I saw this video in mumbai and was amazed but none of the babies I have tried this with have been as sucessful even without drugs, after about 40 minutes we do give up or try to help their bobbing heads when they seem to be getting flustered or sleepy. The problem with waiting longer is that we do want the infant to latch within the first hour studies show that it increases chances of successful breastfeeding later on. WHO recommends breastfeeding up to the first 6 months exclusively.
Ina may Gaskin herself has done many, and its a lost art, lets put pressure on the medical community to bring back the ability to deliver breeches safely vaginally!
http://conference.breechbirth.ca/conference/invite-your-doctor
Different Variations of Breech Presentation
I think it is very important to be culturally sensitive and competent as medical practitioners. This is especially true for midwives and doulas who want to learn from the way other cultures approach birth. In the baby catcher, former bay area midwife, peggy vincent, mentioned some culturally competent situations where the room was made quiet so that an islamic couple could let the first words the baby hear be “god is great, and there is no god but allah,” whispered into the right ear. I had a muslim couple recently and though she didn’t mention this in the birthplan, as I distinctly remember asking if there was any cultural things she wanted in her birth. All she said is that she wanted the baby circumcized, which is another point of contention in S.F. which has made it highly politicized despite its health benefits, but I’ll save that for another posts. My client said many arabic prayers during the labor. and I think her faith gave her strength, and it was really beautiful. Mrs. Vincent, also recalls the black women whose births she attended and they too often reverted to spirituality, singing gospel songs, praying, or calling to “lord jesus” etc. during their difficult stages in labor.
Here is an interesting article on islamic birth rites, which I never heard of prior to reading the baby catcher. http://www.bbc.co.uk/religion/religions/islam/ritesrituals/birth.shtml
The baby catcher:chronicles of a modern midwife by Peggy Vincent was the embodiment of Ina may gaskin’s spiritual midwifery meets Chicken soup for the soul. I think that this documentation is exactly what my birthing blog is trying to achieve. It is the hardships and payoffs of pursuing and living the lifestyle of a bay area midwife. She has lived through a lot of changes in how they treat birthing mothers from twilight sleep as a nursing student, to struggling to have hospitals accept midwives, and natural birth, to now. What is now? In my opinion we are still in the momentous change. it seems to be a power struggle that is everlasting between midwives and ob docs, and the changing attitudes of women who demand either’s services. We see the hostility that exists in new york and north carolina, the struggles still continue for the right for midwives to practice. Mrs. Vincent showed this wonderfully in her book. She, with over 2000 births of experienced and who still remembered with clarity the first who started it all, by defying the standard to be knocked out and stood defiantly labor dancing on the bed. The one who eventually was forced into submission while the young teenage nurse held her hand as she passed out. Peggy, who helped pave the way and set the tone, for the better and for the worse for midwives all over.
I loved the way she gets into the state of a woman, her motions, her mindsets as she progresses through the stages of labor. She takes time to recall each instance where she learned something new about this mysterious birthing process. She also knows that births are unpredictable, yet some are more predictable than others. Like most first time moms have longer births, unless they are teens then they have fast and relatively painless births.
She takes us through daring narratives of the cases which had to be transferred to hospital for prolapsed cords, or fetal distress.. but she said in all of her cases she has never had a mother ask to go for pain. She had mothers bold enough to ask her to perform the c-section in their home, because that’s how adverse they were to hospitals. She has had to force women to go to the hospitals at times, and I admire their bravery, but at a time where midwives were trying to gain respect from their back up doctors and the medical community any bad outcome would be a big “I told you so” from the ob docs, and ruin future midwives chances of having an independent practice. These are the docs who told Peggy that “Normal birth is a retrospective diagnosis, All births are complicated until proven otherwise.” She said that this was the fundamental difference between OBs and Midwives who believed the opposite. In my experience, the medical model is patho-centric, and the only find complications interesting. I’ve been told “there is no such thing as a healthy person, just somebody who hasn’t had enough tests”. So the author had to juggle the desires of her patients, her desires to support vbacs etc, but also weigh the risks of negatively impacting the institution of nursing.
Even today, midwives struggle with acceptance and credibility. When she was wrongly sued for a million dollars (the amount of her malpractice insurance), along with her obstetrician, ambulance drivers and everybody else involved, when a client’s baby came out brain-dead, and they resuscitated it anyhow. Although, the agreement between the spiteful parents had been in the capacity of a doula, and her actions were proper and good Samaritan, her lawyer said that as a practitioner, the good Samaritan law would never apply. This is a good lesson for midwives who think they won’t be liable if they wear a different hat to a birth. This was really sad, because it is true that midwives hardly ever get sued because of their great bonds with their patients. However, california is very sue-happy state, and the jury often rules in the favor of the injured regardless of the circumstances. She lost her ability to practice due to the settlement, and not being able to find another insurance company. She reluctantly agreed to settle, because otherwise she would be liable for the full amount if she lost the case, but kept her virtue. Very few insurance companies insure midwives, and this one case, basically took away her career. Her insurance eventually stopped all home birth delivery midwives and doctors due to another incident. These few rare incidents changed the profile of home birth midwives everywhere, as they were sent to hospitals or underground(uninsured). This spits in the face of scientific evidence that homebirths are as safe if not safer than hospitals. However, with hospitals the assumption is that the death was inevitable. The question Mrs. Vincent poses is, “is the conflict about safety or is it about competition?”. The book ends with home births being given to lay midwives, as it is today, midwives, licensed and capable but without hospital privileges, which makes her impotent. The glory days of the 80s in midwifery, that had been taken into mainstream is once again in the back alleys.
She was relegated to the hospital shift working, where she was no longer able to remember each woman’s birth stories. She likened it to factory, and births were on the conveyor belt. She delivered 9 babies in one shift twice. She was also subjected to the hospital policies. She couldn’t get to know her clients, their homes, their lifestyles, their beliefs, and this is precisely why I dislike the shift work as a doula at the hospitals. I snatch up the offsite mothers who come in asking to work with a doula before labor quick! So far only one of my clients had been a shift work delivery.
This book made me laugh, swoon, cry and become very anxious at the prospect of becoming a midwife, and foolishly I stand undeterred. This reminds me of an interview I had with a newly minted lay midwife, who said she would pass the caveat to me that her preceptors had passed to her. “If you can do anything else with your life, and enjoy it. DO IT!” I think this book was another litmus. The indignancy I felt at her being sued, the sympathy I felt with her dealing with negative, stand-offish clients, the pity I felt at her missing birthdays, christmases, sleep driving in the fog, rain, etc. at ungodly hours made me cringe. Yet she reminds us at the beauty of every birth description why she does what she does, despite it all. The husbands who hit on her during the wive’s labor, the missed births, the emergencies, the negative comments of doctors, the embarrasment of trying to avoid the supermarket encounters of her many former clients who’s names she can no longer recall and awkwardness of seeing kids she delivered grow up and her delivering their babies. It is a constant struggle with self doubt, pressures from the medical community, confronting uknowns in labor, and trying to maintain normalcy in raising a family of her own. She documents this journey beautifully in this memoir. I would definitely read it if you are considering this lifestyle.
This is her passing the midwifery torch like she did a client who wanted to become a midwife at the end of her book.
Here are her pearls of wisdom:
-A woman will labor more like her sisters than liker her mother.
-At night, in dangerous neighborhoods, walk in the middle of the street and whistle,
-Carry a pillow, a blanket, and a change of clothes in your trunk.
-Carry you own favorite brand of coffee or tea.
-Childbirth is normal until proven otherwise.
-Don’t announce the sex of the baby. Let the couple discover it for themselves.
-Don’t wear perfume. Laboring women have a heightened sense of smell.
-Fill your gas tank every Monday, Wednesday, and Friday.
-First labors are long, second labors are short, but third labors are unpredictable.
-For speedy dressing, skip socks and underwear and wear wooden clogs
-If a woman wants a natural, unmedicated birth and her labor is normal, she can do it.
-If you think you can predict how a woman will act in labor, you’re wrong.
-If you think you’ve seen it all, you’re wrong.
-It’s better to be lucky than smart
-Keep breath mints in your purse and carry a toothbrush.
-Kids do fine at births if no one forces them to be there.
-Learn to nap.
-Rare complications are rare. Be alert for them, but don’t go looking for them.
-Redheads bleed.
-Restock your birth supplies as soon as you get home, no matter how tired you are.
-Slow starters are often fast finishers.
-Teenagers often go fast.
-The minute you think you know everything you need to know, you’re dangerous.
-The more rigid the birth plan, the higher the incidence of cesarean section.
-The mother of the laboring woman suffers most.
-Use your care for hospital transports; Forget ambulances.
-Wear 100 percent cotton. Blood comes out if you soak it in cold water first.
And Murphy’s Law of Midwifery: Women begin labor when it’s least convenient for everyone, especially the midwife.
———-
Homebirth supplies
Contents of my birth Kits, which weighed a total of 45lbs.:
Home visit bag:
Ultrasound Doppler fetoscope and regular fetoscope
Adult and baby stethoscopes
Blood Pressure Cuff
Baby exam bag: thermometer, tape measure, cord clamp cutter
Erythromycin eye ointment and Vitamin K
Nitrazine paper, Doppler gel
Blue Plastic Tackle Box:
Top tier:
Pitocin and Methergine
Syringes, needles, IV intercaths, and alcohol swabs
Ammonia ampoules, Ketostix and Dextrostix
Penlight and scrub brush
Spare batteries for pager, doppler and penlight
Second tier:
Xylocaine and suture material
Cord clamps
Tubes for collecting cord blood
Infant airway and rescue blanket
Main Compartment:
Gloves (sterile and unsterile) and KY jelly
4X4 sterile gauze packets
Amnihooks
Big mirror
Baby scale and flannel sling
Sterile instruments:
2 Mayo Clamps, 2 scissors, sponge stick, needle holder, pickups
Box of extra Supplies:
IV Setup and 2 bags of IV solution
Blood drawing supplies
Ambu bag
Box of utility gloves
Extra gloves, 4X4s, amnihooks, etc.
Oxygen tank. Masks for mother and baby.
Supplies Provided by Home Birth Couples:
-Birth Kit ordered from Cascade Health Care Products:
http://www.1cascade.com
Plastic Mattress protector and 1 sets of bed sheets
Flashlight and spare batteries
6 receiving blankets, wrapped in pars in aluminum foil
Pan for receiving the placenta
Baby diapers and clothes.
Stats on the economics of Midwifery (current 2002 when book was edited)
1. Percent of countries providing universal prenatal care that have lower mortality rates than the US: 100%
2. Percent of US births attended by midwives: 4%
3. Percent of European births attended by midwives 75%
4. Number of European countries (Great Britain, France, Germany, Netherlands, Belgium, Denmark, Sweden, Norway, and Finland- all with over 75% of midwife-attended births) with higher perinatal mortality rates than the US: 0
5. Average cost of midwife- attended birth in the US: $1,200
6. Average cost of physician- attended birth in the US: $4,200
7. Heath care cost savings if midwifery care were utilized for 75% of the US births: $8.5 billion/yr.
8. Health are cost savings by bringing US cesarean section rate into compliance with WHO reccommendations: $1.5 billion/yr
9. Heath care cost savings by exending midwifery care and demedicalizing births in the US: $13-20 billion/yr.
Sandi’s Famous Caramels
2 cups white sugar
1 cup light brown sugar
1 cup lighr corn syrup
1 cup heavy cream
1 cup half and half
1 cup butter
4 tsp vanilla extract
1 cup chopped walnuts
optional: chocolate for melting and dipping.
you’ll also need: a very accurate candy thermometer, a 4qt heavy gauge pot, a 9×9 baking pan
combine all ingredients except the vanilla and the nuts in a heavy gauge 4 qt pot. stire until the sugar dissolves and the butter melts.
Reduce the heat. attach the candy thermometer to the side of the pot and cook, stirring frequently, until the thermometer reaches 240 degrees F. Watch closely to prevent its boiling over.
After it reaches the temp. stir constantly to avoid scorching on bottom of pan and cook until temp reaches 248 degrees F exactly. This whole process takes btw 35-60 min.
Remove from the heat at once and let stand 1 minute. Stir in the vanilla extract and the nuts. Quickly pour int the buttered 9×9″ pain. Cool for a couple of hours. Dip the bottom of the pan into a shallow tray of very hot water and turn the caramel slab onto a cutting board. Cut into large or small squares. Wrap individually in wax paper or dip individually into melted, highest quality chocolate and store in the fridge.
Makes 2.5 lbs candy, or 70-100 pieces depending on size.
Natural Birth Guru 