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Archive for July, 2012

Birth Matters: Ina May Gaskin’s recommendations to improve maternity care

We’ve been reading legendary midwife Ina May Gaskin’s fascinating new book Birth Matters: A Midwife’s Manifesta.

Unlike her other recent books, Ina May’s Guide to Childbirth and Ina May’s Guide to Breastfeeding, this latest book isn’t a practical guide for moms but a policy statement which spells out her recommendations for changing our maternity care system.  It also includes a history of obstetrics/midwifery care, explores sexuality and birth, and discusses feminism and birth, among other topics.  And as with her previous books it’s spiced with captivating birth stories from her many years of practice.

But the heart of the book is a call for women to come together to fix the ways in which our maternity care system is broken.  Gaskin details these problems with U.S. maternity care:

A rising maternal mortality rate (near tripling in California between 1996 and 2006), which doubles the risk of mortality for mothers birthing today compared to their mothers.  This increase is occurring despite despite the fact that the U.S. spends more on maternity care per capita than any mother country in the world.

A flawed mortality reporting system which, according to the CDC, could mask a rate up to three times what is currently reported.  This lack of reliable data leaves the system poorly equipped to make changes necessary to lower the rate.

High rates of unnecessary induction and other interventions in labor and birth, leaving mothers unable to labor and birth normally, and leading to poor outcomes.

The highest recorded cesarean rates, which far exceed recommended levels for safety of mothers and infants.

Here are her recommendations for reform, presented in detail in Birth Matters:

Establish woman-centered maternity care (including midwifery care) as a human right.

Revise medical education to train doctors in the support of normal birth before they study related pathologies.

Establish maternity care standards to ensure evidence-based practice for all women.

Salary physicians instead of paying them based on the number of births they take on.

Make birth centers available to mothers in all parts of the U.S..

Ensure that every maternal death is accurately reported and reviewed.

Give consideration to the young mothers who give birth without knowing they were pregnant.

Recognize postpartum home as a necessity, to avoid preventable outcomes ranging from mortality to postpartum depression.

What do you think of Ina May Gaskin’s recommendations?  What would you add or subtract?  How have the problems she outlines affected you?

 

Herbs to support your pregnancy

Curious about using herbs to support your pregnancy?

Several herbs used safely used by women for generations are an excellent source for the increased vitamins and minerals needed during pregnancy, and to prepare your the uterus for labor.

These herbs can easily be made into teas and incorporated into meals on a regular basis. Every person is different, and your body may react differently now to foods than it did previously, but used wisely and in moderation, these herbs make wonderful teas and foods.

  • Raspberry leaf is best known for strengthening the uterine muscles so they work more efficiently during labor. Drink raspberry leaf tea, with its easily assimilated content of calcium and magnesium, to relieve leg cramps. Also high in iron, the leaves and berries help prevent anemia. Raspberry leaf soothes an upset stomach and will help alleviate mild morning sickness. Taken after birth, it slows bleeding, helps the uterus regain tone, and increases breast milk production.
  • Nettle leaves are a storehouse of nutrition, with high iron and calcium contents, as well as an excellent source of folic acid, an essential nutrient during pregnancy. Nettle strengthens the kidneys and adrenals, while it relieves fluid retention. Because nettle also supports the vascular system, it can prevent varicose veins and hemorrhoids. Postpartum, it increases breast milk production. Nettle tea has a rich, green taste and can be mixed with other herbs. Cooked nettle is a mineral-rich substitute for spinach and an excellent side dish with a dash of lemon juice and sesame seeds. Try substituting nettle in lasagna. Pick it fresh from spring until mid summer, but be sure to wear gloves to protect your skin. Its nickname is “stinging nettle,” but this sting disappears when cooked. Pick extra to freeze and have on hand for the winter months.
  • Oats, another herb high in calcium and magnesium, builds healthy bones and nourishes the nervous system. This is the perfect herb to relieve nervous exhaustion and allow for relaxed rest when sleep is difficult. An easy way to incorporate the healing power of oats, and its high fiber content, is to eat oatmeal cereal in the morning, along with oatmeal bread. Oatstraw tea has a mild flavor that can be used alone or mixed with other herbs. And a warm oatmeal bath is not only relaxing, it softens skin and relieves the itch of a growing belly.
  • Dandelion root tea increases digestion and promotes bile to relieve constipation. It is one of the best herbs for cleansing and strengthening the liver, our main detoxifying organ. The liver breaks down hormones no longer needed by the body after birth, and any drugs that may have been given at birth. Containing calcium and iron, roasted dandelion root’s coffee-like flavor, is an excellent morning beverage. Add a handful of the fresh leaves, high in vitamin A, to other greens in salads. Drink dandelion leaf tea if a diuretic is needed to relieve fluid retention. Because of its high potassium content, it does not deplete the body of this important mineral, as other diuretics are known to do.
  • Alfalfa, with its deep root system, contains many essential nutrients including trace minerals, chlorophyll and vitamin K, a nutrient necessary for blood clotting. Many midwives advise drinking mild tasting alfalfa tea or taking alfalfa tablets during the last trimester of pregnancy to decrease postpartum bleeding or chance of hemorrhaging. Alfalfa also increases breast milk production – alfalfa hay is fed daily to milking goats and other dairy animals!

These common herbs are available in most natural health food stores and are well-worth using for their nutritionally-packed support during these special months.

This information is provided for educational, and not medical, purposes.  Consult your health care provider for advice tailored to your needs.

Treating thrush over and over? Maybe it’s Raynaud’s.

If you have a burning pain with breastfeeding, you may have tried treating yourself and your baby for thrush.

But if you’ve been treating it with effective treatments for a while and your pain hasn’t improved, it might be time to consider whether it’s thrush after all.  It might be a relatively common condition called Raynaud’s vasospasm of the nipple.

Raynaud’s is a sudden constriction of blood vessels which limits blood flow and causes color changes.  It’s thought that up to 20% of women of childbearing age may experience Raynaud’s.   Because the burning pain of thrush and Raynaud’s is similar, they are easily confused, and mothers are sometimes treated repeatedly for thrush when the culprit is Raynaud’s.

Typical symptoms in breastfeeding are:

  • A burning pain, felt during and sometimes after the feeding, that isn’t improved by correcting the latch.  This pain is similar to the burning pain experienced by mothers with thrush.
  • Nipples that turn white, blue, or red (or some combination of these colors) after or in between feedings, especially when exposed to cold air.
  • For some women (but not all), the symptoms start during pregnancy.  And for some women, a similar reaction occurs in their hands or feet when exposed to cold.

Raynaud’s is seen more often in women who have an autoimmune diseases such as rheumatoid arthritis, and symptoms may be more common during colder times of the year.

Before you suspect that Raynaud’s may be the cause of your pain, make sure that your baby’s latch is good.  A poor latch is the most common cause of pain with breastfeeding, and compression of the nipple can cause it to blanch after a feeding.  To make sure that the latch is good, have a lactation consultant or another person who is very skilled at helping achieve a good latch help you get the baby on the breast well.  There are many causes of breastfeeding pain (shallow latch, tongue tie, blebs), and a good breastfeeding support person will run through them with you.

The symptoms of Raynaud’s often go away on their own – by about 10 weeks postpartum, according to Dr. Jack Newman.  If they don’t, there are treatments for Raynaud’s which appear to be effective.  Here are some treatment options:

  • Reduce exposure of the nipple to cold, as cold often triggers a painful reaction.  When the nipple comes out of the baby’s mouth, use a dry warm compress – even your hand or arm, if it’s warm – to reduce the cold shock.  Some mothers report an improvement in symptoms when the weather becomes warmer.  See this page on kellymom.com for a good description of how to make a “rice sock” for a warm compress.
  • Avoid nicotine and vasoconstrictive drugs.
  • B6 and/or magnesium supplements.  See Dr. Jack Newman’s handout for information on supplements and Nifedipene.
  • A low dose prescription for Nifedipene, a medication considered “usually compatible with breastfeeding” by the American Academy of Pediatrics.
  • It’s possible to have both Raynaud’s and thrush, so if you haven’t treated for thrush it’s worth considering as well.

If you’d like to seek help from your physician, you may want to print out studies from Pediatrics and Obstetrics and Gynecology, and the Journal of Human Lactation which discuss treatment with Nifedipene.
This information is presented for educational purposes, and should not substitute for medical advice from your health care provider.

Can you be fired for pumping at work? A podcast interview with Jake Marcus.

You can’t be fired for being pregnant, but what about breastfeeding or pumping?

We’re very pleased to share a podcast interview with Jake Marcus, JD on breastfeeding and sex discrimination law.

Jake is the owner of Breastfeedinglaw.com, and is a founding partner of the law firm Cipolla Associates.  She is a lawyer, writer, and speaker who specializes in gender issues such as breastfeeding.  She is co-owner of Lactspeak and Sustainable Mothering.

Jake spoke with Tanya Lieberman about how breastfeeding is treated in the workplace and in public places under sex discrimination law.   They discussed federal and state law, court decisions, and state legislation on the horizon which would protect mothers from discrimination in the workplace because of breastfeeding or pumping.

You can listen to the podcast using the player below, listen with Quicktime, or listen through Motherlove’s free iTunes store!

 

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