Wow, thank you!
Vedrana
From: owner-ozmidwifery@acegraphics.com.au
[mailto:owner-ozmidwifery@acegraphics.com.au]
On Behalf Of G Lemay
Sent: Friday, September 16, 2005
1:22 AM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Re: ]
Friend with breach baby...told CS only options.
There
ARE some important things with breech. This is where your anatomy and
physiology of the newborn is very important. Understanding the
circulatory system of the baby, the way the bones in the head fold over each
other and the concept of creating an airway are some important
considerations. The main rule is "HANDS OFF", however, that is
not all there is to it. With breech births it's important to have a period of
45 mins from the time the woman feels like pushing till when she actively
pushes, in order to prevent the head being caught on an undilated cervix.
Once the baby is born to the umbilicus, you have 7 mins to complete the
birth. You want to avoid rushed handling but you also don't want to sit
there like a lump. The baby can be provoked to draw breath or shoot
his/her arms above the head by meddlesome handling. The body hanging (and
I especially like the all 4's position for this) is Nature's way of bringing
the back hairline to the introitus of the vulva. Sometimes, even without
stim. the arms will be up and it's important to turn the babe's hips using a
cloth and not touching the delicate organs in the belly (you can rupture organs
with your pointy little fingers when the baby's abdomen is engorged and your
adrenal is
running) so that the shoulders are antero-post diameter in the pelvis, then
reaching in and gently sweeping them down. sometimes this requires a
second demi rotation for the second arm. Once the babe's hairline is
visible, then, it's important NOT to let the crown of the head "POP".
Popping can result in a fatal tear to the cerebral tentorum---a drumlike
membrane over the brain. So, at this point, you reach a finger in, get
the baby's lower jaw and gently pull the mouth and nose into sight.
Once there, the mother is told "Stop all pushing." Then she can
stay like this for a very long time and all is well. You want her to
easy, easy, easy get the top of the head born so there is no "pop"
and you know you have an airway to that baby.
One of the guidelines that Michel Odent stresses is to watch the first stage to
tell you how the second stage will go with a breech. If you have a
smooth, progressive first stage, the second stage will follow that way.
If you're having a breech birth where the progress gets hung up or stuck and
the butt doesn't come down to the vulva on its own, you want to consider
cesarean as a safer option.
Gloria
Vedrana Valèiæ wrote:
> Thank you, Gloria. In this article, it is said again that nothing
must > be done except flexing the head at the end and putting the
woman in > hands and knees position (or any position she feels right,
I > suppose?). Is there more to it than I'm getting. Because if
there > isn't, it sounds really simple to me. Do not interfere, just
like in > other kinds of births.
>
>
>
> Vedrana
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