 |
 |
Thank you so much, I will print it. I also have a wonderful waterbirth story where the parents guided their own baby into the world. I had seen the couple before going off shift the evening before as they had come to the unit with ruptured membranes. I said 'See you in the morning' although they were going home and doubted it! When I returned next morning they were both in the pool and labour was advancing well. Once I had recovered from my double take at what was an unusual situation for me, I explained to Dad how the baby would be born and how, with mum leaning on the pool side he could simply guide the baby up through her legs. As the head was crowning she leant back on him so I thought that was the end of his guiding. However as the head was born she seemed to instinctively go back to her forward leaning position and, with no further instruction and after waiting calmly for about 2 minutes (seemed like 2 hours!) for the next contraction after the head was born he just placed his hands under the baby, guided her up through the water between his wife's legs, she sad back on him with baby on her chest and they were an instant family. I was completely overwhelmed and felt like I was part of a dream. It was absolutely incredible. -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Robyn Maude [CCDHB] Sent: 21 January 2008 20:23 To: [log in to unmask] Subject: Re: water birth Hi Amanda, yes of course you can use the story. I had a student midwife with me at this birth (as I do for most births) she was a first year student and was 'blown away' with the beauty of this birth. Afterwards she asked me, "so what is it that midwives do, because you didn't do anything?" -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Amanda Hutcherson Sent: Monday, 21 January 2008 11:53 p.m. To: [log in to unmask] Subject: Re: water birth Robyn could I use your lovely story in my teaching of the use of water for labour and birth? I am working with midwives who just need to increase their confidence a little. Many thanks, Amanda -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Robyn Maude [CCDHB] Sent: 20 January 2008 22:38 To: [log in to unmask] Subject: Re: water birth My story is similar to Carolyn's. At first I had my hands down there all the time - to feel the emerging head, not the perineum. This was more because of the way in which I taught how to 'deliver' a baby in the early 70's than for any other reason and because of that old notion that one had to feel for the nuchal cord and pull it over the head.(incidentally, I do not even do this for land births now). My practice around waterbirth has changed enormously, both as a result of simply being with women and watching how they birth in water and from the work I did for my master's thesis. I rarely get my hands wet now; most of the women I care for let the baby out by themselves, by instinctively putting their hand over the emerging head to let it out gently, then bring the baby to the surface (I am always amazed at the ease with which babies unravel themselves from their cords when they need to in the water). At a recent home birth (3rd baby, 3rd waterbirth) the woman did her own VE to check for full dilataion ["I don't know where I am at" - "why don't you have feel?" "Oh! The baby's right there"], she proceeded to catch the baby and bring it to the surface, then 20 minutes later birthed her placenta and placed it in a dish she had ready. With regard to the perineum; most of the women I have had who birthed in water have had no perineal damage or smallish tears. Never a 3rd degree. I think this is because the water warms and supports the perienum and allows the head to move down without the women necessarily getting the strong expulsive pushing urge that can lead to tears of the genital tract. Many women have been surprised at how close they are to birthing the baby when they put their hand down to feel. So I think the water is protective. We do not need to be interfering at all. But it takes courage initially to change the practices that were drummed into us and to learn to trust women and the birth process. Robyn Maude -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Carolyn McIntosh Sent: Sunday, 20 January 2008 10:01 p.m. To: [log in to unmask] Subject: Re: water birth A couple of colleagues of mine did postgraduate papers on water birth. I do not have the research they used but I do know that there were several stimulants for the baby to breathe after birth. One is being born into air, another is cooling of the skin and another is tactile stimulation particularly around the face. Yes, babies' faces are obviously stimulated as they pass through the birth passages but the chest is compressed at that time and unless they have some foetal distress they are not otherwise being stimulated to breathe. When I first started supporting women to have waterbirth I would have my hands down there to catch the baby. In later times I have been an observant watcher, ready to act but not 'in there'. One of the beauties of waterbirth to me is that the baby's body is supported as it is born. It floats into the world ready to be brought to the surface by the mother. This is not the case with an air birth and the baby needs to be caught is some way. I have never had a 3rd degree tear in water and very few in air. I believe if hands are on for the birth then you have to be very sure you know exactly how the baby is presenting at that particular time. If you are supporting the baby as it is born you need to be sure you are not actually making the presenting part larger than it needs to be. I have witnessed some serious manoeuvres involving stretching of the perineum etc by midwives in the past this has never been part of my practice. Regards Carolyn McIntosh Midwife and midwifery lecturer Otago Polytechnic New Zealand. -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Rachel Reed Sent: Sunday, 20 January 2008 6:25 p.m. To: [log in to unmask] Subject: Re: water birth I have just completed a literature review as part of my PhD. I thought I'd summarise the findings re. hands on and hands off. If anyone would like the refs or more detail let me know. There is no evidence that hands on reduces perineal tearing. There is some evidence to associate hands on techniques with 3rd degree tears. Most risk factors for perineal tearing are fixed and cannot be controlled by the mw ie. size of baby, ethnicity, etc. One of the benefits of a waterbirth is that the mw can't get in and fiddle with the emerging baby. There is evidence that when women are left to follow their own urges they birth in the best way for themselves and their babies (and protect their own perineum). We need to stop blaming ourselves and colleagues for 3rd degree tears and start trusting in the physiological process of birth. Rachel No Viruses were detected in this message. HealthIntelligence eMail Filter Service This email or attachment(s) may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Capital & Coast District Health Board. http://www.ccdhb.org.nz (1C_S1) No Viruses were detected in this message. HealthIntelligence eMail Filter Service No Viruses were detected in this message. HealthIntelligence eMail Filter Service No Viruses were detected in this message. HealthIntelligence eMail Filter Service