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The MAWS eBulletin
| Volume 5, Issue 5
December 2012 | |
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 Greetings!
As fall turns to winter, we here at MAWS are happy to bring you the latest research and midwifery-related news including information on the Flu Vaccine in pregnancy, autism, delayed cord clamping and pacifier use as it relates to SIDS. We've got a slew of great articles to share with you from new studies to local midwives in the news.
Don't miss the critique by Wendy Gordon, LM, CPM, MPH of the recent statement in opposition to home birth in the American Journal of Obstetrics & Gynecology. Along the same vein, we have also created a new page on the MAWS website that compiles Position Statements on Home Birth by prominent organizations. Share this material and the Annotated Guide to the Literature on Home Birth with your colleagues and clients as evidence in contrast to this latest attack on home birth.
This edition of the MAWS e-news also contains several articles and a radio interview intended to help us continue our important profession-wide conversations and self-education about race and privilege. And if you missed the MAWS Fall conference this year or if you'd like to re-visit the awesome topics, be sure to download the presentation slides we've included here. As usual, we've also included upcoming CEU workshops related to midwifery. Be sure to scroll through the table of contents below as there are a few time sensitive items including a petition for NDs to be added to the Health Care Bill and a call for workshops for MANA 2013.
Take care and we hope to see you this year in Olympia for Lobby Day on February 8!
Best,
Kristin J. Effland, CPM, LM
MAWS Vice President |
New Research, Guidelines & a Patient Decision Aid Regarding Delayed Cord Clamping
REMINDER: WA state LMs and CNMs are required to provide information about cord blood banking to clients before the third trimester. The law went into effect July 1, 2010. Click here to read about the requirement outlined in RCW 70.54.220.
New Research:
"Immediate or early cord clamping vs delayed clamping." by DJ Hutchon. in the Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 2012 Nov;32(8):724-9. doi: 10.3109/01443615.2012.721030.
ABSTRACT
FULL TEXT Article currently available through Pubmed & via Heal-WA after 18 mo embargo
"Rethinking placental transfusion and cord clamping issues." by Mercer JS, & Erickson-Owens DA. in The Journal of Perinatal and Neonatal Nursing. 2012 Jul-Sep;26(3):202-17; quiz 218-9.
FULL TEXT Article available to LMs and CNMs through Heal-WA.
The Royal College of Midwives (RCM) in the UK is set to issue advice this winter that midwives should wait before cutting the umbilical cord. Read More.
"Not earlier than one minute" should be understood as the lower limit supported by published evidence. WHO Recommendations for the prevention of postpartum haemorrhage (Fawole B et al. Geneva, WHO, 2007) state that the cord should not be clamped earlier than is necessary for applying cord traction, which the GDG clarified would normally take around 3 minutes." FROM World Health Organization Guidelines on Basic NB ResuscitationFor additional resources on this topic, visit the MAWS Practice Update page. Patient Decision Aid:The Centre for Mothers & Babies has just released a new decision aid designed to support women to know what to expect and make decisions about clamping their baby's umbilical cord after a vaginal birth. DECISION AID LINK |
| MANA 2012
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Past MANA Presidents - Washington's Therese Charvet on the right end of the front row
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MANA 2012 was indeed historic - the 30th anniversary! When Sister Angela called Seattle Midwifery School to invite us to that formative meeting in 1982, neither Suzy Myers nor myself wanted to go because we were waiting for our good friend to have her baby. So we recruited Therese Charvet, aka Teddy...little did we know what a perfect person she was for the job, establishing an organization to bring together all midwives under one roof!
Let the bridge building continue! Reflecting on how far we've come is so overwhelming! When one appreciates the inter-connectedness and contributions of the many organizations spawned since then, the story is truly inspiring. Who would have imagined that we'd now have 26 states licensing direct-entry midwives, all holding certification in a process we created, and we'd be poised on the national agenda for recognition as Medicaid providers!
Our charge nationally is to keep on going: pushing together for universal legislation, refining and continually updating educational, certification, and accreditation processes, getting standards in line with the international picture...not to mention being in the trenches, doing the work, having the privilege and sisterhood each of us experiences as midwives - what could be a more fulfilling livelihood. And next year, 2013, will be the 30th anniversary of MAWS. Let's pause again to celebrate our amazing progress!
-By Marge Mansfield, LM, CPM
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Thank You to Our New Associate Members!
We are so grateful for the support of our associate members. Associate memberships help fund the work of MAWS while offering associates a listing in our directory. Please support our associate members in your area with referrals!
We hope you'll suggest associate membership to service providers you typically refer your clients to--massage therapists, doulas, childbirth educators, etc. You may refer them here on our web site.
1st Choice Acupuncture & Integrative Medicine
David Lin, L.Ac.
Acupuncture, Chinese Medicine (Specializing in Postpartum Recovery)
Bellevue, WA
Acupuncture for Birth
Patrice Hapke, L.Ac., M.Ac.
Acupuncture, Supporting Pregnancy, Birth and Fertility
Seattle WA
Cascade Care
Lisa Whatley, RN, BSN, IBCLC
Lactation Services
Sammamish WA
Northwest Holistic Medicine
Michelle Obertacz, ND, LAc
Naturopathic Care, Acupuncture
Seattle WA
The Next Step Physical Therapy
Karen Calera PT
Physical Therapy Services
Seattle, WA
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Washington Midwife Catches a Baby on the Bainbridge Ferry
 Therese Charvet, former Midwifery Education Program Director for Seattle Midwifery School, past president of MANA (see article above), who used to practice midwifery on Bainbridge Island, was on her way to speak to a group of midwifery students at Bastyr University on Thursday afternoon, November 29, "w
hen an announcement on the intercom system asked for medical assistance, Charvet assumed someone was having a heart attack and stayed put. But fortunately for baby Lucy and her parents, Charvet happened to be sitting near the elevator where Mom was being taken up at the front of the boat.
"I know what a woman in labor sounds like, and I was up there in a flash. The good luck piece was that I happened to be sitting near that elevator instead of the elevator on the other end of the boat," said Charvet. When she explained to the group that she was a midwife, Charvet said, "Everyone gratefully stepped aside. Another older woman there was a labor and delivery nurse, and she stood by holding the mother's hand during the birth."
Within a couple hours of the birth, the news was widespread and even picked up by the Associated Press!
Read the full story from Inside Bainbridge>
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| Black Moms Are Raising Volume on Breastfeeding
By Christina Caldwell, Women's eNews commentator
Thursday, November 8, 2012
Author, Christina Caldwell, never saw a black woman breastfeeding before she gave birth. Now she's glad that two advocates are working to increase visibility in their communities and at work.
Fear. Indifference. Disdain.
These are the emotions that too many African American mothers feel regarding the decision to breastfeed. Instead of having the cheerful "breast is best" line sung to them from family members, colleagues and even physicians, some black mothers have to fight through a host of assumptions, ill-informed statements and unsupportive banter.
The opposition that was thrown at me was overwhelming after I told family members I was choosing to breastfeed. It was as if they couldn't tell me enough about how the baby wouldn't get full, that my milk wouldn't come in, that my milk would run out, that it would be painful. And my personal favorite: I was being too cheap to buy formula.
Fortunately, more voices are chiming in to support black women who breastfeed. Kiddada Green, of the Black Mothers Breastfeeding Association, and Sojourner Marable Grimmett, of Table for Two, are among the growing number of women seeking to erase the stigma of breastfeeding... READ MORE
Related RESOURCES for Moms:
BLOG - Sojourner Marable Grimmett is an Atlanta-based author who is recognized for writing about the joys and challenges of being a "stay-at-work" mom
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Sojourner Marable Grimmett
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and connects with moms, both new and experienced, who have the responsibility of raising a family and maintaining a full-time job. Sojourner has been featured in FitPregnancy, WhatToExpect.com, BlackAndMarriedwithKids.com, MacaroniKid.com, Fox News, and CNN.
Kimberly Seals Allers' Mocha Manual for Pregnant and Breastfeeding Mommas
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Save the Date!
MAWS Annual Lobby Day
Friday, February 8, 2013
Watch for updates, and please plan now to join us in Olympia! |
Download Slides from the MAWS Fall Conference 2012
As usual, slides and handouts from the Fall Conference can be found on the MAWS Website or below.
Update: Hypertensive Disorders in Pregnancy - Robin deRegt, MD OB/Gyn
Frenulums and Craniums: Overcoming Certain Breastfeeding Challenges with Frenotomies and Cranial Therapy - MaryAnn O'Hara, MD and Karen Santos, PT
Frenotomy data Summary
Presentation on OB COAP Data - Ellie Kaufman, MD OB/Gyn with Kristin Sitcov
Update: Non-Stress Tests and Using Fetal Monitor in Our Practices - Karen Hays, CNM DNP
Intermittent Auscultation - Research and Practice - Karen Hays, CNM DNP & Wendy Gordon, LM CPM MPH
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Radio Interview With Author of Understanding Whiteness/ Unraveling Racism
Listen to an interview with speaker and author: Laurie B. Lippen, author of Understanding Whiteness/ Unraveling Racism found on Intersections Radio Online. Her book makes whiteness and white privilege visible, revealing the cultural and institutional structures that keep white dominance in place. The book is both a workbook and reader, providing tools for examining what it is to be white in the U.S., for addressing fear and guilt as barriers to dismantling racism, and for identifying the small daily acts and larger organized movements that further the struggle for social justice and equality. It includes analytical essays, narratives, and poems from a variety of diverse perspectives. Numerous experiential exercises also aid readers in deepening learning through one's own life experiences.
Dr. Lippen is a passionate presenter whose commitment to diversity inspires all who work with her. She is the principal of Lippin & Associates and also teaches at the University of California, Davis. As a soulful accordionist with the HarmoniaSchvesters she plays her own ethnic Yiddish music. A frequent White Privilege Conference presenter where her keynotes and seminars are enthusiastically received, Laurie believes we need to work as individuals and in coalitions to bring needed societal changes and equity for all.
INTERVIEW with Laurie Lippen
Intersections Radio Online
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Obstetricians Claim Homebirth is Unsafe...Again. Where's The Evidence?
by Wendy Gordon, LM, CPM, MPH
Recently, an article in the American Journal of Obstetrics & Gynecology pled with obstetricians to not support planned home birth in any way, and even suggested that those who do "should be subject to peer review and justifiably incur professional liability and sanction from state medical boards" (1). In their strongly worded opinion, the authors (the first two of whom are, curiously, members of the journal's Advisory Board, and four of whom are also board members of the International Society of Fetus as a Patient) make their case that physicians should provide evidence-based information to women that planned home birth is not safe, that reports of patient satisfaction are overrated, that it's actually not cost-effective, and that a pregnant woman has a moral duty to her fetus to give up her autonomy to her doctor's judgment on this issue. Let's take a look at the basis for these recommendations.
Click here to read the full critique published in Lamaze's "Science and Sensibility" and written by MAWS member and Bastyr faculty, Wendy Gordon, LM, CPM, MPH.
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Home Birth: An Annotated Guide to the Literature
Aug 2011. Vedam S, Schummers L, Fulton C. Vancouver, British Columbia, Canada: University of British Columbia
This annotated bibliography provides citations and critical appraisal of original studies on home birth.
Click here to read the full text guide.
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Upcoming NRP Workshop in Seattle: Integrative Resuscitation of the Newborn Workshop with Karen Strange, Jan. 2013
Just back with the latest updates from the AAP/NRP Current Issues Seminar and Conference in New Orleans October 19th!
January 17, 2013 in Seattle, WA
For more information or to register, click here.
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Workshop Proposals for the MANA 2013 Conference DUE January 15!
"Birthing Social Change" Conference Portland, Oregon October 24-27, 2013 MANA 2013 Abstracts Submissions are now open! Submit your abstract by January 15, 2013 to be considered. For more information, Visit: MANA Workshop Proposals
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Petition for Naturopathic Doctors to be included in Obamacare: Signatures Needed by Dec 7
Now that the presidential election is over and President Obama has been elected to serve a second term, the future of the Affordable Care act is no longer in question. A petition has been posted to the White House website, "We the People," asking the government to include Naturopathic Doctors (NDs) as primary care providers under the Affordable HealthCare Act (aka Obamacare). While the health reform bill currently provides for the inclusion of "complementary and alternative medicine practitioners," it does not specify how NDs can participate. It is our hope that the petition will allow the AANP (American Association of Naturopathic Physicians) an opportunity to begin discussions within the government to explore possibilities.
But first the petition needs signatures, 25,000 (or, hopefully, many, many more) by Dec. 7. Consider taking a few minutes to sign and send this petition out to your friends and associates.
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Hija De Mi Madre - The Afro-Latina Identity
by Birth Doula Ynanna Djehuty
Ynanna Djehuty writes "I am an Afro-Dominican woman born and raised in the Bronx. I am a writer and certified birth doula. I am a member of the International Center for Traditional Childbearing (ICTC), and a sister of Mu Sigma Upsilon Sorority, Inc. The focus of my work is the empowerment of women and people of the African Diaspora, specifically discussing the Afro-Latina Identity. I utilize my experience as a birth doula to raise awareness on maternal and infant health for womyn, highlighting the disparities in the healthcare system in the United States for womyn of color.
In October 2009, I completed and self-published my literary work called 'Hija De Mi Madre' (My Mother's Daughter), which is a combination of memoirs, poems and research material that not only explain the effects of race on identity from an academic standpoint but also shares my life as a living example. My second book, "Odas de La Mujer de Miel," is my first collection of poetry in Spanish and was released July 2011. I am studying to become a midwife to continue to advocate for womyn and their overall well-being."
Links to her writings.
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Latest Report From the CPM Symposium
Now Available! The November report from the CPM Symposium: Grounding CPM Midwifery in a Global and National Context
Articles include:
- State of the World's Midwifery: International Strategies for Strengthening Midwifery
- Policy Imperative and Perinatal Outcomes
- Understanding the Upward Trend in Home and Other Out-of-Hospital Births
- Future of Home Birth in the United States: Addressing Shared Responsibility
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Discrimination Can Lead To Low Birth Weight In Babies
 According to a recent study published in Annals of Behavioral Medicine, depression caused by discrimination could eventually result in low weight babies at the time of birth.
Valerie Earnshaw and her team from Yale University have determined that although it has been long known that it is important to decrease the risk of health problems in a woman's life in order to avoid low birth weight, new evidence suggests that discrimination on a regular basis against pregnant urban women can play a large part in increased risk of low birth weight among newborns.
In the U.S., white and Latina women give birth to low weight babies half as much as black women, although the reasons are not yet completely known. However, the evidence that does exist supports the notion that if women who are pregnant are discriminated against, low birth weight occurs.
Low birth weight can result in fetal and prenatal morbidity, suppressed growth and slower cognitive development and chronic diseases later in the baby's life.
Discrimination has also been associated with depression, which results in physiological changes, which hurt pregnancy outcomes in the long run... READ MORE>
FULL TEXT of cited research, available to LMs and CNMs through HEAL-WA.
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Flu Vaccine in Pregnancy
 It's that time of year where clients start asking about the flu vaccine, and the "Flu Vaccine" box on your prenatal visit checklist (if you have one) starts to apply again.
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Are You on Facebook?
"Like" the Midwives' Association of Washington State!
If you're on Facebook, visit us and "like" our page, and encourage your friends to "like" us, too. This is a great way to get the word out on MAWS' legislative work and events.
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| Position Statements on Home Birth & Birth Setting - New Webpage with Links
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Pacifier Use, Breastfeeding and Sudden Infant Death Syndrome
 ABSTRACT:Objective: To review the effect of pacifier use in healthy term infants on breastfeeding duration and the risk of Sudden Infant Death Syndrome (SIDS).Results: The initial search of the databases resulted in 68 references on the use of pacifiers and SIDS; three articles (1 meta-analysis, 1 SLR, 1 narrative review) received a positive rating according to the DAA checklist. The three publications consistently found pacifier use at last sleep was associated with a significant reduction in the risk of SIDS and to a lesser extent, routine pacifier use also provided a significant reduction in the risk. Searching the electronic databases for use of pacifiers and breastfeeding duration resulted in 188 publications and four of these publications were retrieved for analysis (1 Cochrane review, 1 SLR, 1 meta-analysis, 1 cohort study). The epidemiological evidence found pacifier use reduced the duration of any, full and exclusive breastfeeding, but this effect was not significant in four out of the five RCTs analysed in the Cochrane review and the SLR.Conclusion: The present review provides evidence of the association between pacifier use during the postnatal period and a decreased risk of SIDS whilst also drawing attention to the negative association between early pacifier use and reduced duration of breastfeeding (any, full and exclusive). This is the first review to emphasize the U-shaped effect of pacifiers on infant health. When assessing the totality of the evidence the results indicate that pacifiers should be advised against in the first month of life, but after the first month pacifier use may reduce the probability of SIDS.Authors: Hewitt, Katie; Binns, Colin; Scott, Jane; Forbes, DavidSource: Current Pediatric Reviews, Volume 8, Number 4, November 2012 , pp. 285-291(7)
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Autism After Infection, Febrile Episodes, and Antibiotic Use During Pregnancy: An Exploratory Study
ABSTRACTOBJECTIVES: Results of animal studies suggest that maternal immune activation during pregnancy causes deficiencies in fetal neurodevelopment. Infectious disease is the most common path to maternal immune activation during pregnancy. The goal of this study was to determine the occurrence of common infections, febrile episodes, and use of antibiotics reported by the mother during pregnancy and the risk for autism spectrum disorder (ASD) and infantile autism in the offspring.
METHODS: We used a population-based cohort consisting of 96,736 children aged 8 to 14 years and born from 1997 to 2003 in Denmark. Information on infection, febrile episodes, and use of antibiotics was self-reported through telephone interviews during pregnancy and early postpartum. Diagnoses of ASD and infantile autism were retrieved from the Danish Psychiatric Central Register; 976 children (1%) from the cohort were diagnosed with ASD.RESULTS: Overall, we found little evidence that various types of mild common infectious diseases or febrile episodes during pregnancy were associated with ASD/infantile autism. However, our data suggest that maternal influenza infection was associated with a twofold increased risk of infantile autism, prolonged episodes of fever caused a threefold increased risk of infantile autism, and use of various antibiotics during pregnancy were potential risk factors for ASD/infantile autism.CONCLUSIONS: Our results do not suggest that mild infections, febrile episodes, or use of antibiotics during pregnancy are strong risk factors for ASD/infantile autism. The results may be due to multiple testing; the few positive findings are potential chance findings.SOURCE: Pediatrics pp..2012-1107; November 12, 2012 by Hjördis Ósk Atladóttir, et al.ABSTRACTFull Text available through HEAL-WA after one year embargo
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UPCOMING CONFERENCES, WORKSHOPS & COMMUNITY EVENTS
REACHE CONFERENCE Just Passing Through: Is it All About the Pelvis?
March 22, 2012, Renton, WA SAVE THE DATE: MAWS Spring Conference - Friday, May 10, 2013 See the MAWS web site for ongoing continuing education opportunities.
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 BUY PENNY SIMKIN'S UPDATED 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.
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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.
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