Saturday, May 13, 2017

I am expecting twins, can I use the same Spinning Babies techniques for my pregnancy and labor?
TwinsBMap32wk
Yes! Spinning Babies approach works well for multiples. If you can, start early. Otherwise, start today. You may need to add professional bodywork help to balance uterine ligaments.
Ask your doctor or midwife if there is any medical reason not to do any of these activities (inversion, particularly).

When to start Spinning Babies approach in a Twin Pregnancy?

I typically suggest 20 weeks for a singleton. With multiples the start of daily balancing activities might begin earlier, for instance, 16 weeks… Start gently, pace yourself, and be steady rather than athletic, please!

Start now

Is it too late?

Find out what Linda writes at http://spinningbabies.com/learn-more/baby-positions/twins/


Tuesday, May 9, 2017

The Difference a Sidelying Release Makes


A happy doula, and Spinning Babies Workshop attendee, named Beatrice just emailed thirty minutes ago to rave about a VBAC birth. Many of us birth workers love to support a birthing family through a vaginal birth after a previous cesarean. The triumph of self-determination shines through the parent's eyes.  As providers, we know their life will never be the same.

Here is a labor attempting to begin. Contractions start but neither move labor along nor let the woman rest. Twice before this non-progressing latent labor ended in surgery.

The role of this doula was to bring her positive attitude and practical strategies. Let's gain understanding of which of the techniques may have actually advanced labor progress and which ones, though classic, may not have addressed the situation in play.
Of course, we are looking through the lens of Spinning Babies 
We review the good decisions of this doula with a perspective still little known in the doula world.

Beatrice writes,
"Just to let you know I’ve just used your techniques today with amazing results! My lady was really hoping for a VBAC after two emergency c-sections, she went into labour yesterday but her contractions were really mild inconsistent and not getting her anywhere... so she went for a long walk in the park, up and down hills and after eating a nice meal, she went home to put her kids to bed and to rest for a little while."

Here we see the classic, natural birth movement's strategy to allow the simple passage of time to support the flow of labor. Allowing labor to establish on its own is a healthy and respectful choice...when such a strategy matches the labor situation.

In this case, the labor didn't pick up and night turned to day. Beatrice also knew that this particular mom had a history of emergency cesareans.

An emergency cesarean is surgical birth after the onset of labor. Whether the mother or baby are in a life threatening situation or a long leisurely labor is not defined by this way of using the term "emergency." In most cases, finishing the birth with an "emergency cesarean" isn't an emergency at all. It's only a few cesareans in which the baby or parent are in danger and need immediate life saving surgery to escape severe injury or death.

Most of the time, a lot of time passes as the birth team tries many strategies to help the baby down through the pelvis. After more time, the birth team (including the birthing member!) decides enough-is-enough and a cesarean is now the best option for a safe birth. In these situations, the contractions are strong enough to, but don't:
  • Rotate the baby
  • Dilate the cervix, and 
  • Bring baby down the pelvis 


For Beatrice's "Lady", these strong contractions weren't able to accomplish these three important measures of labor progress. This is exactly the scenario we hope to avoid repeating when supporting a VBAC mother. VBAC is Vaginal Birth After a Cesarean (for a previous birth).



In most cases, emergency cesareans are not because the pelvis is too small, but rather the babies aren't angled into their smallest diameters. Like a swimmer diving into the pool, a birthing baby "makes the smallest splash" (meaning the baby slips most easily into the world) when baby pulls the chin into the chest and brings the shoulders and arms close to the chest to make the body "smaller".

Beatrice knew that baby could be helped into the pelvis. She wasn't specific in her email where in the pelvis she believed baby to be. Remember, they hadn't gotten to the hospital yet to have the nurse or provider check the birthing person's cervix and check which level of the pelvis they found the baby at.

"We started a routine of stretching her psoas muscles followed by lunges and wide side squatting and calf stretches  up and down the steps and the birthing ball..." 

Let's look at these techniques to see which part of the birth journey these techniques give specific help for making room for the baby. There are three levels to the pelvis, three gates, as it were for the baby to pass through.
The inlet (top entrance to the bony tunnel)
The Midpelvis (middle)
The Outlet (bottom, exit of the bony tunnel)

I suspect from the history of repeat cesareans followed by a vaginal birth that the missing factor for the earlier births was fetal engagement. It may be that in the earlier births, and for the long leisurely beginning of this labor, the babies were up at the entrance, the brim, or inlet to the pelvis. I may be wrong, but this is a common cause of "emergency cesarean" and the subsequence avoidance of such an "emergency" by helping baby engage.




The inlet (top entrance to the bony tunnel) Stretching her psoas muscles, Forward Lunges are another way of helping the psoas muscle pair lengthen. There is a particular way of doing them that "wakens" the psoas. Going  up and down the steps helps some babies drop into the pelvis but many times there are less tiring ways to do help baby engage.  

The birthing ball can be a help when pumped up properly to let the hips be slightly higher than the knees. For engaging baby, usually what is needed for labor progress first, turn some happy music on and do hip circles and figure eights.

If a birthing mother belly dances those moves may be preferable... actually its not common for belly dancers to have a long labor, so this is a silly addition. About 30-40 minutes of dancing or using the birth ball like a "dancing seat" is usual.


The Midpelvis (middle) Side Lunges or those lunges that look like a sword player are specific to the mid pelvis or outlet. Lunging to the side would not likely help baby drop into the pelvis. Wide side squatting may mean the knees go out to the side. This may help the bottom of the pelvis open but will close the top and reduce the chance that baby will drop into the pelvis. If baby is already deep in the pelvis these may be useful. Squats reveal their usefulness in 3 to 6 contractions. If you aren't seeing good progress after that, try them again when baby is lower (if needed).



The Outlet (bottom, exit of the bony tunnel) Calf stretches can be helpful for the sacrum to move out of baby's way. The mobile sacrum is dramatic for moving out of the way in the mid or lower pelvis, but may help fetal engagement at the top as well. I put it here because the effect of a calf stretch in labor might be minimal on pelvic mobility at the top of the pelvis but may be slightly better on the bottom. Daily calf stretches for a couple weeks followed by weeks of daily squatting would show the effectiveness of the calf stretch in the big picture, but an immediate effectiveness is less likely to occur.

The baby lines up with each of these openings in the pelvis by rotating.  When the head lines up at each gate, the contractions can move the baby down. Balancing tight or loose muscles and untwisting any crooked ligaments help soften baby's path through these three pelvic levels.

You may have noticed in the story that labor wasn't active yet. Strong contractions are necessary. The womb has been working for many hours without building up a momentum necessary to move labor along.

The doula was thinking and the mother was now ready to try something new. They'd tried some gravity friendly positions and movement without success.  Now they began the Queen of the Static Stretch techniques, the Sidelying Release. This is far more than lying on one's side!

Done on both sides to relieve lopsided muscle tension in the pelvis, Sidelying Release is often the solution for uneven pelvic floor muscles. This baby didn't seem to be so far down the pelvis to be on the pelvic floor yet. The doula is using Sidelying Release to help the mother get into active labor.

"...then Sidelying Release on both sides for the duration of three contractions. After nearly three hours of hard work she went in nice long bath... " This description gives us the clue that Sidelying Release allowed a regular, strong labor pattern to establish over the next three hours. Then she took a gentle bath to adjust her mind to labor and perhaps find pain relief. When baby drops into the pelvis and comes on to the cervix for the first time, the emotional release as well as the added pressure deserves a little deep immersion in a warm (but not the exhausting heat of a hot tub) pool or bathtub. If a deep tub or shower isn't available, a gentle version of shake-the-apple tree (jiggling the buttocks muscles) is another way to relax the pelvis.

2 hours later she was on her way to the hospital with contractions every five minutes, she was three cm on arrival [being 3 cm after 5 hours of stronger labor is a good indication that I was right with my assumption the baby was not engaged before the doulas good suggestions. Lack of engagement may have been the leading factor in the previous cesareans.]  but continued mobilising [moving freely] until her contractions were much more intense and soon after she was feeling pressure with each contraction and we barely had time to reach the delivery suite for her to start pushing... baby was born soon after with a very smooth clean and gentle delivery no stitches... mother and baby went home a few hours later!" 

Congratulations VBAC Family and Doula Beatrice! We, at Spinning Babies, are so happy to help!
And we appreciate the chance to discuss this lovely birth with you as an teaching tool for the 3 Levels Solutions.



You can learn more about 3 Levels Solutions to help you pick the right techniques sooner on the
Spinning Babies; Quick Reference Guide digital download for providers;
or
Spinning Babies; Parent Class for parents digital download or watch it streaming on Vimeo.com

US customers can visit the Spinning Babies online shop for the booklet or DVD.

Tuesday, April 11, 2017

Uterus in a twist

When seeking an answer about what to do to protect the normalcy of birth, Spinning Babies asks the question, Where is Baby?

This is because the baby's position reflects the shape of the uterus. For instance, if the uterus is well positioned, the baby is well positioned.
If the uterus has gotten into a twist, perhaps from a woman playing softball or golf, the baby may be angled above the twist. The uterus might look tipped. It seems like baby is all over on one side sometimes, or perhaps at a diagonal.



The twist will be low in the uterus where the musculature is softer. Cervical ligaments seek to anchor the uterus at and around the level of the cervix. It is about this area that the twist may be the most significant. Car accidents, sports, and sudden stops in gravity when the body is at an angle from the stopping point (the bike hits the curb at an angle rather than straight on).

Dr. Carol Phillips taught me this view of the uterus and Debra McLaughlin is her student who has taken the teaching of this concept to excellence for the providers of birth care.

Spinning Babies happily brings this information forward for the purpose of comfort in pregnancy and ease in birth. But perhaps more important than ease is function. Our bodies function when in "balance."

Labor pain awakens the brain release of endorphins which prepare the birthing parent for love. The birthing mind becomes the parenting mind. Too much pain is frightening, or rather, fright is inhibitory to a healthy response of instinctual  movement. Less fright, more love, but not less pain more love...

Yet labor pain increases unnecessarily, and can even become insufferable in some cases, when the uterus is so far out of alignment with the pelvis that the uterus can't contract smoothly to bring the baby into and through the pelvis. The uterus pushes the baby against bone in many cases.

I've asked doctor friends of mine about cesareans. Did they see a twist in the uterus? One friend said oh, yes, but she saw it in cesareans for failure to progress.
Well, that made my case particularly!

When the uterus is significantly twisted babies weren't coming through the pelvis. They were lying at funny angles and uterine contractions weren't able to drop them into the pelvis. In some cases, babies were lying sideways with the uterus twisted around so that the back of the uterus was now in the front of the woman's body. One uterus had to be untwisted before the cesarean because the ovary was in front. Other twists were discovered only after the surgery because the condition wasn't as obvious without a structure like an ovary to give the clue.

These are cases in which the doctors found torsion in the uterus. Torsion is also noted in the literature.


Definition of Uterine Torsion

Uterine torsion is defined as rotation of the uterus of more than 45° on its long axis. (Fatih; Nicholson)

Uterine Torsion can be associated with fetal malposition (Pelosi)



What to do about Uterine Torsion?

Body balancing by addressing the soft tissues brings the uterus into alignment. Chiropractic and Osteopathics can help align the pelvis.  Together these modalities work the best. Some Chiropractors know the myofascial or fascialtherapy and add it to their protocols.


Forward Leaning Inversion with head in flexion at a Korean Birth Center.

Spinning Babies offers the Forward-leaning Inversion, a technique created by Dr. Carol Phillips which allows the weight of the pregnant uterus to hang freely and unwind like an old fashioned telephone ear and mouth piece hanging from a tangled phone cord. This is a self care technique that is quite effective in pregnancy for the baby in a transverse lie, or in labor for the anterior lip and other slow-downs of labor progress.


Debra McLaughlin teaches how to recognize and undo uterine torsion.

Debra McLaughlin teaches us to activate the adductors and abductors and correct the symphysis. She is teaching this in a way that a midwife can understand. Learn about aligning the uterus in context this summer to our Spinning Babies community.

Spinning Babies Professional Bodywork Education week in July will move this conversation forward. Chiropractors, Osteopaths, Craniosacral therapists, Fascial Therapist and Therapeutic Massage therapists will love this week. Birth workers are invited but be aware that the teaching is assuming more anatomical awareness than you would learn in midwifery text about the supporting structures. Some of this will be taught but foreknowledge is empowerment. The more you know the more you will learn, let's put it that way! http://spinningbabiesconference.com/


References

Uterine torsion in second trimester of pregnancy followed by a successful-term pregnancy.
Fatih FF1, Gowri V, Rao K. BMJ Case Rep. 2012 Aug 21;2012


Jensen, J. G. (1992). Uterine torsion in pregnancy. Acta obstetricia et gynecologica Scandinavica, 71(4), 260-265.

Nicholson, W. K., Coulson, C. C., McCoy, M. C., & Semelka, R. C. (1995). Pelvic magnetic resonance imaging in the evaluation of uterine torsion. Obstetrics & Gynecology, 85(5), 888-890.

Pelosi 3rd, M. A., & Pelosi, M. A. (1998). Managing extreme uterine torsion at term. A case report. The Journal of reproductive medicine, 43(2), 153-157.





Wednesday, March 8, 2017

Clarity in your birth


Many visitors to Spinning Babies Website are looking for effective help for an easier birth.

We suggest using Spinning Babies Daily Activities as a part of preparation for birth.
Daily movement and maternal positioning can be added to a great pregnancy diet, deep and full breathing, learning about birth and parenting, enjoying good communication and visits with your provider. Monitoring blood pressure and blood sugars and other health indicators are important but self care is the care you give yourself and your baby. Monitoring for disease can't create the health you want. Here are some ideas to boost your benefit in pregnancy.


  • Community involvement in a pregnancy and/or parenting group preserves sanity, soothes loneliness, and boosts health! 
  • Studies show a doula offers multiple health benefits even though they don't give medical advice. This is the magic of social support. Get a doula, you'll only know why you needed one after you find the doula who is your best match. 
  • Exercise in a group. Create a pregnancy walking meetup up to 3 times a week!


But once you are active, supple and supported, you still need to communicate your
desires, needs, and limits with your care provider.

Sometimes pregnant parents worry that their requests for individualized care, or resistance to procedures will be seen as confrontation by the providers.

Pick a provider who isn't emotionally threatened by parents who have personal needs... uh, oh right, which parents don't?


  • Then be sure to voice your needs, desires, and fears. 
  • Being personal and open yourself, without bailing at their first hesitation, is a good way to communicate with care providers. Look them in the eye expecting mutual respect.
  • Write your list in positive terms that providers and hospital staff can "do" or respond to. People in helping professions want to help. Show them how they can help you have a better birth experience. 




A healthy pregnancy and healthy baby are mostly due to self care of a healthy pregnant person. When health is a challenge, these suggestions are only more important, though they become more challenging to achieve in some cases.

More ideas

  • Join a pregnancy and parenting community, such as attachment parenting, early childhood education groups, and prenatal and parent/baby yoga classes.
  • Bring your partner to a parenting group of their interest. 
  • Learn about infant CPR and life support, home safety tips for babies and
  • How to wear your baby! Yep, the best "jewelry" you'll ever wear! Put that little jewel in a rebozo, sling, or front pack during the early months and on your back when baby is too heavy for your front (unless you know how to wear baby in a cloth sling on your back earlier).
  • Learn lullaby songs, finger play, and stories that will delight your baby and reduce your stress when baby needs connection with you and you need some baby entertainment. Learn them now. 


Join the Spinning Babies Parent Enewsletter on the Spinning Babies Website. It's free.




Will Shoulder Dystocia occur?

A doula friend of mine, "J," asks how real the concern is that a mother with an estimated projected fetal weight of 11 pounds by the time of the due date will have a shoulder dystocia.

"They had her see the OB and heard the reasons for perhaps choosing a repeat surgical birth. She was told that if gestational diabetes is back that they see these big babies with a weight distribution in the upper body (shoulders) that could be problematic during birth. ...

This mama is hoping for a vaginal birth but she is philosophical about the whole thing. She knows there are no assurances but feels she needs more info right now. She is wondering about continuing the Spinning Babies stuff she has been doing. Her abdomen is pendulous and she has been using a rebozo to get some relief for the back discomfort she is having...

Thanks for being out there doing what you do.
Gratefully,
J"

Practicing a typical hospital resolution of Shoulder Dystocia.


Gail Tully responds
Dear J
Hi. I can only share what I would have recommended as a midwife. As a doula I would not have made statements about my opinion of risk or stated recommendations in the following way. This is my post-midwife voice here.

Movement, good nutrition for her blood type (meaning a serving or two of grains and milk products for the Os and As) while getting good protein and veggies, salt-to-taste and water. Minerals help reduce sugar cravings. Red Raspberry Leaf with Alfalfa steeped together is really amazing.

Wearing a pregnancy belt and getting balancing work down, she can have her helper (you?) do standing release with her.

The pendulous uterus is more of a risk for shoulder dystocia than the baby's size alone. Ultrasounds can be off, of course. and her chance of no shoulder dystocia is somewhere around 4 out of 5 if this info is accurate, between the hanging uterus and large baby. What will improve her chance of no obstruction?

  • Wearing the pregnancy belt all the way through the birth of the shoulders!
  • Balance and good diet for good metabolic function!
  • Supple sacrum
  • Avoiding a vacuum or forceps
  • Upright birth position and
  • AFTER the head is born, in any maternal position, a posterior pelvic tilt (which can be done preventively during ONE contraction in 2nd stage.


The pregnancy belt, the right one for her, could be amazing.

Talking to an Obstetrician/surgeon about benefits of cesarean is like talking to a plumber about home improvement. Yes, new pipes may avoid a clogged drain now, but if you had hoped for a consultation on paint colors you are going to go home worrying about potential plumbing problems. It can haunt you. Especially as birth is more important than a broken pipe. But I'm talking perspective. If her midwives are not able to resolve a shoulder dystocia, and the doctors weren't able to help her first baby be born breech vaginally, then what skills is she expecting from them that they don't also have?

There are known side effects to a repeat cesarean (she knows she will have major surgery, separation from her baby, and significant blood loss, postpartum pain in the abdomen, not able to lift or do stairs for a longer time, the risks are that she might have infection, adhesions, problems with a future pregnancy, etc. etc. and there are unknown side effects to a VBAC, such as a sore perineum, possible hemorrhoids, etc. Which is most beneficial if they go well? Cesarean offers a feeling of certainty (though not assurance) and vaginal birth offers the unknown. But vaginal birth also offers hormonal changes from labor, the finish of the hormonal cycle of reproduction with subsequent brain change and probiotic activity, and can be easier to maintain mother/baby togetherness from the start, spontaneous or at least, immediate breastfeeding is more possible but can happen or not happen with either surgery or vaginal birth.

She may have a shoulder dystocia. She may not. I don't dismiss the potential but I don't dismiss vaginal birth because of this person's risk. If she does have a SD, she flattens her lower back while her providers figure out how to rotate the shoulders free. The chance of injury to the baby is about 7 in 100 and reduces to less than 2% when providers do practice drills (Crofts 2014). Permanent injury is also low risk. Death is less but not zero.

The thing she can ask herself is, who does she want to be a year from now looking back at her birth?
What does she want and what is the next action to take to get that? And to remind herself several times a day to hold that vision in her head and body. Asking our bodies to avoid a complication is wrong. Because the mind doesn't hear no, don't, avoid. Ask the body to release, open, birth (as a verb). The physiology-first mind set.

Thank you for your continuing care of our mothers, Doula!

Much love,
Gail

On this video you will learn 5 types of shoulder dystocia and their resolutions using all-fours and other maternal positions. You will see references on how often SD occurs and reoccurs as well as see births and real life resolutions. MEAC CEUs are available with the additional purchase of the continuing education option.

Wednesday, March 1, 2017

Not Afraid to Care

"The 2014 West African Ebola outbreak killed 11,310 people. Liberian nursing assistant Salome Karwah was not one of them." says Time Magazine. "...as soon as she recovered, she returned to the hospital where she had been treated — the Médecins Sans Frontières (MSF, or Doctors Without Boarders) Ebola treatment unit just outside of the capital, Monrovia — to help other patients. Not only did she understand what they were going through, she was one of the rare people who could comfort the sick with hands-on touch. She could spoon-feed elderly sufferers, and rock feverish babies to sleep." wrote Aaryn Baker.

The Washington Post states,
"Last week, Karwah died as a result of complications from childbirth, and the lingering suspicions of Liberians toward Ebola survivors was partly to blame."

Three days after a cesarean birth on February 17th this year, Salome went home and began to convulse. Though her family rushed her back to the hospital, fear of contracting ebola through her saliva stopped the medical staff from treating her. Time reports, "They said she was an Ebola survivor,” says her sister by telephone. “They didn’t want contact with her fluids. They all gave her distance." Treatment may have included heparin if symptoms matched a blood clot, and magnesium sulfate IV if eclampsia was suspected. The anti-seizure medication diazepam may have been considered. But Salome got none of these treatments. Fear and not knowing how unlikely it was to resume an eboli viral infection prevented good medical care. Training may have saved this heroine's life. How bitter that she was so willing to serve eboli victims so these same medical staff members didn't have to risk contact and that later they let her die unnecessarily because they didn't want to risk contact.

The most common cause of seizures after childbirth may be eclampsia which can be seen as rapid shaking of the body, or convulsions. 

Lubarsky (1994) studied late postpartum eclampsia, most of which took place after hospital discharge. After 48 hours the risk lessens but eclampsia can strike two weeks or even three postpartum.

Sibai concluded that postpartum convulsions three days after birth are likely to be cerebral vein thrombosis (1980). Up to 30% of victims do not have headaches preceding convulsions, finds Coutinho (2015). Hormonal contraceptives, pregnancy and postpartum period increase risk. 

A 2012 case report also cites dural puncture from a difficult epidural. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371498/
This woman was given diazepam to stop the seizure and magnesium sulfate through intravenous fluid injection until it was determined by spinal tap examination that a dural puncture was the cause.

So many health care workers and others who give selflessly are reeling from this tragic loss. Those who have worked in similar extreme conditions are all so close to the split of the courage and the fear and the human behavior reflecting the opposites. I can only assume the poignancy with which these fearless rescue worker must feel this news. 



Might I be correct in suspecting many Americans would assume that US medical workers would not bow to fear. We have evidence, we have protocols, hey, we have gloves! 


A recent series of emails with a breech bearing Mama is a common but seemingly less extreme example of fear stopping proper medical treatment.


The pain within this first email may not be blazing, but it's chronic and also epidemic. The loss is not only to be the parent struggling to find help in a society which turns away from natural breech birth but to be a midwife reading her desperation. 


A pregnant woman writes to a group of providers, seeking skills and willingness that is nearly extinct in the USA.
"I am almost 32 weeks pregnant.  My baby was head down but at my check up just presented breech.  I know its early, but my current provider will not even consider anything but a C-section if the baby remains breech.  ...
I have heard no hospitals in the twin cities offer vaginal breech delivery...

Please let me know if you or anyone you could recommend has experience with natural breech birth and still is willing to attend one, and would take me as a transfer patient at 32-33 weeks. Please include cost of service too ..." 

Compounding the sadness is that the outcomes of vaginal breech birth is similar to those of cesarean with a skilled provider. The problem is that the skills are rarely taught in schools and not many providers can travel to breech experts to attain training.

These obvious mourners, mothers and midwives, are not the only ones to grieve skills lost. Thomas van den Akker served birthing families in Malawi. He warns European physicians that there are also hidden victims of denying breech vaginal birth are the subsequent siblings who may die from cesarean after-effects of rupture in later pregnancy and the women and breechlings of low-resource countries whose care providers have now also lost the skills of breech delivery before a system of high-tech surgical suites can be supported in communities.
(Who pays the price? (Foreign) women, future siblings, 2016,Thomas van den Akker MD.PhD, Resident O&G at University Medical Centre, Leiden, The Netherlands as reported in the Amsterdam Breech Conference, 2016 Teach the Breech!) 
Thomas van den Akker at 2016 Teach the Breech
Breech skills retained in high-resource countries save lives in low-resource countries as well.

Cesareans replace the recommended procedures in spite of electricity not being available 24/7 in many rural hospitals. These same communities are devaluing and banning midwives and so lose their knowledge as well. Can the western medical invasion comprehend the resulting die-off caused by the inoculation of hybrid birth practices devoid of community networking and manual skills which need no electric lights to succeed?  Like a viral tsunami, surging western high-tech values wipes the cells of culture, birth, and family from the bed of hands-on skills. 


The late Abby Kinne teaching breech skills to a midwifery student.
Abby was a dedicated teacher to first responders and medical and midwifery students.
Who in her area has taken her place? Does anyone know breech like she did in her region? 
New understanding in physiologically-based exercises for what Carol Phillips coined body balancing seem to help women themselves achieve head-down fetal positions for their babies. Spinning Babies suggests self care and professional bodywork and other ways to help baby get head down before manual force of external cephalic version or skipping attempts at turning babies and going straight to cesarean. 

If no one is available for breech skills, then breech birth is more risky but parents who choose vaginal birth have the right and are, importantly, not wrong to choose vaginal birth. It is the responsibility of providers to insist on breech skill wisdom and to seek it, bring it to teaching venues, and preserve it in law and protocol. We must not find ourselves to afraid to act correctly. 

The same mother writes, 

Thanks so much, Gail!  I did a lot of exercises to try to help the baby turn, and thank God, she did turn head down in just a few days... I am just hoping and praying that she stays that way:)  

Thanks again for all your help and your warm response.

March is Womens History Month. http://womenshistorymonth.gov/about/


Wednesday, February 1, 2017

Is there still time to flip my breech baby?

Spinning Babies helps flip a breech 
The look that says, "I did it myself!"

At 36 weeks the midwives were adamant there was a less than 3% chance of my baby turning from the frank breech position and had never heard of any exercises to do. 
I was recommended to have ECV [external cephalic version is when a doctor (or occasionally a midwife) tries to turn the baby by pushing on the abdomen in a very specific way] or a C-section, and told my homebirth was out of the question.
I did the exercises you outlined. And at my 37-week scan little Pearl was head down. The Sonographer [ultrasound specialist] said she had never seen it before and said she had thought it was anatomically impossible for a baby to have turned that late?!
She was born in the pool in our sitting room while her 2-year-old big sister slept upstairs.

"Spinning Babies empowered me to have 
the most perfect birth for my family."


Spinning Babies offers hope for women who want a vaginal birth. Many women will succeed in improving baby's position with self care techniques. Others will find interventions are less taxing. The sooner you begin, the more likely you will find the "balance" you need for more comfort in pregnancy and more ease in birth.


Typical timeline for breech position 

10-24 Weeks Gestation

Baby is often transverse or a bit oblique. Few babies are vertical now.
By adding body balancing now, the baby has an increased chance of ideal positioning later at 34 weeks and beyond.

24- 30 weeks

Babies are moving towards a vertical  Routine good posture with walking and exercise will help most babies be head down as the third trimester gets under way.

30-34 Weeks Gestation

Chiropractors  may add specific maneuvers for fetal positioning, sacral and symphysis alignment, Webster Maneuver, and other soft tissue work. 
The best time to flip a breech is now. Oxorn and Foote recommend external version at 34 weeks, but most doctors want to wait for baby's lungs and suck reflex to be more developed in case the maneuver goes wrong and starts labor or compromises the placenta.
There is often enough amniotic fluid for an easy flip before 35 weeks.

34-35 Weeks Gestation

A study showed this is the most effective period for moxibustion to help babies flip head down. We suggest doing moxibustion as part of a complete routine for helping baby head down.

36 -37 Weeks Gestation

An external cephalic version may be recommended about this time for the doctor or midwife to manually turn the baby head down. It's about a 50-50 success rate. We wonder if preceding the maneuver with body balancing will increase the success or ease of moving baby. Less tension or torsion in the path of the baby seems like a goal to me.

38 Weeks to Birth

A small number of babies will turn head down in late pregnancy. It may be that up to 1% of breech babies flip head down during labor. That's not a big chance, but it shows it's possible and does happen.
An external cephalic version might be appropriate to try even up to and including early labor.
You can work with your body to prepare and work with your care provider to turn baby safely, if possible, until either your water releases or contractions are regular.


Dr. Michel Odent in his book "Cesarean" suggests waiting for labor even if you plan for a cesarean birth for a breech baby. It's a bit challenging to pull together a surgical team in the middle of the night, but helps baby establish the brain changing catecholamine and other changes for living in air.

Gail and a pregnant couple show a short version of advice for helping the breech baby get head down, Spinning Babies Parent Class.

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.