----- Original Message -----
Sent: Tuesday, August 13, 2002 9:03
PM
Subject: [ozmidwifery] OP babies
I have a question that will probably be seen as
a silly one to some (but remember I am a consumer so it is my right to ask
silly questions!) If one of the main reasons for cs is failure to
progress and fetal malpresentation AND a common factor with both these
'reasons' is a baby that is persistently in OP ... why doesn't anyone do
anything to correct this before labour?
Jo, there was a large research
study conducted in Sydney recently on OP positions. It concentrated on
ante-natal exercises to see if they could 'move' babies into a more optimal
position prior to labour. The results were a dismal
failure........
I know a large portion of bubs are OP
then turn during labour; but it seems like we have found that it is easier
to deal with it by cs or forceps rotation...why is it we don't try to avoid
the situation altogether?
Usually we need to wait to see if
the force of the contractions and the shape of the woman's pelvis will help
the baby to rotate. That's what we're looking for prior to c/s or forceps.
To give the woman's body every chance.
Very few women I have encountered were even
aware of the term OP or what the whole OP presentation involves (longer
labours more interventions etc). Why do we pregnant mums not get told during
ante-natal check ups what position bubs in? Why doesn't anyone check
when labour commences?
On your antenatal card there is
spot for 'presentation'. Usually it has hieroglyphics for the lay person in
it in the form of 'OA'. or ÓT' or 'OP" ( or LOA, LOT,LOP, ROA,
ROT,ROP). That is the position of the baby. Most practitioners start
documenting it from about 30 weeks.
A competent midwife/doctor
will always check the position of the baby when labour commences ( unless
you come in very late in the labour and it's all too difficult!). We need it
to tell us lots of things. Suggested length of labour, readiness of the
baby, potential problems.
I am aware of the optimal presentation booklet
and now try to encourage all women I come across to be aware of their
posture and to try swimming and sitting in positions as well as vertical
positioning during labour that will encourage bub to be OA ....but this
is AFTER I had a cs for failure to progress (8cm and stalled for 2 hours no
fetal distress- due to having a monitor on and being made to be supine...no
wonder bub did not turn himself!)
Good for you, keep trying,
it's better than doing nothing, and many midwives are able to offer other
practical ways of turning babies that are sometimes helpful.
And I agree wholeheartedly, flat on your back is the
worst position to labour effectively in. :-(
Remember this, the shape of
a woman's pelvis will influence her labour. a VERY rough triangle shape
where the pubic bone is at the apex, will allow the baby to rotate to the
anterior nicely. If she is shaped more like a man where the pelvis is more
oval shaped the baby will not rotate anteriorly too
easily.
I am curious why this seems to be something
that is ignored by mainstream but something that plays a major role in how
birth results as cs or ivd??
can anyone shed
some light??
I hope I've been able to help you
a little. I'm getting a little rusty now and others may have other ideas to
contribute I'm sure.
Cheers,
Robin.
Jo Bainbridge
founding member CARES
SA
email: [EMAIL PROTECTED]
phone:
08 8388 6918
birth with trust, faith &
love...