PRENATAL CARE or PRENATAL SCARE?



Women in Australia ask each other “Who are you going to for Prenatal Scare?” Sadly, that could be said in North America, too. Stressed practitioners unloading their personal fears on pregnant women is a common scenario all over the world.
A pregnant woman in Australia wrote to me because of these instructions from her midwives: “Lydia, your baby’s head is not engaged in the pelvis and you are close to your due date. We’re concerned that the umbilical cord might prolapse if your membranes release before your contractions are well established. If that happens, call an ambulance to get you to the hospital and get in an all-4’s position on the floor while you wait for the paramedics!”

She wrote to me in Canada to get my opinion on that advice. I told her my favorite theory about low-probability problems in birth work. I wrote: “Yes, Lydia, all that could happen, but it’s highly unlikely. Do you know that you could be walking down the street in your city and a piano could fall on your head? That’s possible, too, but none of us refuse to walk on city sidewalks because of the falling piano danger.” That explanation gave her confidence to continue with her homebirth plans. The midwives attended and everything went well.

Discussing things that are real and present is what pregnant women need from their midwives prenatally. Hallucinations of possible disasters that aren’t happening need to be silenced.
When a woman comes for a prenatal visit (or you attend at her home), she’s excited to be with her midwife and find out how her baby is doing. When a midwife is doing her best work, she will:
Be listening intently to what the client is saying.
Be organized so the client gets the message that the midwife values the client’s time.
Be writing notes of everything the parents say.
Be able to say “I don’t know the answer to that, but I will look it up and send you what I find out.”

The prenatal visits are a “dress rehearsal” for the actual birth. The family is getting an idea about how the midwife will be once the birthing time arrives. Is she punctual? Does she answer her phone promptly? Does she smell nice? Does she answer questions honestly? Do we feel comfortable, relaxed, and included when we’re with her?

I had a young couple come to an introductory appointment with me about 25 years ago. The government of British Columbia had just regulated midwifery and families wishing to have a homebirth with a midwife could get the service on their medical plan. I was not regulated and I charged $2800 to attend a homebirth. I explained that they could get a midwife “under the medical plan” and I also reminded them that I lived a 90-minute drive away from them. There were midwives working very near where they lived who would be paid by the government.
The father responded that “No, they didn’t want the local midwife and, yes, even though they didn’t have a lot of money they wanted someone like me.” He then proceeded to demonstrate what the local midwife did that he couldn’t accept. He started speaking to me while staring at a spot on the wall that was about 18 inches above my head. He didn’t connect with my eyes for the next little while. It was very weird. Then he told me “That’s what the midwife did. She never made eye contact when speaking to me.” He didn’t want long, deep stares, he just wanted a normal conversation with someone who looked him in the eye once in a while. I wondered what kind of fear state that midwife was in during the appointment.

I had a number of different physicians palpate my belly in my second pregnancy. The possibility of a homebirth had not occurred to me and my husband. We kept shopping for a doctor who would promise that 1. I wouldn’t be given an episiotomy, and 2. The baby would stay with me at all times. Those doctors were very clear that they would be in charge and I would get what they ordered and I didn’t get to tell them what to do.
Finally, we found out there were some midwives in Vancouver, BC, who would attend homebirths. We met with one of them, Elly, and for the first time in my pregnancy, someone palpated my belly with soft, warm hands and seemed to realize there was a real little human in my uterus. That experience sold me on her. Luckily, my husband was very impressed with her, too. I am forever grateful that I found the ideal midwife for me who fit with my family perfectly. Warm hands, a quiet confidence, and a willingness to meet my requests—that’s what her prenatal care encompassed.

Gloria Lemay is a childbirth activist living in British Columbia, Canada. She has a passion for VBAC, waterbirth and ending male genital mutilation. She is a blogger at wisewomanwayofbirth.com. Her film “Birth with Gloria Lemay” was produced in 2012 and has been viewed all over the world.

WISE WOMAN POSTPARTUM DOULA RETREAT 2024

April 5th, 6th, and 7th 2024
Bowen Island, British Columbia, CANADA

Join us for the 1st Annual Wise Woman Postpartum Doula Retreat. Wise Woman Way of Birth will be at the Xenia Retreat Center on Bowen Island for 3 days and 2 nights, surrounded by beautiful nature, soaking up the palpable spirit of these healing grounds.

A replenishing experience for your body, mind, and spirit.
An immersive training in continued postpartum education.
A connection for the postpartum doula community.

“I have been dreaming of this retreat for almost two years now, since moving to Bowen Island. I want to bring together the community of postpartum doulas that has been building over the last few years to connect deeper in person. There are so many brilliant, fascinating women doing this work, and we can all be supporting each other to better support the families we work with. It started as this zygote of an idea to give doulas some of the skills they have been asking for and has grown into this immersive, healing, cup-filling retreat with a dream team of speakers!” Candice Johnson

Wise Woman Postpartum Doula Retreat

CHOLESTASIS

Cholestasis remedy from Nat Dash, Australia (O.C. = obstetric cholestasis)
Source: My good friend and great midwife Lisa.

Dear Gloria, I use Nat Dash’s info. here it is.
Drink minimum 2 litres of purified water daily. THIS IS MOST IMPORTANT!! (2 glasses of warm water with fresh lemon juice, 1st thing in the morning)
I can’t recommend fresh juice enough; I feel they made a huge difference to my health. I chose to use fresh organic fruit & vegetables because of the toxins on the sprayed produce. Washing them in cider vinegar helps to reduce pesticides too though. Large apple, carrot, beetroot, celery & parsley, 3 times a day, 20 mins before a meal. Great for flushing out those toxins!!!
Pineapple & parsley is great for keeping up iron levels.
Porridge/oats made with water or rice milk – great for lowering rising cholesterol, which generally happens with O.C
Raw mushrooms also helped me a lot. I ate about a kilo a day. Later I found out that mushrooms are also beneficial to the liver.
Take all fats out of the diet. None or limited dairy products & meat. These are oestrogen forming… one of the contributing factors involved in Cholestasis is over production of oestrogen.
Deep sea ocean fish would be the best alternative & full of omega 3. If vegetarian, Flaxseed oil is fantastic & great for the skin.
Herbs made up by a qualified naturopath, as listed in article – psyllium husks, dandelion, slippery elm, globe artichoke, milk thistle etc.
Guar Gum is a natural gel-forming fibre & has been very successful in aiding women with this condition by increasing faecal elimination of bile acids. Tablet or powder form should be available from health food store or natural health professional.
Metamucil also helps to bind the bile.
Acupuncture was used throughout my pregnancy to assist with good liver function & for preparation & assistance with natural induction. Acupuncturist needs to be competent working with pregnant women & liver conditions.
Relaxation – Yoga, meditation, stretching, deep breathing, Reiki can all be helpful for both mind & body. Good preparation for labour also!!

Some women find it difficult to retain vitamin K with this condition (vit k is necessary for blood to clot).
Here are some suggestions to minimise bleeding/ Postpartum Haemorrhage (PPH):
Have blood tests to check haemoglobin at 36 weeks; use natural means to help avoid anaemia or supplement – floradix, Spatone etc
Take a good quality multi vitamin for pregnancy
Take alfalfa, 4 – 8 tablets per day, any brand. Alfalfa contains every vitamin & mineral, as it’s roots go extremely deep into the soil – it is an excellent source of vit k

This has worked in my experience.

Lisa

Online(Zoom) Leadership Training

“Leaders in Boys Protection” Project

A training program to unleash leaders in the worldwide push to eliminate male genital mutilation.
Start Date: Tuesday, January 11, 2022
Course Completion Date: Tuesday, March 15, 2022
Time: 7:00 to 8:30 p.m. (Pacific Standard)

This 10-week online training will be headed by Gloria Lemay, a midwifery educator, member of Nurses for the Rights of the Child, and Advisory Board member of Intact America. Gloria has led online courses for midwives and doulas for over 12 years. She is a passionate advocate for baby boys and their right to bodily integrity. She is active on social media as a spokesperson for the “intactivist” movement.

Who should be in this training?: If you have a desire to make a difference in child protection you are welcome to join this online training. You must be able to make a commitment to attend all 10 classes on Zoom once the course begins. If you have been stopped by societal pressure, embarrassment, sadness, anger, overwhelm, or other barriers to expressing your commitment to ending MGM, this will be a safe space to free yourself up and get in action again.

Bonus feature: We will have some special guest presenters who have had years of “on the ground” experience in advocating for baby boys.

What is the cost? There is no charge for the training.

What must I do to participate? Each participant will be asked to create a project of their own that will unleash their contribution to ending male genital mutilation. There will be homework in the course that will be posted on Google Classroom. At some point in the 10-week training, each participant will have an opportunity to present a talk on some aspect of their experience with speaking up for baby boys.

Intended Outcome of the Project

To unleash the expression of people in the intactivist movement at all levels of experience.
Expect unexpected results from coming together with other intactivists to inspire, collaborate and embrace the leadership in all of us!

Please contact me for more information on this project. waterbirthinwoman@gmail.com
Time of class: 7:00 to 8:30 p.m. Pacific Standard Time

WISE WOMAN WAY OF BIRTH DOULA TRAININGS (2024)

Featured

The Next Scheduled Course begins on
Wednesday, September 4 at 7:00 p.m. (Pacific Time)
Cost: $675 (Canadian)

taught by Gloria Lemay

Jessica Austin, with a Doula client.

Jessica Austin, with a Doula client.

This course will give you the skills to assist women giving birth at home or in hospital. Doula services are in demand. There is a pre-reading requirement. Please email waterbirthinwoman@gmail.com for further information and to register for the course.

The course will be on Zoom and assignments and tests will be on Google Classroom.
12 Classes 2 and a half hours long. In 2024, this September course is the last one for the year..

Course Three: Wednesday evenings (Pacific) September 4 to November 20 7:00 p.m. to 9:30 p.m. (Pacific)

Successful students will receive Wise Woman Way of Birth Doula Training certification.

OVERVIEW OF COURSE CONTENT
Class 1: Introductions, birth “politics” and Language
Class 2: Preventing Problems before the Birth: Nutrition. Prenatal Screening
Class 3: Types of “support” in birth: Midwife, Dr, Obstetrician, Doula — what are the differences? Comparison of home and hospital choices. Assisting your client in making a clear Birth Plan for the chosen place of birth.
Class 4: Anatomy and fetal positions, introduce the concept of “pain” and normalizing birth sensations through knowing the anatomy. Introduction to the concept of breech and twins as variations of Fetal positions.
Class 5: Medical Birth Phases and the “real” phases of birth and how to recognize them.
Class 6: Breastfeeding and early days postpartum and newborn care / Doula Role in these.
Class 7: Common Interventions and the Intervention Cascade. (Fetal monitoring, ultrasound, epidurals, Caesarean, vacuum, forceps, etc.)
Class 8: Preventing Birth Derailment in common scenarios and special situations: Induction for Postdates, augmenting a “slow” birth, a diagnosis of Low or High Amniotic Fluid Levels, Meconium, premature release of the membranes, vaginal birth after cesarean (VBAC).
Class 9: “Informed Choice”: what it *really* means and how to use it as a tool for your client vs a tool for enabling the institutional model of birth, more work on creating a Birth Plan with a client
Class 10: Business Basics: Finances, record keeping, professional practices, client confidentiality, and effective advertising. Structuring a plan for working with clients from interview through to completion.
Class 11: Comfort Measures, supporting Long Births, Helpful things to say, Water Birth.
Class 12: Staying calm when the baby comes: Miscarriage, Abortion, and Stillbirth. How to support people through the hard things in birth work.

Added on May 22, 2024 From Gloria, I am training a great group of women to be birth doulas currently. It’s quite amazing to see them creating alliances and support structures from taking an online course. One of them voiced in the classroom that she thought the class would be about rubbing backs and saying comforting words to birthing women. Instead of that, we have to prepare the students for the “sysem” and how to navigate it to protect their clients from harm. This is my response to her: Quote: “Gloria Lemay May 19”
Oh, I wish so much that we could teach a nice course on how you should all be team players, think positive, reframe every terrible experience into a good memory for your client, be liked, be appreciated and live happily within a specific “scope” of practice. There are courses that try to “sell” that model of being a doula. We’re a little different. We name “Obstetric Violence” , “Medical Rape” and “Birth Trauma”. The numbers don’t lie. When 40% of our sisters, cousins, aunts, friends and associates are having their bellies cut open with a knife and their babies being dragged out drugged and dazed, we just can’t “sell” a denial of the facts. Medical birth is assaulting women.
All of your comments above are so important. Thank you for taking the time to read/watch the materials. I know they are disturbing. We need every one of you in the birth advocate business. It is scary and intimidating at times. That’s okay. You’re going to learn and experience things that will help you be better consumers of medical care to protect yourself and your family. You’re going to have moments of such pride and accomplishment when you know you’ve made a difference. You’re going to have times when you want to quit and get a nice job at a supermarket—-don’t do it! The secret agenda I have for each and every one of you is that eventually you’ll all be the woman in your community who is the “Go To, Birth Woman”. People do recognize courage and persistence.”
Contact Gloria Lemay at waterbirthinwoman@gmail.com

Postpartum Doula Certification(2024)

Featured

We have heard such positive feedback about our Postpartum Doula Certification Course. We have put together a great course that will launch participants into action in this career.

The Wise Woman Way of Birth Postpartum Doula Training will be taught primarily by Candice Johnson. Candice is the owner/operator of Cherish Childbirth in Vancouver, BC. She has built her business over the past 10 years and is the “go to” woman when families are having problems in the early days of parenting. She has a broad education in Massage, Breast Feeding, Childbirth Education and Infant Massage. Candice has trained many postpartum doulas and is active in the Vancouver birth community. She is the mother of two boys who were both born at home and breastfed into toddlerhood.
Website: https://www.cherishchildbirth.com/
FINAL COURSE FOR 2024:

6 live classes on Zoom, 2 and a half hours long.
Cost: $525 (Canadian)

Final Course in 2024 dates:

Course: Saturday September 28 to November 2 10 a.m. to 12:30 p.m. (Pacific)

6 Classes Live on Zoom, assignments and materials on Google Classroom.

Course Description:
This course will prepare you to be with families in the months after welcoming a baby. It includes all the aspects of the “fourth trimester” from practical feeding skills, to understanding the postpartum person’s body and how to support the family as a whole.
Our societal structures provide little care for new families. Having a trained eye and calm presence in a home in the early days is invaluable. Postpartum Doula care is proven to improve breastfeeding success, family bonding, and postpartum dis-ease disorders. Postpartum Doulas are in high demand!
The course will be on Zoom and assignments and tests will be on Google class room.
Successful students will receive Wise Woman Way of Birth Postpartum Doula Training certification.
Please email if you need more information or to register. waterbirthinwoman@gmail.com

Class ONE – The Fourth Trimester and the Role of the Postpartum Doula

Class TWO – Postpartum Healing – Physiology, Nutrition and Traditional Practice

Class THREE – Business for Postpartum Doulas and your Post Birth Bag

Class FOUR – Breastfeeding

Class FIVE – Alternative Feeding Methods, Twins/triplets, Newborn Intensive Care Unit

Class SIX – Newborn Care (including diapering and baby wearing).

Introducing Candice Johnson, the course instructor: Quote:
I have been living and breathing all things birth since I was asked to attend my first birth over 15 years ago. I feel a deep innate knowing of the undisturbed birth process. As an extension of my birth work I organically began supporting breastfeeding. I enjoyed my time with families postpartum but until I had my own babies I didn’t fully understand the importance of supporting someone through the postpartum period. Suddenly what I had always known, respected, and held space for I experienced first hand. This sparked a passion for serving new families. I hope by sharing my knowledge of how to support the “fourth trimester” through doula education, much needed support can be brought to communities everywhere.
Candice Johnson, Birth and Postpartum Doula, Childbirth Educator, Breastfeeding Counsellor
— on Bowen Island, British Columbia.

Is the baby breech?

The baby can be breech or head down throughout the pregnancy and it’s of no real concern until 34 weeks gestation. At that point, the baby’s head is big enough and firm enough that it can be palpated and a reasonably good assessment can be made by a clinician. This is also the point in the pregnancy where it makes sense to take steps to encourage the breech baby (3% of all pregnancies) to turn to head down through Webster technique (chiropractic), knee/chest position, or external cephalic version by an obstetrician.

For birth workers, these are some of the things I’ve observed about pregnant women carrying the baby in a breech position. They are not 100% diagnostic but can alert you to look closer for breech position. If the only thing that is concerning in the final weeks of pregnancy is “What position is this baby in?”, it’s possible to have a “one swipe” ultrasound. An ultrasound technician can do a very brief scan and see where the baby’s spine, head and bum are. There’s no need to do a time consuming (prolonged ultrasound exposure) scan just for position. If the baby is breech, you’ll want to know where the placenta is located as well. If the baby is head down, the scan can stop and the parents can go celebrate.

These are some signs that the baby could be breech at 34 weeks and beyond:

1 heart tones heard with fetoscope (not doppler) in upper segment (belly button level or higher).
2. Woman has feeling of a hard ball in her ribcage. Woman tends to squirm and press down on the top of her uterus when sitting.
3 head is slightly firmer than the bum on palpation after 35 weeks gestation age.
4. Abdomen has a more tight/taut sausage shape/quality than the usual round/squishy orange shape/quality.
5. Where are the baby hiccups felt? If high (woman’s belly button region), breech is suspected.
6. If the woman has had a previous breech birth, check carefully because a fibroid or a bicornate uterus (or other unusual anatomy) may predispose to carrying all her babies breech. (One woman I have worked with had 7 breech births. She had 2 uterii.)

I must admit that the best breech births that I have attended are the ones that were NOT diagnosed in advance. Women who have a surprise breech are spared all the worry, over-testing, over-lecturing and general misery that diagnosis of breech can bring.

Please let me know in the comments if you have any other tips or techniques for spotting those little beings who want to back into life. Thanks Gloria

Soothing words for birth

When women start out on the path of birth work, they fear they won’t know what to say to the birthing woman. Quiet is more important than talking. A few words spoken at the right time can renew a woman’s sense of safety and resolve. Practicing saying soothing things out loud will make the words come easy when the time is right. Some things that might be appropriate to encourage a birthing mother:

“It’s safe to let go”
“You only have to do this one”
“Breathe right down into it, it’s safe to go there”
“Breathe oxygen down to your thighs, that’s it. . . breathe in oxygen and breathe out with loose lips.”
“What you’re doing is ancient. . . your mother, your grandmother and your great grandmothers all the way back have done this. They’re all proud of you tonight.”
“If you’re doing this well now, I know you’ll make it through. Each sensation brings you closer to holding your baby in your arms”.
“I’m so proud of you. You’re doing beautifully”.
“Let’s begin this birth anew. Just let your breath wash away the past 5 hours and let’s begin now at the beginning.”
“Breathe some good oxygen breaths for your baby.”
“There’s lots of room for the baby to come through”.
“You’re stretching beautifully. . there’s more space than you know”
“Just let the baby get itself born, you get out of the way”

Gloria Lemay, Vancouver BC Canada

Canadian midwife with client

SUA Single Umbilical Artery

SINGLE ARTERY UMBILICAL CORD

About 30 years ago, a baby boy was born at home in a town about 90 minutes drive away from where I lived in Vancouver, BC. All was normal with the birth (first baby for the family). The baby was about 8 pounds and he seemed healthy.

I was taught to inspect every placenta carefully at some point in the hours after birth. One part of the placenta exam was to look at the cut end of the umbilical cord and make sure there were 3 little openings where the 2 arteries and one vein were. Remember, this was in the days pre-internet. Midwifery training was accessed by reading thick obstetric/midwifery text books in those days. This little boy’s umbilical cord had only 2 vessels. Oh no. Where was that third little opening for the second artery? I re-cut and peered at the end of the cord but, no, only two vessels. The only instructions in any of my textbooks about that possibility were to “call the pediatrician”. So, I did. At that time, we had a kind pediatrician who always took calls from home birth attendants. When I told him the situation, he said “Hmmmmm, I don’t know what that means. Could you go in to Children’s Hospital to the library and look it up?” I didn’t like to leave the family’s home without knowing for sure that the baby would be okay and I had that 90 mins between their home and the hospital library. I decided to call a friend who was a long time hospital nurse. She didn’t know either but thought it might have something to do with the heart. The baby wasn’t showing any signs of blueness around the mouth and was a keen breast feeder so, I didn’t see or hear any heart problem indicators. After a few hours, I headed back to town and went straight to the Hospital Library.

Vein larger than the 2 arteries

In those pre-computer days, the hospital Librarian was a God-send. She was very helpful and looked up a bunch of articles for me but they really didn’t tell me much more than “it could mean a kidney problem”. I was feeling frustrated but, then, got an idea. I could find the pathology department in the hospital and speak to a person who had seen babies with kidney problems and maybe get some useful help.

I was a bit nervous going to Pathology because I was afraid I’d see dead bodies but, no, the place was clean as could be. The Pathologist was glad to see me and have someone to talk to. (I think that’s a lonely job). I told him what was going on and the first question he asked was “How much did the baby weigh?” He then told me that babies with kidney problems tend to be very small so he doubted my finding that there were only two vessels in the umbilical cord of an 8 lb. baby. He suggested that I should bring the placenta in so he could take a look. I wasn’t relishing the 90 minute drive back and forth again but I was more than willing to be wrong about my count of the vessels if it meant I could relax about the baby.

One vein, two arteries

I returned to the family home, got the placenta from the fridge and drove it back to show the pathologist. He cut the end of the cord on his marble slab and peered at it and then said “Well, I see what you mean. There are just two but can you see that the vein, which is usually larger than the arteries, and the one other vessel are both about the same size? I think what happened here is that the two vessels grew together. If the baby is pee-ing normally and eating well, I don’t think you have anything to worry about.” He then proceeded to reach up on to his shelf and bring down a copy of a thick text book entitled “The Human Placenta”. He told me that it was a fascinating book by a pathologist who had been a veterinarian before he pursued pathology. When I expressed amazement that there was enough to say about the placenta that it could fill a whole book of its own, he said that a lot of the information was comparing the human placenta to that of zebras, gorillas, and other wild animals. Somehow, I’ve never been tempted to buy the book. . . I like to keep my placenta knowledge on a “need to know” basis.

That little boy did just fine and he’s a big man now. That’s the only 2 Vessel cord I’ve ever encountered in 1500 plus births, so it’s very rare (and, in this case, not even a real finding).
I hope this story is informative and reassuring to parents/practitioners about SUA (single umbilical artery) diagnoses in babies with normal growth.
Gloria Lemay, Vancouver BC Canada

From www.midwifethinking.com
A great blog

HOW BIRTH STORIES GET JUMBLED

I wanted to share this memory with you, Ted. I don’t know if you remember this incident but I’ve told it to so many people and it always makes me laugh so I thought you might enjoy this trip down memory lane.

Many years ago, when we both had young kids and you were married to Karen, I bumped into you in the parking lot of the “7-11” on West Fourth Ave. We exchanged small talk for a while and, all of a sudden, you got a strange look on your face and blurted out the following, unforgettable (to me) sentence: “Gloria, is it true you were a topless dancer in China?” I couldn’t fathom how that thought could ever enter someone’s head. I’ve been accused of many things in my life but that was pretty far-fetched—I had never been to the Orient, I had never been to the local nude beach, none of what you said made any sense at all. But, somewhere in there, I started thinking “How could this husband of another birth attendant have gotten this idea in his head?”

Then, I remembered a birth that I had called Karen out to one evening. It was the second vaginal birth for the woman. When Karen arrived at the home, I went through the woman’s chart with her. The only surgery the birthing woman had ever had was a breast augmentation. She was a Caucasian woman who was married to a Japanese man. I explained to Karen that the couple had met in Japan and the first child had been born in a Japanese hospital, completely natural birth. The woman had been in Japan because she had taken a job as a hostess in a nightclub in Japan. japanese fan

Now, they were living in Vancouver and having their second child. The baby was born just after midnight and I sent Karen home soon after.

I’m guessing that what happened is that she crawled into bed with you, Ted, and you must have asked her “how did the birth go?” There wasn’t much to tell except that bit about her previous breast augmentation surgery so perhaps Karen told you about that. Somehow, in your sleepy state, that got changed into “Gloria Lemay was a topless dancer in China”.

Once I had retraced the strange pathway of that statement, I said to you: “You know, Ted, that’s not true about me BUT it’s way more interesting than my real life. Will you, please, spread that rumour about me!”

Thanks for the special moments and laughs that knowing you has added to my life. I love you and your dear family.