The role of priestesses and women physicians who helped during childbirth in ancient times is extremely important. However, it has not been studied enough.
Giving birth to a child is taking a life from Death's hands and bringing it into the World. It is, thus, a combat, a battle in which a woman’s own life is put at risk. The patron divinity of birth is Tlazolteotl, Lady of Filth, who inspires sinful thought into people, which leads us to sex, and sometimes to error and wrongoing. Tlazolteotl is also the great purificator, who cleanses all that is dirty and regenerates the cycles of life.
You can find prints of the Temple of Tlazolteotl in my Etsy store! Click here!
In 1759 king Louis XV commissioned pioneering midwife Angélique du Coudray to teach midwifery to rural women to reduce infant mortality. Between 1760 to 1783, she traveled rural France and it is estimated that she trained about 4,000 students during that time.
Du Coudray invented the first lifesize obstetrical mannequin, called “The Machine.” Various strings and straps served to simulate the process of childbirth. The head of the infant mannequin had a shaped nose, stitched ears, hair drawn with ink, and an open mouth, with a tongue.
While the semi-creepy mannequin is not pleasant to look at, let’s hope it helped to save a lot of lives.
“ahaasuwimiikwan#beadwork #indigenouswomen #lifegivers #earth #strong #power #nativebeadwork #beadedmedallion #beadedally #ndnbling #mooncycle made this for a friend of mine @al_yss_ very challenging but she asked me to make something related to midwifery and this is what I came up with ”
Yes, she is taking advantage of the fact that the place they are to be living has lower standards and her passing will be a cakewalk. Especially since she is a Duggar. The local officials will take that into consideration.
Molar pregnancy is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus and will fail to come to term (will not develop into a child). Instead, the cells divide and replicate into a growing mass (mole) of non-foetal tissue.
Molar pregnancy is a gestational trophoblastic disease in which a non-viable egg grows into a mass (tumour) in the uterus that has swollen chorionic villi.
Can develop when a fertilized egg does not contain an original maternal nucleus.
Usually contains no foetal tissue.
Characterized by the presence of a hydatidiform mole (or hydatid mole).
Approximately 20% of women with a complete mole develop a trophoblastic malignancy (malignant disease // cancer)
Complete hydatidiform moles have a 2–4% risk of developing into choriocarcinoma in Western countries and 10–15% in Eastern countries, and have a 15% risk of becoming an invasive mole.
Molar pregnancies make up 1 in 1,000 pregnancies in the US and up to 1 in 100 pregnancies in parts of Asia.
Symptoms
Vaginal bleeding- molar tissue separates from the decidua, causing bleeding.
Uterus may become distended by large amounts of blood, and dark fluid may leak into the vagina.
Hyperemesis - severe nausea and vomiting due to very high levels of human chorionic gonadotropin (hCG).
Hyperthyroidism - thyroid gland is stimulated by the high levels of circulating hCG or by a thyroid stimulating substance (ie, thyrotropin) produced by the trophoblasts.
Partial mole
Partial moles do not generate the same clinical features as a complete mole. Patients instead present with signs and symptoms consistent with an incomplete or missed abortion, including vaginal bleeding and absence of foetal heartbeat.
Callen moved to Pineville, South Carolina in 1923, where she set up practice. She was one of only nine nurse-midwives, at the time, in the area. Callen operated a community clinic out of her home, miles from any hospital. She provided in-home services to “an area of some 400 square miles veined with muddy roads”, serving as ‘doctor, dietician, psychologist, bail-goer and friend’ to thousands of desperately poor patients.
It is estimated she delivered between six hundred and eight hundred babies in her years of practice. In addition to providing medical services, Callen also taught women from the community to be midwives. In December 1951, Life magazine published a twelve-page photographic essay of Callen’s work, by the celebrated photojournalist, W. Eugene Smith. Smith spent weeks with Callen at her clinic and on her rounds. The photos were visually arresting, both as a haunting record of the time but also as ongoing testament to the power of nursing and midwifery to effect social change.
Midwife-friendly laws and regulations tend to coincide with lower rates of premature births, cesarean deliveries and newborn deaths, according to a U.S.-wide “report card” that ranks each of the 50 states on the quality of their maternity care.
The first-of-its-kind study found a strong connection between the role of midwives in the health care system – what the researchers call “midwifery integration” – and birth outcomes. States with high midwifery integration, like Washington and Oregon, generally had better results, while states with the least integration, primarily in the Midwest and South, tended to do worse.
As with most population health studies, the statistical association between the role of midwives and birth outcomes doesn’t prove a cause-and-effect relationship. Other factors, especially race, loom larger, with African-Americans experiencing a disproportionate share of negative outcomes. However, almost 12 percent of the variation in neonatal death across the U.S. is attributable solely to how much of a part midwives play in each state’s health care system.
“Our results show that families experience better outcomes when midwives can practice to their full capacity and are part of the system,” said Saraswathi Vedam, an Associate Professor in the Department of Family Practice at the University of British Columbia, who led the team of U.S. epidemiology and health policy researchers responsible for the study, published Feb. 21 in PLOS ONE. “In marginalized communities in the U.S., where the health system is often stretched thin, expanding access to midwives and increasing their responsibilities could be a feasible strategy for improving maternity care.”
How lucky am I to have such an amazing friend that she documented BOTH of my girls’ births. Here you go little one, your birth story as told my Auntie Bear, with frequentinterjections from Momma :)
Dear DC,
One day you will look back on your life and think, “Time flies…” You will not know exactly where it went, or how you got there, but every experience in your life will have led to that moment. I want to tell you the story of your first experience in this thing we call life. I can’t wait until you are old enough to hear this story told by me, you will laugh hysterically, we all do every time I tell it. Truth be told, the beginning of your story actually occurred prior to your earthly arrival. It was over the Christmas holiday in Saint Lucia, your daddy’s homeland, and your parents decided to give MJ a sibling. By the time I came to Washington DC for your mama’s surprise 29th birthday party, we knew you existed. I now look back on those days and think, “My, how time flies…” It seems like just yesterday we were dreaming of your arrival. Though it feels as though it flew by, a great deal of thought, energy and effort went into the 41 weeks that passed before your birth.
Mama worked very hard to nurture you and provide the perfect home for you to grow in. She loved you so very much, and her expression of that love was evident in the way she loved her body. She ate well, exercised, and learned everything she could about being a strong vessel for your entrance. Her pregnancy and labor with MJ was very difficult, and she wanted to do everything in her power to cultivate a better experience for the two of you. She and your daddy went to hypnobirthing classes so they could learn calming techniques for management of her labor. I took doula classes and an additional hypnobirthing class so I could help your mama and daddy through your birth. By the time your due date rolled around, we were all ready. I arrived in DC 17 days before you did :) and you sure gave us all a lesson in patience. The funny (or not so funny) thing was that your mama thought the hard part was waiting for *my* arrival. She was having contractions all the time, and laid still all weekend so that she wouldn’t have you before I came from Minnesota. However, she did such a great job of preparing for you that you were quite content to stay put in her belly.
I arrived September 29th, but you had other plans for your grand entrance so we had some extra time to get ready for you. We finished decorating your nursery, cleaned the house, and spent each evening and nap time practicing hypnobirthing scripts. I became pretty good at putting your mama in the relaxation zone! It seemed as though you were pretty relaxed, too… We decided to kick things up a notch and tried EVERY trick in the book to get you to come. We had spicy Indian food. We took walk after walk. We went to Great Falls in Virginia and your daddy made a little home movie. Mama got foot reflexology three times! Auntie Bear is forgetting she even baked some type of eggplant labor inducing meal LOL, child we tried EVERYTHING! The night Grandma Judith and our friend Jess arrived, Mama was having strong, consistent contractions. Then, nothing happened. Your due date, October 8th, came and went. Everyone kept asking mama about when it would be time And momma wanted to punch all of those people in the throat. In our culture, we have moved away from nature’s timing and focused so much on “our timing.”
Mama felt a lot of pressure from this, but she resisted. She wanted to wait for you and her body to decide how your story would unfold. Sunday October 12th, we went to the hospital because mama was having consistent contractions again. The midwife thought it sounded like it could be time, and told us to come in. Grandma Judith and Daddy came with, excited that you would arrive before she went back to Minnesota. Mama was dilated to 2cm and the nurses told us to start walking to see if she could make any more progress. Mama was so determined; she walked like an Olympic speed walker. Then, nothing happened. Don’t forget that I also dropped it like it was hot a few times too! They told us it wasn’t time and sent mama home with some sleeping medicine, thinking maybe the next day it would finally be time. Your daddy already had to leave on the weekends to DJ a couple of weddings, which was really hard because mama had to mentally prepare for giving birth without him. Your daddy knew he might have to miss it, which would have been really sad for everyone. Thankfully, that didn’t happen. Because Mommy probably would have NEVER let Daddy live it down. Each night, mama would have hours of contractions. Then, nothing happened. Your mama got to 41 weeks and as another weekend was approaching, everyone agreed we should make a plan to get you here before he had to leave again. Plus, the midwives didn’t want mama to go much past 41 weeks. On Tuesday, we made a plan to go into the hospital at 5:00pm on Wednesday October 15th to see if we could get things rolling! Alas, you were determined to choose your own birthday.
After the false alarm on Sunday, we started thinking maybe you weren’t quite in the right position because mama was having a lot of back pain. We started doing stretches and exercises to make sure you were in the right place. We made an appointment with the chiropractor for Wednesday morning and on Tuesday afternoon decided to go to Virginia to see Lindsey, mama’s hypnobirthing instructor. Lindsey got mama nice and comfortable and read a beautiful script to her about opening up and allowing to you come peacefully. Mama started having contractions during her session. Lindsey did some more stretches with mama and sent us home to rest. Little did we know, there wouldn’t be any rest until we got to meet you!
Mama’s contractions continued during the car ride home. We didn’t even acknowledge them this time. We continued our conversation, she would pause to breathe through them, and I was secretly keeping track of time. They marched on through the long rush hour drive, becoming closer together and lasting longer. By the time we were home, we were both pretty sure this was it Oh I knew it was it, I literally had my feet up on the dashboard, trying to find some relief with counter-pressure. I was so terrified that I was gonna have you in the car because we were, of course, stuck in crazy DC traffic. She had me call the midwife Tara, who could hear mama in the background and told us we better hustle in! I told your Daddy it was time and of course your big sister decided to throw a tantrum in the rush to leave. Jess helped Daddy get everything ready, and I yelled that I was leaving with mama. While mama and I were waddling through contractions to get in the car, the neighbor yelled out to ask if we needed help! We were quite a spectacle. I remember thinking it was a sweet gesture, but seriously what the hell was he gonna do LOL.
We made it to the hospital and they rushed her up in a wheelchair and straight into a room. The man pushing the wheelchair was so sweet, he was giving me a pep talk the whole time. I love people like him. When Jess and Daddy arrived, Tara the midwife ran past them in the hall. After all the commotion, we found out mama was still just 3cm! Thankfully she had time to get her antibiotics in and calmly breathed through contractions for the next four hours. She was so serene, trusting her body and allowing you to work your way into the world. At midnight, Tara checked and told mama she was 4cm. At this point, mama decided she wanted to have her water broken. Since we had gone to Virginia, this was the one day mama hadn’t taken a nap. It was getting late, and mama felt like she had the strength to keep going at this point, even if it got very intense, as opposed to working all through the night and being too tired if you didn’t come until morning.
Mama and I went in the bathroom and I gave her a pep talk. I told her it was about to get really intense, and she had to mentally prepare herself for the change of pace. She said she was ready. Tara broke mama’s water, the sac that held you in place in her womb. We were all braced for the next contraction thinking it would be pretty hardcore. It came and went without much fanfare. We all looked at each other wondering if things would speed up. We didn’t have to wonder for long! In the next hour and forty minutes, mama went all the way through active labor and transition, which is the last phase before pushing. One day you may learn this, but that is A LOT to go through in such a short period of time. She was so incredibly strong and brave. She didn’t complain at all, and soon enough she was showing all of the classic signs of transition, shaking, throwing up, riding an emotional roller coaster, all the fun stuff! She barely got any time between contractions and just as the thick of it hit, she told us “I did it guys, I did my best!” She kept repeating, “I’m all done now, I did my best, I’m done now!” I was pretty confident mama WAS pretty close to finished, since she had already gone through so much and was acting like a woman who is on the verge of pushing a baby out.. We were encouraging her and telling her how awesome she was, and she WAS doing it. Tara even said, “You’re so close! You sound like moms who’ve already had a baby and are just about ready to push!” She asked mama if she wanted to be checked to see how close she was. Mama said no. At this point, I realized that despite everything she was feeling, mama was afraid she might hear she still had a long way to go. It’s impossible to rationalize with someone who is going through so much and working so hard, so we all just kept encouraging her.
Mama put her hand up to my face and tuned me out! She was all done with me at that point. She turned to Daddy, thinking he would support her. He DID support her, by encouraging her and trying to help her relax, but of course, that’s not what mama was looking for. Truth be told I was looking for the weakest link LOL, in this situation Daddy was the weakest link and since Auntie Bear and Tara were hanging tough and doing what I asked of them, I thought for sure I could lure Daddy to the dark side. Daddy doesn’t like to see me in pain so I was hoping he would say, give her the meds now. But Daddy held strong too and in my head I literally said, they are all against me. She just wanted to meet you and be all done! She went in the tub for awhile, and we had a calm hour. She was really so strong and focused, just as she had been for her whole pregnancy. Then, mama started to get really antsy. She said it felt like she had restless legs, but Tara and I could tell she was ready to have you! We asked her if she felt the need to push and she emphatically said “NO!” followed by, “GIVE ME THE FLUIDS!” because she knew she needed fluid in her IV before she could get an epidural. As the fluids went in, she stared at that bag of IV fluid like it held the potion for eternal life! We kept asking mama if she had to push and she kept saying no, even though it looked like she definitely had to. Oh I definitely had to. It was in the tub that I realized it was time to push…I literally could feel you coming out but I was terrified. At this point there were no logical thoughts. I knew it was time, I knew you were coming out and I still begged for medicine.
When she walked back to the bed, I could tell she was squeezing every muscle in her body trying to keep you in, so I was massaging her, trying to get her to relax and let you come. She still said she didn’t have to push! I was literally clinching my butt together as Auntie Bear was massaging it trying to get me to relax. All the while in my head I am straight cussing her out, I can’t relax crazy if I do she’s gonna fall out LOL. She was so focused on getting relief she didn’t realize she could have pushed you out and been done with everything right then! A mean man came in to do the epidural and made mama sit still. He was pretty rude and I whispered, “He just doesn’t understand!” Hell no he didn’t understand, this fool actually asked if I could stop moving and acted like what I was doing was no big deal, he also almost got choked out. while mama was holding on to me. She later told me that’s when she knew I wasn’t disappointed in her for getting an epidural. Then, we waited awhile, but her epidural didn’t even help! So I called the nurse so she could get more medicine, and mama really knew we were on the same team again :)
Mama finally got to rest for a bit. I was so sure you were almost here that I lifted the covers to make sure you weren’t halfway in the bed! Tara said she’d come back in an hour or two to check on mama’s progress. Mama was pretty bummed because she didn’t realize she was going to have to wait even longer to meet you. I remember wanting to cry at this point, I knew you were ready to come right then, I had been holding you in for an hour. When Tara asked to check me I said no because I knew if she looked, she would see your head coming out, but at that point I needed some relief. I had gotten to ten centimeters with no medicine and I was exhausted. After about an hour, she sat up, bright-eyed and ready to push! She told us she had to push all along, but was so freaked out she just squeezed you in! I couldn’t believe it! Well, I could, because she LOOKED like she was ready to push you out, I just couldn’t believe she had a meltdown at the end. But hey, labor is quite a trip!
Thank goodness she confessed though, because we all got a really good laugh and mama was in a great mood for meeting you! I literally apologized to Tara my midwife when she walked back into the room to have me push. “Tara, I have a confession, this baby has been ready, I could have pushed two hours ago…I’m sorry my mind failed me and all rational thought disappeared somewhere.”
After 13 hours of labor, and a whole lot of tomfoolery, shenanigans, and bamboozlement, she pushed for 25 minutes while Daddy stood by her side and we all cheered her on. Then the most amazing thing happened: At 6:25 in the morning on October 15th, 2014, YOU ARRIVED! It was such a beautiful moment. One of the greatest moments of my life. All of the preparation, anticipation and waiting finally came to an end with your glorious entrance. You were absolutely perfect, sweet girl… All 8lbs 5oz and 21 inches of you! You snuggled with Mama and started eating like a champ! Then your Daddy got to hold you close (and show off his muscles at the same time!) DC, the world is a better place now that you are here. I can’t wait to see who you become; you’ve already made such a difference in our lives. But don’t worry my love, we won’t rush you… time flies.
[image: the card I carry with to explain epidurals during labor, created by Penny Simkin]
I had a few requests for me to share my epidural informed consent ‘script’, so here it is in it’s MOST general version. Please remember that this is just an idea of what I might say, and it would definitely be different when I am with a laboring person, as I take their specific health and priorities and concerns and personality into consideration when I discuss this with them. This script is for someone who is undecided during labor about whether or not they want an epidural and is asking for more information.
*Of note: I don’t bring pain medication up without them starting the conversation unless I see them truly suffering. If I bring it up and they say no, I don’t bring it up again.
The conversation usually includes a few parts:
Explaining what an epidural is and how it works
Explaining the process for inserting the epidural
Discussing risks, benefits, and alternatives
Reviewing everything, answering questions, and then stepping out of the room to give them time to discuss if they would like that.
Occasionally it may include offering a vaginal exam ahead of time if they think the information gleaned from the exam would change their decision
“I remember from your birth plan that you didn’t want to talk about pain medication unless you brought it up yourself - now that you’ve mentioned that you might want an epidural, do you feel like you’d like to talk about it? There’s no rush since I KNOW that you can do this and ARE doing this in the exact right way for you right now.”
If yes, I continue.
“Epidural anesthesia is a pain medication that numbs you from here [show them the top of the uterus/diaphragm area] down to your toes. Everyone experiences them differently, so some people are completely numb and cannot even move their legs, while most people have some control over their legs but are numb enough to not feel the intensity of the contractions any longer. While you won’t feel the intensity, you will still likely feel the pressure of contractions or of the baby’s head as the descend in your pelvis, and you will still feel touch to the skin. You will definitely feel the baby’s head coming out, and that may be painful or intense even with the epidural in place. Our anesthesiologists usually do an epidural that allows for your legs to move, and so we will definitely help you into whatever position you need - sitting up, lying down, squatting, hands-and-knees, lying on your side - as long as you are still in the bed. It’s not usually safe to try standing with the epidural since most people don’t have enough sensation in their legs to hold their weight.
“The way they place the epidural is they have everyone but one partner/doula/support person step out of the room and you sit at the edge of the bed with your shoulders slumped over. The anesthesiologist will give you a numbing shot to the skin on your low back which some people say is the most painful part of the whole ordeal - it feels like a bee sting. Once that area is numb, they insert a larger needle into the epidural space, in your spine. [I carry an illustration of this to explain what I mean.] Then just like an IV in your arm, a tiny plastic catheter (tube) is threaded into that space and the metal needle is removed. The epidural medicine drips in a small amount at a time through the catheter. This way we can give you more or less medication at any time depending on what you want or need. Sometimes we will increase the medication if the regular rate isn’t strong enough, or we will decrease if you need more sensation to move or push. It usually takes about 15 minutes to place the epidural and 15 minutes for it to start working.
“In order to have an epidural placed you will need an IV running fluids through your arm, continuous fetal monitoring, and a urinary catheter since you won’t have enough sensation to empty your bladder yourself.”
When it comes to talking about pros and cons I talk specifically about each person’s scenario instead of more generally, since the person I’m talking to is in labor! They don’t have much ability or desire to be thinking about anything that isn’t directly pertinent to them. Because of this I will discuss the epidural’s effects on the part of labor that they’re in now vs the future, but ignore the past. As in, if they’re in active labor I won’t talk about how an epidural might slow down early labor, but I might talk about it’s effects on pushing. For example:
“At this point you are in what we call ‘early labor,’ which means that your labor is still ramping up. It doesn’t mean that early labor is necessarily easier or that you will be in this place for much longer, but I have seen labors slow down when people get an epidural at this time. If that happens, we will talk about trying to stimulate your labor again either by position changes (though slightly limited in bed), nipple stimulation, membrane sweep, or pitocin. If you are coping well and able to go another hour without pain relief, I would recommend that we continue without. However the minute you tell me you have decided on epidural pain management, I will call the anesthesiologist. You are the only one who knows what’s right for your body.”
Another option for someone in active labor:
“At this point in your labor it’s unlikely that your contractions will slow down if you get an epidural, and in fact it’s possible that the relaxation of your pelvic muscles that comes with an epidural could allow baby to descend more and help to open your cervix with the pressure of their head. There’s no knowing what will happen either way.”
“The main risks to an epidural are the possibility that:
Your contractions may space out [discuss what this would mean for their labor]
The possibility of a postpartum headache (this headache happens to about 1 in 100 people and is treatable with pain meds, but is still a very frustrating experience in the postpartum period)
The possibility that your blood pressure will drop and therefore your baby’s heart rate will slow (if this happens you can expect us to move you from one side to another, give you a ‘bolus’ aka large about of IV fluid, and maybe give you oxygen through a mask. Sometimes this can be scary because many Drs & RNs will come into the room all at once to address the issue. Though this may seem scary, when it is treated with the usual measures, it does not cause harm to baby or increase the risk for cesarean birth.)
The possibility that the epidural won’t work at all or will have a small ‘window’ in which the epidural doesn’t work. If that happens our options are to grin and bear it, to try boosting the dose, or to take it out and try replacing it entirely.”
Here is a more extensive chart from LaborPains that I bring out sometimes when people are interested/in the right mind space to discuss further:
“The research is ambiguous when it comes to whether or not the medications passing through the epidural will affect the baby as well as the laboring person. There are no known long term disadvantages for babies. Babies are much less affected by epidurals than other medications used in labor that are administered by IV.”
“There are other things we could use as well to support you in coping with these contractions:
Nitrous oxide - laughing gas (aka gas and air)
IV medications (Morphine, Stadol, Fentanyl, Nubain, Demerol)
Hydrotherapy - hot water in the tub or shower
Sterile water injections - local pain relief without medications for back pain
“What questions do you have? Would you like me to step out for a moment so you can discuss this with your partner/doula/support person?”
Occasionally, if I think it would be useful, I will offer a vaginal exam before an epidural. For some people going through transition, the knowledge that they are close can give them some very needed encouragement. Vice versa, the knowledge that the cervix has not changed in many hours can also give people the information they need to decide that they would like an epidural.
“Would you like a vaginal exam before you decide on whether you would like pain medication or not? Many homebirth midwives will almost never use vaginal exams since they are quite right in thinking that vaginal exams don’t change the course of labor. However, in a hospital setting things change. There are interventions like epidurals to be considered, and a vaginal exam can give useful information to someone deciding on using an intervention. The exam itself IS an intervention in its own right. The information derived from a vaginal exam may tell us what stage of labor you are at right now. It does not tell us what will happen in the next 5 minutes (I’ve seen people dilate from 5cm to 10cm in 5 minutes) or in the next 5 hours (I’ve seen people be fully dilated for 5 hours before starting to push or giving birth). A vaginal exam is not required before you get an epidural, though. If you know for sure that’s what you want right now I will call the anesthesiologist right away.”
