Re: BLOW ME DOWN! - was Re: [NHS] Dr. Sarah disappoints - was Re: Question #2 for Dr. Sarah Vaughan (should women have to ASK?)

From: Helen (helen_at_no-spam.frenchantics.co.uk)
Date: 10/26/04 

Date: Tue, 26 Oct 2004 17:43:30 GMT

> "Not always possible" suggests semisitting and dorsal deliveries are
> infrequent!!! BRAVO!!!

I would really hope that these positions are now becoming less frequently
used, I know that my collegues and I do our best to encourage women into
better positions, and hopefully explain to them why this is not an ideal
position, informed choice...........
>
>
> It seems a little bizarre to me that Sarah had to mention this news to a
> midwife recently - and it sounded like it was indeed news to her (Sarah) -
> news based on reading my posts. In other words - Sarah did not apparently
> hear this news while attending births in her medical training - which had
> to be rather recent - from Sarah's youthful appearance (looks can be
> deceiving I know)...Hopefully, Sarah will correct me if I am wrong (about
> semisitting closing the birth canal being news to her).

I qualified as a midwife 3 years ago, during our training we learnt about
the Rhombus of Michaelis, (J Sutton) and how maternal position was vital in
allowing this movement to occur, and how certain 'traditional' birthing
positions can and do inhibit this movement there by decreasing the available
space, although the Rhombus is high in the pelvis, the movement does affect
the outlet space available.

> Truly bizarre... Maybe UK women aren't offered assistance to go to
> side-lying?

Women who have chosen not to be mobile, or those who can't for various
reasons are most certainly encouraged into the left lateral position, and
the benefits are fully explained to them, obviously I cannont speak for
every delivery suite in the UK, but it certainly happens where I work.

>> Women now are very much more aware of what is beneficial for them during
>> pregnancy and birth, if you ask most women which is the best position to
>> give birth in they will know, but they may not want to do it.
>>
>
> Wow. UK midwives are explicitly telling UK women that semisitting and
> dorsal close the birth canal - and some are insisting on closing their
> birth canals!! *Sacre bleu*!!!!
>
> One might be tempted to say that these UK women *deserve* any unexplained
> baby deaths or unexplained baby paralyses! But what about the babies!??
>
Nobody 'deserves' that fate, as the old saying goes you can lead a horse to
water but you cant make it drink, I think that is often the case here. Women
know ( or are starting to learn) what is best for them but it doesnt mean
they will do it.

> Don't forget, Helen....
>
> Here in the US...OBs and CNMwives are ignoring my pleas and RECOMMENDING
> semisitting (closing the birth canal up to 30% - without telling women
> they are doing so!)....

That is very frustrating and upsetting.Wwe often hear in the UK that birth
is much more medicalised in the US, I'm not sure if that is true, hopefully
its not or is becoming less so, but if that is the case semi sitting and
lying are much more convient if you are 'medicalising' birth, its easier to
see and to perform certain interventions.

>
> Here in the US...when babies get stuck...OBs are violently pushing on tiny
> spines (with oxytocin and Cytotec) and gruesomely pulling (with hands,
> forceps and vacuums) - with birth canals SENSELESSLY closed up to 30%.
>
> QUESTION FOR HELEN: Do you really think when a mother here in the US
> discovers that her baby is PERMANENTLY PARALYZED (after an OB
> cranked/yanked with forceps) - do you really think that she and her
> attorney should NOT be informed that the OB closed her birth canal up to
> 30% (as he cranked/yanked on her baby's neck with forceps)?

The woman hopefully should be informed a long time before this point.

>
> I am quite relieved that you posted, Helen, because (as I wrote - now
> changing the tense)...
>
>>>
>>> Dr. Sarah Vaughan seem[ed] to think it was OK that birth canals were
>>> closed - that there is no real need for OBs and midwives to tell women
>>> that they have been closing birth canals up to 30%. (What about women
>>> whose babies died unexplained deaths or suffered unexplained paralyses
>>> after OBs pulled on tiny necks - sometimes ripping spinal nerves out of
>>> tiny spinal cords?)

I dont think that Dr Sarah Vaughan thought that it was ok at all. and I'm
sure that as far as is possible in her capacity as a Dr, and I am not sure
what sort of Dr she is, she will try to make people aware of this. I think
as health care professionals we have a responsibility of care to our
patients (or clients) to try to ensure they have a much information as
possible to allow them to make informed choices for their care.

>>>
>
> Actually, if it is so common for UK midwives to explicitly tell women that
> semisitting closes the birth canal up to 30% - it is astonishing that
> *Sarah* did not instantly relay this news to me when I specifically asked
> her if she thought women should have to ASK for the "extra" up to 30%.
>
> Are you sure that UK OBs aren't routinely closing birth canals up to 30%
> (placing women semisitting or dorsal) as they pull with forceps and
> vacuums?
>
> I guess if some UK women don't mind before their babies get stuck - it
> might not matter to them when UK OBs start clanking the forceps...

unfortunately yes this does still happen, but not always.
>
> I'd guess though that it DOES matter to babies - which is why I post...
>
> Helen the Midwife wrote further...
>
>> There is a need to inform women of the CHOICES available to them, we all
>> know what is ideal, and we are striving to ensure that women are well
>> informed and well equipped to deal with labour and delivery.
>>
>
> If UK midwives and OBs are explicitly informing UK women that semisitting
> and dorsal close the birth canal up to 30% - and some UK women are
> insisting on semisitting/dorsal - well - blow me down - I am pleased that
> they are being so informed - but astonished some UK women are ignoring
> this info - and sad for UK babies affected...

it is sad that people ignore advice, but sadly it is a human trait, look at
smoking for one, people know its harmful but still do it, the same can be
said for many things, to get people to change there habits you have to
change their attitudes, and that takes time.
>
>
>> Helen the Midwife
>> Madeline 17/5/04 with the extra 30% room supplied!!!
>> One little angel 18/10/04
>
> Helen,
>
> I always put "extra" in quotes and say "up to" 30%.
>
> Again, I am sorry to read of your recent loss.

thank you for your thoughts
>
> Todd

Helen the Midiwfe
Madeline 17/5/04 with up to 30% extra room supplied ;-)
one little angel 18/10/04
>
>

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