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All About SIDS

7/15/2025

SIDS is the sudden, unexplained death of a baby younger than 1 year old. It's called "unexplained" because even after doctors do a full check-up, look at where the baby was sleeping, and review the family's medical history, they still can't find a reason for why the baby died. SIDS is the leading cause of death for children between 1 month and 1 year of age. Sudden Unexpected Infant Death (SUID) is a broader term that describes any sudden and unexpected death occurring during infancy, whether it is explained or unexplained. In the United States, about 3,700 infants died from SUID in 2022, 1,529 of those deaths were from SIDS.
What Causes SIDS?
Doctors and researchers don't know the exact cause of SIDS, but they have some ideas. One idea is called the Triple-Risk Model. This model suggests that three things need to happen together for SIDS to occur:
1. An "at-risk" baby: This means a baby has a hidden problem, like a brain difference or a genetic change, that no one knows about.
2. A special time in the baby's growth: This is usually during the first 6 months of life when babies are growing super fast and their bodies are learning to control things like breathing and heart rate.
3. Things in the environment that cause stress: These are outside things like sleeping on their tummy, getting too hot, or being around cigarette smoke.
Scientists believe that if only one or two of these things are present, SIDS might not happen. But when all three happen at the same time, the chances of SIDS are higher. Since we often don't know if a baby has a hidden problem or when they are in that "special time of growth," the best way to lower the risk is to remove or reduce the environmental stressors.
Ways to Reduce the Risk of SIDS
• Always put babies to sleep on their back.
Once a baby can roll over by themselves from back to stomach and stomach to back, you can let them stay in the position they choose after you've put them on their back to start.
• Avoid overheating.
Dress the baby in layers, and generally, no more than one layer more than an adult would wear to be comfortable. Watch for signs of overheating like sweating or flushed skin.
• Avoid smoke.
Exposure to smoke is a huge risk factor for SIDS.
• Breastfeed your baby.
Breastfeeding can reduce the risk of SIDS. Any amount of breastfeeding helps, and the longer you breastfeed, the more protection there is.
• Don't rely on home monitors for SIDS prevention.
Devices that monitor a baby's heart rate or breathing at home haven't been shown to reduce the risk of SIDS.

The “Back to Sleep” campaign was started in 1994. Since the campaign started, the number of newborns sleeping on their back has tripled, and the rate of SIDS has been cut in half. The dramatic decrease in SIDS as more newborns are sleeping on their backs shows that what position newborns sleep in is a big key in preventing SIDS.

Sources:
https://www.nichd.nih.gov/health/topics/factsheets/sids
https://safetosleep.nichd.nih.gov/reduce-risk/back-sleeping
https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022?autologincheck=redirected
https://journals.lww.com/jaapa/Fulltext/2018/11000/Preventing_sudden_infant_death_syndrome_and_other.3.aspx
https://pmc.ncbi.nlm.nih.gov/articles/PMC8424793/
https://pubmed.ncbi.nlm.nih.gov/34496779/
https://www.eurosafe.eu.com/measures-to-promote-a-safe-sleeping-environment-and-to-reduce-the-risk-of-all-sleep-related-infant
https://www.cdc.gov/sudden-infant-death/data-research/data/index.html

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Alternative Uses for Midwifery Tools

7/1/2025

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I have a lot of tools and gadgets that I use as a midwife. While they are invaluable to my midwifery practice, some of them can also be handy for other purposes.

Here are just a few of the ways I have found some of my midwifery tools to be useful for more than midwifery care:

Chux pads are great for protecting surfaces when you know what you are doing can or will make a mess. My husband’s favorite use for Chux pads is to protect the garage floor when he’s doing an oil change. I have used them when I’m doing something in the kitchen that has the potential to be quite messy like pitting cherries.
Birth pool mirrors can be useful for seeing things inside a car engine bay or on motorcycle engines. I found it invaluable for putting colostomy bags on during my colostomy phase of life.
Infrared thermometers can be used to check oven or freezer temperatures.
Stethoscopes can be used to pinpoint where a noise is coming from, handy if you are hearing a new noise in your car. I’ve also used my stethoscope to get a heart rate on my cat.
Hemostats are a clamp often used to clamp blood vessels. If an umbilical cord tears during birth (rare but it can happen), I would clamp it with a hemostat. My husband has his own set now to clamp hoses on cars and motorcycles.
I’ve used my scale and sling to weigh a cat.
I have started using nitrile gloves when working with jalapeno peppers, onions, as well as car and motorcycle repairs or maintenance.

Using some of my midwifery tools for more than midwifery aligns well with the adaptability and outside the box thinking midwifery demands, not to mention making some of the things I do around my home a little easier.

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Swelling During Pregnancy

6/15/2025

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What can cause it?
Swelling or edema can be caused by impaired blood circulation related to an enlarging uterus and baby. Sometimes baby can be positioned in such a way that blood flow is not optimal. It can also happen as a result of being in one position too long. Diet can affect swelling: a diet low in potassium, a high level of caffeine intake or a low salt diet during pregnancy can all lead to swelling. Even the weather can contribute to swelling, warm and humid temperatures can increase a tendency towards swelling. It can be a normal part of later pregnancy for many women. It is common for ankles and feet to swell as pregnancy progresses, especially on days when you are on your feet a lot or when temperatures are warmer.
Other reasons include:

Increased fluid volume: During pregnancy, your body produces approximately 50% more blood and other body fluids. This extra fluid is essential; it helps create the amniotic fluid, cushions your baby, supplies nutrients, and prepares your body and pelvic joints for delivery.

Hormonal changes: Pregnancy hormones cause your veins to become more relaxed, making them less effective at returning blood to your heart and kidneys.

Pressure from your growing uterus: As your baby and uterus expand, they put pressure on the veins in your pelvis and legs. This pressure can reduce or slow blood flow back to your heart, causing fluid to leak out of blood vessels and collect in your lower limbs.

Gravity and lifestyle factors: The extra water in your body tends to gather in the lowest parts, especially if you've been standing a lot or if the weather is hot. Long days of activity, a diet low in potassium, or protein can also affect swelling. You might notice your shoes feel tighter and rings are harder to remove as you get closer to delivery.

What are the signs that swelling is normal and not concerning?

Swelling develops gradually.

Swelling primarily affects the lower limbs (legs, ankles, feet).

Worsens at the end of the day or after prolonged standing.

Improves with rest or by elevating your legs. You may find that swelling resolves after sleeping all night.

What can I do to reduce pregnancy swelling?

Elevate your feet and rest.

Stay active with light exercise: Regular walks can improve blood circulation and reduce swelling.

Hydrate Adequately: It might seem counterintuitive, but drinking plenty of water (8-10 cups daily) can actually help reduce swelling by flushing out excess sodium and fluids from your body.
Increase potassium intake. Foods rich in potassium include bananas, oranges, papayas and figs.
Increase protein intake.

Choose comfortable clothing and footwear: Wear comfortable shoes and socks, avoiding anything with tight straps or anything that might pinch if your feet swell. Loose clothing, particularly around the legs and waist, can aid circulation.

Consider compression stockings: These can gently squeeze your legs, promoting blood return and reducing fluid buildup. Put them on in the morning when your lower leg swelling is decreased.

Immerse yourself in water: Soaking your feet in warm water with Epsom salts, or immersing your body in a deep bathtub or swimming pool, can help hydrostatic pressure push fluids back into your veins for excretion by the kidneys

Massage therapy: Massaging your feet from toes to heels to ankles can help.

Avoid prolonged standing or fitting with feet dangling. Take breaks, change positions and get off your feet..

Minimize outdoor time in the heat since hot weather can contribute to swelling.
Chiropractic care can help with alignment which can help reduce swelling.
Applying cold compresses to areas with swelling.
Avoid wearing heels.

When should I be concerned about swelling?
If you experience any of the following symptoms, you should contact your medical provider immediately.

A sudden increase in swelling, especially in your face, hands, or one leg.

A very bad or severe persistent headache that doesn't go away with rest or medication.

Problems with your vision, such as blurring, flashing lights, or seeing spots.

Severe pain just below your ribs or upper abdominal pain.

Pain in your back just above your hip bones.

These can be signs of pre-eclampsia which is a very serious condition that requires immediate medical attention.

Sources:
Davis, E (2012). Heart & Hands: A Midwife’s guide to Pregnancy and Birth (5th ed.) Ten Speed Press
Frye, A. (2008). Holistic Midwifery, Vol 1. Portland, OR: Labry’s Press
Sinclair, C (2004). A Midwife’s Handbook. Elsevier Ltd
https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/swollen-ankles-feet-and-fingers/
https://www.medicalnewstoday.com/articles/preeclampsia-swelling-vs-normal-swelling
https://midwivesofnj.com/feeling-puffy-10-ways-to-reduce-swelling-in-pregnancy/
https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/swelling-during-pregnancy/
https://share.upmc.com/2022/03/is-swelling-during-pregnancy-normal/

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Another Health Update

6/1/2025

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One year and 8 days after being placed, my colostomy was successfully reversed!!

Just as I encourage my clients to prepare for labor, birth and postpartum, I did some things to be ready for surgery.

I literally trained for this surgery. I lifted heavy weights three times a week, did zone 2 and HIIT cardio, as well as walking at least 5 miles each day.
I worked on increasing my daily protein intake.
I prioritized getting good sleep.

My doctors and nurses were impressed with how well I could move after surgery. My home health nurses are amazed at how quickly the wound where my colostomy was is healing. I am taking the advice I give clients for the postpartum period. I continue to focus on eating lots of protein and resting well. I am being very mindful to gradually ease back into my normal routine, while listening to my body to make sure I’m not doing too much too soon.
I will continue to focus on recovering well so I can get back to the work I love while serving the most wonderful clients I could ever ask for.

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Birth Pool Considerations

5/15/2025

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As you are looking at what you want for a home birth, using a birth pool for labor and birth is a great option.There are a few things you should be aware of when considering what’s involved in using a birth pool.

Is there enough space for a pool?
The birth pools I use take up a fair amount of space, 65 inches by 57 inches. That is about the size of a kitchen table with one leaf in place.

Is the floor strong enough?
Thinking through where you will put a birth pool is important. Birth pools can weigh a lot once they are filled with water and Mom gets in the pool. The birth pool I have available for my clients holds 127 gallons of water when it is filled to the appropriate level. That means when it is full, it weighs 1017 pounds before Mom gets in.

How much access does the midwife need?
Another thing to consider is how much access to the pool does the midwife need? Does she need access from all sides or just two or three sides? You might need to move furniture, or use a different location than originally planned.

What is needed to fill the pool?
You will need an unused length of hose that can go from the faucet you plan to use to fill the tub to wherever the pool is set up. You may need an adapter between your pool and the hose to connect it. Clients in my practice have used kitchen sink or bathroom sink faucets, as well as showers.

Once it's filled, how do we keep the water at the right temperature?
TThe most common way is to have large pots of hot water on the stove ready to use, bailing some water out of the pool and replacing it with the hot water. If you use this method, be mindful to mix the hot water in with the existing water and not to pour the water on Mom or helpers while adding it. There are submersible heaters, but these seem to be questionably effective, and you often have to be mindful not to let them come in contact with pool surfaces.

Does the water need to be sanitized?
If you are using tap water, there is no need to add anything to the water to sanitize it. If the pool is up for longer than 24 hours, or you want to be cautious, you can add two cups of regular salt to the water.

How does the pool get emptied?
You can create a siphon the old school way by sucking on the end of the hose until pool water reaches the end and then letting the water continue to flow by keeping the hose end lower than the water level (I don’t recommend that). You could use a siphon pumps to empty the pool. Don’t forget to make sure your hose is long enough to reach where you want the water to drain, whether that is a toilet, or outside in a flower bed etc.

What other considerations are there to be aware of?

Pets. Claws can quickly puncture the birth pool if your pet tries to jump on the sides of the pool, or get into the pool
Children. Birth pools when filled are a drowning risk, so you need to be mindful of that when using a birth pool with little ones in the home.

Hopefully this helps you think through what is involved in using a birth pool. With a little planning, portable birth pools are very easy to add to your birth plan.

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All About SIDS

Alternative Uses for Midwifery Tools

Swelling During Pregnancy

Another Health Update

Birth Pool Considerations

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