Posterior Baby
Baby not descending
NB (s’times necessary to combine with sacral manoeuvre)
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Hip Bone Roll
♀ lying on side on 1 hip support weight /body on 1 elbow/arm
– roll thigh and hip as one unit
(Moving leg without rotating pelvis is of no use) Also do Sacral Rock and Hip Lift (remem to lift hip opposite to where baby is lying)
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* Baby not moving through (stuck)
* Labour slowed down / reached a plateau (work wi bony pelvis)
* Tension at top of vagina * Dilation slow * Anterior Lip * Back/hip pain * Pain always in same place /
* Baby transverse
NB you may have to work like this for several hours as baby moves slowly through pelvis
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Hip Bone Lift – (lift hip opp to where baby is lying)
– ♀ lying on side – pillow b/w knees to support upper leg – ♀ be very focussed on reducing internal tension during – ♂ gently, slowly & smoothly press down on top of hip blade. At same time, lift sit bone all to count of 3 – ♂ hold for count of 3 – lower smoothly to count of 3 – repeat 2 or 3 times then wait for 3 or so contractions to see if baby moves through. – get into an upright position for at least 3 Cs – if no change repeat on either side
♂ (This opens more space in general in pelvis. Is very good to reduce inner tension when ♀ can’t do so consciously by herself. It also helps turn a transverse baby to anterior)
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* Instinctive tightening against urge to poo or tear
* Baby ‘hung up’ or slow in coming through vagina in 2nd stage (2nd st not happening)
* Rectum or Vagina tight/tense
* ♀ wants to push, but baby doesn’t seem to move down easily
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Sit Bone Spread
♀ standing facing back of chair – totally straight, feet shoulder-distance apart + bum totally relaxed ♂ behind her with hands on her bum, fingers hooked under sit bones
– ♀ slowly move into a half-squat (straight back) (my knees bend and move slightly out) – ♂ supports squat + pulls sit bones apart while ♀ bending
(This creates space + opens muscles If doesn’t work, maybe baby is actually higher up. If so, use sacral manoeuvre to bring baby down)
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* Back Pain
* Not enough space for baby Amazing if done simultaneously with Hip Lift
* Anterior Lip (Allows baby to move back & reduces pinching on cervix)
* Pain in front where you urinate (2nd stage) |
Important Sacral Manoeuvre
– ♀ lies on the side keeping baby uppermost (as first pref) – Before doing S M : ♀ ‘tucks’ tailbone under, then pushes it out . Doing so helps her feel if/where there’s any inner tension. (Vital to have no tension during SM) – ♀ make every effort to relax m m muscles and don’t try to help ♂; this just creates internal tension) – ♂ faces ♀’s back. With 1 hand, find top of sacrum push in with fingertips to count of 3. At same time, spread other hand’s fingers over mm muscles on either side of tailbone. – ♂ lifts up to count of 3 gently and smoothly – Hold for count of 3 (to give baby time) – Lower to count of 3
Combine with breathing exs & hip lift (need 2 helpers)
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* Cervix not dilating (or v slowly) and nth else working
*VBAC & scar tissue on uterus/cervix (gets cervix to respond to contractions)
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Uterine Lift
– ♂ spreads fingers across top of her pubic bone (or b/w scar and p bine for vbac) With other hand, grab m m muscles (over 1 mm ear) b/w sb and tb. – ♂ gently pulls up tissue under both hands ‘til ♀ tells to stop – Rpt during next Cs, varying which m m ear you place fingers on – ♂ be guided by ♀ – ♀, expand everything inside with directed breathing
– Also try Pelvic Clock, Directed Breathing & relaxation exercises
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* Not enough room in pelvic outlet / mid pelvis
* back pain
* back labour |
Rocking the Sacrum – do instead of pushing s in
– ♀ make every effort to relax m m muscles (vital to have no tension during RS) – ♂ spreads hand over sacrum (diagonally or up-down) – He can gently rock sacrum up – gives room to pelvic outlet & mid-pelvis – Rocking down gives room to inlet – Rocking diagonally gives room to one side or other of pelvis (Sacrum is most important thing to have mobile regardless of your shape for baby to move down easily.)
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Tight bum muscles/back
Pain in back
Delayed 2nd Stage
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Kate’s Cat – ♀ rocking sacrum by h’self
– ♀ stand with feet more than shoulder dist apart, holding onto back of a chair. – Tuck tailbone + feel mmm contract. (This opens top of S and closes distance b/w t.b & p.b.) Push t.b back out: Notice how you can relax mmm as you do this. (This action does opp)
– To isolate muscles needed to move only sacrum & not your whole pelvis; put fingers on p.b. & repeat the tuck. Does yr p.b. move fwd? IF only moving S, then p.b. won’t move much. See if you can keep your p.b. still while tucking S. Check by trying again lying down. Check agin by repeating with fingers on sit bones. They shouldn’t move much either.
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Baby not turning the corner, coming down or moving through opened cervix
Don’t like feeling of baby moving down
Anterior lip
Cervix pinched against pubic bone by baby’s head
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Letting Down Reflex Reaction
Practise before labour several times a day: Lie on back + remember feeling of bowel movt.
– use exhale of directed breath into sacrum to push top of S down to touch bed/floor – move directed breath down inside of S to rectum causing feeling of pooing/bearing down – You’ll feel lower part of S/tail bone come fwd, causing pelvis to tilt up slightly. NB you’re using yr back muscles – This is what relaxed bearing down feels like + lets baby descend – during labour – near end of dilation or in 2nd stage; Know that it’s the baby, not a poo + recreate that relaxed feeling in yr sacrum you’ve practiced
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* Tension/pain (restricts mobility)
*Every other problem |
Simple Relaxation exercises – Stay awake to hidden tension. Seek & destroy inner tension! – ♀, with mind’s eye, tell white connective tissue to relax
4 exercises;
– 1) ♂ place 1 finger gently on ♀’s head – ♀ breathe into that area and relaxes it – ♂ moves down her body touching in diff / any places on body – be guided by ♀ – ♀; breathes in and out and relaxes in each place
– 2) Rpt process with ♂ using flat of hand – ♀ directs her inner vision to relax there
– ♂ ‘relax under my hand’
– 3a) ♀ puts hand on pubic bone and directs her breathing there.
– expand soft tissue there, ‘bulging’ it on the inhale for 1st stage and on exhale for 2nd stage (as do when cough) Do several times.
– 3b) ♀ puts hand over rectum and expands down there (on the inhale for 1st stage and on exhale for 2nd stage.) Do several times.
– 4a) B/w Cs, try purposefully tensing up where feel pain/tension, then relax there.
– 4b) B/w Cs, tense up and relax there by directing your breathing there.
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Baby over pubic bone, rather than coming into pelvic outlet (ie belly muscles weak)
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Wrap a cloth around belly to hold baby in place
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Cervix fully dilated, but baby has not come through bony pelvis (2nd Stage)
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TRY: Hip Lift, Sit-Bone Spread, Sacral Manoeuvre |
Baby not opening birth canal & you feel ‘stuck’ (2nd stage)
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– Keep pstn upright – Remem how position affects perineum; is it tight or relaxed? – Sit-Bone Spread & Sacral Manoeuvre
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