The Spinning Babies approach is dynamic, holistic, anecdotal, and grassroots. But is it evidence-based? Some hospital nurses adapt Spinning Babies techniques into their care, while others are told that this must first be proved by evidence. Is that fair? If US maternity were evidence-based, we'd have a cesarean rate below 15%. Breech babies would be allowed to be born, and there would be a doula in every birthing suite. What's really going on?
It would be nice to have some research on all of the Spinning Babies recommendations and the suggested techniques. My arms are open and waiting for grad students who want to take on some of the successful techniques shared at Spinning Babies. Yet, I can't wait to address the needs of birthing women until after someone does the research on the Spinning Babies approach to childbirth. I can only be non-interventive and request that women work openly with their doctors and midwives about these techniques.
The biggest challenge is that young researchers are pressured to begin with literature reviews - to look at what has already been studied before beginning something new. The next challenge is that to get a technique studied, a student has to get their advisor and senior researchers to pick a technique that is easy to replicate, teach parents and/or nurses to do it and to know when to do it, and to be able to track the results easily. Now do you know why hands-and-knees and sidelying are studied over and over? But we know we need more facts about more techniques!
Researcher Brene' Brown describes some of the quirks of research in her first TED talk.
My husband, Vic Froehlich, is a retired hardware engineer and software programmer for Super Computers. He said the reason he and the team he worked with for Control Data and then General Dynamic had to make "new stuff" is that what existed in computer engineering didn't work for their purposes. Acknowledging it was engineering, not science, he still made the valid point that, in an existing system, people know what they learned in school. In the existing system there often isn't motivation to learn something new, because they have a system and the system works (for them).They will research more about waht they already "know" and see what they can learn about what they are doing, but that's not exactly new. That's an expansion of what is conventional. It isn't even clear that the medical system is working, he notes, knowing that US maternal morbidity and mortality is rising with the rising cesarean rate.
His point is well taken. Since the medical system has a method of dealing with babies that "won't come out" there really isn't a lot of motivation to study new approaches. Their system of intervening on obstructed labor is economical for the hospitals and reduces the time staff spends with patients.
Control studies seek to compare a limited number of variables against a control group. That's why studying a living approach such as Spinning Babies will be a difficult endeavor in the typical university medical education setting. Let's change that.
Some of these techniques have been studied, but not in the manner in which I present them. That will make the study findings less than useful to our purposes. One example of that is the Karaminia's study on pelvic rocking in the hands and knees position, see article in this section.
If you are a medical researcher, doctor, student or midwife with an interest in doing research to advance Optimal Fetal Positioning, Maternal Positioning, and/or any of the Spinning Babies Principles or recommendations, please contact me. Let's discuss something that is doable within your study parameters.
These research topics show promise:
- The 30-second forward-leaning inversion
- Teaching Parents Belly Mapping 20-minutes before a late pregnancy ultrasound and comparing their "map" with the ultrasound image.
- Sidelying (pelvic floor) release and its effect on birth outcomes for asynclitic babies?
- The ROT baby and the route of rotation in comparison with the LOT baby.
- The frequency of ROT or OP fetal positions at the onset of labor compared to LOT or LOA/OA baby these days?
- How frequent is the ROA position at the start of labor among first time mothers?
These are answers I'd like to know! What do you want to study? Please message me on my Facebook or send me an email.
People are asking,
"What is the comparative accuracy rate between the kick, bulge, and movement techniques of [Belly Mapping], the palpations of a doc or midwife, and an ultrasound?"
My reply, sadly, is, no one has done a study on Belly Mapping's comparative accuracy to either palpation by an experienced provider or an ultrasound. This is something I've discussed briefly with a couple of medical students and nurses who have contacted me with an interest in Spinning Babies' potential research topics. However, until I can actually work with a group who are actually able to conduct the research we won't know.
Meanwhile, a provider's skill in palpation varies widely, as do womens' bodies (thickness, tension, amniotic fluid levels, placental location, etc.). These would be the variables effecting efficiency of palpation which would complicate such an analysis.
Several studies show that physician examination of fetal sutures is from 40-60% accurate when compared to ultrasound. We've also seen that ultrasound is not 100% either, due to images that are hard to interpret (as Lieberman discusses in her 2005 study) or due to inconsistency in human interpretation of an "underwater" ultrasound image (as I've noted through observation).
Come aboard. Plan a research study with me. I've been using some of these techniques for 20 years or so. We can find one that fits your study needs. And, they're fun!