Hard to imagine all that happening in an "emergency" (iatrogenic?) c-sec... It's not really new either. This bloke's been advocating it for a while now. http://www.eheart.com/cesarean/oliver.html ----- Original Message ----- From: "Susan Cudlipp" <[EMAIL PROTECTED]> To: <ozmidwifery@acegraphics.com.au> Sent: Monday, December 12, 2005 3:17 PM Subject: Re: [ozmidwifery] article FYI
> Hmmmmm > > I guess for elective C/S when the woman has no other option it is certainly > a better birth experience for both mum and bub, and would require so little > extra effort, just a bit of lateral thinking. BUT to make it sound all so > romantic is dangerous - gives more fuel to the 'too posh to push' brigade. > Still surgical birth! > Isn't it amazing how they can switch from one extreme to another - actually > proposing that delayed cord separation is now beneficial. Radical stuff! > Sue > "The only thing necessary for the triumph of evil is for good men to do > nothing" > Edmund Burke > ----- Original Message ----- > From: "Lea Mason" <[EMAIL PROTECTED]> > To: <ozmidwifery@acegraphics.com.au> > Sent: Monday, December 12, 2005 11:13 AM > Subject: [ozmidwifery] article FYI > > > > http://society.guardian.co.uk/health/story/0,7890,1656341,00.html > > > > A British doctor is challenging convention to pioneer the 'natural' > > caesarean. Joanna Moorhead watched one baby's slow and gentle arrival > > > > Saturday December 3, 2005 > > The Guardian > > > > > > The scent of lavender fills the air and classical music is playing > > quietly. On the bed, Jax Martin-Betts, 42, is calm, focused and in > > control. With the birth of her second child just minutes away, the > > midwife, Jenny Smith, is giving her a massage. Her husband, Teady > > McErlean, is whispering words of encouragement: just a tiny bit longer, > > and our baby will be in our arms! > > It could be a natural birth at any maternity unit in Britain, but we are > > in an operating theatre at Queen Charlotte's and Chelsea hospital in west > > London, and the birth we are about to witness sounds a contradiction in > > terms: a "natural" caesarean section. > > > > Jax has been on the theatre table for half an hour, and the obstetrician, > > Professor Nick Fisk, has almost completed the incisions through her > > abdominal wall and into her uterus. "OK, the baby is about to be born," he > > says. "Let's prop you up so you can see him coming out." > > > > Smith removes the blue drape between Jax's head and her belly, and the > > head of the bed is lifted to give Jax a clear view. Fisk cuts into the > > amniotic sac and a fountain of fluid rises into the air before he rummages > > around to locate the baby's head. In a few seconds it comes into view, > > covered with the milky-white vernix that has protected it in the womb. For > > the next few moments, the atmosphere in the theatre is electric: Jax and > > Teady gasp in wonder at their new son, who is now looking around, although > > his lower body and legs are still inside his mother's uterus. > > > > This groundbreaking approach to surgical delivery - Fisk calls it a > > "skin-to-skin caesarean", or "walking the baby out" - has been pioneered > > by him partly in response to the rising caesarean rate, which according to > > recent statistics reached a new high at 22.7% (of deliveries in England, > > 2003-04). "Whatever your view on caesareans, for some women it's always > > going to be the safest choice," he explains. "And while couples having > > normal deliveries have been given more and more opportunities to be fully > > involved in childbirth, very little has been done to see how we could make > > the experience more meaningful for those having caesareans." > > > > As Fisk started to examine the conventions of surgical delivery, he was > > struck by how easily they could be challenged. Why, for example, did they > > need to be done so quickly, when slowing them down would give the parents > > more chance to participate in their child's delivery and might give the > > baby a gentler experience of coming into the world? Why, too, was it so > > important for the parents to be screened off from the mother's abdomen? > > And was it really essential for the baby to be whisked off for an > > immediate medical examination, rather than delivered into the arms of his > > mother? > > > > "What I realised was that caesareans were done a certain way because > > they've always been done a certain way, but in fact they can be done > > differently - and in a way that parents love," says Fisk. Other doctors > > are sometimes shocked when they hear what he is doing. "They say, but > > surely you have to get the baby out fast so she can get oxygen straight > > away? And I say, when the baby is being born she's still attached to the > > umbilical cord and is still getting oxygen from the placenta. Caesarean > > birth can be gentle, just as vaginal birth can be gentle. > > > > "Obstetricians are too hung up on getting from the point of incision to > > the birth of the baby as quickly as possible: that's been the benchmark of > > a skilled surgeon. But I'm challenging that because, from the baby's and > > from the parents' point of view, it's not very helpful. > > > > "There's also a view that because the baby's chest hasn't been squeezed > > going through the birth canal, there are greater risks of breathing > > difficulties. But by leaving the baby's body inside the uterus for longer > > once the head is out, the body is squeezed and you see the lung liquid > > coming out of the baby's nose. Unless there are other risk factors, I've > > never known a baby born by my method to have problems - going straight > > onto the mother's chest helps regulate breathing." > > > > Smith, who works closely with Fisk, says it's a hit with parents. "They > > feel more involved, which gives them a better start to family life. > > Breastfeeding is easier to establish, and you can see how much calmer the > > baby is." > > > > For Jax, the birth of Finn - who weighed 3kg 25g (7lbs 3oz) - was > > "spellbinding". > > > > "I had an emergency caesarean last time around. I'd wanted a natural water > > birth, but for some women it just doesn't work. This was every bit as > > magical: seeing Finn there in my tummy was a sight I'll savour for the > > rest of my life." > > > > How the baby Finn is born > > Minute by minute > > > > 09.24 Our first sight of baby Finn comes as Fisk gently lifts his head > > through the incision in Jax's abdomen. In a normal caesarean the baby > > would be lifted clear of the uterus immediately and the umbilical cord > > clamped and cut within seconds. The skin-to-skin caesarean gives the baby > > an experience of birth that is closer to a vaginal delivery. Instead of > > being pulled out quickly, Finn's emergence into the world is slow and > > calm, and the cord remains attached for some moments. His body is being > > squeezed slightly by being still inside the uterus, which helps drain > > fluid from the lungs. > > > > 09.26 Fisk begins to lift Finn up out of the uterus. In a normal caesarean > > the focus would now be on the baby's ability to breathe unaided, as the > > umbilical cord would already have been cut. But in the skin-to-skin > > caesarean the cord is left intact for several minutes during the delivery, > > so the baby is still receiving oxygenated blood from the placenta. At this > > point, the birth has been so gentle that Finn still seems to be asleep. > > Instead of being pulled quickly out of his mother, Finn is able to > > acclimatise slowly to his new surroundings. > > > > 09.27 Finn is now beginning to make tiny spluttering noises and is > > becoming aware of the fact that his surroundings have changed > > dramatically. At this moment, though, he is literally suspended between > > his old life in Jax's uterus and his new life in the outside world. His > > upper torso is outside his mother, but his lower body and legs are still > > folded inside the womb. Officially speaking Finn is not yet born, as it is > > only when his body has fully emerged that he is deemed to be an > > independent being. Jax now has a clear view of Finn as his head is lifted > > up. > > > > 09.28 The moment of birth, as Fisk lifts Finn clear of Jax's body. He will > > now hand him to Smith, centre, who will put him onto Jax's chest. Keeping > > the operation site sterile is a crucial consideration in the skin-to-skin > > caesarean, and Jax and Teady are warned not to try to touch their baby > > until he has been handed out of the sterile zone by Fisk. Finn is now > > moving his arms around and his breathing is clearly audible. Babies born > > by caesarean are often crying at this point - which is traditionally > > welcomed as a sign that they're breathing well. > > > > 09.29 Within seconds, Finn is placed on his mother's chest for a cuddle. > > Studies show immediate skin-to-skin contact results in a baby who is less > > likely to cry, has a more stable temperature, is more able to regulate his > > own breathing and has better blood sugar levels. In a normal caesarean, > > Finn would now be on a resuscitaire table, crying and throwing out his > > arms and legs. The skin-to-skin approach means he can acclimatise slowly > > to the world beyond the womb: so far, he has not cried. Lying on Jax's > > chest, hearing her heartbeat and voice, he is a picture of contentment. > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > -- > > No virus found in this incoming message. > > Checked by AVG Free Edition. > > Version: 7.1.371 / Virus Database: 267.13.13/197 - Release Date: 9/12/2005 > > > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
