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Training, Education and Services
December 2006 - Vol 1, Issue 7
Learning to deal with blood!
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Hello friends,
chana luba

Learning comes in many forms and sometimes a crisis can be a great learning experience. This couldn't have been more true during the end of the fall training. I am the 18 women that were attending my Fall Labor Doula Training got hands of practice on what to do in the the case of lots of blood loss. Who did we get to practice on? ME!!!

A dramatic ending!
chana squat 06
My fall training which ended four weeks with 18 women in attendance had a dramatic ending! Here's the story... I was 11 1/2 weeks pregnant and started to bleed a little on Saturday. Looking at the calendar I didn't have another free Sunday till the end of December and really wanted to finish off the last day of my 4 day training. I decided I would let others help me set up and ask for help and stay off my feet as much as possible. I did this pretty well except for some theatrics in role playing of labor which was fun but in retrospect not what my body wanted.

I was bleeding on and off all day, I didn't have a good feeling about what I was seeing. As the women were working on a small group assignment I stood on a bench to get some pictures and felt something large come through my cervix, after inspection at the bathroom I saw a soaked pad but not much blood, I realized in retrospect that my water broke at that time. After returning to class, I sat down, put my feet up on the birth ball and we went over the labor scenario work they had been doing, It was 4pm and I got up to put in a DVD after we had finish and that is when the blood started pouring out of me. Before I knew it I was lying down and the girls were elevating my feet. I put them into action, " okay get the homeopathic kit, get the emergency pack, take out the chucks pads, where are the gloves..." All with a sense of humor and calmness. We called my midwife and husband and it was clear that I was hemorrhaging and we called 911, the EMT's were very mellow and one of the trainees whet with me in the ambulance. After an IV and O2 my pressure went back up and I started to feel a bit better, not so shaky. I made sure they got a group picture and was still talking about the video that was playing as we were waiting for the EMT's. I am sure they were thinking " is this girl for real" I as I was being carried out to the ambulance I remember saying "don't forget to sign up for the yahoo group!" I passed a large placenta followed by the baby soon after we got to the Emergency Room. The bleeding then slowed down.

Well all had a great time at the training regardless and the woman who went with me gave me a card they all had signed as we were in the ER, we had to laugh! I am sure the fall training of '06 is one they will never forget!

Herbs for threaten Miscarriage: Cramp Bark relaxes and tones the uterus. Vitex helps balance hormone levels Skullcap is an antispasmodic
Cultivating Tools...
artist red picture
A woman can hemorrhage during or after a miscarriage, while pregnant if there is a placental abruption or placenta previa or after birth for a number of reasons. Some include retained placenta, uterine atony,placenta accreta, or uterine rupture (God forbid!!) . The more information a doula can have on how to prevent and help manage a bleed the better. Doctors and midwives will have more advances tools, skills and medicines for dealing with this serious complication of childbearing but it is important that the doula be prepared in her own way. As a doula you might find you self in a situation that calls for immediate help. (as the doulas in my training found out!)

As with any emergency situation it is important that one stay CLAM and FOCUSED. As women the more we get in touch with are own blood during normal monthly bleedings the easier it will be for us to handle the sight, smell, or feel of a lot of blood should it start to flow...The two main agendas to attend to if a women is bleeding heavily is firstly to stop the bleeding and secondly prevent shock from the blood loss. As doulas we do not have access to strong medicine such as pitiocin, methergine, or misoprostol which are used to stop uterine bleeding but we should be familiar with herbal and homeopathic medicines that could help.

There is much to learn about hemorrhaging and bleeding in the childbearing years. I will present just a few tips here in this short newsletter. As with most things, the learning process is a continuos affair. Midwifery Today as a great book with lots of helpful information called the Hemorrhage Handbook.
Learning tools...
herrbs
One great herb to have in your birth bag is Shepherds Purse. This delicate but powerful plants is best as a fresh plant tincture (don't make or buy a dried herb tincture). Use a dropper as needed to help with excess bleeding. Note: do not use this as a preventive, it could form clots, use only if there is a true hemorrhage.

Two homeopathic remedies that I would reach for are Aconite and Arnica. Both can be used for hemorrhage. Aconite is indicated when there is a lot of fear and panic happening as well. Arnica is indicated for any type of body trauma and bleeding.

A powerful Chinese herbal mixture that I just learned about is called Yunnan Baiyao. One of the main herbs in it is a Chinese herb called Radix Pseudoginseng. It comes in a powder form and can be taken in 1/2 teaspoon increments mixed with water. Our local herbal pharmacy Goldthread in Northampton is where I learned about it, they carry it there. You can read some more about it here

Knowledge about prevention of postpartum hemorrhages is wise to share with mothers. Herbal uterine tonics can be taken during pregnancy if there is a history of hemorrhage due to atony, which is sometimes that cases if a woman has had many children. Some tonics include Red Raspberry leave tea which can be taken throughout pregnancy. Motherwort tincture is a good uterine tonic and relaxant which can be used starting at 38 wks. or just after birth. After birth a baby should suckle at the breast to help the uterus contract and release oxytocin. Fundal massage is also recommenced and necessary to clamp down the uterus. Making sure women are not anemic is helpful as well. If a women has low iron levels, which is normal for many women, she can increase it with FLORADIX. I have found it is better than any other pill type supplement.

Heavy bleeding is considered hemorrhage if two cups of blood are lost. Unless one has seen lots of bleeds it is hard to estimate blood loss. One things to remember is that if blood is soaking pads in less than 20 minutes, you need to STOP IT! If blood is gushing like a garden hose, it needs to be STOPPED!! If a woman is bleeding a lot and feeling faint, dizzy, chilly, clammily, nausea, is losing color, or passes out, keep her warm, elevate her feet and get professional help ASAP.
Winter Training
fall06med.group
The fall training at Hampshire College filled up nicely with 18 women in attendance! The winter training dates are the four Sundays in February, 4- 25, 2007. Early bird registration is due by December 5th to receive a $20 discount! That's an easy way to save $$!!

If you have done a training with me make sure that you are a member of the Maternal Wisdom yahoo group. With my work at Franklin Medical Center I have a lot of requests for volunteer doulas. If you are still working on your three births for certification be on the look out for these opportunities!

Thanks for taking the time to read this extra long newsletter and feel free to forward it...By the way, I am feeling just fine now...

In peace,
Chana Luba Ertel, CD (DONA), CLD, CCCE, CAPPA Labor Doula Trainer of MA
Maternal Wisdom

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