Bed Dystocia

Ok, I’ve found a new favorite magazine — the Journal for New Zealand Midwives. I’ve only read three articles, and each on is blog-worthy. Keep your Good Housekeeping and Ladies’ Home Journal, and give me a good pregnancy or birth article any day!

If you scroll down to page three of the Journal, you’ll read an article called “Active Breech Birth: the Point of Least Resistance.”

In it, the midwife tells of a conference she attended in which symphysiotomy was discussed — that is the cutting of the cartilage between the mom’s pubic bones — ouch!! It was in the context of vaginal breech birth, and the dreaded complication of head entrapment.

Gruesome you may say – but it was actually very affirming for me as it re-emphasised the importance that the woman’s position plays for giving birth to her breech baby to avoid what I term ‘bed dystocia’.

[“Dystocia” refers to difficult childbirth — long labor, slow birth, etc. — “labor dystocia” is a fancy way of saying that labor isn’t progressing according to the doctor’s wishes; “shoulder dystocia” means that after the baby’s head is born, the shoulders are stuck.]

Bed dystocia occurs when the baby’s progress is halted due to, firstly, reduction of the woman’s lumbar spine curvature (lordosis), secondly, the backward tilting of the pelvis and, thirdly, entrapment of the sacrum by maternal weight, all of which can occur if the woman is lying on a firm bed.

I strongly recommend reading the whole article, and would quote the whole thing except I daresay that would be a breach of copyright! 🙂 But the article continues on to discuss the pelvic diameter in “active” birthing positions (such as a supported squat), compared to the lithotomy position described above. It says that while the symphysiotomy “primarily increases the transverse diameters by 1 cm,” so-called active birthing positions increase the transverse diameter 1 cm plus they increase the antero-posterior diameter by 2 cm. So, while doctors will continue to insist on unnatural birthing positions that put mothers and babies into the worst position possible (but it is the easiest position for the doctor), they are then forced to rely on even more medicalization in order to free the breech baby’s head should it become entrapped.

In other words, doctors don’t know squat!


2 Responses

  1. […] how often they would have been needed — really needed — had the woman given birth in a squatting position, which allows her pelvic outlet to open widest, and also allowing gravity to assist in the […]

  2. […] in a stranded-beetle position, for a better view, more easy access to the vagina, etc. But this is physiologically abnormal for a vertex birth, much less a breech birth; and if it can impede normal birth, how much more might it impede a “variation of […]

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