Always pads aren’t always the culprit

I had a patient fall into my arms and sob recently because she was so relieved at the news I had given her.

Contrary to what it sounds like I hadn’t given her a reprieve from a fatal illness, or good news on her breast cancer screening. It was when I told her that the weeks of genital itching, swelling and pain she had been suffering from was likely caused by using Always brand sanitary pads.

I hate to point fingers but I have to put the brand name out there.

I’ve known for years that Always pads can cause painful chafing and irritation to the point of blisters in “that area.” Besides my personal experience I’ve read recommendations from other women and from midwifery groups warning women about the risk of burning, painful vulvas from using Always pads.

I am not making this up. There is even one small research study published in the Canadian Medical Association Journal that showed women with vulva pain had less pain when they stopped using Always pads.

The woman I mentioned at the beginning of this blog post had recently given birth so had been wearing pads for several weeks. She sought medical attention for what everyone thought was a yeast infection but the medication didn’t make her vulva any less itchy and painful. She was treated for bacterial vaginosis the next time she went in. That didn’t help either.

What finally gave her some relief was using diaper rash ointment and switching to cloth pads. At this point she still wasn’t blaming the Always pads, she was just looking for something really soft and gentle that wouldn’t hurt her sore bottom.

Before I went to see this woman for the first time my nurse filled me in on enough of her history to make me suspect that she was using Always pads.

“I think I may know what’s been going on with you,” I said as I entered the exam room. “Are you using Always pads?”

That’s all it took for her to break down and sob. She told me she felt like everyone thought she was crazy since she kept returning for the same problem and nothing was making it any better.

My patient asked me to tell her story. I agreed it’s a message women need to know. And since then I’ve seen several other women with similar experiences who turned out to be using Always pads.

To be fair not all women are bothered by these pads. And it’s easy to see why women love them – they’re the thinnest pads on the market.

Please don’t ask me what they’re made of because I would probably make up some  inflammatory, smart alec answer that would get the Proctor and Gamble lawyers really excited. I really have no idea what it is about these pads that are hurting women.

Proctor and Gamble, the manufacturer of Always, claims premarket research showed their product was not to blame for the vulvar irritation found in menstruating women but that women are always a little irritated in the nether regions (that may not be the exact wording that they used).

As a midwife I recommend postpartum women use some other brand of feminine hygiene pads since these women can have bleeding up to six weeks or longer. A big fat Kotex like the ones your mother used as a girl might be just what the midwife ordered. Cloth pads are a great alternative if you don’t mind that they’re not disposable. Instructions for making cloth pads are all over Pinterest. Let me know how you like them.

There are multiple causes of genital itching. Women should see a health care professional if they are having abnormal vaginal itching, discharge, pain or odor. Always pads aren’t always the culprit.

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A Midwife’s Horse Teaches a Lesson

We need to appreciate and love people for themselves.

I love reading about the pioneer midwives of the early West. The courage they displayed in spite of limited training and challenging circumstances inspire me to be a better midwife.

I came across this account written by the son of one of those early midwives, Julina Lambson Smith, where he shares a lesson about the need to appreciate and love people for themselves. I especially loved his boyish question about why so many babies are born at night and in the winter (what midwife can’t relate???).

When I was a boy, we had a horse named Junie. She was one of the most intelligent animals I ever saw. She seemed almost human in her ability. I couldn’t keep her locked in the barn because she would continually undo the strap on the door of her stall. I used to put the strap connected to the half-door of the stall over the top of the post, but she would simply lift it off with her nose and teeth. Then she would go out in the yard.

There was a water tap in the yard used for filling the water trough for our animals. Junie would turn this on with her teeth and then leave the water running. My father would get after me because I couldn’t keep that horse in the barn. She never ran away; she just turned on the water and then walked around the yard or over the lawn or through the garden. In the middle of the night, I would hear the water running and then I would have to get up and shut it off and lock Junie up again.

My father suggested that the horse seemed smarter than I was. One day he decided that he would lock her in so that she couldn’t get out. He took the strap that usually looped over the top of the post and buckled it around the post and under a crossbar, and then he said, “Young lady, let’s see you get out of there now!” My father and I left the barn and started to walk back to the house; and before we reached it, Junie was at our side. She then went over and turned the water on again.

I suggested that now, perhaps, she was about as smart as either one of us. We just couldn’t keep Junie from getting out of her stall. But that doesn’t mean she was bad, because she wasn’t. Father wasn’t about to sell or trade her, because she had so many other good qualities that made up for this one little fault.

The horse was as reliable and dependable at pulling our buggy as she was adept at getting out of the stall. And this was important, because Mother was a licensed midwife. When she would get called to a confinement somewhere in the valley, usually in the middle of the night, I would have to get up, take a lantern out to the barn, and hitch Junie up to the buggy.

I was only about ten or eleven years old at the time; and that horse had to be gentle and yet strong enough to take me and Mother all over the valley, in all kinds of weather. One thing I never could understand, however, was why most of the babies had to be born at night and so many of them in winter.

Often I would wait in the buggy for Mother, and then it was nice to have the company of gentle old Junie. This experience with this horse was very good for me, because early in life I had to learn to love and appreciate her for herself. She was a wonderful horse with only a couple of bad habits. People are a lot the same way. None of us is perfect; yet each of us is trying to become perfect, even as our Father in heaven. We need to appreciate and love people for themselves.

This lesson has always stayed with me—to see the good in people even though we are trying to help them overcome one or two bad habits. …

I learned early in life to love and not to judge others, trying always to overcome my own faults.

                                        Joseph Fielding Smith (1876-1972)

Should Pregnant Women be Concerned About Enterovirus D68?

News about Enterovirus D68 is spreading like the virus – quickly and with increasing coverage. And all this talk of children being hospitalized for respiratory illness is scaring people.

Moms are calling me because they’re concerned and are wondering how this affects them. They want to know the best way to protect themselves and their children from this once rare virus that is on the upswing.

To find out more about how this virus affects pregnant women I asked Dr. Michella Switzer, OBGYN with MomDoc Midwives in San Tan Valley what concerns she has for her patients during this outbreak. She says her main worry is for women who already have respiratory illness who may come in contact with the virus.

Dr. Switzer is encouraging pregnant women who suffer with asthma not to ignore worsening asthma symptoms but to see their midwife or doctor if they are exposed to the virus.

“If you have asthma and you come down with the enterovirus you need to come in right away and get your asthma under control,” Dr. Switzer says.

Children and adults with chronic respiratory conditions are at greater risk for more severe symptoms and hospitalization due to Enterovirus D68, according to the Centers for Disease Control and Prevention.

The virus is spread through respiratory secretions and travels from person to person when an infected person coughs, sneezes or touches contaminated surfaces.

Enterovirus D68 is a rare strain of a common summer illness that is usually mild in nature. If you’ve had a summer cold there’s a good chance that it was caused by an enterovirus. Most pregnant women are likely to be exposed to the illness but won’t contract the disease if they are already immune. Women who have previously had the virus will be immune to it.

So what if a woman has never had enterovirus D68 and is exposed during pregnancy. What then?

If women do become infected they typically do not get sick or only have mild symptoms such as runny nose, cough or sneezing, and can have fever and body and muscle aches. This particular strain occurs less commonly and has been reported to cause mild to severe respiratory illness, especially in children.

The good news is that there is no evidence that pregnant women who are infected with enterovirus are at greater risk for miscarriage, stillbirth, or birth defects.

If a woman is infected shortly before she gives birth she can pass the virus to her baby. However, newborns usually have mild illness, and only rarely is severe illness seen in these babies. Breastfeeding has been shown to reduce infection with enterovirus in infants mostly through maternal antibodies found in breast milk.

To protect yourself from the spread of enterovirus:

  • Wash your hands frequently for at least 20 seconds, especially after changing diapers.
  • Avoid touching your eyes, nose, or mouth without washing your hands.
  • Avoid hugging and kissing others who have symptoms or who are sick.
  • Don’t share drinks, utensils, or food with people who are ill.
  • Regularly disinfect toys, doorknobs, and all frequently touched surfaces, especially if someone in the household is ill.

To boost your immune system try these healthy living tips:

  • Increase nutrition including lots of fruits and vegetables
  • Get enough sleep
  • Don’t smoke
  • Exercise most days

Should pregnant women be concerned about enterovirus D68?

News about Enterovirus D68 is spreading like the virus – quickly and with increasing coverage. And all this talk of children being hospitalized for respiratory illness is scaring people. Moms are calling me because they’re concerned and are wondering how this affects them. They want to know the best way to protect themselves and their children from this once rare virus that is on the upswing.

To find out more about how this virus affects pregnant women I asked Dr. Michella Switzer, OBGYN with MomDoc Midwives what concerns she has for her patients during this outbreak. Her main concern is for women who already have respiratory illness who may come in contact with the virus.

Dr. Switzer is encouraging pregnant women who suffer with asthma not to ignore worsening asthma symptoms but to see their midwife or doctor if they are exposed to the virus.

“If you have asthma and you come down with the enterovirus you need to come in right away and get your asthma under control,” Dr. Switzer says.

Children and adults with chronic respiratory conditions are at greater risk for more severe symptoms and hospitalization due to Enterovirus D68, according to the Centers for Disease Control and Prevention. 

The virus is spread through respiratory secretions and travels from person to person when an infected person coughs, sneezes or touches contaminated surfaces.

Keep in mind that enterovirus D68 is a rare strain of a common summer illness that is usually mild in nature. If you’ve had a summer cold there’s a good chance that it was caused by an enterovirus. Most pregnant women are likely to be exposed to the illness but won’t contract the disease if they are already immune. Women who have previously had the virus will be immune to it.

So what if a woman has never had enterovirus D68 and is exposed during pregnancy. What then?

If women do become infected they typically do not get sick or only have mild symptoms such as runny nose, cough or sneezing, and can have fever and body and muscle aches. This particular strain occurs less commonly and has been reported to cause mild to severe respiratory illness, especially in children.

The good news is that there is no evidence that pregnant women who are infected with enterovirus are at greater risk for miscarriage, stillbirth, or birth defects.

If a woman is infected shortly before she gives birth she can pass the virus to her baby. However, newborns usually have mild illness, and only rarely is severe illness seen in these babies. Breastfeeding has been shown to reduce infection with enterovirus in infants mostly through maternal antibodies found in breast milk.

To protect yourself from the spread of enterovirus:

  • Wash your hands frequently for at least 20 seconds, especially after changing diapers.
  • Avoid touching your eyes, nose, or mouth without washing your hands.
  • Avoid hugging and kissing others who have symptoms or who are sick.
  • Don’t share drinks, utensils, or food with people who are ill.
  • Regularly disinfect toys, doorknobs, and all frequently touched surfaces, especially if someone in the household is ill.

To boost your immune system try these healthy living tips:

  • Increase nutrition including lots of fruits and vegetables
  • Get enough sleep
  • Don’t smoke
  • Exercise most days

 

 

 

 

VBAC Success Story

A beautiful mama had a successful VBAC last week and I was privileged to be there with her. As I handed the baby to his mama she began to cry. Now there are a lot of fantastic things about being a midwife but seeing the joy on a woman’s face when she does something she wasn’t sure she could do, something really hard and then she rocks it – that is so, so sweet.

I love it when a mother weeps at the sight of her newborn baby. It reminds me of when I first wanted to be a midwife – when I became a mother.

Way, way back in the olden days, when I was just a young slip of a thing I went to a rural Canadian hospital to have my first baby. I had read a lot about natural childbirth and totally believed I had the whole thing figured out.

On the morning that the contractions started I jumped in the shower, curled my hair, put on my makeup and waited in all my glory for my husband to get home from work to take me to the hospital.

I fully believed that in a few hours I would be holding my newborn in my arms, hair still curled back into Farrah Fawcett waves, makeup glowing. But no.

The nurses weren’t very impressed with what they found when they checked my cervix and they wanted to send me home. We lived a town away, a good 20 minute drive, which looking back doesn’t seem that far, but on a cold autumn Canadian evening the nurse just didn’t have the heart to do it.

So I stayed at the hospital that night and the next night I was still there. My friend’s husband was the doctor and she told me later that after dinner she told him he had better go see me. Although I had been contracting for over 24 hours I wasn’t making much progress.

He took my husband into his office and pulled out some big, fat textbooks to look up statistics and bell curves and there was talk about cesarean delivery and such, an option that wasn’t available except by ambulance ride to Calgary.

Meanwhile I had a ride on a gurney to get an x-ray of my pelvis. Remember this was in the olden days, before routine ultrasound. I had already snuck a look at my prenatal chart and read that I had a roomy, bony pelvis and the x-ray concurred – lots of room for a baby.

As it turns out, getting up and rolling around on an x-ray machine is exactly the kind of movement needed to get a baby moving into a great position to be born. I had a few agonizing contractions on the way back to my labor room and when I got there I headed straight for the bathroom. I needed to go!

That’s when I had a light bulb over the head moment: I had read this in the childbirth books. Feeling like you need to poop means you are fully dilated and need to push.

I asked the incredulous nurse to check me and when she did she wheeled me straight into the delivery room where I pushed out my 8 pound baby boy in two pushes (that’s how I remember it anyway).

If I live to be 100 years old I’ll never forget the feelings I had when I became a mother. The exhilaration, the relief, the happiness was so gratifying after all the pain. I was the strongest, purest, motherliest of mothers that ever had a baby. My babe was the most beautiful, sweet, good baby the world had ever seen. I loved him so much I couldn’t stop staring at him. I put him to my breast and the deal was sealed into a package deal. I was a new person, a mother, so full of joy I couldn’t sleep. Literally. For the next 18 months. But that’s another story.

Midwifery Mythinformation

In an effort to get the word out that our San Tan Valley MomDoc Midwives office is open and seeing patients I have been telling everyone I meet that I’m a midwife. 

Grocery checker: Did you find everything you need?

Me: Yes, thanks. I wanted to let you know I’m a midwife and that our midwife office is right here near the grocery store! We are going to start doing deliveries at Banner Ironwood starting October 1.

Grocery checker (looking unimpressed): I’m not having a baby.

Me: That’s okay. Nurse-midwives provide all kinds of women’s health care including annual exams and GYN care. Tell your friends!

Next stop — the bank.

Male bank teller: Hi, how can I help you?

Me: Did you know that there are soon going to be midwives delivering at Banner Ironwood Medical Center?

Teller: (Nervous smile)

Me :No? Our office is just next to yours, right over there. Here’s my card.

Teller: I’ll tell the other (female) tellers.

Most of my man on the street visits go more like this.

Me: Hi, my name is Karen, I’m a nurse midwife with MomDoc Midwives. My office is next to Banner Ironwood Medical Center where I’ll be doing deliveries starting in October.

Person: Wow, when my wife had a baby they didn’t let midwives do deliveries in hospitals.

Me:  Nurse-midwives deliver in many settings including home, birth centers and hospitals.

Other Person: I really wanted a midwife but I didn’t think I could have a baby without an epidural so I decided on a doctor.

Me: Nurse-midwives support women in their choice of pain control including epidurals, tubs, showers, IV pain medication and relaxation techniques. 

Other Person: I like the idea of a midwife but I wanted my insurance to pay for the birth.

Me: Today all 50 states require insurance companies to reimburse nurse-midwives for childbirth services. 

If you like the idea of a midwife but aren’t sure its right for you schedule a meet and greet appointment. This is a nonclinical appointment for you to ask questions and see how personalities work together. It may be the best thing you ever did. It was for me!

If you want to read more of the truth about nurse-midwives you’ll love this article by Frontier Nursing University titled Busting Midwifery Myths where they separate fact from fiction on this vital healthcare option for women.

 

Hey San Tan Valley, New Midwife Over Here

After decades of channeling Betty Crocker and Molly Mormon I went back to college and fulfilled a lifelong dream of being a midwife.

I’m pretty new to the San Tan Valley; I moved here to work as a certified nurse-midwife this past June. I have a great job providing prenatal care and women’s health in a clinic and helping mom’s give birth in the hospital. I still love to cook and decorate the house, I just don’t have as much time for it.

Outside of work I love being with my family (and a bunch of other stuff that I will talk about in future posts). I have four boys and four girls (yeah, I love babies). Most are grown up now and I am very proud of all of them and their families. I love to brag about my six grand kids and I tell everyone who will listen that I have two daughter-in-laws who have babies due within a couple of days of each other this fall. MIDWIFE HEAVEN!

Why I Became a Midwife
I became a midwife because I want to be with women when they become mothers. I gave birth eight times and had eight really different experiences. Giving birth helped me figure out that there are some things I do not want other women to have to go through if they can be avoided. I believe women should be listened to. I want all women to be treated with dignity and respect. I want women to have informed birth choices and options about birth providers.

I left a pretty sweet set up when I left Utah to move to Queen Creek, including living in an old stone church, a super awesome 90 year old neighbor lady (we did our best to solve the world’s problems during our weekly visits), and these guys, these guys, and her. God must really want me here to take me away from all of that.

Why I Am Loving It Here
I am thrilled to be here meeting the moms and babies of San Tan Valley. The weather here is unbeatable (I’m always cold so this is working out perfectly!). I’m working with some rock star midwives. The new neighbors were at our door within five minutes of our U-Haul pulling into the driveway and soon a crowd had us all unloaded. That kind of welcome gives me the feeling this is going to be a fantastic place to live.