I wish I could give you a detailed rundown on the sessions at the 2nd International Breech Birth Conference as Rixa did on her blog. Unfortunately, I wasn't able to attend any of the daytime sessions (one of the drawbacks to a toddler who exclusively breastfeeds is that leaving her for more than a couple of hours ata a time is pretty impossible) so I'll instead direct you here and here to read about the events at the conference. From what I've read and in speaking to those who attended, it was just awesome and the arguments and evidence in favour of vaginal breech really gave the obstetricians and care providers pause. One obstetrician, quoted by Rixa, expressed delight and excitement to begin attending hands-and-knees breech births.
While I didn't attend the conference itself, I did have the opportunity to attend the two evening events: Birth, Karen Brody's play, on Thursday evening, and a storytelling session with Ina May Gaskin on Friday evening. I enjoyed the play, though I think the cast was tighter and more polished when I saw the play at its debut performance back during the original run in August. It was particularly encouraging to see a greater male presence in the audience. In August, there had been only a very few men present, whereas the audience at the remount in October was at least a quarter to a third men.
On Friday evening, Ina May spent the majority of her time somewhat focused on breastfeeding as her latest book, Ina May's Guide to Breastfeeding has just been released. Her thoughts on breastfeeding and breastfeeding culture were very interesting. There was a lot of laughter, particularly as she related the story of an Amish woman with extremely inverted nipples, and some of the suggestions Ina May made to her for dealing with the issue. She related that she wasn't sure what limitations Amish principles had on the practices of the bedroom, so she wasn't sure how her suggestion that the expectant mother's husband suck on her nipples would be received. She mentioned two ideas suggested in an old French textbook on breastfeeding: that an "intelligent" maid be found to suck on the woman's nipples to draw them out, or to find a large puppy (I kid you not) and put the puppy to the breast. Ina May supposed that, by comparison, having one's husband suck on one's nipples would likely seem pretty tame and acceptable. She noted in her talk about breastfeeding that four-legged mammals very rarely have difficulty nursing. Baby creatures, more often than not, are able to nurse immediately after birth and without trouble, and mothers generally fare best when allowed to follow their natural inclinations to nurse.
During the second half of the storytelling session, questions were submitted by the audience. Some were very specific and related to particular issues in birth, such as CPD and VBAC. One though, was quite thought-provoking. Ina May was asked, "Of all your accomplishments, which one makes you most proud?" She considered for a moment, then responded that learning from Guatemalan midwives the practice of rolling a mother onto hands-and-knees to resolve a shoulder dystocia and publicizing this maneuver (it's refered to, officially, as the Gaskin maneuver) makes her extremely proud. I can only wonder how many infants have been safely birthed because of the judicious use of this maneuver, how many lives saved and how many mothers saved from unnecessary and risky surgery.
In talking about the Gaskin maneuver, Ina May said something which really struck me. She paused for a moment, looked a little wistful, and said "we just need to make the mother a four-legged creature." She had mentioned earlier that it took decades of working with mothers and infants before she noticed that newborns can crawl. They can - even at only 5.5lb, Glynis was able to crawl up my chest for weeks after her birth - but, Ina May noted, only when they are placed face-down. When we lay a newborn on her back, as is so commonly done immediately after birth, the infant is incapable of crawling or moving. In laying the baby on her back, we steal her power and her autonomy, however limited it may be in the first moments out of the womb.
It is the same with birthing mothers. When we lay a mother on her back, we take away her power, her means of autonomy, her control. The Gaskin maneuver has been studied and found to be extremely effective in relieving shoulder dystocia and allowing the birth to proceed normally. I read recently a supposition that it may be the act of rolling the mother over her side which helps dislodge the infant's shoulder, and that the final birthing position on hands-and-knees may be immaterial to the ultimate success in the birth. If there is one thing that birth practitioners simply must appreciate, though, it is that we cannot separate the physiological events in a birth from the psychological ones.
A successful birth requires not only adequate positioning of the infant in utero (adequate, rather than ideal, because babies can and frequently are born in a posterior presentation, though it is far from ideal, just as babies can and are also born breech) but also the confidence and courage of the mother to effect the birth. We cannot expect women to birth if we tell them they are incapable of doing so. When we lay a mother on her back and immobilise her legs, even as we tell her "this is the way to birth" we are telling her body and her mind that she is powerless, she is impotent. But roll her on her hands and knees so that she can sway, she can tilt, she can move, even if only a little, and we give her back her power, her autonomy, her self. We put HER back in control of her birth. We allow her the same dignity afforded an elephant, a dog, a horse, a gorilla, and the opportunity for her to find within herself the same strength, the same wisdom each animal mothers possesses. How, then, can it be any wonder that such a maneuver is so frequently successful?
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