101 East 5th Street, Suite 208, Northfield, MN 55057
Hello everyone! I am excited to begin blogging again!
I hope that this Blog post finds everyone healthy and well! It seems that we are all constantly being bombarded with Covid-19 information and statistics, Treasured Birth, LLC is one of the businesses that was required to close due to the quarantine, and direct-contact with our clients.
However, we are very excited to announce that we have been approved to begin our re-opening for business, June 1st our Minnesota Senator gave the okay for Massage businesses to re-open. This is exciting news for us — and yes, we are Open for Business; but we are including a few important changes in order to maintain the safety of both us, and our clients. Those changes are included below. We are happy to see all of you soon! Please recommend us to your friends, family, and clients (please remember that we only do massage for our women clients, however, Childbirth Education and labor support focus on couples!) Again, we are taking appointments, and scheduling classes through our website. Please visit our website at https://www.treasuredbirth.com to learn more, or to schedule your class/massage! Help us to get up and running again! We look forward to hearing from you!
A Letter to Our Clients, Friends & Family
Dear Treasured Birth, LLC Clients and Families,
We would like to share with you what we know about COVID-19 (Coronavirus) and ways we are addressing potential risks at our offices, and when visiting you in your home.
In order to keep our clients and families as safe and healthy as possible, we are instituting measures to prevent potential exposure as we return back to work. The goal is to “prevent the spread”. We plan to do this by following the Center for Disease Control (CDC) and the World Health Organization (WHO) guidelines to help decrease the spread of illness.
First, it is important to know the symptoms of COVID-19. Symptoms may appear 2-14 days after exposure:
The current recommendation is that if you are experiencing mild symptoms of COVID-19 that you isolate at home during the illness. Do not go to work, school or public areas and avoid public transportation. Get plenty of rest, stay hydrated and manage your symptoms with over-the-counter medications at home. Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). If you have a medical emergency and need to call 911, notify the dispatch personnel that you have or are being evaluated for COVID-19.
Treasured Birth, LLC, will not be testing for suspected COVID-19. We are attempting to keep a zone of wellness at either of our offices. If you suspect you have COVID-19 we suggest you contact your primary care provider. CALL AHEAD and let them know you have or suspect you may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.
When to reschedule your appointment (all types of illness):
TREASURED BIRTH, LLC’S PREVENTION STRATEGIES
We will only be allowing one massage client at a time into the office. Please do not bring your family along for your appointment.
Upon your arrival to the office building, please wash your hands at the Prevention Station before entering, and we will be requesting that you wear a mask (we can’t provide you with one, so please bring one along).
ANYONE WHO IS EXHIBITING SYMPTOMS CANNOT BE PRESENT IN THE OFFICES, (i.e.. WAIT IN THE WAITING AREA). WE WILL REQUEST YOU TO LEAVE IF YOU HAVE A FEVER, COUGH, OR ANY OTHER POSSIBLE VIRAL SYMPTOMS.
How you can help
We will be setting up a prevention station with hand sanitizer, and tissues when you enter either one of our offices. Before entering our office, please immediately go into the bathroom and have everyone, including children, wash their hands. While soaped up, sing the song Happy Birthday twice before rinsing. Please dispose thoroughly of your towels when finished. When you arrive for your appointment, please stop and sanitize your hands.
If you come to one of our Treasured Birth offices exhibiting flu/cold-like symptoms, we will require you to immediately leave and reschedule your appointment.
Children’s Toys in the Office
All toys have been removed from the office.
We are moving all doula prenatals and postpartum visits to online. We will use Skype, or FaceTime, or WhatsApp for our meetings. We will be contacting families who have signed up for meetings, or births in June onward with further information.
We encourage you to join our online Facebook group to stay connected to community. Join here: https://www.facebook.com/treasuredbirth1.
If You are Pregnant or Breastfeeding
Pregnant women should take the usual preventative actions to avoid infection – such as washing hands often and avoiding people who are sick. Here is an article with more specifics for breastfeeding and pregnant women: https://avivaromm.com/covid-19-pregnancy-breastfeeding/
How to Stay Healthy Every Day
These are just suggestions that are common sense and that everyone can do.
We will continue to update our recommendations as more information becomes available about COVID-19 Coronavirus. The global picture of COVID-19 is a fluid, evolving situation and although we endeavor to stay as updated as possible, the information posted here may not reflect the latest news.
On behalf of the Providers and Staff at Treasured Birth, LLC,
Kelly Martin, Treasured Birth, LLC
In this time of Covid-19, we are all becoming more aware of our vulnerability as human beings. But learning about how we can naturally stay healthy using alternative methods is going to become more commonplace as we all make the journey into this new Covid-19, and virus vulnerable world. If we actively pursue learning, we can empower ourselves with the self-knowledge that the old “granny midwives”, and our Post-WWI and WWII ancestors knew. From the book “Herbal Healing for Women,” I make the following post. Please be aware that this is not to diagnose or prescribe, and it is not being stated in any way as a cure for anything. It is more a nutritional suggestion — please consult with your provider before using anything herbal or alternative.
Herbs for Women
(Rosemary Gladstar pages 111-113)
There are many remarkable healing herbs used specifically for the female system. They serve as tonics, feeding and nourishing the reproductive system, and many are also used for healing specific ailments by herbalists. The following herbs are Rosemary Gladstar’s favorites, and they are the ones most often used in her herbal work with women. (For a detailed description of each of these herbs, please see the Materia Medica in Part II of this book).
Though all of the above herbs are used frequently for the female system, they each have different properties and physiological actions and are indicated for different needs and specific actions. It is important to have a basic understanding of the primary actions of these herbs on the reproductive system. This will help you choose the most appropriate herb(s) for each situation and also give you a rudimentary understanding of how and why each herb is working. The following categories characterize the major physiological action of herbs used for the female system. Since herbs are multifaceted and have many actions, most will fit into one or more categories.
These herbs are specific for toning and strengthening the whole female reproductive system. They are generally extremely potent in vitamins and minerals. They feed and nourish the reproductive organs, are used for restoring vitality and balance, and give general tone to the system. They are generally recommended for use over long periods of time and have little or no known side-effects. Some examples of uterine tonics are black cohosh root, comfrey root and leaf, dong quai root, ginger root, licorice root, motherwort leaf, nettle leaf, squaw vine, strawberry leaf, and vitex (chaste berry).
These herbs help stimulate and promote normal menstrual flows. They are very beneficial for relieving menstrual cramps and for bringing on suppressed, or delayed menstruation. While many emmenagogues are also uterine tonics, some promote menstruation by irritating, or stimulating the uterine muscles. Be sure that you know whether the emmenagogue herbs you are using primarily promote menstruation through a tonic, nourishing action, or through a stimulating or irritating action. Some examples of emmenagogic herbs are: Angelica root, black haw, blue cohash, cramp bark, dong quai root, false unicorn root, ginger root, motherwort leaf, mugword leaf, pennyroyal leaf, squaw vine, and yarrow flower and leaf.
Hormonal Balancers and/or Regulators
These are herbs that balance and normalize the functions of the nedocrine glands. They balance estrogen production and regulate the activity of these and other hormones. Hormonal balancers are useful in all aspects of menstrual dysfunction. Contrary to popular opinion, they do not actually contain hormones, but are considered hormone precursors. They provide the necessary elements, or building blocks to produce hormones. Most are also considered prime “liver” herbs, since much of the activity of hormonal production is dependent on the health of the liver. Some examples of hormonal balaners are: Black cohosh, black haw, dong quai root, false unicorn root, licorice root, vitex (Chaste Berry), and wild yam root.
These herbs promote uterine contractions and are used for stimulating delayed menstruation, stimulating contractions during prolonged labor, and as abortifacient agents. Some of these herbs contain oxytocin, which encourages the production of prostaglandins in the body. High levels of prostaglandins in the system stimulate uterine contractions. Some uterine contractors work by stimulating blood flow to the uterus. Other uterine contractors cause contractions by irritating contractors are actually toxic and should be avoided. Though these herbs are a potentially helpful group, you should be sure to understand them, and their particular function well before using them in your herbal work. Some examples of uterine contractors are: angelica, blue cohosh root, cotton root bark, parsley root and leaf, pennyroyal leaf and flower, rue leaf, and tansy leaf.
Stay tuned for the next posting which we will talk about herbs during pregnancy!
Treasured Birth has a long-term goal to uphold the Ethics of Professional Midwifery Practice that supports the International Confederation of Midwives Statements made in 2003, which is the formulation and maintenance of healthy relationships, and an effort for midwives and students to work, support and validate each other. This includes the encouragement and growth of new midwives to practice in our communities. I vow never to bully, or belittle any student, or colleague in our community in order to better or make myself look good. The change starts with me — and you.
“Professional Ethics in Midwifery Practice” by Illysa Foster, page 121:
“It is a great travesty to the profession when new, educated inspired midwives are discredited and undermined by those who are threatened by shifting ways and ideas. To overcome these dynamics, midwifery organizations must take a stand on professional behavior among midwives. The ethical principles of beneficience, nonmaleficence, autonomy, and justice must be applied when working with other professionals, including midwife colleagues and their students.”
“People who bully often feel threatened and are resistant to change (Marinah Farrell, 2007) Overt monitoring, humiliating, persistently criticizing, spreading malicious rumors, and excluding or ignoring are common bullying behaviors (Hadikin, 2001). Hierarchical structures may support bullying, much to the detriment of the quality of midwifery care.”
“To overcome these dynamics, midwifery organizations must take a stand on professional behavior among midwives. Midwifery organizations can explore the concept of the integrity of the healthcare professional and create codes of conduct that set parameters on the behavior of midwives regarding their relationships with others. Midwives must not tolerate bullying in their labor and delivery units or their community. To stop bullying behavior, an individual or group must confront the perpetrator, or perpetrators, explain the effects of their behavior, and ask them to stop. Bullying is damaging to the bully, the victim, the community, and the profession. Greater awareness of bullying and codes of professional conduct that focus on professional relationships are needed.”
There are several organizations that have created Codes of ethical conduct regarding collaboration, referral, or transfer of care. ICM’s International Code of Ethics for Midwives (2003) contains the most developed guidelines relating to working with other professionals. “It is important for midwives to seek and understand the reasons for disagreements with clients and colleagues. Midwives should not stop with just understanding, or respect however. They must work to also resolve those conflicts that need to be resolved in order for ethical care to continue. The emphasis is on the relationship, to go beyond quelling the disagreement and to actively seek resolution of conflict.”
I am currently exploring the idea of opening a new Licensed Birth Center in Southeastern Minnesota. In order to do so, I will be making several blog posts about the process. Not only do I need to find a suitable location, but there are many steps to becoming a licensed birth center. Here is the Minnesota law that addresses the legal requirements for a Minnesota Birth Center. If you have knowledge, suggestions, connections in response to this blog, please feel free to let me know. This is the law as published by the Minnesota Department of Health.
(a) For purposes of this section, the following definitions have the meanings given them.
(b) “Birth center” means a facility licensed for the primary purpose of performing low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are planned to occur away from the mother’s usual residence following a low-risk pregnancy.
(c) “CABC” means the Commission for the Accreditation of Birth Centers.
(d) “Low-risk pregnancy” means a normal, uncomplicated prenatal course as determined by documentation of adequate prenatal care and the anticipation of a normal, uncomplicated labor and birth, as defined by reasonable and generally accepted criteria adopted by professional groups for maternal, fetal, and neonatal health care.
(a) Beginning January 1, 2011, no birth center shall be established, operated, or maintained in the state without first obtaining a license from the commissioner of health according to this section.
(b) A license issued under this section is not transferable or assignable and is subject to suspension or revocation at any time for failure to comply with this section.
(c) A birth center licensed under this section shall not assert, represent, offer, provide, or imply that the center is or may render care or services other than the services it is permitted to render within the scope of the license or the accreditation issued.
(d) The license must be conspicuously posted in an area where patients are admitted.
For new birth centers planning to begin operations after January 1, 2011, the commissioner may issue a temporary license to the birth center that is valid for a period of six months from the date of issuance. The birth center must submit to the commissioner an application and applicable fee for licensure as required under subdivision 4. The application must include the information required in subdivision 4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted an application for accreditation to the CABC. Upon receipt of accreditation from the CABC, the birth center must submit to the commissioner the information required in subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner shall issue a new license.
An application for a license to operate a birth center and the applicable fee under subdivision 8 must be submitted to the commissioner on a form provided by the commissioner and must contain:
(1) the name of the applicant;
(2) the site location of the birth center;
(3) the name of the person in charge of the center;
(4) documentation that the accreditation described under subdivision 6 has been issued, including the effective date and the expiration date of the accreditation, and the date of the last site visit by the CABC;
(5) the number of patients the birth center is capable of serving at a given time;
(6) the names and license numbers, if applicable, of the health care professionals on staff at the birth center; and
(7) any other information the commissioner deems necessary.
The commissioner may refuse to grant or renew, or may suspend or revoke, a license on any of the grounds described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice and a hearing as described under section 144.55, subdivision 7, and a new license may be issued after proper inspection of the birth center has been conducted.
(a) To be eligible for licensure under this section, a birth center must be accredited by the CABC or must obtain accreditation within six months of the date of the application for licensure. If the birth center loses its accreditation, the birth center must immediately notify the commissioner.
(b) The center must have procedures in place specifying criteria by which risk status will be established and applied to each woman at admission and during labor.
(c) Upon request, the birth center shall provide the commissioner of health with any material submitted by the birth center to the CABC as part of the accreditation process, including the accreditation application, the self-evaluation report, the accreditation decision letter from the CABC, and any reports from the CABC following a site visit.
(a) The following limitations apply to the services performed at a birth center:
(1) surgical procedures must be limited to those normally accomplished during an uncomplicated birth, including episiotomy and repair;
(2) no abortions may be administered; and
(3) no general or regional anesthesia may be administered.
(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth center if the administration of the anesthetic is performed within the scope of practice of a health care professional.
(a) The biennial license fee for a birth center is $365.
(b) The temporary license fee is $365.
(c) Fees shall be collected and deposited according to section 144.122.
(a) Except as provided in paragraph (b), a license issued under this section expires two years from the date of issue.
(b) A temporary license issued under subdivision 3 expires six months from the date of issue and may be renewed for one additional six-month period.
(c) An application for renewal shall be submitted at least 60 days prior to expiration of the license on forms prescribed by the commissioner of health.
(a) The commissioner of health, in consultation with the commissioner of human services and representatives of the licensed birth centers, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance Association, shall evaluate the quality of care and outcomes for services provided in licensed birth centers, including, but not limited to, the utilization of services provided at a birth center, the outcomes of care provided to both mothers and newborns, and the numbers of transfers to other health care facilities that are required and the reasons for the transfers. The commissioner shall work with the birth centers to establish a process to gather and analyze the data within protocols that protect the confidentiality of patient identification.
(b) The commissioner of health shall report the findings of the evaluation to the legislature by January 15, 2014.
MASSAGE TECHNIQUES FOR LABOR
Article Published in: “A Midwife’s Touch,” by Elaine Stillerman. © 2008 Midwifery Today, Inc. All rights reserved.
[Editor’s note: This article first appeared in Midwifery Today Issue 84, Winter 2008. Portions of this article were taken from Prenatal Massage: a textbook of pregnancy, labor and postpartum bodywork, by Elaine Stillerman.]
As labor progresses into the active phase, a noticeable shift occurs in contraction pattern and mother’s emotional response. The midwife’s goal is to keep her calm, comfortable and focused and to encourage the normal progress of labor. Another important task is to meet her emotional needs with understanding, nurturing and respect. This will give her a greater sense of control over labor, which can lead to heightened self-esteem and a more satisfying, empowered experience.(13)
The bodywork techniques must now be adapted to the mother’s emotional and physical needs and changes. Her breathing pattern will be different and should be encouraged by breathing (or intoning, moaning, etc.) with her.
Techniques for Active Labor
As labor progresses into the transition phase of stage one, most women are no longer comfortable with long, gliding strokes. Some women may actually pull away from touch altogether as they focus on the task at hand. Hot or cold packs, or ice chips (perhaps imbued with an herbal remedy such as black cohosh, if her blood pressure is low and stable) may be welcome. Holding, rocking or swaying with her may be all the support she needs. Placing your hand on an area of tension or firmly applying pressure on her sacrum during a contraction can relieve back pain. (Don’t forget to keep her face and jaw relaxed, since a lot of women in late labor grimace in pain and lock their jaws.)
Quiet encouragement and reassurance are paramount during transition. Keeping her relaxed and calm lets her natural rhythm of labor proceed smoothly and on course.
After the short resting phase of stage two where she may enjoy a few gliding strokes on her back or belly, strong contractions resume and the urge to push becomes involuntary and compelling. Relaxation is vital to the conservation of her energy and smooth passage, particularly her pelvic floor and adductors, as any physical tension could increase pain and slow labor. Gently and quietly remind her to release tension and allow her body to open.
Helpful ways to support her include encouragement, staying calm and helping her follow patterned breathing and chosen relaxation strategies. Help her change positions and rub any tense areas—if she wants the touch. The strokes of abdominal effleurage during the active phase begin at the fundus and move toward the pubic bone in tandem with uterine contractions. Between contractions, try effleurage of the lower back, or she might prefer gentle pelvic rocking. Leg cramps or muscle spasms can be treated with active or passive stretching or appropriate light leg massage. She will most likely need assistance straightening her legs after squatting to either stand erect or sit down.
Most of the support during the baby’s birth helps to calmly remind mother to stay relaxed and conserve her energy. You can offer some physical support such as counter-pressure or perineal support and help her find a comfortable birthing position.
Expulsion of the Placenta
In the tribal world, placental birth was usually very fast because women were in good physical shape and they used efficient birthing positions. Standing and stretching can expedite placental delivery.(14) Massage was used almost exclusively to encourage expulsion of the placenta in tribal societies. Other procedures included contracting the abdominal muscle, having the woman sneeze, having the new mother bite on something very hard or having her blow into her hands or an empty bottle.(15) Heat applications were also used to effectively expel the afterbirth.
The women of Morocco soak the end of the severed umbilical cord in oil heated over hot coals. Within a few minutes of the treatment, the new mother stands and the placenta falls out.(16) The Filipinos warm the handle of a wooden rice ladle and press it against the woman’s navel. In certain regions of Mexico, a hot tortilla is placed against the mother’s right side.(17) In India, the birth attendant oils her head and rubs it against the standing mother’s belly until all the blood comes out.(18) In Tahiti, the afterbirth is expelled as mother kneads her own abdomen while bathing in the sea. Her husband presses his foot against her to stimulate further expulsion of fetal detritus.(19)
Abdominal massage from the fundus to the pubic bone, skin-to-skin contact between mother and baby (kangaroo care, nursing), nipple stimulation or oral stimulation (by the partner) promote the release of endogenous oxytocin that encourages the uterus to contract and expel the placenta. Midwives can stimulate acupuncture point Spleen 10 to release the placenta. Place the heel of your hand at the top border of the mother’s knee. Your thumb should reach the belly of the vastus medialis muscle where the point is found. Hold for a count of 10, repeating until the uterus starts to contract.(20)
If mom starts to shake, squeeze the arches of her feet to control the trembling and guide her through gentle breathing.
Many helpful bodywork and massage techniques, along with numerous comfort measures and coping strategies, can have a positive impact on the way a woman perceives and experiences her labor. These techniques also provide midwives with additional ways to keep their clients calm, comfortable and relaxed.
Elaine Stillerman, LMT, has been a New York State licensed massage therapist since 1978. She began her pioneering prenatal practice in 1980. She is the developer and instructor of the professional certification workshop “MotherMassage: Massage during Pregnancy” (www.MotherMassage.net) and the author of MotherMassage: a handbook for relieving the discomforts of pregnancy (Dell, 1992); The encyclopedia of bodywork (Facts On File, 1996); Prenatal massage: a textbook of pregnancy, labor, and postpartum bodywork (Mosby, 2008); Modalities for massage and bodywork (Mosby, publication date to be announced). She is the researcher and writer for the PBS-TV show “Real Moms, Real Stories, Real Savvy” and is proud to have helped organize the March 2008 Midwifery Today conference in Philadelphia, Pennsylvania.