Saturday, March 15, 2008
Learning about birth. Midwifery students at Otago Polytechnic
Image: Amy does her first catch supported by Renee.
First year midwifery practice
This week we have been learning about normal birth. We started with learning about the size and shape of the foetal head and then the size and shape of the female pelvis. We then moved on to how the baby's head and body move through the pelvis to allow the baby to be born. To remember the movements and manipulations that occur to allow this to happen we use the Acronym
Families In Childbirth Expect Really Impressive Excellent Love
F = Flexion (the force of contractions push the baby down, it meets resistance from the pelvic floor and flexion is increased causing the occiput to become the leading part).
I= internal roatation (the occiput moves towards the area of least resistance, the vaginal opening and this rotates it forwards on the pelvic floor)
C= Crowning (The largest part of the head, the biparietal diameter, passes the ischial spines, the narrowest part of the pelvis. The Occiput escapes under the pubic arch. The head can no longer slide back into the vagina. Point of no return.)
E= extension (the head extends, the face sweeps the perineum and the head is born)
R= restitution (the head undoes the small turn it made and aligns with the shoulders once again)
I= Internal rotation (the anterior shoulder reaches the pelvic floor and follows the line of least resitance and so rotates anteriorly
E= External rotation (As the shoulder rotates anteriorly the head also rotates along with it. The baby now looks towards the mothers thigh)
L= Lateral flexion (The anterior shoulder escapes under the pubic arch and the body is born following the natural curve of the birth canal, in an attitude of lateral flexion.
This is a very exciting time for the students. They really enjoy learning about this aspect of their future job and life as midwives.
Here is a really interesting article that questions some of the traditional teaching about the mechanism of birth, and poses some important questions for midwives on this topic.
It has been a very exciting and invigorating few weeks. Meeting and getting to know this new group of women who will be our future midwives.
In the previous clinical block we covered how to record vital signs, temperature, pulse, blood pressure. The have also considered documentation and collecting specimens for laboratory tests. We have also introduced them to to a program to learn about drug calculations. This is free open source software.
The journey has begun.