I’ve been wanting to write about evidence based medicine for a few weeks.  I admit to enjoying research and that I like knowing what is likely to happen when I suggest a particular treatment with a client. Evidence helps me make better clinical decisions.  Evidence helps me work more effectively with my clients. What strikes me as most interesting is how easy it is to fault others for lack of evidence for the decisions they make without providing adequate evidence for one’s own suggested treatment.  Birth professionals on both sides of the natural birth fence are at risk of making decisions not because of overwhelmingRead More →

I am proud to be a supporter of natural childbirth.  I am thankful for the opportunities I have had to assist families as they made decisions about birth and parenting as both a childbirth educator and a doula.  But I’m starting to realize something that bothers me. The advice that I used to give as a doula and childbirth educator was not always helpful or even correct. Ouch!  For someone who adores research as much as I do, that is difficult to say. But I’m realizing how unfortunately true that statement is. Why do I say that?  Because I had limited understanding of the real problems inRead More →

My husband needed to run to a store today.  He selected a store in a large mall in a trendy part of town.  The mall has beautiful furniture, enticing little cafes and sushi shops, every popular chain you can imagine.  He likes the freedom to look at other things that interest him when he goes to the mall.  He doesn’t mind the traffic congestion near this mall or the large amounts of people who are always inside.  If he can get the item he wants and spend time at this mall, he feels satisfied and successful with his shopping trip. When I need to pick somethingRead More →

I read an article today that said CNMs can be great, but they have been trained as nurses first so are indoctrinated to the Doctor-Nurse hierarchy, and I had to scratch my head. Hierarchy? As in the doctor is the boss and the nurse follows orders?  This is a very common misunderstanding of the doctor-nurse relationship, and if you believe it you risk not helping your clients  utilize the best services from a nurse. Each nurse is an independently licensed professional with a scope of practice that determines her role.  Nurses deal with responses to illnesses and conditions while the doctors and advanced practice nurses deal with the illness orRead More →

I’m spending time this week (spring break) to work through the postpartum study guide I need to complete for school.  In the process I found an interesting list in Varney’s of reasons a woman may be experiencing inadequate milk supply.  How timely, someone had just asked this on the Facebook fan page last week. So what does Varney list? Infrequent or scheduled feedings, not on cue Replacing or spacing breastfeeding with pacifier Replacing breastfeedings with formula or baby foods Compression of milk-making cells (too tight bra, engorgement) Use of nipple shields Stopping night feedings too soon Poor letdown Prematurity, dysmaturity Retained placental fragments Inadequate glandular tissueRead More →

I’m not really an herb person.  It’s not that I am against herbs, I’ve just never really felt the pull to learn much about them. Honestly, I feel sort of strange about it because I personally have integrated herbs with midwifery in my brain.  It seems natural to me to hear about women whose midwives have prescribed herbal treatments.  So it seems natural to me that I should have knowledge about herbs.  But I can never get myself to actually study any of it. What I do have a pull towards is aromatherapy, which really is herbs but in a oil form. It makes absolutelyRead More →

I am in the semester of my program in which pharmacology is a main focus. Let me rephrase that, my main focus is pharmacology.  For many of my classmates it’s just another class with take-home exams. But I want to really understand why I would prescribe what I prescribe. I keep remembering the words of a midwife friend who shared her struggles with medications when she first became a midwife. When you are the midwife, people expect you to have answers.  Women would show up in her office with a list of medications they were taking and ask, “are these safe?” She admitted to theRead More →