Sunday, February 15, 2015

Tammy dreams of reducing obstructed labor in Kenya

  Obstructed Labor is when the mother is in labor, her body is working hard (sometimes until her uterus tires and contractions slow) and yet the baby isn't able to come through the pelvis. 

Obstructed labor. In this example, baby's hands tap at the fetoscope (stethoscope).
In the doula world, a powerful phrase is the "doula spirit." This means the social love and self sacrifice a community of doulas naturally generates for mothers, for one another, and for large collaborative causes. 

Tammy Ryan is a woman of doula spirit. She has been asked to come to a couple different countries in Africa. Her first visit in 2008, a midwife lead her through a hospital room door and she suddenly found herself responsible for a roomful of birthing women. One woman's labor had already been going on and on and Tammy tried to arrange a cesarean for her. Though they were in a city hospital, the power was out that day and the staff couldn't do a cesarean because they relied on lights and suction machines and electric pump anesthesia and such technology that no cesareans could be done that day. Though Tammy was a doula and had decent training herself, nothing she knew how to do could save the mother. She died in Tammy's arms. Afterwards Tammy escaped outside to cry and rage in her powerlessness. I can't quite imagine. I've been at close calls in American hospitals where a doctor arrived in the nick of time. So I can almost imagine. But not really. 

The death of the woman in her arms both blew Tammy's world and created a deep desire to go back with skills. She has started a GoFundMe site and needs immediate donations this week to attain her goal! Please go now and donate: 


Tammy has an invite from local midwives to return to Kenya and to Nairobi, Africa and help women in labor, too often alone, too often isolated, even in the hospital. There are just too few skilled workers or resources. Yet the women live and love like any of the rest of us. Relationships, dreams and responsibilities are universal.

OP babies drawn by Gail Tully
Obstructed labor. The baby on the left can't get his head in the pelvis. His forehead is overlapping the pubic bone when he faces forward. He must turn or engage (drop into the pelvis) like the baby on the right or he must have a cesarean or die, or his mother could die. A mother's own spontaneous movements MIGHT have him drop in the pelvis like the baby on the right, or help him to turn. But it may be at best about 50/50 with usual maternity care in labor (47%-49% of first moms with a baby that is not engaged end labor with a cesarean in studies). An unusual technique can help. Spinning Babies presents techniques for turning posterior babies and helping engagement at SpinningBabies.com
Spinning Babies Workshops are available to providers and doulas; and a video,
Parent Class, is available for download or as a DVD
 I got back out of bed tonight to write this post because I can't sleep. This week we have a chance to send Tammy back to the countries she has connections with in Africa with Spinning Babies skills. Once Tammy has the Spinning Babies Approved Trainer designation she can teach Spinning Babies Workshops. She is in line as one of 6 pilot program Trainers. In fact, she started the line by insisting. Debbie Young called me at the end of 2013 and said, "Tammy Ryan is going to call you and your answer is yes." She got my attention. 

Well, we've been quietly preparing this trainer training and I've chosen 6 women. Not a lot of trainers,  but we'll talk more about the next trainer trainer in June. For now we have to get Tammy to Africa.
She's set to go back to Nigeria and has contacts in Democratic Republic of Congo and Tanzania, too. The midwives are asking for help! 

Tammy helps with teaching hygiene and the use of sterile gloves, how to diagnose diabetes by the behavior of ants to a cup of pee set in the sun (no labs in some places!) and how to take a blood pressure to catch high blood pressure before a seizure could take the mother's life. 



Tammy wants to go back with the full Spinning Babies awareness of how to resolve a stuck labor. I've analyzed the factors and teach the basics in my day long class. Tammy's taken Spinning Babies about 3 times. But we go in depth with the training. Its 9 days long! She prepares to teach and actually teaches the class before the end of the training. I'll evaluate her. Then she will be ready to go to Africa. 


Tammy can begin saving lives immediately. It would help sooth her aching heart, broken in 2008 by the pain of loss and anguish of helplessness.  Now she has skills. Debbie Young is scheduled to go with her in April. Of course, a doula isn't rich. And like many midwives around the world, African midwives don't have money for airline tickets. But many of us have a few dollars to donate. I've donated to Tammy's cause. Yes, it might be my cause, too, but Tammy is making it happen for me, for all of us. 

Some concern has been expressed to me about a white woman going to help People of Color on another continent. I wouldn't support the conceit of a person thinking they have information to "save" others on a cultural or moral level. To belittle one's culture or beliefs denies the Light of Freedom inherent in the Soul. Nope, not for me.  This is about sharing birth knowledge and while its limited but its still very valuable. 

The growing movement to bring awareness of white police officers shooting unarmed men of color, of the inordinate percentage of African American young men going through prison (I just read one city it was 66%) to keep a prison system funded, and a harsh inequality in health access for minorities can detract from people being helpful to others. I've been shared with good ideas to support organizations of Color who help their own. There is such good in coming to a place of help where you can feel safe. I know I have a great deal more privilege to do that than many a Woman of Color in my country.   Yet as many turn away should others be turned away? Now is just when we need to celebrate turning towards one another.  I read of The Creek of the Ohio region having two villages and as children grew the elders would assign the child to one of the villages according to their nature, the warriors to one and the peacemakers to the other. They saw the value in both.    Life brings us many ways. I have been helped by Persons of Color that didn't turn away from me, thankfully. Some were elders, others I saw as peers. I was taught to see the inner person and though that is not the warrior way, it is my way. Now back to Tammy Girl!


Debbie Young (left) and Tammy Ryan on the day they insisted I begin a Spinning Babies Approved Trainer Training.
(I just love these ladies!)

You can do good through Tammy by supporting her. We can trust her with this task. Debbie Young and Tammy Ryan have both served on the board of DONA International and worked together with Baby Matters. I feel confident that real service will come out of this trip. As Tammy calls herself, Servant's Hands, she is dedicated to this journey. And you can take Tammy's Spinning Babies class yourself in the US or Africa. She'll begin teaching in March already!



The cause of an obstructed labor might be that the baby is too large for the mothers pelvis, which might be because malnutrition or an accident reduced the size of the pelvis. 
Yet many times, I'm finding, though women are told that their baby is too big, a unique move to open the pelvis lets labor finish bringing the baby.


When baby is high, standing and flattening the lower back during contractions can let the baby that was high drop into the pelvis and arching the lower back can open the outlet and let the baby out the bottom.

Sidelying release, isn't just lying sideways. Pressure and rocking and keeping the hips straight (ahem) while the leg hangs over the side of a bed or bench allows shortened hip muscles to lengthen and free movement in the pelvis, soften the pelvic floor, and let baby come lower into the pelvis.

 Sometimes obstruction is from a muscle that has shortened, tightened and pulls the pelvis into a smaller diameter. That would make the pelvis seem too small but the Sidelying Release (not just lying on one's side) can lengthen muscles, the standing sacral release can relax ligaments and fascia and mobilize the pelvis.

There are many moves like these. Many American providers don't understand the concepts until they are experienced and felt. Through our body these concepts enter the mind and flow out again through our hands.

So matching where the baby is in the pelvis to the technique for that muscle, joint, diameter, etc. is really enough to save a noticeable percentage of mothers and babies from death, injury, or cesarean section. That doctors and midwives, whether North America or Africa, don't know movement anatomy. This means that some babies and women die of ruptured uterus, exhaustion and infection because labor is too long or too hard without bringing the baby. It is less common here, but happens. And, an unnecessary cesarean is not without risk at the time and for the next pregnancy, too. So let's reduce misunderstanding in when major surgery is needed to save a life.

Many long labors can be just fine, of course!  Good nutrition and experienced assessment of labor saves lives. Skills for labor progress at all levels of the pelvis should be basic knowledge for all birth workers. Please help this educator empower others through the knowledge of Spinning Babies.

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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.