Labour progress no not politics but birthing

lol not Labour politics but the politics of labour management in birth. Found this today in my facebook newsfeed from The Practising Midwife Journal.   For me a blast from the past and a heavy heart as a retired midwife.  I really do miss my practice and felt honoured to be part of seeing new life in the world.  But I have always been a biologist first and foremost that simply decided to become a nurse and midwife.  I have great respect for biology and the amazing design of birthing.  Despite practising in teaching hospitals I would try to preserve a more intimate environment in the birthing room. I would try to get my colleagues to see that the birthing room is not our room for our power to be exerted, but private sacred space on loan to the couple while they go through the most precious experience ever the birth of their baby - that was made in love and can be brought in the world with love. 

Yes I would have to managed interfered with births for problems that do and can occur from being over scrutinised in the hospital or from fear .. a negative energy from both mother and practitioner.  Fear can impede progress.  It gives the biological trigger that it is not safe to deliver the precious next generation and so labour can be slowed or even stopped.  Some births do need surgical intervention too and I would scrub for C-sections.

Atmosphere is so important I have often quoted this case I remember ..I had to manage an induction of labour with a really loving couple... but we preserved intimacy and were adaptive to the situation still managing birthing ball active labour with CTG monitor.  We had achieved a really loving calm atmosphere no epidural and just going with the flow of the contractions at they came from the first stimulation into action.  Progress was wonderful, the contractions on the CTG showing wonderful regular power... of which, with her husband massaging her back and billing and cooing, she was coping with and breathing calming through riding the waves like a surfer.  But they had given permission for a friend to join them... The friend arrived in the room all agitated and angry as the security at the birth centre had prevented her from coming in but then relented.  The atmosphere changed the whole room ruffled with this energy.... The contractions were clearly demonstrable on the CTG to go haywire... prolonged resting phases and power reduced.. I showed the friend and said look this is the point you entered the room and look before..... we need to settle and merge and reclaim the power of calmness and let this couple work together as they were in love.  The power returned.... so the surroundings and the atmosphere can have an effect on progress. 

‘In spite of the considerable debates and research that have been ongoing for several years, the concept of “normality” in labour and childbirth is not universal or standardized. There has been a substantial increase over the last two decades in the application of a range of labour practices to initiate, accelerate, terminate, regulate or monitor the physiological process of labour, with the aim of improving outcomes for women and babies. This increasing medicalization of childbirth processes tends to undermine the woman’s own capability
to give birth and negatively impacts her childbirth experience. In addition, the increasing use of labour interventions in the absence of clear indications continues to widen the health equity gap between high- and low-resource settings’.

NEW WHO guidelines for Intrapartum Care ‪ to give birth and negatively impacts her childbirth experience. In addition, the increasing use of labour interventions in the absence of clear indications continues to widen the health equity gap between high- and low-resource settings’. 
NEW WHO guidelines for Intrapartum Care ‪ 

My post:
progress is more than just dilation - it is increase power & co-ordination of contractions, it is position of presenting part and station.....and you can have a wonderfully thin cervix anterior pocket with a pp that has dropped from 2 above spines to 2 below into that pocket the os may be still 4cms when you feel behind the pp..but with continued power on that cervix it like roller blinds back and there is nothing holding back the pp which you are likely to see visible within the hour.... so there are lots of dynamics going on in progress assessment....... a rotation from OP to OA is progress... rotation from OL to OA is progress.... and do be mindful of bulging membranes stretching the os to say 7 cms and those membranes rupture or some birth practitioner ARM the os may be 5 cms after ...but the cx has shown that there is progress so with the continued pressure of the pp the os will return to 7cms and continue its yield to open.... I have as performing VE felt dramatic progress with a next contraction... felt the cervix yield under my fingers and the pp press down to delivery ......all with power and yield of cx.... and practitioners do not be so ready to ARM it is amazing how progressive an en caul can be ... and it is more comfortable birth for both mother and baby...... use to love en caul births the babe is like a chick in a see through egg acting as if still in the womb...the breath taken when you tap open the sac ....BIRTH IS MAGICAL and WONDERFUL BIOLOGY ...I feel honoured to have been a midwife for over 1000 of births in my time... Miss it all now retired.
See my past publications under my previous married name of vincent
RCM JOURNAL Progress in a pocket part 1
RCM JOURNAL Progress in a pocket part 2
I did have some good diagrams to explain it all better with visuals... and my VE reports in case notes I would draw what I felt with my examination... it was actually interesting when you flicked through the notes you could see like old cartoon flick film the progress.

If anyone would like me to come and give a talk and share my experience to a group of midwifery students or to a mothers group please contact me marjoriebahhaj@gmail.com