HolisticWisdom.org web site
Linda Diane Feldt
NCTMB, Holistic Health Practitioner and Herbalist
The Ann Arbor Center for Holistic Health and Traditional Wisdom
J. was 27 and this was her first pregnancy. Labor began normally, with mild contractions. After approximately 45 hours of labor with no progress beyond 6 centimeters , an internal exam by the midwife revealed that the bag of waters was intact, with some forewaters, and the baby's head was tilted to one side and posterior (face towards the pubic bone). This position can be more difficult as the natural molding of the babies head and movement down the birth canal can be inhibited.
The option of manually breaking the waters was discussed and ruled out, as the baby's head would then stay in that difficult position. The mother was experiencing back labor, but had good energy and spirits.
It was decided to try cranial work with the unborn baby to help labor to proceed. The midwife, the mother and I were all aware of the need to be as unintrusive as possible, while still hoping that the baby's position could be improved to facilitate an easier delivery. While J. was doing well after nearly two full days in labor, we knew that at some point she would begin to tire and that further progress would be difficult. She had fantastic support from her husband, who was present, and her house mates who were providing support while not actually being present.
The therapy was given while the midwife monitored the baby's skull position by feeling the sutures with her fingers. I was able to feel the cranial sacral movement of the baby by contacting the baby externally, hand placed near the mother's pubic bone.
The first procedure was to encourage greater vitality of the CSF by ascertaining the CSF rhythm, and allowing it to be augmented gently. This was accomplished by "encouragement" and at no time was force or directed energy used. When greater fluid vitality was obtained, both the midwife and I again "encouraged" the straightening of the head, and the baby's head moved within a few minutes to a straight on position, which was maintained for the rest of the therapy. Both the midwife and I had the sensation that we were offering an option to the baby. There was no sense that the position she was in was bad or wrong, just that she could be made aware of other options that might be easier. At that time a "twisting" idea was introduced, by both the midwife and I to allow the baby to move into the easier face down delivery position. At no time was the baby manipulated, pushed, or manually encouraged to do so. If the baby was going to turn, we all felt it was vital for her to do it on her own, and by her desire.
We spent about 10 minutes working with the mother and baby. The mother got up, used the bathroom, walked around a few minutes, sat at the edge of the bed, and 20 minutes after the therapy had ended, her water broke. At that time, the baby's position was checked, and she had rotated the 180 degrees necessary to now present in a face down position. The mother was fully dilated, however a cervical lip caused us to delay pushing for just over an hour. Once the lip was resolved, the baby was born after approx. 20 minutes of pushing.
An interesting note is that this baby was able to turn over without assistance at 6 weeks of age.
The midwife also had an occasion to repeat this therapy a week later, on her own, and had similar results.
One of the most important features of this experience was that it was apparent that the baby turned herself. The intervention was supportive and suggested an easier possibility to her, but was not coercive.
Both the acynclitic and persistent posterior presentations often result in cesarean sections as it can be more difficult for the labor to progress, and the amount of pain experienced by the mother can be greater. Back labor is often associated with a posterior presentation, and is a leading cause for choosing epidurals.
There are two questions that need to be addressed by research. The first, does this therapy indeed contribute to more optimal positioning of the baby so that there is less likelihood of more intrusive and intervention (with additional risks and greater costs)? Second, is it a technique that can be taught to midwives, MDs, and nurses so that it can be readily available to mothers and their babies?
Linda Diane Feldt RPP,NCTMB,NC
Holistic Health Practitioner