Re: [ozmidwifery] Episiotomy - when to cut?
It is amazing that not everyone tears apart under these conditions!! - Original Message - From: Robin Moon To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 2:47 PM Subject: Re: [ozmidwifery] Episiotomy - when to cut? oh, arent protocols cruel everything is wrong for her there, Jo. As Nikki says, pushingat her own pace and in a position that allowed gravity to help all help.IN the position you describe, she's actually pushing uphill, with the coccyxbeing sat on which reduces available space and her body and lungs are all compressed. I guess the protocols also dictated that she must start pushing from the minute 2nd stage begins? So she's dead exhausted when the head finally hits the peri? And has no energyto actually slow the head down during it's exit? I have found that slowing the head down even just by a contraction or two helps enormously. It allows the surrounding tissues to accomodate this sudden insult. Let the head spend more time stretching the perineum, and let the head bejust breathed out, rather than pushed will go a long way toachieving a gentle exit. If we're exercising we dont achieve maximum stretch the first time we try the splits. We get better with each little effort. In a compact way this is the same with the peri. If the women are told ( both during labour and very gently and encouragingly at the time) they understand that it will be beneficial to them afterwards and usually are very keen to help themselves. Heat applied to the peri and birthing in water also help this scenario. The stranded beetle position you describe Jo, will be ingrained on you forever as you learn first hand the horrible effects it has on women. I cant think of one good thing about it. Robin - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Wednesday, June 11, 2003 12:55 AM Subject: Re: [ozmidwifery] Episiotomy - when to cut? Hi Nikki. As most women are where I work, she was semi-sitting; she was "chin on your chest, big breath, PUSH, quick breath and push again!" style pushing; and she was not following her own urges - that would have taken too long! 3 big long pushes per contraction. Anyone pushing more than 1 hour needs intervention... Jo - Original Message - From: Nikki Macfarlane To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 8:29 PM Subject: Re: [ozmidwifery] Episiotomy - when to cut? Jo, What a frustrating situation for you, her other caregivers and of course the woman herself. Can I ask what position she was in when she was pushing. Also,how she was pushing - following her own urge with everyone following her pace or with counting, held breath and purple pushing? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 7:59 PM Subject: [ozmidwifery] Episiotomy - when to cut? Hi all fellow midwives and students and all :) Looking after a woman last night who was a primigravida, term, induction for SROM, not in labour. RMO needed birth experience, so he did the catching. He did not cut an episiotomy, and nor would I have, but this woman ended up with horrible tears, in all directions, almost to the clitoris on both sides. We were 'scolded' by the consultant for not doing an episiotomy.
Re: [ozmidwifery] Episiotomy - when to cut?
It's sad, isn't it :(
Re: [ozmidwifery] Episiotomy - when to cut?
I believe that tearing has a lot to do with the condition of a womans tissues. Diet plays a hugh role in this and research shows when all things are considered, ie position, diet, perineal massage about 25% of women will still tear. There is so much we don't know! For instance was she scared and did she push the baby with a shove so to speak. Was there a hand in the road, was she on her back. I don't know but maybe changing some of those things may have helped. Dierdre
Re: [ozmidwifery] Episiotomy - when to cut?
Jo, I am actually on holiday and travelling so have no references with me but there is a lot of info out there on physiological pushing as well as proper upright positioning etc. Chase up the work of Constance Benyon who wrote about physiological pushing vs the valsalver manouver in 1952. Cheers Judy - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Wednesday, June 11, 2003 12:55 AM Subject: Re: [ozmidwifery] Episiotomy - when to cut? Hi Nikki. As most women are where I work, she was semi-sitting; she was "chin on your chest, big breath, PUSH, quick breath and push again!" style pushing; and she was not following her own urges - that would have taken too long! 3 big long pushes per contraction. Anyone pushing more than 1 hour needs intervention... Jo - Original Message - From: Nikki Macfarlane To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 8:29 PM Subject: Re: [ozmidwifery] Episiotomy - when to cut? Jo, What a frustrating situation for you, her other caregivers and of course the woman herself. Can I ask what position she was in when she was pushing. Also, how she was pushing - following her own urge with everyone following her pace or with counting, held breath and purple pushing? Nikki Macfarlane Childbirth International www.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 7:59 PM Subject: [ozmidwifery] Episiotomy - when to cut? Hi all fellow midwives and students and all :) Looking after a woman last night who was a primigravida, term, induction for SROM, not in labour. RMO needed birth experience, so he did the catching. He did not cut an episiotomy, and nor would I have, but this woman ended up with horrible tears, in all directions, almost to the clitoris on both sides. We were 'scolded' by the consultant for not doing an episiotomy. Get mobile Hotmail. Click here -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
Re: [ozmidwifery] Episiotomy - when to cut?
Jo, What a frustrating situation for you, her other caregivers and of course the woman herself. Can I ask what position she was in when she was pushing. Also,how she was pushing - following her own urge with everyone following her pace or with counting, held breath and purple pushing? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 7:59 PM Subject: [ozmidwifery] Episiotomy - when to cut? Hi all fellow midwives and students and all :) Looking after a woman last night who was a primigravida, term, induction for SROM, not in labour. RMO needed birth experience, so he did the catching. He did not cut an episiotomy, and nor would I have, but this woman ended up with horrible tears, in all directions, almost to the clitoris on both sides. We were 'scolded' by the consultant for not doing an episiotomy.
Re: [ozmidwifery] Episiotomy - when to cut?
Hi Nikki. As most women are where I work, she was semi-sitting; she was "chin on your chest, big breath, PUSH, quick breath and push again!" style pushing; and she was not following her own urges - that would have taken too long! 3 big long pushes per contraction. Anyone pushing more than 1 hour needs intervention... Jo - Original Message - From: Nikki Macfarlane To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 8:29 PM Subject: Re: [ozmidwifery] Episiotomy - when to cut? Jo, What a frustrating situation for you, her other caregivers and of course the woman herself. Can I ask what position she was in when she was pushing. Also,how she was pushing - following her own urge with everyone following her pace or with counting, held breath and purple pushing? Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com [EMAIL PROTECTED] Distance training for the world's childbirth educators and doulas - Original Message - From: JoFromOz To: [EMAIL PROTECTED] Sent: Tuesday, June 10, 2003 7:59 PM Subject: [ozmidwifery] Episiotomy - when to cut? Hi all fellow midwives and students and all :) Looking after a woman last night who was a primigravida, term, induction for SROM, not in labour. RMO needed birth experience, so he did the catching. He did not cut an episiotomy, and nor would I have, but this woman ended up with horrible tears, in all directions, almost to the clitoris on both sides. We were 'scolded' by the consultant for not doing an episiotomy.
Re: [ozmidwifery] Episiotomy - when to cut?
oh, arent protocols cruel everything is wrong
for her there, Jo. As Nikki says, pushingat her own pace and in a
position that allowed gravity to help all help.IN the position you describe,
she's actually pushing uphill, with the coccyxbeing sat on which reduces
available space and her body and lungs are all compressed. I guess the
protocols also dictated that she must start pushing from the minute 2nd stage
begins? So she's dead exhausted when the head finally hits the peri? And has no
energyto actually slow the head down during it's exit?
I have found that slowing the head down even just
by a contraction or two helps enormously. It allows the surrounding tissues to
accomodate this sudden insult. Let the head spend more time stretching the
perineum, and let the head bejust breathed out, rather than pushed
will go a long way toachieving a gentle exit. If we're exercising we
dont achieve maximum stretch the first time we try the splits. We get better
with each little effort. In a compact way this is the same with the peri. If the
women are told ( both during labour and very gently and encouragingly at the
time) they understand that it will be beneficial to them afterwards and usually
are very keen to help themselves. Heat applied to the peri and birthing in water
also help this scenario.
The stranded beetle position you describe Jo, will
be ingrained on you forever as you learn first hand the horrible effects
it has on women. I cant think of one good thing about it.
Robin
- Original Message -
From:
JoFromOz
To: [EMAIL PROTECTED]
Sent: Wednesday, June 11, 2003 12:55
AM
Subject: Re: [ozmidwifery] Episiotomy -
when to cut?
Hi Nikki.
As most women are where I work, she was
semi-sitting; she was "chin on your chest, big breath, PUSH, quick breath and
push again!" style pushing; and she was not following her own urges - that
would have taken too long! 3 big long pushes per contraction. Anyone
pushing more than 1 hour needs intervention...
Jo
- Original Message -
From:
Nikki
Macfarlane
To: [EMAIL PROTECTED]
Sent: Tuesday, June 10, 2003 8:29
PM
Subject: Re: [ozmidwifery] Episiotomy -
when to cut?
Jo,
What a frustrating situation for you, her other
caregivers and of course the woman herself. Can I ask what position she was
in when she was pushing. Also,how she was pushing - following her own
urge with everyone following her pace or with counting, held breath and
purple pushing?
Nikki MacfarlaneChildbirth Internationalwww.childbirthinternational.com
[EMAIL PROTECTED]
Distance training for the world's childbirth educators and doulas
- Original Message -
From:
JoFromOz
To: [EMAIL PROTECTED]
Sent: Tuesday, June 10, 2003 7:59
PM
Subject: [ozmidwifery] Episiotomy -
when to cut?
Hi all fellow midwives and students and all
:)
Looking after a woman last night who was a
primigravida, term, induction for SROM, not in labour. RMO needed
birth experience, so he did the catching. He did not cut an
episiotomy, and nor would I have, but this woman ended up with horrible
tears, in all directions, almost to the clitoris on both sides. We
were 'scolded' by the consultant for not doing an episiotomy.
