Hi all, I recently posted a story of a VBAC where I used the a gentle external 'lift' to reposition baby. A few people have asked me to elaborate on this:
This repositioning was taught to me br Dr John Stevenson when I was working with him some 18 years ago (he is still my mentor today - even at 80 odd!). I find it useful to use when there is a long transition stage - say 4 hours plus without much progress. You often find the accompanying thick anterior lip with a high head that hasn't changed its position - either rotation or descent - for a fair time. The woman needs to lie down or be in water, and between contractions, standing facing her feet, you locate the shoulders above the pubic bones and pull up slowly and gently, telling the baby what it needs to do to help - ie I'm just lifting your shoulders so you can tuck your head down, or finish turning your head or whatever ... The woman needs to fully support this move - it should cause no pain, but may be uncomfortable for some. The idea of the lift is to take some downward pressure off the head for a few seconds thus helping baby to reposition itself. This lift can be tried a couple of times but if that hasn't worked then I'd suggest that it isn't the right technique for the problem you're facing, or not the right time. It seems to be called for when the pelvic room/space is a bit tight. Last week when I used this I very clearly felt the anterior shoulder rotate more to the anterior and baby was down in two contractions. In past times when I've used this technique I haven't felt anything much change, but in more cases than not, rotation and descent have occurred quickly. So it seems this works both on shoulders as well as head presentation - whatever it is that needs to change. I guess this could be useful for the women who get 'stuck' in transition and end up being wheeled off to theatre for 'failure to progress'. It is a simple tecnique that could be done as she was heading down the corridor!! RADICAL- RADICAL- RADICAL- OF THE ROOTS Sue Cookson This tecnique was also written up in a recent Midwifery Today magazine, I think in one of the 'tips of the trade' sections. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
