• This strain of the flu is new- it is a combination of swine and avian flu.
• In pregnancy there is a lowered immune response and therefore pregnant women are at higher risk for the flu (seasonal or H1N1).
• Currently no studies exist that validate the effectiveness or safety of the H1N1 Vaccine. The data from studies that are underway will be available June 2010.

The Vaccine

• Will be available in the coming weeks (mid October)
• Single dose vials do not contain thimerasol (a mercury based preservative).
• The CDC recommends that all pregnant women are vaccinated for seasonal and H1N1 flu.

Additional ingredients include: formaldehyde, eggs, thimerasol, neomycin, polymyxin.

Note: People who are allergic to eggs should know that egg and chicken protein are used in the H1N1 vaccine and that dosage needs to be adjusted based on a persons level of allergy. A person who has a severe allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. A complete list of ingredients contained in the H1N1 flu vaccine is available on the FDA website (link at end of handout).

Your immune system: “It is all about your body’s terrain.”

Improve and maintain a healthy immune system by taking Vitamin C (500-1000mg for maintenance) and getting good quality sleep (8 plus hrs.) in a dark room. Prevention is best if you follow these measures:

• Hydrate yourself. Drinking AT LEAST half of your body weight in ounces of quality water is one of the simplest steps you can take to improve your overall vitality. (For example, if you weigh 150 pounds, you should drink at least 75 oz. of water per day.)
• Washing your hands with hot water and simple bar soap frequently throughout the day is another simple and powerful tool.
• Keep your hands out of your mouth, nose, and ears and generally away from your face.
• If symptomatic: gargle twice daily with salt water. Use Celtic or sea salt (“Real Salt”). Consider also using a neti pot to clear out sinuses.
• Vitamin D3 (“D3” has greater bioavailability) supplementation has been found to have a strong correlation to the strength of immune system function, specifically keeping Vitamin D3 levels above 50ng/ml. It may be necessary to take as much as 5-15,000 IU of Vitamin D3 daily to raise Vitamin D3 levels in an individual with compromised levels. Should be 50 – 65ng/ml
• Take probiotics daily. 70% of our immune system is located in our colon. Just as we encourage our clients to balance their vaginal flora, we can encourage balance in the colon to improve overall health. A high dose (at least 20 billion probiotics bacteria per serving) should be taken for maximum benefit. Probiotic bacteria can also be consumed via cultured dairy products such as yogurt and fermented foods such as sauerkraut.
• Maintain an alkaline state in your body. Our body is able to function most smoothly when our Ph is balanced and in an alkaline state. One amazing alkalinizing food is the famed “Bieler’s Broth,” a recipe that Dr. Henry Bieler recommended in his 1965 book, Food Is Your Best Medicine. (see below)
• Apple Cider Vinegar is an ancient remedy and can be used as a dietary supplement (1 oz., 1-3 times daily), and/or in a warm bath. Pour 1-3 cups of raw unfiltered apple cider vinegar into the bath once water has been drawn. This remedy, used when sick, gently draws out toxicity from the body. Although there have been no formal studies on the use of apple cider vinegar in pregnancy, it is a very old remedy that has been used over many generations of women and children.
• General herbal immune enhancers, if symtomatic, are Elderberry, Wolf Berries, Astragulus, garlic, ginger, in moderation and Echinacea’s.

Influenza A (H1N1) Further Resources:

• Clinical study data from the National Institute of Allergy and Infectious Diseases: http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm
• NPR Audio/ article entitled, “What you need to know about Swine Flu” http://www.npr.org/templates/story/story.php?storyId=113446539&sc=17&f=1001
• Sherry Tenpenny’s Vaccine Information Center: http://drtenpenny.com/default.aspx
• CDC website link for vaccination and pregnant women: http://www.cdc.gov/h1n1flu/vaccination/pregnant_qa.htm
• Complete list of approved vaccines and their ingredients form FDA: http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm181950.htm
• Dr Sear’s website, article explains the 4 approved vaccines, their manufactures, and ingredients: http://www.askdrsears.com/thevaccinebook/2009/09/four-swine-flu-vaccines-approved-by-fda.asp
• Janine Roberts book, entitled Fear of the Invisible, available on Amazon.com: http://www.amazon.com/Fear-Invisible-Janine-Roberts/dp/0955917727/ref=sr_1_1?ie=UTF8&s=books&qid=1254713625&sr=8-1
• Dr Mayor Eisenstein’s website which includes subscription option for email updates about H1N1: http://www.homefirst.com/

Source for high potency probiotics:
Custom Pure http://www.customprobiotics.com/

Bieler’s Broth © Recipe

Ingredients:

• Zucchini squash
• Green beans
• Celery
• Parsley
• Clean, chemical-free water

Instructions:

• Cut up equal amounts of zucchini squash, green beans (frozen or fresh) and celery. (Chop the celery 1/2 inch or less to eliminate stringiness.)
• Steam until soft using clean water (distilled – or – reverse-osmosis and carbon filtered) in a porcelain or stainless steel pot. Do not use aluminum or copper cookware.
• Fill blender 1/2 full with the vegetables and the water used for steaming. Add a small handful of chopped raw parsley. Blend to a consistency of pea soup (or, as desired).
• Add small amount of unsalted organic raw butter or preferably extra virgin olive oil.

For variety and to suit your own taste, try adding garlic, onions, cayenne pepper, ginger, herbs, etc. Season with tamari or wheat-free soy sauce, etc.

By Lisa M. Bodnar, Marijane A. Krohn and Hyagriv N. Simhan

Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; and Magee-Womens Research Institute, Pittsburgh, PA 15213

Bacterial vaginosis (BV) is a highly prevalent vaginal infection that is associated with adverse pregnancy outcomes. Vitamin D exerts an influence on the immune system and may play a role in BV. The objective of this study was to examine the association between maternal vitamin D status and the prevalence of BV in early pregnancy. Women (n = 469) enrolled in a pregnancy cohort study at <16 wk underwent a pelvic examination and provided a blood sample for determination of serum 25-hydroxyvitamin D [25(OH)D].

BV was diagnosed using Gram-stained vaginal smears interpreted using the method of Nugent. Approximately 41% of women had BV (Nugent score 7–10) and 52% had a serum 25(OH)D concentration <37.5 nmol/L.

The mean unadjusted serum 25(OH)D concentration was lower among BV cases (29.5 nmol/L; 95% CI: 27.1, 32.0) compared with women with normal vaginal flora (40.1 nmol/L; 95% CI: 37.0, 43.5; P < 0.001).

BV prevalence decreased as vitamin D status improved (P < 0.001). Approximately 57% of the women with a serum 25(OH)D concentration <20 nmol/L had BV compared with 23% of women with a serum 25(OH)D concentration >80 nmol/L.

There was a dose-response association between 25(OH)D and the prevalence of BV. The prevalence declined as 25(OH)D increased to 80 nmol/L, then reached a plateau.

Compared with a serum 25(OH)D concentration of 75 nmol/L, there were 1.65-fold (95% CI: 1.01, 2.69) and 1.26-fold (1.01, 1.57) increases in the prevalence of BV associated with a serum 25(OH)D concentration of 20 and 50 nmol/L, respectively, after adjustment for race and sexually transmitted diseases.

Vitamin D deficiency is associated with BV and may contribute to the strong racial disparity in the prevalence of BV.

By The Lancet

Oct 22, 2006 – 10:53:57 PM

OTTAWA (October 20, 2006) A Canadian population-based cohort study has revealed that medical induction of labour increases the risk of amniotic-fluid embolism. The study was led by Dr. Michael Kramer, Canadian Institutes of Health Research (CIHR) Senior Investigator from McGill University, and will be published in the October 21st issue of The Lancet.

Amniotic-fluid embolism (AFE) is a rare, but serious and even fatal maternal complication of delivery. While its cause is unknown, it is one of the leading causes of maternal mortality in developed countries, accounting for seven of 44 direct maternal deaths in Canada in the period 1997-2000.

This population-based study examined the association of AFE and medical induction of labour in a cohort of three million hospital births in Canada, for the twelve fiscal years 1991-2002.

“AFE remains a rare occurrence,” said Dr. Michael Kramer, principal investigator of the study and Scientific Director of CIHR’s Institute of Human Development, Child and Youth Health. “Of the 180 cases of AFE we found, 24 or 13% were fatal. AFE arose almost twice as frequently in women who had medical induction of labour as in those who did not; fatal cases arose 3 times more frequently.”

“Dr. Kramer’s research has resulted in a discovery that will benefit physicians who look after pregnant women as they will now be aware of this potential complication should they induce labour”, said Dr. Joseph Shuster, Interim Scientific Director of the MUHC. “This is an example of how academic university teaching hospitals improve the quality of patient care.”

The research team also found several other factors to be associated with higher rates of AFE, including multiple pregnancy, older maternal age (35 years or older), caesarean or instrumental vaginal delivery, eclampsia (a serious complication of pregnancy characterised by convulsions), polyhydramnios (too much amniotic fluid), abnormal placental position or separation, and cervical laceration or uterine rupture.

“Our findings confirm the hypothesis that medical induction of labour is related to an increased risk of AFE,” added Dr. Kramer. “Although the absolute risk increase of AFE for women is very small (four or five total cases and one or two fatal cases per 100,000 women induced) and is unlikely to affect the decision to induce labour in the presence of compelling clinical indications, women and physicians should be aware of this risk if the decision is elective.”

Source:
Canadian Institutes of Health Research
© Copyright 2006 by Doctors Lounge

Carol Gautschi

• “Faith is to believe what we do not see; and the reward of this faith is to see what we believe.”
• “Find out how much God has given you and from it take what you need; the remainder is needed by others.”
• “Our affections bribe our discernment.”
• “Good prenatal care is really what you think and do between visits!”
• “Our mind can know but our heart not believe.”

St. Augustine of Hippo
Numidian-born philosopher and theologian (A.D. 354-430)

• “Miracles are not contrary to nature, but only contrary to what we know about nature.”
• “A thing is not necessarily true because badly uttered, nor false because spoken magnificently.”
• “God bless you extravagantly, without measure, and for absolutely no reason.”

Carol’s Husband’s Grandma

• “You can get use to anything, but hangin from your neck!”

Joan of Arc
A peasant girl born in eastern France, national heroine of France and a Catholic saint (A.D 1412-1431)

• “We’re all in Gods hands, even those to whom choose to think otherwise.”
• “To believe yourself brave is to be brave; it is the one essential thing.”
• “Patience is the companion of wisdom.”

A Boston study analyzed the relationship between maternal vitamin D status and the prevalence of primary cesarean section, because one symptom of vitamin D deficiency is “poor muscular performance.” The study included 253 women, 43 of whom had had a primary cesarean. This small study showed that women with vitamin D deficiency had increased odds of having a primary c-section.

- Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2008-1217, published online 23 Dec 2008

This 3D medical animation of a baby’s birth shows a time lapse view of labor and delivery during normal vaginal birth in a simplified form with only the mother’s skeletal structures and the baby in the uterus.

Also shown in detail is dilatation (dilation or dilating) and effacement (thinning) of the cervix during childbirth contractions. 

See more 3D medical animations from Nucleus Medical Art at http://www.nucleusinc.com/youtube

Click here to view the embedded video.

Source: BMJ Medical Journal, June 18, 2005

Abstract

Objective: To evaluate the safety of home births in North America involving direct entry midwives, in jurisdictions where the practice is not well integrated into the healthcare system.

Design: Prospective cohort study.

Setting: All home births involving certified professional midwives across the United States (98% of cohort) and Canada, 2000.

Participants: All 5418 women expecting to deliver in 2000 supported by midwives with a common certification and who planned to deliver at home when labour began.

Main outcome measures: Intrapartum and neonatal mortality, perinatal transfer to hospital care, medical intervention during labour, breast feeding, and maternal satisfaction.

Results: 655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated.

Conclusions: Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

Introduction

Despite a wealth of evidence supporting planned home birth as a safe option for women with low risk pregnancies, the setting remains controversial in most high resource countries. Views are particularly polarised in the United States, with interventions and costs of hospital births escalating and midwives involved with home births being denied the ability to be lead professionals in hospital, with admitting and discharge privileges. Although several Canadian medical societies and the American Public Health Association have adopted policies promoting or acknowledging the viability of home births, the American College of Obstetricians and Gynecologists continues to oppose it. Studies on home birth have been criticised if they have been too small to accurately assess perinatal mortality, unable to distinguish planned from unplanned home births accurately, or retrospective with the potential of bias from selective reporting. To tackle these issues we carried out a large prospective study of planned home births. The North American Registry of Midwives provided a rare opportunity to study the practice of a defined population of direct entry midwives involved with home birth across the continent. We compared perinatal outcomes with those of studies of low risk hospital births in the United States.

Click here to continue reading

Birth: it’s a miracle. A rite of passage. A natural part of life. But more than anything, birth is a business.

Compelled to find answers after a disappointing birth experience with her first child, actress Ricki Lake recruits filmmaker Abby Epstein to examine and question the way American women have babies. The film interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system. When director Epstein discovers she is pregnant during the making of the film, the journey becomes even more personal. Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?

Pending bills to further this goal have significant backing in several states, which home-birth supporters want to add to the 25 states that already have taken such steps.

Nationally, a group called the Big Push for Midwives marked President Barack Obama’s inauguration with an email campaign urging him to ensure that midwives who specialize in home births are included in deliberations on federal health care reform.

“We’re at a tipping point now,” said Katherine Prown, the Big Push campaign manager. “Home births are still only a small part of the total, but it’s poised for growth.”

The campaign seeks to emphasize that in this time of economic crisis, home births can be a safe, satisfying and money-saving option for many women. But it runs into adamant opposition from the American Medical Association and the American College of Obstetricians and Gynecologists.

“Childbirth decisions should not be dictated or influenced by what’s fashionable, trendy, or the latest cause celebre,” the obstetricians’ policy statement says. “Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby.”

According to the latest federal data, there were only about 25,000 home births nationally in 2006 _ most of them assisted by midwives _ out of nearly 4.3 million total births.

Midwife-attended home births increased by 27 per cent between 1996 and 2006. Home-birth advocates believe the numbers will rise as more states amend their laws to accommodate the practice, which they contend is at least as safe as hospital births for healthy women with low-risk pregnancies.

One of the strengths of the state-by-state campaign is its diversity, Prown said.

“We’re one of the few movements that’s succeeded in bringing together pro-life and pro-choice activists, liberal feminists and Christian conservatives,” she said. “In every state we manage to recruit Republican and Democratic co-sponsors who normally would never be on the same bill together.”

The states are now evenly split on legal recognition of certified professional midwives (CPMs) _ those who lack nursing degrees and who account for most midwife-assisted home births.

Half the states have procedures allowing CPMs to practise legally _ including five which have taken such steps since 2005. The other 25 states lack such procedures and CPMs are subject to prosecution for practising medicine without a licence.

Depending on legislative decisions, the balance could shift this year. Among the battlegrounds:

_In North Carolina, a House study committee recommended in December that the legislature develop licensing standards for CPMs. The committee said the current system doesn’t meet the needs of women who chose non-hospital births because of the “extremely limited supply” of obstetricians and nurse-midwives offering to handle such births.

_In Idaho, advocates who failed previously to get a voluntary licensing bill through the legislature are back with a mandatory licensing bill. State Representative Janice McGeachin (R-Idaho Falls) says the changes helped persuade the state boards of nursing and pharmacy to drop their opposition. The Idaho Medical Association, which fought the earlier version, has expressed respect for the changes in the bill and is deliberating on whether further changes might produce a version it could accept.

_In Illinois, advocates also are back with a new version of a licensing bill that failed in 2007. Representative Julie Hamos (D-Evanston) says it toughens qualification standards for CPMs _ changes that prompted the Illinois Nurses Association to drop its opposition. The Illinois State Medical Society remains opposed.

“There are many in the legislature who feel a need to have this option _ they need to be educated,” said Dr. Shastri Swaminathan, the society’s president. “We’re in strong opposition to licensing midwives who don’t have the medical training to provide safe home births.”

Cost is a major element in the debate. A routine hospital birth often can cost $8,000 to $10,000, with higher bills for cesarean section deliveries that now account for 31 per cent of U.S. births.

Midwives’ fees for home births are often less than a third of the hospital cost, in part because the mothers generally don’t receive epidural anesthesia or various other medical interventions at home.

For pregnant women, insurance coverage can be a decisive factor in their choice. Many insurers cover care by nurse-midwives in hospitals; coverage is less common for midwives who aren’t nurses or who assist with home births.

Many obstetricians acknowledge that the spiralling cost of maternity care and high rate of C-sections are problems.

“But the answer is not to have births at home,” said Dr. Erin Tracy, an obstetrician at Massachusetts General Hospital in Boston. “We obviously support women’s empowerment, but the No. 1 guiding principle has to be the health and safety of the mother and baby.”

The national physicians’ groups do support births assisted in hospitals and birthing centres by midwives who have completed nursing school or an equivalent postgraduate program.

The American College of Nurse-Midwives, which represents these midwives, says it differs from the AMA in considering home births a legitimate option for pregnant women. But the college says only nurse-midwives or others with comparable training should be allowed to assist.

“We don’t believe it’s safe without being integrated into the full health care system,” said Melissa Avery, the college’s president.

The education standards endorsed by the college would exclude many of the estimated 1,400 certified professional midwives, who often acquire training through apprenticeships.

Jane Peterson of Iola, Wis., is an example. She began a midwife apprenticeship in 1980 and has attended more than 1,330 births since then, many of them before she and her counterparts were legally authorized to practice under a 2005 state law.

Peterson, 56, said she strives to develop collaborative relations with local doctors so that transfers to hospitals go smoothly if risk factors develop. She believes such co-operation should be encouraged nationwide, so more women can feel comfortable about choosing home births.

“People will tell you that you changed their lives,” said Peterson, reflecting on the rewards of her job.

“It’s hard work _ getting up on a cold winter night, going out one more time through the snow. What keeps you going is the recognition women feel _ as though they are a different kind of mother when they’ve been able to give birth their way.”

On the Net:

American College of Obstetricians and Gynecologists:

http://www.acog.org/

Big Push for Midwives:

http://www.thebigpushformidwives.org/

Copyright © 2009 The Canadian Press

My name is Carol Gautschi. I’m a mother of seven blessings, grandmother to six and wife to Paul since 1974. My calling to become a midwife began after I had become a mother of two and had experienced midwifery firsthand.

I was given a contrast by comparison…

The fact is, I was sexually and physically molested separately by two different doctors with my first two births – and also given grossly wrong information that caused breastfeeding delay and hindered bonding. I was plagued by fear, again by misinformation. Didn’t take a rocket scientist to see a profound message in that!

My first two birth experiences strongly planted seeds for the need of global reform and I started the reformation there and then in my own body… I was personally moved by the power of birth and right away sensed the sacredness and vulnerability of the moments during, before and after. Those moments had been stolen from me. With my third born – I was swollen with the need for change as was my belly. This time, fiercely protective of my precious blessing within (I had been privileged to attend two homebirths in 1970 and 1973 and knew intuitively the differences), I was determined to do it differently, to reclaim what had been denied me previously. Frustratingly, the closest help was over 60 miles away. All I wanted was someone – a guardian of sorts- to hold this space to cradle my womb as she would like her own to be – to love and trust this power moving in me and the creative force emerging during this time.

Gentle, calm reassuring Joan stepped into my life through an acquaintance. The time spent with this midwife transformed me, helping me see that labor is wondrously spiritual, powerful, and a profoundly healthy force. I, to this day believe that women are being robbed by a society that does not see to care about the uniqueness of this time, this right of passage, and that not treating it with tender, sensitive respect, we are doing ourselves harm– more harm then we can imagine. From that moment on I believed that birth is the highest place a woman can go in her body on this planet. I knew then that all women deserve the type of loving and compassionate care that women like Joan provided. She was the catalyst for my life’s work of service to women during their pregnancy and birth, a life-changing monument that was driven deep within me at that time. I want to send Joanie a big kiss for all her love and the beginnings I received from her, as well as Doctor Ettinghausen and his helpers during my early years.
A couple of people have referred to me as a Christian mystic midwife. Is that different or what?

For me, becoming a midwife was a metamorphosis, coming largely from practical heart-and-hands experience. I‘ve served families as an empirical midwife and doula or Monitrice since 1978. Midwifery to me wears many hats. I am “with-woman” in many capacities… counselor, confidant, nutritional advisor; breastfeeding consultant; childbirth educator; family health supporter; parenting resource, friend, at times her spiritual advisor and more. I am pleased when women come back to tell me they have been nurtured with a sense of personal strength and self-confidence so that they may experience birth with dignity and empowerment. Giving birth at home with most midwives facilitates a gentle and warm welcome for the baby, instills a sense of respect and control for the parents and strengthens the family. I am tremendously honored and humbled to serve women and their families during one of the most important and sacred events in life.

I caught my first baby by “accident”… (*grin* really – by divine appointment). My best friend’s baby came faster then the scheduled midwife arrived. She looked at me and said “you can do it”. That was in 1981. Thus… began my essential midwifery journey. The first 50 births or more were like midwife training boot camp – If you have the opportunity to sit in on one of my childbirth classes I use many examples of that era to let you vicariously experience the depth of that time and why I am who I am today.