Dear All, I hope that I have not given the impression that as an osteopath I do not believe women can birth normally. I encourage women to believe in themselves and to find the support networks they require to help them understand the physiology of birth and how to achieve their desired birth outcomes.
Most women I see who are pregnant are suffering form pain. Commonly back pain or pubic symphysis pain. The treatment helps to relieve them of their pain and helps to enure good pelvic mechanics for the birth. I don't believe that women are made to believe that they need treatment to help them through the pregnancy and labour. However, back pain is a major problem with our society, with approximately 1 in 3 everyday people having at least a week off work due to back pain, during their working life. Back pain is very common during pregnancy and treatment can help. A vast majority of back pain either during pregnancy or not, is related to altered functioning of the mechanics of the body. This can be due to previous accidents, posture, obesity etc. Treatment can help relieve restrictions and help the body adjust to the changes during pregnancy. This will also hopefully aid the pelvic mechanics for birth. I must stress that any internal exam or treatment of pregnant women is not a common, nor the only treatment an osteopath will provide. I posted the question not to upset people, and not to insinuate that women are unable to birth by themselves, but to try and benefit from the large experience base of people on the list. I believe that collating all the different information and views is beneficial in determining treatment plans. I do not have the direct reference here, but I know that the some of the first osteopathic research done in around 1900 was comparing lengths of labour in women who had had osteopathic treatment and those that had not. The research found that women who had osteopathic treatment had shorter labours. I am currently trying to locate another research article that addressed the same issue. I think that good osteopathic care during pregnancy, is more than the treatment. I also try to educate patients about birth physiology. As part of my course we had a days lecture with Michael Odent. I have also done reading on the subject. I would like to think that I can be part of a team of people that pregnant women can receive help from. I hope that I have not offended anyone with my views. I do appreciate everyone's feedback as it gives me greater understanding to share with my patients. Thanks for reading Simone ----- Original Message ----- From: "Sue Cookson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Friday, July 02, 2004 9:18 AM Subject: Re: [ozmidwifery] Cervix position and labour duration > Hi all, > I believe most of the discussion around osteopaths and cervixes is still > leading pregnant women to believe that they 'need help' before during or > after birth and creates more tension than it could relieve. There are > active osteopaths and also acupunturists in my area and the women seem > to spend lots of time and money with little observable change in > outcome, just a greater dependency on 'others' to help them. > Obviously noting baby's lie is very important leading up to labour, but > how the cervix behaves is part of the mother's journey through labour. > I guess my observations come from over 20 years working in this area of > childbirth and I spend most of my time helping women to believe that > their bodies are perfect. Most of the women I see do birth normally and > who knows how their cervixes and all the rest of their ligaments etc are > at the time of birth ... > Hope this helps, > > Sue > > > Hi Lieve and Monica, > > > > Thanks for your replies, I'll try and answer them! > > > > I did a post graduate course in Osteopathy in Obstetrics at the > > European School of Osteopathy in Kent. We were taught internal > > techniques by Christine Michel, a French midwife and osteopath. (the > > French are very open!). The main reason for doing internal techniques > > were: > > > > to treat restrictions of the coccyx if not resolving with external > > treatments, as it is important to be able to move freely during > > labour, and is the major attachment of the pelvic floor. (this can be > > a PR or PV technique) > > > > TO asses tension and/or previous scaring of the pelvic floor and > > perineum, As osteopaths we will work with the tissues of the body to > > ensure that there is no tension affecting the free function of the area. > > > > To assess the cervix for position and tension of the uterosacral > > ligaments that may restrict its dilatation > > > > To asses the obturator interna muscle which cannot be palpated > > externally. > > > > I would not describe the treatment as massage! It is an assessment of > > the function and then treatment is usually a functional technique. > > Probably easiest to describe it as an unwinding of tension in the > > tissues, finding the ease. > > > > The treatment is not strong or as invasive as you may perceive. There > > is no force used during the treatment, it is quite gentle and not > > uncomfortable like other internal exams I have had with midwives, > > doctors and nurses. > > > > I use internal techniques occasionally. I have found that in some > > patients it can make a dramatic difference. I had one lady who had > > sciatica prior to falling pregnant, which then got progressively worse > > until she saw me. Most of the treatment was external, however on > > discussion with her she felt that an internal technique was > > appropriate. She had a massive spasm of her obturator interna > > muscle. This released with treatment and she felt an immediate change > > in the comfort of how the baby was sitting plus a significant > > improvement in her symptoms. I believe that this was of benefit to > > her for her later labour, as if it ad not been released it could have > > restricted the baby's descent and position. > > > > Lieve, Why do you feel that it is dangerous during pregnancy? There is > > less force than during sexual intercourse and no more germs likely to > > be presented. I would be interested to know your reasoning. > > > > I am trying to put my osteopathic training into the big picture of > > pregnancy and childbirth. From my training I felt that if you > > released tension around the uterosacral ligaments this would help the > > dilation of the cervix. Normally the assessment would be done by 28 > > to 30 weeks gestation. This would then help the cervix during labour. > > > > Monica, if it moves during or just before labour, then if it is > > restricted would that slow the progression? I do not generally treat > > women in labour, although I have seen one lady who was in early labour > > when she came for her last appointment. In most cases I am not using > > internal techniques anyway. The treatment is an inhibition technique > > of the uterosacral ligament, which if tense will tend to pull the > > cervix posteriorly and superiorly. It is quite a simple technique and > > one that could possibly be used by midwives! > > > > My aim with the posting this question was to see if the osteopathic > > perspective fitted in with what midwives found in practice. If > > midwives find that there is no relationship, then I would therefore > > review my treatment aims. Lieve this is why I am interested to know > > why you feel the internal technique is dangerous as obviously I would > > not want to be doing anything to harm my patients! > > > > I was also interested to see that you feel that the cervix may > > represent the position of the baby. I do work a lot around the > > external structures to help the baby adapt an anterior presentation. > > > > AS for the treatment described by the osteopath, it is difficult to > > comment. I feel that there are some genuine reasons for an internal > > assessment, but each case needs to be assessed individually. I Give > > my patients written information, time to consider their options, ask > > questions and schedule an appointment if so desired. They must sign a > > consent form and are offered a chaperone if they wish. In most cases > > I will only do one internal assessment for a patient, unless there is > > a major problem that needs to be addressed. I think that it is > > important that the osteopath is qualified, and registered, If you > > have any concerns you can contact the registration boards, or any > > association they are a part of to check up on them. It may be a > > genuine treatment depends on what he was doing and why, however there > > can be bad apples in any profession so be aware. > > > > I hope this all makes sense to you > > > > Simone Keddy > > > > > > > > > > > > > > > > > > ----- Original Message ----- > > > > *From:* Lieve Huybrechts <mailto:[EMAIL PROTECTED]> > > *To:* [EMAIL PROTECTED] > > <mailto:[EMAIL PROTECTED]> > > *Sent:* Wednesday, June 30, 2004 5:09 PM > > *Subject:* Re: [ozmidwifery] Cervix position and labour duration > > > > Hoi Simone, > > > > I am independent midwife in Belgium and we send a lot of mothers > > to an osteopath for different reasons. > > > > The position of the cervix often tells a lot over the position of > > the child, so when there is a posterior position in the baby you > > find mostly a posterior cervix. So it is important during > > pregnancy to inform mothers how to get an anterior position for > > their babys. An osteopath can help there to resolve tensions in > > the utero-sacrale ligaments. > > > > I don't believe in vaginal examinations during pregnancy and I > > will seldom do it, I think it causes more harm than good. So I > > don't think that we have to check so for the position of the > > cervix. I would rather acces the position of the baby and help the > > mother to correct it by her behaviour. > > > > I alsohave a question for you: last week I had a homebirth. The > > mother had a long prelabor. She started on sunday morning and gave > > birth on monday evening. During labor she told me she had visited > > an osteopath who did vaginal techniques on her. So he indeed did > > twice a vaginal touche. He calls himself an energetic osteopath. > > I made a phonecall to him because I was surprised and I needed a > > good explanation for the treatment he gives. I always try to > > convince women and gyns that a vaginal checkup during pregnancy > > is not neccesary and possible harmfull and now there is again an > > osteopath who is doing it. He explained that he was thaught that > > most of women have leisures in the vagina and cervix, caused by > > vaginal infections. He massages them and he promises a fast and > > easy birth.( not so in this case) > > Do you have some more information over this treatment? I want to > > be informed about what happens to the pregnant women. > > > > warm greetings > > Lieve > > > > *From:* Simone Keddy <mailto:[EMAIL PROTECTED]> > > > > *To:* [EMAIL PROTECTED] > > <mailto:[EMAIL PROTECTED]> > > *Sent:* Wednesday, June 30, 2004 5:34 AM > > *Subject:* [ozmidwifery] Cervix position and labour duration > > > > Hi all, I just have a question that some of you may be able > > to help me with. I am an osteopath with a special interest in > > osteopathic care during pregnancy, having done post graduate > > studies in the UK. > > > > One of the things we learnt about in our course was the > > position of the cervix and how that could affect the rate of > > dilation during labour. The theory being that if the cervix > > is held posteriorly then the uterine contractions will not be > > pushing the baby's head directly over the cervix and thus > > decrease the rate of dilatation. > > > > AS part of my course I spent some time observing midwives in > > the hospital setting in the UK. I discussed this with them > > and they told me that they recorded the position of the cervix > > as being posterior or not during labour, but did not correlate > > this to predicted outcome. > > > > So after all that blurb.. what I wanted to know is: > > in Australia is the position of the cervix noted? > > and secondly is there any correlation made to rate of dilation > > of the cervix? > > > > I was wanting to know peoples opinion on this, since as an > > osteopath it is something that I could assess and offer some > > treatment for ( by addressing tension in the uterosacral > > ligaments etc.), thus hopefully helping the natural > > progression of labour. > > > > I would be interested in any feedback that anyone may have. > > > > And I must finish with saying that I really enjoy reading all > > the emails and I have learnt a lot from it. > > So thanks to all > > > > Simone Keddy > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
