There has been a number of mailings and a couple of different threads and
I'm posting a response under a fused thread heading.
Patterns of labouring seem to vary so widely that as a midwife attending a
homebirth I expect to learn something more and different each time from each
birth. As long as mother, baby and midwife are alright then WHY impose any
intervention.
The bit about the midwife being alright really rang a bell for me a few
weeks ago. Then when it was restated by Jane Evans, an independent midwife,
at the Midwifery Today conference in London and it felt good to be reminded
about that publically by peers. It was okay to withdraw from a situation
where I felt unwell and was glad I was honest about this and then the woman
was able to have midwifery attendance by someone else. The mother was okay
about the change and all went well.
The discussion about the gaps/pauses in labour reminded me of the well-known
concept in the Association of Radical Midwives called "the rest and be
thankful" phase. It is usually associated with a woman being what some
American midwives call "complete" or in UK fully dilated. I like the term
"complete". Some women have very long rests/sleep sometimes and then start
active pushing of their own body/mind volition. Mostly, they do have the
reflex urge to push but every so often they don't but they just want the
baby born anyway.
It was funny to hear about something that has been happening as part of
normal birth for years to be given a name like "Lotus birth". I think the
woman on my geographical patch (a tough inner city area) will be amused to
hear of it. Was it named after the car, the crooner or something else?
One local story attached to not cutting the cord is to do with the idea that
the baby will turn out to be able sing well! Perhaps that's why requests
from women not to cut the cord until after the placenta has been maternally
given up has happened for years here and that's how I learnt to cut the cord
until the whole birth is over in my midwifery practice. Mostly the parents
do it these days anyway. In my hospital education they were very keen to
promote oxytocic drug and cct method so not a good learning space about
normality nor good for choirs!
I don't really feel for when the cord stops pulsating but I've read that
practitioners who do check for this say a few minutes. Women who are in
their own power and place, deliver placenta when they are ready to even if
the midwives get a bit antsy. Sometimes it takes seconds after the birth
sometimes an hour or so from my personal experience. I've heard of longer.
Back to the: Is the woman and baby okay Why intervene?
The big problem in the UK is the inappropriate guidelines and protocols that
often lead to intervention. However, I like some of the evidence-based ones
that discourage interventions that Jane Munro has written up for the ARM's
Midwifery Matters-they are reproduced on the ARM webpage also.
Oh, so much research activity to be done.
Best Wishes,
Kerri-Anne Gifford
Community Midwife.
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