The MAWS eBulletin
| Volume 3, Issue 2
May 2010 | |
|
|
 Greetings!
Happy Belated International Day of the Midwife (May 5) and Happy Mother's Day in advance. Thank you, Washington midwives, for all the work you do serving mothers in WA state! The value of the gift you give mother's and babies on their special birth day and throughout their pregnancy and postpartum is immeasurable.
We are proud to report that, statewide, there has been a 30.7% increase in births attended by licensed midwives from 2003-2008! Also during that time, there was a:
- 6% increase in births attended by CNMs
- 9.9% increase in all midwife-attended births
- 17.4% increase in Birth Center Births
- 11.5% increase in Home Births
- 14.1% increase in births at home and birth centers combined
The following counties had increases in home and birth center births during that time: Asotin, Chelan, Clallam, Clark, Ferry, Franklin, Island, King, Klickitat, Lewis, Mason, Okanogan, Pacific, Pend Oreille, Skagit, Snohomish, Spokane, Whatcom counties. If you would like help publicizing this information in your local area, contact the MAWS Public Education and Public Relations Committee Chair at vicepresident@washingtonmidwives.org.
We look forward to seeing many of you next week at our Birth In Balance Conference. We hope you have also invited the other health care professionals and birth professionals with whom you work using our Downloadable Flyer. We are excited, as usual, to offer our professional members an opportunity to participate in an All-Region Peer Review the day following the conference. Please contact Sunita Iyer to RSVP or for more information.
We hope you will take the time to print out and read or save and re-visit this e-newsletter. It is chock full of great resources and reading material.
If you have any suggestions for topics or content for future e-newsletters; or if you would like to submit an article or link to be included, please email Kristin at vicepresident@washingtonmidwives.org.
Thanks for your time - we wish our Washington midwives and mothers all blessed, sweet births in the upcoming days and months,
Sincerely,
Kristin Effland, Vice President
Midwives' Association of Washington State
|
|
Important OB COAP Announcement
Please enter your OB COAP data for March, April, and May by the end of May. An interim report is going to be compiled and the Foundation would like as much representation from the midwifery community as possible!
|
WA state midwifery and WA Study on benefits and cost savings cited in article on Missouri midwives
|
Are you familiar with Pacific Mothers Support, Inc.?
PMSI will send the following items free to women on DSHS:
Breast Pump
Maternity Support Belt
Compression Hose
Blood Glucose Monitor
Pregnancy Wedge
Reflux Wedge
Hydrogel Pads
PP abdominal support binders
Other insurances can sometimes work too. Call for details
(800) 578-2260. Website>
|
Amnesty International Report on Maternal Mortality
Too Many Women Dying in U.S. While Having Babies
Read this March article by Push author, Jennifer Block. According to recent CDC statistics, nearly half of the maternal deaths in the US are preventable.
Click here to read the NY Times article>
|
 Save the date!
Save the date to attend Seattle Midwifery School Senior Paper Presentations June 18th at the SMS Talaris campus - click here for directions. 4 MEAC CEU contact hours will be available upon approval. Look for more details to come.
|
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:
Sarah Huntington, Lactation Consultant and Doula
Lactation consultation, birth doula services, midwifery and doula training. Maternity care consulting.
www.sarahdoula.com
Olympia
Cheryl Murfin
Nesting Instincts Perinatal Care
Provides birth doula and postpartum doula services on
a sliding fee scale to families throughout Puget Sound. Photography
services, placenta encapsulation and childbirth education services are
also available.
www.nestinginstincts.org
Seattle
|
|
MAWS MIDWIFE IN THE NEWS
Prosser midwife Kristin Eggleston was interviewed by KIMA TV in Yakima.
|
MAWS 2010 SPRING CONFERENCE - ONLY A WEEK AWAY!
Friday, May 14th at Seattle Pacific
CLICK HERE TO REGISTER NOW!
CLICK HERE FOR MORE INFORMATION
CLICK HERE TO RSVP.
|
NIH Consensus Development Conference: Vaginal Birth After Cesarean: New Insights Draft Statement
Have you read the Consensus Statement draft from the NIH VBAC Conference? Click here to read the document>
|
Reimbursement for Doula Care
Some Insurance plans including some Blue Cross/Blue Shield plans will reimburse clients for doula services. Click here for a form that you can provide to your clients to submit to their insurance company to request reimbursement for their birth doula!
|
Research You Can Use from Childbirth Connection
Systematic review: Severe Nausea and Vomiting in Pregnancy is Associated with H. Pylori Infection Sandven I, Abdelnoor M, Nesheim BI, Melby KK. Helicobacter pylori infection and hyperemesis gravidarum: a systematic review and meta-analysis of case-control studies. Acta Obstet Gynecol Scand. 2009;88(11):1190-200.
Many women experience mild to moderate nausea and vomiting during pregnancy. While this usually goes away after the first trimester, up to two percent of pregnant women suffer from severe, persistent vomiting that results in weight loss and the presence of ketones in the urine, a condition called hyperemesis gravidarum. Studies in recent years have linked infection with the bacterium H. Pylori with a variety of gastrointestinal diseases. A recent review looked for an association between H. Pylori infection and hyperemesis gravidarum.
The authors pooled the data from 25 case-control studies, totaling 1,455 cases of hyperemesis and 1,970 controls. They found significantly increased odds of a positive test for H. Pylori among women with hyperemesis compared to those in the control group. This association remained strong when the authors used statistical methods to control for possible areas of weakness among the included studies that could account for significant differences in their results. Women with symptoms meeting the definition for hyperemesis gravidarum were almost three times as likely to test positive for H. Pylori than women without the condition.
The take-away: The results of this review suggest that H. Pylori infection is a significant risk factor for hyperemesis gravidarum. Since H. Pylori is a common infection that can be treated with medications that are safe for use in pregnancy, the results of this review provide important clinical information for maternity care providers and women experiencing severe, persistent nausea and vomiting in pregnancy, as diagnosis and treatment of H. Pylori may provide relief from that condition.
|
|
|
Washington Midwives Beth Coyote and Karen Hays Head for Haiti
 MAWS members Beth Coyote LM CPM and Karen Hays CNM leave for Haiti on Friday May 7th. They are going with Midwives for Haiti (MfH), an NGO start by CNMs who have been
active in Hinche, a town in the middle of Haiti, for about 6 or 7
years. They have a midwifery school and help in the local
health delivery system and have achieved the support of the Haitian
government. Since the earthquake, they have gotten requests from other
NGOs who are looking for midwives (CNMs and CPMs) to help out with
health care needs, which their local staff are overwhelmed with. MfH is putting midwives in a number of different sites, and approximately 250
have stepped up to volunteer.
Beth and Karen will be in Carrefour, about 10 miles west of Port au Prince, near the earthquake epicenter. They will help with the clinics run by Haiti Family Ministries and also help the Adventist Hospital. According to Karen, they will "do maternity care for sure, but may also have to help in outpatient clinics, mobile clinics, in the wards, and in the O.R. We'll pitch in wherever we are asked to contribute. We are told to bring all our own bedding (including tent or mosquito net, since no one sleeps indoors anymore), all our own food, and all our own medical supplies that we think we might need."
Beth noted that "clients at Rainy City Midwifery (and their extended communities) have been so generous and supportive. Most of my expenses have been paid for by donations...I feel like I am an emissary for so much good will on the part of birthing families in the US."
If midwives or nurses are interested in volunteering, the key person to email is Terrie Glass. If anyone wants to make a tax-deductible donation to Midwives for Haiti, it can be done so through their website.
Midwives for Haiti has a large community on Facebook, and workers post there. Visit the Facebook page to see what's going on.
|
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."
|
Clinical Quandries: Expectant, Medical or Surgical Management for Incomplete Miscarriage
When attempting to respond to my clients' questions regarding miscarriage, I found that I have some unanswered questions. For mothers who want to avoid surgical intervention, how long is it safe to wait? Does that clock start from the time the woman learns she has miscarried even when an ultrasound suggests that the baby may have stopped growing weeks ago? What is the latest evidence regarding the medical management of miscarriage with misoprostol? To help me begin to answer some of these questions, I turned to recent research in search of new information and, of course, to my peers.
Here are some links to recent full text articles that I found available online:
Management of miscarriage: expectant, medical, or surgical?
British Medical Journal May 2006
How long is expectant management safe in first-trimester miscarriage?
The Journal of Family Practice - October 2005
Treatment of incomplete abortion and miscarriage with misoprostol
International Journal of Gynecology and Obstetrics 2007
These articles peaked my interest because we often have women who would prefer to avoid surgical management after a miscarriage as I imagine many midwifery clients do. And finally, reading about the option of medical management of incomplete miscarriage with misoprostol has me wondering if the drug legend for Licensed Midwives might be expanded to include this option. Perhaps a midwifery student might like to do her/his senior research paper on the topic so that all the evidence can be compiled and presented to the state.
|
 Seattle-Area Midwives:
Request for Assistance From UW Human Centered Design and Engineering Students!
MAWS recently received this letter:
"My name is Alexis Hope. I am a senior at the University of Washington studying Human Centered Design and Engineering. As part of my senior project (and in collaboration with computer science students and a Radiologist at Harborview medical center) I am designing and developing a portable ultrasound machine for midwives in Uganda. Uganda has a very high rate of maternal and infant mortality and it is our hope that a portable ultrasound device could help midwives diagnose breech birth, placenta previa, and multiple fetuses. Our goals are twofold: make this device as inexpensive as possible, and make it very usable for midwives who have little training with ultrasonography.
We are planning to do usability testing with midwives in Uganda in the future, but we are currently about halfway through our design process and would love input from Seattle area midwives about the usability of our device, and how it might fit into the Midwife model of care. I was wondering if there might be anyone at MAWS who would be interested in speaking to us about this project and possibly taking a look at our prototype so far to assess it's usability. We are very open to input and suggestions--we really want our design to support the work practices of midwives in the developing world!"
Please contact Alexis if you're interest in talking to her group.
Click here to learn more about their project>
|
Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births
Published in the American Journal of Obstetrics and Gynecology by Joseph R. Wax, MD et al.
OBJECTIVE: We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home).
STUDY DESIGN: Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility.
RESULTS: A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores 7. In contrast, home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight 2500 g.
CONCLUSION: Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores.
To read the full text article, click here>
|
Updates on Recent Evidence
Following are a list of links to the abstracts of recent journal articles related to midwifery. To read the abstracts on Pub Med, visit the links below:
The fetal occiput posterior position: state of the science and a new perspective.
Simkin P.
Birth. 2010 Mar;37(1):61-71. [Full Text available through Heal-WA]
Inconsistent evidence: analysis of six national guidelines for vaginal birth after cesarean section.
Foureur M, Ryan CL, Nicholl M, Homer C.
Birth. 2010 Mar;37(1):3-10. [Full Text available through Heal-WA]
Vietnamese women's cultural beliefs and practices related to the postpartum period.
Lundberg PC, Trieu Thi Ngoc Thu.
Midwifery. 2010 Apr 16. [Epub ahead of print]
Postpartum sexual function of women and the effects of early pelvic floor muscle exercises.
Citak N, Cam C, Arslan H, Karateke A, Tug N, Ayaz R, Celik C.
Acta Obstet Gynecol Scand. 2010 Apr 16. [Epub ahead of print] [Full Text available through Heal-WA]
Avoiding litigation - a matter of consent.
Starr L.
Aust Nurs J. 2010 Mar;17(8):29. No abstract available. [Full Text available through Heal-WA]
So many materials, so little time: a checklist to select printed patient education materials for clinical practice. Fraze J, Griffith J, Green D, McElroy L.
J Midwifery Womens Health. 2010 Jan-Feb;55(1):70-3. No abstract available.
Management of protracted active labor with nipple stimulation: a viable tool for midwives?
Razgaitis EJ, Lyvers AN.
J Midwifery Womens Health. 2010 Jan-Feb;55(1):65-9. No abstract available.
How caregivers manage pain and distress in second-stage labor.
Bergstrom L, Richards L, Morse JM, Roberts J.
J Midwifery Womens Health. 2010 Jan-Feb;55(1):38-45.
Managing mental health conditions in primary care settings.
Hackley B, Sharma C, Kedzior A, Sreenivasan S.
J Midwifery Womens Health. 2010 Jan-Feb;55(1):9-19.
A collaborative protocol on oxytocin administration: bringing nurses, midwives and physicians together.
Mandel D, Pirko C, Grant K, Kauffman T, Williams L, Schneider J.
Nurs Womens Health. 2009 Dec;13(6):480-5. [Full Text available through Heal-WA]
Much ado about nothing: two millenia of controversy on tongue-tie.
Obladen M.
Neonatology. 2010;97(2):83-9. Epub 2009 Aug 25.
Patient safety. Birth of a new age in maternity care.
Carlisle D.
Health Serv J. 2009 Apr 16;119(6152): 16-7.
Assistant or substitute: exploring the fit between national policy vision and local practice realities of assistant practitioner job descriptions.
Wakefield A, Spilsbury K, Atkin K, McKenna H, Borglin G, Stuttard L.
Health Policy. 2009 May; 90(2-3):286-95. Epub 2008 Dec 3.
|
UPCOMING CONFERENCES AND WORKSHOPS
Birth in Balance: Integrating What We Know
MAWS 2010 Spring Conference
May 14, 2010 - Seattle Pacific University
Speakers include Michael Klein, Penny Simkin, Molly Gray and Sheila Capestany
More information>
Normal Labor & Birth: 5th International Research Conference - The Benefits & Challenges of Preserving Physiologic Birth
July 20-23, 2010 -Vancouver, BC. More information>
AWHONN Convention
June 12 -16, 2010 at Gaylord Opryland Resort, Nashville, TN. More information>
International Lactation Consultant Assoc
July 21 - 25, 2010 San Antonio, TX. More information>
DONA International Conference
August 5 -8, 2010 Albuquerque, NM. More information>
50th Anniversary Mega Conference
Lamaze & ICEA Together! Uniting for the Future of Birth
September 30 - October 3, 2010 Milwaukee, WI. More information>
The Midwives Alliance of North American 2010 Conference
Nashville, TN - October 14-17, 2010. More information>
See the MAWS web site for ongoing continuing education opportunities.
|
FREE Pamphlets & Posters from the Department of Health
Did you know that the Department of Health has Client Education Materials of all sorts available for health care practitioners to order for FREE?
 This month's FEATURED RESOURCE: Tobacco Quit Line Card - For instructions on how to order FREE Tobacco Quit Line Cards for your clients & waiting room, click here.
|
|
 BUY 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.
|
|
|
|
|
