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.

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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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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The Best Kept Secret: The IUD

Looking for a convenient, safe and highly effective form of birth control? Then look no further than the IUD (intrauterine device).  This very popular method boasts the highest  satisfaction among couples of any birth control method. IUD’s are among the most popular method used worldwide.

The IUD is a small (approximately 2 inches) T-shaped flexible plastic device that can be easily inserted by your provider in the clinic. The IUD is placed through the cervix and rests in the uterine cavity with a small string (1-2 inches in length) that remains outside the cervix .  Insertion generally takes 5-10 minutes or less.                      SAM_0017

Two types of IUD’s are currently available with a third type soon to be available as well (I will be writing a blog detailing each of these IUD types soon!).  The Paragard IUD (Pictured on the right) can remain in place for 10 years and the Mirena IUD (pictured on the left) for 5 years.  The newest IUD will be effective for 3 years.  IUD’s can be removed easily at any time by your provider with no delay to fertility should a pregnancy be desired.

SAM_0019Considered by many to be the most effective, reversible contraceptive method, the IUD has an effectiveness rate approaching that of permanent sterilization. Though originally developed to be used by women who had already had children, modern IUD’s can safely be used by most women of all ages even those who have never been pregnant.  As with any prescribed contraceptive, be sure to fully discuss the IUD with your provider as she will want to carefully review your history and discuss whether this method would be suitable for you.  When considering contraception, in my opinion, for many women the IUD may be the ideal choice.

Stay tuned for more information in upcoming blogs on the specific types of IUD’s as well as a discussion of benefits, risks and side effects of each.


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