Congratulations Andrea on the births you are sharing with us. I love birth stories in 
themselves and for what I can learn from them. But what is NBF? Forceps? Vacuum? 

Thanks also for your ideas on anterior lips Robyn. More ideas for  when women I 
support are told they have one. Mostly I've heard suggestions that women alternate 
lying on their sides. And with my own daughter I was told to have an epidural. 

Margie

At Fri, 3 Jan 2003 23:53:50 +1100, 
Robyn Thompson ([EMAIL PROTECTED]) wrote:
> Well done Andrea and well done to the wonderful woman who chose 
> you to be
> with her.
> 
> Your exhaustion is easily identifiable, this is where you really 
> need the
> woman to have the services of a backup midwife in place.  I know 
> it's hard
> for you to get someone else but your health and wellbeing is very 
> important.
> You can go off and have a sleep knowing that things are continuing 
> as you
> would like while you rest your mind, body and soul.  I find 
> another midwife
> when hospital transfer is necessary is a real blessing because of 
> my desire
> for good continuous documentation.
> 
> Not sure if you are asking for advice but I have offered some 
> anyway.
> 
> This may be a silly question -Did you try (with her consent) to 
> push the lip
> of cervix back between the pelvic bone and baby's head over several
> consecutive contractions, resting for a while then trying again?
>   a.. Another way to help with an anterior lip take up, is to make 
> sure the
> abdominal axis is vertical often when women have asynclitism they 
> have an
> associated angled/oblique abdominal axis which slows progress.
>   b.. There is a typical vaginal picture with a persistent lip of 
> cervix.
> There is a good amount of room in the sacral area a definite 
> sacral hollow,
> the baby's head sits to one side of the pelvis and pinches the 
> cervix which
> is most times offset in the left anterior pelvis.  The head can 
> give the
> impression that it at the station of pelvic spines when in fact it 
> is still
> above spines.
>   c.. Another way of trying to move this persistent lip of cervix 
> to stand
> behind the woman, support her abdomen and uterus from under the 
> lower
> segment with your cupped hands and gently hold her abdo and uterus 
> upward as
> she contracts, this can help the cervix that is pinching between 
> the pelvic
> bone and baby's head to slip back.
>   d.. Hands and knees alternating with stepping left leg on a 
> chair for a
> contraction then right leg on a chair then next contraction then 
> leaning
> back into a supported semi reclining position for the next 
> contraction can
> also be of help.
>   e.. Walking through a contraction that is step by step by step 
> supported
> by someone each side of her or you in front of her walking 
> backwards, as she
> rests her hands and forearms on your extended forearms and just 
> keep her
> walking right through the contraction and repeat as many times as 
> you can.
>   f.. I am sure Wintergreen will have many other suggestions.
> Hope this makes sense and that you have recovered with some well 
> earned
> rest.
> 
> Robyn
> 
>   -----Original Message-----
>   From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED]]On Behalf Of Andrea 
> Quanchi
>   Sent: Friday, January 03, 2003 11:10 PM
>   To: [EMAIL PROTECTED]
>   Subject: Re: [ozmidwifery] Christmas Baby
> 
> 
>   I have had three times in my short career as an independent 
> midwife when I
> have had two women due at the same time. The first two I tried to 
> think of
> all the computations of what could happen and have decided to give 
> that up
> as it just wastes energy that could be better used elsewhere. This 
> week I
> have had two due and haven't worried about it and it was much 
> easier. i have
> always told the women concerned that I have someone due and a 
> little about
> each other if they don't know each other or the opportunity to 
> meet doesn't
> arise. They always ask about each other without me bringing it up 
> and when
> questioned post birth are very open and honest about their 
> feelings about
> knowing this. It doesn't seem to worry them as they are sure they 
> will not
> labour together and can usually tell me who will birth first.
>   I have spoken to many midwives about this issue and the general 
> consensus
> was that if you keep the women informed about your movements and 
> it is
> important to them that you are at their birth they won't labour 
> when you are
> not available. This is invaluable for me and has proved to be true 
> when I
> need to leave town I tell the women that are due and I call them 
> as soon as
> I am available again. I have had one so far who went into labour 
> not long
> after I called her. She told me there was no way she was doing it 
> while I
> was gone.
> 
>   I attended a birth yesterday that left me totally exhausted. 
> Mind you the
> Mum's teenage Taxi on New Years Eve contributed to the issue as 
> well. The
> women a primip at 41+2 went into labour spontaneously at 2130 and 
> laboured
> strongly all night. At sometime she developed an oedematous 
> anterior lip
> that refused to budge despite all the things I could think of to 
> try. She
> remained upright and active all night but told me that while 
> travelling the
> 40 min in the car to the hospital where she had chosen to birth ( 
> a good
> reason to birth at home I think) she felt a pinching senstation in 
> her
> pelvis but couldn't find a way to relieve it and despite my having 
> suggested
> it didn't stop and get out or get herself into a hands and knees 
> position.
> I'm wondering wether it developed then because when she was 4-5cm 
> I could
> feel this very oedematous section even then. Eventually she chose 
> to have an
> epidural that gave her several hours rest but she remained able to 
> stand/
> hands/ knees at will. (One of the few that I have seen work so 
> effectively).
> Despite many hours of patience she decided that she wanted the 
> baby to be
> born and mid afternoon a beautiful baby girl Nell was born by NBF. 
> I have to
> confess that I was relieved when she decided that she was ready 
> but I wanted
> to be sure it was her decision and not because she knew how tired 
> I was. I
> talked to her about it today and she she felt that although that 
> was a part
> of helping her to decide she had had enough and felt she and her 
> baby were
> doing OK at the moment but she wasn't sure how much longer that 
> was going to
> be the case. She felt that her husband and my support was a major 
> factor in
> her being able to keep going and she wanted that support to be 
> strong till
> the end. A difficult situation for me that I need to get my head 
> around I
> guess. Still thank goodness it happens so infrequently. Anyway she 
> feels
> completely empowered by her birth because she feels she was in 
> control and
> even though it didn't end exactly as she planned all the decisons 
> to change
> her plans were hers. And isn't this the whole point.
> 
>   And despite the total exhaustion I come home feeling so 
> privilaged in this
> profession I have been lucky enough to have found,
> 
>   Andrea Quanchi
> 
>  


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