|March 2, 2016|
Volume 18, Issue 5
|Midwifery Today E-News|
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In This Week’s Issue
Learn about shoulder dystocia
Our 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.
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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.
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.
Join 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.
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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.
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
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FlipFLOP: Four Steps to RememberFlipFLOP 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:
The F in FLOP
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
The O in FLOP
The P in FLOP
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.
Read this article excerpt from Midwifery Today magazine, now on our website:
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