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A General Look at the Normal Birth Process
Until he is completely born, the baby is usually known as the foetus. However in this book he will be called baby—a boy, because there are often two females in the picture already—Mother and midwife.
To make the journey easily the baby must;
Be head down.
Have his back to his mother’s front between her left hip and umbilicus.
Be able to move his head and tuck it in as he descends.
Have his bottom pushing forward.
The books call this Vertex LOA or “the first vertex.”
A Good Posture To Encourage Baby Into L.O.A Position
The mother must during the last few weeks of pregnancy (from 36 weeks for first babies, and 38 weeks for any more) –
Do everything she can to encourage her baby to settle in this position, sometimes known as “The Optimal Foetal Position”.
Keep her knees as far away from her spine as possible—the way they are when walking. This leaves plenty of moving room for the baby.
Rest and sleep on her side, preferably the left.
When sitting, place a cushion under her bottom, to tilt herself forward.
Watch TV while sitting backwards on a dining chair, or lie over a beanbag.
Walk to the shops when possible—borrow a friend’s baby and pushchair.
When driving, put a firm, preferably wedge-shaped cushion on the seat.
Now the process –
As birthday approaches, the baby in the right position gives his mother’s body very clear signals to start getting ready.
Her pelvic joints start to soften, and her back begins to sag. This gives a swayback, or lordosis. If backache is a problem, then a girdle or support should be worn.
The tissues of the birth canal soften and become quite swollen.
The cervix, or neck of the uterus also softens and starts to shorten.
The uterus has sessions of “practice” contractions, as the baby moves about trying to get his head into the pelvis. These can be very tiresome, but mean that the baby is doing his best to get ready. These are not labour contractions, no matter how regular or painful they may be.( the tummy stays the same rounded shape, and the contraction is felt towards its top.)
At some time during the day or night, the mother will feel the tightening of her uterus has changed. The discomfort is now at the bottom. It feels different from the way the baby’s head felt. A short tight cramp, and it’s gone.
To begin with, these cramps may come at quite long intervals, but they get closer, and last longer. When the mother notices that with each one, the shape of her abdomen (tummy) changes, from a round to a shoe box she knows that this is the “real thing”. These contractions are proper labour ones, and will open her cervix, and then push her baby out.
Initially, the mother will have feelings of excitement and anticipation—just as when any new event is starting. As the contractions get stronger, and the cervix opening can be felt, most mothers drift into a detached inward focusing state. They need to know that they are safe, and supported, but should be left to sink into themselves. Too much fussing and hands on care brings them to the surface, and slows down progress.
As the first stage nears its end, the contractions are much longer and closer together, and most mothers feel the need for someone special to hold them. Again, the need to feel safe and protected.
The last few contractions, as the cervix comes over the widest part of the baby’s head, will really take the mother’s breath away. Still, she knows that if she stays upright it doesn’t take long.
Usually, at this point, the membranes holding the liquor rupture – the “Waters Break”.
Suddenly, everything stops. The cervix is wide open, and the baby’s head is in the birth canal. The mother relaxes, and finds somewhere to lie down. Some mothers have a short nap now. This stage is sometimes called “The Rest and Be Thankful” stage. During this pause, which is very important, the uterus recovers from the loss of much of its contents, as its muscles regain their tone.
The baby finishes turning his head, to be facing his mother’s spine, with his nose up against the inside top of her sacrum. His shoulders should follow, and be straight across the inside of her pelvis at the top.
Second stage labour begins once the uterus has recovered from its efforts in first stage, and some interesting things happen.
The mother, whether lying on her side, standing or kneeling will raise her hands, and throw her head back. She will arch her back, and begin to move her pelvis as her knees bend down and open.
The back of her pelvis (the rhombus of Michaelis) will move outwards and the coccyx will straighten. This means much more space at the outlet for the baby to pass through.
The uterus begins to contract again, but this time it is pushing the baby down and out. The mother has no need to push if the baby is lined up properly, and she keeps her knees well away from her body.
The baby begins to emerge, facing mother’s back. Once his head is out, he makes a 90 degree anti – clockwise turn to face mother’s right leg. Now his shoulders will fit easily. The back (left) one comes first, and he lies peacefully on his stomach. If his front shoulder comes first, he lies on his back, which is not as good for fluids to drain from his nose.
Second stage labour will have been short and there should be no need for anyone to help the baby out. Touching his head confuses him and stops the automatic process of descent and birth so it is best not to do this.
Tears or episiotomies don’t happen when the tissues are soft and pliable, and the mother always keeps her weight forward. Leaning backwards tightens the pelvic floor, creates a need to push and hinders the baby’s progress.
This mother and baby can feel satisfied that they did it themselves. They will both be ready to move on to the next stage of life, – getting to know one another.
Now it is time to look at the individual parts involved in the process, and how they work together.
© Copyright Jean Sutton