resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
December, 2008, Vol. 08, Issue 12
In Honor of a Doula
By Elaine Stillerman, LMT
Doula (doo-lah) is a Greek word that means "servant" or "handmaiden." Doula also refers to the compassionate labor coach who supports, advocates, nurtures, massages and protects a laboring woman from her first contraction until after her baby is born.In childbirth, the presence of this highly skilled, nurturing professional can completely change the labor experience for the better.
When we were still living in close-knit communities, it was common practice for the friends and family of a laboring woman to assist the midwife or doctor (when they still made house calls) during birth. But as we moved into urban and suburban areas, away from rural traditions, we moved away from this intimate circle. Women found themselves giving birth in hospitals without the support and assistance of anyone other than their partners - that is if the hospital permitted her to have that essential companionship. Fortunately, a labor doula and (for postnatal care) a postpartum doula fill the role of the community of women and provide the emotional and physical support that a laboring woman needs.
The labor doula is not part of the medical team. She doesn't deal with medical issues and unlike the obstetrician or midwife, she doesn't catch the baby. She is there for the duration to keep mother calm, relaxed, comfortable and focused on the task at hand.
In a controlled study conducted at a public hospital affiliated with the Baylor College of Medicine, women who labored with doulas had C-section rates of 8 percent as compared with 18 percent for women without doulas. The need for pain medicine dropped from 55 percent to 8 percent and labor was shortened by two hours when a doula was present. In addition, neonatal hospitalization dropped by half. These doulas recorded that on average, they touched the woman 95 percent of the time, as compared with less than 20 percent by male partners.1
Five studies conducted in Guatemala, Canada, the United States and South Africa confirmed that the presence of a labor doula reduced the need for surgical deliveries, shortened labor time and reduced prenatal and postnatal complications.2
At Jefferson Davis Hospital in Houston in 1993, 600 women who had never carried a pregnancy to term were divided into three groups: a control group, an observed group to measure the effects of a passive observer, and a group actively supported by a labor doula. The doula group had the following results as compared to the control group:
So, what exactly does a doula do? To give you an idea, let me tell you about my doula, Ilana. I knew Ilana professionally for years before I worked with her as a laboring mother. She was among the better known and most sought-after labor coaches in New York City. She founded the Metropolitan Doula Group (MDG), which is an organization that provides skilled doulas in the New York area. The MDG also conducts classes for its members and brings doulas into hospitals for women who can't afford them. They believe that no woman should labor without the support of a doula, and money shouldn't be the determining factor. During the 9/11 crisis, the MDG sprang into action by providing doulas for any laboring woman in a hospital, birthing center or at home who wanted one free of charge.
I called Ilana when I became pregnant. She came to my home to interview me and my husband about our hopes for the big day. Ilana took copious notes in the attempt to get to learn my likes, dislikes and what would be most helpful during labor. She gave us a realistic list of items I would need to make my labor more comfortable. Since then, I have provided my clients with that invaluable list and offer it in my textbook.
When the day came, Ilana had just returned from another birth she had stayed at for 13 hours. She had been home for two hours when I called. "Don't worry," she said, "I'm on mommy time." My water broke and I went into active labor within minutes. The contractions were coming one after the other. She asked to hear a contraction. Did this mean put the phone on my abdomen? Or did she want to hear the sounds I was making? By this time, all rational thought was out the window. "What?" I asked. "Let me hear a contraction," she repeated. Mine were silent. "I'll meet you at the hospital."
Once there, she directed my husband to get a different nurse and a private room for me. She disappeared for a few minutes and came back with a pile of waterproof pads and clean gowns. She opened her bag of goodies and asked if I was hungry or thirsty. And she held me. She massaged me. She danced with me. When the pains got intense, she took my face in her hands and said, "Give me the pain. Give it to me." And the pains lessened.
When I felt I was losing strength, she told me to relax my feet and let Mother Earth's power help me. She stayed by my side for 19 hours, encouraging me, honoring my efforts and nurturing me. And when my son was born, she told me how magnificent I had been. A week later, Ilana came to my home for a visit, bringing lunch, gifts, pictures and my birth story. We shared a life-affirming experience and I wasn't going to let her out of my life since she had been such an important part of it.
But life sometimes has other plans. In a cruel twist of fate, Ilana got ovarian cancer and lost her four-year battle last month. Her family and friends showered her with the same unconditional support she provided to the hundreds of new mothers she cared for and the countless doulas she taught. Ilana was all about giving, respecting and honoring a woman's efforts. That's a doula.
Click here for previous articles by Elaine Stillerman, LMT.
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