RE: [ozmidwifery] Manual rotation
One really shouldn't try and do a manual rotation before full dilation. I'm surprised the woman agreed, especially the second time, it must have been very painful. One doesn't usually push back the last cm. One may try and slip an anterior lip over. Seems pretty dodgy to me. I saw a midwife push on the fundus with one hand while pulling on the baby's head with the other, (her knuckles were going white) to speed up a birth. After all, it was getting on for knock-off time. Maureen -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of [EMAIL PROTECTED] Sent: Wednesday, 28 June 2006 10:12 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Manual rotation Quoting Susan Cudlipp [EMAIL PROTECTED]: Did this incident cause some adverse outcomes? Regards, Sue Thanks for everyone's reply's.. Yes, this particular time, the outcome was forceps and a third degree tear which obviously not a direct result of the manouvre, but from the maternal exhaustion which ensued. In this case I think, it wasn't just the procedure, but the reasons for, and manner in which it was done. The midwife suggested it to the woman as a means of speeding up her labour (even though she was nine cm and had only been in the hospital for two hours!!), and had already performed an ARM for the same reason. She suggested that she could push the cervix back that last cm and rotate the baby, to save the baby doing so, and thereby reducing the overall time of the labour!! I couldn't believe what I was hearing! The woman agreed (???!!!) and this went ahead, with the woman instructed to push afterwards as she was apparantly now 10 cms. When no head appeared in due time, the woman was checked again and it was discovered that the cervix had gone back to 9cm.(suprise suprise) This scenario was repeated several times, with the woman encouraged to actively push in between. She eventually was so exhausted that the same midwife determined that forceps would be required... etc etc.Why not leave well enough alone in the first place? Anyway, the question I really wanted answered was that of safety. Obviously this was not a good illustration of appropriate of necessary use of this kind of technique, but my dilemma is that I have been told on the one hand that this kind of thing is dangerous and unnecessary, and then I read about it in Mayes, and several of you have replied that it is something you would do on occasion. I guess this is something I need to look into further. Thanks for all your help, regards, Astra. - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 6:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 19/06/2006 -- 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
Re: [ozmidwifery] Manual rotation
Hi Astra Thanks for the further details In this case I would suggest (not having been in the room at the time) that there was obviously unwarranted interference and the midwife would seem to have compounded the problem of OP instead of helping. If the woman was a primip, 'pushing back the lip rarely works well. I have sometimes done this with multips who have a stretchy cervix, if they are getting tired and wanting to 'get on with it' and have felt the baby descend and rotate quite magically, but to do both procedures under the circumstances you describe sounds quite mad - what was she trying to prove?? If the woman was making good progress as you describe the best thing would have been to leave the membranes intact - this allows better rotation of the head in any case - and WAIT. Pushing 'cause you are now 10 cms' is very old and not good practice (as I said before) and I have often seen where someone has apparently pushed a lip back only to find it had returned after the poor woman has pushed valiantly against her own instincts (being directed to do so) and yes, they do get exhausted! Waiting for physiological urges to push gently gently will accomplish far better results as the baby will be being rotated slowly as he is descending. A stubborn lip of cervix - as sometimes happens with OP's - is best dealt with by encouraging the woman to breathe through, perhaps in left lateral or hands/knees position until the head reaches the pelvic floor and she will naturally push strongly once the lip has gone. Funnily enough this was similar to what happened to me with my 2nd bub (1st VBAC) My midwife colleague was so keen to deliver my baby having been with me all night, that she held the lip up 'got me pushing' and determined to stay on duty until I had birthed! I remember wishing she would get the hell away and go home, but like a good girl I tried to do what she wanted - second midwife was trying to persuade her to let me be but she was very determined! I don't think she tried to rotate the bub (who was by then OT) but had her fingers in my poor peri the whole time! ( something I have NEVER done since!!) I pushed for 1 1/2 hours with the doctors clanging the forceps outside the door (great VBAC practice huh!!) He eventually emerged after a LARGE epis and I was so exhausted that I couldn't even register the fact that it was over - snored loudly while being sutured. I still wish she had gone home and left me to the oncoming shift, I know I would have birthed much better if he had been left to descend and finish rotating in his (and my) own good time. Thanks for sharing your experience - learn from everyone but decide for yourself :-) Sue - Original Message - From: [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 28, 2006 8:11 AM Subject: Re: [ozmidwifery] Manual rotation Quoting Susan Cudlipp [EMAIL PROTECTED]: Did this incident cause some adverse outcomes? Regards, Sue Thanks for everyone's reply's.. Yes, this particular time, the outcome was forceps and a third degree tear which obviously not a direct result of the manouvre, but from the maternal exhaustion which ensued. In this case I think, it wasn't just the procedure, but the reasons for, and manner in which it was done. The midwife suggested it to the woman as a means of speeding up her labour (even though she was nine cm and had only been in the hospital for two hours!!), and had already performed an ARM for the same reason. She suggested that she could push the cervix back that last cm and rotate the baby, to save the baby doing so, and thereby reducing the overall time of the labour!! I couldn't believe what I was hearing! The woman agreed (???!!!) and this went ahead, with the woman instructed to push afterwards as she was apparantly now 10 cms. When no head appeared in due time, the woman was checked again and it was discovered that the cervix had gone back to 9cm.(suprise suprise) This scenario was repeated several times, with the woman encouraged to actively push in between. She eventually was so exhausted that the same midwife determined that forceps would be required... etc etc.Why not leave well enough alone in the first place? Anyway, the question I really wanted answered was that of safety. Obviously this was not a good illustration of appropriate of necessary use of this kind of technique, but my dilemma is that I have been told on the one hand that this kind of thing is dangerous and unnecessary, and then I read about it in Mayes, and several of you have replied that it is something you would do on occasion. I guess this is something I need to look into further. Thanks for all your help, regards, Astra. - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 6:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined
Re: [ozmidwifery] Manual rotation
There is a low intervention alternative to encouraging babies to turn when they are posterior or ROA in labour - Rotational Positioning. It does not involve any manual manipulation, vaginal examinations or any other intervention and it is successful. Unfortunately no controlled trials, only anecdotal evidence but so far proving to be extremely effective when done. Reduces intervention rates significantly, turns babies alot quicker than any other technique and focuses ont he mother and baby dyad. Nikki Macfarlane Childbirth International -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Manual rotation
Quoting Susan Cudlipp [EMAIL PROTECTED]: Did this incident cause some adverse outcomes? Regards, Sue Thanks for everyone's reply's.. Yes, this particular time, the outcome was forceps and a third degree tear which obviously not a direct result of the manouvre, but from the maternal exhaustion which ensued. In this case I think, it wasn't just the procedure, but the reasons for, and manner in which it was done. The midwife suggested it to the woman as a means of speeding up her labour (even though she was nine cm and had only been in the hospital for two hours!!), and had already performed an ARM for the same reason. She suggested that she could push the cervix back that last cm and rotate the baby, to save the baby doing so, and thereby reducing the overall time of the labour!! I couldn't believe what I was hearing! The woman agreed (???!!!) and this went ahead, with the woman instructed to push afterwards as she was apparantly now 10 cms. When no head appeared in due time, the woman was checked again and it was discovered that the cervix had gone back to 9cm.(suprise suprise) This scenario was repeated several times, with the woman encouraged to actively push in between. She eventually was so exhausted that the same midwife determined that forceps would be required... etc etc.Why not leave well enough alone in the first place? Anyway, the question I really wanted answered was that of safety. Obviously this was not a good illustration of appropriate of necessary use of this kind of technique, but my dilemma is that I have been told on the one hand that this kind of thing is dangerous and unnecessary, and then I read about it in Mayes, and several of you have replied that it is something you would do on occasion. I guess this is something I need to look into further. Thanks for all your help, regards, Astra. - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 6:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 19/06/2006 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Manual rotation
Hi Astra I have used this in the past having been shown it by (even) older midwives, but not for many years. I had mixed success with it, there's no doubt that it can help on occasions, as with all these "old skills" some situations require a bit extra and if a midwife is alone she needs to use all the skills known to her (or him - sorry). I have not had a situation in which to think of it for a very long time. OP's mostly rotate after full dilation and when they begin to descend, so trying to rotate them prior to that or when they are still high,seems pointless now. It seems to me to be part of the old "you are fully now so let's get you pushing" scenario which I no longer practice. Physiological pushing when the woman feels the urge will accomplish rotation in most instances. If a woman is pushing as directed by her own sensations and has a baby in OP it will often take a long time to bring the baby into view because she is pushing him around gently - I rarely see a persistent OP these days, don't know when I last caught or sawa 'face to pubes' bub. =I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed.= Did this incident cause some adverse outcomes? Regards, Sue - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 6:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 19/06/2006
RE: [ozmidwifery] Manual rotation
I have
seen OP's rotate once on the peri and vaginal dilation present. It was
fascinating to see, the saggituial suture rotating 180
-Original Message-From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Susan
CudlippSent: Thursday, 22 June 2006 6:05 PMTo:
ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Manual
rotation
Hi Astra
I have used this in the past having been shown it
by (even) older midwives, but not for many years. I had mixed success
with it, there's no doubt that it can help on occasions, as with all these
"old skills" some situations require a bit extra and if a midwife is alone she
needs to use all the skills known to her (or him - sorry). I have not
had a situation in which to think of it for a very long time. OP's
mostly rotate after full dilation and when they begin to descend, so trying to
rotate them prior to that or when they are still high,seems pointless
now. It seems to me to be part of the old "you are fully now so let's
get you pushing" scenario which I no longer practice. Physiological pushing
when the woman feels the urge will accomplish rotation in most instances. If a
woman is pushing as directed by her own sensations and has a baby in OP it
will often take a long time to bring the baby into view because she is pushing
him around gently - I rarely see a persistent OP these days, don't know when I
last caught or sawa 'face to pubes' bub.
=I witnessed a digital rotation, or manual
rotation of the baby of a woman in late first stage of labour, and a cascade
of issues followed.=
Did this incident cause some adverse
outcomes?
Regards, Sue
- Original Message -
From:
Astra Joynt
To: ozmidwifery@acegraphics.com.au
Sent: Tuesday, June 20, 2006 6:31
PM
Subject: [ozmidwifery] Manual
rotation
Hi eveyone, I am a first year Bmid student who
has recently joined the list, and have been getting a lot out of reading the
posts on various subjects. Now I'm wanting to ask advice on an issue that I
have been trying to resolve since early on in my clinical experience.
Without going into the whole story, I witnessed a digital rotation, or
manual rotation of the baby of a woman in late first stage of labour, and a
cascade of issues followed. In debriefing with my lecturers at uni, I was
told this is not good or safe practice at any time. I then witnessed the
same midwife perform this procedure again a few weeks later. Debriefing with
a clinical educater, I was told it is an 'old skill', and certain very
experienced midwives still practice it. Then my clinical supervisor refuted
this and said it is dangerous and has no place in midwifery practice.This is
a very brief summary of these conversations, but I hope you get the gist.
Anyway, I was happy with this, until I read in Mayes Midwifery the other day
that this procedure can be used to help turn a posterior baby!! I am
completely confused! Safe, or not? Evidence based, or not? I would really
appreciate any light cast on this subject... and just in case no one knows
what I mean by digital rotation (if this is not the common term for it) It
is the midwife using her fingers internally to sort of hook the baby's head
(cervix fully dilated I guess, or close to it) and turn it into a more
optimal position, using her own strength and accompanied by the woman
actively pushing. I just want to also say that I know this is not something
that should be occuring in any normal straightforward birth, but what other
information or experience to you have,
warm regards, Astra
No virus found in this incoming message.Checked by AVG Free
Edition.Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date:
19/06/2006
Re: [ozmidwifery] Manual rotation
Me too - many times - it's pretty cool to watch them spin round on the peri huh? Sue - Original Message - From: Ken Ward To: ozmidwifery@acegraphics.com.au Sent: Thursday, June 22, 2006 4:38 PM Subject: RE: [ozmidwifery] Manual rotation I have seen OP's rotate once on the peri and vaginal dilation present. It was fascinating to see, the saggituial suture rotating 180 -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Susan CudlippSent: Thursday, 22 June 2006 6:05 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] Manual rotation Hi Astra I have used this in the past having been shown it by (even) older midwives, but not for many years. I had mixed success with it, there's no doubt that it can help on occasions, as with all these "old skills" some situations require a bit extra and if a midwife is alone she needs to use all the skills known to her (or him - sorry). I have not had a situation in which to think of it for a very long time. OP's mostly rotate after full dilation and when they begin to descend, so trying to rotate them prior to that or when they are still high,seems pointless now. It seems to me to be part of the old "you are fully now so let's get you pushing" scenario which I no longer practice. Physiological pushing when the woman feels the urge will accomplish rotation in most instances. If a woman is pushing as directed by her own sensations and has a baby in OP it will often take a long time to bring the baby into view because she is pushing him around gently - I rarely see a persistent OP these days, don't know when I last caught or sawa 'face to pubes' bub. =I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed.= Did this incident cause some adverse outcomes? Regards, Sue - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 6:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.9.1/369 - Release Date: 19/06/2006 No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.394 / Virus Database: 268.9.2/372 - Release Date: 21/06/2006
[ozmidwifery] Manual rotation
Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra
RE: [ozmidwifery] Manual rotation
Title: Message Hi Astra, If you read Pauline Scott's book Optimal Foetal Positioning you will see the technique described, at least that's where I think it is in. I have used this technique but you rely on an intact firm pelvic floor. Does not work as well when an epidural is insitu which is often the reason they are posterior.A firm pelvic floor allows the baby's headto rotate itself during a contractions as it has some resistance to turn on. Basically with consent I do a VE usually the woman is at 7-8 cm, place my fingers firmly on baby's head and maintain that firmness and with at least 3 contractions my fingers act as a foundation or resistance that the baby's head can swivel on to a more favourable position. I do no more than that but I have heard midwives say they move their fingers as well with the contraction. You must be very careful you do not trap or apply pressure to the cervix. Usually it works especially if you are unable to physically move the woman to a different position because of an epidural. I am sure you will hear some wonderful ways midwives 'work with' the uniqueness of the woman's body and using the power within. Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Astra JoyntSent: Tuesday, 20 June 2006 8:32 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra
Re: [ozmidwifery] Manual rotation
I have seen midwives more using their fingers to support a high posterior head to create like a false pelvic floor for the baby to rotate on - to positive effect. not rotating the head but providing a platform. Suzi - Original Message - From: Astra Joynt To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 20, 2006 8:31 PM Subject: [ozmidwifery] Manual rotation Hi eveyone, I am a first year Bmid student who has recently joined the list, and have been getting a lot out of reading the posts on various subjects. Now I'm wanting to ask advice on an issue that I have been trying to resolve since early on in my clinical experience. Without going into the whole story, I witnessed a digital rotation, or manual rotation of the baby of a woman in late first stage of labour, and a cascade of issues followed. In debriefing with my lecturers at uni, I was told this is not good or safe practice at any time. I then witnessed the same midwife perform this procedure again a few weeks later. Debriefing with a clinical educater, I was told it is an 'old skill', and certain very experienced midwives still practice it. Then my clinical supervisor refuted this and said it is dangerous and has no place in midwifery practice.This is a very brief summary of these conversations, but I hope you get the gist. Anyway, I was happy with this, until I read in Mayes Midwifery the other day that this procedure can be used to help turn a posterior baby!! I am completely confused! Safe, or not? Evidence based, or not? I would really appreciate any light cast on this subject... and just in case no one knows what I mean by digital rotation (if this is not the common term for it) It is the midwife using her fingers internally to sort of hook the baby's head (cervix fully dilated I guess, or close to it) and turn it into a more optimal position, using her own strength and accompanied by the woman actively pushing. I just want to also say that I know this is not something that should be occuring in any normal straightforward birth, but what other information or experience to you have, warm regards, Astra
