Saturday, January 30, 2016

Don’t say Posterior? Does silence serve?


Doulas and patient-centered providers of all types have a well-placed desire to protect a woman’s confidence to cope with childbirth. 

Birthworkers must navigate the topic of fetal position between a natural birth ideology and the medical research on posterior presentation.
I didn’t say we have to choose between natural birth and research, mind you. But we move from personal proclivity to interpreting complex and sometimes incomplete research from which to make sense of fetal position changes. 

Social ideals for natural birth pull against the expanding variables of fetal rotation. My interest is to offer a functional understanding from which the doula and provider can discuss posterior position with parents and others in an empowering way.  

You can read a portion of such a discussion with midwives in my article Posterior Perspectives in Midwifery Today, Issue 114, at https://www.midwiferytoday.com/enews/enews1716.asp#main

Rachel Reed, midwife and PhD, and insightful blogger of Midwife Thinking poses the fact that “most babies rotate” as ideology in Celebration of the OP baby,  “These situations only become problematic when we apply generalised expectations about how labour should be to an individual woman, baby and situation.” To quell the fear-factor risen about posterior fetal position over the last two decades, Catie Mehl from Ohio, and Angela Horn from Arizona, two active doulas doing good things for families in their communities promote the ideological viewpoint which seems, at first, to reject challenges due to fetal malposition. Each blogger seeks to cast fear from the examination of proclaimed complications about birth, through which stating concerns might alarm pregnant women: the large baby, the overdue baby, and in this case, the posterior baby. Their post at once acknowledges the risks of posterior, and rejects the advantage of proactive support of the woman’s  birth companion, or doula (doo-la), in  discussing activities to prevent or prepare for such a labor. Selina Wallis keeps a scholarly eye on posterior issues on her blog, Magical Birth. She did a fine job discussing  Catie and Angela's conclusions so I will say less rather than more. 

Our heroines claim their resistance to educating women is because evidence is lacking to support maternal position changes to rotate babies out of the occiput posterior position (OP). They propose doulas should not discuss OP as a concern in pregnancy with clients, as these have the “potential to influence how pregnant women perceive their preparation for birth and the experience itself.” For now, let’s look at the justification for discarding proactive preparation. The ideology over physiology argument rests on missing data points and over stating research conclusions. We’ve already established the value of these doulas in their community so we will follow this advice from Angela Horn with what might be missing from her assumptions.

“The research shows us that most babies will be OP at some point in labor, and the vast majority of the time it does not cause issues with the labor. When it does, we need to focus on the comfort of the laboring person rather than rotation, as there is no evidence to suggest maternal posturing will fix baby’s position, and most babies will rotate just fine on their own.”

Does the fact that “most babies” will rotate on their own is true, permit well meaning doulas to ignore those that can’t rotate for themselves in our discussions with pregnant families?  Sizer found 65% of OP babies rotated to OA and Lieberman found about 4 out of 5 posteriors rotated at each labor phase observed for fetal position.


Relying on the fact that  “most” babies rotates leaves, the 15-35% of babies that don’t rotate to potentially long labors with cesarean surgery, or as Angela Horn cites, uterine rupture and occasional death (Fantu). And though Lieberman shows 20% of posteriors turning to face a hip, 24% of those ended labor with a cesarean for deep transverse arrest.


Randomly posterior?

Lieberman’s 2005 study seemed to limit posterior studies to comparing ultrasound diagnosis to the doctor’s fingers until recently. If fetal position changes were random, then why study fetal rotation? The fact that Lieberman observed that 36% of the babies were OP at one time in labor is not equal to their requirement to be OP, or that some women’s pelvises must have an OP baby.

Assuming the wrong conclusion slowed research. The question should be, if one variable doesn’t explain the pattern of fetal position changes, what else might we explore?

Going back to the 1800s we see physician description of right obliquity of the uterus (Dakin). This anatomical normality of uterine shape then might be a variable in deciding flexion or extension of the fetal spine and, so, head diameter. Spinning Babies Workshops illustrate this possibility.

“It’s a hypothesis, GG. A hypothesis is a way of looking at the world to see if something you think about will work in that world,” Alton, my four-year-old grandson, told me while I tucked him in at bedtime after his Little Scientists class.



Accuracy to determine occurrence and cause may need the addition of multiple variables. Extension and the dynamics of the pelvic floor are two such variables. 
Pelvic floor dynamics play a part in the extended baby rotating to posterior as the more front of the head becomes the rotation denominator, rather than the round crown. 

So the baby from the Right Occiput Transverse position will more often rotate to posterior (Sutton). So if the Occiput Transverse position whether right or left was counted as one single data point in Lieberman's study, for instance, flexion and extension are ignored twice, once because the angle of the head for flexion was not measured and two, because right or left occiput transverse was not considered different.

Variables of fetal position may include degree of fetal head flexion or extension, size of baby, asynclitism at or after 0 station, and shape of parietal eminences; maternal anatomical features -- such as which of three levels of the pelvis (described in America as stations of the pelvis) in which the baby was, and whether the diameter of that level matched the baby’s anterior, transverse, or posterior position (which is to say, the head was in an unfavorable diameter) -- pelvic floor tone and relative symmetry, sacral mobility, size of pelvic outlet, and location of placenta.


Can a variable have a variation?

If the strategy for support and care for posterior labors hung only on the seeming randomness of a single variable fetal position change and the usual success of the birth process, might we only expect 80-90% of babies to survive birth. And would rejecting proactive measures seem to have the doula accept William Barth, Jr.’s sobering treatise on the high maternal morbidity of OP? Not to repeat Fantu’s heartbreaking report on obstructed labor in Ethiopia. The justification for neglecting proper pregnancy counseling is confusing.

Thankfully, we do have medical interventions for the mothers of the persistent and non-fitting few OP babies, especially since repeated studies find only 17.4% of first-time mothers with OPs have a spontaneous birth without medical interventions (compared to 76.2% of anterior), with 64.7% of women finishing their posterior labor with a cesarean (compared to 6.3% anterior, Lieberman).

While maternal position research study sample sizes are small, they open evidence-based pathways to application of techniques. Maternal positions studied were found favorable as comfort measures. Guittier et al studied maternal positions suggested by de Gasquet  in Trouver sa position d’accouchement Paris: Hachette Livre; 2009:126. But none of the proposed positions opened the inlet. (Reitter, 2015) where the posterior baby needs the room to move from the anteriorposterior diameter to the oblique or transverse direction of the opening to the pelvic passage.

Desbiere’s interesting attempt to compare three maternal postures to rotate baby did find that all women that used hands and knees position and recumbent were successful in rotating baby out of the posterior position. Strebler also found some success. There is evidence for maternal positioning to rotate a baby out of posterior.

For birthworkers, Ms. Simkin advises, “Avoiding OP positions is a worthy goal” (Simkin 3). I agree and bet my life work on it. The challenge comes, of course, in choosing truthful words to speak to a mother whose baby remains OP. Spinning Babies serves doulas, providers and parents who choose to explore the small samples in the research and explore concepts proven in physical therapy models and apply them to birth.

Spinning Babies celebrates physiological and spontaneous birth and seeks to understand the variables to replicate the environment of success for that still-significant percentage of women whose babies won’t spontaneously turn. Many don’t need a cesarean.  Many avert their cesarean by applied techniques without control study evidence. .

How do we reach these women? We actually don’t have to speak of posterior fetal position! We can easily promote the comforting and effective maternal positioning techniques “to make room for the baby!” Many women enjoy being proactive in her pregnancy. Women seek physiologic options before resorting to obstetrical and mechanical interventions.

I will continue to help women have a healthy, safe, even happy birth with the mother's reports as my evidence. Its true that some women would have had a shorter easier second birth than their first posterior labors, but the frequency of short subsequent labors might be worth investigating. The Spinning Babies approach to maternal positioning strategies for fetal rotation are sufficiently successful and ever improving. Gentle techniques with scant research but abundant anecdotal evidence to support them are now spread worldwide with the social networking enthusiasm of birth activists and appreciative parents. Certainly, women are benefiting now from my and others recommendations for maternal positioning. (Gizzo) I add myofascial (muscles and connective tissue) passive stretch techniques to make room, or reduce tightness, in the path of the baby.

World fame may be transitory without convincing research. I so want research specific to Spinning Babies’ approach to provide a third leg of the stool to balance the two opposing strategies of Wait-n-see vs. Cut-em-out. There are more than two answers to any argument. And this is certainly the case for labor progress solutions for posterior and other challenging positions.


A Research Dilemma

How shall we study something as complex as a paradigm?

For a premise like Spinning Babies, scientific clarity begs multivariable factors for the
flexion, rotation and descent of normal cardinal movements of birth. For instance, we cannot consider that all the factors for a progressing labor are exactly similar in a non-progressing labor. Most pelvises have been shown to be “adequate” after cesareans. Most babies estimated to be large are found, after the cesarean, to be smaller. Might there be other elements of the anatomy than that bony pelvis at play with birth?

Can the most simple solution be the answer to a complex problem? The Karminia study is often cited to disregard maternal positioning, though only hands and knees and pelvic rocking was studied and only 11% of study subjects fully complied to the 2 ten-minute periods for the full three weeks before birth. Even with that low compliance we should have seen a difference in outcomes for those few. But we learned that this highly-recommended comfort measure is not also a rotation measure in pregnancy. That’s all. In labor, hands and knees position helped OP babies rotate (Stremler), especially when adding Rebozo sifting (Cohen) .

At Spinning Babies, our solutions to stuck labors begin by looking to the level of the pelvis where the baby waits to match a corresponding technique(s) (Vitner, Iqbal). In other words, we don’t use an outlet technique for an inlet problem and expect it to work. While squatting might work for an OP baby below the midpelvis, the Abdominal Lift and Tuck with a flattened lumbar (Janie King’s Abdominal Lift with Penny Simkin’s adaptation of counter-nutating the pelvic sacrum) is specific for helping an OP baby rotate off the inlet. However, the research community prefers a single variable study. How one variable may determine the validity of a holistic method seems more suited to starting a study than applying it in real life situations. Single variable investigation is the nature of control studies that confounds scientific exploration from paradigm review (KC Johnson).



Conclusion

Neglect of prenatal and intrapartum care for the laboring woman and her posterior fetus may result from a lack of understanding on the part of her doula or provider in interpreting evidence. There is sufficient evidence to justify the doula and the provider offering non-medical, “physical theory” prophylactic strategies for the posterior fetus. Anecdotal evidence of a collection of concepts and techniques put forth as Spinning Babies is gaining popularity for comfort and resumed labor progress for posterior and undetermined fetal positions collected through the timestamped emails and posted Facebook testimonies. Increased understanding of the birthing baby’s rotations through the pelvis may come from combining variables in prospective research observations.

By rephrasing our advice to pregnant women away from concerns about fetal position, towards the enjoyment of bonding (“binding-in” in pregnancy), we are truly proactively preparing for easier childbirth. “Making room for the baby” replaces potentially trauma-inducing words like “uh-oh!” and “malposition” or “stuck baby”.  The diagnosis of fetal position becomes suddenly less vital. Meanwhile we are sensing and observing, guiding a pregnant women towards full range-of-motion for the best flexibility, mentally and physically, for the upcoming expression that is her birth.

Call to action: I need a research assistant to help prepare for studies who has office software skills and is in school for their doctorate or is post-grad. Email me at Gail@ you know the website! (robot dispelling email hint)

Sunday, January 24, 2016

Spinning Babies and High Blood Pressure and Pre eclampsia

Spinning Babies seeks to reduce the struggle of Good morning Gail,

Just had to share a success story with you.  We had a 38 week induction for severe pre-eclampsia on the floor.  She'd been on pitocin for hours, was up to 22mu and still only 5cm, -3 or -4 station, head ballotable and seeming to be caught on the brim of the pelvis (with an epidural).  

Her labor nurse had been to a midwife conference last fall where there must have been a workshop on spinning babies. [Yes, I presented Engaging the Inlet; Labor onset beyond cervical ripening, at the American College of Nurse Midwife chapter of Minnesota conference, Oct. 2, 2015]. 
So we talked about doing some Spinning Babies moves.  I went in to help her and we did Side-lying Release and a "modified" Abdominal Lift and tuck on her knees on the bed. [Consider this variation for when the moms had an epidural. Be sure she has a person on each side of the bed holding her steady.]  

An hour later she was 6cm -1 station, and another hour later she was 9-10cm.  Can't tell you how happy I was for that patient and the ability to help her!  

As a side note, I happened to be teaching a student clinical that day (not actually working the floor) and my student was able to see this fantastic work and can't wait to be an OB nurse. 

Thanks for all the work you do, Lisa B. RN


The nurse's testimony came the same day this week that I got a consultation call from a second time mother hoping for an upcoming vaginal birth after her previous baby was born by cesarean (VBAC).

Jess Tate (not her real name) was 36 weeks and 5 days pregnant when we spoke. She wanted tips to avoid another cesarean for transverse arrest, the cause of the cesarean for her first birth. If you do, too, check out, http://spinningbabies.com/learn-more/techniques/the-fantastic-four/sidelying-release/

I asked if there were any medical reason not to do a forward leaning inversion? See the contraindications and instructions for when its safe to do at http://spinningbabies.com/learn-more/techniques/the-fantastic-four/forward-leaning-inversion/

She said her doctors were watching her for high blood pressure, although it wasn't quite 140/90, it was over 30/15 points higher than her normal. I asked a few questions about her symptoms.

That means, no inversion. We don't go upside down when there is risk of a stroke.
Abdominal release and standing sacral release will have to do for it. Not identical, not all inclusive, but as close as we can get.

Her liver profile wasn't encouraging.
Generalized swelling including her face
Severe headaches
Flashes of light and other visual disturbances

She did not have protein in her urine.

The headaches began 3 weeks earlier and were severe enough to deny her sleep. The doctor prescribed Promethazine.

She wondered if she were going into labor as she was showing early signs of possible latent labor. The warnings on Promethazine are not to take in labor in case it causes the baby to bleed. Bleeding in the brain can be fatal to newborns. How can she sleep then on the night she might or might not go into labor? Second time moms may experience several nights like this.

Yet now she couldn't sleep and if she didn't take the Promethazine she was up all night. She had nightmares when she took it. She was anxious during the day. I noticed that was a side effect as well as the nightmares.

The medical plan was to see if she could stay pregnant long enough for the baby's lungs to mature before she had a siezure, her ration worsened, or her blood pressure went up 3 more points.

I introduced Jess to the Brewer Diet immediately. As we spoke, her husband made her a high protein meal.
She was seeing the doctor in the morning. I asked her to eat 50 grams of her 100 gram daily goal of protein before seeing the doctor.

The next day she was normal enough to remain home. She felt somewhat better. We talked again the day after that 36 hours after starting the high protein, salt-to-taste, 3 quarts of water, leafy greens and more good food diet designed by Dr. Tom Brewer some decades ago. This diet has been a Bradley Method Childbirth  Class recommendation and a home birth midwife recommendation since the 80s. Babies end up big and healthy.

Reduce sugar, white flours, etc. and eat close to the farm, so to speak, to avoid large sugary babies. We love 'em but for a VBAC mama it'll be easier through those ischial spines, since this mama needed strategies, and her baby would have good size and good health from good food.

36 hours later she said her headaches, swelling and flashes of light were gone. She still hasn't had her baby yet, so we are hoping for improving health and spontaneous and safe birthing!

Yesterday.
Sarah Longacre of Blooma.com asked me to come down and talk with some of the relatively fresh doulas. Expecting Spinning Babies topics they may have been a little put out to have a lecture on blood pressure, Brewer style via Gail Tully.

Success has happened so far for every one of the mothers I've counseled who followed the Brewer Diet but one that we also had to involve homeopathic advice from a professional. The stories are dramatic. Read it yourself,
http://www.therealblueribbonbaby.com/

There are wonderful complimentary modalities, alternate modalities, for hypertensive disorders when given by the expert practitioner. The Brewer Diet has saved lives and let babies grow to full gestational potential. Check it out.

LAST UPDATE! Jess Tate (in the story above) called me while I was grocery shopping. She is now at 38 weeks and feeling much better. The headaches have not returned and her swelling is gone. Her blood pressure at the doctor's visit was 108/60. She continues to eat 100 grams of protein a day and wonders about her contractions. More questions about her contractions show they last 1-2 hours just before dinner time! She's hungry and Baby's hungry, so to speak. I suggested a snack about 4 pm so her body has the energy to wait for her husband's arrival at their 6:30 supper together. Now that her blood pressure is normal, I asked her to ask her provider if there is any more a medical reason not to do forward-leaning inversion. We'll see.  But I don't think her contractions are due to a fetal position, but rather a late afternoon need for a protein snack. 

Monday, January 11, 2016

Walk proud after birth! Mama, you can Strut!

The timing was perfect, the product was something she could get behind, the deal was done!
Then I heard about it and here is a product-based blog post to tell you about Mama Strut.


Tammy Ryan was contacted by Jill Bigelow of Pelv-ICE right about the time she was enamored  with the pelvic floor during her training to come on the Spinning Babies Approved Trainer team.  Jill approached Tammy to promote their new Mama Strut postpartum recovery aid. She loved it. When Tammy told me about it, in my private thoughts, I was like,
"Someone designed a pair of shorts to hold an ice cube? What is the mom doing out of bed that early, anyway?"  Well, when I saw the actual pair of shorts, I was very impressed. Jill put so much quality and creativeness into her product. And the support panel aspect in itself offers powerful postpartum comfort. Actually, for the mom who has to get out of bed early, perhaps to walk to the nursery, Mama Strut will add a health safety advantage.  I knew I would feel good telling others about it, too!

So, Tammy and I put together a little video Q and A about Mama Strut.

Spinning Babies asks, What is MamaStrut? 




The visual on the pants is hard to see, so I will include a photo from the Mama Strut Website.

These pants are actually a medical device! So you know I found them well stitched and well made.
See if your insurance carries the cost.
Now you can see how to put it on at https://vimeo.com/109742584

We are so impressed, we affiliated with Mama Strut, and asked Jill to have Mama Strut be a Spinning Babies Sponsor. So you can see the ad at the top of our website banner.

Contact Tammy Ryan, Director of Education and Sales, for MamaStrut.

There are exercises to protect your pelvic floor as well. Mama Strut is a super smart support tool but you will also want to stand, walk, Rest Smart and Move Smart for Postpartum as well. Moving will definitely feel better for weeks and months after birth. Buy Mama Strut from Spinning Babies Website and we'll both feel better. Thanks for reading this weeks Product Blog! 

Thursday, November 19, 2015

Growing (Spinning) Babies!


Spread the breakthrough message of Spinning Babies.




Spinning Babies eases birth by helping baby rotate more easily through the pelvis. Less pain and intervention is readily possible. As the Spinning Babies Lady (that's me on the left). I began a personal mission to make birth easier for mothers, babies, AND their doctors, nurses, midwives and doulas. I observed birthing women, combined information from sources outside of the birth world, and developed further some of the brilliant insights of those who’ve walked before me.

Observing birth, I noticed what most stuck or stalled labors had in common: where in the pelvis the baby waited and the angle of baby's head in relation to that part of the pelvis. In fact, my midwife friends said I could "see inside." By that seeming talent, I've developed an "assess and match the technique" approach that apparently has not been considered so fully before.

Now it is true that the position of the baby is well shown in medical and midwifery studies to be a leading cause of long labor and even cesarean. Every birth attendant knows that. But knowing how a baby can be helped out of a difficult "fetal position" is less understood. Force is too often the chosen solution - pump in the drugs to strengthen the uterine contractions or manually turn the baby by hand. Though both approaches have some risk, they are sometimes necessary and often effective.

A common, more gentle approach is to wait, and some providers get the mother moving. This approach is often successful but not if baby is stuck. So far, then, help has been random and so are the results. Meanwhile, too many women suffer hoping someone will finally know what to do.

Women are too often told, "the baby is too big" when the angle of the head that is the real issue. A better angle of the head (called flexion) lets even a large baby fit the pelvis of most all women.

For years, the emphasis on "The 3 P's of Labor: Passenger, Passage, and Pressures" has been the excuse for pouring Pitocin (Syntocin) into a woman's veins and even using life-threatening Cytotec (unapproved by the FDA for use in birth) to pressure a woman's cervix into opening with too little regard for the passenger or passage.

I've offered the world a new approach of Balance, Gravity, and Movement, the "3 Principles of Spinning Babies. Showing women how to "balance" muscles and ligaments so they aren't too tight or too loose. The pelvis becomes more mobile and the support structures to the womb lengthen, soften and “make room for the baby.” Balance allows the baby drops into the pelvis with a tucked chin and helps labor to begin –and continue– on its own. And if labor has stalled or stopped progressing, I offer a new perspective on assessment and matching solutions.

I teach providers to ask, "Where is the baby?" Then we choose a technique for that place in the pelvis. Is baby engaged? Which way does baby? And, how far down has baby descended? Asking where gives the clue to match the right technique and allow labor to finish as nature intended. And it doesn't matter much to the success of the technique if the mother has pain drugs or goes completely natural. That's the mother's choice.

Being in balance may add comfort to pregnancy, ease the birth, and lessen the pain so women can cope with confidence. Then a woman's desire for natural birth has a better chance of blossoming into the birth she wants for her child.


My website, SpinningBabies.com has given free and comprehensive information for 14 years.

Track record: I‘ve already offered the world a Belly Mapping Workbook and a couple of videos, professional workshops and 6 trainers to give Spinning Babies day-long workshops. I have an amazing Director of Optimism working 30-40 hours a week and a Director of Practicality working only 5 hours a month, new part time office support, an accountant, and myself. This would be enough if I were not hoping to reduce suffering in birth around the world. Those that I’ve  helped say I have already changed the world of birth. But honestly, Spinning Babies has not accomplished her full potential. My heart is breaking right now because so I could offer so much more. I need a professional support structure for my 5-year plan to ease the way the world addresses stuck birth. 
But isn’t this what midwives already do, you might ask? There are many smart and gentle midwives. These are the very professionals at my workshops telling me, “I wish I had known this 30 years ago when I started,” and “I could have used this knowledge yesterday, we would have avoided that cesarean.”


I need you to help me make a significant contribution to babies and mother, providers, and birth practice that lasts into the future. Doctors could turn force into "balance" when a long labor requires their expertise.

Please help me and all Spinning Babies enthusiasts to get past the hump.

Though Spinning Babies isn't a non-profit, the model IS to serve foremost. You see, I was a small time midwife with a breakthrough idea, not a person planning to start an international business.  The little engine that could is not just going over the mountain to the children on the other side. Help build the track to run with this message. Spinning Babies is going global and that's a lot of children! I need HHhelppp!!!

What will your donation do on a tangible basis?

·      A Spinning Babies Book for parents in several languages

·      A provider reference book to look up what to do when

·      A Trainer Training expert hired to head up the training for my 6 eager trainers and train the next group to expand Spinning Babies message around the world (I've found her, if I can hire her!)

·      An Office Manager will manage my time for creative efforts like a book and an app (hiring October 2015, shall I call him the Time Lord, since he'll be scheduling my every project? oh, I so want this chance to succeed!)

·      An app to help solve common labor stall issues

·      If we exceed expectations, we may be able to fund some research!


True Quote: "I have been practicing Spinning Babies for the past 2 years to the best of my knowledge, and with using the Side lying release and Abdominal lift, I believe I have saved at least 50 people from having a cesarean section! This is so empowering to women and myself as a labor nurse." Jennifer Crews, RN, California

That’s one nurse, two years, 50 major surgeries averted. That may be 25 less infections, could be 30-50 more babies handed straight to their mothers, perhaps a month less postpartum pain for each woman, and several women without the struggle wondering why their “body didn’t work.”  

Kate Lawrence, CNM, in Ohio said in the months following a Spinning Babies Workshop for nurses the head of the department noted the drop in cesareans and asked what had been the impetous.

Lorenza Holt says, the stalled labor is less often a “failure to progress” than it is our “failure to assist.” She is now teaching midwives in Mexico the Spinning Babies approach to include with their traditional knowledge about natural birth.



Spinning Babies isn’t necessary for all birthing women. But it is necessary to counter the leading cause of unanticipated cesarean – the labor that doesn’t  bring the baby. Whether it’s called “failure to progress,” or “baby is too big” or “malpositioned fetus,” Spinning Babies has immediate help and prevention throughout pregnancy that will help more women and babies than ever before. That gives a doctor, midwife, or nurse some real satisfaction.


Your donation gets you in on the wonder behind stories like these:

True Story: A man and woman have been in hard labor struggling to give birth to their child for 3 long days. No midwife lives on their Indonesian island. Something is holding up the birth but they don't know what to do. The woman's exhaustion is growing worse. Her husband takes her to the dock where the ferry will come and take them to the hospital sometime the next day but the father doesn't know if his wife and child will still be alive when the sun comes up. He sends his neighbor by rowboat to get a midwife from another small island without a hospital. She's got internet and (amazing to me) has read the Spinning Babies Website. She identifies the problem, does the technique and 15 minutes later the baby slips out--right into the sand!

 Yes, you can save lives even where no cesarean is available.

True Need: World expert Obstetrician in Frankfurt, Germany invites me to bring a technique to study after seeing me present in Brazil. Forward-leaning Inversion to allow a baby stuck sideways in the womb to turn and line up with the pelvis. His university setting would allow before and after proof. How will I leave necessary office tasks to prepare and oversee research. Other doctors, nurses, and midwives ask for research options for their sites.

True Story: British midwives, some of the best-trained midwives in the world, wait with a mother on a gurney cart outside an operating room. They have tried all the tricks of their training and the baby seems too big to be born naturally. The OR is being cleaned, however, and they have to wait. “As long as we're waiting,” they say to one another, “let's try that technique from Spinning Babies.” In 15 minutes, they call into the Operating Room, "Never mind, we have a baby in the gurney!"

True Need: Korean physician with a 10-bed maternity clinic has an 8% cesarean rate. She feels that rate is too high and knows Spinning Babies will reduce the unnecessary surgeries in her practice.  US rates of cesarean are over 32% and we know that 1/3 of all women are not unable to give birth if they were just supported to do so. She wants a protocol for when to do what.


True Story: A woman is induced at 40 weeks gestation and wants more than ever to have a vaginal birth of her 2nd child after a cesarean was done for her first. The midwives say her cervix is staying at 6 cm for 4 hours and she needs a cesarean. She asks for 1 more hour. Intense use of body balancing techniques including release of tight jaw muscles and then the sacrotuberous ligament changes the size of her pelvis and she dilates to 10 in 3 subsequent contractions. She pushes a long time but has her baby without any further intervention.

True Story: Midwife is about to give up after all her known techniques aren't helping a mother in a stalled labor. She texts me and over the next 14 hours I guide her through steps including releasing the jaw muscles, connective tissue holding the nose, releasing adhesions in the leg sockets and muscles to the pelvis. Her pelvis opens, as proven by the sudden increase of the size of the rhomboid of Michaelus (how much of her sacrum is seen under her skin) and she dilates to 10 cm.  The baby is born after much pushing. Not a one of these techniques is taught in midwifery school or medical training.



True Text: “I am stunned at the amount of learning that can happen at one birth even after nearly 20 years of going to births!”

This last comment is from my midwife friend Vicki who is both a CPM, the certification of the North American Registry of Midwives, and a CM, the certification of the American College of Nurse Midwives. Her excellent education didn’t provide the kind of answers to release the connective tissue spasm that pulled the mother’s tailbone into the path of her baby and stopping the birth at 6 cm. In fact, she had never read nor heard that body work that she herself could learn at a birth could change the size of a woman’s pelvis when the pelvis was only smaller due to something like a shortened ligament.



Some of the techniques are on the website and some have yet to be written down. Nurses and midwives need a “what to do when” reference. Where's the App? is as common a question as Where's the Book?







Many places in the world could use a picture book without much text to show midwives how to assess --without needing technology-- when baby isn’t coming out and what to do about it –without needing technology-- that the birth attendant just doesn’t have access to in remote locations, and parents can’t afford to pay for when it is available.

Some words from the book, A Path Appears, make me think to add some comments here. Some may assume making birth safer and less painful might make low resource areas even more populated. Nicholas Kristof and Sheryl WuDunn share that about 20 years after families stop losing some of their babies to the effects of poverty they self regulate to smaller families. Difficult birth not only harms babies but mothers, too. Long obstructed labors increase fistulas, hemorrhages (excessive blood loss), infection and incontence of the bladder and rectum. Easier birth is not just potentially enjoyable but improves health outcomes.

If Spinning Babies is going to contribute to massive improvements for birthing women, the office is going to need development and the book needs to be written!

It takes more than great ideas. Myriad steps include planning, legal advice, time management, design, production, coordination and love. It takes many of you to do a little and a few of you to do a lot.




Raising a child may take a village, but so will raising the understanding to help babies get born safely!

Would you or your family member have benefited from Spinning Babies information?

Did you or your family member benefit from SpinningBabies.com or something you learned from one of the workshops or products?

Would you have liked your birth to have been easier? And mothering more confident because of a joyful birth? Or even just a straightforward birth?

Would you like your birth practice to be more physiologic, have less interventions and more solutions?

Please donate to Spinning Babies and prove we can do this! Do it now, our time is short and our goal is big.

On the 6th day of labor in a birth center in Korea, a doula asked to try a technique she learned from Spinning Babies. The doctor agreed. “and to his surprise, mom was fully dilated and at +1/+2 and baby's head was OA. …C-section averted! Thank you so much for teaching me this. I am thankful that I was there and that my client had such an easy birth that I could help. Now, two more doulas know this technique. I had talked to them about them before but I don't think they believed until they saw for themselves.”


Watch the site for the pre-order option or donate to this effort. 

Bottom's Up

Last night I was with the wonderful Adrienne Caldwell as she led a small group of enthusiasts and parents through a hands-on protocol of massage techniques for Breech Balancing.

Wait, pregnancy massage like relaxation? 

No, massage is working with muscles and ligaments that have shortened from living in gravity to return to normal length and function. Shortened muscles are tight and may pull pelvic bones closed. Fascia may be released. Fascia is a thin but strong sheath of open membraneous fibers that carry fluid and so electrical current to help our muscles work and give our joints their range of motion.



Ok, but what is balancing?

Not too tight, not too loose.
Allowing baby the space to spontaneously move into a head down and bottom up position.



Three Chiropractors were present and learning from Adrienne. Parents come to learn what to do that may help a breech baby flip head down. This night a couple came for help for their posterior baby. I wasn't sure they needed it as they'd had two births without surgery before and this baby was then likely to rotate in labor. Some women prefer to be active in preparing for birth, adding balance and usually gaining immediate comfort.

Adrienne  was really sweet to me and said to the class, I'm going to suppose you've already done the list at
SpinningBabies.com on the Flip a Breech page.

Including

  • Moxibustion
  • Rebozo Sifting
  • Forward Leaning Inversion (from Carol Phillips, DC)
  • Breech Tilt
  • Open Knee Chest 
  • Diaphragmatic Release





Here are some of the things Adrienne Caldwell adds:

Address the front of the pelvis

  • Round ligament release (part of the Chiropractic Webster maneuver) or similar to a trigger point release on the under side and lateral side of the round ligament.
  • Release tension in the inguinal ligament.
  • Tensor fasciae lattae...
  • Posts release (See Liz Koch if you want full resolution!)


Wait, do you have to buy coffee to get babies to flip? Is it the caffeine, then?

No no, no caffiene. That's a muscle... there's another little one above that crossing under the hip bone down to the top of the leg joint. That's gotta loosen up too.

  • Side opening between the rib and iliac crest
  • Sidelying Release
  • And Leg circles. Lots of leg circles. 
  • Open the arms and shoulders. 


Why? 

Because the ribs and neck and all the body happens to connect through the train track of muscles and ligaments and fascia. And there's a few more for the pelvic floor, psoas, and respiratory diaphragm.
Massage therapist with special pregnancy training can do these things in a gentle way, respecting the looser joints of pregnancy and avoiding labor inducing ankle points and such.


Adrienne is establishing this wonderful protocol that she will teach at the Spinning Babies 2016 World Confluence and which may be recorded for distribution. Her intuitive hands and extensive knowledge of physiology makes her my "go-to" friend in learning and getting an occasional massage.
(Adrienne, when can you fit me in?)

Breech babies have a human right of birth. But where will such compassion and skill be found today? Not many places. So meanwhile, gentle art of breech balancing is growing. Nicole Morales, CPM, and Deb B. are having success in San Diego, Carol Gray in the NW, and Carol Phillips in Maryland. Deb McLaughlin in Duluth. There are several more people, too, lovely practitioners in our Minneapolis/St. Paul area. So many it is hard to list.  Chiropractors, like the three magical women that were with us last night, Sharon Prahl, DC at 7600 Parklawn (around the corner from Flutterby Birth Services where we meet in Edina), Amber Moravec in St. Paul at Health Foundations, and Angie Graper, DC. We also have Acupuncturists, and Massage Therapists, and you know I love CranioSacral Therapy and Myofascial Release and Maya Abdominal Massage.




Please, Mamas, start considering hands on help between 32 and 34 weeks. Don't wait much beyond that. We see success is highest between 32-34 weeks, with diminishing but continuing success for some women after 36 weeks.
If you've had a head down baby before or this baby was head down at 32 weeks before flipping it maybe easier to get baby head down.
If you are under 35, don't have a family history, don't have low thyroid, or a history of an accident including a twist, etc.
Otherwise start about 30-32 weeks. Is that early? I don't think so even though some others do think so.

You get to decide.






Thursday, October 15, 2015

Olive Marie's Elevator Birth: Using the Abdominal Lift & Tuck to Engage Baby

Melissa Thornton shares her fourth baby's birth story. She wouldn't have found it so funny if she didn't have other births to compare:

"I will start by saying that this pregnancy has been a major blessing from day one. I was sick in the beginning but after that felt great. I slept great, gained the right amount of weight, it was all just great. Her being a girl was just icing on the cake. All along though I did have this “fear/thought” that this would be a fast labor. Mostly based on the fact the fact that Zael’s labor was slow then super fast at the end. I thought for sure I could skip the slow part and go straight to the fast part. Ha. Anyways, Zael was born at 40 weeks and I thought for SURE she would be born earlier. Funny. Anyways. it gets to be 38 weeks and I decided that the baby is coming soon, so I get all ready for her. I still felt fine but mentally I was “done” with the pregnancy, bad idea by the way. That week went by then by 39 I thought for SURE this would be the weekend, I even went to the chiropractor to move things along. Nope. 40 weeks (my due date was on the weekend) I start having contractions, I walked, get ready, then after a day or so it all stops. That was fine, I was glad for the break. The following week I got my membranes stripped, which started contractions, but nothing real or strong. Every day that week I thought would be the day, nope. Finally on Thursday night I started to have contractions, painful ones. I tried to stay in bed but it was too painful so I spent the night watching Dance Moms (gag me) and laboring between 5-7ish min apart. I thought those were painful, and they were, now i think they were early labor. I let Michael sleep and woke him around 5:30am and told him about the labor. I wanted to get out before the kids woke up and I wanted to get to the hospital before it got bad.

We bring in reinforcements for the kids and get in the car, we drive to the hospital, the way there I had one contraction. Michael says “Well I guess you wont get that car birth you were worried about” (ha). We get to the hospital and they hook me up and it all stalls. Not 100% but didn't continue enough to stay. Not to mention a night of labor and I was at the same dilation and effacement as I was at the doctors office the day before. I was not a happy camper. I knew then that it had to be positional and she just wasn't in the right position (spinning babies became my go-to source). The nurses would say “she's just not ready” those are NOT words anyone wants to hear at this point of life by the way. Amanda (the midwife I saw AND has been at all of my natural births) told me my choices were to either stay and walk for a few hours or go home with a shot of morphine in my rear to help me rest. I COULD be induced but there were no rooms and we would sit in triage for hours and that meant monitors and wires. I chose the shot of morphine, best decision ever. The morphine helps you rest and kinda stops contractions while you are sleeping. When it wears off your labor either stops or picks up quickly. I went home, and basically laid in bed all day. I don't think I slept the whole time I just felt like i was laying on clouds..ha. I did have some contractions and when it was almost worn off I was woken by a strong contraction. I got up, had dinner, Mike took the kids. That night I went to bed around 8pm. And thats when the “fun” started. From 8pm until about 4am I had VERY painful contractions almost exactly 10 min apart on the dot. I read spinning babies and decided around 2:30am to try the Abdominal Tuck and Lift for 10 contractions. Of course that took about 1.5 hours. And it HURT but I really think it hurt less than the contractions without it; because she was shredding my bones with her sweet little head. Around this time I also called L and D and told them the situation, they said if the contractions aren't at least 5 min apart then Im probably not making progress (AHH!), so wait for that. They were totally full and had no room for me and that was probably part of why she said that. But I knew that the pain I was feeling WAS active labor.

Around 4:45 am I called Michael (keep in mind Olive was born at 5:30 am). Michael was sleeping in our little guest house, I called and said “mike, I need you to come in, I think we should go”. Soon as I hang up BAM, transition hits. I decide to take a shower (??) and I think I completed transition in the 10-15 min between the shower and brushing my teeth. Meanwhile Im screaming during contractions and Mike is like we have to go NOW! And Im brushing my teeth….

As he's dragging me out I feel like I need to go to the bathroom, when I tried to go and couldn't I knew I was getting “pushy”. I did NOT tell Michael, he was freaked out enough. Mikes mom still wasn't there but we had to leave anyway, the kids were still asleep. We get in the car and start the very quick drive to O'Neal. Only to realize that O'Neal is CLOSED (?), Michael turns the car around and is asking me how to go. I start trying to give him directions, through my screams…lol. It was those contractions that I tried just letting my pelvic muscles relax and I knew she was headed out the birth canal; my water bag was bulging. I was in the most uncomfortable position possible in his truck bc I couldn't sit down. Ok, back to the drive. I gave him the correct direction until O'Neal and Harrell's Ferry. So he went the wrong way and pulled into a parking lot that I have seen a million times but didnt recognize at that moment. He said “where are we? What way do we go??” I was in that stage of labor where you are fake crying/moaning/complaining. I looked around had no clue and said “I don't KNOOOOOOOOOOWWWWWWW :insert hysterical crying here:” Contractions coming like nuts, no breaks. By the grace of God he turned the right way. Somewhere in this time he called L and D and begged to have someone waiting at the door. They told him to meet them at the ER (a place we have never been). We FINALLY pull up at Ochsner, Mike then pulls into a parking lot, can't find the ER entrance, rides over a curb (big bump!) and pulls in at the front entrance (the same one we had used the day before). He gets out of his side of the truck and comes around to my side. Right as he opens the door my water breaks, I was like AHHH MY WATER JUST BROKE! He said just get out!! Lets get inside!!!! He tells me to sit in the wheel chair that he found but I couldn't sit so I pushed it in. The door was open, it should not have been open, a miracle. We go in the lobby, Im screaming. As we get onto the elevator I start to feel “the ring of fire”. I hear mike saying “what floor?” I know what floor but have no way of getting those words to my mouth. So he pushes 2 (its not 2). We get to floor 2 and it opens, I can see its the wrong floor, the door opens and Mike says something along the lines of “we need help!” two cardiac nurses get on. Out of the 4 of us on the elevator I was probably the least scared/nervous. While on floor two the elevator goes back DOWN to floor 1, the doors open and there is a couple standing there (I don't remember this as I was delivering Olive’s head at just that moment). For obvious reason the couple decides to wait for the next elevator. Before we FINALLY get to floor 4 she is completely born. Thank goodness for skirts rights? (I was standing up) Goo/fluid flies everywhere. 
All over my legs, the floor (gross!). I cant lift her completely bc she is still on the cord so I hold her on my belly. She cried a little, but just to be sure I flipped her and made sure she was breathing, she turned pink instantly. The nurse gives the ol’ “your doing a good job mama” but it doesn't hide the fact that she is totally freaked out. I sit in the wheelchair and they roll me out. 

I didn't know this at the time but Michael had run to the front desk and yelled “WE NEED HELP! NOW! WE JUST HAD A LIVE BIRTH!”. The nurse came and told me later that they thought that was super funny, ha! When I told mike later he realized how dumb that sounded too and he laughed at himself. I am wheeled into triage (where we will stay for 7 hours due to a lack of rooms even though Amanda had a nice room for me complete with a relaxing tub of water). I stand up, blood goes all over my shoes and legs; and I never saw those shoes again. They were my favorite but somehow they got lost in the crazy. I get on the bed and Amanda and another nurse come and say that they were waiting in the ER for us when they were called up because we were already there. She even told me about the nice room she had set up for me, boo I never got to see it. So i get on the bed, deliver the placenta, no tears, no stitches, not much bleeding. And all I felt was SERIOUS relief that it was over. They tried to clean me up, they weren't totally successful. But thankfully in about 10 min I was able to to the bathroom where the nurse cleaned me a bit better.

I am very glad that this was not my first natural birth, because although it was interesting and a great story it was NUTS. Im happy that I do have 2 other births to look back and say “aww, birth is such a beautiful event”. Also you hear stories of women giving birth in cars and get jealous, nooooo, the car is hands down the most uncomfortable birth position. 
 
So baby girl is here, she is THE calmest and sweetest baby I have ever had the pleasure of meeting. Which is good, because we named her Olive bc we needed a peace maker around this house! I have no idea how to wrap up this story but I hope you enjoyed it! :)"

-Melissa Thornton

Monday, October 5, 2015

Happy Breech-Cephalic Twin birth

 Midwife Jewel shares a happy birth story: "Kathryn came to me at 8+6 wks gestation. At the time her fundal height was more like 15-16 weeks. We talked about possibility of twins, dates being off, how she often measured large for dates early in her other pregnancies. She wanted to wait until 20 weeks for an U/S, but I think we both knew something was afoot and she had one at 14 weeks that confirmed twins. 


"It seemed like the most important thing was to find someone experienced with supporting a mom with twins and there just wasn't an option in Casper, WY. Plus, even though Kathryn had had 3 previous straight forward, no issues, VBACs (after a primary c/s for FTP ). [failure to progress, an obstetrical phrase generalizing a lack of progress leading to cesarean.] The local hospital has a VBAC ban and that was going to be an issue too. The most frustrating part I think was that the doctors kept stringing her along, perhaps thinking that she would just give and schedule a c/s. Little did they know of Kathryn's determination.

"I have a good friend in Boulder, a midwife," Jewel shares, "and I called to get some referrals and encouraged Kathryn to contact them. We continued to see one another monthly so that I could do Mayan Abdominal massage, review The Three Sisters, keep encouraging her to eat adequately for twins (enough protein etc) and just keep her spirits up. I think all of that played into the awesome outcome she had with her twins. She also did moxa with an acupuncturist several times and that may have helped turn baby A. Kathryn was doing Rebozo Sifting twice a day, and following it with a forward inversion. She was also doing belly massage and have done the sacral and pelvic release. She walked for 15-30 minutes each morning."

Kathryn, herself, adds:

After the childbirth options in Casper WY left me hanging, I decided to pursue other options out of state. My midwife was not able to deliver twins (per Wyoming state law), the OB I transferred to was a kind but was not comfortable (or very experienced) delivering twins naturally and counseled me to have a C-section. Further the local hospital has a VBAC [vaginal birth after a previous cesarean] ban and even if I persisted against my OB's wishes, I would still be met with a non-supportive hospital staff. 
My midwife and other friends helped seek out VBAC/twin friendly doctors in Denver Colorado (4hour drive). I interviewed the first doctor and felt very confident that he was the one (Dr Breeden) but in the week prior to meeting with him (33 weeks) we discovered that both babies were breech. ...I needed a VBAC friendly doctor who was not only  experienced with twins, but also willing to do a first twin breech delivery. 

I had been given Dr Hall's name, but felt inwardly nervous about a breech delivery. And of course, anyone I mentioned a breech not only thought I was crazy, but also thought I was taking my babies lives in my hands. While thinking and praying about consulting Dr Hall,  I continued with Spinning Babies recommendations for rotating breech babies. The website was extremely helpful. I started by keeping it simple (Rebozo Sifting, Forward Leaning Inversion, walking, rocking, staying upright etc). After a week went by but no shifting, I consulted a chiropractor and a acupuncturist. I also went ahead and made a future appointment to see Dr. [Michael] Hall. 
Just because of scheduling, I saw the acupuncturist first for Moxa treatment. I was able to see her twice before the babies came. One baby did rotate from full breech, to vertex/transverse, but would you believe it was Baby B!? So we were still looking at a breech delivery for a first baby and by now I was 35 weeks.
I went ahead and met with Dr. Hall, Denver's own breech specialist. We left the appointment with joy and peace! After almost 35 weeks of closed doors, a door finally opened that would allow a natural delivery. Praise God! Dr. Hall was humble and kind, he was informative and helpful, he talked with my husband and I for over an hour... Discussing breech birth, what it would look like, what the risks were etc. He even counseled my husband on how to deliver the babies should we not make it to the hospital in time. We talked about birth plans and how to facilitate this birth without having to make a drive in labor.

Dr. Hall asked us to come back at 36 weeks. The babies were both measuring big (6lbs) and the plan was have a gentle induction in Denver to rule out the risk of driving in labor (or going into labor in WY that would end in a C-section per hospital policy). At 36 weeks he would do a cervix check. If dilated we'd go ahead with the induction then, if not dilated, we'd hold out another week (37 weeks) and induce then. I wasn't thrilled with the thought of an induction, but considering the alternative (C-section) it seemed like the best thing.

At 36 weeks (a Thursday) we went down for my appt. I was dilated to 4cm, but Dr Hall was in surgery and was traveling out of town the next day. (still wish this had been timed better!) Dr. Hall's midwife told my husband and I that we should not go back to Casper, but should stay in Denver until Dr. Hall returned the following day. So we had a short "baby moon" and tried to relax and not do anything to get labor started, until our breech friendly doctor was home available to deliver the babies. It was a challenging few days for me-- it was hard to relax and wait, but we did our best! On Saturday, we started walking and actively trying to promote labor on its own. Sure enough, contractions began to get closer and more steady, coming every 3 minutes and hard enough to breath through. We didn't want to wait to long (we'd had a very fast labor with baby #4 and barely made it to the hospital) so we called Dr. Hall (he had given us his personal cell phone!) and headed in. 

As God had ordained it, the contractions all but stopped during our walk from the parking garage !! I was so disappointed I was crying by the time we got to L&D! Dr Hall was right there ready and waiting. They checked my cervix. I was still at 4cm 40%effaced, station -3) but they were not going to discharge me, pregnant with twins and a history of precipitous labor. 

We started the plan for a gentle induction, and all Dr. Hall did was strip my membranes, and tell me to start walking. We walked and walked. I rocked on a birth ball, hit the jacuzzi tub, practiced lunges in the hallway, but labor would not start up again. It was evening by then, and so we just went to bed. Contractions seemed to appear and get harder while I was lying down, but almost disappeared when I got up and moving. This was unlike anything I'd experienced! After a rough night trying to sleep in a not so comfortable hospital bed, I was ready to give up and go home the next morning! 

Dr. Hall came in again that morning. Did another cervix check, now 5cm, and 80%, and said he really didn't like inductions, especially not with VBAC's and breech births, but said given my situation (multi para, history of fast labor, twins, breech, distance to home) he couldn't think of a reason to send me home. We couldn't think of a reason either (except that I was still a little nervous about an induction, but really what else could we do than indefinitely wait in Denver for labor to start?) So we decided that he would let us rest a bit and then come back to break my water. 

Anesthesia came in to discuss my options during this respite, and I declined an epidural or any pain medication. I had been on the fence about possibly getting an epidural placed (but not used) in case of emergency and need for c-section, but truly felt that Dr. Hall would do all he absolutely could to deliver these babies naturally and if it came down to a section it would be a true emergency (not a convenience thing). And in a true emergency I was okay with being knocked out with general anesthesia.

When Dr. Hall came back and broke my water. Later that afternoon things progressed very quickly. They placed an internal monitor on breech baby A which allowed me to get out of bed and move around while still keeping track of my little breech baby. [This is not typical, but then, neither is a breech Baby A in twins.]

With my water broken, it took about 10 or 15 minutes before I felt regular contractions but then I dilated rapidly. from 5cm to 10cm in less than an hour. Maybe less than half an hour. 

We called the nurse when I hit transition and the Dr Hall came right in and checked my cervix (we later found out he has never left labor and delivery but stayed close by so he could watch the babies-- they say he loves his breech babies and twins). While he checked my cervix, they got the team ready to take me down. 

By the time we got to the OR I was ready to push but needed to wait until we got situated. There was a huge team of medical professionals (anesthesia and her team, pediatrics and their team, OR nurses, L&D nurses, my doctor and his team, and a handful of random medical professionals who just wanted to watch). And they all hustled to get ready. Once we were all set (this seemed to take a while, but it was really only a few moments), I was moved to the OR table, where I laid on my back, with my legs resting in stirrups (not my feet). This would allow for me to deliver the baby at an angle that would let the breech baby dangle. It was an awkward position, but we had agreed on it before hand and Dr. Hall thought it the best/safest way to deliver a first breech twin. 

Once on the table, I was given the okay to push with the next contraction. Dr. Hall had also instructed me to push hard and stay focused as he didn't want that breech baby getting into trouble. So when told to push, I pushed!! Baby A, our dear sweet Abigail, was born in just two pushes. She was born breech, with her hands raised up over her head as though in victory! :) it was truly a moment of victory and excitement! She was here! The breech delivery was by far the most painful of my births, but it was over so quickly and the reward so sweet, I've all but forgotten. 

They right away put her on my chest, and delayed cord clamping, but only for a few moments as it was Baby B's turn! 

Dr. Hall manually positioned Baby B, who had been sitting transverse/vertex and she came down head first. She was born just 3 minutes after her sister with just one push. Baby B, Elizabeth Hannah,  was put right on my chest and had delayed clamping her cord for quite a bit. Time stood still as we reveled in the joy of two healthy babies!

Next was the enormous placenta, which never got weighed, but it was likely the size of one of the babies. I was so wiped out I did not want to push anything again, but I did. Dr. Hall said he'd never seen such a healthy twin placenta. It had been two placentas, but they joined together during the pregnancy hence the large size. 

It was over! My twins were here and here safely. What joy and amazement! The hospital staff just about cheered, and people kept congratulating me as they packed up the OR. Dr. Hall gave me a huge hug and stood by me stroking my head and praising me for making him look like a breech specialist. It was a touching moment.

Both babies, though fraternal, weighed in exactly the same 6lbs 12oz each. I was commended again and again for the size and health of the babies, twins born at  36 1/2 weeks. The twins were so healthy and did not need intervention or NICU time. 

This took me weeks to type out, but was such a wonderful way to process the birth of these girls. Everything went so smoothly and in hind sight I don't think it could have gone better. Truly what a miracle it was to find a breech doc and then to have an experience like this with two beautiful healthy babies. 

Thank you, Jewel, for all your help and support in this process!! I'm grateful for you in so many ways. Despite the, often time, unsettling circumstances , God really showered his blessings on us and caused us to trust His plan. We are so thankful."

Gail adds: It's wonderful to read about breech and twin births
happening in a variety of settings.
Would you like to share a story with me? Email it in a reply here or start a new thread.
I like to include stories that show use of Spinning Babies topics, of course! This month we are sharing a happy outcome when Spinning Babies didn't work!  

Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.