Sometimes women sit down a bit this opens the pelvis and flattens the perineum, helping the baby come down. Don't lift the mother's buttocks and push the mother up at this point! You'll see the baby siting on the floor/birth bed. You'll see a crease in the chest (or "cleavage") indicating that the arms are close to the head and not to worry about. The legs flick out on their own and the shoulders come into the pelvis. The knees look a bit inside out as the legs are emerging, but that's normal for newborn anatomy. Once the parts are out, look at the tone. So please don't flick out the legs!!Īs soon as you can see the baby, you won't be able to hear the heartbeat as easily. It's very tempting to flick out the legs, but if you do that the baby won't have to extend its pelvis so far around the mother's symphysis pubis, which means the baby will have a harder time bringing its shoulder and head past the sacral prominence. The body descends and the legs seem to go on forever. You'll see the baby's bum and lower part of the torso. At the top of the pelvis, that rotation brings the shoulders into line with the widest part of the pelvis. That then triggers the baby's rotation back to RSA and continues round to direct sacrum anterior. The posterior buttock comes into contact with the mother's sacrum, and that triggers a lateral flexion of the baby's hips, which brings the posterior shoulder onto the back and upmost bit of the muscles in the pelvic brim. Use that observation as a little flag.Īs the baby comes into the pelvis-because of the architecture of the bony pelvis, muscles, and ligaments-the baby comes in RSA, comes onto the pelvic floor, and then rotates to RSL or RST. More babies that come in on the left don't rotate. In her studies, 55% of breech babies enter RSA while 45% of the babies enter LSA. The optimal position for a baby to be in, for breech, is RSA as it drops into the pelvis. About 30% of breeches are still undiagnosed at the start of labor, so you'll need to know how to assist a breech birth: how not to panic, how to help if the baby needs help. British midwife Mary Cronk first piqued her interest in breech and set up a study day in 2003 after the TBT came out. She has been studying breech for over 20 years. I also recommend reading Jane's article Understanding Physiological Breech Birth (PDF) in Essentially MIDIRS Feb 2012 (pages 17-21).Jane's goal today was to recap what to look for and and what is normal is in a breech birth, particularly when the woman is upright. Although you cannot see the video footage she had playing in the background, you can still follow the baby's journey as she demonstrates on a doll & pelvis. Fortunately, she gave me permission to film her at the Heads Up! Breech Conference in D.C (2012). This conference summary is best understood when watching Jane Evans demonstrate the cardinal movements in person. Other posts about Jane Evans include: Physiological Breech Birth and Cardinal Movements of the Breech Baby ( Heads Up! Breech Conference, D.C., 2012). Jane Evans is an independent midwife in the U.K.
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