Bradley Method and 2nd stage

I've been reading "Natural Childbirth the Bradley Way", my current feeling
is that I want to combine their methods with being in water for the 1st
stage, but their 2nd stage methods are leaving me very confused,
particularly as having done it once before I do at least have something to
compare it to!

There recommended position is the sitting squat, basically you lay back at
45 degrees but in all other ways position yourself as the standing squat,
the do also encourage the standing squat and suggest moving between the two,
but acknowledge the difficulties of maintaining squatting for any length of
time.

Looking at the pictures of the sitting squat it looks to me as if it gives
all the advantages of width, but ignores to problem of the tailbone. The
book then goes on to have a downer to sidelieing as you only can move one
leg out of the way, but again ignores the advantage of getting the tailbone
out the way. It also has a complete downer on hands and knees, but I
couldn't quite grasp why, other than the emotional detachment of the
position. I think this is a Todd moment?

Also the pushing technique was a bit odd, along the lines of two big long
slow breaths and push on the the third, so only pushing at the peak of the
contraction, logical, but then if you can get an extra even if less
effective push in doesn't that mean less contractions to push through in
total and so less time, which seems like a good thing, I know I did 2 or 3
pushes per contraction and pushed for about 7 contractions, time given was
16 minutes which I figure is better than breathing and going on for half an
hour or more?

I haven't given much thought to positions, but I imagine I'm likely to push
either leaning forward against the pool edge either kneeling or squatting,
or resting my back against it. If I don't manage to get in the pool, or I
don't like it, then sidelieing again. Basically whatever feels comfortable.

Cheers

Anne

--
Anne

read about out adventures in Korea at
http://www.livejournal.com/users/annekrogers

Also the pushing technique was a bit odd, along the lines of two big
long
slow breaths and push on the the third, so only pushing at the peak
of the
contraction, logical, but then if you can get an extra even if less
effective push in doesn't that mean less contractions to push through
in
total and so less time, which seems like a good thing, I know I did 2
or 3
pushes per contraction and pushed for about 7 contractions, time
given was
16 minutes which I figure is better than breathing and going on for
half an
hour or more?

After experiencing birth twice, the only thing I would want to do is
listen to my body and push when it says to rather than fight the urge.
But, I have heard of people fighting the urge to push some in order to
avoid tearing.

KC

Anne Rogers wrote:


There recommended position is the sitting squat, basically you lay back at
45 degrees but in all other ways position yourself as the standing squat,
the do also encourage the standing squat and suggest moving between the two,
but acknowledge the difficulties of maintaining squatting for any length of
time.

Looking at the pictures of the sitting squat it looks to me as if it gives
all the advantages of width, but ignores to problem of the tailbone. The
book then goes on to have a downer to sidelieing as you only can move one
leg out of the way, but again ignores the advantage of getting the tailbone
out the way. It also has a complete downer on hands and knees, but I
couldn't quite grasp why, other than the emotional detachment of the
position. I think this is a Todd moment?

Well, I gotta tell you I delivered two babies on hands and
knees and I think it's fabulous. Sure, it's perhaps not the most
elegant position in the world, but what about childbirth is? And
yes, you don't get to grab your baby and pull him/her up to your
chest, but frankly, it only takes a moment to turn over and get
your baby and for me it was absolutely fabulous for getting out
even a rather large baby. My other baby was delivered side lying,
and I don't really think it's that big a deal that you can only
move one leg. It certainly seemed sufficient for me.
I agree that the sitting squat isn't going to give you
as much room to work with. Personally, I'd avoid it.

Also the pushing technique was a bit odd, along the lines of two big long
slow breaths and push on the the third, so only pushing at the peak of the
contraction, logical, but then if you can get an extra even if less
effective push in doesn't that mean less contractions to push through in
total and so less time, which seems like a good thing, I know I did 2 or 3
pushes per contraction and pushed for about 7 contractions, time given was
16 minutes which I figure is better than breathing and going on for half an
hour or more?

I think any sort of patterned breathing and pushing is crap,
unless you find you need that to keep yourself focused and not
panicking. Push when and how you feel like it, and just avoid
tensing up or wasting energy.

I think if you do what your body tells you to do, most
of the time you'll be doing what's right. In none of my births
did I have a preconceived notion of how I would push. I pushed
however my body told me to, and it was pretty clear on what I
needed to do.

Best wishes,
Ericka

BRADLEY METHOD **WARNING** (LAMAZE TOO)...

The "Bradley Classic" - semisitting - closes the birth canal up to 30%.

Bradley Students: Is the "Bradley Classic" still pictured in The Bradley
Method STUDENT WORKBOOK?

Bradley Method educators I have spoken with ignore the "Bradley
Classic" but I would like to know - is it still in the Bradley Method
STUDENT WORKBOOK?


Anne Rogers,

Thanks for bringing up this point.

More below...

"Anne Rogers" wrote in message
...
I've been reading "Natural Childbirth the Bradley Way", my current feeling
is that I want to combine their methods with being in water for the 1st
stage, but their 2nd stage methods are leaving me very confused,
particularly as having done it once before I do at least have something to
compare it to!

There recommended position is the sitting squat, basically you lay back at
45 degrees but in all other ways position yourself as the standing squat,
the do also encourage the standing squat and suggest moving between the
two, but acknowledge the difficulties of maintaining squatting for any
length of time.

Looking at the pictures of the sitting squat it looks to me as if it gives
all the advantages of width, but ignores to problem of the tailbone. The
book then goes on to have a downer to sidelieing as you only can move one
leg out of the way, but again ignores the advantage of getting the
tailbone out the way. It also has a complete downer on hands and knees,
but I couldn't quite grasp why, other than the emotional detachment of the
position. I think this is a Todd moment?

Also the pushing technique was a bit odd, along the lines of two big long
slow breaths and push on the the third, so only pushing at the peak of the
contraction, logical, but then if you can get an extra even if less
effective push in doesn't that mean less contractions to push through in
total and so less time, which seems like a good thing, I know I did 2 or 3
pushes per contraction and pushed for about 7 contractions, time given was
16 minutes which I figure is better than breathing and going on for half
an hour or more?

I haven't given much thought to positions, but I imagine I'm likely to
push either leaning forward against the pool edge either kneeling or
squatting, or resting my back against it. If I don't manage to get in the
pool, or I don't like it, then sidelieing again. Basically whatever feels
comfortable.

Cheers

Anne

--
Anne

read about out adventures in Korea at
http://www.livejournal.com/users/annekrogers


From a previous post...
WARNING:


In 1989, the Bradley Method Student Workbook in effect recommended closing
the birth canal up to 30% ("the Bradley Classic") (!!)


In 1991, after Bradley Method guru Jay Hathaway came to my home to learn the
simple grisly biomechanics of semisitting delivery, he assured me that his
Student Workbook would stop recommending "the Bradley Classic," closing the
birth canal up to 30%...


See Dear Mothering, Dear ICAN, Dear God...
http://health.groups.yahoo.com/group...t/message/1166


Incredibly, in 1997, closing the birth canal up to 30% ("the Bradley
Classic") was apparently still being recommended in the Bradley Method
Student Workbook!


BRADLEY METHOD STUDENTS: Please check your workbooks!


The Bradley Method website has no email address published. I try copying
them via and also via someone who is apparently a
Bradley instructor

(I received no response.)

Here is what I wrote in 2002 when I learned Jay Hathaway's Bradley Method
was still apparently promoting closing birth canals in 1997...


BRADLEY METHOD FLAW...

....My thanks to Laurie ) for recently resurrecting that
1994 (!) Bradley Method thread...
http://groups.google.com/groups?q=g:...hl=en&lr=&ie=U...


Anna Fiehler ) wrote on that same thread (in 1997!):


"The Bradley classes we took focused on knowledge of the childbirth
process...My only gripe...the recommended delivery
position, semi-reclining. They do talk about squatting too, but almost
every tape and illustration in the book show the
semi-reclining position."
http://groups.google.com/groups?dq=&...&selm=32D691AD....
mathworks.com



END excerpt of Gastaldo's Oct. 27, 2002 post...


http://health.groups.yahoo.com/group...t/message/1691

The next day - Oct. 28, 2002 - I noted that LAMAZE also promotes closing the
birth canal up to 30%...
http://health.groups.yahoo.com/group...t/message/1692


The following is a large excerpt from my 1997 post (as usual, LONG post)
regarding the possibility that "the Bradley Classic"
may cause postpartum pelvic pain...

THE BRADLEY "CLASSIC" AND PPPPain - and possible PREVENTION...


Bridget remarked on something Suzanne Powell wrote:



In short, what Todd Gastaldo is saying is that sitting in a semi-sitting
or semi-reclining position causes your tailbone (in lay terms) to be
pushed forward into the pelvis. You can avoid this by using alternate
delivery positions or by using the above positions in a birthing bed
that has a "U" cut out of it (when the take the bottom of the bed off).


He makes some valid points, but truthfully, how many of you actually
kept reading his novel length post? Suzanne Powell


I stopped reading it in the first confusing paragraph. Thank you for
translating it into "English"


I guess this gives more support to the positons that Bradley recommends -
especially in early labor.



The Bradley Method makes a MOST PECULIAR position recommendation - fetal
skull squashing (the "Bradley Classic") - for the actual delivery. As
suggested above, this peculiar delivery position recommendation may also
cause severe postpartum pelvic pain (PPPP) in some mothers...

According to Dutch researchers Mens et al. [1996], "Maximal flexion of
spine and hips" during delivery might enhance the risk for peripartum
pelvic pain (PPPP). [Mens JMA, Vleeming A, Stoeckart R, Stam HJ, Snijders
CJ. Understanding peripartum pelvic pain: implications of a patient
survey. Spine 1996;21(11):1363-70.]


Unfortunately, Mens et al. don't state exactly what they mean by "maximal
flexion of spine and hips."


I suspect they may be referring to - and cautioning against - the fetal
skull squashing "Bradley Classic" delivery position where the woman sits
in maximal flexion - squarely (and only) on her buttocks/sacrum during
delivery? (Semisitting delivery is also recommended by ASPO/Lamaze.)


Norwegian physiotherapist N Bjørnstad similarly cautions against sitting
on the sacrum at delivery, but does not mention prevention of fetal
skulll squashing as a co-benefit:


"Birth positions recommended are...various sitting positions where sacrum
will not be locked against the bed...avoid unnecessary stretching of the
pelvic ligaments and locking of the joints." [Bjørnstad N. Obstetric
physiotherapy, observation and treatment (abstract). Scand J Rheumatology
1991; Suppl. 88:22-23. (N. Bjørnstad, Bjerkåsen 5, 1310 Blommenholm,
Norway)]


According to Bradley Method educator Stacey Yeaman, photographs of the
fetal skull squashing "Bradley Classic" may still be found in current
editions of Jay and Marjorie Hathaway's Bradley Method Student
Workbook.[Personal communication with Bradley educator Stacey Yeaman
1996.]


Ms. Yeaman told me she has not been emphasizing the "Bradley Classic" in
her classes because it seemed to her that it would be hard on the coccyx.


She seemed surprised to learn that the entire sacrum moves - if women
would only get off it. The late obstetrician Robert Bradley, MD himself,
Founder
of the Bradley Method, also seemed surprised to learn this when I called
him... See below.

The Bradley Method is renown for its unmedicated birth record;
and I am not disputing that the FACT that Dr. Bradley stood fast against
routine birth medication amidst stiff medical opposition to his position.
Dr. Bradley and his army of child birth educators are to be commended;
and indeed, they *are* commended, indirectly, in the 1995 and 1997 editions
of Conn's Current Therapy. Details on this for any who ask.


A photo of the fetal skull squashing "Bradley Classic" may also be found
in Doris Haire's paper, "The Cultural Warping of Childbirth" where it is
termed "the physiological position for childbirth." (I responded to Ms.
Haire's promotion of fetal skull squashing - and CNMwifery over direct
entry midwifery - with an article titled, "Unwarping Childbirth," which I
sent via California Governor Pete Wilson to his Maternal and Child Health
Branch Chief Rugmini Shah, M.D.)


The grisly "Bradley Classic" also appears in Susan McCutcheon-Rosegg and
Peter Rosegg's Natural Childbirth the Bradley Way [NY: Penguin 1984], a
book prefaced and "highly recommend[ed]" by the now-retired founder of
the Bradley Method, North American obstetrician Robert A. Bradley.


Most recently, the grisly "Bradley Classic" appears in the 1996 edition
of Susan McCutcheon's Natural Childbirth the Bradley Way [NY: Penguin
1996] - again recommended by obstetrician Robert A. Bradley.


I mentioned Ms. Haire and the Hathaways above because Ms. Haire and the
Hathaways learned from me years ago the grisly biomechanics of the
"Bradley Classic." Ms. Haire learned by phone and via surface mail; and
Jay Hathaway learned by driving from Los Angeles to Sunnyvale in
California for a personal demonstration on my living room floor, using
Hathaway's model pelvis.


In December 1991, Mr. Hathaway sat on my living room floor as I
repeatedly demonstrated the biomechanics of the Bradley "Classic" using a
model pelvis. Later that evening, Mr. Hathaway told me that he would
begin telling all his instructors that the Bradley "Classic" denies up to
30% of pelvic outlet area. Six months later, however, three of his more
prominent instructors still hadn't heard this information.


I contacted Mr. Hathaway again when I learned that he wasn't educating
Bradley instuctors as he had promised. (I learned this from Dr. Carolyn
Wheeler of Los Angeles College of Chiropractic, who regularly invited Mr.
Hathaway to speak to her obstetrics classes.) On the telephone, Mr.
Hathaway casually dismissed the importance of EXPLICITLY INFORMING women
that semi-sitting (the Bradley "Classic") denies fetuses up to 30% of
pelvic outlet area and indicated he wasn't interested in any further
discussion.


Since Mr. Hathaway had just obtained Dr. Moysés Paciornik's address from
me, and since Mr. Hathaway was simultaneously showing Dr. Claudio
Paciornik's video "Birth in the Squatting Position" (and attributing to
semi-sitting a squatting benefit), I decided to write and inform Dr.
Paciornik of Mr. Hathaway's peculiar
we-support-squatting-but-our-workbook-tells-women-that-semi-*sitting-widens-t
he-birth-canal" philosophy.


Mr. Hathaway received a copy of my letter and immediately wrote to Dr.
Paciornik (copy to Gastaldo) complaining that, after all, he (Hathaway)
is in favor of squatting and even shows "Birth in the Squatting Position"
to all of the instructors he trains. Mr. Hathaway told Dr. Paciornik
that most of what Gastaldo said was true - but that he couldn't
understand (and resented terribly) that Gastaldo had compared him with
Williams Obstetrics co-author Norman F. Gant who told me he believes that
most women don't really need the extra room. More on this below.


Dr. Paciornik replied, gently reminding Mr. Hathaway that placing women
in the semi-sitting position does force the sacral tip into the birth
canal and possibly causes neurological damage.


Soon after, Mr. Hathaway stopped accepting telephone calls from me. (I
persisted in calling to insist that he should change the Bradley Student
Workbook to warn students that the Bradley "Classic" narrows the birth
canal. I also insisted that Hathaway issue a statement of clarification
to the thousand Bradley instructors who still hand out the Bradley
Student Workbook. As noted above, he reportedly included the Bradley
"Classic" in his new workbook...)


Through an assistant, Mr. Hathaway insisted that any further
correspondence on this matter must be in writing, and that any
correspondence with Dr. Bradley must go through his (Hathaway's) office.


I again urged Mr. Hathaway, through his assistant, to inform Dr. Bradley
of the pelvis-narrowing characteristic of the Bradley "Classic." A year
later (1993), a Bradley instructor gave me Dr. Bradley's address and
phone. That's when Dr. Bradley told me that he hadn't yet heard from Mr.
Hathaway on this subject.


As alluded to above, I noted in my letter to Dr. Paciornik that my
experience with Mr. Hathaway reminds me of my experience with Williams
Obstetrics author Norman F. Gant, M.D. When Dr. Gant called to thank me
for pointing out that Williams Obstetrics was erroneously using Borell
and Fernström to support a claim that the dorsal lithotomy position
widens the pelvis, I asked him whether he would now begin advising
obstetric students to encourage women to use alternative delivery
positions. "Most women don't really need the extra room," he said.


It astonishes me that Susan McCutcheon and Peter Rosegg heard nothing
about the grisly biomechanics of the "Bradley Classic." Ms. Haire, Dr.
Bradley and Jay Hathaway - all of whom were informed of the grisly
biomechanics - are acknowledged in Ms. McCutcheon's 1996 text.


Particularly noteworthy is the fact that obstetrician Robert A. Bradley
himself failed to notify McCutcheon and Rosegg. Surprisingly, Dr Bradley
himself was unaware that sacro-iliac motion occurs. He probably forgot
that, years ago, he had been in attendance in New York City when Dr.
Roberto Caldeyro-Barcia went over Borell and Fernström's work. Mr.
Hathaway, who videotaped the presentation, showed my wife and I the video
tape after dinner (after my demonstration to Mr. Hathaway on my living
room floor; see above) and told me that Dr. Bradley was in attendance
when Dr. Caldeyro-Barcia went over Borell and Fernstrom's work.


According to Dr. Bradley's preface to McCutcheon [1996], the Bradley
Method was preceded only by the late Dr. Grantly Dick-Read's childbirth
method. [Childbirth Without Fear 1944]


Bradley states he "had a wonderful visit" with Dick-Read - though he
"did have a little bit of trouble with...[Dick-Read's] assertion that 'a
little gas or medication wouldn't hurt anything.'" [Bradley in McCutcheon
1996]


Regardless of whether it was Bradley - or the Hathaways - who made a
"Bradley Classic" out of jamming tailbones up to 4 cm into fetal skulls;
it is a fact that Dick-Read saw nothing wrong with placing women
semiseated on their buttocks at delivery.


The Nov. 5, 1955 issue of the British Medical Journal carries a letter
from Dick-Read promoting semisitting delivery over the left lateral
position. Dick-Read believed the left lateral position and "exaggerated
lithotomy" to be "the result of short-sighted teaching of an unnatural
position." To make his point, Dick-Read invoked observations of
"coloured races" living in Africa, made by "100 collaborators, including
Government medical and administrative officers, missionaries, paramount
chiefs, and aged settlers who appreciated the novelty of this
investigation."


Dick-Read also invoked various ancients - including Aristotle who he
quoted ("The woman should lie on her back...between lying and
sitting..."), Soranus of Ephesus, and Shipral and Puah "the Egyptian
midwives to the Israelites."


Dick-Read continued his attack on the lateral position by noting proudly
that "the left lateral position was used and discarded by the great
American obstetrician, Joseph de Lee, who stated his reasons for
reverting to the dorsal position..." (de Lee was the fine fellow who
established episiotomy as a routine obstetric procedure.)


Dick-Read concluded: "My investigations throughout the past few years
show that the large majority of peoples of the world of all colours
employ for delivery the squatting attitude, with the body weight take
either on the feet, knees, buttocks, or lower back...Surely this galaxy
of opinion favouring the dorsal attitude thoughout the ages must have
some foundation of good sense and purpose. There is ample evidence of
this from obstetricians, midwives, and the women and mothers of our time
who have experienced both methods adequately to enable them to arrive at
a balanced conclusion..." [Dick-Read G. Position for delivery (letter).
British Medical Journal (Nov5)1955:1142-3]


Dick-Read's mention of midwives reminds me that prominent American
midwife Ina May Gaskin told me that she agreed with Williams Obstetrics
author Norman F. Gant, M.D. that "most women don't really need the extra
room." I had called Ms. Gaskin upon discovering in the journal Birth
that most of her births were done in the semisitting position. Ms.
Gaskin had just co-authored (with Meenan and Hunt) in the Journal of
Family Practice an article on a hands-and-knees method of handling
shoulder dystocia which for some reason (known only to Gaskin et al.)
would not be adopted by large hospitals.


Gaskin et al.'s comment about hospitals not adopting the practice of
opening the pelvis reminded me of Varney Burst's comment in her Sept. 24,
1996 letter to me that nurse-midwives would continue to encourage
semisitting in hospital delivery rooms - to "enlighten" those rooms.
(Attention Deborah Flowers, Midwife, 47 The Farm, Summertown, TN 38483.
I thoroughly enjoyed our telephone conversation. Please ensure that Ms.
Gaskin receives a copy of this Open Letter to Prof. Varney Burst.)


Although Gaskin apes this ill-advised medical practice (semisitting
delivery), she is on record in the medical literature using the same
radiographic study I use [Borell and Fernström 1957] - and the same
biomechanics - to encourage getting women off their tailbones when
problems occur.


The medical profession, by contrast, will likely NOT use simple
biomechanics in its hospitals [Meenan, Gaskin and Hunt J Fam Pract 199_].


Instead, the medical profession actually recommends placing women on
their tailbones when forceps become necessary. (The authors of the 1993
Williams Obstetrics cite a study in which 295 Residency programs in the
U.S. and Canada responded. 5% of the programs utilized outlet forceps,
with half reporting their use in 5% of deliveries and one third reporting
their use in 5% of deliveries or more... [Ramin S, Little B, Gilstrap L.
Survey of operative vaginal delivery in North America in 1990. Abstract
presented at meeting of Society of Perinatal Obstetricians, Orlando, Feb.
1992. Am J Obstet Gynecol 1992;166:430. Cited in Williams Obstetrics
1993.])


Even worse, in cases of breech delivery, obstetricians add a grisly step:
An assistant helps to impale the after-coming fetal skull on the sacral
tip. This is the "Mauriceau maneuver" illustrated in the 1993 Williams
Obstetrics. (Fig. 25-7) (It is interesting to note that, in addition to
this grisly breech delivery maneuver, the semi-sitting position itself is
credited to Francois Mauriceau (1637-1709); though he apparently
plagiarized the idea from Aristotle. [Dunn PM. Francois Mauriceau
(1637-1709) and maternal posture for parturition. Arch Dis Child
1991;66:78-9. Address: Prof. Dunn, Southmead Hospital, Southmead Road,
Bristol BS10 5NB])


An interesting Dick-Read coincidence: The "new/old" definition of
chiropractic that I got published in the 1988 27th edition of Dorland's
(reprinted in the 1994 28th edition) is quite similar to a definition of
natural childbirth penned by Grantley Dick-Read, M.D.


The "new/old" definition of chiropractic:reads as follows:


"Chiropractic: a science of applied neurophysiologic diagnosis...based on
the hypothesis that disease is caused by noxious mechanical, chemical and
psychic irritants...treatment is the removal of these irritants by the
most conservative means possible"


Dick-Read's definition of natural childbirth reads similarly:


"Natural childbirth means no physical, chemical or psychological
condition likely to disturb...the natural phenomenon or parturition."
[Grantley Dick-Read, M.D. quoted in Noble E. Childbirth with insight
Boston, MA: Houghton Mifflin, 1983:38]


Dick-Read's irrational "psychological condition" (support for
semisitting) creates a dangerous "physical condition" (fetal skull
squashing) which by its nature not only harms fetuses - but may also harm
mothers.


If Mens et al.'s "maximal flexion" delivery position is the same as "the
Bradley Classic"; then Mens et al.'s hypothesis that peripartum pelvic
pain (PPPP) is caused by "strain of pelvic ligaments" suggests a reason
they found a higher frequency of PPPP in a population of women subjected
to "maximal flexion." Women subjected to the "maximal flexion"/"Bradley
Classic" delivery position have their sacra pinned to the delivery table
as their legs and thighs crank down on acetabulo-sacroiliac lever arms
[Gastaldo Birth 1992;19:230] which, in turn, strain hormonally relaxed
sacroiliac ligaments in a direction exactly opposite what might be
considered a "normal" strain at delivery.


Interestingly, Mens et al. cited radiographic studies from the 1930s but
failed to cite Borell and Fernström's 1957 radiographic study, when they
referred to increased sacroiliac mobility during pregnancy as having been
"observed in an anatomic study and in radiographic studies."


Borell and Fernström's work is decades old but is still cited in the 1995
British Gray's Anatomy as evidence that "radiological pelvimetry has
become a refined technique" (p. 671).


British obstetrician Jason Gardosi, MD cites Borell and Fernström's 1957
work in the OB-GYN-List archive to support a point on which he and I
agree: Many cases of shoulder dystocia are caused by jamming the sacral
tip up to 4 cm into the pelvic outlet. See my posts in the OB-GYN-List
archive...
http://forums.obgyn.net/forums/ob-gy...9707/0128.html
http://forums.obgyn.net/forums/ob-gy...9707/0153.html



END Gastaldo's 1997 post regarding the possibility that "the Bradley
Classic" causes postpartum pelvic pain...

Bradley Students: Is the "Bradley Classic" still pictured in The Bradley
Method STUDENT WORKBOOK?

Thanks for reading.

Sincerely,

Todd

Dr. Gastaldo

I haven't given much thought to positions, but I imagine I'm likely to
push
either leaning forward against the pool edge either kneeling or squatting,
or resting my back against it. If I don't manage to get in the pool, or I
don't like it, then sidelieing again. Basically whatever feels
comfortable.


In the videos I've seen of unassisted births, just about every woman gave
birth in some relatively upright or forward leaning position. Kneeling with
knees apart, squatting, one was sitting, but almost bolt upright and leaning
over on one hip so her pelvis had a lot of room to move (hard to describe),
kneeling in a pool, hands-and-knees, standing, or completely supported by
water. Interestingly, I've seen photos and videos from a number of uc's and
"mother assisted" waterbirths where the mom birthed kneeling in water.

The positions adopted naturally were *not* ones where the knees were spread
wide. They were not ones with the legs flexed back to the shoulders. They
were not, ever, lying on the back, or sitting on the tailbone with no
mobility.

Most positions that are used in the hospital (even side-lying, hands and
knees) are ones where the mother *cannot* catch her own baby or simply birth
the baby gently onto a soft surface. Most positions I've seen moms adopt
when pushing the baby out *without interference or help* are positions where
the mother could guide the baby gently down to the surface under her or up
to the surface of the water. There's no worry of "dropping" the baby,
because there's just not that far for the baby to go.

I was talking to my midwife about right after the birth recently, and she
said she's stopped automatically "hat-and-blanketing" newborns the moment
they come out. She also avoids putting her hands in the way of the birth
unless the position the mother is already in requires it. What she's
observed is that rather than the "usual"
baby-comes-out-caught-by-provider-flipped-onto-belly-hat-on-instantly thing
you see with most attended homebirths even, that moms tend to let baby rest
between their legs for a moment (which allows fluids to drain) and then they
slowly pick the baby up and explore the baby, smelling the head, looking at
the baby's body, gradually bringing baby up and close. If you've ever seen
an animal birth, you know that those moments after birth are *not* the rush
of modern obstetrics, but a slow unfolding, as the mother turns, noses her
offspring, pulls membranes away, licks the baby instinctively (which
stimulates blood flow and breathing) (and later eats the placenta, but
that's going a bit far in most cases even for die-hard UC'ers.)

There's an obsession with "keeping the baby warm" within an instant of
birth...but that shock of air-on-wet-skin helps stimulate breathing and
circulation like nothing else. And once baby is up in Mama's arms, a
mother's body helps thermoregulate the newborn better than any incubator
can. The mother starts shivering if the room is too cold... and that
shivering raises her body temperature rapidly for the baby, and when people
bundle up the mama, the baby is wrapped too, in with her, rather than
separate. Any "hypothermia" of the newborn in this circumstance is going to
be very short-term, transient, and probably therapeutic. I would be
surprised if the "shock of air on skin" didn't help the transition from
fetal to newborn circulation--certainly the shock of air on the face is a
major trigger for the first breath, which is why waterbirth works.

Jenrose

STATED MORE FORCEFULLY - "SITTING SQUAT" CLOSES

See below...

"Ericka Kammerer" wrote in message
...
Anne Rogers wrote:


There recommended position is the sitting squat, basically you lay back
at 45 degrees but in all other ways position yourself as the standing
squat, the do also encourage the standing squat and suggest moving
between the two, but acknowledge the difficulties of maintaining
squatting for any length of time.

Looking at the pictures of the sitting squat it looks to me as if it
gives all the advantages of width, but ignores to problem of the
tailbone. The book then goes on to have a downer to sidelieing as you
only can move one leg out of the way, but again ignores the advantage of
getting the tailbone out the way. It also has a complete downer on hands
and knees, but I couldn't quite grasp why, other than the emotional
detachment of the position. I think this is a Todd moment?

Well, I gotta tell you I delivered two babies on hands and
knees and I think it's fabulous. Sure, it's perhaps not the most
elegant position in the world, but what about childbirth is? And
yes, you don't get to grab your baby and pull him/her up to your
chest, but frankly, it only takes a moment to turn over and get
your baby and for me it was absolutely fabulous for getting out
even a rather large baby. My other baby was delivered side lying,
and I don't really think it's that big a deal that you can only
move one leg. It certainly seemed sufficient for me.
I agree that the sitting squat isn't going to give you
as much room to work with. Personally, I'd avoid it.


Ericka,

Stated more forcefully...

The "sitting squat" (semisitting) CLOSES THE BIRTH CANAL - up to 30%.

When babies get stuck, OBs routinely KEEP the birth canal closed the "extra"
up to 30% as they pull with hands, forceps or vacuums.

Sometimes OBs pull so hard they rip spinal nerves out of tiny spinal cords.

Some babies die - some get paralyzed - most "only" have their spines
gruesomely wrenched.

ALL spinal manipulation is gruesome with the birth canal senselessly closed
up to 30%.

Ericka, I still think it bizarre that prominent childbirth educator Henci
Goer still fails to state this explicitly after I informed her years ago.

I also think it bizarre that you indicated she does explicitly state the
biomechanics...

I wrote:

"Ericka, you also apparently don't think it relevant that a prominent
childbirth educator who bills herself as "the other side" (Henci Goer) can't
manage to explicitly state in her BOOKS that OBs are closing birth canals up
to 30% and keeping birth canals closed when babies get stuck - and lying
about it."

You replied:

"You keep harping on this, but she says clear as can be
(in OMvRR) 'The lithotomy position is the worst position because
it increases the incidence of fetal distress, the mother pushes
the baby uphill, and her pelvis, made flexible by the influence
of pregnancy hormones, is fixed in position by the delivery
table." She also cites several studies and reviews promoting
upright positions. Heck, she even uses your favorite term
'lying' when describing the mismanagement of labor and 'CPD.'"

Henci Goer does NOT say "clear as can be" - or even close - that OBs are
routinely closing birth canals up to 30% and routinely KEEPING birth canals
closed the "extra" up to 30% when babies get stuck...

How very, very bizarre that a woman who putatively represents "the other
side" (Henci Goer) fails to explicitly point out what OBs are doing - and
you say she does - "clear as can be"...

Clear as mud.

See again: Good one Ericka!
http://groups-beta.google.com/group/...16e8654b160ba2

Todd

PS Just in case Henci Goer is reading this somewhere in the world...

THE FOUR OB LIES

OB LIE #1. After MASSIVE change in the AP pelvic outlet diameter was
clinically demonstrated in 1911 and radiographically demonstrated in 1957,
the authors of Williams Obstetrics began erroneously claiming that pelvic
diamaters DON'T CHANGE at delivery.

OB LIE #2. After Ohlsen pointed out in 1973 that pelvic diameters DO
change - the authors of Williams Obstetrics began erroneously claiming that
their most frequent delivery position - dorsal - widens the outlet.

OB LIE #3. After I pointed out in 1992 that dorsal CLOSES - and so does
semisitting - the authors of Williams Obstetrics - put the correct
biomechanics in their 1993 edition - but kept in their text (in the same
paragraph!) - the dorsal widens bald lie that first called my attention to
their text...

OB LIE #4. OBs are actually KEEPING birth canals closed when babies get
stuck - and claiming they are doing everything to allow the birth canal open
maximally. (ACOG Shoulder Dystocia video - also forceps and vacuum births
are performed with the mother in lithotomy.)

See Make birth better: Dan Rather, before you leave CBS...
http://health.groups.yahoo.com/group...t/message/2983

I noted some of the OB lies in an Open Letter to the FTC years ago...
http://home1.gte.net/gastaldo/part2ftc.html

ETHICAL VIOLATION

MDs are violating AMA's Principles of Medical Ethics, failing to strive to
expose the OB fraud and deception, as in,

"[AMA physician[s] shall...strive to expose those physicians...who engage in
fraud or deception."

"[AMA p]hysician[s] shall...seek changes in those requirements which are
contrary to the best interests of the patient."

"[AMA p]hysician[s] shall...make relevant information available to patients,
colleagues, and the public..."
http://www.psych.org/psych_pract/eth...nions53101.cfm

CHILDBIRTH EDUCATORS - like for example Henci Goer (and Carl Jones) - are
supposed to make relevant information available to patients, colleagues, and
the public.

Henci Goer IGNORES this information - and Ericka says Henci states it "clear
as can be"...

"You keep harping on this, but she says clear as can be
(in OMvRR) 'The lithotomy position is the worst position because
it increases the incidence of fetal distress, the mother pushes
the baby uphill, and her pelvis, made flexible by the influence
of pregnancy hormones, is fixed in position by the delivery
table." She also cites several studies and reviews promoting
upright positions. Heck, she even uses your favorite term
'lying' when describing the mismanagement of labor and 'CPD.'"

Something is wrong with this picture, Ericka...

This wouldn't be such an issue for me if it wasn't for the fact that a
massive spinal manipulation crime is being committed and baby nervous
systems are at stake - i.e. - baby lives and limbs are being lost as OBs
blithely close birth canals up to 30%...

Most bizarre. Henci is clear as mud on this issue.

Todd

Also the pushing technique was a bit odd, along the lines of two big long
slow breaths and push on the the third, so only pushing at the peak of
the contraction, logical, but then if you can get an extra even if less
effective push in doesn't that mean less contractions to push through in
total and so less time, which seems like a good thing, I know I did 2 or
3 pushes per contraction and pushed for about 7 contractions, time given
was 16 minutes which I figure is better than breathing and going on for
half an hour or more?

I think any sort of patterned breathing and pushing is crap,
unless you find you need that to keep yourself focused and not
panicking. Push when and how you feel like it, and just avoid
tensing up or wasting energy.

I think if you do what your body tells you to do, most
of the time you'll be doing what's right. In none of my births
did I have a preconceived notion of how I would push. I pushed
however my body told me to, and it was pretty clear on what I
needed to do.

Best wishes,
Ericka

Thanks for confirming my suspicions Todd, I'll stick with pushing on hands
and knees or squatting, and if I really need to lie down it will be on my
side!

Anne

In the videos I've seen of unassisted births, just about every woman gave
birth in some relatively upright or forward leaning position. Kneeling
with knees apart, squatting, one was sitting, but almost bolt upright and
leaning over on one hip so her pelvis had a lot of room to move (hard to
describe), kneeling in a pool, hands-and-knees, standing, or completely
supported by water. Interestingly, I've seen photos and videos from a
number of uc's and "mother assisted" waterbirths where the mom birthed
kneeling in water.

not impossible, I did the last bit unassisted, the midwife had tried to
protect my perinium and unlooped the cord on the previous contraction and I
started out side lieing, unfortunately being in hospital though I got a
precious 30 seconds they were then clamping, covering the baby, etc.
wonderful moment of birth followed by desire to thump the midwife!

Anne

"Anne Rogers" wrote in message
...
In the videos I've seen of unassisted births, just about every woman gave
birth in some relatively upright or forward leaning position. Kneeling
with knees apart, squatting, one was sitting, but almost bolt upright and
leaning over on one hip so her pelvis had a lot of room to move (hard to
describe), kneeling in a pool, hands-and-knees, standing, or completely
supported by water. Interestingly, I've seen photos and videos from a
number of uc's and "mother assisted" waterbirths where the mom birthed
kneeling in water.

not impossible, I did the last bit unassisted, the midwife had tried to
protect my perinium and unlooped the cord on the previous contraction and
I started out side lieing, unfortunately being in hospital though I got a
precious 30 seconds they were then clamping, covering the baby, etc.
wonderful moment of birth followed by desire to thump the midwife!



That's so very not what I meant by unassisted birth.

What I mean by unassisted birth is a birth where there is no caregiver
present. "Mother assisted" is where a caregiver is present, but not really
catching the baby. In neither case would you expect a "precious 30 seconds
followed by clamping" etc. You'd expect minutes of unfolding and discovering
and *no rushing* or worrying about the cord until someone noticed a while
later that it was getting in the way. At which point it would likely be
flacid and white and limp and not "need" clamping.

There's a profound difference betweeen a birth in which no one is even
offering advice about pushing positions and one in which the midwife happens
to step back at the moment of birth and then return a moment after. One
midwife I know says that even the act of a midwife putting a chux pad down
on a bed can alter how the mother positions herself for a birth, or where
she births. The chux pad says, "park it here"...

For me, even with a hospital birth, I ended up instinctively landing all the
"messes" (water breaking, birth, placenta) in the same 2 foot by 2 foot
section of floor next to the hospital bed (to the side, not the end). And my
natural tendency was to be in a standing squat. They had to almost pick me
up bodily to get me into a position to "slow the birth down".

So that you gave birth side-lying but a midwife was there and actively
involved before and after doesn't have much to do with the type of birth I'm
talking about. It's not that your birth was *bad* or wrong, simply that it's
not what I'd call "instinctive birthing" or "undisturbed birth". The reason
I look to unassisted birth for an idea of what mothers do "instinctively" is
that there are so many little things that a caregiver can do at the end of
labor that will take a woman from "instinctive" to "directed" even if the
midwife doesn't happen to have her hands on the baby's head at the moment of
delivery. Even simply checking the cervix to "see if she's dilated enough to
push" may have an impact on the position a mother ends up in... "Lie on your
back so I can check you. Yep, you can push now...." Do you see? Even if, in
that moment, we think of Todd and roll on our sides, we're still in a
position that is much harder to get out of to an upright position than if we
stayed on the toilet or kneeling or squatting or wherever we were just
before the grunting started that triggered the "let me check you" thing.
Hell, I'm not even in labor and once I get lying down, getting back up again
is a *project*. Putting a chux down when a mom has been moving around says,
"Birth here". Even listening to heart tones may require that Mom shift to
accomodate the caregiver.

What I find fascinating is how birth differs when no one is messing with
Mom, and how her interaction with baby differs when no one is rushing in to
check heartbeat, tick off the apgars, get a hat on the baby, clamp the cord,
get all that "goo" off, etc. etc. Suddenly you have a mom who, upright,
gently guides the baby out onto a towel under her, then backs up a little,
puts hands down on the baby, touches the baby, then gently picks the baby up
and holds the baby close, kissing the baby's head, talking to the baby
gently and constantly in many cases, instinctively rubbing the baby. It may
take her minutes...maybe even a half hour, to get to the point of helping
baby to the breast. There is no rush to get the placenta out--but she's
upright, no one has cut the cord, so the conditions are optimal for the
placenta to come out easily and quickly. Chances are it just comes out a few
minutes later, or when she gets baby to breast. Baby might cry reflexively
at first in response to air on wet skin...or not. Some babies just pink up
and look around, recognize the sound of Mother's voice, and find the source
of that voice. It's a whole different world from the usual thing you see on
the reality TV birth shows. You have babies who aren't necessarily stressed
by the birth, aren't in shock from bright lights and loud noises, who are
only hearing the sounds of the family.

Women who birth this way often comment on how "ordinary" it seemed...how
normal...

There are a few midwives now who are looking at what's coming out of the
unassisted birth community and changing their practices. Backing off. Taking
their time. Not rushing in to do routine things, but being available if
needed.

Michel Odent described looking at every single intervention they routinely
did at Pithiviers and analyzing whether it actually benefitted mom or baby.
His conclusion? Don't disturb the mother. Support her as needed during the
birth, but don't interfere if you don't have to. Don't mess with the baby
if you don't have to. Treat that time immediately after birth as sacred. He
went so far as to *not* attend the birth of his own children because he felt
so strongly that the biochemical processes in the body were best met by a
mother having as much privacy and solitude as possible. Personally, I'd like
my husband there, don't mind my daughter being around, but am perfectly
comfortable sending them to another room if I need to be alone. Odent
describes how even speaking to a laboring woman can alter the brain
chemistry to be less favorable to birth. And touching can be even more
disturbing, even massage can be "too much" for a woman in late labor, as
many of our husbands have learned the hard way, let alone vaginal exams and
fetal monitoring. Is there a place for those things? Yes. But we can't
assume that they are "neutral" or "harmless"... they have a potential cost.

I've heard several caregivers talk about how each additional person at a
labor and birth adds an hour to the process. And yes, that may include
support people, nurses, doctors, midwives, doulas, etc. Many midwives
comment how if they come in and find 8 people milling around the laboring
woman, they know they'll be there for a while. And while not every
unassisted or minimally assisted birth is fast, many of the women I've
talked to online have described labors which were *much* faster, much
simpler than what we come to expect from a hospital birth.
Jenrose

oops I cut and pasted the wrong bit, what I meant to leave in was

Most positions that are used in the hospital (even side-lying, hands and
knees) are ones where the mother *cannot* catch her own baby or simply
birth the baby gently onto a soft surface. Most positions I've seen moms
adopt when pushing the baby out *without interference or help* are
positions where the mother could guide the baby gently down to the surface
under her or up to the surface of the water. There's no worry of "dropping"
the baby, because there's just not that far for the baby to go.

in which case my reply makes sense, that it is possible to catch your own
baby starting sidelieing, because that is what I did,

oops

Anne