----- 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...
