Sage Women

Habits:
An orthodontist will screen a child for the persistence of habits such as thumb-sucking, tongue-thrusting, mouth breathing and teeth grinding. In many cases, early detection and treatment can head off difficult problems later on. An example of this is a thumb-sucking habit-breaker that will stop and reverse the effects of a habit that can be much more difficult to fix later on.

Cross-bites:
An orthodontist will examine how a child’s teeth are fitting, and determine if a cross-bite exists. Most often, it is due to upper teeth being inside of lower teeth: in the front or back. At this stage, a cross-bite is usually much easier to fix: often with a removable device.

Crowding:
“Dad’s big teeth” and Mom’s little jaws,” will often lead to crowding of the new teeth: and an orthodontist will be able to recognize this early, and take steps to make the outlook for the permanent teeth brighter. An example is extraction of lower baby teeth, and a holding arch.

Mismatches Between Jaws:
An orthodontist will be able to tell you early if your child is headed toward an “overbite,” or an “underbite.” Often, early management of these conditions will make things easier later on. In certain cases, the eventual need for jaw surgery can be headed off with some early orthodontic treatment.

Other Developmental Problems:
An orthodontist will be able to detect early a vast array of other issues that may be brewing in your child’s mouth, often under the gums. These can include: missing teeth, extra teeth, oddly-positioned teeth and oddly-shaped teeth.  Addressing these issues early means much less trouble later on. An example of this is an extra tooth detected and removed, and some limited braces to head off a really tough situation later in the child’s life.

 An orthodontic screening at age 7 in the office of a Certified Specialist in Orthodontics may just save you and your child myriad problems before they become more difficult to address. Ask your dentist or hygienist for a referral, or check out the guide to orthodontists in the Yellow Pages. Your child can see an orthodontist without a referral from a dentist. It will make you, and your child smile!

R. Bruce McFarlane
DMD BScD MClD FRCD(C)
Diplomate: American Board of Orthodontics

PH: 204-947-1825
www.drmcfarlane.com

 
Sage Women
Many local moms-to-be are turning to midwives to guide them through pregnancy and birth.
By Lindsay Stewart Glor

In preparation for this article, I asked a number of women in my life to finish the following sentence: Birth is. . . The answers were varied, but one stuck out. It said simply: Birth is worth it. Whether the experience is joyful or touched by sorrow, filled with blinding pain or a sense of peace, every pregnancy and birth is dramatic and challenging, but the payoff is tough to beat.

To help guide them through this life-altering time, women turn to husbands, partners, mothers, friends and some kind of medical professional. While the majority of women in Manitoba enlist family doctors and obstetricians, a smaller percentage seek out the care of midwives. It was midwives who guided me through my recent pregnancy, birth and beyond, leaving me to sum up my own experience in this way: Birth is only part of the journey. Midwifery care begins during the first few months of pregnancy and extends into the sixth week postpartum. It offers a holistic approach to pregnancy and childbirth, with a focus on informed choice and continuity of care. And no, they don’t offer epidurals.

Having a caregiver who looked at pregnancy, labour, postpartum care, including breastfeeding, as equal parts of the birthing process appealed to Rina Ricci, who enlisted a midwife for the birth of her first child last fall. “It wasn’t about a medical procedure or one day,” she explains. “It was an experience that lasted nine months and more.” And with her parents living six hours away, Ricci says she was eager to find a more personal kind of care. “[My midwife] became like a surrogate mom to me at that time,” says Ricci. “I was alone and having a midwife felt like a security blanket, because I knew she would be there when I needed her.”

If you are interested in having a midwife, and are lucky enough to make it off of a waiting list* and into a waiting room, you will probably be paired with two to three practitioners from the same practice. This ensures that the people you build a relationship with will also—barring any unforeseen issues (or having a baby during Folk Fest!)—be the ones attending your birth. The hope is that by building a level of trust with their midwife, women will have the confidence to express their concerns, questions and expectations and go on to be active participants in the birthing process. “It will also make them less fearful of what is happening,” offers Winnipeg midwife Kelly Klick, “because it is happening ‘for’ or ‘with’ them, not ‘to’ them.”

Being confident also helps when faced with the myriad decisions that have to be made, from which tests to have done, to which positions to labour in. It’s all part of what midwives call “informed choice.” The idea of informed choice is central to midwifery practice, says Beckie Wood, president of the Midwives Association of Manitoba. “As a pregnant woman, you have choices to make about your own health care. With midwives, everything is presented to you with as much information as you want.”

This input can be empowering. “It felt like I was in control and she was just guiding me through it,” says Ricci. Taking the lead was also important to Paula Blair when she enlisted the help of a midwife for the birth of her second child. It was 2001 and new midwifery legislation had just come into effect. The new rules required all practicing midwives to be licensed, and also gave women the choice of having a midwife-assisted birth at a hospital or at home.

For Blair, the option of having a home birth was a major factor in choosing midwifery care. “Being in a medical environment didn’t seem like the right place for us,” she explains. “I feel it is best to surround yourself with people who believe in what you’re doing, who allow you to follow your own schedule without interrupting the process of birthing.”

For those who are experiencing birth for the first time, a midwife can be a lifeline of experience. “She knew where I needed to be soothed when I didn’t even know where I needed to be soothed,” offers Ricci. And even when birth plans go awry through medical complications, the decision to have an epidural or some other kind of medical intervention, the midwifery team usually remain involved and continue on to provide postnatal care. Six months on I can see my labour and delivery through a clouded rear-view mirror. It is instead the postpartum care that stands out. Having my midwife care for my daughter and I during her first six weeks of life was, for me, an immeasurable gift. And it is this period of aftercare that is most enthusiastically discussed when I speak to other parents. “She saved my life, there’s no doubt about it,” says Ricci, who dealt with stressful breastfeeding issues postpartum.

Breastfeeding is often the main focus during early home visits. “It’s an important part of midwifery care because  breastfeeding and bonding is so important to us,” explains Wood. “The first months of life are crucial to that baby’s
development.” Making sure a new mom is healing, both physically and emotionally, is also a key part of postpartum care. Thanks to a well-established relationship, midwives can often pick up on subtle clues that things aren’t going as smoothly as some new moms would like others to believe. For me, having a midwife offered knowledge, empowerment, security and reassurance that I needed. Others find what they require from obstetricians, family doctors, doulas, friends and family. This leads me to one last quote from a fellow new mom. “Birth,” she wisely writes, “is what you make it.”

*Why the wait?

For a woman who has decided she wants a midwife, it can be frustrating to be relegated to a waiting list. Unfortunately this is not an uncommon scenario. There are about 20 full-time midwifery positions in Manitoba and each of those women take 30 to 40 patients a year. So why not just hire more midwives? The answer is complex, offers Beckie Wood of the Midwives Association of Manitoba. Training programs, internship opportunities and position funding are all issues the association is tackling. However access to care isn’t just a problem in midwifery, but in maternity care in general, says midwife Kelly Klick. Indeed, a recent article in the Globe & Mail called the growing shortage of obstetricians in Canada a “looming crisis.”

GIVING BIRTH IS…

…not as painful as I anticipated. — Catharine
…exhilarating. — Tracey
…empowering, mesmerizing and astonishing. — Marianne
…pretty crazy! — Amy
…miraculous. — Jessica
…pushing the limits of pelvis geometry. — Barb
…empowering. — Chantal
…not what I expected. — Nina
…what you make of it. — Elana
…unbelievable. — Helen
…such a relief it’s worth the pain. — Lisa
…like falling fast and landing up on a soft and reassuring surface. — Mary
…the most unforgettable experience a woman can have. — Colleen
…worth it. — Kara