Birthowl’s natural childbirth

Traditional midwifery and Breech
Diagnostic touch also plays an important part in traditional childbirth. Starting as soon as a woman has missed her first period, the Indian dai palpates the abdomen to feel the live energy (jeevan) in her body, and continues to do this regularly through her postpartum.
The Colombian comadro visits the expectant mother every month to massage her, using oil for lubrication, both to treat backache and in the last six weeks or so to check the baby’s position. She uses external version to reposition the baby if necessary. After doing this she wraps the mother tightly in a binder to maintain an anterior vertex presentation.
…Touch may be both diagnostic and manipulative, and these two functions often overlap. A midwife’s hands are her most important tool for turning the baby into the correct position for birth. Among the Zapotec of Oaxaca in south-west Mexico, midwives use abdominal massageda, soba and pelvic rocking, manteada, to ensure that the baby is in the right position. These skills date back to preColombian times and are effective in turning a baby from posterior to anterior.
A Zapotec partera will massage the woman’s legs to diagnose tension. By becoming aware of tension in her legs she discovers where the baby is pressing against the woman’s spine and causing backache, and this shows how the baby should be repositioned. She starts doing this at thirty-two weeks and massage sessions are arranged every fifteen days. As well as massage of the legs, she palpates the abdomen, kneads it, lightly massages it with the sides of her hands, and ‘lifts’ the baby if the mother has uncomfortable pressure against her bladder and pelvic floor…If the baby does need repositioning she asks the woman to lie on her back on the ground, with her knees drawn up and heels flat. Then she places a long shawl, the rebozo, under her back and pulls it up at either side so that it cradles her hips. She pulls alternately with her hands to rock the woman’s pelvis from side to side in the sling formed by the rebozo. She may also do this in the second stage of labour with the woman in a standing position, leaning back against her, to help her to push the baby out. These complex techniques of massage and rocking are now being reassessed and incorporated into modern midwifery skills in Mexico.

An aboriginal tribe in Japan, the Ainu, also used massage to turn the baby from posterior to anterior. Indeed, evidence from many cultures suggest that this is a midwifery practice that has been largely forgotten today.

In the past in Europe and North America, obstetricians often used to turn a baby from breech to vertex in order to avoid Caesarean sections and difficult vaginal deliveries. But over the last twenty years or so, few have learned how to do it and many now consider it not worth the bother. Yet randomized controlled trials have revealed that two out of three birth can be turned, and will stay head down for birth, if rotation is performed after thirty-seven weeks or early in labour. This halves the Caesarean rate for breech births.

Modern midwives are not taught how to do this. Nor do they know how to rock and massage babies from posterior to anterior so that the head is in a more favorable position to pass through the cervix and birth canal. Only in countries where professional and traditional midwives have an opportunity to share their skills is this still possible.

Sheila Kitzinger “Rediscovering birth”


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