FYI for native women

Just an FYI for all of you…

 

Midwives Resistance: How Native Women are Reclaiming Birth on Their Terms

Mana Preconference/for native midwives

2 FULL DAYS:

Indigenous Midwifery: Ancestral Knowledge Keepers – $150. (Proceeds go to Native American Midwives Alliance)

When: October 14-15, 8:00-5:00PM

Indigenous Birthworkers Network Birthworkers who are Midwives, Doulas, mothers…

Midwifery is On the Rise In Native Communities

Nicolle Gonzales CNM ~ Blessingway of a Native American Midwife  Video

Midwives of Color

2018 American Indian and Alaska Native National Behavioral Health Conference

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Birth Trauma – Part 2

What can you do to prevent problems in labor, and miscommunication with your doctor? My recommendation is to follow the recommended diet for pregnancy, exercise (for pregnant women), drink a lot of water, and attend to the prenatal visits.

Never be afraid to ask questions!

Why a certain test is being done, what does that word mean, etc. Some things I can assist you with during the Childbirth Education coursework…but asking the questions of your doctor is important. You get to know your doctor, and he/she can get to know you.

Your right as a patient is to have any procedure or test explained to you, by your doctor.

Questions such as:

-Is the particular procedure / test done because it is required?
-Who requires it?
-Why is it required?
-Is it because of doctor concern? What precipitated that concern?

Your doctor is not GOD.

If the doctor is not responding to your questions or you are not comfortable with the explanation / or attitude of the doctor you still can address the issue. Sometimes just a rewording of your question is helpful.  If still you are not being listened to, the following outlines your rights…

HIPPA law outlines a patient’s rights:

To Clear Communication

The AMA’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions.
[https://www.emedicinehealth.com/patient_rights/article_em.htm#communication ]

To Informed Consent

Informed consent involves the patient’s understanding of the following:

  • What the doctor is proposing to do
  • Whether the doctor’s proposal is a minor procedure or major surgery
  • The nature and purpose of the treatment
  • Intended effects versus possible side effects
  • The risks and anticipated benefits involved
  • All reasonable alternatives including risks and possible benefits.

[https://www.emedicinehealth.com/patient_rights/article_em.htm#informed_consent ]

Within the perimeters of informed consent, the doctor ethically understands the responsibility of:

  • The patient being told what the doctor is going to do
  • That the patient is helped to understand the medical implications
  • Whether it is a minor or major procedure
  • The risks and benefits
  • Alternatives with the information about risks and benefits

The patient rights also include:

  • Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion
  • The right to refuse or withdraw without influencing the patient’s future healthcare
  • The right to ask questions and to negotiate aspects of treatment

    The 3rd part follows in one week…

Birth Trauma – Part 1

Many things come up during the labor and birthing of a baby. These may or may not be emergency-level events. A woman in labor is focused on the process they are involved in: birth. The woman may not be aware of what is being discussed around them, nor the things happening that may alter their ideals of the “perfect”  birth.

Here are some things that may occur:

  • Slow dilation of the cervix
  • Labor stalling
  • Movement of the baby stops
  • Blood pressure of the mother rises

Often doctors in the hospital will want to intervene. The remedies may be interventions that you really do not need.

These interventions could possibly be:

  • Monitors
  • IV insertion
  • Inducing labor (Pitocin)
  • Or even the decision to have a c-Section (read my blog post on this here: )

The first two  can be alleviated by using gravity (walking, dancing, leaning forward onto the labor bed with feet on the floor and doing squats). Usually stressors or nervousness are the cause.

With Labor stalling, if already dilated 6-7cm, it could very well be a natural stall while going into the next stage of labor or “Transition” (Balaskas 127-131). Body tension can also effect how labor progression.

Low moaning sounds are effective here, in that the vocal cords being activated relaxes the sphincter muscle group of the pelvic floor, as Ina May states ” The state of relaxation of the mouth and jaw is directly correlated with the ability of the cervix, the vagina, and the anus to open to full capacity (Ina Mays Guide, 170). The sphincter muscles will close due to stress or fear. Goer suggests that “obstetric management can obstruct progress (The Thinking Woman’s, 108)”

Remember: Babies are birthed when they are READY. Not on some sort of perceived time schedule.  This is a process that cannot be forced.

If the baby stops movement, inform your doctor. You can use “kick counts” as a method to monitor movements if you are concerned. In active labor, the baby tends to move in a spiral as baby moves into birthing position . Sometimes stopping movement for a short period of time can be an indicator of  the baby 1) shifting position 2) resting before birthing.

Blood pressure issues could be gestational diabetes, or just stress. The cause for the blood pressure rising needs to be found. High blood pressure is also a symptom of pre-eclampsia. But if you were not having signs of this condition and diagnosed in pregnancy (which is why prenatal visits are essential) then it may be something else.

Of course, water by mouth could assist in lowering the blood pressure level. Here is suggested reading for you to understand the seriousness of this condition: https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy

So now we move onto the second part of this discussion, published one week from this page.

Our Gynecological Health – Part 1

First of all, we women have left all the charting of our gynecological health in the hands of our doctors. We can keep our own records, at home.

I will be posting a .pdf file of a chart you can use as a “master sheet” of your exams and an example chart to assist you in filling it out. Use it to keep track of your weight, blood pressure, general gynecological health (which would include the breast exam, pap test, vaginal culture, etc.).

Much of what we see in our doctor’s charts, may seem to be a problem, only because we women do not understand or are taught about normal feminine health. We can understand them better when we see what actually are the “true” gynecological conditions.

These “True” Gynecological conditions would be:

• Vaginal infections
• Abnormal bleeding
• Premenstrual syndrome
• Breast lumps
• Endometriosis
• PCOS
• Nabothian (cervical) cysts

“…charting enables a woman to understand her body in a practical way (Wescheler, 230)”. A woman who charts every day is so aware of what is normal for her own body, that she can actually assist her doctor determine what is not normal based upon her symptoms. Keeping the chart of her menstruation cycle assists her In well-being, and working with the doctor.

Normal Healthy Cervical Fluid VS. Real Vaginal Infections

We live in a culture that advertises douche and sprays for vaginal “discharge” giving women the idea that they are “dirty” all the time. Douching and sprays only act to confuse the identity of healthy cervical fluid and what would be a real infection.

Wescheler explains in her book, that doctors say you don’t need either. On a talk show she watched, she says that the doctor stated that the infections from these products were “…enough to send his children to college (Wescheler , 231)”. Then there is also the yeast infection products that women self-diagnose and take every month for a “recurring” problem.

But, using the chart, detection of an actual infection will be easier, and discovered earlier. You can get treatment before discomfort sets in. Secretions mid-month are normal, but late in the month may indicate infection.

Symptoms of Vaginal Infections That Can Be Distinguished from Normal Cervical Fluid
Once you have routinely charted your normal cervical fluid, an infection can be distinguished by the unpleasant symptoms that set them apart from what is normal. Vaginal infections can range from STIs (See: The Effects of Sexually Transmitted Infections on Pregnancy) to a variety of forms of Vaginitis and of course the generic “yeast infection”.

• Abnormal discharge
• Itching, stinging, swelling, and redness
• Unpleasant odor
• Blisters, warts, and chancre sores

Avoiding Infections

Besides the consequences of douching, you should not wear clothing that is damp or too tight, as these create an unhealthy vaginal environment. Also you should wear cotton underwear, or at least cotton crotch underwear as these allow your body to breathe.

For more information see: Part 2

Protein Foods

Protein Foods

(with the protein foods containing the most essential amino acids first).

Proteins
Eggs (preferably organic, or at least “free-range”)
Milk
Fish (preferably:
Poultry (preferably: baked, broiled or stewed)
Tofu & other beans
Oats (preferably not quick cooking)
Nuts (especially almonds)
wheat
cornmeal

Protein Food Combinations

(to assure best usage of the most Amino Acids found in the food /Proteins )

Beans + Wheat
Beans + Rice
Corn bread + Beans
Corn tortillas + Beans
Lentil Curry + Rice
Pea Soup + Wheat (bread)
Pasta + milk and/or Cheese
Cheese + Wheat (cheese sandwiches)
Macaroni + Cheese
Garbanzo dip (hummus)
Sunflower seeds, peanuts, roasted soybeans (snack foods)

_______
“Diet for a Small Planet”. Fig.14, page 176
Ibid. page 181 (Chart)

Stress, Part 3

Stress

stress

Stress and Pregnancy

This is a huge transitional period for the family unit, and usually characterized as stressful. Due to new roles to learn, adjustments within the family unit, communication patterns are re-established. These shifts may trigger biologic changes, hormonal function shifts, and immune system vulnerability.

The whole family unit is thrown off it equilibrium due to restructure of family roles, adjustments to family goals, physical and emotional changes that pregnancy may bring. This is the case for the average and normal situation and pregnancy. What about other circumstances or high risk pregnancy?

If the pregnancy is from an already stressful situation such as a rape or domestic violence has occurred, the stressor of pregnancy brings additional problems. Decisions need to be made to assist the mother, if other children are involved, their safety attended to.

In high risk pregnancy situation, stress is further aggravated if hospitalization is required. “High risk” is a label given to those whom the health of the baby or mother to be is threatened.

The pregnant mother’s ability to adjust and or adapt to the situation may be in jeopardy by the excessive level of stress. The mother must understand the causative factors in being labeled high risk and accept the situation in order to have a good outcome. As well as the pregnant mother, all other family members need to assess, accept, and readjust to this prognosis.

Unfortunately, pregnancy on the reservation is almost always considered high risk. This is due to poverty, gang activity, teenage pregnancy, alcohol consumption and drug abuse.

Only YOU can change this! Change the additional stressors in your life, and then you can change the outcome of your pregnancy and delivery!

Stress, Part 2

Stress

stress

Social and Family Stress

Social stress can be an actual threat or that what is perceived as a threat. These are within ones social environment. This could be relationships at work, conflicts at school, or interactions that occur within a person’s society.

Inside the family unit certain life events can affect the family directly or indirectly. Some of the stressors could be things that are deemed “normal” such as a birth in the family.

Stressors could be caused by ambiguous facts, such as an illness of unknown cause in which the doctor states the person will die at some time. Also, there are stressors that are caused by nonambiguous facts such as the onset of a severe storm and its aftermath.

Volitional stressors are things such as divorce, things that members of the family may cause or control the end result. Chronic stressors are events that occur over an extended time, such as a handicapped family member. Acute Stressors are temporary, such the hospitalization of woman giving birth. An isolated stressor is a singular event, such as the arrest of a family member.

Family stressors can proceed a crisis within the family but not all family stress leads to a crisis. Here are four indicators that a family is in a crisis:

• Members within the family are no longer able to function with their family roles
• Family members cannot make decisions and solve problems
• They are unable to give care to each other in a way usually seen
• A shift from family to individual survival

Methamphetamine – Use in Pregnancy

Methamphetamine

It is described as the number one drug problem in America. It is relatively cheap, highly addictive, effects the population across the socioeconomic spectrum. It makes its users hypersexual and uninhibited.

When smoked, it produces a potent and very long-lasting high. Those who use the crystalline form, are awake and do not eat for 24 hours then will “crash” for the next 24 hours. Its active ingredient is pseudonephrine. It is easy to make or “cook”.

Clinical Manifestations

It creates an euphoric state, abrupt awakening, increase in energy, the person on Meth is talkative, may be elated, or be agitated. Meth causes irritability, hyperactivity, a sense of grandiosity. The effects also cause weight loss, ectopic heartbeat, urinary retention, constipation, and dry mouth.

Meth can cause paranoid delusions, violent behavior, seizures, cardiac shock, and death from over-dosage. Most of the effects are similar to that of Cocaine.

Neonatal Complications

Complications are less than what is found with cocaine users. But, a meth user may still have preterm birth, intrauterine growth restrictions with smaller head circumference.


REFERENCES:

Kitzinger, Sheila. The Complete Book of Pregnancy and Childbirth. (1996) Alfred A. Knopf.

Lowdermilk, Deitra Leonard and Shannon E. Perry. Maternity and Women’s Health Care. 9th Ed. (2007) Mosby/elsevier

Sexually Transmitted Infections – Part 1

Chlamydia Trachomatis

This is a highly transmittable disease. It is difficult to diagnose, and the symptoms are nonspecific. It is very expensive to culture.

It is important to identify this disease early. Without doing so and not getting treatment, it can lead to salpingitis or pelvic inflammatory disease.

It increases the risk of ectopic pregnancy and tubal factor infertility. If this disease has infected the cervix, it can cause a cervical inflammation leading to ulcerations…increasing the risk of HIV infection.
Women under the age of 20 are at highest risk for infection. They are 2 to 3 times more likely to have it.

Risk Factors:

Multiple partners
Not using barrier methods of birth control

Cervical cultures should be taken at the first prenatal visit. The use of silver nitrate on the newborn may not be sufficient to prevent the transmission of this disease from mother to infant. Early culture and treatment is a must.

Treatment

For cervical, urethral, and rectal infections: doxycycline or azithromycin.
If the woman is pregnant: erythromycin or amoxicillin.
If she has HIV, treatment would be the same as those without.