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?
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.
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.
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:
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:
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.
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.
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