Category: English

Crazy times…

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(Español aqui)

Well, it has been kind of crazy here. Several births, a new midwife partner, starting the Midwifery Association of Yucatan, chickens! So many exciting changes. Among them all, we are planning on holding the first “Respected Birth” Conference in October, proceeds going towards building our birth center!

I am super excited about it. We are fundraising for our conference/expo to put the down payment, so that we can hold the date and start selling some booths and tables. We are hoping to have a wide range of participants, and anticipate a large crown (over 5,000 people). We are going to be having it the second or third weekend in October from 10:00AM -10:00PM Saturday and Sunday. I am super excited to start fund raising for this event and the birth center, all in the hopes of making natural birth more accessible to women everywhere.

If you would like to donate to the efforts, you have several options. You can use a car or paypal here or if you would like to deposit at Oxxo, please WhatsApp (9999.91.23.16) me, and I will send you the account number. You can also donate via GoFundMe. You can also donate in person at my Merida location. We also are always accepting baby and birth supplies for our birth scholarship mama’s. The majority of these moms are under 18 or single mothers with limited resources.

Please share with as many people as you want to and don’t forget to make a donation today!

 

Primary Care in Midwifery

A Certified Nurse-Midwife’s Role in Primary Care

c0dce58dEvery day, more and more woman are choosing to see alternative care. In the past, physicians authority has not been questioned; their opinion was the only consideration. This is changing. Now, woman are seeking a more personalized experience, they are becoming more autonomous in their healthcare. Having a provider who is not only well trained, but also respects a woman’s control over her own healthcare, is more important than ever. When a woman believes she has a yeast infection, she may want someone to tell her exactly how it should be trerated, but she may also want someone who is able to discuss all treatment options, including natural remedies.

As certified nurse-midwives in the United States, we receive advanced training in assessing, diagnosing, and treating primary care concerns. With this training, we are then able to offer the women we serve a safe alternative to a primary care physician. We are able to help support the woman’s chosen lifestyle as she makes the decision that is best for her unique situation. Respecting her wishes for her care are of utmost importance.

Another consideration is safety. There is a reason that a woman feels that she needs to seek a professional opinion. We have advanced nursing practice degrees and have completed rigorous clinical requirements. We are qualified to give safe, sound medical advise. When doing so, we do expect our clients to ask questions, but we can also be trusted to give the best medical advise possible. In cases that are beyond our legally regulated scope of practice, or even our personal comfort zone, we will (just as any medical provider) recommend that you seek care with a specialty provider. This is why online midwifery care works in primary and urgent care situations. If you have a cold, you may want Tamiflu, but you may want elderberry tea. SaratheMidwife.com offers personalized, flexible, dependable healthcare on your schedule. Make an appointment today!

A Special Birth

 

A Special Birth

20160122_053129So, this was my first patient who went to c-section. I feel a bit… sad. Sometimes, the labor we plan, is not the labor that happens. I was looking into the mothers tired, exhausted eyes, she was barely able to keep them open, after 2 days of hard labor, baby’s heartbeat was going up… it was not looking good. I knew I had to make the call before I wanted to make the call. I had never had to do this before, and I didn’t like it. I didn’t like the feeling, maybe if I asked her to move more, maybe if I advised her to rest longer, maybe if I hadn’t come so early, was this my fault? Then, telling her, it was time to give up her dream of a water birth at home. I felt like I was slapping her in the face. Her supportive family (who took a lot of persuading to be that way) were all looking at me. I felt the full weight of being a midwife on my shoulders. The hopes and dreams of a woman, her life and her baby’s, her family’s expectations, and so much more… Am I the reason that she is going to hear “I told you so” when she tells people how the story ended? I was hoping they could give her some medicine to help her sleep and maybe she could get some strength back. But that wasn’t in the cards. We went to the “non-emergency” hospital of her choice and met with my back up OB. He checked the baby’s heartbeat, it was still going up, the contractions were disappearing and I knew this wasn’t going to end well. After talking over the options, c-section was chosen as the best option. Her family was grateful to me for keeping the first baby in their family in 19 years safe, and their beautiful, strong, amazing daughter/sister/niece/girlfriend safe. The doctor confirmed that I made the right decision to bring her when I did. I was able to be there, next to the new dad, as I watched the OB pull the little guy out of her womb. The doctor was nice and held the baby for a minute, the surgical lights were turned away from the baby, so he wasn’t looking into the bright lights, and the baby was quickly examined and then placed skin-to-skin with mom. It was a beautiful, gentle, surgical birth. It made it almost sadder- would she have been better if she had just done that in the first place? Either way, she and the baby were healthy, and finally done. I know this was not a failure for anyone, not me, not her. But I do, I feel like a bit of a failure. I realize this birth was not about me, obviously, yet it represents something I knew would eventually come, but always dreaded it – my first transfer to a section. In the end, everyone is safe and happy, and healthy, and that is exactly why I am a midwife. I may not have been able to give her the birth she wanted, but I was there when she and that precious baby, and her family needed me. So, I shouldn’t feel like I failed. That makes me feel better. This birth has taught me more than any other birth so far…

It’s Been a While…

It’s Been a While…

Well, it has been two weeks since my last post. In the past two weeks, I have made huge strides with my new practice. I have new home birth patients, I have new hospital privileges, new back up physicians, pediatricians, just a whole network of people supportive of a women’s right to birth where and how they want! I met with the most amazing doula ever – just so many blessings! Hopefully, we will be welcoming a new addition in the next couple weeks here too! I am so glad that we are where we are, when we are here. I am also glad that my online midwifery service is getting more momentum, slowly but surely. My study will also be starting this week. Honestly, I am so glad to be here and able to help pioneer this amazing profession as we fight for the women here. I am hoping to be able to get a student here soon as well. I really believe God has given me a nitch here and the practice will continue to grow!

I got an interesting question this week – when will I return to fertility while breastfeeding? That really depends on so many things! First, how often are you breastfeeding? You need to be feeding at least every 4 hours, AROUND the clock. Have you gotten your period? While you will ovulate before you notice a period, simply bleeding does not mean you are ovulating. However, you should consider other birth control if you have had a period after your baby has been born. How long ago was baby born? Generally, if your little one is over 6 months old, you should be using another form of birth control. Personally, I recommend if you do not want to get pregnant after a baby, to use condoms because many women experience ovulation before getting a period, or while pumping (even if you pump every 4 hours). I believe it is a good idea to think about back up birth control if you have any doubts about becoming pregnant now.

 

 

Oh, boy, oh, boy

Oh, Boy, Oh, Boy

Today, someone asked me about circumcision, or more appropriately called- genital cutting. Boy or girl, modern day genital cutting is nothing compared to what it was when it was first instituted. It kills over 100 boys annually. No, not in the third world, not in poor hygiene situations- in US hospitals. Therefore, I am firmly opposed. The US is also the only first world country where routine genital cutting is performed. Canada and Australia stopped in the ’50’s. When someone asks me if they should do this to their son, I applaud them for looking into it and then I recommend they watch a video of what is going to happen to their son.

While working in a hospital when I was 18, on a pediatric unit, I was cursed with the task of assisting with this procedure. Now, as an 18 year old girl, I had no idea that this was optional. I had the erroneous belief that it was something that HAD to be done. After the procedure, swore I would never do that to my child, and then I started actually looking into it. After doing research, I became even more convinced, and three boys later, I am glad I decided not to do it. After all, only a little over 30 – 50% of boys in the US are cut now, meaning all those classic “locker room” arguments are pointless now. The study about HIV rates being lower in cut men? Thanks to long term studies in Africa – debunked in 2008! It’s prettier? That’s an argument I have heard before, my response to that is a blank stare. How else can I respond to that one… So concerned with your babies sexual function? Cutting has many known and proven effect on sexual pleasure for both the man and his partner. “Female sexual dysfunction (often in the form of dryness) may be “diagnosed” because the woman is sleeping with a cut man whose member has decreased sensitivity, a hardened head, and an exposed coronal ridge that sucks out moisture. Perhaps it is over diagnosed in preference to changing the practice too many Americans infallibly believe is good for their sons.” (see article).

Take home point: it is not your penis, so…. Also, I do not believe in shaming or judging other people, so please do not bash, as I also restrain from bashing.

If you are debating – check out these links:

A summation of the effects

Elephant in the Hospital (video)

What is Circumcision and What is in Not?

Anatomy of a Healthy Penis

Breastfeeding and Medications

Breastfeeding and Medications

Breastfeeding is beneficial to both mother and baby. Make sure your provider understands that this is a priority for you!

A new question arose this week that really shines the light on the amount of misinformation out there on breastfeeding. “Can I take antibiotics while breastfeeding?” The answer is, YES! But this mother was told by many women that it was dangerous – including her own OB-GYN. I am glad she sought another opinion. Most substances are not passed into the breastmilk, this includes many medications. If you are told that you cannot breastfeed with something – or “pump and dump” for weeks while giving your child formula, ask for a different medication! If you are given no safe alternative, do your own research and make sure that you were correctly informed. Many times, to avoid risks of litigation, providers will err on the side of caution, ruining a beneficial breastfeeding relationship, but it does not have to happen.

My favorite non-provider site is safefetus.com. This is a start! Please use this as a resource with which to speak to an appropriate healthcare provider. Address the risks and benefits involved in the condition and the medication you are prescribed or curious about. If this is something that is important to you, remember, your provider works for you! Speak to them openly and honestly about your concerns and do not leave until you are sure about the plan of care. This is especially important when trying to maintain a breastfeeding relationship. The more you know, the more you can be sure that you are getting the best care for both yourself and your child.

Please let me know if you have questions about this topic. It is something that many women are concerned with but feel intimidated about speaking to their healthcare provider about.

Third Trimester Impatience

40weeks-300x297Third Trimester Impatience

Since working with pregnant women, the number one question from women in the third trimester is- “Please, can this child come out now?” And that is how I was by my due date with each of my children as well. Check out my new article for more information about inducing labor “naturally.” I always encourage waiting for the baby to start labor, but for those facing “Give birth now or you have to be induced” I think it can be helpful to know there are options beyond an in-hospital induction. I love working with post-daters who need a little boost, so feel free to talk to me about a personalized plan to see if we can get your labor going.

There are some (such as castor oil) that I left off entirely since I would not want to recommend that to the general population of women. Too me, castor oil can cause severe dehydration so it should not be attempted unless you are under the care of a midwife. Again, that is something that can be considered in some cases, but most of the time there are other, more effective ways of getting things happening. There are so many different beliefs and “old wives tales” so it is important to discuss any attempt to induce labor – natural or not – with a provider. Some things involve too much risk and can be dangerous to attempt such as the herb ruda or rue, often touted as a natural induction herb to be taken in the third trimester. Other things, like eating spicy foods or pineapple were not other list as the things on the list tend to have more success then those methods for he majority of women, although those methods have worked for some women (which is how they got the labor inducing reputation).

Please share some other ideas about inductions or methods you have heard of or have tried and how they worked for you.

And such is menopause

c0dce58dHow fun is menopause?

Today, we added a new article about menopause. While I have am not there yet, I worry that more and more women dread this change in life. Since I am having no more children (barring a miracle), I have to admit, I am looking forward to the cessation of menstruation. No more inconvenient bleeding on the one day you decide to wear white pants, no more PMS or painful cramps every month. No more pregnancy scares – although you can still become pregnant when you are peri-menopausal. Maybe it is seeing the glass half full, but I see so many benefits!

I understand the trepidation, there are so many stories we hear about it. But that too will pass… I think the most important thing to consider is that menopause is not an illness. It is not something that needs to be cured. Instead, it is a new beginning. The end of one chapter, and the beginning of a new and exciting part of life. I am convinced that the more a woman resists or fears the changes, the worse the symptoms will be – just like the pain of child birth or puberty.

When I ask a woman afraid of menopause what scares her most, it is usually not the answer you might expect – fear of the symptoms. Instead, it is the idea of growing older, the loss of the ability to reproduce, some feel as if menopause threatens their womanhood. I challenge that idea. Since when did getting older become a bad thing? I know Hollywood values youth in women (do not get me started there, please), but why? Aging is not a disease. All those creams and anti-aging products don’t cure aging. They add chemicals to your beautiful, perfectly aging skin.

As we grow older, we watch our children blossom into adults, we welcome new life into the world, we develop our careers, we make our legacy. If we stayed young, none of these things would come. Menopause may be synonymous with growing older, but growing older does not have to carry this negative connotation that we have seemed to attach to it. When I see an older woman, I see a mentor, someone who has lived and can teach, I see wisdom and knowledge. Instead of judging ourselves by the number of wrinkles we see in the mirror (and I have found a couple myself) or the number of gray hairs we have, wouldn’t it be better to embrace each day as another lesson learned, another opportunity to see our legacy develop?

The North American Menopause Society is one of my favorite resources for women with questions about menopause. And of course, make an appointment with us or email us if you have any questions or concerns.

 

 

What Kind of Midwife Are You?

As a midwife, I treasure my time with women. I became a midwife to help women, to empower women, to be a presence in time of uncertainties and joys. I decided to go into midwifery instead of becoming an OB/GYN because I was drawn into the sanctity of birth, the midwifery model of care, treating the whole woman, and not just her symptoms. So, I never thought I would be writing a blog… Those who know me, know how I fear blogging, it was not something I believe I can do easily. But here I am, writing my first blog post! I should share some of my midwifey thoughts so here goes…

What kind of Midwife are you?

Something I was recently asked- “What kind of Midwife are you?” I answered with my professional title “I am a Certified Nurse-Midwife, so I am a registered nurse and a Master’s educated advanced practice nurse.” “No,” she replied, “Are you into natural remedies or do you do hospitals and prescriptions and that kind of thing?” Well, I had never really thought of how I identified my “kind of midwifery.” I didn’t know what to say, so I responded with the first thing that came to my mind “Both, I guess.” As I considered this question later, I was glad that was my answer. I am trained in advanced pharmacology and can write prescriptions with the best of ’em, but I also know and use herbs, teas, oils, and alternative therapies and I am not afraid to recommend them. As a midwife, I have the luxury to get to know the women I serve, get to know their preferences and needs. This is awesome and one of the best things about being a midwife. The sad thing about many doctor’s, including online doctor services, is that usually, they are not able to spend enough time to deliver the care that is personal and centered around women. Now I know an even better answer “I am whatever kind of midwife my client needs.” The women who come to me with their urgent care needs are the women who decide what kind of midwife I am at that moment and I love being able to have that flexibility. I love to educate my clients, but beyond that, what they decide goes (safety first of course). I would never push Tums on someone who prefers using marshmellow tea and vice versa.

Now that we know what kind of midwife I am, lets find out what kind of blogger I turn out to be… Hopefully a helpful one!