The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
Better pregnancy nutrition can grow a healthier baby, keep perineal tissues intact and support VBAC
In my experience, there are significant
things a pregnant woman can do to improve
the integrity of the tissues and thus help
to reduce complications.
Better Baby Book: Use nutrition,
your environment, and your mind to create
the healthiest, smartest, autism-free baby
possible by Lana Asprey, MD, and Dave
Asprey, "To help parents gift their
children with better health and higher
intelligence for life." It's available
either on Kindle or paperback.
This book was written by a couple who
know more about pregnancy nutrition than
anyone I've ever heard, met or read about.
From Triad: Facts: Lube Jelly Recall and Product recall involving Sterile Lubricating Jelly manufactured by Triad Group.
From Triad: Facts: Alcohol
There has been ONE report of a potential contaminant out of hundreds of millions of products sold.
From the FDA: Triad Group Issues a Voluntary Nationwide Recall of All Lots of Alcohol Prep Pads, Alcohol Swabs, and Alcohol Swabsticks Due to Potential Microbial Contamination
From the FDA: Class
- Sterile Lubricating Jelly see related information - Date
January 21, 2011
to developing countries and countries in central and eastern
Expire By Richard Altschuler
How They Benefit the Pharmaceutical Companies - Are
Drug Expiration Dates Really Used to Indicate Danger?
of Medical Companies
Allegro Medical Supplies
- general supply place - they have an extensive supply of home
products, and they also carry trochanter belts!
Radiant Belly -
and custom home birth kits, many midwifery supplies and some
newborn baby clothes
Everything Birth, inc.
– Professional Medical Supplies that cater to midwives, holistic
midwifery and medical students
purveyors of supplies and equipment to midwives, doulas and
In His Hands -
and Home Birth Supply Center
Everything Birth, Inc.
- they carry those nice single-use tubes of erythromycin eye
Spirit Led Childbirth
and Parenting Supplies (1-888-683-2678)
Precious Arrows -
and Birth Supplies
Birth With Love Midwifery Supplies - The Complete Source for all Your Health Care Supplies, including the FREEBIE LIST - 1-800-434-4915
Birth With Love still carries the Hesseltine
Cascade HealthCare Products
Cascade seems to be the biggest midwifery supply house. Customer
1-503-595-1720 (9am-5pm Pacific Time/ Orders: 1-800-443-9942, same
They have three main subdivisions:
My Birth Pools - offer advise and information on home birthing products our vaules are to engage, understand and fulfill womens home birth needs.
ICEA: BOOKMARKS: 1-800-624-4934 : an excellent source of books
programs for childbirth educators and doulas.
Moore Medical Corp. . 1-800-234-1464
Arista Surgical Supply Co., Inc. 1-800-223-1984 - Discount Catalog Arista Surgical Supply in New York City - They carry American pattern (pelican?) umbilical scissors for $3.50 (American made) or $21 (German made). These are much better than Cascade! Email: email@example.com
Henry Schein Med. Supply
1-800-772-4346 (8am-9pm Eastern time)
1-800-299-3366 ext 287
Labor of Love Support & Services for Childbearing Families
OK 405-250-0993 services & products for childbearing
You can get Baldrin from a healthfood store or from a friendly
The company is, Vitaminerals, Inc., Glendale, Ca 91201.
Green Scrubs - great selection, used to carry hemp scrubs.
Uniform Store - Internet discounts - 800-542-1732
Sassy Scrubs - has
NOTE - Many of these free samples are intended for health care
to hand out to their clients. They are often not available
There's a FREEBIE
LIST at Birth With
Avent offers samples of their products to lactation consultants, nurses, midwives, childbirth educators, and others in the medical community in an effort to aid women in breastfeeding longer.
Here's their offer:
Avent Naturally Feeding System
Members of the Medical Community: you are welcome to fax us, on company letterhead, your sample request. The fax should explain your role in the medical community and list the product(s) you are interested in obtaining for demonstration to your clients and patients. Should you have any questions, please call us at 1-800-54-AVENT.
I would appreciate your help in this matter. If you have
questions or concerns, please feel free to contact me at ext. 118
the number above. Thank you for your time.
Free Samples Nursing Pads
Johnson and Johnson
Consumer Products, Inc
600 Industrial Avenue
Paramus, NJ 07652-9688
My Breast Friend Nursing Pillow
Free brochures and demonstration sample. Call 1-800-555-5522
pHisoderm Samples (For Baby brochures and samples for class.) Call 1-800-366-6077 Ext. 243.
First Moments (pink packets include magazine plus samples of
lotion, Dove body wash, Dreft Soap)
First Moments Inc.
55 Northern Boulevard
Greenvale, N.Y. 11548
1-800-645-6306 or 1-516-484-5740
This organization offers a pink packet of samples, coupons and a magazine, complete with a childbirth planner which can be useful for birth plans.
You can also get a packet from Carnation, I think. Their number is 1-800-628-2229.
Lamaze Parents Magazine, 1-800-832-0277
This organization offers a Parent's Magazine as well as a lending video library for CBEs on baby care and products.
Proctor and Gamble's Pampers division. They have a set of bound charts that illustrate helpful positions during labor and birth, peel-off poster pads (8.5 x 11) of the charts, pocket folders, and samples of Pampers diapers. These can come in handy for the beginning teacher (like me), especially for providing parent folders. I believe they come in cases of 50. Interested people need to call way ahead of time, since they have only certain times during the year that they send the materials out (I have to wait until June because I called in February). the toll-free number is: 1-800-950-0078. (They also have a quarterly newsletter for teachers including tricks of the trade and journal updates.)
American Baby Basket (for magazine plus samples of Baby Magic and
51 Battle Road
Hampton, VA 23666
Warner Lambert (for Tucks pad samples with plastic cases)
Sales and Marketing Support
4914 Lambert Road
Dublin, VA 24084
I get samples of Lansinoh, which are free. Astroglide is a
that you can a whole box of samples of for free and they have an
lots of moms have vag dryness. I have gotten female condom
from the Reality people. There is a company in Washington
wonderful cotton breastpads called Milk Diapers. I couldn't
samples but was able to buy sample pairs for about $1.20 a pair
moms love finding them in their packs! They come with a coupon for
of if moms want to purchase more and some nice little handouts
Motherwear, a company that makes attractive breastfeeding clothing, has some nice free booklets they will send that support breastfeeding and nice catalogs that can be tucked in.
I keep my eyes open for companies that make products that I like that could be useful to new parents, and have called to see if they make sample sizes or are willing to distribute samples that I could give to my new parents. Sometimes you can support local businesses in the same way. You might find a local chiropractor who would be willing to give a coupon with a discount for an after birth business, a massage therapist, or some such person.... this advertises that person's business and the parents get a discount or maybe even a free visit in some cases and there is no cost to the midwife. You can approach pharmacies and other local stores who may have some sample items or be willing to provide a coupon for a certain service..... same deal. This kind of networking can be beneficial to the midwife too...... As the majority of us are very small businesses, there can be some advantages to forging alliances with other small businesses. After all, in exchange, they may be willing to put cards or brochures out for you.
I also include a postpartum care booklet that I wrote and developed that my clients love. Since I wrote the booklet, and illustrated it, my only cost is photocopying and each booklet costs well under a dollar to photocopy. Lately I have been making little booties out of some left over flannel for our babies...... They take only a few minutes to make unless you get fancy (I like to embroider mine so it takes a few more minutes), and cost almost nothing except my time. Since I like to sew, and find it relaxing, making booties is no big deal to me. If I hated making them, it would be different. I also make newborn caps. They are very inexpensive. I bought a box of 4 inch diameter cotton stockinette (which comes in handy for other things too sometimes). I double a length of stockinette that I cut, tie the raw end with colorful yarn, and fold up the "brim" and voila, have a cute little elf hat for pennies. I started making these when we started doing clinic births and they were so cute that I decided they were a nifty thing to send home with parents. I also make personalize birth certificates that can be framed on my computer. When we do the newborn exam, we use a footprinter so we can take the footprints of the baby and put it on the certificate. Again, it is something the parents love to frame or to put in the baby book, and the cost is negligible.
At any rate, we can come up with many useful "free" or very low cost "gifts" for our new moms that don't compromise our principles (I do not/will not accept or give out *anything* that promotes bottle feeding. I feel very strongly about this for instance). As the hospitals, and certain companies know, providing those little goodies makes good business sense.
C. Ione Sims, CNM,ARNP
Community Nurse Midwife/Shelton Birth and Family Center
Coordinator, WA ACNM Chapters Website: www.cnm.wa.org
"a good traveler has no fixed plans and is not intent on arriving" Lao Tzu
Suggestions for Client's Birth Supplies
Supplies Recommended for a Home Birth
We have clients buy a custom kit that contains exactly the
we find helpful from Cascade. We try pretty hard to keep
were using in the kit and delete things if we find we never use
we can keep costs down for folks. It has chux, sterile gloves,
ob pads, etc. in it. We also give them a list of supplies to
things anyone would already have around the home or can easily
receiving blankets, placenta pan, toilet paper, cookie sheet,
olive oil, etc.
I've pretty much got everything I need to do births - sterile & non-sterile gloves, X-Tenda gloves, instruments, suturing set, stuff to clean & wrap the instruments, flashlight, sharps container, Doppler, BP cuff, fetoscope stethoscope, infant stethoscope, baby hats, sterile bulbs, 4 x 4's, cord clamps, betadine scrub brushes, bottle of alcohol, amnihooks, cord blood tubes, sutures, catheters, syringes, meds., baby scale & sling, thermometer, cord clamp cutter.
I only have a few homeopathics, Caulophyllum, Arnica, Pulsatilla, Chamomilla, Bellis Perennis & Arnica gel.
Herbs: St. Johnswort, Labor enhancement tincture, Motherwort, Angelica root, Skullcap, Shepherd's purse, & honey straws, Evening primrose oil, Goldenseal capsules
I also have my oxygen and ambu bag.
I try really hard not to carry anything I don't know how to use. It keeps me out of trouble. I admit, I haven't sutured yet, and haven't catheterized either.
Books: Spanish-English dictionary, a homeopathy book, a little
that came with my maternal-newborn nursing text that gives
Does anybody have experience/opinions on using washable cloth
bed pads in place of chux? I read an article written by Jeannine
Parvati Baker fairly recently...she said she'd been doing
washing (with bleach? never use it, borax maybe?) sufficient to
worries about disease transmission (HIV, HepB, etc)?
perhaps cloth bed pads would help assuage my environmental conscience...and I certainly think they'd be more comfortable to lie on...and they're bigger too, and not slippery on the back so they might not slide around under moms so badly.
Comparing costs only:
Chux (from Cascade) run from 25 cents each (23"x24" economy, 17.5 cents in quantity) to $1.20 each (30"x36" super, 75 cents in quantity). Reusables (also from Cascade) run from $9.00 each (24"x36", birdseye cotton, $7.50 in quantity) to $14.50 each (36"x42", cotton/poly, $12.00 in quantity).
If your parents provide all their own birth supplies including
this wouldn't save YOU any money, but if you provide the chux, it
would, besides saving the environment, right? The Cascade birth
between $4.25 and $9.00 worth of chux pads in them. It wouldn't be
to ask your parents to all buy enough reusables for their birth,
the other hand, it would cut $5-10 off their birth kit cost if you
had a supply on hand.
I do, because we have a birth center, I too cringed at the
So I bought 8 of the large pads from Cascade and then I had some
Hutterite ladies make some smaller ones from some old materials.
bed pads, towels ,etc. Covered with sheets. They are about 1/2 the
of the big ones and aren't waterproof but I put them on top of the
one and it saves them, usually only use one or two of the big ones
many of the small ones that we can change and keep clean. We
and toss when too soiled. We usually toss on a chux when they
the big blood gets on them. They are much nicer as they are most
The washable pads are great! I have used them in the hospital;
course they wash them in all kinds of germ killing things. I would
squeamish about taking anything soiled with body fluids and
in my washer at home(I don't know if that is what you meant). But
about using a combination of the disposables and cloth. Cloth is
nicer to sit on, AND if the parents buy them they can use them on
or bed to protect the mattress from spitups and bedwetting. A lot
nurses in the hospital where I worked would put them under the
protect the mattress from SROM late in pregnancy.
and DISCOUNTED washable pads.
A one to 10 solution of bleach kills HBsAg while almost anything kills HIV. The above recommendation was given to us by the CDC when I worked in Dialysis where HBV is prevalent.
By the way, I am now using Pursue brand concentrated disinfectant
AMWAY. A concentration of 2.5 oz to a gallon of water sprayed on
wet for 10 minutes kills the following: Klebsiella, Pseudomones,
Aureus, Salmonela (2 types), E-coli, Strep pyogenes, Strep
molds and fungus (athlete's foot) Herpes simplex, vaccina (pox),
and influenza. This is great for cleaning hard surfaces (including
covered mattress and pillows, tubs, some of your equipment), and
that soaking soft stuff (bedding etc.) in the correct
do the job.
I have a couple. Very nice.. Just not sure they are worth the hassle, and the transport mess to use them often.
But it's VERY easy to do births with no disposables. A flannel backed plastic table cloth or two and a dozen bath towels; with perhaps a dozen cloth baby diapers will do for just about any birth!
Everything washes up fine with no staining . (Run through a cold water wash with no soap; then a hot/warm wash with soap. Nothing else needed). Even the table cloth is washable and reusable. Added benefit -- no transport or potential transfer of blood soaked materials.
Most births only make one load of laundry...
Lands End "Lighthouse Attache" makes a great birth bag.
The Freedom Bag is small,
it fits into most larger main bags, but it opens up to carry SO
I found a great company that makes terrific custom bags - Wells
Cargo Co. - email: firstname.lastname@example.org, toll-free # is
I don't think I have just the right birth bag yet, but I do like the way I have things arranged. Three things to carry:
About every 3-4 years, I change the way I carry things to births.
there's not a "best" way for me, just new things to try. Right now
a canvas/nylon cheap bag that is just the right size for a large
box to fit into. The bag keeps it clean in my car and easy to
handles. At a birth, I take the box out and remove the lid. I
box around to wherever it's needed during the birth. In the box, I
stuff in gallon Zip-Loc bags, divided into categories like labor
regular birth stuff, resus stuff, newborn exam stuff, suturing
I can see pretty quickly which Zip-Loc bag I need. I also have
canvas bag with extra non-emergency supplies like chucks, gloves,
etc. in case it's a long birth and we use up the stuff in her
This bag usually stays in the car until it's needed. The stuff in
birth kit is usually unpacked onto her dresser top or a table near
birth - it's laid out so everything is visible. I have seen some
cloth bags on exhibit at some of the MANA conferences, but never
that really looked useful to me. I do have a problem in not having
stuff for a postpartum bag, so I have to take things out of the
for postpartum visits and remember to put them back in the birth
a great plan! But I'm working on it.
I guess I am one of those midwives who have tried different things along the way. For the longest time I used two of the bags that Moonflower sold, with all the pockets. They were good, but I hated that I couldn't see what I was looking for, and my apprentices would have to open every pouch to find things.
About 6-8 months ago I decided to try something different. My son was working in a soccer store and while visiting him I saw some soccer shoe bags by Nike that looked to be THE perfect midwife supply carrier. The dimensions of the shoe bags are about 3" deep, 16" long and 9" wide. They have an easily seen through mesh top with a zipper going the whole way. I bought a medium sized sports bag, by Umbro, and 4 of the Nike shoe bags. At the end of the sports bag are two large pockets, in one I keep all my after-birth handouts and the file of the birth I am attending, and in the other one I keep my herbal, meds. and homeopathy bags (I have small bags for each of these).
In the main compartment I carry the four see-through shoe bags. In one I keep all my resuscitation supplies, in one I keep all my instruments and everything I need for sterilizing them, in one I keep misc. birth things, and in the last bag I have everything I need for a quick birth....all I need to do is unzip it and there are gloves, 4 x 4's, oil, mirror, flashlight, K-Y, baby hat, etc. Under my four see-through bags I keep a few chux pads. I use a different soccer shoe bag that isn't see-through, but with a nice handle on the end, for the things I use at prenatals and at births....my Doppler, fetoscope, BP cuff, stethoscope, baby scales, measuring tape. I take it to the office and tuck it into my birth bag when going to a birth.
Everything neat and easy to find.
Years ago I bought my husband a camera tripod and case for
On Christmas morning I looked at that tripod case and thought that
tank (a large one, I think size E) would fit perfect in it. I
out and it did. My husband never got his tripod case and I found a
way to carry my tank. I just slip the handle over my shoulder to
The top sticks out just enough to put the regulator on when I get
Last week I sewed myself a bag like a jewelry or lingerie travel kit with clear vinyl pockets with zippers on fabric. Saw one in the summer that a midwife in Ontario used. It was big enough to drape over a chair, she liked it because if she was sending someone unfamiliar with where stuff was, they could see it and not have to figure out which of a variety of Tupperware etc. containers it was in.
I came home and hunted in the department stores, but found a couple little ones with a makeup bag attached.
I'm quite pleased with myself, I made it as wide as would fit into my duffel bag, and the length of the fabric (45"), it fan folds, and a friend on the weekend gave me a good suggestion to the colored twine I am using to hold it closed. It is bulky when filled and folded, but so were the various containers I had.
It has 6 pockets which are about the right length to fit an amni-hook, and 3 are deep enough to fit sterile glove packages. So I have the basics for birth in the top pocket - gloves, instruments, deLee, amni-hook, sterile ky, maybe a bulb syringe.
Next pocket has bags of nonsterile gloves, and syringes, swabs, oxytocin etc., then tinctures, anchored with 1/2" elastic, then a collection of catheters, amnihooks, amniswabs, extra deLee.
Then sutures, syringes, anesthetic, extra needles, as well as Vit K and syringes and alcohol and finally more gloves and instruments for suturing in the last pocket.
I'm not down to 1 bag yet, I have resuscitation equipment, blood
and IV supplies in another bag, Oxygen tank, birthing chair plus
bag, and don't have a really good way to carry files. But it's
As all of my apprentices will attest to, I have tried MANY
methods of getting my stuff to a birth. (And the truth is, I will
try MANY more) For the moment, I am happy with using 2 of the
now being sold as luggage. I use one large and one medium size
have the retractable handles and wheels. Inside each I use plastic
to hold the supplies. The smaller one is marked as birth kit #1
everything for a quick birth. The larger one, birth kit #2, holds
including newborn exam and suture stuff. This way I can grab #1 or
anyone to the van to get what I need. My 02 tank is the large one
that is on a carrier with wheels. This is the cargo I am least
right now. Not only do I feel very uncomfortable with the
the regulator getting whacked, I also must carry my resuscitation
in yet another small bag. Someone wrote about a tripod bag and
she puts the regulator on after arrival. I had not thought of
and would like to discuss how some of you transport your 02 tanks.
Here's how I carry my files and I like it. I use a 3-ring Note
binder that velcros shut. I use those clear plastic sheet holders
for 3-ring binders. These are great for keeping each clients
(also you don't have to 3-hole punch everything). The front
my binder has client records. The back has extra forms,
sheets, heelstick supplies and any other pieces of paper I might
carry. Use dividers if you want to keep things separated for easy
The pockets in the binder cover hold pens, gestation wheel,
etc. Important pieces of info. like dosages for assorted remedies,
conversion chart, pager # etc. are taped on inside of binder
all paper stored in plastic not only keeps stuff together but
it from spills and messes. The other day when a young child at a
spilled water all over my notes the only thing affected were his
records (and not that seriously as all that).
You can get birth balls from the DONA
Boutique, and if you keep looking on that page, you'll find
Item Number BBCS,
Birth Ball Carry Strap, $14.95
Birth Balls can be purchased from Cutting
Birth balls can also be purchased at health and fitness shops
e.g. The Gym Ball Store
Some people say that the 65 cm ball is too big for most
I felt this way until I deflated it slightly. Now I
this size! And in its slightly deflated state, it rolls
and seems more stable for the mom - there's more of a cradle for
as she's in a bit of a squatting position.
from Christine Jarc of Pacific Birth Support
I want to share with you my solution for dealing with the birth ball.
I always carry my ball deflated in a separate bag that I use only for that purpose. I carry in it a small squeeze-type inflation pump that can be used in the hands, or placed under a foot to pump. When I arrive at the hospital, I always give the dad the ball and pump and let him have at it. It takes a good while with this pump, and I've learned that this serves a very useful purpose. Firstly, it gives dad a good way to direct his nervous energy and work out a little physical tension as well. It makes him feel useful at a time when the mom is settling into the room and perhaps dealing with the staff of some initial procedures. After he inflates the darn thing, I even have him take out into the hall for a little Lysol spray (also in the bag), and then a towel-dry.
The dads seem relieved to have something specific to do.
balls in birthing by Australian midwife, Joy Johnston.
First, determine size ball you need:
5 yrs age to 4'11" 45 cm - 18 inches
5'0" to 5' 7" 55 cm - 21.5 inches
5'8" to 6'2" 65 cm - 25 inches
6'3" to 6'9" 75 cm - 29.5 inches
These balls can be used for exercising, physical therapy, and for exercise with children. Here's one supplier (the cheapest):
GYMNIC 1 800 752 2255 7am to 6 pm Mountain time
45 cm 11.95
55 cm 13.95
65 cm 16.95
75 cm 21.95
Add S&H costs, no sales tax if you're outside Colorado.
Packages are available which include ball, video guide, pump and dynaband (?) for $34.95. You could also use an air mattress pump with the pointed tip end to blow up.
To blow up ball: Inflate until legs are at 90-degree angle to
and you have a 90-degree angle at your knees when sitting on the
We order from Ball Dynamics 1-800-752-2255. If you order $100 or more, no shipping fee.
BTW, we feel the 65 cm ball is too big for most of our clients.
stock the 55 cm ball.
E-mail Loveborn1@aol.com - ask Kim for a catalog - the birth balls she sells are even cheaper ($19.95 + shipping).
And she sends them second day (postage runs about 4 bucks). My
and I bought all three of our BB's from LoveBorn.
About the birth ball covers, I made one from white flannel. Use
big circle for the bottom, and a rectangle for the sides, and
at the top with a drawstring. It took a lot of flannel, but is
than the sheets, gowns, chux pads, etc. we used to cover up the
with. The rubber of the ball is just too yucky for bare faces and
to be touching, IMO. I used white flannel so I could wash it with
and bleach after each birth. It then goes into a gallon-sized
back into my birth bag until next time. And yes, I wash my birth
a bleach solution after each birth.
well, this weekend, i made a birth ball cover! yahoo! here's the thing, i made two of them, one in a fleece, and one in a knit, and the cool thing is, there are no buttons, velcro, snaps or nothing! it fits nice and snug around the entire ball, and stays put by overlapping the first and last panels! they can be scotch-guarded, and washed (but not dried in the dryer!) to avoid stains, etc. Much handier than trying to lay a blanket/towel over the ball, and with the cover, mom can move ball around without having to readjust the cover!
Anyone interested in obtaining a birth ball cover can email
I bought my Joy Chair some years ago (1998?) from an ad in
If you practice where moms deliver on birthing beds, would you
comment on whether you prefer the bed to remain intact or broken
the birthing chair configuration? ...and why you prefer it "your
We have an Adele bed and I never break it down for the birth, but sometimes do if I have a nasty repair. I use a squat bar a lot, and drop the foot when using it, otherwise it stays flat or with the head up a bit. It has stirrups to go with it, but I'm not sure where they are, since I have NEVER used them. I put the mom's feet in the little pedals if I break the bed for the repair.
As to birthing chair mode - I NEVER use that. too many tears.
In my vast experience doing hospital deliveries, (4 so far!!)
even thought of using the bed. Have used lots of positions and
though. The birth rooms in both the hospitals where I have
a poster about the bed (sorry, never thought to look which brands)
its various positions and uses. We did break the bed and used the
for a doc who came to repair a particularly nasty tear for one
think she could have done it quite nicely with the footrest
she (the doc) didn't want to, she wanted stirrups. sigh
I've only broken the bed once, for a very large woman where it
seemed easier to do so, and more helpful for her to have her feet
foot pads. I use only the foot pads, never the stirrups. Will
the foot a little, esp. if anticipating a large baby, but prefer
unbroken also for that reason, in case I need to flip her over
and knees. I do break the bed for repairs, (unless it's just a
and quick job), as it makes it easier on my back to be able to sit
between the mom's legs. Again, I use the foot pads for that.
I started out at my hospital with birth room beds that were low to the ground and did not break. I have never gotten used to the birthing beds being so high. I have some problem with being so high off the ground when the baby comes out. I have always wanted to do births on a pallet like Odent.
So, on most of the beds, you have to raise the bed quite a way to
it into a chair. So I only use that if that position has been the
effective pushing position. I most often deliver in the pushing
When I did births with breakable beds, I never took the end off, although I might lower it a bit depending on the circumstances. My reason for not "breaking the bed": very simple -- those darn babies are slippery!!!!!
For those who think I am joking, I am not. That babe comes out
in vernix and amniotic fluid and blood and sometimes they come out
fast and I am not exactly known for my skilled hand-eye
like a nice solid soft bed under that baby, not a four foot drop
hard floor. Usually I ease the babe out and lay it down on the bed
a few seconds while I dry it a bit and take a brief look and then
it ever so gently onto mom's chest. Also, if you (god forbid) have
you have a handy work surface that does not require cutting the
the parents can watch you work.
I rarely "break the bed" As a student, we spent time at an Air
base whose practice was the typical delivery room, sterile set up.
was a whole set of hand maneuvers that we were supposed to do to
hands with the baby". I never got the hang of it, though I never
the baby. So, to get to attend births in a bed that has a gillion
for me and the woman is a treat. I put the baby on her tummy, I
it to the warmer if we have troubles. But best of all, I think
woman who is birthing can do just about anything she wants at the
she wants it. We break the bed for vacuums and for expected large
but that is usually with one of the MD's standing by and I think
more comfortable with that because it is what they are used to.
About the book How to Buy Almost Any Drug Legally Without a Prescription:
According to WWW.Amazon.Com this book is difficult to find but they can get you a used copy in 2 to 6 months...it is WORTH ITS WEIGHT IN GOLD! and for $5.00 how can you go wrong??
Author: James Johnson
Published by AVON in Nov. 1990
ISBN 2 are listed:
Remember that if your client acquires her own meds and self
you have a better chance of not falling out on the wrong side of
Selecting a Sphygmomanometer or Blood
LITTMANN STETHOSCOPES - An Overview and a Stethoscopes Comparison Guide
in Low-Resource Settings - different types of
I'd like recommendations on hemoglobinometers. Cascade carries one using "the Oxyhemoglobin method." But, what I thought I was looking for was definitely different than what they picture in their catalog.
What I have seen before was a one step process with the blood drop going into a disposable clear plastic thing-a-ma-jig and filling in the circle area. Then, (this is the one step part), the clear plastic thing is set into a small drawer and the drawer is closed. The hemoglobin value is then digitally displayed. Does anyone know from this description what this machine is and/or who distributes it and how to contact them?
Maybe someone could tell me the plus and minuses of the one from
Or, do you have other recommendations for consideration?
You are talking about a Hemocue. The difference in the two mainly
that the Hemocue is internally quality controlled which is a CLIA
for exempt laboratory status. The hemoglobinometer sold by Cascade
on the clinician doing all the steps right to get a good result.
Thanks for the name of HEMOCUE. I immediately searched the web,
found the following:
23263 Madero #A
Mission Viejo, CA 92691
Ms. Yvonne Martenson
Telephone: (714)-859-2630 Fax: (714)-859-3066
HemoCue(TM) Blood Hemoglobin system for the screening of the
with laboratory accuracy and precision. The system consists of a
designed photometer and unbreakable plastic microcuvettes. The
serve as pipette, test tube and measuring vessel all in one. The
system reduces the exposures to blood screening the donors.
Glad the name Hemocue helped you in your search. We had one at
Center where I worked. I don't remember the model number but it
Hemocue Hemoglobin System. We used it for checking hemoglobin at
36 weeks and 6 weeks postpartum. (The first visit lab work
so we didn't need to use it then.) It was very easy to use. I have
about the price but I'd guess several hundred dollars. The
on the expensive side (don't remember the exact price but I think
$100 for 150). That's still a lot cheaper than an outside lab plus
and a lot more convenient.
I have used the treated paper method (you put a drop of blood on
paper and eyeball-compare it to a chart. Seems pretty reliable.
compare the numbers we get with a recent lab test, they are
I use the Tallquist book too for doing repeat hgb.......not the
ones. The book certainly is cheap, costs $5.00 from Cascade.
Me Too - I always used the Tallquist Book at a cost of $6.00 as
to a hemoglobinometer - complete unit cost $200.00. When I
they were close enough so that I could treat a woman for anemia or
anemia, if necessary.
How to take a
Devices - a review from children
Three Tenderletts are available, with varying incision depths:
Tenderlett (1.75 mm)
Tenderlett Jr. (1.25 mm)
Tenderlett Toddler (0.85 mm)
I just went through EMT training, and the guy explained some of this. Some of the POs measure the darkness of the blood - they bounce light through the skin and measure the darkness. Now, blood can been various shades; some of the PO cannot discriminate between dark red and dark blue or light red and light blue. Further, some of the PO are "fooled" when the baby has darker skin color. The expensive PO have different technologies that can sort through the variables.
We have been using pulse oximeters on babies who have poor muscle
or are a strange color- or who are tachypnic-- or any baby
on to resuscitate so besides getting a pulse it tells you how well
the kido is -- actually has gotten rid of some stress and guess
Can you tell us more about this? Is there a special type for newborns, or is it just a different sensor? Do you feel it's reliable? I took in a baby with a heart problem, and the sensor they used didn't want to stay on the baby, and they had readings all over the place.
Are the sensors reusable, or do you need a new one for each baby? Where did you buy it? I've seen them on E-Bay but would not really know what kind to buy or where to buy supplies.
I've wished I had one just a couple of times.
I've got one, and I do feel that it has saved a few transports for urgent evaluation of a marginal newborn. You do need to have one that is designed for neonatal use.
I've had mine for about six years, and it's been very reliable.
I got my Fingerprint Pulse Oximeter from Moore Medical:
[NOTE - Moore Medical often has substantial discounts - up to 10% - tell them you're a new customer and ask what kinds of discounts they have.]
I like the fact that this has a little built-in printer for documenting my findings, but they've got a good selection of other models.
Here are the manufacturer's pages, and you can see they've got some newer devices and here are the sensors, including neonatal.
Although they say the neonate sensor is disposable, it really can be re-used, and you could improvise with the tape that holds it in place.
I found the Fingerprint Pulse Oximeter on sale for $625 at:
or even for $605 (a sizzling summer sale!) at:
More shopping might yield better prices:
It's a pricey instrument, but you can claim insurance reimbursement for it:
94760 Single Noninvasive O2
94761 Multiple Noninvasive O2 sats $71
I've only used mine 6-7 times that I can recall, but it's saved a lot of gray hair and sleepless nights!!!
And . . . if you get the "Sleep" version, you can use it on your friends and family to diagnose sleep apnea! What a bonus!
P.S. A close-knit midwife community could have one that is
for loan as needed, similar to a portable EFM device. It's the
device that you rarely need URGENTLY, i.e. you can safely stay and
observe the baby and be ready to resuscitate if needed while
(an apprentice or assistant or even a family member) goes to pick
from a central location.
Tired of worrying about when to send your assistant to the oven to retrieve the warming baby blankets? Want to have a nice warm blanket to offer mom after the birth?
Those new insulated "cooler" bags are terrific for this; obviously, if they are insulated to keep stuff cool, you can use them to warm blankets up if you wrap the blankets around a warm/hot heating pad. You need to get a bag with a reasonable capacity, typically measured in "cans", as in how many soda cans it will contain. Anything above 40-cans is likely to be OK, but I think the larger, flatter ones are easier to use because they conform better to the shape of the heating pad.
California Innovations makes some really nice bags that have various straps and outer bags and pouches, which can be nice if you want to carry additional stuff in the bag. I got a mine (40-can or 26 quart/24.6 liter capacity) for around $15 at Costco. I called them at their toll-free number, 888-413-2665, and they said they're available at many department and hardware stores, such as BJ's wholesale club, Costco, Sports Authority, Loew's, Target, Walgreen's, and Kmart. They also make one that has a capacity of 72 cans - 18x13x13 - this would be my first choice if I could find it easily at a good price.
I also saw one that was the ideal shape at Wal-Mart; it was longer and not as deep, had fewer pockets and less fancy straps, for around $18.
To load the "warmer" bag:
According to Cascade: "Res-Q-Vac. Enthusiastically recommended to us by several practicing professionals, the Res-Q-Vac safely removes meconium from the baby's airway with virtually no risk of cross contamination. Easy to use, nonelectric & portable, Res-Q-vac fits into a birth bag. Complete set includes reusable handle/ pump, pediatric single use canister and two catheters. Replacement units include canister and one 14", 10 fr catheters." Complete set $ 58.00 Replacement units $8.95 Case of 10 $ 89.50.
As one who has gotten a mouthful of mec using a De Lee (yuck) and
that I need more suction than I get with one I am interested in
But is it really any better?
During our NRP class, the instructor brought a variety of suction devices, Bac-Shield DeLee, regular DeLee, Res-Q-Vac, and I don't remember what else. She then made up a thick instant pudding and had us try to suck it up. It was possible, but nearly pulled your sinuses out with a regular DeLee, impossible with the Bac-Shield, and very easy with the Res-Q-Vac.
I've used a standard DeLee once, and Res-Q-Vac once. The only advantage I see with a regular DeLee, is that you have two hands free to guide the catheter and you need one hand to pump with the Res-Q-Vac. I've seen the Res-Q-Vac work well on very thick mucus (like rubber cement).
I was convinced enough to buy one.
Undergarments for Relief of Back Pain and
I really like the numerous options available from Prenatal
Cradle, including support for the baby's weight, a
brace", and vulvar supports.
The Baby Belly Band
be used for vulvar varicosities, round ligament pain, pubic
hernia, etc. The Abdominal Band is Velcro adjustable to fit
pregnancy, and groin bands or shoulder bands can be Velcro
the Ab band for greater support if needed.
carries a diverse product line, including medical compression
back supports, stomach binders.
Jobst has a Store
Maternity Support, #3090 without insert - this belly support
a top strap that might do what the Asian binders do . . .
into the pelvis on the early side.
Collection, including Maternity Elastic Support Belt,
Girdle, Maternity Graduated Compression Elastic Support Pantyhose,
Support Girdle, Abdominal Support Girdle, Elastic Abdominal
Bra, Graduated Compression Elastic Support Hosiery, Pantyhose, and
garments from Allegro
Binders - for use postpartum, not during pregnancy
Lift" maternity supporter - a simple, comfortable belly
off the shoulders. Can be ordered from Moore Products, P.O.
Belmont, CA 94002, 1-800-457-1567 [patent No. 4005715]
Elastic Support Hosiery
I am looking for vendors names, addresses, and phone #s who make
binders for abdominal support. I am working with a multigravida
a significant diastasis (separation) of the rectus abdominis
diastasis recti] and needs to correct and maintain fetal position
Big 5 Sporting Goods makes an abdominal binder of sorts called
Glove. Mostly used for support after the baby is born. Plus it is
as a sort of loose weight thing.
Here is one that I think is reasonably priced- the "Prenatal
company- Tel # (517) 386-6038- they are $40- - they also have a
varicosities support, as well as a more advanced belly binder.
Check different pharmacies. I had to call in a Rx for a really good one for my multip with twins. Her husband was the one who did the searching.
Also saw one in Midwifery Today ad - 412 694-5283 Trennaventions
Hill St, Derry, PA, 15627. Called the Baby Hugger.
I do not recommend the Prenatal Cradle. You can get a support
pregnant women cheaply at Penney's--some maternity stores carry it
I've had it work well for clients.
I just got a Prenatal Cradle for a woman with significant vulvar
and I think it is really helping. But I also sell the Maternity
I work with Hutterites and they really think they are necessary
all. They sell for $17.50 , hence much cheaper and just as good if
just need abdominal support.
I just use a piece of long cloth to wrap around the belly for a
and either tie or pin it. This can be used starting when the belly
to feel heavy for anyone who's p and during pp. It can be great
moon time, too.
The Berkley digital electronic hanging scale can be ordered from Bass Pro Shops at 1-800-227-7776. As of 9/97, the cost is $24.88 The scale appears to display weight in pounds and fractions of a pound, rather than pounds and ounces - not sure. The accuracy of a FS-1 weighs in 1/10 of a pound, up to 50 pounds.
Bass Pro Shops (1-800-227-7776) also carries a couple of Normark
electronic scale that display weight in pounds and ounces. One
to 15 pounds ($24.94) and the other up to 50 pounds ($39.94).
accurate within 2 ounces and have a special tare weight feature.
I have the Normark Weigh-In Scale. It goes up to 50 lbs, though I
need that much of course. I really do like it......I hook up the
sling, and turn it on, and it will zero out. Then leaving it
I put baby in the sling and hook it up.
I have an old cotillion brass type, purchased 20+ years ago. I
it to the local grocery 1x mo to check the weight by weighing
those scales are checked by weights and measures folks from the
least 1x year and are certified accurate.
I have used several digital hanging scales and have yet to be happy with them. Even with the great accuracy rating they have I have not found them to be accurate. At one birth I was at, no one believed how big the baby was so my partner weighed her again (without taking her out of the sling or anything) moments after the first event...and got a 5 once difference from the original reading. I had another similar experience at a birth just a few weeks ago.
The thing supposedly zeros itself out every time you hit the power button but I am not so sure.
I am relying on my good old brass scale.
You should be able to find the scale at any fishing store. I got mine for 24.95 on sale, regularly about 30$. I then made the sling. Fabric at 28x45 inches. Hem the raw edges. For added safety, use six inches of elastic and stretch and sew it on the center of both hemmed sides opening. Get 2 - 2 inch D rings (had to find them at a tack store, like saddles and stuff). Pleat the edge in two inch pleats, then wrap them through the D rings and hand stitch shut. (mine was too thick for my machine. Cascade has them for about ten dollars, but they are ugly. I got great flannel that is really cute.
This is the hemmed side 44"Pleat the 28" side, wrap it through the D rings and secure. I really like the addition of the elastic because it seems to be more secure.
| XXXXXXXXXXXXXXXXXX |
| | elastic is sewn
| | where the X's
| | 28" are
| XXXXXXXXXXXXXXXXXX | (these x's should
__________________________________________________ be on this line)
I ironed the raw edge in 1/4 of an inch, placed the elastic on it
then ironed and hemmed it an additional 3/8 of an inch. I zig
You can get sturdy, black plastic 2" D-rings from The Rain Shed Inc., a supply house for outdoor gear. Call 541-753-8900 or fax 541-757-1887 or write to them at 707 NW 11th, Corvallis, OR 97330.
The cost is 40 cents per D-ring, plus $2.25 shipping and handling for 8 or fewer D-rings. Or just send them your credit card number and they'll figure it out.
They also sell metal D-rings, but I always worry that they might
and hit the baby.
American size 6 or 7 needles
Cast on 30 stitches
Row 1: knit; row 2 purl; row 3 knit
Repeat these 3 rows (each set of three rows makes a ridge)
20 times for a 6-7 lb. baby
24 times for an 8-9 lb. baby
Sew together the cast on and the cast off sides to make a tube.
Then sew around the top and pull tight to make the top of the hat.
New Umbilical Clamp And Cutter Invention
$6.00 Stanley wire stripper or off-brand wire stripper-$3.75
Sears Craftsman side cuts
Diaper pin - remove pin intact
cigar cutter - $15-20
Nexaband wound closure "SuperGlue" cyanoacrylate
item #FACU $7.65 for a 2 ml tube w/extender applicators
Livestock/equine shoulder-length OB gloves (for waterbirth)
item #ATG2 $9.90 for a box of 100
There's a $5 service charge for orders under $50. If you order
group of midwives, you can order 2 boxes of gloves and 4 tubes of
for just over $50, to avoid the service charge.
KV vet supply. 100 shoulder-length gloves for $9.00 - shipping is typically free.
They also have Nexaband SC for wound closure, and they have good
on suture material and BD syringes and needles. Also
inexpensive instruments and exam and sterile gloves.
The number to get a catalog is 800-269-0093. Ask for the Pet
Homebirth Options Midwifery IndependencE (H.O.M.E.) has tee shirts and bumper stickers. The tee shirts have a small 3X3 inch design in the left corner of the shirt.(above the breast) The design is the outline of a pregnant belly and the mother's hand on her belly. Another hand comes in from the right side(the midwife's hand). Underneath it says, "MIDWIFERY Preserve the Art" They are great tee-shirts; the best quality 100% heavy duty white cotton (no way to see through these) with a black ink design. Folks love them, nothing overstated, just right...classy. All sizes are available. $20.00 (half of the fee goes as a donation to the organization which promotes pro-active legal action for homebirth)
The bumper stickers are also fun. They have white lettering and design with a black background. The same logo design, but they say, "There's no place like HOME...birth!" (HOME has received calls from across the coast, requesting these bumper stickers-no kidding!) They are only $2.00, and while the group doesn't make any $$ on the bumper stickers, they certainly get the word out about homebirth.
To request either of these items (it's not too early to order for
favorite midwife or friend for the holidays!) please contact HOME
PO Box 166
Walden, New York 12586
She'll be happy to take your order.
Allergy Test Discerns Relevant Allergens [Mescape
is a comprehensive, up-to-date listing of latex allergy-related
the Internet. It also includes articles and practical information
Hygiene of the Skin: When Is Clean Too Clean? [Medscape registration is free]
"[F]requent handwashing is not only potentially damaging to skin,
is also time-consuming and expensive. Finnish investigators
that after frequent washing the hands of patient-care providers
damaged and posed greater risk to themselves and patients than if
had washed less often."
You can get a selection of glove samples from Master
Products - 1-800-826-2242
OSHA's page on Latex Allergy [Revision Date: 03 October 2000]
OSHA issues latex allergy warning amid intense storm of accusations - Technical bulletin alerts field inspectors to risks for health care workers [June, 1999]
from the National Institute for Occupational Safety and
Preventing Allergic Reactions to Natural Rubber Latex in the Workplace from the National Institute for Occupational Safety and Health (June, 1997)
Latex Allergy Association) is a non-profit, tax exempt
provides information about latex allergy and supports natural
(NRL) allergic individuals.
Delaware Valley Latex Allergy
Just as a precaution, realize that wearing latex gloves can lead to latex sensitization and an allergy that will pull the rug out from under your chosen line of work. I know this as I have a latex allergy after doing 4 1/2 yrs in L&D. I can no longer pursue my clinical interest in childbirth (some blessings come in obscure disguises!!) If you use gloves routinely in your doula work, I might suggest speaking with the infection control administrator at the hospital you are familiar with and ask her/him about the latest in latex-free gloves that offer the same protection as latex. I personally use a glove called NITRILE. It is a blue glove and has similar elasticity, is not powdered and works well for routine use. One drawback is that the gloves are MUCH more expensive than latex gloves. The comparison is a box of 100 latex exam gloves will cost around $4-$5 and a box of 50 NITRILE gloves will run around $18.00 A huge expense? Yes. Is it worth it? I think if you love your work, it is. Read the latest in the Journals of Immunology, Allergy, etc.......
There is also a lot of information on the web relating to Latex allergy.
If anyone who uses latex gloves routinely when providing prenatal care, labor support, midwifery, or postpartum care experiences ANY redness, itching, swelling, cracked skin, a rash that appears after wearing gloves for ANY length of time that ends at the wrist or watery, itchy, swollen eyes, difficulty with breathing or persistent upset stomach while in a clinical setting, or a sensitivity to certain foods such as milk, bananas, kiwi, some nuts like chestnuts, avocados...... GET MEDICAL ATTENTION!!!! First, you will need a RAST test. Not very reliable, yet can give you some info. Skin testing is the most conclusive, yet can cause a light syst. reaction.
Don't try to rationalize out of it. This is serious and there
deaths attributed to latex allergy. I have to carry epi-pens at
and have stopped breathing in the dentist's chair 3 times.
I agree!! I have a neg blood test for latex allergy, but break
hives something horrible when wearing latex gloves! I have used
but also break out in hives from the powder in them. I am also
allergic to bananas ( a relative of latex) and must carry two epi
just in case!
I did forget to mention that a hospital's SPD (Supply and
Dept.) should have catalogues of different companies. If they have
crash cart.. (TOTALLY ESSENTIAL THESE DAYS) they should stock
that dept. and they might be able to point you in the right
The foods I mentioned do have similar protein structures as latex which is why they will also bother you. A lactose intolerance is not uncommon in adults, yet it can be another signal that your body is building up allergens to the latex. The powder in the gloves only makes it worse. The bad part is that the uninformed person may suggest that you wash your hands more often and use lotion to relieve the dryness. This only makes the problem worse!!
The lotion just helps the latex proteins get deeper into your
The whole thing is really rotten because it seems that as soon as
Precautions went into force in (I think) it was 1987, the glove
knew that the demand would be up and larger contracts would be a
In order to underbid the competitor and get the large accounts,
several of the purification steps to cut costs. This kept many of
causing particles (proteins) in the rubber and then.......
and ALLERGY! Sadly, many health care professionals have had to let
their life-long careers and passions due to Capitalism at its
Just a footnote..........Be alert to the possibility that those
are attending may have this allergy and if you are wearing latex
you may create a reaction for them, too. In the hospital where I
have a LATEX-FREE cart of supplies to use for these special
I, myself have no problems with latex. However, I never use latex
of the risk to the women I work with who might have an allergy.
Thanks for mentioning the possibility of patients/clients having the allergy. I know recently it is becoming more prevalent, evidenced by hospitals having latex-free crash carts and supplies.
I hope with this early warning you can avoid future exposure to latex products and preserve your career.
For those who think they may suffer from latex allergy or have clients with this condition, please subscribe to the following list. It is an informative list much like the one you subscribe to now and can give you many sources of support, encouragement and latest info in this area of medicine. When you write to the address below, you may have to request info on how to subscribe properly.
Is there ever a concern that we will then, as a species, develop
Chemistry was never my strong point, but the way it was explained
me is that because latex is a natural product (i.e. arising in
it has proteins in it, and it's the proteins that trigger
Vinyl is a synthetic manufactured product and doesn't contain
Is anyone out there using a Leff fetoscope during labor? Are you
to use it exclusively, i.e. without needing a Doppler? Can you use
listen to heart tones throughout a contraction, or just in
I have always used a Leff, was trained on one, before we used
Can almost always get heart tones. All the midwives in our
them. However, i LOVE my Doppler, which is politically incorrect
circles. I love that the moms can hear it so clearly, that it is
to use, that moms don't have to lie down to get heart tones, that
get really early heart tones, that everyone at the birth can hear
going on if there is a problem. --sorry, that is more than you
can listen with the Leff, through contractions, and you could do
I used to use one when a labor and delivery nurse along many
I liked them. We used them during the delivery and could hear
if she was not pushing, and after.
I use a Leff fetoscope for all clients who do not want Doppler.
occasionally had to ask a woman's permission to use the Doppler
some strange reason, I can't hear - probably positional, or if I
a lot of decels or bradycardia and want more confirmation. I like
better than other types of fetoscope because the woman can listen
it as well and it is more flexible for different positions and it
I used a Leff fetoscope during the early 1980s, before I had a Doppler. My experience was that I was able to get heart tones well throughout labor and most of second stage (though not with the crisp tones of the Doppler). FHTs were often difficult for me to get in late second stage/crowning, however--had to rely on scalp color and intuition. I do prefer the Doppler but use my Leff-Sklar during prenatals and early labor when I have clients who are concerned about ultrasound exposure. I do explain to them, however, that I'll need to use the Doppler during late labor/second stage. So far everyone's been okay with that. I prefer the Leff to the Allen, but the weighted bell is always cold, has to be warmed if this bothers your clients.
It can be held under very warm water for about 20-30 secs and
nice and warm. It can also be set on the edge of a wood stove to
or kept between a heating pad with the receiving blankets. Under a
light bulb would work, too, if it was close enough
you can use a wash cloth dipped in hot H20 and wrung out to wrap
in to keep it warm between auscultations.
The Leff stethoscope "For auscultation of the fetal heart, with
bell, chrome plated, black latex tubing, "Y" connector, binaural,
I bought one, and it is nice. The bell connects with a
piece on the tubing that stays connected by friction to the bell
of like a ground-glass perfume stopper) instead of the bayonet
have seen one other stethoscopes of this type. I've used it once,
is really different. I know midwives who love these.
I have an old address label for the amnicators if anyone is
The address is Medical Wire & Equipment Co., Corsham,
SN13 9RT Telephone is (0225) 810361. Fax is (0225) 810153
The National Institute for Occupational Safety and Health (NIOSH) provides some information about oxygen tanks, aka Self-Contained Breathing Apparatus (SCBA)
There is also information about Explosions
and Fires in Aluminum Oxygen Regulators and Safe Practices
and Operating Oxygen Equipment
Air is air, but oxygen is not all the same oxygen, and oxygen is
air. It's your prerogative to not believe it, but I wanted
to the other replies here, because there are a LOT of students and
midwives here, and I don't want them to think that medical grade
is not necessary. I'm not sure how many sources and which
sources could help you to believe it, so right now, I'm speaking
students here. In some areas, they would have no problem
welding oxygen, but they may not be able to acquire medical
if they come away from here believing they're the same, there
trouble for a client or baby someday. Medical grade is
must be so for human use. So all you students, please keep
The medical grade has been purified, gone through an extra step
out the contaminants. If I'm pushing oxygen through a baby
apneic, I want it to be as pure as I can control.
Air is 21% oxygen and 79% nitrogen (approximately). What comes out of an oxygen tank should be 100% oxygen. The purpose of using 100% oxygen, of course, is for a person who is compromised for some reason and would be assisted with the higher percentage of inhaled oxygen i.e. to get mom's blood to a higher percentage of oxygenation so that a baby with a squished cord will thus benefit from this higher blood percentage. Normal blood oxygen percentage would be 95% - 100% so you see that if mom is normal at these percentages but baby is sinking into the 60 - 70% because of a cord cut-off or partial placental abruption and we put an O2 mask on mom which delivers 100% O2 - we thus boost mom's percentage up to maybe 200% - then baby benefits from the higher available supply.
You need an Rx for oxygen because because if oxygen at greater
50% is administered continuously for more than 24-48 hours - it
"oxygen toxicity" and lung damage (all oxygen and little nitrogen
the lung and alveoli can collapse).
This, of course, does not usually apply to midwives but makes the Rx a pain.
PS - you need a "nonrebreather" mask to deliver 100% O2 to mom
has a one-way valve so that when a person breathes out it opens
closed so that when a person breathes in - they are only getting
from the tank. Potential problem with this mask is that if
tank runs out, person can suffocate.) A regular "simple"
will deliver about 40 - 60% O2 and is usually best for midwives to
in discussing with my dh-(emergency room doc)welding grade oxygen
have contaminants, like lead, mercury, other gasses-it doesn't
go through testing such as flame spectrophotometry to prove
it is pure oxygen without contaminants.he feels strongly that it
to use on newborns-it could be contaminated with something as
as cyanide-the regulations are very loose and it is not necessary
the purity factor as it is not intended for use on humans. Simply
one has never had a problem and/or because a person working in the
business is willing to fill an oxygen unit- it does not make this
If you are a student midwife -- or a midwife who does only a few
=- and are having difficulty finding medical grade O2... I would
suggest going without it rather than buying welding O2. Rely on
-- your ambubag or m-to-m -- and wait the couple minutes for the
to show up with medical grade O2 rather than using a controversial
possibly contaminated substitute.
Oxygen cylinder sizes: Size C = 250 Liters Size D =
Liters Size E = 680 Liters
Oxygen - We get our oxygen refilled at a welding supply house and the guys there are always friendly and never ask any questions. Other midwives get prescriptions from friendly docs or CNM's to have their tanks filled at more standard medical supply houses.
So, anyone who knows whether or not O2 should be kept upright and
or not keeping it in my hot car is safe, please respond.
I sure hope keeping it in a hot car is safe, because there really is not any alternative when you have someone due soon. You have to keep everything with you when you run errands, and so on.
My brother, who transports welding gasses, says that the important thing is to make sure the stem on the tank will not bang against anything. That's why I really like my hard case (toolbox). I've heard of the stem being banged, and the banging causing a blast of oxygen. Aluminum oxygen tanks are a softer metal than the steel tanks, so the threads the stem screws into can leak if the stem gets banged around.
I have an old article that came from "The Farm", maybe Birth Gazette? that states that oxygen should be carried upright, and in a case that will protect the regulator as well as the tank from damage. I don't know about this "upright" part, since fire trucks etc., that carry many oxygen tanks have them all stored on their sides. Also, a lot of the bags, etc., that you can buy to carry the O2 are made to have the tank lying down.
In the book "Practical Skills Guide for Midwifery", under Oxygen
it states "...take care not to leave the free-standing cylinder in
upright position unattended. Make sure the cylinder top is not
ARM'S REACH: Bedside Co-Sleeper - A 3-sided crib that fits next to mommy's (and daddy's!) bed. it converts into a changing table AND a playpen as well! you can fold it up with a carrying case too, so you can take it where ever you go!
OK - I've often dreamed about having a portable ultrasound
I could whip out to make a positive diagnosis of posterior or
head positions, in addition to ruling out breech. Well, you
the SonoSite 180Plus for
or so. Maybe someday . . . Or, you can get the MySono
ObGyn for only $13,750, or, if you can live without the
probe, you can get the MySono
General for only $8950. Personally, I'm going to wait
of years and see if the price comes down!
Fetal Doppler - can hear fetal heart at six weeks???
Oils can damage the soft rubber (or elastomer) faces of ultrasound probes. Hard faced probes are not usually damaged by the use of vegetable or mineral oils but the cables to your probes will become brittle with time and crack exposing bare wires. In time, the oil will work its way down to the probe head, the transducer will start to corrode and eventually your probe will stop working.
Don't forget that you may also be exposing your patient to hazardous voltages etc while carrying out your routine examination.
KY-jelly is safe to use.
A rep. from Imex/Nicolet
sent me this copy: " Imex / Nicolet is one of the leading
of fetal Dopplers in
the world. We provided a broad selection of user features, including waterproof probes, to fit every need and budget. Our 30 day demo program allows you to try any of our products before you commit, thus optimizing your purchasing experience. Call us and compare. You will be very pleased with the results."
I don't know if any of you have used the "Sonicaid" hand held Doppler, but it is what I am ordering. It is a one hand Doppler, very sensitive, speaker can be on or off, with a volume control, and digital readout that calculates for you and helps determine good variability, and it is available waterproof, or non waterproof. I have used it in the tub, shower and elsewhere out of water at one of the birth centers I go to and love its compact size, one hand operation, ease of use, sensitivity and waterproof features. It goes for around 599.00 for non waterproof, and 699.00 for waterproof, I THINK BUT DON'T QUOTE ME ON THAT AS I HAVEN'T ORDERED IT YET. Available from:
Medical Systems Division
11526 53rd St North
Clearwater, FL 34620
I just called the company that has the Sonicaid Doppler, I posted
earlier, and they have a special Midwifery price of 599.00 for
and 499.00 for non-waterproof.
My current favorite is the Oxford, one piece, waterproof, built
and fetal calc. Costs about $750. Sonicaid 121 -- $495 for
The midwife we hired yesterday used aloe gel...what are you folks
I hadn't seen this before, though it was nice.
I've been using olive/almond oil for some time. i think the
MUCH clearer than with the Doppler gel, less staticky, and the oil
into moms tummy (doesn't stiffen up and get sticky like the gel
Was worried at first that it might somehow harm the Doppler, but
at all -- the head looks superb!
I used to use olive oil and it looked ok but the Doppler started
have problems and I found out that the oil had seeped into the
ruined it. So I would say don't use oil.
any viscous substance will work. The midwife I apprenticed
used the herbal massage oil - but then we were told by the Doppler
that the oil can seep into the Doppler head & do multiple
now, I use a hand cream - it is still thick enough not to seep
rubs nicely into mom's belly when done. I even received samples
(don't remember where) of hand lotion in a small bottle that fits
in my Doppler case - I can just leave it behind with that mom when
after her birth. So much nicer than Doppler goop.
I've been using arnica gel. Then we can just rub it into the
What kind of hand cream do you use? I would just rather use this
the Doppler gel. You always have to wipe it off and sometimes you
it. Plus in labor when listening to FHT's often it would be nice
it on and not have the mom put her hand there and get it all over
No particular brand - just find one that has a thicker
I usually use Doppler gel, but as far as I can tell, it's just
blue coloring. Anyone know what's actually in the stuff? Aloe gel
nice, but it would be more expensive. I would avoid oils or
lotions (i.e. the vast majority of hand lotions), as they can ruin
Doppler head, as someone mentioned earlier. If you have a Doppler
a hard plastic probe like Imex, it's probably not as important,
you have the kind that has that thin plastic membrane on the probe
like Parks, and I think most Medasonics, stay away from anything
oils in it. They're very expensive to replace.
I think the Doppler gel is different. One of the midwives I work with was out of Doppler gel, so filled up the bottle with K-Y, and at every birth we have a plugged nozzle on the bottle. The KY is also a lot more runny, dries up into little balls all over everything etc.
I HATE using KY on the Doppler.
I'm really sorry to hear that the lotion might not be such a good
I was really liking the sound of that!
My fiance, the industrial ultrasound engineer, says that most
gels are solutions of cellulose and water. He says the main
between the industrial and medical gels is the dye color used.
I would not use k-y on the Dopplers with the plastic cover on the
either. My preceptor (13 years ago) ruined her medasonics with k-y
it was so drying. It dries and flakes and will crack the plastic.
Several messages have been posted about gels for sonography. Here's my .02 worth.
In the 1970's mineral oil was the standard until manufacturers came out with delicate 1/4 wave matching layers on the front to the transducer to improve the noise to signal ratio (better pictures), which the oil destroyed.
Then the water soluble, non staining gels were developed. They are similar than K-Y, but I'm not sure they are exactly the same, but probably are. We often use sterile surgilube when called for, particularly with endovaginal transducers since there have been a very few reports of yeast infections following sonography (may have been coincidental, and not caused by, who knows). We did have infection control test some gel and they were able to grow cultures from it. The problem is many labs refill gel bottles, this is an accepted procedure. They also keep them warm, this is humanitarian. However, the warmth may promote bug growth. I have never personally seen any identifiable problems from this in 22+ years of experience, but the potential is there.
Of course, any liquid can be used as an air-tight coupling. Water is advised for endovaginal in fertility laboratories because the gels retard sperm motility. However, for transabdominal scanning, water won't stay where you put it, and is cool due to evaporation.
Now about Aloe gels, they seem nice and work well. The only objection to them is when they dry they leave a residue, sort of like dried mucus.
Not particularly attractive. However if you clean your equipment properly, this is not a problem.
Hand lotions can also be used. However, some contain alcohol or
solvents that might be damaging to transducer parts. At a
transducer you probably want to be sure the manufacturer approves
you use. The safest is to use gels designed specifically for this
Other wise your transducer may dry up and drop off.
Modern transducers use thin layers of material (1/4 wave matching layers) that have a rubbery consistency. The exact material is usually proprietary and manufacturers won't tell what it is, but they all claim theirs is best.
Mineral oil, alcohol, and other solvents will be absorbed, or
this layer. Many liquids will also penetrate into the crevices of
and loosen the glue that adheres the back-damping material to the
of the crystal elements. It is a good practice to look at the
transducer) in the air and observe the "ring-down" in the Fresnel
(near-field). Then press with your hand on the front and observe
the ring-down is reduced or not. Good transducers will not have
and pressing will reduce it only slightly more. If it doesn't
or makes it worse, then the transducer is probably cracked or the
material is loose.
I don't do US scans but do use a Doppler which is one purchased several years ago. I used to use KY Jelly with the Doppler as gel because it was so inexpensive rather than Doppler gel but was told by the Doppler company that even ky is different composition than the stuff produced specifically for use with Dopplers and could damage the probe. As my Doppler was already beginning to sound a bit staticky (I don't know if that is truly a word or the actual spelling but I trust you understand my meaning), I decided to just use the gel produced for this purpose and haven't had further problems since. However I notice that many other practitioners do use KY gel on the Dopplers, and even the little hospital where I sometimes do births uses KY on their FM transducer which surprised me. I also notice that the Dopplers where practitioners use lots of KY seem to produce more static, but maybe this is artifact as the Dopplers are older anyway.
So, I suppose my question would be is it true that using KY jelly
than aquasonic gel might damage the probe to Dopplers? If so, I
to be able to pass this on to the people I know who use KY on a
basis. I would never dream of using oil or lotion with my Doppler
it was an emergency. Too paranoid, I guess.
There's a set of vaginal weights that are used for women to
muscle tone. The weights are called StepFree and are
Timm Research Co. You can reach them at (800)
I heard they were selling for around $35 including S&H.
MILEX has vaginal cones - western div is 800-milex-12
Soon after the birth, we fill the family's washing machine with
water, 1 cup table salt and their regular detergent. As
we gather up the laundry with blood and/or meconium and put it in
agitating for a few minutes t work in the salt and
once it's all in, we agitate a little more, let it soak for an
then wash normally. This gets the blood out beautifully, but
work very well for the meconium.
Meconium was a huge laundry problem for me for a long time - I
all sorts of fancy enzymatic preparations made for pet
they worked very well, but they tended to smell awful! Then
told me that Tide has enzymes in it and should do a fine job, and
it does. Now I carry my own Tide and add that to the birth
and it all comes out really clean and smelling fine. I often
second rinse on the laundry because a lot of it will be re-used on
baby's skin, and we want it to be free of detergent residue.
I use liquid ivory dish soap - the clear variety. It works on
anything. I soak it into the spot and roll up the item and leave
a couple of days. Then wash with the rest of the laundry. Rarely
have success. This works as well for oil and grease splatters,
long as it is not straight blood - so blood mixed with amniotic
tomato stains, fruit stains, etc. In Canada, Ivory recently
"Dawn" except that the clear variety is still called Classic Ivory
is a little hard to find.
One of my clients recommended Bac-Out
Odor Eliminator - she said it worked fine on meconium with
her first baby; it's non-toxic and environmentally safe . . .
plus for a newborn! It's a lot less harsh than Tide.
NOTE - This section is out-of-date, and I am no longer adding
Arms' Reach Co-Sleeper - You and your baby derive many benefits from sleeping near each other. The Co-sleeper makes this easier for many families. (Recommended by Dr. William Sears and Martha Sears, RN, authors of The Baby Book.)
Breastfeeding & Attachment Parenting Products from NursingFamilyMagazine
Source for low-toxicity baby clothes and bedding
Buchic Bamboo Clothing for baby - bamboo is grown without pesticides and is remarkably soft, hypoallergenic and easy to clean. I love mine!
The truly hip and environmentally conscious baby will want to be wearing hemp diapers from hipHemp! or What's Hempenin' Baby?
A Collection of Sites about Natural Baby Products: cloth diapers, organic cotton baby clothing, layette, natural baby care, organic baby food
Organic Cotton Alternatives, with a special section on the Natural Nursery
shopping guide at Mothering
Magazine contains links to lots of natural and organic baby
There's also the NATURAL BABY CENTER, sponsored by Mothering Magazine!
The New Native Baby Carrier - organic cotton slings
Go Organic, Baby! offers hemp diapers. Now that's an idea whose time has come!
The Natural Baby Company, 816 Sylvia Street, 800 B-S, Trenton, NJ 08628-3299, (800) 388-2229
Diaper Reviews and DIAPER CATALOG GUIDE
Some parents are very enthusiastic about Indisposables (from
They do look like they'd work well. They're available only
individual distributors (or from a second-hand shop at
discount!). You may want to do a Web search for them, but
you an idea of the product.
can be a good source for patient education pamphlets aimed at good
Krames has an extensive list of patient education materials, including a Maternity section
They also maintain a
of additional external resources that support your patient
and health promotion goals.
Underwear are absolutely wonderful for postpartum
women. You use them as an outer layer to hold regular OB
does a great job of preventing any kind of leakage, so moms sleep
and they don't have the hassle of changing sheets or sleeping on
sheets. Unfortunately, this product is so popular that I
finding it on local shelves. I've found it online at drugstore.com.
The use of filter needles is new to many of us experienced midwives. Here's a nice powerpoint presentation that shows how to draw up meds from glass ampules and the use of filter needles on p. 40.
Aseptic Technique - Vials and Ampules
• To withdraw medication from ampule
By convention, these are used for injecting only, NOT for withdrawing. This is presumably because there might be different people drawing up the meds and administering them, and if you're the one doing the injecting, you can't really be sure what was used to draw up the meds.
However, in a single-person practice where the meds are drawn up
then used right away, it might make sense to use the filter needle
up the meds, rather than inject. This is especially true
available filter needles are of a higher gauge than one would
In particular, you might want to use something smaller than a 19g
for perineal repair. IDEALLY, get vials instead!!!
Craftsman Peter Fallon makes mahogany fetoscopes that are long
to reach from belly to mom's ears. domain: hotmail.com,
Harbor Scientific used to make a terrific little BirthWatch
it was a stopwatch that would record the 5? most recent
then could display the interval and frequency. Very handy
on top of those irregular contraction patterns. I don't know
A more recent incarnation of this idea is the
BirthWatch(r) maternity timepiece - estimated availability
or early December, 2001!
BirthWatch Products LLC, 4044-104 W. Lake Mary Blvd., PMB 328, Lake Mary, FL 32746, 1.877.698.5668
Corometrics makes a great **large** and easy to read gestational
wheel. They used to be free, but now they're charging for
Name Tag Jewelry - Work in an instititutional environment and need to wear a name tag? Here's a beautiful way to wear it!
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