|
Curiosity at hand...Was the mexican sling a side to
side movement of the woman with the shawl or an up and down movement of the
woman's pelvis? I too saw this at the conference but can't remember Thanks
DEbbie
----- Original Message -----
Sent: Thursday, April 14, 2005 10:28
AM
Subject: Re: [ozmidwifery] Foetal
positioning
Had an interesting situation the other day. Came on the PM
shift to be with a woman who had been induced with prostin the evening before
spontaneous ROM two hours later then nothing and so synt in the AM. Noted on
admission by midwives that baby OP and mother resisted co operating in any
suggestions to turn it because her GP had told her that the baby was all ready
to go.
When I came on she was lying down complaining and resisting to
move because her back was hurting to much!!!!!!!!!
I sat and watched for a
couple of contractions and then said in a confidant manner oh thats easy to
fix I'll run the bath.
Which I did and in she got with her sister dragging
along behind reminding me that she would not be able to get out again. I
reassured her that I had never had a woman who had remained in the bath for
ever so it would be OK.
Once in she proceeded to relax and after a very
short time began swaying with the contractions, still on her back???? but
almost flat with her head in the water and feet apart but flat on the
bottom.
Then she began thrusting her pelvis skyward with each contraction
and it reminded me of the mexican shawl thing that we were shown at the Andrea
Robertson study day recently. What was it called Andrea!!!! Anyway shortly
afterwards she opened her eyes and said I'll need to push soon. Which she did
and went on to have her baby with a very moulded head. Despite her resistance
to all suggestions to rotatet her baby she instinctively did it her self once
in the water which was deep enough to enable her to float freely.
When
we were talking about it afterwards she told me that her GP had told her that
there was an 80% chance she would have to have a LUSCS because her mother had
had all difficult forcep births and her sister had had two LUSCS. So she had
convinced herself that she just had to endure whatever until he decided to do
the LUSCS??
How sad is that and talk about sabotage.
There were four
generations of women in that room as the baby arrived and the three elder ones
were dumb struck at the beauty of it and the was she had been encouraged to
labour. We had a discussion above the little listening ears of the 4 &5
year old nieces who came in minutes after the baby arrived but had sat around
all day waiting because their Mum was supporting their aunty about how they
could empower those girls by the language they use to talk about birth now
that they had seen how it could be done. At least those girls might have a
chance.
All in all a satisfying result. but my message was really how
she had used the thrusting motions in the bath to turn the OP
Andrea
Quanchi
On 13/04/2005, at 8:29 PM, Sally Westbury wrote:
Foetal
malposition lengthens labour and poses maternal risks
Source: Obstetrics
& Gynaecology
2005; 105:
763-72
Assessing
the impact of foetal position at full dilatation on labour duration and
indicators of maternal
morbidity.
Pregnant
women with occiput posterior or transverse position at full dilatation are
at increased risk of a prolonged second stage of labour and of maternal
morbidity, research shows.
"Since
Mauriceau's classical work was published in 1681, the occiput posterior and
transverse malpositions have remained an obstetric challenge," write Julie
Senecal (Laval University, Canada) and colleagues.
For
the current study, the team assessed the effect of such foetal positions on
the duration of the second stage of labour and on indicators of maternal
morbidity, using retrospective data for 210 women whose foetus was in the
posterior position, 200 with it in a transverse position, and 1198 with an
anteriorly positioned
foetus.
This
revealed that foetal malposition at full dilatation was associated with
significant maternal morbidity, including increased risks of instrumental
delivery, caesarean delivery, oxytocin administration, episiotomy, and blood
loss exceeding 500 ml.
In
addition, the duration of the second stage of labour with early or delayed
pushing was higher for transverse (3.6 hours and 2.5 hours, respectively)
and posterior (3.8 hours and 3.0 hours, respectively) positions than for the
anteriorly positioned group (3.1 hours and 2.2 hours, respectively).
"Guidelines
that propose norms for expected labour duration should take into
consideration position of the foetal head at full dilatation and the
strategy of pushing," conclude the researchers.
Posted:
12 April 2005
Sally
Westbury
Homebirth
Midwife
"It
takes courage to remain a true advocate for women, challenging authority and
sacrificing social and professional acceptance. It takes courage for a woman
to choose a caregiver who will truly advocate for and empower
her." -Judy Slome Cohain
|
