May 27, 2015
Volume 17, Issue 11
Midwifery Today E-News
“The Pelvis”
Print Page

Welcome to Midwifery Today E-News !

The Power of WomenSave $5 on any one Motherbaby Press book

Check out our Spring into Savings page to find out how. Choose from The Power of Women, Brought to Earth by Birth, Survivor Moms or Placenta: The Gift of Life.

Midwifery Today Online Store

MT online storeBelly dance and pregnancy: A perfect pair

Learn how to do it with Dance of the Womb: A Gentle Guide to Belly Dance for Pregnancy & Birth. This 2-disc DVD set includes a 45-minute warm-up and six dance chapters that teach specific movements and their uses during labor. You’ll also see belly dance in practice during labor, as well as a beautifully filmed 50-minute homebirth documentary. To order

This issue of Midwifery Today E-News is brought to you by:

Look below for more info.

In This Week’s Issue

Germany conferenceCome to Germany this October!

Plan now to attend our conference in Bad Wildbad, Germany, October 2015. You’ll learn from teachers such as Robin Lim (pictured), Elizabeth Davis, Cornelia Enning, Gail Hart, Fernando Molina, Sister MorningStar and Michel Odent. Choose from a wide variety of classes, including Breech, Mexican Techniques, Shoulder Dystocia, Birth Positions and Organic Midwifery.

Learn more about the Bad Wildbad, Germany, conference.

Quote of the Week

To lose confidence in one’s body is to lose confidence in oneself.

Simone de Beauvoir

Are you enjoying your copy of Midwifery Today E-News?

Then show your support and get more content by subscribing to our quarterly print magazine, Midwifery Today. Subscribe here.

The Art of Midwifery

One of the midwife “tricks” that we were taught was to ask the mother’s shoe size. If the mother wore size five or more shoes, the theory went that her pelvis would be ample. Well, 98% of women take over size five shoes so this was a good theory that gave me confidence in women’s bodies for a number of years. Then I had a client who came to me at eight months pregnant seeking a home waterbirth…. She was Greek and loved doing gymnastics. Her 18-year-old body glowed with good heath, and I felt lucky to have her in my practice until I asked the shoe size questions. She took size two shoes…. I thought briefly of refreshing my rusting pelvimetry skills, but then I reconsidered. I would not lay this small pelvis trip on her. I would be vigilant at her birth and act if the birth seemed obstructed in an unusual way, but I would not make a self-fulfilling prophecy. She gave birth to a 7 lb girl and only pushed about twelve times. She gave birth in a water tub sitting on the lap of her young lover and the scene reminded me of Blue Lagoon with Brooke Shields—it was so sexy. So that pelvis ended the shoe size theory for me.

Gloria Lemay
Excerpted from “Pelvises I Have Known and Loved,” Midwifery Today, Issue 50
View table of contents / Order the back issue

ALL BIRTH PRACTITIONERS: The techniques you’ve perfected over months and years of practice are valuable lessons for others to learn. Share them with E-News readers by sending them to

Send submissions, inquiries, and responses to newsletter items to:

RSS Feed Subscribe to the Web Updates RSS feed to stay on top of what’s new or highlighted on the Midwifery Today website. Be alerted when conference programs go online, new articles are posted and more.

Editor’s Corner

Midwifery Today Around the Globe

Midwifery Today has always been concerned with changing birth practices internationally as well as at home in the US. From our first magazine issue, we have highlighted birth and midwifery from around the world. Every woman and baby deserves the best possible pregnancy, birth and first years no matter where they live. There is no country that fully embraces this truth, although some do more than others.

To carry out our beliefs during our 29 years of publishing, we have had international articles in each issue of Midwifery Today. We even started a separate publication, International Midwife, which we published for a few years.

We have done approximately 75 conferences, many of which were held in different countries, such as China, Japan, Jamaica, Costa Rica, Mexico, the Bahamas, Australia and all over Europe, with many more planned. We hope you will join us for one!

The goal for each international conference is to bring the best ideas and information delivered by excellent teachers. We also hope that each and every registrant is inspired to fan the flame of midwifery and keep it burning brightly. Then, hopefully, each attendee goes back to their country and spheres of influence to bring lasting change.

Midwifery Today magazine is now being translated into Chinese by a native Chinese midwife. Our hope is that our magazine will bring changes to China, where so many of the world’s babies are born! Coming this fall will be a digital Spanish edition of Midwifery Today translated by my friend and colleague Eva Darias. As the magazine is already being translated into Russian, this means Midwifery Today will be in four of the most-spoken languages!

— Jan Tritten, mother of Midwifery Today

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

Midwifery Today on Facebook
Midwifery Education: Caring and Sharing (Facebook)

Please support our advertisers
Buy Individual Suture Packets from!

eSutures is a discount distributor of brand name suture and surgical supplies at below market prices in quantities YOU choose. We stock over 1 million items, including Ethicon, Covidien, and Dermabond, all available INDIVIDUALLY. Why pay for more than you need? Visit our website or call 888-416-2409 for pricing and availability today.

Conference Chatter

2015 Germany Conference

From herbs and homeopathy with Lisa Goldstein to Spinning Babies with Gail Tully, the 2015 Midwifery Today conference in Bad Wildbad, Germany, promises to be our most enlightening and informative yet. Join Michel Odent, a leader in childbirth for over 60 years, for a full day of questions and answers on topics that concern you. Or watch and listen as the very skilled Angelina Martinez Miranda discusses positioning, remedies, techniques and customs from Mexico. Involve yourself in the magical process from conception to delivery with Fernando Molina and help a mother reconnect with her inner wisdom.

Register before 8 June to take advantage of the best discounts, and join our new Facebook group just for those who are going (or want to go) to Germany.

— Misha Hogan, conference coordinator

Keep up to date with conference news on Facebook:

Please support our advertisers!
Are You Interested in Being a Nurse-Midwife? Learn More about Frontier Nursing University’s Midwifery Program.
Frontier Nursing University

Frontier Nursing University’s nurse-midwifery program is the longest-running midwifery program in the United States, was the first to offer distance education, offers one of the only ADN-MSN online bridge options and educates more certified nurse-midwives than any other program in the country. The community-based distance education program allows you to complete your coursework online and clinical work in your own community.


Featured Article

Pelvic Trauma in Childbirth

How the body goes about getting a baby out is an extremely amazing feat. Seems downright impossible if you look at the size of a newborn baby and the size of the pelvis, especially the vaginal opening. What does make it possible is the way both the baby’s head and the mom’s pelvis are able to shift their sizes. The fetus’s cranial bones overlap to make it smaller, and the pelvic inlet and outlet are made larger by the movement of the pelvic bones as the baby passes through.

Most of the time in an uncomplicated birth this process goes about smoothly. However, if the pelvic bones aren’t able to move normally, then dysfunction can occur in the pelvis and the baby’s head gets greater than normal pressures on it as well.

The biggest issue I encounter in working with postpartum women is the lasting effect of abnormal tension in the ischial bones. These bones are not commonly addressed in standard postpartum care. The lasting effects on women with ischial dysfunction could be low back and hip pain, pelvic floor muscle weakness, prolapsing of pelvic organs and painful intercourse.

Our pelvis looks like one continuous ring of bone, yet different parts of the pelvis have different names. The pelvis is comprised of two big ilial bones, which are the broad, elephant ear-shaped bones that connect on either side of the sacrum in the back. This area of connection, where you see little dimples in the low back area on some people, is called the sacroiliac joint. If you were to put your hands on your hips at your waist, you have contact with the top portion of these ilial bones. When you slide your hands down the outside edge of these bones towards the midline of your body, where your buttocks connect into your upper thigh, this is the area where your ischia are located. When you sit down on a chair, the pelvic bones in contact with the chair are your ischial bones. In the picture of the pelvis, the ischial bones are that part of the pelvis that has a hole in the middle. The lower part of the ring of ischial bone goes forward to connect to your pubic bone that sits low in the front of your body, in the middle of your two groin areas. The bone leading from the ischia to your pubic bone is called your pubic rami.

During the first stages of labor, the upper part of the pelvis needs to widen to allow the baby’s head to enter into the pelvis. To do this, the top portion of the sacrum needs to move backwards while the lower part of the sacrum, the tailbone area, moves forward. This is called sacral counternutation. In the later stages of labor, the opposite sacral motion, nutation, needs to occur where the tailbone moves backwards, while at the same time the ischial bones widen out to the side. It is during the last part of labor as the baby is coming out that pressure may be exerted more on one side of the ischium than the other.

As a physical therapist, I understand the mechanics of the joints and muscles and what needs to happen for childbirth. Adding to that knowledge is a skill I have developed to be able to sense or feel what the tissues and bones have gone through during a birth or an injury.

As I have worked on postpartum women, I have felt many pelvic floors where the tissues are still twisting a bit from the baby’s head rotating to come out. The pelvis may be a bit twisted or rotated as well. Many times the baby’s head has contacted one ischium more than the other. Most of the time that ischium is still splaying out to the side more than it should be. Sometimes both ischia are still in that splaying-out position and need help coming back into midline again.

Lynn Schulte-Leech
Excerpted from “Pelvic Trauma in Childbirth,” Midwifery Today, Issue 104
View table of contents / Order the back issue

Featured Products

Learn about the pelvic exam

Maternal Exam for the Student Midwife, Part II, The Pelvic Exam, is a two-disc DVD set packed with information about various aspects of pelvic examination. You will see how to do internal, bimanual, rectal and speculum exams. Also covered are visualization of the external genitalia, palpation of the internal reproductive organs, and the procedure for collecting cultures from the cervix and surrounding tissues. To order

Maternal Exam for the Student Midwife, Part I, is also available.

book cover

What is Midwifery Today magazine?
A 72-page quarterly print publication filled with in-depth articles, birth stories from around the world, stunning birth photography, news, reviews and more. Subscribe. Midwifery Today Magazine

Discover belly mapping!
The Belly Mapping Workbook shows how a woman can discover her baby’s position in late pregnancy. This technique can be a fun bonding activity and is often used for proactive childbirth preparation using optimal fetal positioning. The workbook includes 100 drawings and photos that take you through details of head-down and breech babies. At just $14.95, it makes a fine gift for a pregnant friend! To order Belly Mapping Workbook cover

Bring breech birth information with you
wherever you go!
Breech Birth e-book cover

Download Breech Birth, a collection of 15 articles by some of the greatest minds in the natural childbirth world. Articles in this e-book include “Breech Birth from a Primal Health Research Perspective” by Michel Odent, “Instinctual Breech Birth” by Sister MorningStar and “Three Surprise Breeches” by Ina May Gaskin.

Available on Amazon or on Smashwords in a variety of formats.

How would your baby like to be born?
How Will I Be Born? In How Will I Be Born? Jean Sutton explains the principles of optimal fetal positioning in a clear and straightforward manner. Written for expectant parents, this book is packed with helpful advice and information, including an informative chapter on posterior position. A must-read for all pregnant moms and a book for the practitioner’s lending library. To order

Second Stage Handbook

Do you work with laboring women?

If you do, you need Midwifery Today’s Second Stage Handbook. This book explores how to best serve women at this crucial stage. You’ll learn from expert practitioners as they reveal their observations on when to push, what works and choices available for the mother. The Second Stage Handbook is part of the Holistic Clinical Series. Order the book.

Website Update

Read this article excerpt from Midwifery Today magazine, now on our website:

  • Crossing Borders with Andrea—by Sister MorningStar

    Excerpt: Andrea called me at my home in the US, and we discussed her experiences, her past, her feelings, the doctor’s actions and statements, Andrea’s desires, needs, people resources and her instinctual knowing. Andrea’s expected due date was November 24 and it was November 29 when she called me again. She spoke of her confusion with the medical way with birth and her own instinct that it should be a natural straightforward event. Fear dominated the birth stories that circled around her. “Every time I interact with the medical people, I become filled with fear. Otherwise, I feel calm.” Andrea decided to keep waiting.

Promote Your Product or Service Here
advertise in E-News

For as low as $100 per insertion for a text-plus-graphic ad, you can put your birth-related product or service in front of over 20,000 E-News subscribers from around the world. This is a great way to reach midwives, parents, childbirth educators, physicians, nurses, doulas and others interested in safe, natural birth.

Learn more here or contact our Ad Director at

Birth Q&A

Q: Do you use pelvimetry? If so, when and why or why not?

— Midwifery Today

A: Nope. Baby will either come out or it won’t. We can figure that out by laboring.

— Cheryl Gates

A: Nope. It does not tell us what the baby or pelvis will do in labor and during birth. Pointless and adds another element of fear to the process.

— Lisa Sulffridge

A: I wish I did. I met a postnatal mama this week who had been encouraged to go for a VBAC. She ended up with another emergency c-section. She told me her first baby never engaged; once she was kicked in the pelvis by a horse. It would have been nice to at least offer pelvimetry for this woman the first time around, not to mention the second time round. I know it’s seen as old-fashioned, and here in the UK it’s classed as an old science. Personally, I’d like to have those skills for special circumstances, not routine.

— Anouk Lloyd

A: Our practice offers this at 40 weeks as part of a vaginal exam; women can always decline. We wait till then so that we can assess the pelvis “when it matters” at the end of pregnancy when the pelvis has made the accommodations to pregnancy and had the full effect of the hormone relaxin. I don’t think that I would ever tell a woman that she should not try for vaginal birth based on the findings, unless it was pretty extreme. But it can be helpful to note pelvic shape to anticipate potential issues at birth. In CNM school, this was a required skill.

— Aubre Tompkins

A: I’ve offered suggestions to women of positions that allowed her to move the baby past a problem area based on pelvimetry. A coccyx that’s curved too deeply into the birth canal might have to break to allow the head by—usually a coccyx that was broken in the past. Whatever knowledge is gained should never be used to instill fear in anyone, including the birthing woman and the provider. I agree there are so many variables. Pelvimetry is not a panacea, just information.

— Kathy Berry

Classified Advertising

Busy West Texas Midwifery practice is seeking a CPM or LM. Will help with relocation fees. Joyful work environment, homebirth and birthcenter practice. Competitive pay. Please send resume to:

Tell our readers about your business. Just $48/issue ($135 for four) gives you 35 words to promote your products or services. Go here to learn more or write

E-News Subscription Information

Remember to share this newsletter—it’s free. You may forward it to as many friends and colleagues as you wish—just be sure to follow the copyright notice at the bottom of this page.

Manage your E-News subscription

To subscribe

Just go here and fill out the form:

Change your e-mail address

If you are a current subscriber and you want to change the e-mail address to which the newsletter is delivered, please click the “update subscription preferences” link at the bottom of any mailed issue and then make your changes.

If you are a current subscriber and want to stop receiving the newsletter, please click the “unsubscribe from this list” link at the bottom of any mailed issue and then make your changes.

If you have difficulty, please send a complete description of the problem, including any error messages, to

Learn your subscription status

If you are not receiving your issues, but have subscribed, contact with the address you used to subscribe and we will look into it for you.

Learn even more about birth.

Midwifery Today Magazine—mention code 940 when you subscribe.

 1-Year Subscription2-Year Subscription
United States$55$105
All other countries$75$145

E-mail or call 800-743-0974 to learn how to order.

Or subscribe online.

How to order our products mentioned in this issue:

Secure online shopping

We accept Visa and MasterCard at the Midwifery Today Storefront.

Order by postal mail

We accept Visa; MasterCard; and check or money order in U.S. funds.

Midwifery Today, Inc.
PO Box 2672
Eugene, OR 97402, USA

Order by phone or fax

We accept Visa and MasterCard.

Phone (U.S. and Canada; orders only):  800-743-0974

Phone (worldwide):  +1-541-344-7438

Fax:  +1-541-344-1422

E-News subscription questions or problems

Editorial submissions, questions or comments for E-News

Editorial for print magazine



For all other matters

All questions and comments submitted to Midwifery Today E-News become the property of Midwifery Today, Inc. They may be used either in full or as an excerpt, and will be archived on the Midwifery Today website.

Midwifery Today E-News is published electronically every other Wednesday. We invite your questions, comments and submissions. We’d love to hear from you. Write to us at: Please send submissions in the body of your message and not as attachments.


This publication is presented by Midwifery Today, Inc., for the sole purpose of disseminating general health information for public benefit. The information contained in or provided through this publication is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment.

Midwifery Today, Inc., does not assume liability for the use of this information in any jurisdiction or for the contents of any external Internet sites referenced, nor does it endorse any commercial product or service mentioned or advertised in this publication. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding any medical condition.

Copyright Notice

The content of E-News is copyrighted by Midwifery Today, Inc., and, occasionally, other rights holders. You may forward E-News by e-mail an unlimited number of times, provided you do not alter the content in any way and that you include all applicable notices and disclaimers. You may print a single copy of each issue of E-News for your own personal, noncommercial use only, provided you include all applicable notices and disclaimers. Any other use of the content is strictly prohibited without the prior written permission of Midwifery Today, Inc., and any other applicable rights holders.

© 2015 Midwifery Today, Inc. All Rights Reserved.

Midwifery Today: Each One Teach One!