Monday, February 01, 2010

what's in a midwife's bag?

A midwife sent a message to her colleagues who are members of a national email list, asking for people with experience to provide her a list of helpful herbal tinctures which may come in handy at a birth.

There were various responses, which can broadly be categorised into those who 'do' and those who 'don't'. Since I'm in the 'don't' group, I'll share my comments here. Readers are welcome to share your thoughts on the topic too.

  • Can I ask why a midwife would take herbal tinctures? If birth is not an illness, why do some midwives come along with a bag of 'medications', even if they are herbal or homeopathic or natural? 
  • Of course a lot of my clients use natural remedies, and in most cases I don't see any harm in them. But there are times when I ask a woman to stop looking for remedies - whether naturopathic, or even a tub of water - and get on with the job.
  • Midwifery is about being 'with woman' rather than being a therapist of any kind.
  • Herbals can have alkaloids and other substances that have very real effects on the function of the human body. Many mainstream drugs were herbals once upon a time.  Unless the product is well tested for its potency and dose rate, it could cause unintended harm.
  • Other 'natural' therapies, including homeopathy, may have a placebo effect, without having a direct medicinal effect.

My thinking on this topic has been influenced by Maggie Banks in Home Birth Bound: mending the broken weave, Chapter 9. She describes 3 traditions of healing: the scientific, the heroic, and the wise woman tradition. Of course life is not black and white in any situation, and as a midwife there will be times when I use the scientific (as in collecting cord blood and administering anti-D to a Rhesus negative mother), and times when I reach (in a small way) for the heroic modalities (such as vitamin B6 supplement for fluid retention); but underpinning it all is the wise woman tradition - the knowledge and skill of working in harmony with normal physiological processes.

I will not attempt to present the case for those who 'do' use alternative medicines as part of midwifery practice.  It's a complex and fascinating field of study.  Some midwives have studied aromatherapy, homeopathy, reiki, herbal medicine, crystals, meditation, and various physical therapies (to mention just a few).  At the end of the day the midwife's skill is in promoting health and harmonising her own life with that of the labouring woman, with the intention of supporting and protecting wellness in birth.

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