Sunday 13 May 2012

How will you carry out your dream? - Jan Tritten

* Dont share your dreams with negative people
* Put encouraging people around  you!
* Take the first step then the next!
* Draw strength from those pioneers around you in the world that have carried out their dreams
* Never never never never never give up! Mothers and babies are counting on you!
* Dare to dream! dare to do!
* if you need encouragement e-mail jan@midwiferytoday.com or jan trittens midwifery page on facebook
* LOVE, HONOR, CHERISH AND RESPECT OURSELVES! CREATE REAL MIDWIFERY!

Uncommon Complications - Diane Gosling, Elizabeth Davis

*After the babies heart has stopped beating in the womb and the baby is dead up to 5 weeks after is a safe time to deliver the body.
*DIC- A blood clotting disease- resulting in massive blood loss and death
angelica Root
Don Qui
Penny Royal
Black cohash                                   All are herbs used to bring on miscarriage
Ladys Mantle                                     A stimulant combined with an active
Golden Seal
Shepherds Purse
* Always check after the miscarriage and ectopic pregnancies that the uterus is empty- Twins sometimes survive
Amneotic Fluid Embolism (AFE)
* induction and c-section have created many more AFE than natural birth
* due to abdominal scarring, hyper stimulation of uterus and extra oxytocic drugs , also sloppy repairing of uterus after c section
* To avoid AFE at VBAC( vaginal birth after C section) ask woman how she healed after operation, if it was badly then advise a hospital birth
* Fever, pain , dischage, slow healing are all symptoms of AFE
* Blackcurrent Oil
   Vitamin E Oil                     All healing to scar tissue
   Comfry Oil 
*Excercise helps the inside heal as well as keeping the outside fit.
*AFE is related to any tauma during labor eg - rupture of membranes, induction, c-section
* There is NO good rationale for early rupture of membranes!
Labial Hematoma ( varicose veins on vagina)
* Hot and cold stimulates circulations and moves the blood around
* change positions and switch about because all movement gives mama and baby a chance to re-evaluate
* Get mums to practice vaginal exercises squeezing each level starting at the sub basement and moving up to level 5, then go back down again. Breathe in and out with each squeeze and hold for 5 seconds.
  5
  4
  3
  2
  1
  Basement     - This is where giving birth occurs!
  Sub basement
* Use arnica tincture internally and externally
Retained Placenta
* increased DNC or internals put her at risk
* Check uterus tone- gently place hand on fundus ( top of womb)
*Large loss of blood is detremental to recovery.
* Get the mama to check herself
  cervical tear
  vaginal tear              cause blood loss
  partial seperation
* If the mum has been given pitocin  ( Synthetic oxytocin) she will not make her own oxytocin to close the uterus for at least 30 minutes.
* Angelica Root or Shepherds Purse tincture directly under the tongue held there for one minute will help the placenta release.
* If the placenta is not coming and the mother is not pushing, put two fingers in , follow cord up past the cervix, if there is no placenta there, it is still attached.
*Give herbs or pitocin to seperate placenta
* Pitocin does not close the cervix it contracts the long muscles of uterus.
* Put hand inside the uterus follow the line of the placenta to the connected piece, use hand as a spatula and gently smooth placenta away from the uterus wall
* SOMETIMES CIVIL DISOBEDIENCE IS A WAY TO CHANGE THINGS FOR THE BETTER!
* Just leaving the new family to bond and relax is the best way to assist the birth of the placenta.
* If the placenta will not be removed by hand , peel the lumps off the uterus wall so there is less bulk and then the uterus can close easier - then call an ambulance.
* Drinking water assists amnotic fluid production
Compound Presentation
* Arms , transverse lie, all that can be done is tore insert limb then attempt to turn the baby to breech and get hold of the feet to deliver- either internal or external version or both
Bleeding Labor
Just get the baby out ASAP! Either push or get an ambulance!
 Shoulder Dystocia
* signs- babys neck is like a turtle or its head is purple
actions- get mama on all fours, put hand in to get the posterior shoulder,
 or strong super pubic pressure, or strong fundal pressure, then go for the posterior shoulder
* If there is a woman with a VBAC there will always be more bleeding
Cord Prolapse
* get mum in knees chest position
* put hand in cervix, push babies head off the cord
* get cord warm and into the vagina
* check that the cord is still pulsing Transfer to hospital ASAP
* If there is no hospital- push baby out ASAP and be prepared to resusitate
* cotton root bark - regulates hormones and the whole system
* Herbs and oxytocics will not work if the bladder is full or if the uterus is full of clots.
*  REMAIN CALM- ACT IN LOVE AND RESPECT


*



























Breech- Betty ann Davis, Diane Goslin Marcos Leite

* Breech twins - When the mother is on hands and knees the babies seem to just turn and come out.
* If you feel a hip and a foot this is probably not a footling and more likely a full breech
* If the head does not flex , use 'Franks Nudge'- hold babies body in both hands and press inwards with thumbs just under the shoulder, this flexes head.
* Or put fingers below eye sockets and pull chin towards the neck.
* Or 'Chrysteller' - Get behind woman, clasp hands together above baby, rotate hands towards spine and push down , then use super pubic pressure
* Arms not coming out-  mother on hands and knees and turn her head to the left- turn baby to face mothers spine then to right, this releases the arms.
* ALWAYS WEIGH IN THE BALANCE!  Unless you know what to do  if the baby gets stuck then the breech birth process is dangerous for you, baby and mother.
* SHARPEN YOUR SKILLS!
* When a baby malpresents- always check the other factors in the motherbaby  physiology and psychology.
* PROTACT THE MOTHERBABY!
* PROTECT YOURSELF!
* PROTECT THE MOVEMENT!
* When the mama births on hands and knees there is less chance of the cord being squashed! This will give the birth more time.
* Sometimes babies die!
* Death is part of life!
* The apgars at vaginal breech birth are lower than at a cesarian birth- babies are more shocked
* Babies take more time to wake up! They need time and space to work out where and what they are!
* Low apgars do not mean unhealthy babies
* Baby injuries from breech birth according to the term breech trial study - 1% c-section, 1.9% on hands and knees, 16% on her back
* Touch the baby as little as possible, maybe put hands on its feet, talk to the baby, let them know that they are not alone.
* Leave the mama to move naturally as much as possible - most move into hands and knees.
*  TRUST IN EACH OTHER AND THE PROCESS!
* THE WOMAN , BABY, BIRTH PROCESS IS A PERFECT MECHANISM
* MOST BREECHES DO FALL OUT!
* Some moves are strong interventions but hey are less interventionalist than c-sections!
* BABIES NEED TIME TO GET INTO THEIR BODIES!
* GIVE THEM TIME!
                                                                   LOVE
www.coalitionforbreechbirth

Thursday 3 May 2012

Tricks of The Trade - midwifery today conference , harrisberg pennsylvania 2012

* For hemorrage take a piece of placenta, put it in the mums mouth - she will stop bleeding!
* Also you can use the membrane the same way if the placenta is not out
* To keep perinium intact - olive oil & geranium and ' Young living' gentle baby oil
* If the mother is needing to push but not complete - then massage her in the all fours positon feeling for the lump of the head, then strongly massage the head away from the pelvis following the line of the back.
* To ease blood clots and varicosities- use warm cider vineger on a rag, wrap around clotted vein and alevate
* Also quersitin - pectin of apples or vitamin E
* For hemmoroids - use a piece of potato inserted up the bottom
*To help with pregnancy nausea - suck lemons
*To cure upper resperatory tract infections - chop garlic finely and leave in honey overnight, use resulting syrup as medicine 1 tsp 3 x a day
* Breastmilk cures - sinus problems, earaches, nappy rash, in fact everything
* garlic cures- breastmilk infections, mastitis, worms, thrush, ear infections
* If you have recurring blocked milk ducts use sya lecithin
*Pinard skills- place pinard where you believe babies back to be, face the mother, ear to pinard, pinard to belly, let go with hand and lsten
* When babies are stuck- the emotons are stuck, the emotions of the mother and the emotions of the baby are very important. To assist communication assists birth.

Implimenting ideas for change in Midwifery and Birth - Midwifery Today

* Every Birth is Amazing
* Each time a Woman gives Birth it is Amazing
* She Evolves , Grows and Transforms!
* We must Celebrate! Respect this time and create ceremony for this amazing part of life
* To impliment change we must-

* Be aware what needs to change
*.Be confident about our power to change.
* Be active about change
* Be open minded
* Be creative
* Be hopefull
* NEVER GIVE UP!

* Every place we walk , every place we stand, we can impliment change for birth
* go to colleges and schools and offer to teach
* Go to radio stations and offer stories
* put birth stories out there
* Teach men and boys about natural birth
* run classes, meet ups and gatherings
* Connect people - talk and listen more.

Amish and Menonite Midwifery - Mary Hosteler and Lydia Byler

* It doesnt matter what creed , religion , color, you are Birth is an extreme physical sensation!
* It can be overwhelming
* It can take our breath away
* Our faith in the Process of Birth and the power of God assists in Positive Birth Stories
* Birth Stories assist in all generations to know the story of Birth, so everyone in the family knows what happens at a Birth so then there is less chance of anyone being afraid.
*The extended family supports and loves the new addition to the family
* The faith gave the first menonite women the courage to birth their babies at home with no-one but god with them.
* Love is a many splendored thing - Babies are made in Love
                                                           Babies are born in Love
                                                           Midwives support Births in Love
*Love is Honored Cherished and Respected
* Birth is painful but beautiful.
* We check , massage and talk with the mother every 6 weeks for the 1st trimester, every 3 weeks 2nd trimester, every2 weeks 3rd trimester
* Nutrition is the best medicine! - Fresh foods , low suger, low fat, low salt
*Shepherds Purse - for stopping excessive  bleeding
* Blue Cohash, red raspberry leaves, blessed thistle, black cohash - all are use as gentle assistants to birth.
                     LOVE  LOVE AND MORE LOVE IS ALL A BIRTHING MAMA NEEDS







MASSAGE FOR MATERNITY- ELAINE STILLERMAN

MASSAGE FOR BIRTH - ELAINE STILLERMAN

* Safe , Nurturing , Non-Judgemental, Well- Informed , Loving, Stress- Reducing.

* THIS IS THE ENVIROMENT TO CREATE FOR MASSAGE AND BIRTH
* The Quadratus Lumborum is the primary muscle involved in back pain during pregnancy, it can be relieved with counter strain eg:-

* STRAIN, COUNTER STRAIN

* Assist mother to lie on her side, keep knees together as much as possible when getting into position to support and protect the symphisis pubis ( the cartilage join in the middlle of the pelvis , above the pubic bone.)

* Support the belly, raise the knees with pillows

* Find the place where there is the most strain in the muscle, by feeling and asking the client

* When you have found the exact spot, press spot with your thumb, whilst holding other hand on the hip and pushing with a medium force forward ( this gently rotates the pelvis while you are relaxing and recallibrating the muscle with your other hand)

* Repeat on the other side so the body is balanced!

* HOLD THESE POSITIONS FOR 90SECS WITH EQUAL FORCE THROUGHOUT. This resets the neurons and the receptors in the body, brain and muscles and relieves the pain.

*THE PSOAS - This is the muscle that reaches from the back of the hip downto the side of the knee pains here can be treated with muscle relaxation and strain counter strain.

* MUSCLE RELAXATION

* With the woman lying on her side supported bt cushions, get her to bend her leg up towards her stomach and lift it towarsd the sky.

* practitioner stand facing the womans belly , assisting the lift of the leg with R hand and giving something to push against with the L hand

* Have woman push her leg forward like she is bending her knee upwards for 5secs, then release.

* This assists the hip to release and the leg will extend further, when she straightens it out along and back from her body.

* Repeat this 3 to 5 times until the desired extention and pain relief has occourred.

* repeat on the other side so the body is balanced1

* STRAIN COUNTER STRAIN

* Have the client lie on her back with one leg straight one leg bent at right angles outwards.

* Feel the top of her pelvis in towards the pubis until you find a sore spot.

* press the point with your top hand thumb, support the knee and lift gently to rotate the hip with the other hand.

* Hold this position for 90 secs the muscle will release and reset its neurons and receptors

* Repeat on both sides so the body is balanced!

* PERIFORMIS - This is a muscle that reaches from the hip bone to bottom cheek!

* Pain can be relieved with STRAIN COUNTER STRAIN

* Have the woman lie on her side supported by pillows

* Face her belly and lift her top thigh a little upwards with your forearm

* With your other hand feel for a sore point from top hip bone to bottom of bottom cheek

* When you have the place , apply thumb pressure and rotate hip for 90secs

* The muscle will release and reset its neurons and receptors

* Repeat on both sides so the body is balanced!

Elaine Stillerman is a brilliant massage therapist, designer of the amazing massage balls( smelly balls) and a great karaoke singer! With these techniques she totally helps create a calm pain relieving massage that uses the least amount of effort whilst creating the most amount of relief.

 

Tuesday 1 May 2012

Respectful Maternity Care- Debra pascale- Bonero

http://childbirth connection.org
thewhiteribbonalliance.org/respectfulcare
* Both these site have many resources andinformation  about respectful maternaty care : Tackling disrespect and abuse during facility base childbirth
* What does respectful maternity care look like?
* takeaction@whiteribbonalliance.org
*  GET CREATIVE, SHARE YOUR VISION WITHART , SONG, STORY ,DANCE
* check out the film ' No woman no cry' by christie brinkley
* also ' Deadly delivery' by amnesty intrenational
* www. womendeliver.org
* check out ' Half the sky ' kristof & wudunn
 * 'The Princess and The Poo' by Lara Fairy Love
                              
                                      GET CONNECTED GET ACTIVE!

Autonomous Midwifery- Jan Tritten

* Are we Midwives or Medwives?
* Midwives are creators of ceremony from womb to tomb
* BIRTH - MENSTRUATION-MENOPAUSE - DEATH
* We have the ability to  create positive experiences for our fellow women
* It is our responsibility to be brave and speak our truth- to empower our fellow women towards
                                                  POSITIVE LIFE EXPERIENCES
* When you doubt yourselves remember that you are part of the Global Community
                                                    TOGETHER WE ARE STRONG!

                                                           LOVE WILL PREVAIL!
*                                INTENTION AND INTEGRITY CREATES POSITIVITY!
* Stepping up to the huge skill body of midwifery is the way to create a furure full of Autonomous Midwives!
*   MIDWIVES SUPPORT WOMEN WHO DELIVER BABIES!
* THE RIGHT TO HUMANE AND LOVING CARE IS A BASIC HUMAN RIGHT
*  check www.un.org/milleniumgoals/
* Lets imagine a world where all women recieved humaine and loving care, nutrition and welfare
* Midwives are needed and need to be treated with respect
* The world needs 300,000 more midwives
* MAKE IT HAPPEN
* INTERNATIONAL ALLIANCE OF AUTONOMOUS MIDWIVES ( IAAM0
* Women and their babies have their right to birth in a hospital or at home without fear of mistreatment or industrialized medicalization
* Cutting 1, 2 or 3 women is a buman rights violation and is literally stealing their miricle!
* read articles 2, 3, 4, 25,( 1&2) of the human rights act
* Every woman has the right to an optimal birth
                               BIRTH IS A HUMAN RIGHTS ISSUE!











Trust yourself to trust birth - Gail Hart , Tine Grieve

* You can trust birth to work
* Intervention is risky
*When women are confident it is a normal healthy birth - fear creates problems

*                                                      TRUST YOURSELF!

                                                     TRUST EACH OTHER!

                                                          BELIEVE IN BIRTH!

                                                     CREATE POSITIVITY!

                                                          CREATE LOVE!

Alternative to suturing , also tear prevention - Gail Hart

* There is alot of preparation before birth- excrecise , massage, deep breathing, squats, streatching
* Stratagies for second ( pushing ) stage- aviod coached pushing- encourage her to listen to her body and to stop pushing and breathe as her baby is on the perinium
* A compress of hot water, olive oil, coconut oil, avocado oil, grapeseed oil, sweet almond oil or arnica oil is very helpfull
* Most stuff we all know is because someone told us from their personal experience NOT thru research
* Standing and squatting positions create less tearing of perinium
* Ginger increases circulation to tissues so it can stretch - it also minimises swelling and smells good
* Comfry activates cell rejuvination and reduces swelling
* 96 degrees is ideal heat for a birthing pool
* Compression will always stem bleeding
*Spray adrenaline onto a gauze put this on the tear to stop bleeding
* yunan payao seaweed helps too
* sugar collagulates wounds also salt and honey
* honey is great for wound healing
*  IF TWO PIECES OF VAGINA ARE IN THE ROOM THEY WILL MOVE TOGETHER!

Fourth Stage Transition - Tine Grieve

* What should we do at birth and after to facilitate breastfeding?
* Pitocin( synthetic oxytocin) reduces mothers oxytocin levels- the drip creates a stable levelof oxytocin so that the brain does not secrete a proper level of oxytocin- sometimes as much as 2 days later.
* natural oxytocin stays in the blood for 45 seconds and is then replaced
* A mother who is medicated in labor does not secrete oxytocin properly so she does not bond with her baby easily- so she is more prone to post partum depression and breastfeeding problems
* Eastrogen builds oxytocin receptors in the brain
* Oxytocin is contageous- even if a woman has no natural oxytocin at birth she can still feel love and therefore have the let down reflex and naturally breastfeed.
* Loving care and respect for nurturing bonding is the best way to create good breastfeeding practices for mother and baby
* Birth assistants primary goal in the fourth stage- is to support the creation and respect for a sacred bonding space for ' motherbaby'
*PROPER BONDING TAKES TIME!
*  Babies need to release all reflexes before it can breastfeed   www.biologicalnurturing.com
*   THE MIDWIFE IS THE PROTECTOR OF THE BIOLOGICAL PROCESS

Basic newborn complicatations and emergencies - Tine Grieve

* Ther should never be a surprise low apgar score all observations should tell you how the baby is.
* There should only ever be fatal illnesses causing low apgar e.g. heart defects and lung defects
* To use our intuition, eyes, ears, hands, smell and ears , this is what gives us clues to what is happening in the womb .
* To fully rely on machines is to rely on a totally fallible information source
* A pinard tells us - the beat of the heartbeat and the quality of the heartbeat
* A heartbeat is so much more than a frequency it is much more of a feeling
* The pinard gives the feeling of an irregular heartbeat and also shows the changes when you move the baby- you must listen before , during and after the rushes
* We do not want to hear late decelerations
* We want accellerations at the same time as rush and then decellerations as the rush ends.
* To listen after rush shows how the baby is recovering from lack of oxygen. If the rate decellerates later than the end of the rush then the baby is not recovering properly and needs attention.
* If the baby comes out flat then we need wait to let the baby recover from the rush and lack of oxy gen.
* keep the cord intact because this is the babies life support system
 * BABIES NEED TIME TO RECOVER FROM BEING BORN!
* The first 60 seconds we need to remember to let the baby recover from being born - especially if the babies heart pattern is healthy right up until the birth.
* If the babies heart rate is low during labor and birth and comes out flat and starved  of oxygen- these babies can crash at the breast 5 minutes later
* If the heartrate sounds muffled then be aware that there may be after birth difficulties
* If you know how to use the pinard correctly it is safer than the doppler
* At the beginning of labor- listen for 15mins at 5 min intervals
* In the middle of labor- listen for 5mins before during and after rushes
* At the end of labor listen when you feel that you need to
*                             LISTEN ATTENTIVELY - FEEL THE HEARTBEAT

*       BE WELL INFORMED SO YOU ARE READY TO RESPOND APPROPRIATELY!
*

Hemorrage and 3rd stage difficulties - Gail Hart

* 1/3 of women  die in childbirth A LIE! -  women at full term die of - septic miscarriage
                                                                                                                 - blood loss
*Fainting
  Sickness
  Mothers face pale
  Lips blue                                                       ALL SYMPTOMS OF HEAMORRAGE
  Low blood pressure
  Rapid pulse (100, 110)
  Convulsions

* Average blood loss is 435 cc ( 4 cups ) to 800cc (6 cups) - 1 full pad = 1/2 a cup
* Women can lose up to a litre of blood ( 8 cups) and still survive ! - however we should be vigelant about blood loss and keep it to a minimum
* 500cc of blood loss = 1g heamoglobin loss
* In waterbirth if you can see the bottom of the tub then the blood loss is normal.
* If a woman is bleeding too much her uterus needs to be closed - if the placenta is still in it has to be removed.
* To keep the cord intact helps the placenta trigger the seperation - the whole system remains oxygenated
* Routine use of pitocin ( synthetic oxytocin) or oxytocic herbs to over stimulate labor can be cause of bleeding
* Normal birth= normal placenta delivery
* Let the uterus expel the baby- assist the baby and mother to skin to skin contact
* to watch the physiological stages of seperation means to assist the true way of expulsion
 * placental expulsion can take from 30 mins to 6 hrs!
* To pull on the cord when the womb is not contracting will only cause problems
* Hold the cord, fel the womb , feel the slack - DO NOT TUG!
* Watch, Wait, Allow physiology to progress - be like the animal and  let nature take its course
* Shepherds purse herb can stop bleeding and contract the uterus
* You can also use your hands to contract the uterus- rub the mamas belly flat handed, support under the uterus and push from above - you are trapping those blood cells and stopping the bleeding.
* Also nipple stimulation and breastfeeding can help
* A thumbnail piece of placenta in the mothers mouth activates uterus contractions in 20 seconds!
* Getting upright and  blowing in a bottle bothe help the placenta to seperate
* Get the mama to cough or sneeze this can also help
* The best way is to not disturb the natural bonding space of mother and baby- leave the room for 20 mins or make yourself invisible - leave the woman to birth her placenta herself with no fuss!


hi lara, you take great notes, but I need to post a correction there. I probably mispoke something in the class. "I" was not the midwife who said to leave the room for 20 minutes to give the mother privacy to birth her own placenta. I said I know of this teaching and assisted a midwife once who followed this. "I don't personally do this or advocate it; I just know of some who do, but I'm personally not comfortable with leaving her. I always stay with the woman, nearby but as much out of her way as possible, so I can observe her and her baby and help if needed. But I try to stay quiet and pretty invisible and unintrusive. I could be on a chair nearby, or perhaps just by the door, but I don't leave About using your hands to stop bleeding: The hands are the best and most effective tool. Faster than medications. About placenta -- it is a very effective emergency treatment, and the knowledge should be reclaimed. It used to be known throughout the world but has been forgotten in many on Hemorrage and 3rd stage difficulties - Gail Hart







A Midwives Healty relationship to Fear - Elizibeth Davis

* To work with fear is a way to be active and alert in a situation where most are frozen and inactive .
* Womans healthcare providers' Midwives' have always been here
* It is an honorable position , respected and powerful.
* However our fear is grounded in a history of persicution since ' The Burning Times'
* To repress and attack midwives is to deny the power of women
* In any patreachal society midwives will always be seen as trouble makers because they care for the health and rights of women
  " At this time noone is more dangerous to the state and church than the midwives." The spanish inquisition for the catholic church  - six million women died!
* These 'Burning times' created a pain body for all the women who came after - the line of story was broken- now we are beginning to reweave  the story lines
* FEEL YOUR FEAR - It keeps you alert and  assists you to be aware and watch your back , it helps to keep you safe!
* TO MEET FEAR OPENLY INSTEAD OF CLENCHING AND FREEZING MEANS WE CAN OPENLY RECOGNIZE IT  AND OPEN OURSELVES TO THE POSSIBILITIES OF OVERCOMING IT!
* To cleanse yourself of the fear that is felt is a very important tool , then you do not bring every fearfull event to each moment of fear.
* To cleanse and heal gives us the opportunity to work with our fears and grow past them.
* Fear, anger, jealousy - are all from the primal part of the brain ,
  DANGER! - creates adrenaline - enables us to respond - as concious beings we can choose how we respond.
                                    ADRENALINE - frozen, closedness , hate, fear
                                                                    or
                                    OXYTOCIN - Love , Compassion, caring, openness

* A woman giving birth runs a 100 times more Oxytocin than at any other time
* when we run oxytocin at a birth we entrain to the birthing woman and we learn how to be in LOVE   - our brain waves drop thru ALPHA- BETA - THETA - Theta waves being the place where time becomes elastic and brainwaves open so that experiences can be rewritten.
*                                     

                                                       BE IN LOVE!