A. Is a good idea, and they like it.
B. Is not a good idea because it makes them dizzy.
C. Requires special equipment, like a merry-go-round.
D. Should be done by those with a strong grip.
Actually, the Spinning Babies I’m talking about is one of my favorite websites/training courses/things every pregnant woman and birthing professional should know. In a nutshell, SpinningBabies.com is a place to learn more about fetal positioning, the effects of fetal positioning on birthing outcome (the truths and the myths), and what a pregnant woman can do to optimize fetal position without unnecessary intervention.
Because hardly any babies read my blog, I choose to educate moms and professionals on maternal as opposed to infant-alignment. But in case you missed reading and memorizing everything I've ever written, a mother’s movement and alignment habits change the shape of the baby space (inter-utero), which, in turn, affects what a baby can do in terms of positioning themselves optimally. Tight pelvic floors, psoai that don’t yield (lengthen or shorten readily), habitual pelvic tilt, and rib thrusting all change fetal environment, which can change fetal behavior, which can then affect birthing outcome.
When you have some extra time, you can read through a ton of info at SpinningBabies.com. To give you an overview of the nuts and bolts, I thought I’d interview the Spinning Babies guru, Gail Tully and she’s thrown some questions back at me.
Read. Learn. Enjoy. Spin.
So, Gail. How'd you get started spinning babies?
My journey began in the mid 1980s as a doula, back before I was a midwife. I was helping a woman who wanted a natural birth for her second child after having had a cesarean for her first. She envisioned she’d start labor at night and give birth as the sun came up. And while her labor did start at night, it didn't finish with the sunrise she had expected! It was her labor that alerted me to the needs of women birthing sunny-side-up babies. And I wanted as many tips as I could find to help mothers and babies both before and smack in the middle of this situation. Our website, DVDs, and courses share the tips that are most likely to help, ones I get a lot of positive feedback from and have tried myself with moms I've helped.
Can you explain what a sunny-side up baby is to those who don’t know?
Sure. A fetus fits the pelvis more readily when facing the mother's right hip or back at the start of labor. But some babies seem to fit the lower uterus easier while facing their mother's pubic bone, meaning the back of baby's head (the occiput) is at the mother's posterior. In this posterior presentation, the angle of the baby's head doesn't mold as small. Baby may have a hard time curling close in a tube-shape to fit the pelvis. Labor can be longer and sometimes (but not always) harder on mom and baby. A portion of posterior labors need interventions, like labor strengthening drugs, or a cesarean surgery to finish the birth.
I really like this approach. If I had a dollar for every mother I knew personally who wanted a vaginal birth but opted for a scheduled cesarean because of a breech position before they actually went into labor, I’d have about... $13.00. Which seems like hardly any money at all, now that I type it. But 13 women out of about 40 women that you know well is actually a very high number when it comes to birthing outcomes!
And the there' what I could do with 13 bucks...
Anyhow, do you teach others to spin, or is Spinning Babies more about teaching the mother what to do to allow a baby to spin?
Spinning Babies is about what parents and providers can do that is not invasive. There are valid, invasive methods that doctors can do, if they know how, but Spinning Babies is all about the "Balance, Gravity and Movement" techniques to be done in pregnancy or even during labor to either help baby turn or, if not, then have more room to come through the pelvis. I've collected these techniques and seek to teach the why, when, and how to use them. I began presenting this to midwives, nurses, and doulas 12 years ago and this year have or will be teaching in 3 other countries, England, Mexico and Germany.
Do you ever teach in Australia? Because it would seem that when they come out, they would spin in reverse right? (Just kidding, you Australians. I know how things work. Most of the time.) All over the world, what point in the pregnancy do we start spinning?
Before pregnancy, Katy! As you know, its never too soon for "balancing" our bodies. We want to make room for baby, sure, but also improve hormonal circulation and so, function, by addressing muscle and fascia, joint alignment and flexibility.
Amen. In fact, let’s all start right now, shall we, and make sure you’re not reading this “how can I better align my body and fetus” article sitting down with your pelvis tucked under and your ribs thrusting.
I would imagine that the centrifugal force of being on one of those playground Merry-go-rounds would not be helpful to a baby trying to turn. Do you have any evidence that supports my hypothesis?
I have plenty of evidence, Katy - I have an older brother! I remember being the subject in this study. He also thought going down the stairs in a box was like sledding, and that if we flapped our arms fast enough while jumping off the roof we really would fly. But now we have Ethical Guidelines Governing Human Subject Research.
I've noticed that there aren't any fun, launch-a-kid off onto the asphalt toys anymore. Have you noticed that too? I guess Spinning Babies is cool, but spinning kids until they throw up is passe.
See my answer above.
Gail, let's say I'm 30 weeks along in my pregnancy. Let's say this because I am. What can I be doing now or what should I be doing (or not doing) to provide adequate turn space?
I hope you are doing an inversion a day, Katy.
Wait, ME? The name implies that the babies have to do the work, man. You want me to get up and move around? Can’t I just eat a ton of sugar to get the baby to perk up and stop being so lazy? And can you specify what you mean by inversion? I’m not stoked on headstands at this point.
This inversion (click here for all the info) gives the utero-sacral ligament behind the uterus a little stretch and then, when you swing up again, the release of that ligament helps resolve any possible torsion (causing back pain, a breech or posterior presentation, or a tipped uterus before pregnancy). Gentle stretches, certain "restorative rest" positions (but NO pressure/deep massage on the psoas!) and long walks all help the psoas to lengthen. Gravity works 24/7, so good posture in the mama promotes good posture in le bebe. But for many women, maternal positioning isn't enough to promote optimal fetal positioning. Many of us need to do more to overcome weak muscles which make the pelvis unstable or imbalances that create twists in the musculature that can make one leg shorter or the cervix tipped, or the round ligaments tight causing premature contractions or breech presentation. I have a list of daily activities to increase pelvic alignment and balance and flexibility in the muscle and fascia. In other words, we can't slouch or sit pinned to a chair or car for 30 years and expect our pelvis to be happy to suddenly open up. We gotta move!
(Um, are you still sitting down and reading this or have you gotten up yet??)
And, while resting, rest smart! Let your belly be a hammock. Don't worry about sleeping only on your left side unless your provider tells you to specifically stay on your left side for your blood pressure (an unlikely extreme). You'll have to let circulation back into your left shoulder occasionally!
I like that piece of advice. I think there are a lot of pregnancy websites that are putting out a list of “what pregnant women should be doing” (i.e. sleeping on their left side) without understanding that this is a prescription for one very small group of pregos. I’ve worked with many women who thought they had to sleep on their left side their entire pregnancy and now have a jacked up shoulder. Thanks for clarifying that one!
And while pelvic tilts are still good to do, there is also a mistaken idea that doing them on your hands and knees is the major activity for turning the posterior baby in pregnancy. That may work with 20 minutes of regular 3-min apart contractions, but in pregnancy, a forward-leaning inversion is much more effective.
Are there contraindications for inversions that you list?
Yes: Don't invert if you are at risk for a stroke, have so much amniotic fluid that your doctor sees you weekly, or you don't want to. A few women find that their head may pound for the first few times. Only go upside down for 30 seconds! Yes, that's 30-Seconds. This is not down-dog which you can do for longer, unless you have the same contraindications.
Here’s a question from a fan: “How do you advise to women with big babies? I had a 10.5 pounder and they would NOT let me deliver and told me his shoulder or my pelvis would break. Now, knowing what I know, I really wonder--would that have happened? How do you feel about the "your baby is too big to deliver" sentence?
Institutionally-trained and corporately-employed providers are losing basic birth skills because the threat of litigation and the ease of major surgery means that hospital administrators no longer find it cost effective to allow doctors and midwives, even nurses, to sit with a woman in labor. When hospital budgeting depends on 50% cesarean rates, administrators demand fewer natural labors. Doctors have to pick who gets chopped from the birthing suites. Eventually, quite quickly, they begin to believe avoiding childbirth is safer. But for most, its not. Major surgery has its consequences. Meanwhile, the skills for breech (bottom first) birth, long labors, and shoulder dystocia are disappearing fast. I created a 2-hour DVD with clear instructions on how to rotate the shoulder off the pelvis without breaking mom or baby. Its very popular and I hear regularly from relieved midwives who use the memory FlipFLOP to ease the large, stuck baby out in those occasional situations. I'm sorry your providers were limited in skill, or possibly in permission by employers or policies, to help you naturally. They put you at greater risk by insisting on major surgery. For non-diabetic women, for each permanent brachial plexus injury prevented by the policy of elective cesarean section for babies estimated to weigh over 4,000g (8lb 13 oz), 3695 cesarean deliveries were performed at an additional cost of $8.7 million...For the policy of elective c/s for babies estimated at over 4500g (9lbs 15 oz), it takes 2345 cesarean deliveries and $4.9 million to prevent one permanent brachial plexus injury.
To read more, check out: The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound. Rouse DJ; Owen J; Goldenberg RL; Cliver. JAMA 1996 Nov 13;276(18):1480-6)
http://www.homebirth.org.uk/shoulders.htm Dr Henry Lerner has an excellent website called ShoulderDystocia.com with an article citing many studies to dissuade this trend to section women with suspected large babies.
Here we see 54 cesareans have to be done to prevent one non-permanent injury from shoulder dystocia. Cesareans are associated with higher infection rates, blood loss, breastfeeding issues, long term adverse reactions and a rising maternal death rates in our nation. So avoiding labor is not an easy answer and has not been shown to be the correct answer for non-diabetic women with large babies.
Here's a question from a Canadian fan: "I like how spinning babies is all aboot putting your hands on ladies. My doctors don't seem to do that anymore, and I find that being touched makes me feel so calm and comfortable, eh. I've actually almost fallen asleep at the dentist during cavity filling because my dentist used to put his hand on my cheek while he worked, eh. Do you have anything to say aboot using a hands-on technique?"
The hands-on she may be talking about is simply my preparing to paint the baby's portrait on the mother's belly after a Belly Mapping presentation. Belly Mapping isn't about hands-on palpation (feeling through the abdomen), actually, its about the mother learning the clues to the sensations she feels herself inside and by touching her own belly. But since the photographs of the belly painting process are much more interesting, there are a lot of pictures of this, giving the impression that the provider is "doing" something. Its really mother-led. That being said, many women love having the attention of the painters and helpers who touch their bellies. It can be very healing and bonding. There are some hands on techniques to "make room for the baby" through simple myofascial release techniques and comfort measures. Others are hands-off, so women can choose which ones they prefer according to their needs. We need touch. Kind, trustable touch raises our oxytocin, bonds us together, and reduces stress. Babies love to be touched for this reason. All adults are still those same babies, but now with responsibilities. How can we be a midwife without touch? How can we really be a healer of any kind without touch? Prayer, yes, ok. But then the touch is from above.
Will you ever write a "Spinning Babies" book? Because you should. It's super easy and you make a lot of money. Hahahahahahahhahahhahahahahahhahahhahahahah (deep breath) HAHAHAHAHAHAHAHAHAHAHAHAHAHAHA.
Hahaha. I'm laughing with you, Katy.
If there was one thing you would want to tell every mom-to-be out there, what would it be?
Whatever you choose, whether you choose to do things for easier childbirth, whether they work or they don't, whether you have a spontaneous birth, use interventions, even surgery to finish your birth, the most important thing is love.
Word. And, because this post is already so long, how about I post my answers later this week?