Midwifery for All Series

“Midwifery for All is for you—education, support, and exploration of the options for your care.  You can use it to start discussions with your physician or midwife about the kind of care you would like to receive.”

Welcome!

Midwifery for All is intended to highlight some of the areas where fear has built up a tradition of practice that might not be in line with either good science or your needs.  We understand that the greatest risk many face in their pregnancy care is the perspective and bias of providers and the healthcare system.  We are missing out on options for preventative health care simply because of preconceived notions and societal and systemic stigmas about the health of pregnant people.

Read: Size Friendly Pregnancy Care

This causes devastating effects across multiple outcomes–leading to extraordinary emotional and financial costs for families and decimating the healthcare system.  While providers and systems are responsible for the tangled mess we are all in, it is the consumer–people just like you–who can create change by changing our expectations and demands for education-based, preventative healthcare.

We are managing to save a lot of people from the brink of severe conditions during pregnancy.  But it is not enough to save someone from dying. That is a terrible standard of care when so many pregnant people have clear signs and symptoms of needing help long before they need a life saving rescue.

We believe we can prevent almost all of these conditions from progressing to disease through kind attention, education-based care, and skilled and thoughtful provider behavior. You deserve to live in good health, strength, and with all of the energy you need to do what you would like to do each day.

Midwives have the time, space, and skills to address underlying health needs over the course of your pregnancy and life.  In our practice we focus on predictable, preventable, and reversible conditions that start off with just a hint of something not quite right (you know the feeling!) and progress all the way into a diagnosed disease. Our goal is to pay attention to the first hint, your signs and symptoms, and to respond in partnership with you to quickly turn a corner into good health. We don’t wait for pregnancy to start this work–if you are considering your first or subsequent pregnancy, or might want to have a family one day–we can help get you prepared through this same program.

Through this series we dig deep into the issues that so many of us are afraid of when it comes to pregnancy: race, size-friendly care, stress, poverty, preterm births, prior cesarean births, smoking, HIV, and many more.  Check back often as we upload booklets, we will live-link them here.

Midwifery for All is for you—education, support, and exploration of the options for your care.  You can use it to start discussions with your physician or midwife about the kind of care you would like to receive.  It is a tool for pregnancy and birth decision making, and we would love to hear which booklets you enjoyed, what questions you have, and how you are moving forward in your care.

Wishing you the best for healthful and joyful pregnancy, birth, and parenting!

Do you have a topic you would like to see addressed?  Contact Us and let us know!

GBS Prevention

Read the long article

See the Infographics up-close

This post examines the role of preventative health care in the inhibition of Group B Streptococcus (GBS) infection.  It uses the term “mother” for simplicity’s sake although babies have all kinds of parents who identify in all kinds of ways and all are welcome here.

Let’s break down the long article:

Infections resulting from GBS  can be life-threatening to a newborn.  All pregnant moms are offered a test which detects this bacteria around 36 weeks of pregnancy.  If found, it can be treated through the use of IV antibiotics during labor, which significantly reduces the rate of infection and resulting meningitis and/or sepsis in newborns. While this article does not focus on the treatment of women who test positive, it does promote prevention, which improves the overall health of both mom and baby through the use of probiotics taken orally throughout the pregnancy.  These come in tiny capsules or a liquid packed with powerful lactobaccili (among other gut-friendly bacterium) that usually cost between five and twenty dollars per bottle or package).  It’s a small price to pay for so many amazing benefits.  As a midwife, I often pay for them for clients because of the massive health benefits of these supplements to every mom and baby, including avoiding a host of obstetric complications that would increase risks to mom and baby and often require transfers out of my care.  Great midwifery promotes the intrinsic health of mother and baby through programs like this which lend greatly to positive birth outcomes.

Let’s explore just some of the many benefits:

The Mother

Take a look at what the microbiota is if you aren’t already familiar with it.  The use of probiotics promotes this system that does a bit of everything good in the body including prevent the over-colonization of “bad” bacteria like GBS.  It also happens to prevent diabetes and keep your mood even.  It exists in the mouth, gut, and vagina of the mom and the placenta (and some studies found evidence in the fetal gut as well).

Over the course of pregnancy, the levels of good bacteria in the microbiota change.  By the time you give birth, you have an over-growth of lactobacilli which ensures that your baby will get exposure to this important “good” bacteria during vaginal birth.  When the system is supported right it will also prevent yeast infections, and keep the bacteria that cause UTIs and GBS in check.

The Baby

Impaired levels of probiotics have been correlated to preterm birth.   They are correlated because “bad” bacteria like GBS and candida (yeast) cause cellular damage to the cervix.  It loses its integrity and is not able to hold in the pregnancy as long as it should.  There are dramatic consequences for being born too early—the March of Dimes was founded because of babies born too early or too small.

When mothers take probiotics, they are found in the placenta and fetal gut and stay with the baby after birth to help regulate the baby’s microbiota.  That’s profound!!  You can help your baby synthesize vitamins and amino acids, regulate immune function, have smoother transitions between emotional states, and get a balanced healthy start just by taking probiotics during pregnancy.  After pregnancy, breast milk takes over the important function of populating the baby’s microbiota with everything it needs.

What Matters

  • Take probiotics throughout pregnancy to help keep your body hostile to “bad” bacteria and to strengthen the integrity of your tissue (muscles and skin included), especially uterine tissue like the cervix (and to boost your immune system, keep your mood even, etc., etc., and etc.!)
  • If you are planning a VBAC this winds up mattering a lot. Infections like candida and GBS can wear down the tissue that you are relying on to keep the scarred area strong and healthy.  Take a full dose of 4 probiotic capsules per day for your entire pregnancy.  I have supported an extremely high percentage of VBACing moms in my practice and this statement is NOT a judgment about your scar.  It is part of a recipe that will contribute to your overall success.  Check out this article for more ideas from the VBAC playbook or contact me to discuss further.
  • Have a vaginal, antibiotic free birth for maximum exposure to lactobacilli
  • Ask your provider ahead of time about swabbing your vaginal tract during labor prior to any antibiotics if you need them for any reason (including a planned or unplanned cesarean birth)
  • Regardless of how you deliver your baby, spend time skin to skin with her or him. Allow them to touch your breasts and arm pits with their hands.  You have lactobacilli on your skin that they will benefit from
  • Breastmilk feeds babies and promotes the growth of healthy bacteria in baby’s own microbiota, boosting their immune system and setting them up for good health
  • Babies born to a mom who had to take antibiotics or who were born by cesarean or who drink formula exclusively or as a supplement can all be given oral probiotics. They are available with a dropper or can be mixed into breast milk or formula and given through a bottle or made into a paste (just break open a capsule and add one drop of water at a time, mixing with your finger) and applied to mom’s nipples which is both soothing and healthy for the breast

Some disclaimers and information of note

  • The recommendations in this article are not designed to cheat a test but to actually improve the health of the mother, the integrity of the cervix, and the health of the placenta, fetus and newborn
  • Taking probiotics is not a guarantee of avoiding GBS or other complications related to imbalanced or missing gut flora. Talk with your provider about nutritional measures you can take to support your over-all health.  No amount of probiotics or exercise can undo the effects of a diet high in sugar and processed foods
  • Do get tested between 35 and 37 weeks for GBS. If you still test positive after a sustained period of time taking probiotics, eating a diet low in processed sugars and carbs, and rich in food that looks like it was alive, the colonization is highly likely to be one that needs antibiotic treatment. A pregnant woman who tests positive for group B strep bacteria and gets antibiotics during labor has only a 1 in 4,000 chance of delivering a baby with group B strep disease. If a pregnant woman who tests positive for group B strep bacteria does not get antibiotics at the time of labor, her baby has a 1 in 200 chance of developing group B strep disease.
  • If GBS is found in your Urine during pregnancy, antibiotics can eliminate or greatly reduce the high colonization. Take probiotics at the same time as you take antibiotics and for the rest of your pregnancy.  The CDC recommends that anyone with GBS in their urine at any point during their pregnancy receive antibiotics during labor
  • Please discuss this information with your provider and work together to find a solution that is right for you. If your provider does not have time to discuss this or other preventative measures with you, there are plenty that will and I highly recommend you shop for the one who will serve you best

Capture

You can see the source for these infographics and get an up-close view by clicking here

Share your thoughts on preventative health care during pregnancy and your comments and questions below!

Additional Resources

Microbiota/Microbiome and Pregnancy/Birth/Breastfeeding

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943946/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/

https://www.amazon.com/Your-Babys-Microbiome-Critical-Breastfeeding/dp/1603586954

https://www.amazon.com/Microbiome-Effect-Affects-Future-Health/dp/178066270X/ref=sr_1_2?s=books&ie=UTF8&qid=1490123008&sr=1-2

Preterm Birth

http://www.marchofdimes.org/complications/premature-babies.aspx

Group B Strep Disease

https://www.groupbstrepinternational.org/

Schedule a Visit Today

Schedule your appointment today. We have availability beyond what is listed on the calendar…

If you are a professional looking to network or meet with Jodilyn, or would like to schedule her to come and talk at your event or school, you can call directly at 901-471-1606 or contact to schedule by email.

If you would like to talk with Jodilyn about midwifery services,  you can call or text (901)471-1606 to schedule a meet and greet.

If you have an urgent question please call 206-340-7467 and follow the instructions on the voicemail.  Your call will be returned within 10 minutes.

Step One:  Meet the Midwife!

Step Two:  Schedule Your Initial Visit

After establishing care you can book your Regular Prenatal Visits online.

The Link between Justice and Health

…Our health is the launching pad which allows us to reach our full potential. Healthcare that actually improves health, protects access to the opportunity to participate in the economic, social, political, and personal lives of an individual’s community and world…

If you are new to the idea that health, healthcare, and justice are linked:  here is the fundamental reason we all need access to high quality healthcare:

Our health is the launching pad which allows us to reach our full potential.  Healthcare that actually improves health, protects access to the opportunity to participate in the economic, social, political, and personal lives of an individual’s community and world.

Beyond this, there are of course complicated, systemic and overt drivers that prevent communities from participating in the political, social, economic, and personal lives of their community and world.  I am not here to say that those aren’t  real, impactful and destabilizing for the individual.  But without health, those determinants play second fiddle.  With health, the engagement of identifying problems and solutions becomes a discussion and a possibility from within a community.

In today’s world where inflammation, insulin resistance and adrenal dysfunction are deeply tied to each other and the way we–or whether or not we manage to–integrate and recover from stress, this is more true than ever before.

Let’s look together at a dramatic example:  Before I knew to offer education for this, I watched immigrant women who had arrived in America in the year prior to their pregnancy, continue to eat the same diet they had in their home country with one exception.  The ingredients were American.  The flour refined and void of the fiber naturally found in the food they grew up eating.  These women disintegrated before my eyes and their health became almost exactly like the health of most women coming from whole lifetimes of American poverty and the “typical” American diet.  In fact, the occurrence of maternal child outcomes taking a nosedive within the first generation of arrival in America has been well documented, though not well explained. How is it possible that women arrive from developing, or even war-torn nations and their health declines?!

The women I saw developed persistent fatigue which made work a complete drag and engaging with their family a lost art.  Mostly, when asked, they ascribed it to the difficulty of being away from family.  But their sense of their vigor and their actual blood glucose levels told a different story.  Interestingly no one blamed pregnancy–they had all grown up where pregnancy was viewed as a normal, active, and healthy time in a woman’s life.

During a home visit, one of the families cooked us dinner and it was there that as I chatted in the kitchen with the mom while she prepared the food that I saw what I came to demonstrate in my practice as the one of the Real Culprits.  With guidance to find imported flours–and to eliminate the processed American foods–blood glucose levels returned to normal.  The extra belly fat melted away as the muscles could once again absorb the insulin being delivered by the pancreas instead of creating a toxic and hostile environment from which each woman was supposed to work full time, care for her family, establish herself in a new home with all of the stress that moving brings, and support the activities at her church or community center (or both).  This food was not so slowly and ever so surely poisoning these women and their babies, who often grew so big that despite well supported labor and best practices, were born by cesarean section at alarming rates.  This was true for first time moms who naturally carry a higher risk of cesarean birth, but also for 2nd, 3rd, and 4th time moms who had healthy vaginal births as part of their health history.

I combine catered education about nutrition with stress reduction strategies at each prenatal visit for every family.  Have a mom bring in a picture of her pantry if you can’t do a home visit.  Frame it is a starting point, not a place to drip shame, fear, and humiliation into her life.  Let’s learn together–have her teach you about her life, her stress, her nutrition, her loves.  Rich or poor, immigrant or 4th generation American. Everyone receives education that meets them where they are at and responds to their life in that moment.

One of the more important maternal/child health results of addressing these deep needs of mothers is that babies grew to be the right size for their mother’s body.  That is a reduction in healthcare costs in the tens of thousands per mother/baby. It reduces so many immeasurable personal costs and so very many short and long term healthcare costs.  A healthcare actuary could have some good solid fun with seeing the numbers all the way through.  It lends to the potential for each baby to be born to a mom ready to mother physically and engage mentally, because they feel good, they feel energized, they feel like themselves.  Even in a foreign country.  Even with a minimum wage job when they are actually qualified mathematicians, accountants, doctors, or teachers.  Even when they miss their family and are learning a new language. Even when they want to somehow muster the  capacity to attend night school to learn a new trade or earn a new certificate so that they can move into a life of opportunity for themselves and their children. 

**an interlude for all of you now fuming advocates from the world of the threat of a big baby  = cesarean birth.  Let me save you from skipping the rest of this article so you can leave an inflamed comment.  This is not that.  These babies are at real risk–their pancreas having been tested and pushed beyond its limits while en utero, they develop a lot of brown fat around the cheeks and shoulders, and are usually 1-4 pounds heavier than mom’s other babies.  These are not the robust babies who could have been born vaginally if mom had providers who knew to use positioning and time to aid in a healthy birth.  They look very, very different than a baby who is just born a big healthy baby.  None of those babies are included in this observation** [also, I love you for the work you do educating mothers about how to use their bodies to birth their babies and demanding that providers get with the program written so many thousands of years ago]

Back to the blog…

The model of healthcare delivery I offer is wrapped in listening and free from standard time constraints.  And still, I almost missed it.  It took listening, observing, and participation in the lives of the families I serve to find this connection.  It took nothing at all for me to apply the lesson to every pregnant woman who came through the door.

If we want to use our privilege as healthcare providers to launch families onto a platform where they can begin to see that opportunity funded by energy, vitality, and good health is different than opportunity funded by the massive domino effects of refined foods and stress without recovery–the disability of diabetes, cardiovascular failure, endocrine implosions, adrenal fatigue–well, we are in the perfect position to do so.

What do you do to offer healthcare that promotes justice?  Do you want to learn more about offering this kind of healthcare?  Are you a healthcare consumer who has or has not received personalized care?  Share your story!