Sarah Tewhey
Forum Replies Created
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Welcome Maggie! I look forward to learning together and getting to know you.
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Hi!
In my area (rural Northeastern US), out of hospital midwives like to see good labor happening within 24-ish hours and a baby not far behind after ROM (rupture of membranes). Whether or not someone is GBS positive and if so has agreed to IV abx (which are within scope of practice for CPMs here in Maine) also influences decision making around timing. The midwives monitor closely, avoid cervical exams and make sure their clients are informed of risks, etc. Care in the hospitals in my area is similar. The willingness to wait 48 hours out of hospital would be unusual in my area.
Evidence Based Birth has a signature article on the subject…happy to attach it if you’d like to see it.
Claudia and Zena would be great to ask about patterns for PROM. In general what I see most often with PROM in an otherwise healthy pregnancy is less a EAM pattern and more an issue with baby position or pelvic fit – with OP (occiput posterior) being the most common issue.
In those labors where position/fit doesn’t seem to be the issue many of the people I’ve seen with PROM tend to be high stress/anxious individuals with Liver stagnation OR have a history of being endurance athletes/doing hard physical work like farming and haven’t had their normal level of intense physical exercise in pregnancy. This seems to leave them a bit yang xu…they get sort of pale and the tissues in general get a bit doughy. I don’t know what impact this might have on the membranes, but it certainly isn’t a good starting place for the yang required for contractions to start. We need strong and healthy yang to get contractions going in a timely way.
Interested to hear other’s thoughts and experiences.
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Hi Michael,
A fellow New Englander! How fantastic. There are a handful of us in the program…you might be the first in New Hampshire?
Thank you so much for sharing a bit about your background. I really look forward to getting to know you and hope you enjoy the program.
All the best,
Sarah -
Hi Erin,
What excellent experiences you already have!
I’m so excited you are going to be part of MAMPS this year and hope you enjoy the program. Hoping you’ll be able to bring so much new knowledge into your clinic and the patients you serve. Welcome!
Warmly,
Sarah
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This is fantastic Anisa!!!
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Hi Kristen,
It sounds like you are giving really good support. I also feel a bit under-educated in terms of providing lactation support and am considering doing a CLC. There should be IBCLCs available in the NICU and in my area they often work with people after they go home – sometimes even doing home visits. I think working with an IBCLC is a really good idea.
In terms of East Asian Medicine, between the hemorrhage and the c-section you can focus on really building the blood with acupuncture, moxibustion herbs and food. An iron supplement like Floradix can also be added if she’s not already taking supplemental iron.
I generally do a customized tincture formula with Ba Zhen Tang as its base as a well as a nutritive tea that contains things like milky oats and nettles for nourishment and lemonbalm and chamomile to help with calming the shen. Obviously you’d want to cross check herbs/supplements with any medications/contraindications, but this is where I usually start.
If doing moxibustion at home feels too complicated she can just put heat packs on the areas of UB17 and/or stomach 36. I’ve been using these recently:
https://www.thermacare.com/heat-wraps/back-pain-therapy/
https://www.thermacare.com/heat-wraps/joint-pain-therapy/
She can also do pressure on CV17 when she starts a nursing session as it seems to increase let-down sensation.
I hope that helps. 😉
Sarah
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Good job Heidi!!!
I am so glad that you got to be there for her in a challenging moment. Your skill and kindness will be remembered by her for the rest of her life.
Birthwork is so physically and mentally challenging, but also provides us with such deep avenues for personal reflection and development of our professional skills….and we get to show up in ways that impact people for years and years to come. Birth is amazing all around. I hope that this program helped you in some small ways during those 24 hours.
Well done…and I hope you got to have a good sleep once you got home
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Hi all,
So Debra is going to ask Lorne about how long students have after the program has ended to complete CEUs…she said its “usually several months”. So there may perhaps be more clarity on that at the live discussion once she talks with him.
Debra also shared that the material/forums in the MAMPS 2023 classroom remains open to all students until the next cohort begins in April 2024. So my understanding is that you have until March 31, 2024 to access the materials from the program. Students who decide to continue the program as alumni (which is a monthly fee…I’m not sure exactly what it is) have access to the 2023 program as long as they are in the alumni program. So this means that you can always go back and reference the forums and the live discussions, which generally don’t get carried over from year to year.
I hope that helps. Debra will hopefully have more specifics.
Sarah
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Hi Emma,
I actually don’t know the answer, but many people are catching up and I would imagine there will be ample time to complete CEUs. I’m checking with Debra and Claudia and will get back to you!
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Hi Liz,
Apologies I am only seeing this now.
How did it go?
Hope you are well.
Sarah
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Hi Kristen,
Ugh. I hope she fares ok. In my experience pregnant people who had the primary series, but haven’t had any boosters have fared ok with covid. It was those patients of mine pregnant in 2020 and 2021 who got covid without vaccination who got really profoundly ill.
We are having a bit of a tough time in my area with pregnant women getting bad information around boosting. I’ve had several pregnant patients go in for annual physical exams (outside of care with their prenatal providers) and had the PA or NP tell them that they can’t be boosted in pregnancy…. and I’ve also heard of several local women booking booster appointments online at chain pharmacies and then being turned away by pharmacy techs because the tech believes that they can’t be boosted in pregnancy. Its very frustrating.
Here a recent article from the NIH: https://www.nih.gov/news-events/news-releases/covid-19-vaccination-boosting-during-pregnancy-benefits-pregnant-people-newborns
Evidence Based Birth put out some great material on the vaccine a few years back, but I haven’t seen them do anything on the boosters.
Hope that helps and that your patient fares OK.
Sarah
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Hi Heidi,
Marking things complete doesn’t impact CEUs…that button is just there to give us as mentors an idea of where people are in the program and give each student a visual reminder of which lectures they’ve completed. Plus, I know I got great satisfaction as a student from pushing that button!
CEUs are dependent on completion of the worksheet, quizzes and evaluation for each module. There was a website issue with Module 5 that has been corrected. If you did not receive your CEU certificate for that Module please let Lorianne know.
All the best!
Sarah
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Hi Danielle,
I’m not sure we have specific lectures on this. I know that Debra covers it a little bit in her “Updating The Essential Guide” lecture in the pregnancy module.
We’ve talked about it during live discussions in prior cohorts. I remember that of the most in depth discussions we had was with Joan Boccino who spoke at a live discussion during the 2021 cohort about her research with Type II diabetes and how it might be applicable to GDM. I’m attaching her work here.
I use this ear protocol with all of my patients who have GDM. I have yet to have anyone need any intervention beyond dietary management or metformin. I’m not sure if that is because of the protocol or if it is because my GDM patients are often very proactive with diet, but it certainly hasn’t hurt! There is strong motivation in my area for patients to control GDM with diet and/or metformin as individuals who need insulin risk out of the local hospital and care has to be transferred to a much larger (and less physiologic birth friendly) hospital over an hour away. So we work really hard to keep GDM under control…I find that managing stress and ensuring good sleep is really helpful and acupuncture is wonderful for that!
Hope this helps!
Sarah
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Hi Heidi,
I hope so. I have been trying to reach Ali, but have not heard from her.
I will keep you posted.
All the best,
Sarah
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Hi Cally,
Am I missing something? I’m not seeing the attachment.
Hope you are well!
Sarah