Midwives Association of Washington State
mama baby - feb enews
The MAWS eBulletin
Volume 3, Issue 1
February 2010
in this issue
:: Childbirth Connections's Blueprint for Action
:: Washington Midwives in the News
:: Greetings from the QMP/MAWS Liason
:: Join the Discussion Forum - Read the Latest Minutes
:: 2010 Membership Renewal
:: New Additions to Our Midwife-Friendly Provider Directory
:: MAWS Midwives to Join WA Research Project
:: Babies Exposed to Toxic Chemicals in Utero
:: Tell Legislators its Time to Eliminate BPA from Baby Bottles
:: PHOTOS NEEDED
:: Sugary Colas Tied to Gestational Diabetes
:: Spring Conference - Save the Date
:: Clinical Quandries: Accurate Pregnancy Dating
:: Upcoming Conferences & Workshops
:: Buy Comfort Measures and Penny will donate 10% to MAWS
Midwives Association of Washington State Greetings!

The snow is falling in the mountains of Eastern Washington, but it's been unseasonably warm and dry this January for those of us along the I-5 corridor - one example of the diversity of experience between MAWS members.  Thank you to those of you who made the trip to Lobby Day - we will keep you posted about our successes in Olympia. 

We on the MAWS Board look forward to an exciting new year and to continuing to improve the organization for you, our members.  And we also set our sights beyond our own professional development this year with renewed energy for launching our Better Birth Options campaign to improve maternity care for the women and families we serve. 

Look for an update on the work MAWS has been doing for you over the last eight months in the Annual newsletter that will be arriving soon via snail mail!

With great hope for increasing the number of women who have access to normal empowering birth and prenatal care,


Sincerely,

Audrey Levine, President
& Kristin Effland, Vice President
Midwives' Association of Washington State


Childbirth Connections's Blueprint for Action!
Following on the tails of their Milbank Report, Childbirth Connection released their Blueprint for Action this week.  

MAWS is already beginning to think about what we in WA can do to take action!



Washington Midwives in the News - "Benefits of midwifery go beyond money saved"

"Midwives in Washington state provide an excellent service to expectant mothers and have their place in the budget under consideration by state lawmakers," states an editorial in The Olympian this week.

"Midwives provide comprehensive prenatal care for mothers with low-risk pregnancies who plan to deliver at home or at a birth center. State records show that there are 86 licensed midwives. Collectively, they give pregnant women a safe alternative to a hospital delivery, saving taxpayers a considerable amount of money."

Read the full article in The Olympian>

Greetings from the QMP/MAWS liason!
I am happy to bring you this brief update. Every January and every July, I will provide a brief QMP update for the MAWS eBulletin regarding the work that the QMP is doing for you!  

The QMP was hard at work in 2009 and we accomplished a lot.

  • We addressed and solved the problem in our mail pick-up/distribution system (there used to be a rather lengthy time lag between the MAWS mailbox and the QMP). This problem no longer exists. We are now getting our mail on time and responding appropriately. Since Lynn Hughes collects the mail from the MAWS address and forwards it along to the QMP, we have her to thank!

  • We successfully updated our IRP document, which has much more lenient and flexible timelines for operation. We were very pleased when the Department of Health approved this revised document because we are now able to better comply with the guidelines.

  • We updated various IRP documents and created new documents.

  • Our committee meetings are running smoothly and efficiently. We were able to properly address all of the new incidents that were reported to the QMP in 2009 (12 total) and we are successfully continuing to track all of the cases which remain open from previous years.

Sincerely,
Erin Curtiss, L.M.



MAWS FORUM - Come on! Try it out!

If you haven't joined the forum yet,  click here and register. Please use a login or email that is identifiable so we know you are a member and can approve you quickly. (The MAWS Discussion Forum is for Professional Members Only.)

Check out some of the studies in this e-news and post your thoughts to the forum. Go to the board, "Clinical News & Issues," and post under the category, "Clinical News and Issues."

THANK YOU TO EVERYONE WHO HAS RENEWED THEIR MEMBERSHIP FOR 2010

Many of you have already renewed, and we so appreciate that! We're pulling together some important materials we want to pass along to you in a membership packet this year (including a hard-copy newsletter), so you will receive your certificate in that packet by the end of February. If you have a more urgent need for proof of membership, please contact Lynn, and we can send your certificate as a pdf for you to print out quickly.

IF YOU HAVEN'T RENEWED YET, PLEASE TAKE A MOMENT NOW! If you need help with the membership system (you're not alone), just write to Lynn. Send your phone number with good times to call if you'd like a phone call.

THANK YOU TO OUR NEWEST ASSOCIATE MEMBERS!

The following list contains our newest Associate Members (those who have joined since the last eBulletin) who are supporting MAWS at the $100 level. Click here to find out how you can help support MAWS by recruiting your favorite providers to become Associate Members. You will find these Associate Member listings in the MAWS online directory under "Midwife-Friendly" Providers:

Stacy Bowker
Snohomish Valley Holistic Medicine
Naturopathic pediatric and family medicine; well child exams; sports & school physicals; immunizations; acute illness care.
www.snovalleyholistic.com
Port Orchard

Kendra Machen
A Dalai Mama - Your Birth Guru

Childbirth Preparation classes by Certified Educator; Breastfeeding classes; Professional Labor Support Doula with current CPR, first aid and NRP provider certifications; Birth Tub rentals; Professional Placenta Encapsulation.
Send an email to Kendra
Port Orchard



MAWS MIDWIVES TO JOIN WASHINGTON RESEARCH PROJECT

A tremendous opportunity has presented itself and we're thrilled to share the news with you. MAWS has been invited by the Foundation for Healthcare Quality to participate, along with 8 hospitals in Washington State, in a 6-month project called OB-COAP (Clinical Outcomes Assessment Program). Licensed midwives who are members of MAWS are being asked to contribute very basic data for out-of-hospital births occurring between January and August 2010. You'll have the option of submitting data electronically or on paper and it is estimated that each entry should take no more than 10-15 minutes of your time (or the time of the lucky person in your practice who does your MANA stats).
 
We're hoping that the MAWS community will enthusiastically embrace this chance to put our data alongside hospital-based data to demonstrate not only that licensed midwifery care in Washington State results in excellent maternal and neonatal outcomes but that these results can be achieved without a heavy reliance on costly medical interventions. Our participation in OB-COAP is being regarded by the Foundation for Healthcare Quality as part of a strategy to affect change in hospital-based birth practices, lower costs, and improve outcomes for moms and babies. 
 
You'll be receiving more details about OB-COAP in the mail next week, including information about the two upcoming WebEx trainings (February 22nd from 1 - 2:30 or February 24th  from 10:30 - 12). It is our expectation that ALL licensed midwives who are MAWS members will participate in OB-COAP because the quality of the data depends on full participation. You will be rewarded for your time and effort! Be sure to open the mailing to find out how!


Babies exposed to toxic chemicals in utero! MAWS board member Molly Gray to testify this week at a Senate Hearing in DC

New tests by the Washington Toxics Coalition reveal that children spend their first nine months in an environment that exposes them to known toxic chemicals. Washington Toxics Coalition tested nine pregnant women, from Washington, Oregon, and California, for chemicals including bisphenol A, phthalates, mercury, and "Teflon chemicals."

The first-of-its kind study tested blood and urine from pregnant women during their second trimester of pregnancy and found their bodies contaminated with chemicals found in a wide variety of consumer products. This means that when babies are born, they've already spent nine months developing in an environment contaminated with chemicals linked to cancer, reproductive problems, and diabetes. In order to understand the issue and help your clients reduce their baby's exposure utilize WA toxics coalition "Tips for a healthy pregnancy".

MAWS board member, Molly Gray, ND/LM, was part of a study by the WA Toxics Coalition regarding toxic chemical exposure in pregnancy, and we're proud that she recently traveled to Washington DC to testify on this issue
!
Tell legislators its time to eliminate BPA from baby bottles!

Exposure to BPA before birth has been linked to a host of health problems including early puberty, infertility, and cancer.  After they're born, children's exposure continues from countless sources, including baby bottles, sippy cups and infant formula cans. Thankfully, we have a monumental opportunity to do the right thing in Washington state and eliminate BPA from food and beverage containers intended for young children.

Urge them to make protecting the health of Washington families a priority by passing the Safe Baby Bottle Act! Click here for more information on this action from Washington Toxics Coalition.
Then click here for an easy way to write to your legislators.


BEAUTIFUL PHOTOS NEEDED FOR MAWS WEB SITE

We are embarking on a web site face lift and are also developing a co-branded sister site called "Better Birth Options" specifically targeted to consumers! We need high quality photos of moms, babies and families for these sites.  Please send your client photos (with their permission, which we are happy to confirm) to Lynn.

Sugary Colas Tied to Gestational Diabetes

Study found drinking five or more per week prior to pregnancy increased risk by 22%

Women who drink five or more servings of sugar-sweetened cola per week before they conceive increase their risk of developing diabetes during pregnancy, a new study indicates.

"Previous studies have shown an association with other chronic metabolic problems," said study author Dr. Liwei Chen, an assistant professor of epidemiology at Louisiana State University Health Sciences Center, in New Orleans. "This is the first to show an increased risk among pregnant women."

The report appears in the December issue of Diabetes Care. Read full article>


SPRING CONFERENCE - SAVE THE DATE!

Planning is underway for the Spring MAWS Conference coming April 30, 2010.  Watch for details.

calendar page MAWS conference date

Want to help with the conference?  Send us an email.



Clinical Quandries: Accurate Pregnancy Dating
Kristin Effland, LM, CPM

Accurate pregnancy dating can be a clinical challenge for midwives and our clients.  Routine dating ultrasounds are not recommended for clients who have regular cycles and who keep accurate records of their last normal menstrual period.  However, the majority of clients may not fit into this narrow category since many of them will have one or more factor that complicates the calculation of an accurate EDD.  Still, many midwives and our clients feel concerned about the potential risks that may be associated with the overuse of ultrasound. 

I am particularly interested in this topic because in my practice in Northwestern Washington, we find that many clients report "regular" periods because they have recently discontinued birth control pills that made their cycles regular but that also may have caused them to ovulate at an unexpected time during their cycle.  We also have clients with recent miscarriages or who are still nursing which as we all know may affect when they ovulated.  Other clients are often unsure of their LMP or didn't take a pregnancy test until many weeks after their missed period.  Other clients will report a known LMP from which we calculate an EDD using Naegele's rule only to find at a fetal survey ultrasound that their expected EDD is >10 days different than expected.  Because of these and other related issues, I contacted our local ultrasound imaging center to ask for clarlity about the margins of error related to ultrasound dating at various stages of pregnancy.  They reported the following margins of error for ultrasounds conducted at their facility:
Prior to 10 weeks gestation (8 weeks by embryo dating) +/- 5 days
10 weeks - 22 weeks +/- 10days
22 weeks - 30 weeks +/- 14 days
30+ weeks +/- 21 days
Margins of error in ultrasound dating may vary by facility.

Here are two articles with current research related to this topic:

Issues in Pregnancy Dating: Revisiting the Evidence: Ultrasound Dating published in the Journal of Midwifery & Women's Health. 2009;54(3):184-190.
Read article>

New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study published in Ultrasound Obstetriscs & Gynecology 2008; 31: 388-396.
Read article>


To discuss these and related issues with fellow MAWS members, visit the MAWS online discussion forum. 

UPCOMING CONFERENCES AND WORKSHOPS

Midwifery Update 2010 - 11TH Annual Pacific Northwest Conference
February 10, 2010 - Shoreline, WA. More information>

What to do - The Unexpected Breech at Home - Kitsap Birth Collective
February 20, 2010 - 1025 Tacoma Ave. Port Orchard. Event listing with more information on Facebook  or send an email to Kendra.
 
CIMS, 2010 Mother-Friendly Childbirth Forum & Annual Meeting

February 26-27, 2010 - Austin, TX. More information>

NIH VBAC Consensus Conference
March 8-10, 2010 - Bethesda, MD. More information>

Trust Birth Conference
March 12-14, 2010 - Redondo Beach, CA.
Speakers include Sarah Buckley, MD, Gail Hart, Karen Strange, Carla Hartley. More information>


Midwifery Today Conference

April 14-18, 2010 - Philadelphia, PA
2010 speakers include Ina May Gaskin, Marsden Wagner, Michel Odent, and Debra Pascali-Bonaro. More information>

Normal Labor & Birth: 5th International Research Conference - The Benefits & Challenges of Preserving Physiologic Birth
July 20-23, 2010 -Vancouver, BC. More information>



See the MAWS web site for ongoing continuing education opportunities.

Simkin's Comfort Measures DVDBUY PENNY SIMKIN'S NEW COMFORT MEASURES FOR CHILDBIRTH DVD & PENNY WILL DONATE 10% TO MAWS!

This 90-minute interactive DVD contains more than 40 techniques for reducing and managing the pain of labor contractions. Christiane Northrup, MD states, "Comfort Measures is wonderful. I suggest that it be required viewing for all pregnant couples and childbirth professionals." Use this link to buy it now or click here to read more about it.

 
This is your newsletter.  Please send any feedback or suggestions to Kristin Effland.  We welcome suggestions for future topics, popular articles or research to include.