I participated in a wonderful two-day Spinning Babies intensive workshop taught by Rachel Shapiro in Jerusalem beginning of November 2018. During the workshop my midwife brain was thinking yes, yes, this is wonderful, it makes so much sense! When I did my Bachelor of Health Science degree in Midwifery at Ryerson University Toronto Canada, we learned anatomy and physiology on many important levels, including the mechanisms of the birthing baby and pelvic floor anatomy. During my education as a midwife, we discussed ideal positions in labor and birth to open the pelvis bones making it easier for baby to come through, however there was little discussion on how to make more room by also releasing soft tissue, ligaments, tendons and fascia. Hearing this in the Spinning Babies’ workshop was like a light bulb turning on in my brain, I was very excited by its possibilities to solve my clients’ labour challenges. I thought of so many births I had witnessed in the past that ended up in cesarean that very well could have been prevented with the knowledge I have gained with Spinning Babies.
When you learn a new paradigm of viewing mechanisms of birth, the pelvis and soft tissue it does not become second nature overnight. Learning a new skill takes time to build confidence and courage to implement it. As if the universe was saying “Yes Terri you can do it, you are on the right path!” circumstances were placed in my lap that were ideal for Spinning Babies skills. Who knows maybe these issues were always there, maybe it was that I was looking at them with different eyes, a different perspective. Whatever it was, I decided to go with its forward momentum. I began with teaching my clients the ‘Three Sisters’. The ‘Three Sisters’ includes the Forward leaning inversion, the Side-lying leg release, and Rebozo sifting all of which if done regularly prenatally can release ligaments, tendons, pelvic floor muscles and fascia. The Three Sisters works by making more room for baby to enter the pelvis optimally. Then I got the opportunity to put my new found knowledge into action in labour. Toward the end of one of my Doula client’s pregnancy at 38+6 weeks gestation her waters broke with a very large gushes of water, without labour. She moved to the hospital, to be assessed for rupture of membranes which was confirmed. She had no signs of labor and babies head was high (-4 station). The stop watch was set by the hospital, for multiple reasons one: being her Group B Streptococcus (GBS) status was unknown (A type of bacteria that has the potential of infecting the fetus or newborn baby, about 30% of women carry GBS at the time of birth). Another reason for the time limit was due to the protective membranes no longer present thereby allowing GBS and other bacteria’s to travel to the fetus and mother potentially causing infection. Most women will go into labour within 24 hours of Spontaneous Rupture of Membranes (SROM) and the rest within 48 hours of SROM. I sprung into action the first morning they were at the hospital wanting to start the three sisters with her, to help encourage her baby to enter the pelvis and ideally start labor spontaneously. Entering her tiny hospital room shared with 3 other beds, I realized this was going to be easier said then done. One of the Three sister maneuvers I was able to do with a little creativity was the Rebozo Sifting. In order to do it for her I stood up on her hospital bed with the head of the bed for her to lean on and succeeded to do Rebozo Sifting without a staff member walking in to see me standing on the bed. This is what I meant about needing courage: implement a new and effective method in an institutional clinical environment is not always easy. Fast forward almost 2 days after pre-labour SROM where breast pump induction, homeopathic options and the Three sisters possible in such a small room were used , unfortunately without significant spontaneous contractions.
The decision was made between the hospital and my client to start Pitocin. At 15:00 Pitocin was started by IV and the babies head was still very high (-4 station in the pelvis) which means above the inlet of the pelvis. There is terminology called the 3 P’s that I was educated in my Midwifery degree. The three P’s are Passenger, Powers and Passageway. ‘Passenger’ being the baby, ‘Powers’ being the uterine contractions, ‘Passageway’ being the pelvis and soft tissue. In my client’s clinical situation, the ‘Powers’ were being addressed by adding Pitocin and creating contractions from the uterus. Her body responds quickly to the Pitocin and she developed very strong contractions. That being said the Passageway (pelvis) and Passenger (baby) were not being considered, the baby remained very high. To complicate things further she was asked to lie on her back in order for the monitor to read the contractions more easily. Lying on her back narrowed the passage way, not allowing baby to enter the pelvis, not to mention increasing her pain level. Spinning Babies philosophy strongly supports problem solving labor progress by looking at where the passenger is- where the baby is and how to optimize their position in the pelvis and descent through the pelvis hence the word ‘Spinning’. Spinning meaning the babies rotation and descent through the pelvis during the different stages of birth. Due to the fact that I had not yet been called to her labour for support and my client needed to lie on her back with strong contractions she requested an epidural for pain relief at 19:00. I arrived at 20:00, the babies head remained high and was noted to be asynclitic (tilted to the side). At 20:45 my client’s cervix was noted to be 9.5 cm dilated but the head was still high at -2 station and asynclitic. At this point Mom has developed a fever and babies heart rate has become tachycardic (a heart rate above 160 beats per minute), the medical team is starting to become worried about the mother and babies well-being. We requested to do Spinning babies to help the baby to descend in the pelvis, her midwife was luckily very open to the idea. We started side-lying leg release and within 5 minutes of doing it she begins to feel pressure. The midwife reassesses her and the babies head has descended significantly from -2 to +1 station ( moving from above the pelvis inlet into the mid-pelvis.) The baby did not stay descended in the pelvis (regressing to -2 to -1), we did the other side for side-lying leg release and the baby came down in the pelvis +1 and she becomes fully dilated the time was 21:30. 22:30 pushing began, doctors and midwives are in the room and still very concerned about the babies elevated heart rate and talking about cesarean if baby is not able to be brought down low enough to be assisted by vacuum. Pushing on her back does not descend the pelvis, as in this position the sacrum is being pushed in and thereby narrowing the outlet of the pelvis. I advocated for her to able to push on her side, side lying pushing successfully progresses the baby further down. Eventually her baby is low enough for the doctors to assist the mother with birthing her baby, baby is born at 23:40 healthy and put skin to skin with Mom. I truly believe after going through this experience that this labor would have ended in cesarean if it weren’t for the help of Spinning babies. I look forward to future opportunity to use my new found knowledge, its possibilities are endless.