Midwife Matters

Pregnancy preparations, women's health, and care options

Happy Mother’s Day!!

Picture 012From all the nurse-midwives at HealthPartners

we wish you a very Happy Mother’s Day!!


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Celebrate Midwives!!

Today is international day of the midwife!

Midwives from all over the world will try to raise awareness for the importance of the profession for women globally.  This is the day to call on the public and its governments to invest in healthcare in order to improve services, infrastructure, and reproductive health policies so that all women can have access to safe care.  Give your midwife a shout out or hug today.

HealthPartners Midwives 🙂

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Water Birth: What To Do

As I am sure many of you have read that Allina Hospitals has temporarily suspended all water births at their hospitals.  We are in the process of trying to get that re-established as quickly as possible.  In the mean time we want all our patients who have consented for a water birth to continue to have that option.  What you will need to do is sign a consent for Regions Hospital and make sure you meet their criteria.  They will be happy to accommodate your desire for a water birth.  At your next visit ask your midwife and she can answer all your questions and get your consent signed and faxed over to Regions Hospital.  Sorry for this unfortunate circumstance and know that we are doing everything we can to meet your needs.

HealthPartner Midwives


Take A Virtual Tour Of The Mother Baby Center At Abbott

Don’t have time for the real thing?  center_slideshow4

Now you can take a virtual tour of The Mother Baby Center at Abbott Northwestern Hospital.

Of course you can do both.  They offer tours every week.

Sign up for a free tour on-line or call 866-904-9962.


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Partners in Pregnancy

HealthPartners is now offering Partners in Pregnancy:  A great alternative to traditional prenatal care.

Beginning Saturday, April 19, 2014 from 9am to 11am, the midwives will begin group prenatal care.  The group will consist of 8-10 women with October 2014 due dates.   The classes provide individual health assessments,  group prenatal education and social support.  There is ample opportunity to ask questions with lots of time Pregnant_redspent with the midwife.  This is a unique chance to connect with other women who are pregnant and going through similar experiences.  Partners are also welcome and the sessions begin and end on time.

Click HERE to find out more about Partners in Pregnancy.

For more information or to sign up please contact:

Ruth Sheldrake at 651-293-8114 or email her at:


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Meet The Midwife

Please note the Meet The Midwife at Abbott (The Mother Baby Center) has been changed to Thursday, February 6th from 6pm -7pm.

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Nausea In Pregnancy: How To Cope

In her blog, Mary M. Murry, RN, CNM from the Mayo Clinic reveals some coping techniques for nausea and vomiting in pregnancy.  In the comments section women weigh in with additional suggestions and advice about what has worked for them.  As always, if you don’t know if something is safe to take in pregnancy ask your midwife first.

Some tips to deal with pregnancy nausea and vomiting

By:  Mary M. Murry, RN, CNM

Karin Marshall, CNM

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Is My Cervix Ripe?

As providers we often refer to a cervix as ripe or not at the end of pregnancy.  To many women this can be confusing and frustrating.  What exactly do we mean when we say your cervix is not ripe?  Here is what we are checking for:

  • Typically a cervix is 3 to 5 centimeters long throughout a pregnancy.  As you get closer to the end of your pregnancy the cervix can start to thin out, or efface.  When we check your cervix we can feel how long it is from an exam.  If a cervix starts out at 4cm and is now 2cm that is called 50% effaced.  When the cx is completely thinned out, then it is 100% effaced.  How do we know exactly what your cervix was before…3cm, 4cm or 5cm?  We don’t, we make our best estimate.  That is often why you will get different numbers from different midwives.  Don’t worry, you are not going backwards like it may sound sometimes!
  • Next we check the position of your cervix.  It can be posterior (meaning far back in the vagina), mid position or anterior (easy to reach, close).   Everyone is different, but most women tend to be posterior or mid during pregnancy.  As the cervix effaces and gets more ready for labor it will ordinarily be easier to reach or more anterior than it had been.
  • A cervix during pregnancy is firm.  It should feel somewhat like touching the end of your nose.  A sign that your cervix is changing can be that it has gotten softer.  As pregnancy/labor advances the cervix usually becomes softer, sometimes almost mushy feeling.
  • We also check where the head of your baby is, more commonly referred to as the station.  If it is engaged in the pelvis that is a 0 station, its head is at the ischial spines of your pelvis, which is the narrowest part of your pelvic structure.  Above the spines means the head is not engaged in the pelvis and is measured in centimeters but with a negative sign in front of it.  If the fetal head is 2cm above the spines, then the station would be -2.  As you move closer to the pushing stage of labor the fetal head advances past the ischial spines and it is again measured in centimeters but with positive numbers.  An example would be the fetal head is at a +1 station.  At a +5-6 station you can see the head at the entrance (introitus) of the vagina.  Up until the end of pregnancy the baby should not be engaged in the pelvis.  When we refer to the baby as ballotable, it means we can move the baby up and down in the uterus.
  • Lastly we check the cervix for dilation.  During pregnancy the cervix is normally closed.  The last few weeks of pregnancy, especially if you have been pregnant before, the cervix can start to open or dilate.  This is not necessarily an indication that you will labor early.  Some women are dilated several centimeters weeks before they go into labor.

We put all of these assessments into a score called a Bishop score.  Each one of the above parameters is scored and then we add them up and come up with how ripe or ready your cervix is for labor.  If you are a first time mom a ripe cervix is a score of 8 or above.  For moms who have had a baby before it is 6 or above.  The higher the score the more ripe or ready your cervix is for labor.

Women often want their cervix checked at the end of the pregnancy during their prenatal appointments.  This is where you will hear the report if your cervix is ripe or not.  I have seen many women with an unripe cervix go into labor over the next few days and vice versa – a woman with a very ripe cervix go for many more weeks until labor begins.  In other words it doesn’t really mean much, so you shouldn’t worry about it.

The one time an unripe cervix does matter is if you need to be induced.  In that case we would start the induction with a cervical ripening agent and get your cervix more ready for labor.  This however doesn’t happen very often.  We try to induce only women who have a medical indication for inducing labor.  In my next blog I will discuss cervical ripening and how that is done.

Karin Marshall, CNM


Trans Fat: The Big Fat Truth

We have all heard of trans fat and that we shouldn’t eat it.  But what exactly is trans fat and how do you know what food it is in?  I decided many years ago to eliminate trans fat from my diet.  But just tonight I ate something and then looked at the ingredients…and there it was, YUK!

For years I ate margarine because “they” said it was healthier that butter.  Then I found out that margarine is filled with trans fat.  Read this blog from the website A Dietician To Go, and find out more about trans fat and how to avoid it in your diet.

Trans Fat:  The Big Fat Truth

By:  Brittany Carpenter RDN/LD, BS

Happy eating!!


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Happy New Year 2014!

Yes, it is that time of year again when we look ahead to the year before us and consider some new resolutions that we want initiate.  You look back at last year and think…hmmmm, I should eat better, I need to exercise more and spend more time with my family and friends.  So, great my decision is made and I will do better at all those things.  But then you suddenly recall that you made those same promises to yourself last year, and come to think of it the year before too.  Then you conclude that you aren’t very good at this and just toss those thoughts aside.

BUT wait…maybe it’s because you didn’t have a plan.  You can not move forward without some kind of strategy to help you out.  First you need to set a goal, an achievable goal.  If you have a hard time changing your habits then set a very small goal that you know you can accomplish.  I have found for myself that I can only set one goal at a time.  I may also further break it down into smaller steps that make it seem easy to achieve.  That way when you look back over the year you will be amazed how far you have come.

This year my goal is eating better.  So what does that mean?  Everyone will have different objectives depending on what they eat now.  I have been working on my diet for some time, but there are still many areas that need work.

1.  Stay away from processed foods, eat only real food

2.  Eat more veggies (I eat 1-2 servings a day and the recommendation is 4-5 a day)

3.  Cut back on chocolate…I love dark chocolate and tell myself that it is an antioxidant and is good for me!  I have to limit the number of calories a day of chocolate to 200.

These are my three goals for the year.  I will take one at a time and work on it step by step.  It doesn’t seem like a lot, but looking back over the last few years I am astonished how much I have learned about nutrition and therefore changing my habits.

Women tend to take care of everyone but themselves.  This is the year to look inside and make a resolution and come up with an action plan of how you can become the woman you want to be.  Small tiny steps at first.  As you achieve one small goal after another your self esteem will rise and so will your self respect.  It is a great feeling when you take care of yourself!!

Start by making an appointment with your nurse-midwife to get going on improving your health.  Do you need a health maintenance appointment?  Do you have birth control that you can count on?  Are you up to date with your immunizations?  Need to talk about other health concerns?

Planning a pregnancy?  We are here to support you in your efforts to be healthier and to set goals for you in 2014!!

Karin Marshall, CNM

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