Re: [ozmidwifery] OP babies

[Larissa & Tim]

Hi Jo,
I don't know why this isn't 
presented to pregnant women - such a simple thing that can often be 
avoided.
On that note I am going to toot my 
own horn so to speak and tell you that it is one of the topics I am covering in 
CBE classes that will start in November. I am a very passionate person about OFP 
and it is one of the first things I tell my women about. My small way of helping 
change!
Guess I will see you tomorrow 
morning!
Hugs, Larissa
 
 

Re: [ozmidwifery] OP babies

[Robin Moon]

 

  - Original Message - 
  From: 
  Jo 
  & Dean Bainbridge 
  To: [EMAIL PROTECTED] 
  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 Bainbridgefounding member CARES 
  SAemail: [EMAIL PROTECTED]phone: 08 
  8388 6918birth with trust, faith & 
love...

Re: [ozmidwifery] OP babies

[Lois Wattis]

Robin, you have covered this matter very clearly and 
accurately, which saves me the trouble of trying to do it.  Optimal Fetal 
Positioning in pregnancy is a subject I cover with all my clients 
antenatally.  The case which this discussion arose from unfortunately 
demonstrates what can still happen.  This woman went to a lot of 
trouble to optimise her baby's position in the last month of pregnancy -- even 
forced herself to lie on her left side to sleep rather than back lying which she 
preferred.  Her baby was in a lateral position (ROL) on palp and VE 
throughout her labour (about 48 hours latent phase).  She utilised upright 
positioning and water throughout her labour and reached 8cm 
dilation with the presenting part at spines before the 
baby turned to OP and deflexed, and receded back to -1.  The 
obstetrician/surgeon made the statement that he "didn't believe the baby was 
ever in the pelvis" based on the little moulding of the head - but she 
was!  The woman has now been told (by the GP/ob who attended in 
theatre but never examined her physically) that she most 
definitely will need a CS for any subsequent births based on her 
long slow labour, and that the baby (7lb 2oz) did not 
fit through.  Maybe it's true.  Maybe it's not.  Only 
another labour will tell the story.  It's disheartening for her and for me, 
but the outcome is a live, healthy baby, and Mum is recovering 
extremely well.  She's a gutsy girl who will, I'm sure, research her 
options well if and when she travels the birthjourney again.  Best wishes, 
Lois
   

  - Original Message - 
  From: 
  Robin 
  Moon 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 8:45 
  PM
  Subject: Re: [ozmidwifery] OP 
babies
  
   
  
- Original Message - 
From: 
Jo 
& Dean Bainbridge 
To: [EMAIL PROTECTED] 

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. :-(
 
Re

Re: [ozmidwifery] OP babies

[Marilyn Kleidon]

Lois and Robin:
 
I think you have covered this extremely well. When 
I was in Seattle, we all greeted the book and exercises offered by Optimal 
Foetal Positioning with anticipation. However, it seems that there is more to 
the baby's positioning than exercises and posture of the mum. While I agree 
one hundred percent that the posture and exercises should be taught and offered 
antenatally they are no guarantee for avoiding a babe in OP position. I have 
been midwife with 2 extremely fit young primiparous women who had relatively 
small babes (6lb 12 and 7lb 4) settle very snuggly into OP positions in labor. 
They were informed of the exercises and encouraged re posture (which incidently 
was excellent and neither were couch potatoes) by both their midwives and 
antenatal class teachers, and one had Penny Simpkin as her doula. One never 
dilated past 3 cm (over 2-3 days at home then another 24 hrs in hospital) and 
the other galloped to complete then the baby never descended past 0 station, 
again after several hours. The babys were never in distress and had excellent 
apgars upon their cesarean births. However both mums were really disappointed, 
understandably. During many other births I have been a part of, the baby has 
often been in an OP position either prior to labor or during labor but 
obligingly turns at sometime or is born sunnyside up. I even had one bub 
twist at the waist to come out OA and upon restitution totally unwind herself 
birthing herself to the waist in one movement (I don't know if that describes it 
adequately). 
 
On a personal note, my eldest daughter was born 
sunnyside up after a forceps lift out 26 years ago. I always assumed the forceps 
were for fetal distress but never really got an adequate explanation. I only 
know that I had pushed through 2 contractions, the midwife listened for FHT, and 
I was suddenly up in stirrups, pudendal block, epis, forceps and she was on my 
belly crying lustily. When her head was out the midwife said to the doctor "it's 
a face"; since her little face was never puffy or bruised I am assuming face up 
not a face presentation. In any case, I always felt the OP presentation was due 
to routine ROM on admission not giving her the cushioning to rotate. Obviously I 
dilated and the labor was not overly long, however I went on to have another 
daughter in frank breech position born vaginally, and my third daughter OP on 
the one VE in labor. That time I refused to have the bag broken at any time and 
was upright throughout, she was born in the caul, OA in 3 pushes. I think I have 
a  pelvis which predisposes to these positions. My grandmother only had one 
baby in five born OA, the other 4 were 2 breeches, one OP, and my mum who was 
the fifth and a transverse lie (podalic version delivered footling breech, 
alive) all born at home 1906 to 1913.  
 
I can't think how to end this, so that's all for 
now.
marilyn

  - Original Message - 
  From: 
  Lois 
  Wattis 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 7:07 
  AM
  Subject: Re: [ozmidwifery] OP 
babies
  
  Robin, you have covered this matter very clearly and 
  accurately, which saves me the trouble of trying to do it.  Optimal Fetal 
  Positioning in pregnancy is a subject I cover with all my clients 
  antenatally.  The case which this discussion arose from unfortunately 
  demonstrates what can still happen.  This woman went to a lot of 
  trouble to optimise her baby's position in the last month of pregnancy -- even 
  forced herself to lie on her left side to sleep rather than back lying which 
  she preferred.  Her baby was in a lateral position (ROL) on palp and 
  VE throughout her labour (about 48 hours latent phase).  She utilised 
  upright positioning and water throughout her labour and reached 8cm 
  dilation with the presenting part at spines before the 
  baby turned to OP and deflexed, and receded back to -1.  The 
  obstetrician/surgeon made the statement that he "didn't believe the baby was 
  ever in the pelvis" based on the little moulding of the head - but she 
  was!  The woman has now been told (by the GP/ob who attended in 
  theatre but never examined her physically) that she most 
  definitely will need a CS for any subsequent births based on her 
  long slow labour, and that the baby (7lb 2oz) did not 
  fit through.  Maybe it's true.  Maybe it's not.  Only 
  another labour will tell the story.  It's disheartening for her and for 
  me, but the outcome is a live, healthy baby, and Mum is recovering 
  extremely well.  She's a gutsy girl who will, I'm sure, research her 
  options well if and when she travels the birthjourney again.  Best 
  wishes, Lois
     
  
- Original Message - 
From: 
Robin 
Moon 
To: [EMAIL PROTECTED] 
    
    Sent: Tuesday, August 13, 2002 8:45 
PM
Subject: Re: [ozmidwifery] OP 

Re: [ozmidwifery] OP babies

[Lynne Staff]

Ditto Larissa

  - Original Message - 
  From: 
  Larissa & Tim 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 10:17 
  PM
  Subject: Re: [ozmidwifery] OP 
babies
  
  Hi Jo,
  I don't know why this isn't 
  presented to pregnant women - such a simple thing that can often be 
  avoided.
  On that note I am going to toot 
  my own horn so to speak and tell you that it is one of the topics I am 
  covering in CBE classes that will start in November. I am a very passionate 
  person about OFP and it is one of the first things I tell my women about. My 
  small way of helping change!
  Guess I will see you tomorrow 
  morning!
  Hugs, Larissa
   
   

Re: [ozmidwifery] OP babies

[Lynne Staff]

There are many lifelstyle factors which could 
contribute to the number of OP positions seen. In my mid education, we were told 
it was 10% of women. I think it is more common than this, and talk about 
changing the way we do our daily activites, which can encourage a little 
one to settle itself into an anterior position.
 
It seems to help, and while I have not done 
await for itRCT.women tell me it helps and the fact that they are 
also upright and active in labour with no routine ARM is something they 
appreciate too
 
Regards, Lynne

  - Original Message - 
  From: 
  Robin 
  Moon 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 10:45 
  PM
  Subject: Re: [ozmidwifery] OP 
babies
  
   
  
- Original Message - 
From: 
Jo 
& Dean Bainbridge 
To: [EMAIL PROTECTED] 

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 Bainbridgefounding member CARES 
SAemail: [EMAIL PROTECTED]phone: 
08 8388 6918birth with trust, faith & 
love...

Re: [ozmidwifery] OP babies

[Lynne Staff]

Another great and very enjoyable thing women can do 
to help is raq shaqui (belly dance). And nothing beats some heavy (energetic) 
rocking and rolling late in the labour too!

  - Original Message - 
  From: 
  Lois 
  Wattis 
  To: [EMAIL PROTECTED] 
  
  Sent: Wednesday, August 14, 2002 12:07 
  AM
  Subject: Re: [ozmidwifery] OP 
babies
  
  Robin, you have covered this matter very clearly and 
  accurately, which saves me the trouble of trying to do it.  Optimal Fetal 
  Positioning in pregnancy is a subject I cover with all my clients 
  antenatally.  The case which this discussion arose from unfortunately 
  demonstrates what can still happen.  This woman went to a lot of 
  trouble to optimise her baby's position in the last month of pregnancy -- even 
  forced herself to lie on her left side to sleep rather than back lying which 
  she preferred.  Her baby was in a lateral position (ROL) on palp and 
  VE throughout her labour (about 48 hours latent phase).  She utilised 
  upright positioning and water throughout her labour and reached 8cm 
  dilation with the presenting part at spines before the 
  baby turned to OP and deflexed, and receded back to -1.  The 
  obstetrician/surgeon made the statement that he "didn't believe the baby was 
  ever in the pelvis" based on the little moulding of the head - but she 
  was!  The woman has now been told (by the GP/ob who attended in 
  theatre but never examined her physically) that she most 
  definitely will need a CS for any subsequent births based on her 
  long slow labour, and that the baby (7lb 2oz) did not 
  fit through.  Maybe it's true.  Maybe it's not.  Only 
  another labour will tell the story.  It's disheartening for her and for 
  me, but the outcome is a live, healthy baby, and Mum is recovering 
  extremely well.  She's a gutsy girl who will, I'm sure, research her 
  options well if and when she travels the birthjourney again.  Best 
  wishes, Lois
     
  
- Original Message - 
From: 
Robin 
Moon 
To: [EMAIL PROTECTED] 

Sent: Tuesday, August 13, 2002 8:45 
    PM
Subject: Re: [ozmidwifery] OP 
babies

 

  - Original Message - 
  From: 
  Jo 
  & Dean Bainbridge 
  To: [EMAIL PROTECTED] 
  
  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 enco

Re: [ozmidwifery] OP babies

[Lois Wattis]

Thank you to everyone who has contributed to this 
discussion on OP position during labour.  It has been very beneficial 
to me to share and debrief in this forum, and 
it will also be helpful when "N" is ready to discuss and 
debrief - down the track.  Cheers, Lois
 
  - Original Message - 

  From: 
  Lynne 
  Staff 
  To: [EMAIL PROTECTED] 
  
  Sent: Wednesday, August 14, 2002 7:22 
  AM
  Subject: Re: [ozmidwifery] OP 
babies
  
  Another great and very enjoyable thing women can 
  do to help is raq shaqui (belly dance). And nothing beats some heavy 
  (energetic) rocking and rolling late in the labour too!
  
- Original Message - 
From: 
Lois 
Wattis 
To: [EMAIL PROTECTED] 

Sent: Wednesday, August 14, 2002 12:07 
AM
    Subject: Re: [ozmidwifery] OP 
babies

Robin, you have covered this matter very clearly 
and accurately, which saves me the trouble of trying to do it.  Optimal 
Fetal Positioning in pregnancy is a subject I cover with all my clients 
antenatally.  The case which this discussion arose from unfortunately 
demonstrates what can still happen.  This woman went to a lot of 
trouble to optimise her baby's position in the last month of pregnancy -- 
even forced herself to lie on her left side to sleep rather than back lying 
which she preferred.  Her baby was in a lateral position (ROL) on 
palp and VE throughout her labour (about 48 hours latent phase).  She 
utilised upright positioning and water throughout her labour 
and reached 8cm dilation with the presenting part at spines 
before the baby turned to OP and deflexed, and receded back to 
-1.  The obstetrician/surgeon made the statement that he "didn't 
believe the baby was ever in the pelvis" based on the little moulding of the 
head - but she was!  The woman has now been told (by the 
GP/ob who attended in theatre but never examined her physically) that she 
most definitely will need a CS for any subsequent births based 
on her long slow labour, and that the baby (7lb 2oz) did not 
fit through.  Maybe it's true.  Maybe it's not.  
Only another labour will tell the story.  It's disheartening for her 
and for me, but the outcome is a live, healthy baby, and Mum 
is recovering extremely well.  She's a gutsy girl who will, I'm 
sure, research her options well if and when she travels the birthjourney 
again.  Best wishes, Lois
   

  - Original Message - 
  From: 
  Robin 
  Moon 
  To: [EMAIL PROTECTED] 
  
  Sent: Tuesday, August 13, 2002 8:45 
      PM
  Subject: Re: [ozmidwifery] OP 
  babies
  
   
  
- Original Message - 
From: 
Jo & Dean Bainbridge 

To: [EMAIL PROTECTED] 

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 bab

Re: [ozmidwifery] OP babies

[Laraine Hood]

Hi Lois, I have also had this experience of knowing 
the baby was well down in the pelvis only to be told by Obs that it was never in 
there and I was sadly mistaken in my judgement. One happened to say these words 
of 'wisdom' in front of the client who promptly stated that in fact the baby was 
because she'd felt it too when doing her own VE under my guidance!  
Naturally we were both wrong then and he was still right.  The great 
benefit to both you and N (and other clients in future) is the support from 
having an informed advocate/midwife there to keep the balance.  Never 
underestimate your role in these cases because without your care and support, 
the experience would be a lot more traumatic.  Also, you are a valuable 
historian, helping to piece together areas that will undoubtably be blurry for 
the mother.  Keep up the good work, Laraine

  - Original Message - 
  From: 
  Lois 
  Wattis 
  To: [EMAIL PROTECTED] 
  
  Sent: Wednesday, August 14, 2002 8:12 
  AM
  Subject: Re: [ozmidwifery] OP 
babies
  
  Thank you to everyone who has contributed to this 
  discussion on OP position during labour.  It has been very 
  beneficial to me to share and debrief in this 
  forum, and it will also be helpful when "N" is ready to 
  discuss and debrief - down the track.  Cheers, Lois
   
    - Original Message - 

  
From: 
Lynne 
Staff 
To: [EMAIL PROTECTED] 

Sent: Wednesday, August 14, 2002 7:22 
AM
Subject: Re: [ozmidwifery] OP 
babies

Another great and very enjoyable thing women 
can do to help is raq shaqui (belly dance). And nothing beats some heavy 
(energetic) rocking and rolling late in the labour too!

  - Original Message - 
  From: 
  Lois 
  Wattis 
  To: [EMAIL PROTECTED] 
  
  Sent: Wednesday, August 14, 2002 
  12:07 AM
  Subject: Re: [ozmidwifery] OP 
  babies
  
  Robin, you have covered this matter very clearly 
  and accurately, which saves me the trouble of trying to do it.  
  Optimal Fetal Positioning in pregnancy is a subject I cover with all 
  my clients antenatally.  The case which this discussion arose from 
  unfortunately demonstrates what can still happen.  This woman 
  went to a lot of trouble to optimise her baby's position in the last month 
  of pregnancy -- even forced herself to lie on her left side to sleep 
  rather than back lying which she preferred.  Her baby was in a 
  lateral position (ROL) on palp and VE throughout her labour (about 48 
  hours latent phase).  She utilised upright positioning and water 
  throughout her labour and reached 8cm dilation with 
  the presenting part at spines before the baby turned to OP and 
  deflexed, and receded back to -1.  The obstetrician/surgeon made the 
  statement that he "didn't believe the baby was ever in the pelvis" based 
  on the little moulding of the head - but she was!  The 
  woman has now been told (by the GP/ob who attended in theatre but 
  never examined her physically) that she most definitely will 
  need a CS for any subsequent births based on her long slow labour, and 
  that the baby (7lb 2oz) did not fit through.  Maybe it's 
  true.  Maybe it's not.  Only another labour will tell the 
  story.  It's disheartening for her and for me, but the outcome is a 
  live, healthy baby, and Mum is recovering extremely well.  
  She's a gutsy girl who will, I'm sure, research her options well if and 
  when she travels the birthjourney again.  Best wishes, 
  Lois
     

  
- Original Message - 
From: 
Robin Moon 
To: [EMAIL PROTECTED] 

        Sent: Tuesday, August 13, 2002 8:45 
PM
Subject: Re: [ozmidwifery] OP 
babies

 

  - Original Message - 
  From: 
  Jo & Dean Bainbridge 
  
  To: [EMAIL PROTECTED] 
  
  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

Re: [ozmidwifery] OP babies

[Robin Moon]

Barbara,

If it hasnt already been published, I'm sure it's about to. The hospital I
worked at was involved in the data collection and I became friends with one
of the research midwives. I saw her at lunch a short while ago and
discovered this info.

Robin


- Original Message -
From: Barbara Howe <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, August 14, 2002 10:12 AM
Subject: [ozmidwifery] OP babies


> Robin
> Has this research on OFP been published in a journal
> somewhere?
> Barbara
>
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Re: [ozmidwifery] OP babies

[Andrea Quanchi]

Do you know if the results of marie Chamebrlains study have been published yet???
Andrea Quanchi
On Tuesday, August 13, 2002, at 10:45  PM, Robin Moon wrote:

 

- Original Message -
From: Jo & Dean Bainbridge
To: [EMAIL PROTECTED]
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...

Re: [ozmidwifery] OP babies

[Lois Wattis]

RCT stands for Random Controlled Trial (ie research). Regards, Lois Wattis


- Original Message - 
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, August 14, 2002 5:38 PM
Subject: [ozmidwifery] OP babies


--- Lynne Staff <[EMAIL PROTECTED]> wrote: > 
What does RCT stand for (2nd paragraph below)?

Thanks, Jen
 
>There are many lifelstyle factors which could
> contribute to the number of OP positions seen. In my
> mid education, we were told it was 10% of women. I
> think it is more common than this, and talk about
> changing the way we do our daily activites, which
> can encourage a little one to settle itself into an
> anterior position.
> 
> It seems to help, and while I have not done
> await for itRCT.women tell me it helps
> and the fact that they are also upright and active
> in labour with no routine ARM is something they
> appreciate too
> 
> Regards, Lynne

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Re: [ozmidwifery] OP babies

[elizabeth mcalpine]

One response I heard recently.."if we tell the 
mothers that their baby is OP,  we will cause anxiety".
 
Personally, I think it is important to avoid this 
position, and tell them, and believe that women should be 
told. 
It does indeed cause many problems as you 
mentioned. 
I also tell them what to do to try to correct it, 
prior to labour, from 34 weeks primip, 37 - 38 multi as Sutton & Scott 
advise.  They suggest that the following happens; early SROM, inco-ordinate 
contractions, post maturity, induction, augmentation, increased pain, longer 
labour, medical complications etc.  
 
If its during labour, its off the bed, 
upright, movement - rocking, climbing, birth ball, hands and knees etc.  

 
Liz

  - Original Message - 
  From: 
  Jo 
  & Dean Bainbridge 
  To: [EMAIL PROTECTED] 
  
  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?  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?
  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?  
  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!)
  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??   
  
  Jo Bainbridgefounding member CARES 
  SAemail: [EMAIL PROTECTED]phone: 08 
  8388 6918birth with trust, faith & 
love...

RE: [ozmidwifery] OP babies

[Ken Ward]

It is 
suppose to be our life style. Too much sitting around.  My last baby was ol 
to oa and rotated around to op during labour and got stuck.. Awful feeling, as 
if I had a piece of 4x2 up there.  Anyway a gentle keillands rotation, and 
she just about fell out.  Where I did my mid the obests. would often do a 
rotation and then let the babies birth naturally.  I don't think it's my 
pelvis 'cause the boys were oa,s.  But no. 1, another girl, was also an op.--Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]]On Behalf Of Jo & Dean 
BainbridgeSent: Tuesday, August 13, 2002 9:04 PMTo: 
[EMAIL PROTECTED]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?  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?
  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?  
  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!)
  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??   
  
  Jo Bainbridgefounding member CARES 
  SAemail: [EMAIL PROTECTED]phone: 08 
  8388 6918birth with trust, faith & 
love...

RE: [ozmidwifery] OP babies

[Eleanor crighton]

I work at Warragul Hospital in our antenatal clinic OP position is discussed 
with all women and infomation given to promote optimal position as part of 
routine antenatal care.  If women have previous had an OP labour we usually 
lend Jean Sutton's OP booklet.
Cheers
Eleanor Crighton


>From: "Ken Ward" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: RE: [ozmidwifery] OP babies
>Date: Thu, 15 Aug 2002 15:59:04 +1000
>
>It is suppose to be our life style. Too much sitting around.  My last baby
>was ol to oa and rotated around to op during labour and got stuck.. Awful
>feeling, as if I had a piece of 4x2 up there.  Anyway a gentle keillands
>rotation, and she just about fell out.  Where I did my mid the obests. 
>would
>often do a rotation and then let the babies birth naturally.  I don't think
>it's my pelvis 'cause the boys were oa,s.  But no. 1, another girl, was 
>also
>an op.--Original Message-
>From: [EMAIL PROTECTED]
>[mailto:[EMAIL PROTECTED]]On Behalf Of Jo & Dean
>Bainbridge
>Sent: Tuesday, August 13, 2002 9:04 PM
>To: [EMAIL PROTECTED]
>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?  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?
>   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?
>   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!)
>   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??
>   Jo Bainbridge
>   founding member CARES SA
>   email: [EMAIL PROTECTED]
>   phone: 08 8388 6918
>   birth with trust, faith & love...




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Re: [ozmidwifery] OP babies

[Lynne Staff]

Randomised Controlled Trial - the methodology given the most research
"street cred"
- Original Message -
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, August 14, 2002 7:38 PM
Subject: [ozmidwifery] OP babies


> --- Lynne Staff <[EMAIL PROTECTED]> wrote: >
> What does RCT stand for (2nd paragraph below)?
>
> Thanks, Jen
>
> >There are many lifelstyle factors which could
> > contribute to the number of OP positions seen. In my
> > mid education, we were told it was 10% of women. I
> > think it is more common than this, and talk about
> > changing the way we do our daily activites, which
> > can encourage a little one to settle itself into an
> > anterior position.
> >
> > It seems to help, and while I have not done
> > await for itRCT.women tell me it helps
> > and the fact that they are also upright and active
> > in labour with no routine ARM is something they
> > appreciate too
> >
> > Regards, Lynne
>
> __
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> Everything you'll ever need on one web page
> from News and Sport to Email and Music Charts
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> Visit  to subscribe or unsubscribe.

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