|November 9, 2016|
Volume 18, Issue 23
|Midwifery Today E-News|
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In This Week’s Issue
Now through November 19, you can save $20 on any order over $200. Or, save $10 on any order over $110. Shop early for Holiday giving and take advantage of this limited-time offer. To order
How can you normalize the breech delivery?
If you attend pregnant women, you need basic knowledge of the breech delivery. In Normalizing the Breech Delivery, midwives Valerie El Halta and Rahima Baldwin Dancy share their expertise in a clear, detailed manner. You’ll learn a Breech Scoring System to help evaluate risk, various positions for the mother in delivering a breech baby, the key points for diagnosing and delivering a frank breech and more. Perfect for midwifery training programs and self-study by both student and experienced midwives, this DVD is a must-have for every birth library. To order
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Quote of the Week
The bat hanging upside down laughs at the topsy turvy world.
— Japanese proverb
The Art of Midwifery
The path through the pelvis and birth canal that a head-down baby takes has long been recognized as being optimal if the back of the baby’s head is on the left and in an anterior or lateral/transverse position in the mother’s pelvis (LOA). Some babies, possibly influenced by the internal shape and structures of the mother’s pelvis, are born in different positions, such as with the back of the head to the right in the mother’s pelvis, in an anterior or lateral/transverse position or in a posterior position (ROA or OP). Babies, whatever their position, are guided by the internal structures, bones, muscles and ligaments of the mother’s pelvis, along with the movements both mother and baby make, working as a dyad from life in the womb to life in the outside world. These positions (ROA or OP) are unusual, not abnormal for birth and all are possible, though not necessarily optimal. Mother Nature intended mothers and babies to survive.
Three to four percent of all human babies at term (37–42 weeks gestation) are born body first, with the head coming after (breech position). There is still a clear path for these babies through the pelvis and birth canal. Tragically, in the areas of our world most influenced by the developed world, knowledge of the path taken by a baby in a longitudinal, but head-up position is rapidly being lost and major surgery is being used in the majority of cases.
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It is interesting that breech birth has become such a controversial issue. For centuries, it was considered normal and just another form of birth. It is surely something one needs extra training for and not something to be taken lightly. That is why we offer classes on breech birth at every conference. Babies can turn breech easily, so it is important to always be prepared for this possibility. Since most doctors no longer do breech birth, the medical world is losing its skill in the art of breech; the only option then is to have a cesarean or to find one of the few midwives willing to assist in a vaginal breech birth.
My dear friend Cornelia Enning, one of our conference speakers, does a class on breech in water because she says this is the best way to help breech babies. Cornelia says that breech birth in water is safer, in part because it improves fetal oxygenation by increasing uterine blood supply during immersion. Frank breeches need no special maneuvers because water alters the effects of gravity. Mobility of the mother in water allows better interaction of the baby through the pelvis and any maneuvers that may be required are easier in water. You can attend Cornelia’s breech workshop at our conference in Finland.
— 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.
We just finished the conference in Strasbourg, France, and it was an amazing event. It was so good that it makes me excited to be working on the Eugene, Oregon, conference that will happen this April 5–9, 2017, with the very special theme: The Heart and Science of Birth. With all of the information coming out about the microbiome, science is proving what we midwives and doulas have always believed! Among other things, the baby needs his mama, skin to skin, immediately after birth.
Whenever we are at a Midwifery Today conference, we network and make plans for the next conferences. It has become such an essential part of what we do. It is thrilling to get people together and spread the important information we are all learning.
We also have the dates and place for our next international conference. It will be in Helsinki, Finland. The venue is very special. It is on an island; to get there requires a 10-minute ferry ride from the pier in Helsinki. The island is a UNESCO site, as it was a fortress. Save the date: October 4–8, 2017.
Now that we are home from our international conference we are getting ready to offer online classes. Watch for notices with more information in E-News and on our website.
— Jan Tritten
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The Best Dream Ever: Otto’s Breech Birth
I woke up feeling tired and grumpy. By 8 pm I started having period-type pains, which came in irregular waves and were completely bearable, so I didn’t think much of them really.
My husband, Fin, fell asleep at about 11:30 pm and I tried sleeping, too, but couldn’t. I was suddenly really hungry and thirsty, so I went to the kitchen and ate some food and had a drink. The contractions were getting more intense, but still bearable—I really didn’t want to wake the midwives until I was completely sure that this was the real thing.
At around 1:30 am I asked Fin to get me a sick bucket and a hot water bottle. I think it was at this point that I realized this might be the real thing. I stayed in bed a while longer, just keeping calm and breathing through the contractions. I then got up and really needed the loo and had a huge contraction on the toilet. I was still breathing through them, but I started to get quite vocal and loud. I called Fin and he rushed out of bed and said, “Okay I’m going to call the midwives.” I remember thinking that I was making a bit of a pathetic fuss!
Just after 2 am I had two enormous contractions while standing up with my hands on the arm of the sofa. I was very vocal through these (read: “I shouted my face off!”). I was definitely on a different plane of consciousness and my body was taking over. When Fin was off the phone to the midwives he said he was going to call a cab so we could head to St. Mary’s Hospital for the birth, but after another big contraction I said, “You need to call an ambulance now!” I was still leaning on the sofa, and after the second big contraction I said to Fin, “This can’t be right—I am having urges to push!” One more contraction made me yell out, “I can feel something!” I put my fingers behind me and there was something, a bottom or maybe a leg, just starting to present itself. Fin got on the phone to 999.
I was now on all fours on the floor with my face on the sofa. It was at this point that another quite vocal contraction woke my 10-year-old daughter, and in the middle of a contraction, I became aware of her in the doorway. When that one was over, I didn’t want her to be scared (she wasn’t anyway!) and also I wanted her to feel part of things so I smiled and said, “‘Hi Star! Come and hold my hand!” which she did, although she was keeping a very curious eye on what was happening at the other end too!
The paramedics (five of them!) bundled into my flat and stood in a semicircle behind me. I had two contractions which pushed the baby’s bottom (still in the sac) out, but I felt it go back in again. I felt the bottom come out and go back in again twice, and it must have been during the second one that the sac broke and then the next contraction pushed the bottom out fully. The legs and torso followed, and then I felt the arms ping out one by one—a very odd sensation! Star said that seeing her brother’s body out while his head was still in was the coolest thing she’d ever seen in her life.
I suddenly realized that there were no midwives there to advise me whether to push with the next contraction or what to do, and I saw two paths ahead of me: either I could panic, tense up and try to push, or I could relax, trust my body and see what happened. The contraction, quite a mild one, came. I felt my vagina relax and get bigger to allow the head through, then close up when he was out. Otto Gaze-O’Brien was born at 2:33 am on November 9, 2010.
I had no stitches or anything. Bizarrely, it didn’t even hurt afterwards.
The paramedics passed Otto through my legs (I was still on all fours) so I could have a rather awkward cuddle. They tried to cut the cord straight away, but I refused, as I wanted it to stop pulsing.
Our midwife, Liz Noonan, arrived at our flat about 10 minutes after our baby was born, and Fin, Star and I sat on the sofa giggling like school children and asking each other, “Did that actually just happen?!” It felt like a dream—like the best dream ever. About 30 minutes after I gave birth to Otto, Star watched me squat to deliver the placenta. She said, “Mama, that was beautiful. It was…it was majestic!”
Read this article excerpt from Midwifery Today magazine, Issue 119, now on our website:
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