Friday, March 27, 2015

Springing Into Perspective

Springing into perspective

The late season snow, so necessary in our midwest drought, is gently melting into our soil.  Thoughts of renewal frame the season change.

Renewal comes in cycles in our lives as much as for the earth in the annual Spring. Renewal is by definition out of something gone old, even decayed or perhaps wiped flat by storm. Somethings given up, there is a loss, there is a death. Winter is likened unto a sleep among the Seasons. Spring like an awakening.

A human life is a journey of growth, and even though the body is full height, the mind and heart grow on. In middle age, each decade or half decade seems to bring a broader perspective, in youth its by the year and in childhood by the quarter, and in infancy by the week. So my steps may be slower than they once were, but oh, so much more landscape is covered.

Birth is the first big visible, social celebration of a person's life. The community recognizes a new member. The older members of the community, the elders or the providers, depending on the culture of the birthing mother, guide the birth by actions founded on the beliefs held in their established values.  Often these are protective actions,  and some actually do protect. Coming to a location set aside for birth, whether a hospital or a hut, eating and drinking or intake of certain foods, fluids or substances, and having certain rituals, whether IV fluids or prayers and things to effect the environment (disinfectants or incense, for instance). Whatever it is, the action carries great importance to the people providing this service. Looked at spiritually, these are gifts to the life of mother and child. Looked at from a wider view, the results may or may not be useful to the wellbeing of mother and child. Let the mother have a say and enter the discussion.

All these actions also act to guide the mother and child into the values of the larger community.  To step outside of those protective actions can seem like a rejection to the people who are prepared to help. So why would someone choose a variation from the expected path?

I think one part of it, not all, but part of our reach beyond is because our heart and mind reaches further than the norm. A growth spurt, perhaps, a Spring branch stretching for the Sun.

There is often a struggle involved. This may be in the search for the birth attendant who has the skills, both in birth and in personality - and legal rights! It may be in the personal relationships with those who are happy not to reach. It may be within amongst the very parts of our own spirit as we reach in one area and are unsettled from a deep comfort in another.

The evolution of the human spirit is dependent on this reach. Birth rights are also dependent on the reach and the support for that reach. I am proud to be part of a World community of BirthKeepers, parents and providers, womens' circles, social activists, lawyers, doctors and even marketers who help us spread the word for how birth can be better.  Oh, that morning stretch!!

Wednesday, March 18, 2015

Where OP babies get stuck in labor and what to do

Occiput Posterior Presentation
The Occiput Posterior baby is head down with the back of baby's head, or occiput, towards mom's posterior, or back. The posterior positions are LOP, ROP, OP, and midwife Jean Sutton includes ROT due to the strong tendency for the ROT baby to rotate to posterior before the end of the birth process). 

Facing forward makes the baby's head seem bigger. This is because the head angles in to the pelvis in a larger diameter than the baby's who is curled up and facing the mom's back (OA). Baby can't help with the birth because their neck is already extended, they have less spinal movement because of spinal extension. 
Left Occiput Anterior position

Anterior babies have the room for more flexion to get into the pelvis (at the brim) and can then help with the birth better. Spinal flexion and extension helps with the birth - when they occur at the proper level of the pelvis. 

Arrest at the Brim
For first time mothers, just less than half have a vaginal birth if the baby is not engaged when labor begins. Not even half of the babies who are in direct OP at the time of delivery were born vaginally. I believe many of the babies who do not engage are in the posterior position and can be helped to rotate and engage.

Posterior babies may have their chin up and when so, can have their forehead on the front of the mother's pelvic brim. Even if the dome of baby's head is low in the pelvis, the fact that the forehead remains overlapping the pelvic inlet means that the baby is not actually engaged. 

Baby has to flex, or to flex and turn, to fit into the pelvis. We hope the baby turns to face mother's right side, putting their back to mother's left. Baby being hung up on the brim is a common reoccurrence in VBAC (Vaginal Birth after Cesarean) labors when the first labor was due to lack of engagement.

Transverse Arrest at the ischial Spines (found at 0 station):
If a baby was stuck at 0 station, the usual reason is that baby remains facing one of the mother's hips and hasn't turned to get past the boney bumps called the ischial spines- the narrow part of the middle pelvis. The baby may, alternately, have started labor posterior and began the turn at the pelvic floor found at 0 Station. Now stuck on the ischial spines, the baby can't fit the long angle of the head, which is to the mother's side, through the narrow midpelvis. Rotation can be hard for baby to turn at 0 station due to the ischial spines are holding baby from turning, and sometimes from pelvic floor tension. 

Baby must turn or all the Pitocin, pushing or contractions will not bring baby down. The rotation solution is to help baby turn to the oblique diameter or to face the back directly to fit. 

  • Sidelying Release softens and lengthens the pelvic floor and other pelvic muscles temporarily. Follow with lunges with one foot flat on a chair through 3 contractions on each leg. 
  • Rotation off the protruding spines while lying down requires a "bed lunge,"  
  • A peanut ball to straddle  while on a sort of hands and knees position to open the pelvis, 
  • Few doctors, nurses, or midwives know to manually turn the baby, but that is another option. If a cesarean is the only solution known and if baby can't fit or turn, then the cesarean is a lifesaver. If these techniques are tried first, there may well be another cesarean avoided!
Would it happen again? It might, small chance? Solution? Works like a charm - if the sacrum isn't pulled in...

Pitocin may help if the head isn't actually caught on the bones. Give the list above a try first if you can. Be precise with the Sidelying Release.  You may be able to solve the issue within an hour and if not, then give the Pitocin a try (if in the hospital).

Immobile Sacrum or one that is pulled inward by ligaments: 
An immobile sacrum doesn't move out of baby's way in labor. All the exercise and most of the self-care suggested on my website and in my workshop is not likely to help if the sacrum is pulled in by a short (due to a chronic spasm) ligament pulling it into baby's path. 

Pitocin is unlikely to help bring baby down.

Mobilizing the stuck sacrum outward takes a specific release from a body worker or physical therapist. Trigger point release may help. It takes about ten minutes generally. In tougher cases, longer. But once done the sacrum swings out and, if the baby was held back by it, now descends to give the birthing mother an urge to push.

Illustration by Netter.
The sacrotuberous ligament connects the sacrum with the ischial tuberosity. Think of it this way, the stretchy bridge between the sacrum and the site bone can become shortened (tight) and then brings the sacrum into baby's path.
The trigger point to release it is next to the tailbone on the inside/underside of the ligament - actually you can reach that from the outside of the body, you don't have to go inside to find it but you will still be in a very personal space.
Not all professionals will touch it there, because of it being in such a personal area
(near enough to the anus to feel the warmth, if I may be so blunt).
A doctor or midwife can access that spot and 2 minutes of mild stretching and it tends to release and the sacrum becomes mobile for a while until it tightens up again. Sometimes, a good body worker will help it resolve long term.
Helping the cranials have free motion will help the sacrum. See a craniosacral therapist to make sense of that, please.

Massage of any small adhesions surround the sacrum, acupressure or acupuncture, chiropractic, and forward-leaning inversion followed by "shake the apple tree" may also help a lot if this is a borderline issue or tension is from muscles not sacrotuberous ligament.

Would it happen again? Yes, unless the sacrum was mobilized to swing out into its neutral position. Recheck the sacrotuberous ligaments periodically in the later part of the next pregnancy AND during birth. 

A little less than half of persistent posterior babies are born vaginally in modern university settings (See Lieberman, 2005). With better knowledge of how to open pelvic diameters, soften and lengthen pelvic muscles and ligaments, I believe we can increase the rate of vaginal birth for persistent posterior babies. 

Monday, March 16, 2015

    Hi, Spinning Babies,
   I am 39 week pregnant and been reading and doing Spinning Babies exercises on and off since 30 weeks as baby been on Right Occiput Lateral (Right Occiput Transverse in US) and Right Occiput Posterior for all pregnancy. I had him go transverse for a week and back down again. 2nd baby. I can't find links to the positions to do in labour since the site has changed and my partner has just taken some time off work to get up to speed with what he needs to be telling me and helping me with in labour, as was clueless last time! Was wondering if you could send a link?
    Thank you!
    -N____ in the United Kingdom

Dear N,
Here's a few direct links which will hopefully lead you to what you're looking for:

For a list of techniques (you can click on them to go to individual pages with descriptions) you can see the lists here and here.

I hope that helps! If there's anything else you're looking for specifically, please don't hesitate to write. 

Thank you!


Wednesday, March 11, 2015

New website goes up tonight!

We're so excited to announce that the new Spinning Babies website will be going up tonight. There might be some time while the old site is migrated over to the new one where you can't access We've compiled a list here of important articles if you find yourself in need of some guidance while the site is down!

In Labor Now? Here's what to do.
How to do The Fantastic Four
Why won't this labor start properly?
Arm first -What is Baby's position?
Help! I want to avoid induction
Labor isn't starting or starts and stops?
Deb Lawrence's Dip the Hip Circles myofascial release
The abdominal lift and tuck to help engagement during labor

SpB Trainer Training 2015

Please help me to welcome our new Spinning Babies Trainers with me!

Preparing for months ahead, our Trainer Training brought everyone together for 10 days from our arrival on February 27th through March 8, 2015.

My sister, Kathleen, and I are proud to announce the lovely emergence of
6 Spinning Babies Approved Trainers!

In alphabetical order,

Lorenza Holt, Massachusetts
Marya Molette, Virginia
Nicole Morales, California
Ginny Phang, Singapore
Tammy Ryan, Iowa
Jennifer Walker, The Netherlands

We gathered, prepared, filmed, learned, shared, taught, and everything in between!
Enjoy the love and eagerness in these faces. I could look at these pictures for hours.

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.
  1. Rebozo sifting
  2. Forward leaning inversion through 3 contractions
  3. 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.

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.