----- Original Message -----
Sent: Tuesday, June 10, 2003 2:47
PM
Subject: Re: [ozmidwifery] Episiotomy -
when to cut?
oh, arent protocols cruel???? everything is wrong
for her there, Jo. As Nikki says, pushing at her own pace and in a
position that allowed gravity to help all help.IN the position you describe,
she's actually pushing uphill, with the coccyx being sat on which reduces
available space and her body and lungs are all compressed. I guess the
protocols also dictated that she must start pushing from the minute 2nd stage
begins? So she's dead exhausted when the head finally hits the peri? And has
no energy to actually slow the head down during it's exit?
I have found that slowing the head down even just
by a contraction or two helps enormously. It allows the surrounding tissues to
accomodate this sudden insult. Let the head spend more time stretching the
perineum, and let the head be just breathed out, rather than pushed
will go a long way to achieving a gentle exit. If we're exercising
we dont achieve maximum stretch the first time we try the splits. We get
better with each little effort. In a compact way this is the same with the
peri. If the women are told ( both during labour and very gently and
encouragingly at the time) they understand that it will be beneficial to them
afterwards and usually are very keen to help themselves. Heat applied to the
peri and birthing in water also help this scenario.
The stranded beetle position you describe Jo,
will be ingrained on you forever as you learn first hand the horrible
effects it has on women. I cant think of one good thing about it.
Robin
----- Original Message -----
Sent: Wednesday, June 11, 2003 12:55
AM
Subject: Re: [ozmidwifery] Episiotomy -
when to cut?
Hi Nikki.
As most women are where I work, she was
semi-sitting; she was "chin on your chest, big breath, PUSH, quick breath
and push again!" style pushing; and she was not following her own urges -
that would have taken too long! 3 big long pushes per contraction.
Anyone pushing more than 1 hour needs intervention...
Jo
----- Original Message -----
Sent: Tuesday, June 10, 2003 8:29
PM
Subject: Re: [ozmidwifery] Episiotomy
- when to cut?
Jo,
What a frustrating situation for you, her
other caregivers and of course the woman herself. Can I ask what position
she was in when she was pushing. Also, how she was pushing -
following her own urge with everyone following her pace or with counting,
held breath and purple pushing?
----- Original Message -----
Sent: Tuesday, June 10, 2003 7:59
PM
Subject: [ozmidwifery] Episiotomy -
when to cut?
Hi all fellow midwives and students and all
:)
Looking after a woman last night who was a
primigravida, term, induction for SROM, not in labour. RMO needed
birth experience, so he did the catching. He did not cut an
episiotomy, and nor would I have, but this woman ended up with horrible
tears, in all directions, almost to the clitoris on both sides. We
were 'scolded' by the consultant for not doing an episiotomy.
