

Guest post by Cheryl K. Smith, Midwifery Today Managing Editor

Read articles about Cesarean birth on the Midwifery Today web site

Feeding Your Family While on Call

January 11th, 2009 (11:46 pm)

One of the great joys of my life is growing our food. I translate this into meals as I bring it in from the garden. It is ever so handy to have meals already prepared after working all day. When I was doing births I would just call my daughter and have her get, for instance, spaghetti sauce out of the freezer, make noodles and a salad and dinner was done while I was off helping motherbaby in their birth journey.

Even if you don't grow your own food you can get a head start on meals, so your birth practice makes less of an impact on your family. You can take advantage of getting produce at a farmers' market or buy in bulk at farm stands and then turn it into your favorite meals. Also, when you make dinner you can triple the recipe and freeze the extra.

This year as I harvested a basket of vegetables, I would decide what I would spice it with. It almost didn't matter what veggies I brought in--just a wide variety. Then I made a soup with Mexican spice, then one with Italian, then a Thai soup, adding coconut milk and Thai spices to the soup. Mostly I made soups, but also our other favorites.

I just finished a delicious Indian soup with the turkey carcass from Christmas. The flavor was in the coconut milk and loads of Indian spices. The only problem is that I can't repeat it because I don't follow a recipe unless I am making bread. Bon Appetit!

Jan Tritten
Midwifery Today

Read about nutrition on the Midwifery Today web site

Be Kind

January 11th, 2009 (10:13 am)

Jan is making yummy bread.... She had stopped baking for many years because of her busy schedule. But after a trip to her favorite bakery she made the decision to start baking. They told her that she needed to put in an order for the bread she wanted, but in a not-so-nice way. She hasn’t been back since and has decided that baking is well worth the time and effort in so many ways, including not being verbally abused.

Often we go through everyday chores, lists and errands not really paying attention to how many people we come in contact with and how many words we say that might make or break that person’s day. In this New Year’s resolution atmosphere, we should each resolve to be more respectful and really take the time to measure the words we speak.

Guest Post by Eneyda Spradlin-Ramos. Eneyda has been involved in childbirth, breastfeeding and homeschooling for the last 21 years and has attended homebirths for the last 13 years.

Read free articles about birth on the Midwifery Today web site.

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