Editor’s Correction: What is a Midwife?

We apologize to Erin Kaspar-Frett for our mistake of calling her a lay midwife in our last issue. Erin explains the difference between a CNM and a lay midwife below.

What is a Midwife?

by Erin Kaspar-Frett

Many might assume that a midwife is a midwife. While in some countries this may be true, in the US, there are stark differences. Certified Nurse Midwives attend and receive a nursing degree first and then go on to receive their Master’s degree in Midwifery. Their training includes rounds as a nurse and then as a student midwife. They can prescribe medications and typically work for a hospital and clinic.

The Licensed Midwife first becomes a Certified Professional Midwife and then applies for licensure in their state. Wisconsin and Minnesota both offer licensure. In some states, with the exception of Certified Nurse Midwives, midwifery is illegal.

The path to becoming a Certified Professional Midwife is also varied. Some attend a Midwifery Education Accreditation Council (MEAC) accredited school, learning academics through schooling and apprenticing with a more experienced midwife. After finishing school, the candidate must take the National American Registry of Midwives (NARM) written exam, an all-day, extensive exam testing the knowledge of the midwife candidate. Once passing the NARM exam, the midwife becomes certified. Thereafter, she may choose or be required to go on to become a Licensed Midwife, if her state has or requires licensure.

The other path to becoming a CPM is as a direct entry midwife (DEM). A DEM to CPM candidate participates in academic self-study and apprentices with an experienced midwife. In this path, she will take a NARM skills exam and then take the NARM written exam. After passing both exams, she becomes a CPM. She may also go on to become a Licensed Midwife.

The CPM/LM may not prescribe medication, but she may administer some medications, in accordance with state law. Medications are generally used for situations such as post-partum hemorrhage, giving Rhogam to an Rh Negative mother, or administering newborn vitamin K.

A DEM, Traditional, or Lay Midwife, is a midwife who apprentices directly with an experienced midwife, often participating in self-study. She does not get her CPM or LM, either by choice or because it is not available under the laws of her state.

Giving birth is one of the most important, powerful, and transforming experiences of a woman’s life. The factor that has the most impact and effect on the outcome of each birth is the woman and couple’s comfort. It is of utmost importance to trust the caregiver and feel comfortable in the setting chosen for birth.

Erin Kaspar-Frett is a Licensed, Certified Professional Midwife with a Master’s of Science in Midwifery from the Midwives College of Utah. She lives with her family in Ellsworth, Wisconsin and serves a geographical area within a two hour radius of her home office. She can be reached at 612-801-9967 or erin@earthmothermidwife.com. For more information about Erin and the safety of homebirth please visit www.earthmothermidwife.com.

Stay Sharp

Ever wonder how your 90-year-old neighbor seems as sharp as a tack while you seem to be dropping the ball? In a recent study in the journal Neurology, 2,500 people over 70 were watched for their cognitive abilities. The results were that ½ had the normal decline in function, while 30% seemed to show no change at all. Here are the secrets to being in the top 30%.

Exercise

Those who exercised more than once a week were 30% more likely to maintain function than those who did not. Exercise helps the brain develop new brain cells in the hippocampus where memory is stored and learning achieved.

Education

Having a high school education helped individuals stay sharper. Dr. Alexandra Fiocco, PhD, adds that it isn’t necessarily the formal education, but the skill to continuously challenge yourself. Those who have completed school are more likely to challenge themselves later in life.

Staying Smoke Free

Those who did smoke were 2 times more likely to lose function. Fiocco says smoking increases oxidative stress on the brain, hindering cognitive function.

Socializing

Those who worked later, volunteered, or hung out socially with friends were 24% more likely to maintain a higher cognitive function than loners. Social interaction requires memory and attention skills.

Keeping Your Children Healthy: Preventing Childhood Obesity

by Dr. Brent Jensen, Sacred Heart Pediatrics

All children gain weight as they grow and develop. However, putting on more weight than is needed to support growth and development can lead to childhood obesity. Over the past 30 years, the number of children with weight problems in the United States has risen at an alarming rate. Today, 1 in 3 children and teens is overweight or obese — putting them at risk for developing health problems such as early onset puberty, as well as conditions that were once only seen in adults, including: type 2 diabetes, high blood pressure, high cholesterol, or bone and joint problems.

The good news is that early intervention can protect the health of your child now and in the future.

Understanding Obesity
Understanding how children become overweight is an important step toward breaking the cycle. Although there can be some genetic or hormonal causes of childhood obesity, most weight gain is caused by children eating too much and exercising too little.

It’s easy for children to eat too much when they:

  • Are exposed to large portion sizes in restaurants or at home
  • Eat meals in front of the TV
  • Snack frequently
  • Eat foods that are calorie dense and have no nutritional value, such as: chips, crackers, fast food, and processed foods
  • Consume beverages with added sugar
  • It’s hard for children to be physically active when they:
  • Spend up to 4 to 5 hours with media, including watching TV and DVDs or playing videos — which is the average for children today
  • Go to a school where physical education class has been cut back or eliminated

What Parents Can Do
The number one risk factor for childhood obesity is having a parent who is obese. Children who have one obese parent are 50 percent more likely to become obese themselves. Those with two overweight parents are 75 percent more likely to become obese. The key to keeping children of all ages at a healthy weight is to lead by example and get the whole family involved.

You play a huge role in helping your child live a healthy life and at all ages, even as early as birth. Some tips include:

  • Breastfeed if possible. In addition to its many health benefits, breastfeeding may help prevent excessive weight gain. Breastfed babies may be more able to control their own intake and follow their own internal hunger cues.
  • At 4 to 6 months, introduce rice cereal and then vegetables. By introducing vegetables before fruit you help your child develop a taste for vegetables as opposed to the sweetness of fruits.
  • Establish a family centered mealtime where everyone comes to the table to eat.
  • Get children involved preparing meals. When they are young let them measure and mix and get their hands dirty. As they get older, give them more responsibilities.
  • Don’t allow children to graze all day. Keep their food intake to three good meals that include a protein, vegetable, and complex carbohydrate, plus one snack each day.
  • Keep portions in control. If the meal is balanced there should be no need to go back for seconds or thirds.
  • Teach children about healthy and unhealthy foods. Allow them to have unhealthy foods on special occasions and encourage them to enjoy the treat without feeling guilty.
  • Allow your children to have 2 hours of unstructured play every day.
  • Plan 15 minutes of structured exercise 2 to 3 times a day for your children, such as bike riding, walking the dog, practicing soccer, etc. And get out there with them.
  • If you are worried that your child or adolescent may be overweight, make an appointment with your doctor who can assess eating and activity habits and make suggestions about how to make positive changes.

Unraveling the Childhood Obesity Problem
In order to solve the problem of childhood obesity, we must treat it on many levels. The child must be educated and helped to make healthy choices. Parents must become involved by setting a good example and creating a family atmosphere that fosters good eating habits and physical activity. The community must be encouraged to create environments that increase physical activity and healthy eating among its citizens. For example promoting the availability of fresh produce through neighborhood markets or the creation of safe playgrounds, parks, and walking trails. Finally, the federal government must become involved with programs like Michelle Obama’s “Let’s Move” campaign.

It will take us all working together to help our next generation become and remain healthy.

Dr. Brent Jensen is a board certified pediatrician with Sacred Heart Pediatrics. His goal is to help children grow strong and healthy.

Doula Dedication

by Rhonda Gearing

I have been asked over the course of the last several years, “What is a doula?” Really, the answer can be summed up into three basic words: nurture, empower, and love. To nurture means to supply with nourishment, educate, and to further the development of; empower is to promote the self-actualization or influence; and love is warm attachment, enthusiasm, or devotion.

The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional, and informational support to the mother before, during, and just after birth; or who provides emotional and practical support during the postpartum period.

I loved the time in my life when I was carrying our babies and anticipating each labor and birth. I had very positive birth experiences with a great support team, so it was very natural for me to want to continue to be involved in the world of pregnancy and birth. I had a purpose in my heart to offer that same opportunity to other women. It was after the arrival of my third baby that I was introduced to the term “doula,” and it has grown to be my passion…who I am.

After much research into the many programs available, I became a member of DONA International (Doulas of North America) and followed the guidelines to become a certified birth doula.

Here’s how my role usually plays out. I am generally contacted directly by the pregnant woman and/or her family sometime during the course of her pregnancy. As her doula, I provide prenatal visits, during which time we talk about her pregnancy and discuss previous prenatal visits, possible complications, and her feelings and needs as they pertain to this pregnancy. I also ask how she envisions her birth and what would make it a positive experience from her point of view. That sets the tone for how we will work together to achieve her goals. We talk about the natural stages of labor and birth along with what one might expect, for example, possible interventions, medication and natural remedies for pain relief, positions, and options along the way. I also offer assistance in creating a birth plan to express her preferences and desires, empowering her to make decisions for her and her baby.

In addition to our prenatal visits, I offer telephone and email support both during the pregnancy and in the postpartum period. At the time labor begins, I join the expectant mother at whatever point she requests, whether at her home or the hospital. My role as the birth doula remains the same whether the mother is planning a home birth or a hospital birth, including if the need arises where medical circumstances require hospital/traditional doctor care. I strive to keep the mother encouraged and empowered, reminding her that she is strong and able to maintain an active role in her care, nurturing her as she maneuvers through the journey of labor and birth.

I remain with her in labor until the baby has been born, providing continuous emotional support, reassurance, and comfort. In the immediate postpartum period, I also assist with the first feeding.

About a week after the birth of the baby, I make a home visit to talk about the birth experience and to answer any questions the new family may have, whether it pertains to the emotional or physical well being of the new mother or the baby. This is a perfect opportunity for me to provide a nurturing environment.

Studies have shown that when doulas attend births, labors are shorter with fewer complications, babies are healthier, and they breastfeed more easily. In my experience as well, I have seen this to be the case. If you’re interested in learning more about doulas or want to find one for yourself, visit www.dona.org.

Natural Birth: A Local Look

Sacred Heart Hospital in Eau Claire

715-717-4121, www.sacredhearteauclaire.org
Traditional OB care as well as Certified Nurse Midwives (CNMs). CNMs, like physicians, provide all prenatal, delivery, and postpartum care. CNMs are unique care providers because they are in the hospital well before the birth, offering labor support. Six Marshfield Clinic CNMs practice at Sacred Heart Hospital and women are encouraged to have visits with each of them. Jet tubs for labor are available, in addition to the option of birthing in water. All CNMs, along with some physicians, do water births.

Luther Midelfort in Eau Claire

715-838-3311, www.luthermidelfort.org
Women’s Health patients may choose either a certified nurse midwife or obstetrician for prenatal, delivery and postpartum care. Wide selection of prenatal classes including Lamaze and breastfeeding. Certified lactation specialists to assist both in the hospital and after discharge. Level II Special Care Nursery. Brand new, state-of-the-art facility opening December 2010.

Morning Star Women’s Health & Birth Center in Menomonie and St. Louis Park

715-231-3100, www.morningstarbirth.com
Morning Star offers prenatal, labor and birth, postpartum and newborn care through six weeks, and breastfeeding support in the Midwives’ Model of Care™. Clients may choose to deliver at the birth center or at home. Our Birth Centers are accredited by the Commission for the Accreditation of Birth Centers. All care is provided by licensed and certified midwives. In addition to maternity care and lactation support, we offer various classes, well-woman care and referrals to collaborating specialists when needed. Many insurances cover services offered through Morning Star.

LifeCircle Midwifery & Wellness Center in Shell Lake

715-338-3499, www.lifecirclewellness.com
Certified Professional & State Licensed Midwife. The provider you meet with will be the provider you birth with. Visits unhurried and in a comfortable home-like environment. Two birth rooms to choose from. Water birth always available. Pre-conception counseling, prenatal, labor, birth, newborn exams, postpartum and well-woman care provided by our midwife. Family, friends, doulas and children warmly welcomed for visits or birth itself. Other services include: Yoga classes, Aromatherapy classes, Childbirth education classes, and massage therapy. Come tour our facility!

Lay Midwives

Erin Kaspar Frett
612-801-9967, 715-273-4081, erinfrett@yahoo.com

Doulas

Rhonda Gearing, serving Eau Claire
715-533-4370, rhonda@doulainosseo.com