Midwife Matters

Pregnancy preparations, women's health, and care options

National Midwifery Week!!

This is National Midwifery Week 2013!  555942_676791132331463_2142164159_n

 Find out more about midwives and how they provide satisfying, safe and evidence based care.  Are midwives right for you?  Read more HERE.

Want to be Like a Princess? Use Midwives!!

Duchess of Cambridge Kate Middleton just gave birth to her first child using Midwives!!130723150642-03-royal-baby-0723-horizontal-gallery

She had an unmedicated, 11 hour labor that was attended by a team of 4 Midwives.

To find out more click here.


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Delayed Cord Clamping is a Good Idea!

Research has shown that by delaying cord clamping for 1-5 minutes after birth, your baby will have multiple benefits. The blood in the placenta will transfer to the baby during  that delay of clamping the cord. This delay of cord clamping has benefits  beyond the first few days. Studies have shown the following:

1.  Iron stores in the blood that are given to the baby  dramatically reduce newborn and infant anemia.  This improves your baby’s nervous system development for as long as 24 months of age.

2.   The baby’s oxygen levels are improved.

3.   The best news it that it gives your baby a store of Stem Cells.   Stem cells provide long term benefits to prevent age related disease.

Babies benefit from these three simple actions:

  1. Placing your baby on the mothers abdomen after birth
  2. Keep the cord intact for the first few minutes of life
  3. Breastfeed your baby within the first hour of life


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The Midwife Solution

Today is International Day of the Midwife!!  To celebrate I am posting an article on how Midwives can be part of the solution to our nation’s healthcare crisis.  Read more about how adopting the Midwifery Model of care can do that.

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Tdap Vaccine. Is It Really Safe To Get Vaccines During Pregnancy?

Tdap is tetanus, diphtheria, pertussis (whooping cough) vaccine.  In 2012 there were 4125 cases in Minnesota. There were so many it was classified as an epidemic.  The Center for Disease Control and the Minnesota Department of Health recommends every pregnant woman get a Tdap every pregnancy.arm-shot


1. Because of the Pertussis epidemic.

2. Because it offers the best protection for your baby.

3. Because giving the vaccine during pregnancy gets antibodies to your baby.

A recent letter from nine organizations in Minnesota including:  MN Department of Health, MN College of OB/GYN, MN Assoc of Pediatrics, MN Perinatal Organization, MN Nurse Midwives, MN OB and Neonatal Nurses and the MN Medical
Association state the following:

Women should receive Tdap vaccine during every pregnancy. 

Ninety percent of pertussis deaths are in infants younger than four months. Giving Tdap vaccine during pregnancy prompts prenatal transfer of pertussis antibodies, protecting the newborn during his or her first months of life. It also prevents post-partum transmission of maternal pertussis. Tdap is considered safe to give during pregnancy, regardless of the interval since the patient’s last tetanus booster or previous Tdap vaccination. The optimal window for administration is between 27 and 36 weeks’ gestation.

If a woman does not get the vaccine during pregnancy, the postpartum vaccine will offer some protection by not exposing the baby to Pertussis. The post partum vaccine will not offer the baby the important antibodies given through the vaccine during pregnancy.

Fathers, daycare providers, grandparents and other family who will be in close contact need one Tdap as an adult.  This is to prevent transmission to the baby.  They do not need one every pregnancy because they do not pass antibodies to the baby.

Please ask your provider about this important vaccine!

For more information please visit The Center for Disease Control and Prevention website.


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New Mothers Take Note

Every new mom should read this great article in The Atlantic on motherhood and dealing with a new baby.  Being a new mom  is wonderful, but it isn’t always easy either!

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Constipation in Pregnancy

Constipation is a common occurrence in pregnancy, especially early on.  It is caused by changes in your hormones that slow down your digestive tract causing things to move at a slower pace. Nausea may have also changed your eating habits in early pregnancy and this can also play a role in constipation. Ultimately you feel bloated and can have abdominal pain as well as difficulty passing stool. Thankfully there are some easy things to try to remedy this.

1.  Drink at least 8-10 glasses of water a day. Sometimes a glass of warm water (flavor it with lemons) in the morning can help you to have a bowel movement.

2. Try to add fiber to your diet by eating fresh vegetables and fruit, beans and whole grains daily. You may also try fiber bars or fiber supplements but be sure to drink plenty of water with these.

3. Pick up some whole flax seeds or whole millet and sprinkle these onto your food. It is tasteless and adds bulk easily to your diet.

4. Get some exercise every day, this will often stimulate your bowels into action.

5. If constipation continues you may try a stool softener such as colace that helps moisten the stool for easier passage.

If you continue to have problems or have not had a bowel movement for more that 3 days you should talk to your provider for further assistance.


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Vaginitis (Vaginal irritation/infection)…How to Avoid It.

Symptoms of vaginitis are extremely common, accounting for over 10 million office visits per year.  We often self treat with over the counter medications.  Moreoften however, we can are treating the wrong thing and need to be seen for the proper care.

Normal Vaginal Discharge:

Is white, clear, thick or thin.

Does not smell bad.

Amount of discharge varies especially if pregnant, using birth control or prior to menses.

Abnormal Discharge/Symptoms:

Causes itching of the vagina or around the vaginal area

Redness, pain or swelling around the vagina

Discharge that is foamy, greenish/yellow, or bloody

Bad/Foul smelling discharge

Pain when urinating or having sex

Pain in lower abdomen


Causes of Vaginal infection: 

Good bacteria from vagina have been destroyed by other bad bacteria

Reaction to something in the vagina such as a tampon or condom

Sexually transmitted infections

Sensitivites to soaps/detergents/lubricants etc.

Hormonal changes

Recent use of antibiotics


Each vaginal infection requires a different treatment, you should see your midwife if you have concerning symptoms.  If you are diagnosed with a sexually transmitted infection your partner should be seen as well for treatment.


Wear cotton underwear, avoid thong underwear.

Wash the genitalia only with warm water, no soap.  The vagina is self cleansing.

Bath only in warm water, do not add any perfumes,salts, oils or bubbles to the water.

Use white, unscented toilet paper, avoid using baby wipes.  Wipe from front to back.

NEVER douche.

Use only non-scented tampons and pads, and use only if absolutely needed.  AVOID Always brand.

Use clear body soaps, nothing milky/creamy.  Especially avoid Dove, Ivory and Caress.

No fabric softener sheets.  No Tide detergent.


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Perineal Massage…A Great Idea!!

One of the biggest fears for women about to give birth is the possibility of experiencing an episiotomy or a tear during their delivery. Statistics show that 40% to 85% of women experience a tear during birth. This tear typically occurs in the perineum, which is the area between your vaginal opening and your rectum. This is the area most likely to require an episiotomy or cut, during labor. Having stitches after childbirth can sometimes lead to pain and discomfort, which most women would prefer to avoid. One method shown to improve outcomes is called Perineal Massage.

Multiple studies have been completed and evidence has shown that perineal massage reduces the likelihood of perineal trauma (mainly episiotomies and significant tears). In addition, women report less perineal pain or discomfort during their recovery. By beginning perineal massage and stretching about one month before delivery, you enable the perineal tissue to expand more easily during birth. In one review, those performing perineal massage for as little as once or twice per week from 35 weeks to delivery were less likely to experience perineal trauma and pain. These results were especially evident for women who had not given birth vaginally before.

So what exactly is perineal massage?

This type of massage involves using two fingers to stretch the perineal tissues. It can be performed by you or your significant other. Ideally, this should be done once or twice daily for 10 minutes, beginning 4-6 weeks before the birth of your baby.

  • Your hands should be clean, and nails trimmed, and a lubricant such as vitamin E oil or water soluble jelly should be used.
  • Lying comfortably back with your knees bent and legs apart, you should practice relaxing the muscles in your perineum. Place your thumb or your partners finger, about 1 to 1.5 inches inside your vagina. Press downward toward your anus and to the sides until you feel a slight burning, stretching or stinging sensation.
  • Now, hold that position for 1 to 2 minutes.  After that time you can gently and slowly begin massaging the perineum while pulling the tissue forward (similar to what the baby’s head will do during delivery).
  • Use this time to practice slow, deep breathing. This should continue for about 10 minutes each day, or as much as possible. After 1 to 2 weeks, you should notice an increase in the perineal ability to stretch with less burning.

Another good idea is to practice Kegel exercises. This helps tighten your pelvic floor muscles, keeping them strong. Do a Kegel while you are performing the perineal massage. You can feel how tense and tight this muscle can become. Consciously release them while you are doing the massage. Practicing Kegel exercises helps improve muscle tone and strength.

Good communication, and gentle understanding is required if a partner is helping perform the massage. However, knowing that you are doing something that may improve your outcome, is free, doesn’t hurt, and is easy to do, makes this a great way to prepare for your delivery.  If you have any questions or concerns, please feel free to contact your midwife.  They will be glad to discuss your concerns and provide further tips in preparing for your delivery.  Best of luck!!


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What Happened to Paps Every Year?

Many of us entered our adult women years being told how important it was to get a Pap  every year.  But that science has changed and we now know much more about screening for cervical cancer.

The purpose of a Pap is to identify any changes to the cells of the cervix that may lead to cancer of the cervix.  A Pap does not diagnose sexually transmitted infections, uterine fibroids, ovarian problems, etc.  It is primary for the diagnosis of cervical cancer.

It is now understood that HPV (Human Papillomavirus) is the major cause of cervical cancer.  It is a virus with many “types”.  Kind of like there are many types of trees. The virus types that are more concerning have been labeled “High Risk HPV”.  In fact, there are more than 100 “types” and of those, 8 are linked to being High Risk.  Some are more of a nuisance and not a threat to cervical health.

After extensive research of cervical cancer and testing, the following has been determined to be the safest schedule for cervical testing:

No Pap before age 21.

Almost all younger individuals will have the HPV virus in their body.  For the vast majority of individuals the body will identify that virus and will do a self immunity process. This will clear the virus from the individual.

Pap every 3 years for women who have normal Paps and are between the ages of 21 and 65.

At 65 some women no longer need a Pap.

Your provider will clarify this for you.

Also women who have had a complete hysterectomy:  the cervix and uterus have both been removed, also no longer need a Pap.

If your Pap is not normal, your provider will make a plan for follow up that may include a colposcopy or just a repeat Pap in one year.  This is all based on the results from the pathologist..

Next to come on the blog:  Then what happens at an “annual visit”????


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