- Category: Research and references Research and references
- Created on Tuesday, 18 November 2008 15:22 18 November 2008
Researcher Aaron Caughey finds giving more time will reduce 400,000 cesareans a year. See the Nov. 18, 2008 Orgyn.com article called Patience after stall in labor advised. Read the research itself. Obstetrics and Gynecology 2008; 112: 1109-15 Perinatal Outcomes in the setting of active phase arrest in labor.
From the abstract at PubMed:
We identified 1,014 women with active phase arrest: 33% (335) went on to deliver vaginally, and the rest had cesarean deliveries. Cesarean delivery was associated with an increased risk of chorioamnionitis (adjusted odds ratio [aOR] 3.37, 95% confidence interval [CI] 2.21-5.15), endomyometritis (aOR 48.41, 95% CI 6.61-354), postpartum hemorrhage (aOR 5.18, 95% CI 3.42-7.85), and severe postpartum hemorrhage (aOR 14.97, 95% CI 1.77-126). There were no differences in adverse neonatal outcomes. Among women who delivered vaginally, women with active phase arrest had significantly increased odds of chorioamnionitis (aOR 2.70, 95% CI 1.22-2.36) and shoulder dystocia (aOR 2.37, 95% CI 1.33-4.25). However, there were no differences in the serious sequelae associated with these outcomes, including neonatal sepsis or Erb's palsy. CONCLUSION: Efforts to achieve vaginal delivery in the setting of active phase arrest may reduce the maternal risks associated with cesarean delivery without additional risk to the neonate. LEVEL OF EVIDENCE: II.
Good midwifery care and attending to the 3-Principles can protect the mother during a long labor. Sometimes labor is long when baby is stuck. Use the techniques to balance the body, bring in a body worker who can do myofascial release, a Chiropractor who can do adjustments, and/or a Craniosacral therapist; all help resolve the imbalance.
Caughey found that 1/3 of mothers after an active phase arrest were able to continue to a vaginal birth. That's way too small a number! Active phase arrest means that the mother is 4 cm or more dilated when contractions are strong but no progress is being made.
The clock is ticking and the OR is just down the hall. The culture of institutionalized birth will use technology whereas the homebirth midwife uses more wit and wisdom. That's not to say that some of these cesareans aren't warranted. Some are.
Homebirth moms with posterior or asynclitic babies often have active phase arrests. It is quite unusual to go on to a cesarean. Going in to the hospital for more support (some cultural, in other words the mom or midwife feels the need for those nurturing arms of Labor and Delivery, and sometimes IV Pitocin) The CPM2000study of 1500 planned homebirths showed an overall transport rate of 13% so many long labors finished at home with out significant issues.
On long labors
Good hydration with electrolyte drinks is important, but not overdoing it. Let the mother eat throughout labor. Help her to rest when contractions stall, and I mean snore. But without drugs. You'll gain skills to help her get that relaxed even if her emotional state is keyed up, believe me.A midwife or nurse can see that the mother isn't clinically exhausted. Many women are strong enough, when well nourished and supported to go through a long labor.
But there is a time to call it quits. When baby is in a good position and labor is quite strong (advanced), we expect some descent within 4 hours of strong contractions. If baby has to rotate, or we have to get contractions in a regular pattern, then going 4 days is certainly an option. There are too many variables for you to think that you can get all you need for a safe birth from a web site, even mine! Please hire an experienced midwife or physician to help you assess labor to see if mother and baby are safe and fine to continue laboring.
A co-venture video experience with Spinning Babies and Blooma Yoga! Coming Soon!
Spinning Babies; Daily Essentials For Pregnancy Video.
Together Sarah Longacre, international prenatal yoga instructor and birth doula, and Gail Tully, yours truly, created a unique instructional video for flexibility and comfort in pregnancy and to support better fetal positioning in time for birth.
Here are daily activities for stretching and balancing a pregnant body. Start early in pregnancy to prepare to make the most space for baby's best birth position and the most ease for mother's opening during the birth process.
We begin the program for women of average flexibility (or just plain stiff to start with) and beginner tips. But soon, you'll be ready to move freely! That's when Sarah brings the stretches all together into her easy to follow, playful, sensual, and flowing "Blooma Style" daily routine.
Sarah's "dance of opening," moves joints and ligaments to come alive under the delightful melody and percussions of Carin Vagle. This isn't about core strength; its about freedom of movement and creating space in the body.
Sarah plays along with Gail's little game of "Flashlight" to show pregnant women how to evaluate their own posture and positions. Smart Maternal Positioning helps baby snuggle their backs into the front of the womb for Optimal Fetal Positioning.
The Daily Essentials For Pregnancy includes tips for using Maternal Positioning around the house. Actual scenes in the bedroom, living room -and even the bathroom- gives practical instruction like no other video. You will be sleeping more comfortably immediately when using these tips. Within a week or two many pregnancy discomforts of the pelvis and lower back may be reduced when all these nurturing techniques are integrated into your daily lifestyle. Spinning Babies and Blooma Yoga-- a natural collaborative!
Spinning Babies Childbirth Preparation Class.
Soon pregnant parents around the world can take a Spinning Babies class from their own monitor! Join six couples as they learn the reason why Spinning Babies works and how it can enhance your labor and birth.
See techniques to do daily or weekly. Actual, real consultations with two couples right at our class location, one with a breech baby (head up) and one with a baby in a transverse lie (lying sideways).
Couples do the techniques together and show you how to do these at home.
Used alone or with the Daily Essentials, Spinning Babies Childbirth Preparation Class goes beyond the basics. Simple props show complex concepts sweetly. Little-known anatomy is linked to childbirth and the role of fetal positioning.
The section on labor discusses two labor patterns- the one "promised" in other books and the unexpected one associated with the posterior labor. Learn the common causes of long labor and techniques to help baby through the pelvis.
Be empowered; be prepared. After using this video throughout your pregnancy, while we can't promise, of course, you may not need the tips for labor progress. You can use that knowledge to help your neighbor. This video is all Spinning Babies.
Blooma Yoga Prenatal Yoga for AM and PM.
Warm up in the morning and cool down in the evening in two 30-minute sequences. Sarah Longacre shares her own blossoming pregnancy, Blooma style, to the exquisite music of Carin Vagle. Sarah's affirmations will carry you through labor with emotional strength and encouragement. Play this video when the others become too basic and you just want to dance and have fun. Wait, dance? Isn't this yoga? With Blooma and Carin Vagle, your spirit won't know the difference. Soar to greater freedom of movement. Bring your hormones into harmony with the day. Begin your day with serious play. Cool down at night with a sleep enhancing stretch before bed. This video is all Blooma!
Sarah's video is ready for you now! Get Blooma's AM/PM Yoga here
All three videos are professionally produced by Melissa Koch of Grey Duck Productions, with stills by Tanya Villano Photography, each of these three videos are dynamic on their own. Together they will enhance your pregnancy and labor experience with fun and empowerment in the most practical manner. Feel hope for your birth abilities, this is support for your journey. Gain the confidence and flexibility to fully bloom. I believe these videos carry the potential to bring your best birth dreams into the gentle reality.
Compassionately priced. Estimated Due Date for Daily Essentials March 2014; for Spinning Babies Parent Class, Fall 2014.