Changing the world by communicating about childbirth
Wednesday, March 11, 2015
In labor now? Here's what to do.
Are the following happening?
Strong labor seems to start and stop, or surge and withdraw, for some hours to days
Surges come on at any time
Contractions may be long and irregular, but strong for hours and then fade away
Pattern occurs with or without back labor
An internal exam reveals that baby is still high in the pelvis
Baby might not be engaged. For some, the uterine action to engage baby seems like labor, sometimes as strong as labor associated with transition. But the baby isn’t even on the cervix.
When the baby is not engaged in the pelvis the uterus works very hard to try to get the baby into the pelvis. The pain is on the pubic bone, but can also be felt in the back or rectum. When baby moves, baby may “grind” the forehead on the pubic bone trying to rotate away from the front of the pelvis. Sometimes there isn’t pain to give a clue.
The cervix is often open less than 3 cm in a first time mom. But don’t rely on the cervix! Sometimes women open all the way to 10 cm and yet the baby hasn’t come into the pelvis.
If the baby isn’t engaged, the nurse, midwife, or doctor may say the baby is -3 station. This unengaged posterior baby often must rotate to left occiput transverse before engaging. Spinning Babies techniques aim to help rotation. Rotation may solve the problem to let baby engage and descend through the pelvis, helping the mother potentially avoid a cesarean.
The mother can check her own abdomen for a little tell-tale “ledge” resting on her pubic bone. If the ledge is there, it’s usually baby’s forehead. Then we know contractions may start and stop until the baby is turned.
High in the pelvis might also be termed -2 station (2 cm above the halfway point of the ischial spines).
When baby is directly posterior the back of the head might be felt in the pelvis at -2 and the provider thinks the baby is engaged. This is also because the head won’t wiggle. If the forehead overlaps the pubic bone then the forehead isn’t in the pelvis and the baby isn’t truly engaged.
Spinning Babies has the solution for many women in this situation:
3 Sisters of Balance relaxes the mother’s abdomen and makes room for fetal rotation.
Forward leaning inversion through 3 contractions
Sidelying release through 3 contractions on each side
Now the laboring woman can often rest. Labor may be mild for an hour. She can snooze.
Surges begin again. If a woman isn’t pushing her baby out, she follows the 3 Sisters with the techniques to match pelvic level.
Baby still high? We balanced, now we reposition the baby for flexion! Do the Abdominal Lift and Tuck through a contraction for 10 contractions in a row. Let the belly down and relax the back in between contractions. Doing the Abdominal Lift with a posterior pelvic tilt to flatten the lower back and move the sacral promontory out of the way will help baby to tuck the chin and rotate out of posterior and descend.
Or, Baby is Zero, “0,” station, in the midpelvis, or +1, +2 station, lower down in the outlet. Either way, strong labor isn’t progressing labor. Do 3 lungeson each leg, resting between contractions.
This series of techniques will help almost everyone.
A woman with an android pelvis, large baby and low thyroid may need help with more techniques, including a manual rotation of the baby by her OB or Midwife (done internally). If the posterior baby is large for the mother’s pelvis and the mother’s ligaments are tight, an excellent myofascial therapist who is specially trained in pregnancy may be necessary to avoid a cesarean. To prevent that crisis in a labor, begin before pregnancy or early in pregnancy to release spasms and imbalance in the whole body and pelvis to promote optimal fetal positioning in labor.
The 3 Sisters is the most powerful contribution of Spinning Babies to the birth world. These Sisters work to balance the pelvis in pregnancy and in labor. Starting balance in pregnancy may mean you won’t need them in labor. Starting balance in pregnancy may mean you don’t end up with a crisis in labor to a stalled labor or a case of “baby won’t fit.” Some women may need more specific balancing activities.