Tuesday, January 29, 2008

Our new baby, installment #16

During one of our regular visits with a home birth midwife, we talked about my first birth (in the hospital, back labor, epidural, hours of pushing, cesarean, yadda, yadda, later to learn that the baby was posterior, or facing the wrong way, face up, as he tried to make his exit.) Recently, I told the midwife, I had heard a statistic that some 30 percent of all first births involve a posterior baby.

"Why is that?" I asked.

The answer seems to be a bit of a mystery but one thing is for sure: Posterior babies in general are becoming increasingly common. Perhaps that is because of our sedentary lifestyle, sitting at desks all day using poor posture, driving home in a car with bucket seats and then lounging on the couch at night...the baby settles into the mother's body as if it were laying in a hammock, its back curved against the slouch of the mother's spine, she explained.

Alarmed, I sat up as the midwife reached over to her shelf and handed me an older book called Optimal Foetal Positioning (I don't even think the book is in print anymore, but please correct me if I am wrong), written by a midwife and a childbirth educator, one of whom had been trained in engineering. They explain that if the mother sits forward and upright, the baby is nudged out of the hammock and will assume the proper position. I devoured the book and began to keep better posture immediately.

Of course it is tricky for a very pregnant woman to sit forward because the belly gets in the way. So I made it a habit of sitting in a very unladylike fashion, legs spread, belly pushed forward, sitting on the edge of my seat. I was pretty sure the technique was working, if for no other reason than I did not feel the same sort of back pain toward the end of my pregnancy that I had felt the first time.

The solution seemed so easy and so low-tech. If every pregnant woman in America could read this book, would the c-section rate still be more than 30 percent?

In the end, I wondered, would the book save me from having another posterior baby?

16 comments:

The Eckerts said...

I sure wish I knew that information as well during my first pregnancy. I know it now, and it is sure making a difference. The baby is comfortably anterior and hasn't moved in quite some time. Found your site a week or so ago. Love it. Looking forward to hearing how your story ends!

mamaofquiteafew said...

I made it a habit of sitting in a very unladylike fashion, legs spread, belly pushed forward, sitting on the edge of my seat.

That is how I sat, on a birth ball, for most of my recent twin (twin HBAC) pregnancy, while reading, surfing the web, etc. Although I couldn't find the book you mentioned, I read constantly at spinningbabies.com (similar info). Since my cesarean, on baby #3, was for transverse lie (hours and hours spent driving in bucket seats and nobody ever told me that could be bad), I was determined not to do that again. Although my second twin was still posterior at birth, I had 2 head-down babies and was able to have them vaginally.

Can't wait for the next installment!

PS- Reading Birth:... now, and LOVING it. What an awesome history!

Howdie said...

I'm guessing the book you're referring to is Jean Sutton's. She is a New Zealand midwife and frequently does Optimal fetal positioning workshops in the UK of which I have attended a couple. I think the original book IS in fact out of print although she does have a newer one called "let birth be born again" which is along the same lines. I don't know if it is widely available in the US but Midwifery Today seems to sell it

http://www.midwiferytoday.com/merchant2/merchant.mv?Store_Code=MT&Screen=PROD&Product_Code=LBBA

She has also written a fantastic article called "Birth without active pushing" which I think is accessible online here:

http://www.harcourt-international.com/e-books/pdf/465.pdf

Don't know if these links will work in this post. If they don't then i'm happy to email them to Tina to post on her blog.

Howdie said...

Actually, I think you can maybe still get the original OFP book but only via Jean's daughter in law in the UK. Her email address is either thesuttons@onetel.com or thesuttons@onetel.co.uk, can never remember which it is. Jean's d-i-l's name is Julie and she may also also be able to send you the other book cheaper than Midwifery today as I seem to remember it was only about £16.

randiedoula said...

Here's a question: The information out there says that 30% of babies are OP in a first birth, and the reason they are not (that frequently) in subsequent births is because the tissue is stretched, does the practice of utilizing these positions in a second pregnancy work? I would say that of the 6 c-sections I attended as a doula last year, 5 were probably due to malpresentation. All had really long, drawn out, erratic labors, as did I with my first. The only thing that saved me from a surgical birth was an attempted homebirth. Though I did end up transporting to the hospital, I was able to deliver vaginally. I am 100% positive I would have had a C if I was having a hospital birth.

The 5 births I mentioned were all primips, and unfortunately they will probably never have the chance to see if they could deliver vaginally in the future:(

I am definitely looking forward to the continuation of the story so we can all see what happened!

Tina Cassidy said...

Howdie, thanks for your sluething. And the copy of Optimal Foetal Positioning I read was, in fact, by Pauline Scott and Jean Sutton (1995).

Tina Cassidy said...

randiedoula, do the women you mention have desk jobs or drive alot?

mamaofquiteafew said...

In addition to the desk jobs and driving, I'd wonder about whether there was AROM, since most NCBers I know suggest that AROM can cause a baby to get positioned poorly in the birth canal.

Tina Cassidy said...

Mamaofquiteafew, is the suggestion that artificial rupture of the membranes causes malpresentation because the baby has not "assumed the position" so to speak before getting squeezed out? That is interesting. I am sure it happens. In my case, my water broke on its own both times.

BOLD said...

Tina, I would say that they were mostly office people, all fairly active, none who spent excessive time driving.

What is a NCBer?

mamaofquiteafew said...

NCBer is just me being lazy (NCB= Natural Child Birth) and saving keystrokes! Sorry!

Yes, the thought is that rather than gradually easing down into the birth canal with time and room to turn naturally, AROM could release the fluid and pull the baby down into the birth canal without the baby having the chance to rotate in the same way that s/he might otherwise. I know in one of my births (my second twin), my midwife "pricked" my bag of waters so that it would be a slight, slow trickle out, rather than a gush.

Lisa-Marie said...

I know this post is from awhile ago, but I just wanted to point out that there is another very similar book called 'Sit Up and Take Notice' by Pauline Scott (which appears to be out of print now). You can get OFP from http://www.capersbookstore.com.au/scripts/shop_item.asp?by=aut&item=334

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