[ozmidwifery] Re: broken collar bone subsequent birth
One of the pitfalls in the birth of a large infant is urging the mother to push a little more for the chin to be birthed. I'm talking about those faces that creep over the perineum and stop with the upper lip of the baby out of the perineum and the lower lip still inside. There's something tidy about getting that face completely born BUT this is where you will get the turtlenecking effect and, it's here that the shoulders get impacted. If you wait for the next contraction and just be patient and let that chin stay inside, you'll avoid the shoulder dystocia because on the next big sensation, there will still be room above the woman's pelvis for that baby's shoulders to turn. The chin and the shoulders will roll out together. I find that, while waiting for that next push, giving the mother a big slurp of water helps to hydrate her and ,like a plant, she'll perk up for that final great heave-ho push to get the baby out. Getting the father to do some nipple stim helps, too. We always have to wonder if any manouevres actually get the baby out or whether it's just that time is passing and the fundus has some time to thicken, rally and piston down on the baby's bum while everyone is flinging the mother about. Gloria Lemay, Vancouver, BC Canada Janet Fraser wrote: http://midwiferytoday.com/enews/enews0416.asp#main Shoulder Dystocia The explanation for the success of the all-fours [Gaskin] maneuver probably lies in movement at the sacroiliac joints at term, which can result in a l-cm to 2-cm increase in the sagittal diameter of the pelvic outlet. The -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Re: broken collar bone subsequent birth
I think it's erroneous to describe breaking the clavicle as a "technique". It's always an accident when it happens and no one is trying to break a clavicle. Those babies are slippery, pudgy and when they're jammed in tight you have absolutely no room to flex them. I think of it like trying to break a chicken bone that is embedded in the centre of a pound of butter. When people say "Then I broke the clavicle" it sounds like it was intentional but it wasn't. I've never had one in my work either but am almost afraid to say that out loud because the karmic gods will get me within the month, if I do. Gloria Mary Murphy wrote: Jennifer wrote: A # clavicle is not a big issue in a neonate and doesn't necessarily mean excessive force was used. The neonates bones are pliable and the # is usually a 'greenstick' or partial break or Well, I have NEVER seen a #clavicle in 26 yrs of both hospital home midwifery, even in big babies where some force has been used. MM
Re: [ozmidwifery] Re: broken collar bone subsequent birth
G Lemay wrote: One of the pitfalls in the birth of a large infant is urging the mother to push a little more for the chin to be birthed. I'm talking about those faces that creep over the perineum and stop with the upper lip of the baby out of the perineum and the lower lip still inside. There's something tidy about getting that face completely born BUT this is where you will get the turtlenecking effect and, it's here that the shoulders get impacted. If you wait for the next contraction and just be patient and let that chin stay inside, you'll avoid the shoulder dystocia because on the next big sensation, there will still be room above the woman's pelvis for that baby's shoulders to turn. The chin and the shoulders will roll out together. I find that, while waiting for that next push, giving the mother a big slurp of water helps to hydrate her and ,like a plant, she'll perk up for that final great heave-ho push to get the baby out. Getting the father to do some nipple stim helps, too. We always have to wonder if any manouevres actually get the baby out or whether it's just that time is passing and the fundus has some time to thicken, rally and piston down on the baby's bum while everyone is flinging the mother about. Gloria Lemay, Vancouver, BC Canada That makes so much sense, Gloria! Jo (RM) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
