are putting a leg up on pool helping deliver the body- in some of the scenarios they probably aren’t a true shoulder dystocia but maybe a ‘tight fit’ where the shift in position helps deliver. Also, under the water we are hands off, and some babies need a little gentle traction to birth their bodies, which standing up out of the water makes possible. If a woman was on dry land and experienced a shoulder dystocia, the light traction would have already been tried, and the shifting a leg up position may not be so easily achieved by a mum who has already birthed their babies head, depending on their birth position.
Theatre staff- I really don’t know why we aren’t hotter on staff staying up the head end wherever possible. I’m thinking it’s a case of “what we do in theatre” for the staff there but definately worth challenging, particularly for things like putting the catheter in. I rarely venture into theatre but will definately look with fresh eyes next time.
Pemberley- sorry to hear this. I’m assuming maybe the extra people were part of the obstetric team, they often move in groups with a mix of senior to junior, learning from each other and providing care as a team. Everyone should be introducing themselves and their roles as much as possible though. I think some of these things may be related to hospital culture. Ours seems very hot on this.
I’m not sure about whether traumatic births are more frequent. We do see a broader range of complex health issues in our women these days so obesity/age/complex medical conditions likely play a part. We are also more litigation wary than ever before which probably leads to more intervention. I think historically women were more likely to accept awful ongoing implications of their births as part and parcel of childbearing, the number of women suffering ongoing urinary incontinance and not seeking help for years for example. Also women were less informed and less included in their care, seen as a patient who received care rather than an active participant in the process. Much like all aspects of healthcare I guess. We speak out more now, still not enough, but we are finding our voices as women and challenging the care we receive.
I’ve not attended any births where surrogacy featured but have cared for a surrogate mum in pregnancy. The arrangement seemed very positive for all concerned. It was challenging in a way as a midwife because I wanted to make sure that all parties were adequately supported and represented, but had very little access to the family who would be raising the child and felt they needed a more thorough care package really.
Cephalopelvic disproportion is a thing, but a rare thing. Years ago obstetricians thought it was much more common than it is, hence the attempts at measuring women’s pelvis’s and fretting over the size of their feet.
Ps you absolutely don’t have a rubbish pelvis. Maybe it’s not ideal for birth, but it’s doing an amazing job of keeping you upright.