Non-medical baby-moving techniques

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>With respect to your other methods, is there any good evidence to their
>effectiveness? There are no randomised controlled trials studying them
>on the Cochrane database. However, you talk about these methods as of
>proven rather than possible value.

I have no idea if any of them have been subjected to randomised controlled trials. I would guess probably not, but does that mean they are any less effective? No, it just means that we don't have scientific back-up. Every method I mentioned, however, came from experienced midwives who seem to believe the methods work. At the very least, they are not going to cause harm, so why not suggest them as something to try, with no guarantees.

We could get into a whole discussion about evidence-based-medicine, but I think it's been well covered on the professionals list :) Of course, I don't consider suggesting midwifery techniques to be practicing medicine, so maybe it's a moot point! :)

>Will you please excuse me a joke at your expense. It is not intended to
>offend. The phrase "old wives tale" originates from medaeval times and
>refers to midwives who were ridiculed for giving advice that didn't
>work. Of course later in history midwives became witches in the
>original doctor versus midwife battles. More widwives were burnt at the
>stake for being witches than any other group of women. The accusations
>were originally made by apothecries (physicians) and barbers (surgeons)
>who were trying to take over the practice. It always brings us down to
>reality to realise that our profession was started by hairdressers!

No joke... pretty good history lesson though! :) As evidenced by the literature of the times, there were good midwifery techniques being used in the 1st & 2nd centuries. In the 3rd century, these began to be lost with the decline of the Roman culture. During the Dark Ages, medical knowledge in general was virtually non-existent, & midwifery techniques were very rudimentary. Physicians weren't even allowed to attend births! During the Religious Reformation, the Scientific & Artistic Renaissance and following, both midwives and mothers were martyred for using herbs and medication for the pain of childbirth. Due to lack of knowledge of sanitation procedures, childbirth fever reached horribly epidemic proportions as birth moved into hospitals (though the rates were lower among midwifery patients). Nowadays, our medical knowledge is still rapidly expanding, but basic midwifery techniques are largely ignored, and rarely given enough credence to actually be subjected to clinical trials.

>On a more practical note, why haven't these methods been studied to
>modern day standards. Such studies would not be difficult to organise.

See above, but I'm all for the studies being done!

>The problem with the statistics you give is that 80% of breeches turn on
>their own. It is only after 37 weeks when a breech is less likely to
>turn that any method has been proven to be of statistical benefit. I
>would love to take part in such a study.

I would love for such a study to be done. Yes, I know 80% will turn on their own, but I see no harm in suggesting various techniques to encourage them to turn. Especially if the dr is talking ECV (which around here is often done as early as 36 weeks).

>Finally, I was once shown a slide by a colleague who disagreed with my
>view that a bicornuate uterus wasn't a contraindication for ECV. It was
>of a hysterectomised uterus which resulted from a completedly torted
>uterus after an attempted ECV in a uterine didelphys. Now this is
>anecdotal evidence but bearing that in mind, I'm not sure that I would
>be happy with a woman pushing her own baby round.

Nothing I suggested involved actually pushing the baby around :) I think it is good for mom's have a feel for how their baby is positioned (showing them what the knees feel like, what the head feels like, etc), but that doesn't involve pushing on the baby any more than pregnant moms already do (when trying to guess what they're feeling or trying to get the baby to get that foot out of mom's ribs!). I would tend to agree with you that mom's actively pushing the baby as docs do with ECV would be out of my comfort zone :)

>I loved reading your post. Have you any more for any other obstetric
>problems? Please post them.

I have info on various obstetrical problems, including a great article written by a midwife (who's name escapes me right now) about posterior presentation. I've been "Wooleyized" when talking about them, so tend not to, but will if you are seriously interested :)

I was going to answer your post about herbs here, too, but this has gotten long, so I'll make that another post.

**************************************************** Suzanne S. Powell, ICCE, CD Childbirth Educator & Doula; Student midwife

--
Women's Heatlh Forum advisor @ OBGYN.net

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http://www.mindspring.com/~suzannep/CBW.html

Partum Me! Educational & Support Services
Peachtree City, Ga.
Visit my WWW site at http://partumme.hypermart.net/partumme.htm
****************************************************

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