January 15, 2014
Volume 16, Issue 2
Midwifery Today E-News
“Shoulder Dystocia”
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Learn about Shoulder Dystocia and Malpresentations with Midwifery Today’s 4-CD Audio Set

When you order this CD set you’ll be able to listen to Gail Hart, Mary Cooper and Ina May Gaskin as they discuss a variety of important topics. Material covered includes how to identify true vs. false shoulder dystocia, how nutrition can be one of the best methods of prevention and how to assist shoulder dystocia when it does happen during birth. Also included is information about malpresentations such as twin, breech and asynclitic births and brow, face and periatel presentations. To order

MT online store

In This Week’s Issue

Harrisburg conferenceShare your passion and joy for midwifery

Come to our conference in Harrisburg, Pennsylvania, next April. You’ll meet midwives from around the world while attending classes with teachers such as Gail Tully (pictured), Jeanne Ohm, Sister MorningStar, Elaine Stillerman and Carol Gautschi.

Learn more about the Harrisburg conference.

Join us in the UK this spring

UK conferencePlan now to attend our conference in Bury St. Edmunds, UK, May 26–30, 2014. You’ll be able to choose from a wide selection of classes, including Rebozo Techniques and Practice, Breech Skills, Spinning Babies, Comfort Measures and Prolonged Labor. Planned teachers include Robbie Davis-Floyd, Eneyda Spradlin-Ramos, Jane Evans and Elena Piantino.

Learn more about the Bury St. Edmunds, UK, conference.

Quote of the Week

Treating normal labors as though they were complicated can become a self-fulfilling prophecy.

Judith Rooks

Midwifery Today E-News is just the beginning.

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The Art of Midwifery

Squatting during birth has been around since antiquity and still enjoys widespread popularity. Squatting opens the pelvic outlet and closes the brim slightly. Moving into a squat may shift the pubic bone and roll the shoulder out from under the pubic bone. The widening of the ischial spines will increase room in the transverse. In this vertical position, uterine contractions may be stronger and more efficient. Moving the mother to a standing position can work as well. The pelvis may be more mobile when a mother stands with knees slightly bent. A strong helper can hold her under the arms to stabilize and support her. Standing allows a hand in, if needed, more than squatting.

Gail Tully
Excerpted from “Shoulder Dystocia: The Basics,” Shoulder Dystocia, a Midwifery Today e-book

ALL BIRTH PRACTITIONERS: The techniques you’ve perfected over months and years of practice are valuable lessons for others to learn. Share them with E-News readers by sending them to mtensubmit@midwiferytoday.com.

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Jan’s Corner

Changing Birth

Let’s make 2014 the year to change birth practices. There is so much you can do in your sphere of influence, even if you are doing it with little kids in tow! We can all talk to anyone who will listen about how truly special and powerful birth can be. In the grocery store, at the farmer’s markets, at PTA meetings or wherever you are, tell what you know about how beautiful birth can be. Midwifery Today has many articles on our website if you need some help on what to talk about. We even have Sara Wickham’s article on changing birth. If you need scientific evidence, Michel Odent’s Primal Health Databank is packed with research results.

If we can all learn to work together in unity, I believe we will change birth. Midwifery Today is hosting an upcoming conference in Harrisburg about this important theme of unity. I hope to meet some of you there. Unity does not mean we all have to think alike or train alike, but that we work with respect as we make loving midwifery care the norm around the world. It is our desire for every mother and baby to have their best birth possible. We can rally around the idea that there are many kinds of women and many kinds of midwives and each mom can find who will serve her the best. We will never agree on every issue, but we can begin to respect each other. So for 2014, let us each learn to respect our sister midwives and doulas.

— Jan Tritten, mother of Midwifery Today

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

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Midwifery Education: Caring and Sharing

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Learn about midwifery education!

Are you an aspiring midwife who’s looking for the right school? Are you a practicing midwife who would like to learn more? Visit our Education Opportunities page to discover ways to start or continue your education.

Conference Chatter

UK Conference/Retreat

We at Midwifery Today have completed the conference program for our May event in the UK. Many of you have been asking for it and now here it is: /conferences/UK2014/

We have a great line-up of teachers, from both the UK and around the world. As always, Midwifery Today conferences are about uplifting birth workers to keep doing this work with enthusiasm, as well as increasing birth skills in many subject areas. Whether you are a midwife, doula or just checking out this calling, Midwifery Today conferences are for you. Everyone is welcome. Our UK theme is “Midwives Hold the Future.” We indeed do, literally and figuratively.

The conference will be held in Bury St. Edmunds, UK, 26–30 May 2014, at the Culford School, a property of 480 acres in a beautiful retreat-like setting; take a look here! We will all spend the nights in Culford’s dorms. This type of accommodation affords more time with teachers and other attendees. With this intimate setting, we will all have time to deepen old friendships and make new ones. We have a very rich program for you, so follow the link and plan to join us.

And lastly, please “like” our new conference page on Facebook. It’s a general page where you can keep up with current and future conferences, share photos and experiences, find women to share hotel rooms or rides with, etc.: https://www.facebook.com/MidwiferyTodayConferences

— Jan Tritten

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Featured Article

How Being a Homebirth Midwife Enabled Me to Learn about Shoulder Dystocia

Back in 1970, if you wanted to be a midwife, there were very few options for training. There were two nurse-midwifery education programs then, but since I didn’t live in New York City or Jackson, Mississippi, I had no way of knowing about them. I just knew that I wanted to be a midwife. I was lucky to have the opportunity to witness the most gorgeous birth anyone could possibly have, and that birth launched my quest to become a midwife. Those who have read Spiritual Midwifery already know that my initial training came from a short seminar from a kind obstetrician whom I met on the caravan I traveled with at the time. That quick course in emergency birth assistance was later supplemented by the relationship that I developed with Dr. John O. Williams, Jr., a local family practice doctor who lived near the place where my friends and I finally settled and where we started the community that we still call The Farm. Sixteen years of being the main access to medical care for the local Amish community had taught Dr. Williams that homebirth was nothing to be afraid of, as long as you were alert to early signs of complication.

This may sound strange to today’s readers, but Dr. Williams taught us that the way to deal with shoulder dystocia was to deliberately fracture the baby’s clavicle. He remarked that this intentional injury could save the baby’s life, that the fracture could quickly heal and that it was an injury that was preferable to a brachial plexus injury, since the latter injury was sometimes a permanent one. I remember wondering if there might be some way to avoid having to take this route with a difficult birth.

I had been attending births for a little more than six years when some members of my community and I made our first trip to Guatemala to do relief work after a massive earthquake had ravaged the country some months earlier. It was there that I met the local district midwife, Etta Willis, whose job it was to supervise the traditional comadronas (midwives who attended virtually all of the births for the highland Mayan women). It was Etta who told me that the comadronas had a better way of dealing with shoulder dystocia than the methods she had been taught in midwifery school. All you had to do was help the mother into a hands and knees position and the previously stuck baby would be born. (Please note that I later learned that sometimes it’s necessary to rotate the baby’s posterior shoulder into the oblique position, but the hands and knees position makes this easier to accomplish than when the mother stays on her back.)

Ina May Gaskin
Excerpted from “How Being a Homebirth Midwife Enabled Me to Learn about Shoulder Dystocia,” Midwifery Today, Issue 103
View table of contents / Order the back issue

Featured Products

Keep shoulder dystocia info at your fingertips
Shoulder Dystocia e-book cover Our e-book, Shoulder Dystocia, features top-notch information from the brightest minds in natural childbirth. When you buy this book, you’ll be able to read articles such as “Shoulder Dystocia: The Basics” by Gail Tully, “Preventing Shoulder Dystocia” by Michel Odent and “How Being a Homebirth Midwife Enabled Me to Learn about Shoulder Dystocia” by Ina May Gaskin. Available on Amazon or on Smashwords in a variety of formats.

Are you ready for birth emergencies?

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Birth Emergency Skills Training

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What goes on during a shoulder dystocia?
The Resolving Shoulder Dystocia DVD shows you five types of shoulder dystocia and techniques to address them. A one-hour studio class includes slideshows, birth clips and demos, while the second hour shows systematic and clear demonstrations of techniques using a doll and pelvis. This is an important resource for your birth library. To order Shoulder Dystocia DVD

Looking for a good appointment book
for the New Year?
With Woman Appt and Resource Book The With Woman Appointment and Resource Book is just what you need. This handy spiral bound book lets you record 15 months of appointments and is perfect for midwives, doulas, childbirth educators and lactation consultants. You’ll appreciate the reference guides and resources, the place for listing client information and the handy pocket in the back that can hold business cards or a gestational wheel. If you’re a student it can help you keep track of your prenatals, births and postpartum visits. Not a midwife? With Woman makes a great gift for someone who is.
And this year, in celebration of their 10th year of publication, they will donate $1 for every book you buy to the Sukuli Primary School fund to build a primary school in a remote Sierra Leonean village. To order and view inside pages

Sick and tired of seeing birth misrepresented in the media?
Laboring Under an Illusion

Then you need Laboring Under an Illusion: Mass Media Childbirth vs. the Real Thing. Explore media-generated myths about childbirth as you watch over 100 video clips chosen by anthropologist Vicki Elson. This DVD is a thought-provoking tour of diverse attitudes and practices, and an enlightening look at how media influences our attitudes toward birth. Get the DVD.

Website Update

The amazing umbilical cord is featured in the winter issue of Midwifery Today. After a birth, many midwives, doulas, mothers, fathers and even children become scientists as they explore the placenta and umbilical cord, marveling at the twists, colors and texture of what was the baby’s lifeline for nine months (or more!). How wonderful it is to take the time to explore these things and give thanks for the marvelous way in which new life grows and develops. This issue specifically honors the umbilical cord with articles from Michel Odent, Patricia Edmonds, Susun Weed, Sister MorningStar and others.

The table of contents is now online here: Midwifery Today, Winter 2013

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Birth Q&A

Q: How do you handle shoulder dystocia?

— Midwifery Today

A: I use the all-fours position, followed by variations, such as runner’s stance and gentle extraction of posterior shoulder if needed.

— Kate A. Barrell

A: Hands-and-knees position and then runner’s start are my first approaches now. I haven’t needed to use anything else since I started with those maneuvers first. I may need to help the baby rotate, but these two positions offer a lot more room to do hand maneuvers that help the rotation.

— Anni McLaughlin

A: I do what I can to prevent should dystocia. If mom does not have an epidural, I encourage her to listen to her body and be in the position that feels best for her. I encourage controlled pushes and allow time for internal rotation of the shoulders rather than encouraging the head and shoulders to come out with the same push (which may not allow for rotation).

— Emily Jackson

A: I teach “go for the posterior arm” (because it takes you to the shoulder and you end at the arm if you need to be there) as the first internal maneuver, not the last. All other internal repositioning is pretty much a waste of time.

— Gail Hart

A: I rotate the shoulder oblique first—that almost always works. I have had to get the posterior arm two times when that didn’t work. One time I broke the clavicle.

— Tuesday Elaine Lach

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