March 2, 2016
Volume 18, Issue 5
Midwifery Today E-News
“Shoulder Dystocia”
Subscribe
Print Page

In This Week’s Issue



Learn about shoulder dystocia

e-bookOur e-book, Shoulder Dystocia, features top-notch information from the brightest minds in natural childbirth. When you buy this book, you’ll be able to read articles such as “Shoulder Dystocia: The Basics” by Gail Tully, “Preventing Shoulder Dystocia” by Michel Odent and “How Being a Homebirth Midwife Enabled Me to Learn about Shoulder Dystocia” by Ina May Gaskin.

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



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

Look below for more info.



Quote of the Week

Growth is painful. Change is painful. But nothing is as painful as staying stuck somewhere you don’t belong.

Mandy Hale


The Art of Midwifery

By bringing the arm around to the baby’s chest, the midwife reduces the baby’s diameter. The midwife may need to continue to bring the arm out to make the baby’s girth small enough for an android pelvis’s outlet. Midwives have many successful techniques for freeing stuck shoulders, but let’s keep in mind that the arm on the chest side of the baby will help make all our treasured techniques successful.

Gail Tully
Excerpted from “Arm behind the Back: A Shoulder Dystocia Complication,” Midwifery Today, Issue 103
View table of contents / Order the back issue



Midwifery Today Conferences

Are you ready for Uncommon Complications?

Mary Cooper and Fernando Molina will present ways to help you be more prepared for uncommon complications such as unusual bleeding, thrombocytopenia, meconium, neonatal jaundice, hematoma formation, signs of embolism and more. Learn how to manage these while keeping the family and yourself calm. Bring your questions and cases to study.

Learn more about the Harrisburg, Pennsylvania, conference.



Fiji conferenceJoin Suzanne Thomson and Carol Gautschi as they share their knowledge of breech birth

Suzanne and Carol will start the class with a discussion of how to turn a breech baby and what to do if the baby won’t turn. Palpation skills, estimating fetal weight, amniotic fluid, and how to communicate with the baby will also be covered. Frank, footling and complete breech will be discussed, as well as cord prolapse, fetal heart tones, intrauterine growth restriction (IUGR) and other complications of breech presentation.

This full-day Breech Skills workshop is part of our conference in Suva, Fiji, 20–24 June 2016..



Do you like what you’re reading?

You’ll get even more content when you subscribe to our quarterly print magazine, Midwifery Today. Subscribe here.


Editor’s Corner

Shoulder Dystocia

This can be one of the most devastating complications. Ina May Gaskin has given the world one of the most helpful techniques to resolve this. She gleaned her technique from midwives in Guatemala. It is now called the Gaskin Maneuver, and it involves turning over to hands and knees. I used this on one of the first births I attended and I do believe it was a lifesaver. The senior midwife had just learned that her ex-husband had been killed and I was there with another student midwife who couldn’t get the obviously stuck baby out. The baby’s head didn’t rotate, it turned purple and it retracted against the perineum. I said, “Monika, turn over to your hands and knees.” She did and out came the baby. The “baby” is now married with her own daughter and she is still a good friend of mine!

Gail Tully has also contributed solutions to this tough complication. She uses a mnemonic based on the Gaskin Maneuver to prompt recall of a list of techniques to resolve most shoulder dystocia types. She shows how understanding pelvic layers can match techniques for rotation and reducing the breadth of the shoulder girdle.

Resolving shoulder dystocia is a subject you want to keep studying and practicing until what you do is part of your muscle memory. Someone’s life may depend on your quick action and knowledge. The overriding principal is to never, never, never give up.

— 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
Join Us for GOLD Lactation Online Conference 2016: April 11 – June 6, 2016
advertiserGOLD Lactation 2016 offers 25+ hours of accredited education by leading researchers through a convenient and economical online format! Speakers and topics are now online!

You’re invited to join us for our LIVE public Keynote Presentation on April 11: “More than just a Good Latch: Trifecta Approach for Breastfeeding Support” by Maya Bunik.

Space is limited! Reserve your seat today by visiting this page.


Conference Chatter

Your Birthing Toolbox

Do you have the tools to resolve shoulder dystocia in your birthing toolbox? If not, a Midwifery Today conference is a great place learn about procedures to resolve shoulder dystocia. Classes are presented at each conference in order to refresh your knowledge and experience regarding this challenging complication. Midwifery Today recognizes the need for the skills of dystocia resolution to be consistently offered at each event. The more you review the information, the more it will become part of your knowledge base on exactly what to do. This in turn will help you react quickly and with care, should mother and baby run into this hurdle.

The shoulder dystocia class at the conference in Harrisburg will be led by Gail Hart on Friday, April 8, at 1:30 pm. Not able to make it to the Harrisburg conference? No worries! Shoulder dystocia will be taught in Fiji and Strasbourg later in the year as well. Don’t let shoulder dystocia be the wrench in the cogs of labor. Register for a conference and continue to build your skills in natural childbirth.

— Oriona Turner, conference coordinator

Keep up to date with conference news on Facebook:


Please support our advertisers!
Become a Nurse-Midwife: Frontier Nursing University Accepts Registered Nurses with an ADN or Bachelor’s Degree.

Frontier Nursing UniversityFrontier Nursing University’s nurse-midwifery program is the longest-running midwifery program in the United States and is ranked by U.S. News & World Report as the #1 program. Through our distance education model, you can complete coursework online and clinical work in your own community. Earn a Master of Science in Nursing degree online today.

LEARN MORE



Featured Article

FlipFLOP: Four Steps to Remember

FlipFLOP is a memory tool listing four successful techniques to free a baby from shoulder dystocia, an emergency caused by one or both shoulders caught by the pelvis after the birth of baby’s head. In FlipFLOP, two well-known midwifery techniques combine with two effective obstetrical techniques for a step-by-step solution suited to helping an active birthing woman. In FlipFLOP, the four steps spell out the word flop like this:
  1. Flip the mom over with the Gaskin Maneuver
  2. Lift the Leg
  3. Rotate baby to the Oblique
  4. Bring out the Posterior arm

The F in FLOP
From Central American midwives, Ina May Gaskin learned that with shoulder dystocia, it is best to turn the mother over onto hands and knees. The success of this maneuver (and our love for the messenger) is revealed by the fact that this technique was named after Ina May and is now commonly called the Gaskin Maneuver. It is often the turning over onto hands and knees that frees the baby.

When a woman has been on hands and knees for the birth of the head, she has made the largest diameter for the pelvis, but a baby may still get stuck. Hands and knees won’t prevent every shoulder dystocia. The midwife needs to know that flipping the mother over to hands and knees, whether independently or with help, is the point of doing Gaskin’s—not being in that position already. If the mother is already on hands and knees with a shoulder dystocia, she can simply go on to the next technique in FlipFLOP: lifting her leg.

The L in FLOP
Lifting the leg puts the knee to the mother’s armpit and the foot flat on the floor (or mattress). This posture pulls open half the pelvis on the same side as the lifted leg. The mother looks like she may be in the starting position to run a race, so we call it Running Start.

The O in FLOP
Rotating the shoulder girdle of the baby into the oblique diameter of the pelvis was popularized by the insight of Woods in 1943. Later, Rubin reversed the direction of the dial, so to speak, to adduct the shoulders, thus reducing the diameter of the baby. I’ll discuss a hand placement that protects the baby’s bones from breakage.

The P in FLOP
Bringing out the posterior arm is an old technique that has recently gained much praise. With one arm out, the baby’s diameter is 20% smaller, and if the baby is still tightly impacted in the pelvic outlet, the baby’s anterior shoulder can be rotated 180 degrees and the other arm can then be brought out safely by the same technique.

Each of these techniques may succeed independently. But in this order, the least invasive actions, the Gaskin Maneuver and Running Start, put the mother in the most optimal position for steps 3 and 4, should they be needed.

Gail Tully
Excerpted from “FlipFLOP: Four Steps to Remember,” Midwifery Today, Issue 103
View table of contents / Order the back issue


Promote Your Product or Service Here

advertise in E-NewsFor as low as $100 per insertion for a text-plus-graphic ad, you can send information about your birth-related product or service to over 15,000 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 ads@midwiferytoday.com.



Featured Products

Read about shoulder dystocia management, techniques and experiences

MT store The Shoulder Dystocia Handbook will help prepare you for this complication. Authors include Marion Toepke McLean, Gloria Lemay, Gail Hart, Mayri Sagady, Sara Wickham and Jill Cohen. To order



How would your baby like to be born?

MT store 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



Midwifery Today Back Issues have the information you need!

MT online store From second stage and prematurity to birth change and natural remedies, back issues of Midwifery Today print magazine are packed with informative articles that will help you improve your practice. You’ll also find inspiring birth stories, birth news, poetry and stunning black and white photography. Choose from these available back issues.



Prepare your body for birth

MT online storeDaily Essentials: Activities for pregnancy comfort and easier birth features activities to balance your pregnant body. This DVD starts with “Daily Activities,” a gentle 35-minute stretch that will help you move more freely. Once you are comfortable with these movements, turn to the easy “Blooma Style” daily yoga routine, which pulls the stretches together into 28 minutes of flowing movement. Produced by Sarah Longacre, international prenatal yoga instructor and birth doula, and Gail Tully, the Spinning Babies Lady, Daily Essentials is perfect for expectant mothers and a must for any birth professional’s library. To order



Gain a fresh insight into the amazing journey each woman takes in becoming a mother

MT online store The Big Stretch DVD presents women in different stages of pregnancy as they prepare for a natural birth and reflect with their partners on how they are “stretched” in every way—emotionally, physically and spiritually. Topics explored include breath awareness, pain and the intensity of birth, body awareness, relationship and personal transformation, asking for help and women’s challenges. To order



Website Update

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

  • The Newly Born: Gazing and Human Development—by Sister MorningStar

    Excerpt: There is a sacredness and long-lasting physical, psychological and spiritual eventuality to newborn gazing. By spiritual, I mean the will or spirit of the human creature. How do we protect the moment of birth in relation to gazing, in relation to the undisturbed, uninterrupted search of newborn eyes for maternal eyes?


Give the gift of information
You’ll save $5 per subscription when you order two one-year Midwifery Today subscriptions at the same time. And one of these can be your own renewal or new subscription. Subscribe. Midwifery Today Magazine


Classified Advertising

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 ads@midwiferytoday.com


Manage Your E-News Subscription

To subscribe

Just go here and fill out the form:
http://eepurl.com/FKkBT

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 newsletters@midwiferytoday.com.

Learn your subscription status

If you are not receiving your issues, but have subscribed, contact newsletters@midwiferytoday.com 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
Canada$68$131
All other countries$75$145

E-mail inquiries@midwiferytoday.com or call 800-743-0974 to learn how to order.

Or subscribe online.

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.


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

Conference

Advertising

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: mtensubmit@midwiferytoday.com. Please send submissions in the body of your message and not as attachments.


Disclaimer

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.

© 2016 Midwifery Today, Inc. All Rights Reserved.


Midwifery Today: Each One Teach One!