Title: Message
I'm
inclined to agree, Jackie!
My own
babies love that direct op posi. They've all been quick, the
last 4.5kg and still manage to come out within the hour! No back
pain.Must be my HUGE childbearing hips! (says she putting the belt on the size 8
pants cause they just fell down)
Too
much fussin can cause more dramas than we started with.
I do
talk to my clients about optimal fetal positioning...in a relaxed way...going
back to the days of old and showing the differences in general posture with
digging for yams and washing clothes in the river, compared to drving in
the car and watching TV.
If the
babies are persistantly OP I just smile and say, ''some babies just like it that
way...they work it out along the way''
And
they do!
Vicki
-Original Message-From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Jackie
KitschkeSent: Wednesday, August 14, 2002 12:25 PMTo:
[EMAIL PROTECTED]Subject: [ozmidwifery] OP labours
(long)
Dear Jo and all,
I find the whole idea about optimal fetal positioning an
interseting one. I have attended in the past, a session with Jean Sutton
discussing it and found it very interesting and indeed sometimes use the
positions she suggests to suggest to women in labour. The interesting and
amazing thing about midwifery practice is that it is the women who teach you
so much. So many women I have been with in labour will adopt these positions
themselves ie put one foot up and rock into the side the baby needs to rotate
into, sit on the loo, rock etc as long as they are given the space to do it.
They do what their body's tell them to do.
I understand Jo the logic of wanting to know or be told
about this but I fear that we are turning another part of normal childbirth
into an abnormality and if not careful in years to come these women will not
be allowed to birth with midwives as they are high risk (I know I sound
paranoid but I am sure if midwives or hundreds of years ago were now told that
breech and twins were considered high risk they would laugh at us). So many
women now come into the antenatal clinic and look worriedly at you as you
palpate there tummies and ask if the baby is in the right position. Some of
these women are only 28 weeks. I have looked after women in labour with OP
babies and thought that this will be a long hard labour and the next minute
the woman wants to push. And conversly the baby who is the "perfcet position"
what ever that is has a baby that takes forever or comes out face to pubes and
you wonder how that happened.
In the last MIDIRS there is and article titled "Malpositions
and malpresentations of the occiput: current research and practice tips" that
discusses the research around this. It states that a "Gardberg and
colleagues research into op found that 68% of babies presenting as persistant
op at birth had developed from a malrotation during labour from an initial oa
position. Only 32% of persistant op cases were op at the start of labour".
This confirmed for me some of the things I have experienced. I just fear that
we are putting fear into women antenatally and blaming them and/or their
babies when perhaps this is not true. It is like when someone says to a woman
antenatally that her baby is too big to fit through. It is more difficult to
work with that woman when she is having a long labour as she doesn't trust her
body.
My sister (the one I sent that champagne charged email about
in December) started her labour in op. She niggled and contracted at home for
3 days and when she finally came to the BC in established labour she was 3 cms
at 3am and gave birth to her boy at 0930am. Now I would have thought with the
start she had not to expect a baby at best till the afternoon. So I think this
is another example that we just have to trust the process and inspire in women
the confidence to birth their babies.
We can only learn from women if we give them the space to do
their best work. THis can only happen within midwifery models of care. Working
with women having an OP labour usually means a slow start and getting them
through that is the key but you only see that when you work in a midwifery
model. Keeping those women at home until the active part of labout starts is
vital and then supporting them with encouragement, privacy and time. The more
you care for women the more you learn about the amazing things they do and it
is this experience that helps you with the next birth and also gives you the
stories to relay to women when they are concerned.
Sorry this is so long
Jackie
