This is such a great resource! If you have some time read it through and make notes :)
Article taken from Childbirth Solutions
Wise Use of Herbs during Pregnancy
by Linda B. White, M.D.
To make love with the goal of creating a child represents longing incarnate. It is an act both wonderfully irrational and a bit reckless. Once the child within takes hold, you are no longer one, even after the birth. Being pregnant reminded me of those Russian Matrushka dolls with tiny women nestled one inside the other--only in pregnancy, the figures are strung together by umbilical cords. Motherhood can evoke feelings that run the gamut from profound to mundane, rapturous to maddening.
A woman and her fetus are literally connected--spiritually, emotionally, and physically. If you desire a child, now is the time to optimize your health. A few weeks--critical ones for organ development--typically pass between conception and the realization that you are pregnant. Susun Weed, herbalist and author of Wise Woman Herbal for the Childbearing Year, offers the following advice: "Basically, what we should be doing every day of our lives is taking care of ourselves--getting sufficient rest, eating well, exercising, making sure that we're touched lovingly, that we're supported by people who believe in us and encourage us."
Herbs Commonly Used during Pregnancy
Although herbs are not necessarily needed by all women during pregnancy, the following herbs are recommended by experienced herbalists and have been used safely by women for centuries. Kathryn Cox, owner of Motherlove, an herbal company for women in Laporte, Colorado, suggests generally choosing herbs that can be eaten as food: nutritive herbs rich in vitamins and minerals such as red raspberry leaf, nettles, alfalfa, and dandelion. Rosemary Gladstar, author of Herbal Healing for Women, stresses that with these traditional pregnancy herbs the whole plant is meant to be used, preferably eaten as a vegetable (in the case of dandelion greens or nettles) or in some cases taken as a tea or tincture. Unless under the care of a health practitioner, pregnant women should not use concentrated botanicals that isolate a few chemical properties. Also, do not exceed recommended dosage guidelines unless advised to do so by your healthcare practitioner.
Red Raspberry is a tonic that has been used safely by people in North America and Europe for hundreds of years. Catherine Hunziker, owner of WishGarden Herbs and an instructor at the Rocky Mountain School of Botanical Medicine in Boulder, Colorado, calls it "the best all-around herb for a healthy pregnancy. It's a nourishing, building herb that has an affinity for the reproductive system."
This nutritive herb is rich in calcium, magnesium, iron, phosphorus, potassium, vitamins B, C, and E, and the alkaloid fragarine--the constituent that contributes to the plant's potency as a pregnancy tonic. It increases fertility in men and women (especially when combined with red clover), tones the uterus, eases morning sickness, and assists in plentiful milk production.
If you have a history of miscarriage, some herbalists recommend that you should delay using the common variety of red raspberry (Rubus idaeus) by itself, especially as a tincture, until after the first trimester. You can then drink one to two cups of tea a day every other day. Also, if your previous labor has been under three hours, red raspberry may be contraindicated. Check with your health practitioner.
To make a tea, add one to two tablespoons dried leaf per cup of boiling water and steep ten to 20 minutes. You may want to alternate red raspberry with other nutritive herbs such as nettles or combine it with other nourishing herbs. Motherlove's "Tea for Two" recipe contains red raspberry, red clover (blood cleansing), nettles (nourishing), alfalfa (also nourishing), and spearmint (tastes good and calms the stomach).
Nettles are rich in biochelated iron, calcium, and protein, as well as a host of other important nutrients. "It is virtually a pregnancy tonic by itself," says Gladstar. The benefits of drinking nettle infusion before and throughout pregnancy include nourishing and strengthening the kidneys, increasing fertility in men and women, nourishing the mother and the fetus, diminishing leg cramps and childbirth pain, preventing hemorrhage after birth, reducing hemorrhoids, and increasing the richness and amount of mother's milk. According to Sharol Tilgner, ND, president of Wise Women Herbals in Creswell, Oregon, nettles should be picked prior to flowering to avoid bladder and kidney irritation. Although use as a tonic is considered safe in pregnancy, concentrated extracts of stinging nettles (such as used to treat hay fever) can act as an abortifacient.
Alfalfa is loaded with vitamins A, D, E, and K, eight digestive enzymes, and numerous trace minerals. It is particularly helpful in late pregnancy because the vitamin K it supplies promotes proper blood clotting, thereby reducing the risk of postpartum hemorrhage.
Dandelion. Both the leaf and root of this common garden "weed" provide many essential nutrients: vitamins A and C, iron, calcium, potassium, and many trace elements. The root is said to be a specific remedy for the liver. The leaf is a mild, nonirritating diuretic, which can reduce water retention during pregnancy. You can eat flesh leaves as salad greens, cook them, or steep them as a tea. However, because dandelion is rich in vitamin A, a fat-soluble vitamin that can accumulate in the body, use only in moderation.
Herbs to Avoid during Pregnancy
Experts agree that pregnant women should avoid herbs that have strong medicinal or potentially toxic effects. Francis Brinker, ND, author of The Toxicology of Botanical Medicines, notes that many of the herbs not recommended help initiate menstrual flow, particularly in nonpregnant women. For women who miscarry easily, higher doses of these herbs in early pregnancy may increase this risk.
Under professional guidance, a woman may be advised to take some of these herbs to treat specific conditions, including complications of pregnancy. For instance, herbalists have traditionally used black haw, false unicorn root, cramp bark, and wild yam root for threatened miscarriage. Both blue cohosh and black cohosh are sometimes recommended during the last weeks of pregnancy to prepare the uterus for childbirth or to stimulate contractions. Shepherd's purse has been utilized to abate hemorrhaging during childbirth.
The point is not to self-medicate with the following botanicals. It is also important to realize that the examples in each category do not represent an exhaustive list.
Herbs that stimulate uterine contractions: birthwort, blue cohosh, cinchona, cotton root bark, ergot (as in commercial preparations for migraine headaches), goldenseal, gotu kola, Peruvian bark.
Herbs that stimulate menstrual flow: agave, angelica, bethroot, black cohosh, chicory, feverfew (in flower), hyssop, horehound, lovage, milk this-tie, mistletoe, motherwort, mugwort, nasturtium seed, osha, fresh parsley leaves (especially placed vaginally), pennyroyal, poke root, pulsatilla, rue, saffron, sumac berries, tansy, thuja (white cedar), watercress, wormwood, yarrow.
Herbs high in volatile oils (which can stimulate or irritate the uterus): eucalyptus, nutmeg, osha, yerba mansa, and the mint family members basil, catnip, lemon balm, marjoram, oregano, peppermint, pennyroyal, rosemary, true sage, and thyme. For the common culinary herbs, the concern lies with the use of high doses in women susceptible to miscarriage, not with using herbs to flavor food.
Plants high in alkaloids (which can also stimulate the uterus): barberry, blood root, broom, goldenseal, coffee, mandrake, tea.
Herbs that affect hormonal function: dong quai, hops, licorice, motherwort, wild yam.
Harsh herbal laxatives: aloe, cascara sagrada, purging buckthorn, rhubarb, senna, and yellow dock (in large amounts).
Strong diuretics: juniper berries, uvaursi (bearberry).
Thursday, March 25, 2010
Wednesday, March 24, 2010
birth without violence
Frederick Leboyer, M.D. was a French physician who was responsible for creating the awareness in maternity wards of the intact an functioning senses of the newborn. Many doctors at the time even thought newborns to be blind at birth! His revolutionary book "Birth without Violence" changed the way in which many parents and professionals bring babies into the world.
Monday, March 22, 2010
Interview with Midwife Cara Mulhahn
Cara Muhlhahn, CNM, and midwife featured in The Business of Being Born (documentary film)
Why did you decide to become a midwife?
I knew from a very early age that I was destined for a medical profession. A series of events led to the decision, but the first birth I attended is what got me hooked. So much of what we do is helping women navigate their own process by giving them reflection and feedback about the normalcy of what’s going on from the outside—when they think they’re dying, splitting apart, falling into oblivion.
You started your career as a lay midwife in your early twenties. What made you decide to become a certified nurse-midwife?
When I was apprenticing for home birth I heard about a maternal death at home. I immediately thought, “I need to pay attention so I’m doing the safest thing.” I knew there was more education I could get. I also wanted legitimacy and legal protection. I didn’t want my entire career to be at risk in the event of an unavoidable bad outcome.
Did you ever consider becoming an ob/gyn?
When I went to college, everyone wanted me to be a physician because I was first in my premed science classes. I did consider becoming an ob/gyn for a while, but the one thing that held me back was that I did not want to do surgery. I was worried about becoming inured to the sacredness of the body and possible intervening unnecessarily in a natural process. Midwifery seems to be a better fit for me.
What made you choose to practice in a home setting?
I worked in a freestanding birth center for four years in New York. I loved the birth center, but I had to leave that setting in order to graduate to midwifery based on experientially honed clinical judgment call, rather than what I view as restrictive protocols. Adherence to institutional protocol can be a first step, an essential one for securing safe outcomes while working as a novice. Practicing at home allows me to make clinical birth plans based on the unique circumstances of each birthing woman’s labor and contributes to lessening the interventions that often make up the slippery slope of the descent into resolution by cesarean section.
How do you view your colleagues who practice midwifery in hospitals?
I’m not interested in promoting a division between home birth and hospital midwives. All midwives are making headway in the battle to bring the power of birth back to the woman—who is actually doing most of the work. If we legitimize home birth and hospital birth, people are going to naturally find their comfort level. Opponents of midwives will just use the old “divide and conquer” to keep us from our deserved triumph.
How did you get involved with The Business of Being Born?
Abby Epstein, the film director, approached me by telephone and said she was working with Ricki Lake. Synchronistically, a couple of weeks earlier, I said to one of my student midwives who had just gone to film school that we needed to make a film. Abby and I first met at a neighborhood café, Ciao for Now, and talked about the proposal. And I said “The film you are proposing is the one I wanted to make, but not being a filmmaker, I’d rather you do it.”
What was it like making the film?
It took us over two years. I created a persona that could completely tune out the cameras most of the time. If I hadn’t been able to do that, I can imagine things would have been quite difficult. Allowing the filmmakers into such an intimate personal and professional space was clearly an act of faith. At the end of it all, I can pretty much attest to Ricki and Abby´s adherence to portraying midwives as we would like to be seen.
How do you feel about how you are portrayed in the movie and what would you like to have changed?
First of all, I want to say that I’m very grateful for this film. However, it leaves some questions unanswered. One is that there is no clip of me listening to the baby’s heart beat in labor. I’m one of the stricter home birth midwives in terms of how closely I follow ACOG guidelines for intermittent fetal heart rate monitoring. It would have been better for the public to know that we do check on their babies when they’re in labor.
Abby ends up being one of your clients in the film, but it looks like she visits several care providers during the course of the movie. Were you Abby’s prenatal care provider?
I was not until very late in the game. I had two prenatal visits with her and another scheduled two or three days after she went into preterm labor at 35 ½ weeks. At 32 weeks, I knew the baby was breech.
The film ends with a lot of drama when Abby goes into preterm labor at home. What do you think about the transfer scene?
They don’t show all of the clips of me executing the decision to go. They don’t realize the drama in the lobby scene makes it look like I was not in charge of the transport. We were only at the house for about an hour, and Abby and I arrived at the hospital before the physician. I was in the operating room during the cesarean section at Abby´s head.
What do you envision as a positive future for midwifery?
The Business of Being Born can help initiate a necessary conversation between the birthing public and birth professionals. Here is an opportunity for an honest exploration and evaluation of what home birth midwives really do instead of reliance on the convenient and self serving projections of a suspicious and undereducated governing body. We need to make a stance and we need to make it strong. The women of this country desperately need midwives on their behalf to help them birth normally.
The Transfer Scene: What the Cameras don’t Show
If you’ve seen The Business of Being Born, you probably have some questions about the preterm labor and the cesarean section at the end. ACNM member Cara Muhlhahn, CNM, shares the details that didn’t make the final cut.
What do you think about how you are portrayed in the movie and what would you like to have changed?
First of all, I want to say that I’m very grateful for this film. I feel that midwives are portrayed in a very positive light. However, there are a few lapses that leave some questions unanswered. One is that there is no clip of me listening to the baby’s heart beat in labor. I’m one of the stricter home birth midwives in terms of how closely I follow ACOG guidelines for intermittent fetal heart rate monitoring. It would have been better for the public to know that we do check on their babies when they’re in labor.
Abby Epstein, the film director, ends up being one of your clients in the film. But it looks like she visits several care providers during the course of the movie. Were you Abby’s prenatal care provider?
Not until very late in the game. She was undecided about her choice of birth site and provider until after 28 weeks. Her early prenatal care was done by the physician in the film, Dr. Moritz. I had two prenatal visits with Abby and another scheduled two or three days after she went into preterm labor at 35 weeks. At 32 weeks, I knew the baby was breech.
Can you explain the events that led to your decision to do a transfer to the hospital?
The night Abby called me, she didn’t sound like she was in labor on the phone. She said that she might be having contractions, but she didn’t know. Since I live in the neighborhood, I decided to walk over and spend some time with her face to face. When I got there, I checked the baby. The baby was fine, but still breech. Abby was lounging in the tub, but I was watching her contract and saw that her affect had become less rational. When I examined her, she was already 3 – 4 centimeters. I also knew that Abby’s mother had a six hour labor with her first child, which meant that Abby was likely to progress quickly. So that’s when I said, “Let’s get this show on the road.”
The transfer scene seems pretty rushed. What are your thoughts on that scene?
Of course documentaries are edited for dramatic effect, which may be the source of my discomfort with how Abby´s labor transfer is portrayed. It appears that we were home for hours, which isn’t true. She had a precipitous labor for it being her first baby, which didn’t give us a lot of time. But they don’t show all of the clips of me executing the decision to go. They don’t realize the drama in the lobby scene makes it look like I was not in charge of the transport.
You and Abby take a taxi to the hospital. Why didn’t you call 911 instead?
911 is a slower transfer. It takes the ambulance an average of eight minutes to get to the house and a lot of important time can be lost just registering the patient to EMS. EMS would also take Abby to the hospital of their choosing, allowing institutional protocol to outvote my judgment call as an experienced midwife.
After Abby’s water breaks, you do not appear on camera during the rest of the transfer and cesarean section. Were you still with Abby?
Yes. Abby’s water broke in the driveway of the hospital. I examined her in the wheelchair on the elevator ride so that I could hold the head up in the event of a cord prolapse. (The baby ended up having the cord around his neck, which is why he didn’t turn vertex.) Abby and I arrived at the hospital before the physician. I was at Abby’s head in the operating room during the cesarean section.
Although Abby’s baby boy arrives safely, the physician says that Intrauterine Growth Restriction (IUGR) occurred. Do you want to talk about that?
In the film it appears like the baby was starving, everybody missed it, and the doctor saved the day. But the situation was misconstrued because of a critical detail that was lost during the emergency transfer. The physician who received the transfer was under the impression that the baby was 40 weeks. Abby’s baby was actually born at 35 ½ weeks. A 3 lbs, 5 ounces baby at 40 weeks would have been much more serious than at 35 ½ weeks.
Cara Muhlhahn's Home Birth Stats:
Years of CNM Experience: 18
Years in Homebirth: 16
Number of Births Attended: ~800
Transfer Rate: 9%
C-section Rate: 3.5%
Article taken form Peaceful Parenting
Midwife Cara Muhlhahn
Why did you decide to become a midwife?
I knew from a very early age that I was destined for a medical profession. A series of events led to the decision, but the first birth I attended is what got me hooked. So much of what we do is helping women navigate their own process by giving them reflection and feedback about the normalcy of what’s going on from the outside—when they think they’re dying, splitting apart, falling into oblivion.
You started your career as a lay midwife in your early twenties. What made you decide to become a certified nurse-midwife?
When I was apprenticing for home birth I heard about a maternal death at home. I immediately thought, “I need to pay attention so I’m doing the safest thing.” I knew there was more education I could get. I also wanted legitimacy and legal protection. I didn’t want my entire career to be at risk in the event of an unavoidable bad outcome.
Did you ever consider becoming an ob/gyn?
When I went to college, everyone wanted me to be a physician because I was first in my premed science classes. I did consider becoming an ob/gyn for a while, but the one thing that held me back was that I did not want to do surgery. I was worried about becoming inured to the sacredness of the body and possible intervening unnecessarily in a natural process. Midwifery seems to be a better fit for me.
What made you choose to practice in a home setting?
I worked in a freestanding birth center for four years in New York. I loved the birth center, but I had to leave that setting in order to graduate to midwifery based on experientially honed clinical judgment call, rather than what I view as restrictive protocols. Adherence to institutional protocol can be a first step, an essential one for securing safe outcomes while working as a novice. Practicing at home allows me to make clinical birth plans based on the unique circumstances of each birthing woman’s labor and contributes to lessening the interventions that often make up the slippery slope of the descent into resolution by cesarean section.
How do you view your colleagues who practice midwifery in hospitals?
I’m not interested in promoting a division between home birth and hospital midwives. All midwives are making headway in the battle to bring the power of birth back to the woman—who is actually doing most of the work. If we legitimize home birth and hospital birth, people are going to naturally find their comfort level. Opponents of midwives will just use the old “divide and conquer” to keep us from our deserved triumph.
How did you get involved with The Business of Being Born?
Abby Epstein, the film director, approached me by telephone and said she was working with Ricki Lake. Synchronistically, a couple of weeks earlier, I said to one of my student midwives who had just gone to film school that we needed to make a film. Abby and I first met at a neighborhood café, Ciao for Now, and talked about the proposal. And I said “The film you are proposing is the one I wanted to make, but not being a filmmaker, I’d rather you do it.”
What was it like making the film?
It took us over two years. I created a persona that could completely tune out the cameras most of the time. If I hadn’t been able to do that, I can imagine things would have been quite difficult. Allowing the filmmakers into such an intimate personal and professional space was clearly an act of faith. At the end of it all, I can pretty much attest to Ricki and Abby´s adherence to portraying midwives as we would like to be seen.
How do you feel about how you are portrayed in the movie and what would you like to have changed?
First of all, I want to say that I’m very grateful for this film. However, it leaves some questions unanswered. One is that there is no clip of me listening to the baby’s heart beat in labor. I’m one of the stricter home birth midwives in terms of how closely I follow ACOG guidelines for intermittent fetal heart rate monitoring. It would have been better for the public to know that we do check on their babies when they’re in labor.
Abby ends up being one of your clients in the film, but it looks like she visits several care providers during the course of the movie. Were you Abby’s prenatal care provider?
I was not until very late in the game. I had two prenatal visits with her and another scheduled two or three days after she went into preterm labor at 35 ½ weeks. At 32 weeks, I knew the baby was breech.
The film ends with a lot of drama when Abby goes into preterm labor at home. What do you think about the transfer scene?
They don’t show all of the clips of me executing the decision to go. They don’t realize the drama in the lobby scene makes it look like I was not in charge of the transport. We were only at the house for about an hour, and Abby and I arrived at the hospital before the physician. I was in the operating room during the cesarean section at Abby´s head.
What do you envision as a positive future for midwifery?
The Business of Being Born can help initiate a necessary conversation between the birthing public and birth professionals. Here is an opportunity for an honest exploration and evaluation of what home birth midwives really do instead of reliance on the convenient and self serving projections of a suspicious and undereducated governing body. We need to make a stance and we need to make it strong. The women of this country desperately need midwives on their behalf to help them birth normally.
The Transfer Scene: What the Cameras don’t Show
If you’ve seen The Business of Being Born, you probably have some questions about the preterm labor and the cesarean section at the end. ACNM member Cara Muhlhahn, CNM, shares the details that didn’t make the final cut.
What do you think about how you are portrayed in the movie and what would you like to have changed?
First of all, I want to say that I’m very grateful for this film. I feel that midwives are portrayed in a very positive light. However, there are a few lapses that leave some questions unanswered. One is that there is no clip of me listening to the baby’s heart beat in labor. I’m one of the stricter home birth midwives in terms of how closely I follow ACOG guidelines for intermittent fetal heart rate monitoring. It would have been better for the public to know that we do check on their babies when they’re in labor.
Abby Epstein, the film director, ends up being one of your clients in the film. But it looks like she visits several care providers during the course of the movie. Were you Abby’s prenatal care provider?
Not until very late in the game. She was undecided about her choice of birth site and provider until after 28 weeks. Her early prenatal care was done by the physician in the film, Dr. Moritz. I had two prenatal visits with Abby and another scheduled two or three days after she went into preterm labor at 35 weeks. At 32 weeks, I knew the baby was breech.
Can you explain the events that led to your decision to do a transfer to the hospital?
The night Abby called me, she didn’t sound like she was in labor on the phone. She said that she might be having contractions, but she didn’t know. Since I live in the neighborhood, I decided to walk over and spend some time with her face to face. When I got there, I checked the baby. The baby was fine, but still breech. Abby was lounging in the tub, but I was watching her contract and saw that her affect had become less rational. When I examined her, she was already 3 – 4 centimeters. I also knew that Abby’s mother had a six hour labor with her first child, which meant that Abby was likely to progress quickly. So that’s when I said, “Let’s get this show on the road.”
The transfer scene seems pretty rushed. What are your thoughts on that scene?
Of course documentaries are edited for dramatic effect, which may be the source of my discomfort with how Abby´s labor transfer is portrayed. It appears that we were home for hours, which isn’t true. She had a precipitous labor for it being her first baby, which didn’t give us a lot of time. But they don’t show all of the clips of me executing the decision to go. They don’t realize the drama in the lobby scene makes it look like I was not in charge of the transport.
You and Abby take a taxi to the hospital. Why didn’t you call 911 instead?
911 is a slower transfer. It takes the ambulance an average of eight minutes to get to the house and a lot of important time can be lost just registering the patient to EMS. EMS would also take Abby to the hospital of their choosing, allowing institutional protocol to outvote my judgment call as an experienced midwife.
After Abby’s water breaks, you do not appear on camera during the rest of the transfer and cesarean section. Were you still with Abby?
Yes. Abby’s water broke in the driveway of the hospital. I examined her in the wheelchair on the elevator ride so that I could hold the head up in the event of a cord prolapse. (The baby ended up having the cord around his neck, which is why he didn’t turn vertex.) Abby and I arrived at the hospital before the physician. I was at Abby’s head in the operating room during the cesarean section.
Although Abby’s baby boy arrives safely, the physician says that Intrauterine Growth Restriction (IUGR) occurred. Do you want to talk about that?
In the film it appears like the baby was starving, everybody missed it, and the doctor saved the day. But the situation was misconstrued because of a critical detail that was lost during the emergency transfer. The physician who received the transfer was under the impression that the baby was 40 weeks. Abby’s baby was actually born at 35 ½ weeks. A 3 lbs, 5 ounces baby at 40 weeks would have been much more serious than at 35 ½ weeks.
Cara Muhlhahn's Home Birth Stats:
Years of CNM Experience: 18
Years in Homebirth: 16
Number of Births Attended: ~800
Transfer Rate: 9%
C-section Rate: 3.5%
Article taken form Peaceful Parenting
Wednesday, March 17, 2010
Midwives assisted UC?
Interesting article on midwives dealing with UC'ers (Unassisted Childbirthers) from the Navel Gazing Midwife Blog.
Friday, March 05, 2010
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