----- Original Message -----
Sent: Tuesday, August 13, 2002 9:03
PM
Subject: [ozmidwifery] OP babies
I have a question that will probably be seen as a
silly one to some (but remember I am a consumer so it is my right to ask silly
questions!) If one of the main reasons for cs is failure to progress and
fetal malpresentation AND a common factor with both these 'reasons' is a baby
that is persistently in OP ... why doesn't anyone do anything to correct this
before labour?
Jo, there was a large research
study conducted in Sydney recently on OP positions. It concentrated on
ante-natal exercises to see if they could 'move' babies into a more optimal
position prior to labour. The results were a dismal
failure........
I know a large portion of bubs are OP then
turn during labour; but it seems like we have found that it is easier to deal
with it by cs or forceps rotation...why is it we don't try to avoid the
situation altogether?
Usually we need to wait to see if
the force of the contractions and the shape of the woman's pelvis will help
the baby to rotate. That's what we're looking for prior to c/s or forceps. To
give the woman's body every chance.
Very few women I have encountered were even aware
of the term OP or what the whole OP presentation involves (longer labours more
interventions etc). Why do we pregnant mums not get told during ante-natal
check ups what position bubs in? Why doesn't anyone check when labour
commences?
On your antenatal card there is
spot for 'presentation'. Usually it has hieroglyphics for the lay person in it
in the form of 'OA'. or �T' or 'OP" ( or LOA, LOT,LOP, ROA, ROT,ROP).
That is the position of the baby. Most practitioners start documenting it from
about 30 weeks.
A competent midwife/doctor
will always check the position of the baby when labour commences ( unless you
come in very late in the labour and it's all too difficult!). We need it to
tell us lots of things. Suggested length of labour, readiness of the baby,
potential problems.
I am aware of the optimal presentation booklet
and now try to encourage all women I come across to be aware of their posture
and to try swimming and sitting in positions as well as vertical positioning
during labour that will encourage bub to be OA ....but this is AFTER I
had a cs for failure to progress (8cm and stalled for 2 hours no fetal
distress- due to having a monitor on and being made to be supine...no wonder
bub did not turn himself!)
Good for you, keep trying,
it's better than doing nothing, and many midwives are able to offer other
practical ways of turning babies that are sometimes helpful.
And I agree wholeheartedly, flat on your back is the worst
position to labour effectively in. :-(
Remember this, the shape of a
woman's pelvis will influence her labour. a VERY rough triangle shape where
the pubic bone is at the apex, will allow the baby to rotate to the anterior
nicely. If she is shaped more like a man where the pelvis is more oval shaped
the baby will not rotate anteriorly too easily.
I am curious why this seems to be something that
is ignored by mainstream but something that plays a major role in how birth
results as cs or ivd??
can anyone shed
some light??
I hope I've been able to help you a
little. I'm getting a little rusty now and others may have other ideas to
contribute I'm sure.
Cheers,
Robin.
Jo Bainbridge
founding member CARES
SA
email: [EMAIL PROTECTED]
phone: 08
8388 6918
birth with trust, faith &
love...
