Hi Narelle....Remember me from Cairns Base? I was a student midwife in
those days. Funny you should mention this....i was at Maggie Banks's
workshop on the weekend adn that topic came up....Her belief is that a baby
will try to escape numerous VE's if someone keeps pushing on its head.
Sounds basic...but makes a lot of sense. I also agree that sometimes they
move back to realign in the birth canal also.
Unfortunately i won't be seeing you at the ICM. Have a great time.
Tanya.
----- Original Message ----- .
From: "Judy Chapman" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Tuesday, July 12, 2005 3:40 PM
Subject: Re: [ozmidwifery] Ascending head
I have not seen exactly as you describe Narelle but similar at
an earlier stage of labour.
I am sure it is related to the way the head is lined up with the
opening and the pressure behind the baby at the time. As you
know it is common to feel the difference if doing a PVE either
during a contraction or when the uterus is relaxed. I would
imagine that if she stopped the rocking that the head became
misaligned again and so did not descend during a push???
Cheers
Judy
--- Narelle Crane <[EMAIL PROTECTED]> wrote:
Now that I've broken the ice and made my initial post I have a
question. Has any one else experienced an "ascending head"?
I'll explain. Recently I took over the care of a primip who
was starting to have some involuntary pushes with
contractions. She was lying on the bed and was attatched to a
monitor as there was mec liquor. She was complaining of a lot
of back pain and had been given Pethidine an hour previously.
She did not want to get off the bed or even change position.
Her partner was rubbing her back. After about an hour the
involuntary pushes were much stronger but the woman was too
scared to really "let go" and despite my reassurances she
wanted to know if she was fully dilated. A very quick PVE
confirmed that she was fully dilated and the head was at +1 -
+2. With this knowledge the woman was happy to try different
positions and to "listen to her body". Within 15 minutes her
partner and I could see a small amount of head with
involuntary pushes while she was kneeling. For the next 45
minutes the woman changed positions frequently but was mainly
standing and rocking and rotating her pelvis while she
involuntarily pushed with contractions. After 45 mins or so I
started getting anxious that despite lots of poo I was seeing
very little sign of further descent and suggested that I
should recheck the position of the baby. I couldn't believe
what I was feeling - The head was now at or above the spines
and there was caput +++. I was unable to feel sutures or
fontanelles. I asked the doctor to review but as he was very
busy it was another 15 mins before be came. In the meantime
the woman recommenced doing full pelvic circles and pelvic
wiggles - I encouraged her to "do what feels right". She also
continued to push with contractions. When the doctor
reexamined her the head was OA and at +2. He insisted that
she be made to "push properly" and asked for synto to be
started as "those piddling pushes weren"t getting her
anywhere". After 30 mins of minimal coaching on my part and a
sniff of synto
a very heallthy girl was born. On examination the baby had a
large amount of caput over the right side of her head!
Has any one else seen anything like this? I have told many of
my collegues aboout this and some have said it was impossible
for the head to go back and that I must have been mistaken
when I did the initial PVE. Others, like me believe that
anything is possible when it comes to labour and birth
allthough noone has seen anything like it. Was this another
wonderful case of mother and baby working together to give
birth? What do you think?
Narelle
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