What
is a Midwife?
While thousands of families have benefited from the preconception care MAIA provides, many people may not recognize that the outstanding quality and client centered approach they are experiencing is actually midwifery care. While some may have known about midwives for a long time, others may be new to this approach. Because the care offered by a midwife is so beneficial throughout the process of conceiving, pregnancy, birth and the postpartum period, I would like to take this opportunity to define what midwives do, how the midwives at MAIA work with fertility, and the special benefits of midwifery care for single parents and LGBTQI families.
What Is a Midwife?
A midwife is a health care provider who serves families in the transition to parenthood. Midwifery care is holistic; a midwife cares for body, mind and spirit. A midwife provides clinical care and education while also attending to the emotional and spiritual transformations that inherently take place in the process of bringing a new life into the world.
Midwives hold the belief that pregnancy is a normal physiological event, and they focus on building and supporting health so that the body can function normally. Such an approach is preventative, as the body is more likely to stay well when its needs are met.
Midwives teach people how their bodies work, a process that facilitates personal empowerment and taking responsibility for one’s own health. In this way, midwives work in partnership with the people they serve. Recognizing that no single health care approach will work for every person, they provide information and support so that individuals can make the decisions that are best for them.
Midwives are independent care providers for the entire course of a normal, uncomplicated pregnancy. When complications arise, midwives help people get the medical care they need, and they function as part of the health care team.
Midwives are primary women’s health care providers in most parts of the world. Countries with the highest rates of midwifery care also have the highest rates of positive pregnancy outcomes: healthy mothers and healthy babies.
An “LM” is a Licensed Midwife, who is governed by the state regulating agency. In California, this agency is the Medical Board. LMs in California attend births primarily at home or in birth centers.
A “CPM” is a Certified Professional Midwife, which means that this midwife has national standing through the North American Registry of Midwives. Many states, including California, require midwives to pass the CPM exam as a requirement for licensure.
A “CNM” is a Certified Nurse Midwife. In our state, CNMs are governed by the California Board of Registered Nurses. CNMs work primarily in hospitals and birth centers, although some provide home birth services.
How Do Midwives Work with Fertility?
A midwife gives full value to the amazing changes that happen as the body passes through its fertile window each cycle. Often more revealing than pee sticks or temperature readings are the myriad of signs that appear each month with ovulation, if only a person knows what to look for and how to utilize the information. People are empowered by this experience, not to mention more likely to get pregnant.
Because tests, drugs and technological advancements can never supersede the body’s basic needs, those who are seeking pregnancy are well served by midwives. A midwife directs her attention to the underlying state of health in the body and offers education and support to help the body function to its fullest capacity, based on good nutrition, moderate exercise, adequate sleep, stress reduction and a healthy sex life. This not only makes pregnancy more likely to happen, but it also improves lab values and increases the effectiveness of medical and pharmaceutical fertility treatments.
Midwives help people sort out the information they receive from medical practitioners, filling in gaps in understanding and helping people come to their own best decisions as to how to move forward in their care.
Midwives provide individualized care, utilizing statistics when appropriate but focusing mostly on the individual. This approach is most often experienced in regards to age. While we do know that fertility wanes with age, where an individual lies on that spectrum may or may not fall within the statistics. Rather than approaching care based solely on a person’s date of birth, a midwife looks at the whole picture, starting with the current state of health, as evidenced by the body’s physical signs of fertility along with lab tests and other information.
People who are attempting to conceive with assisted reproductive technology often feel as if their bodies don’t work. A midwife provides a different, supportive prospective. After all, inherent within becoming pregnant is the expectation that the body will work—it will grow and sustain a new human life! On both a physical and an emotional/spiritual level, shifting to enhancement and holding space for this to be a positive experience, opens the body to pregnancy, rather than being shut down in stress. Most of all, a midwife holds space for the power and beauty of the body, often when people need it most.
How Can Midwives Help LGBTQI Families and Single Parent Families, Specifically?
LGBTQI families and single parent families are especially well served by a midwife’s perspective. The need to go outside one’s own physical body to procreate leads many people to the erroneous perception that their body can’t do it on its own. The need to procure sperm is completely unrelated to your own body’s fertility. Many fertility clinics lump together those who are perfectly fertile yet need access to donor sperm and insemination services, with those who are actually struggling with infertility. And, conceiving with donor sperm often requires a few months trying, which leaves many people wondering why it’s not working and what might be wrong with them. A midwife helps people sort out this complex experience.
Women in our society still make 24% less income, on average, than men. This means that female households and single women are more than likely living at an economic disadvantage, while often in a situation that requires them to pay for sperm and/or insemination services in order to conceive. Therefore, a hallmark of midwifery care in service of such families is to improve success rates, and therefore save money over the long term, by enhancing fertility and helping clients ascertain the best insemination timing.
Midwives uphold the inherent value in creating family with intention and love. A midwife who serves alternative families celebrates this choice for its beauty and strength. A midwife honors and nurtures the
parent(s) who will care for the coming child, and this role is never so paramount as it is with these families.
The midwives at MAIA have developed this unique style of midwifery, but not all midwives hold this expertise. Once you become pregnant, you may choose a midwife to care for you throughout your pregnancy and birth, as well. Midwives are available in hospital, birth center and home birth settings, and many midwives provide concurrent care to families who are also seeing an obstetric physician and plan to give birth in the hospital.
For more information about midwives, visit
http://cfmidwifery.org/index.aspx
and http://mothersnaturally.org/midwives
Classes & Support Groups
Facilitated by Kristin Kali, LM CPM
NEW CLASS OFFERED! Following
the success of
So You Want to Make a Baby: Getting
Pregnant 101
MAIA now presents...
Living a Fertile
Lifestyle: Getting Pregnant 201
In this class we will take an in-depth look
at what you can do to make your body as fertile as it can be.
With concrete suggestions and simple solutions, you will leave
this class with a solid plan for the care and feeding of the
body that will carry your child.
These classes are offered once a month and
are taught by Maia midwife Kristin Kali, LM CPM. In addition
to helping you learn what you need to know to conceive quickly
and easily, these classes are a great way to meet other folks
who are planning to start or enlarge a family. For more information
and to register, click here.
Childbirth Classes
for LGBTQI Families
Postpartum, Breastfeeding and Newborn
Care Class
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Eat Your Beets!
Beets rock! From the beautiful, round
or oblong roots to the leafy green tops, beets are a powerhouse
of nutrition. |
The beet (Beta vulgaris) belongs
to the same family as spinach and chard. The roots are typically
a reddish purple hue, but also come in golden and red/white
striped varieties.
Beets have long been used for medicinal purposes,
primarily for their effect on the liver’s detoxification
processes. Beets are a blood tonic and so are good for anemia,
the heart, and circulation. They purify the blood, alleviate
constipation and promote menstruation.
Beets are also gaining recognition for their
anticancer properties. The pigment that gives beets their rich
purple/crimson color, betacyanin, is a powerful cancer-fighting
agent. Beet fiber has also been shown to have a favorable effect
on bowel function and cholesterol levels as well.
Nutritional Highlights
Beetroots are an excellent source of folic acid and a very
good source of fiber, manganese, and potassium. Beet greens
are richer in calcium, iron, and vitamins A and C than the roots.
Both roots and leaves are a good source of magnesium, phosphorous,
iron, and vitamin B6.
If you start to see red when you increase
your consumption of beets, don't be alarmed. You're just experiencing
beeturia,
or a red or pink color to your urine or stool. No need to panic;
the condition is harmless.
Individuals with kidney or gallbladder problems may want to
avoid eating beet greens, as they are among a variety of foods
that contain measurable amounts of oxalates, which can exacerbate
such conditions.
A few ways to enjoy beets...
• Add chunks of beets to roasting vegetables
• Marinate steamed beets in olive oil, lemon juice and
fresh herbs
• Sauté greens as you would chard or spinach
• Make borscht
Simple Borscht
1-2 TB ghee, olive oil or butter
1 tsp caraway seeds (or to taste)
1 medium onion, chopped
1 stalk celery, chopped
1 carrot, chopped
3 medium beets, peeled and chopped
1 bay leaf
filtered water
sea salt
apple cider vinegar
sweetener
Heat ghee, oil or butter in medium soup
pot. When hot/melted, add onion and caraway seeds. Sauté
until onion is soft, about 5 minutes. Add celery and carrots
and continue to sauté another 5 minutes or so until vegetables
begin to soften. Add beets and stir well to combine. Cover vegetables
with water (you want the water to be approx ½ inch above
the veggies) and add bay leaf. Cover and bring to a boil. Then
turn down heat and simmer until vegetables are tender, approx
15-20 minutes. Remove bay leaf, and season to taste with sea
salt, apple cider vinegar and sweetener. Blend soup or enjoy
as is.
Nutrition for Fertility
Hits the Mainstream
By Maia intern Doreen Zeranick Bonde
Recently, Newsweek magazine ran a cover story
about the new book, The Fertility Diet,
based on the Harvard Nurses’ Health Study which tracked
more than 18,000 registered nurses, some of whom said they were
trying to get pregnant.
As a holistic nutrition educator, I often
find that the media (and some authors as well) take the data
from a study and over inflate certain aspects (“ice cream
increases fertility!”) or draw conclusions that may not
be accurate.
While this book has some of these weaknesses,
it also emphasizes some valuable nutritional advice for women
trying to conceive. Though making changes in dietary habits
can sometimes be challenging, the authors offer suggestions
that nearly everyone can do, that cost very little, and are
free of side effects.
The Role of Carbohydrates
After the high-carb/low-fat diet fads of the
1990’s and the no-carb Atkins and South Beach diets that
followed it, the American public has stopped eliminating an
entire category of macronutrients and started having a healthier,
more balanced attitude about carbs. The Harvard study emphasizes
that carbs aren’t bad in and of themselves, but that the
kind of carbohydrates consumed are very important, and can actually
impact hormone levels.
The authors used the Glycemic Index (GI)to
relate the diet consumed by study participants to overall levels
of fertility. The GI is a scale, from 1 to 100, that indicates
how a particular food affects blood sugar and resulting insulin
levels. Based on the study’s findings, the authors recommend
eating mostly “slow carbs,” foods that take longer
to digest and promote more balanced blood sugar, such as beans,
brown rice, and nuts. They recommend staying away from “fast
carbs” which include foods like potatoes, cold breakfast
cereals, and sweets. You can find more information about the
Glycemic Index and a database of the GI of foods from the University
of Sydney at http://www.glycemicindex.com
Protein
The researchers looked at how much and what
kinds of protein the women were eating. Their statistics showed
that women with the highest level of animal protein intake were
39% more likely to experience ovulatory infertility, also known
as "unexplained fertility", a condition in which a
woman is ovulating but has difficulty conceiving.
To explain this finding, the authors used a computer program
to compare the nurses’ intakes of proteins and carbohydrates.
Based on the theory that the more a person eats of one thing,
the less they eat of another, they attempted to measure what
the impact of certain ratios of animal protein, plant proteins
and carbohydrates might be on fertility. Using this model, they
purported that replacing animal proteins and/or carbohydrates
with plant proteins related to a lower incidence of ovulatory
infertility. Good sources of plant proteins include nuts and
nut butters, seeds, beans and vegetables. In his new book, In
Defense of Food, author Michael Pollan offers a great seven
word philosophy on nutrition: "Eat food. Not too much.
Mostly plants."
Another perspective on this research finding
is that a diet high in simple carbohydrates and low in protein
is likely to wreak havoc on the body’s blood sugar regulation
and negatively impact fertility. So, a diet with higher amounts
of protein is simply less likely to correlate with ovulatory
infertility. Whether that protein should come from animal or
plant sources cannot be accurately surmised from the study,
because the study did not track the types of animal protein
the women ate. If they were eating commercial meat products,
from animals that were given growth hormones, then their fertility
may have been affected by this. Nutritional scientist Weston
Price puts forth the theory, based on the study of traditional
human diets, that animal protein is necessary for optimal body
functioning and fertility, as long as the animals are kept organically
and grass-fed. More information about this can be found in the
book Nourishing Traditions, by Sally Fallon and Mary Enig, or
at http://www.westonaprice.org.
Cow’s Milk and Dairy Products
The researchers concluded that eating two
servings daily of full fat dairy products contributes to improved
fertility. They admit there is little research on dairy intake
and fertility, and their research is focused on ovulatory infertility
only. However, they do point out that removing the fat from
milk, as in low fat or skim milk, dramatically changes its balance
of naturally occurring sex hormones, thereby possibly affecting
ovulation and conception.
In addition, proteins are added into these
low fat products to make them look and taste creamier, which
changes the milk’s structure even further.
“Ice Cream for Fertility!"
That's one of the tips from a new book on
how to get pregnant. This is an actual title of an article in
the December 16th Boston Globe about The Fertility Diet. Surprisingly,
the authors of the book do mention ice cream as a full fat dairy
choice, though they remind us that the results they found came
from two ½ cup servings of full fat ice cream per week,
which means a pint of ice cream should last for two weeks. (Frankly,
I don’t know of many people who actually eat ½
cup-it’s not very much – try measuring it!)
While an occasional ice cream treat is fine,
it seems to be a bit of a stretch, nutritionally speaking, to
call it a “fertility food.”
If you do take the recommendation to add full
fat dairy to your diet, it’s worth the extra money to
buy organic dairy products. Organic milk means the cows are
not treated with antibiotics or growth hormones, they are provided
with time outdoors, and when they graze they do not eat anything
treated with artificial fertilizers or pesticides (plus, it
tastes better!)
Exercise
The Harvard researchers recommend making exercise
a part of your life in order to stay healthy and increase fertility.
They recommend a “fertility zone” of not too much
or too little exercise, at least 30 minutes a day. They also
emphasize incorporating four types of exercise: aerobic, strength
training, stretching, and the activities of daily living.
The authors point out that women dealing with
infertility are sometimes told to avoid exercise due to old
research that suggested that exercise could stop menstruation
and ovulation, but this applies to women who exercise at an
extremely high level (i.e. elite athletes) who also have very
little body fat. The potential benefits of exercise for women
trying to conceive are many: increased fertility, improved health,
better mood, weight control and reduced stress.
The Role of Fats
The Harvard researchers also took a close
look at dietary fats and the effect they may have on fertility.
They note that body fat is fairly well understood in relationship
to fertility: having too little body fat can interfere with
menstruation and ovulation, while having too much can also negatively
impact fertility by affecting hormones and ovulation. In their
research, the authors found no connection between ovulatory
infertility and the amount of fat in the diet. One important
connection they did find was in relation to the kind of fat
in the nurses’ diets. They found that the higher the intake
of trans fats in the diet, the higher the likelihood that the
women would experience ovulatory infertility.
According to the FDA, “trans fat is made when manufacturers
add hydrogen to vegetable oil--a process called hydrogenation.
Hydrogenation increases the shelf life and flavor stability
of foods containing these fats…the majority of trans fat
is formed when food manufacturers turn liquid oils into solid
fats like shortening and hard margarine.” The average
American adult consumes 5.8 grams of trans fat per day, mostly
in cakes, cookies, crackers, pies, bread, and other processed
foods.
The Harvard study demonstrated an increase
in ovulatory infertility when women consumed only four grams
of trans fats per day in place of other, healthier fats. For
example, a small bag of potato chips has three grams of trans
fat, a doughnut has five, and a medium order of fast food french
fries has eight grams. In order to avoid trans fats, become
an avid label reader. Stay away from foods that contain “shortening,”
“partially hydrogenated vegetable oil” or “hydrogenated
vegetable oil.” Instead, use real butter or ghee, olive
oil, or coconut oil. You can find more information on healthy
fats in the book Nourishing Traditions.
While there is room for criticism of some
of the conclusions drawn from the study, the authors of The
Fertility Diet make some useful recommendations and offer a
reminder that nutrition is a vital part of overall health and
fertility. When faced with difficulty conceiving, nutrition
is an important consideration when looking for the possible
cause.
Doreen Zeranick Bonde is a lesbian mom
of two and a Master’s student in Holistic Health Education
and Nutrition at John F. Kennedy University. Previously, she
was a sex educator and writer for Good Vibrations, a community
support facilitator for adults with developmental disabilities,
and a massage therapist.
Doreen can be reached at doreenruth@yahoo.com
