Safer Child Birth - Prevent Shoulder Dystocia - LMS Medical

[josigrosie]

Are you an expert "incooper"?!?!?!?

[lncooper]

Do they take into consideration that what they do to moms in the hospital is usually what causes SD? Being stuck in bed, augmentation, induction, & instrumental deliveries majorly increase the risks of SD.

Having a c-section will take away some of the worries about risks when having a baby? Really? Cesareans are far riskier for baby, mom, & any of mom's future babies. Instead, they should focus on good nutrition & maintaining mobility during birth.

[dylenger]

Delivering the baby by midwife at home is no better. At least with technological advances we have now we can anaticipate and reduce the ill effects a vaginal delivery can cause. 120 years ago when all babies were born at home there was a smaller chance of life success rate then there is now, because of all the things hospitals do with their fancy instruments.

[lncooper]

Around 120 years ago, there was poorer living conditions, sanitation, & overall quality of life. Yes, an OB & hospital can be beneficial for the ~5% of end up needing them, but for the rest of us & our babies, they cause more harm than good. When birth first moved to the hospital, MORE moms & babies were dying because of infection. The movement to the hospital was a social status one & driven by access to pain medications, not one based on evidence or safety.

[lncooper]

We need to compare birth settings, interventions, & outcomes to those of other places NOW, not in the past. Countries with better outcomes for moms & babies have the midwifery model of care as the standard of care & access to homebirth. Overall outcomes for babies are the same whether at home or hospital, & outcomes for moms are better at home- less intervention, better breastfeeding support, less infection, less wounds from birth, less instrumental extractions, less breathing difficulties,etc

[lncooper]

Their fancy instruments are beneficial when applied appropriately, but cause more harm than good when used too often or routinely. WHO says c/sec rate no higher than 10-15%, induction no higher than 10%, & episiotomy rate no higher than 20% with a goal of 5%. I don't know of a single hospital that has intervention stats within those evidence-based standards, but I know countless homebirth midwives who do. Exceeding these rates places moms, babies, & mom's future babies at avoidable risk.

[Carabin33fr]

@lncooper Shoulder dystocia is completely unpredictable. There are certain risk factors like macrosomia and pelvic anomalies but it is definitely not favorised by hospital care. Hospital care, on the contrary, is necessary, among many other things, when dystocia actually occurs to save the baby. Please don't try to inform others when you're completly ignorant yourself.

[lncooper]

@Carabin33fr What makes you think I'm "completely ignorant"? (Note: corrected spelling of completely) You note that macrosomia & pelvic anomalies may be risk factors, but forget to note that inability to move while pushing is a risk factor too. Birthing in a position that closes up the pelvic outlet is a risk factor often imposed by the obstetrical model of care.

[lncooper]

When mom is not able to move around while pushing, not only does this make shoulder dystocia more likely to occur, but it can also lead a case of sticky shoulders to become something much more serious (like full blown shoulder dystocia). The ability to move is crucial should sticky shoulders or shoulder dystocia occur. The vast majority of women birthing in hospitals are tethered to bed by monitors, impeded by medication, &/or made to birth on their backs.

[Carabin33fr]

@lncooper I didnt forget to mention anything..I did not want to enumerate them all but i have to say.. I have simply never heard, learnt or read anything concerning the inability to move as a risk factor. Do you have any valid source you could share? I'm sorry for calling you an ignorant but your criticism against hospital care doesnt seem founded. It isn't perfect but it enables fast intervention when necessary. Which would not be possible at home. Precisely in the case of SD.

[Carabin33fr]

@lncooper I didnt forget to mention anything..I did not want to enumerate them all but i have to say.. I have simply never heard, learnt or read anything concerning the inability to move as a risk factor. Do you have any valid source you could share? I'm sorry for calling you an ignorant but your criticism against hospital care doesnt seem founded. It isn't perfect but it enables fast intervention when necessary. Which would not be possible at home. Precisely in the case of SD.

[lncooper]

@Carabin33fr Look up lithotomy position and shoulder dystocia on any search engine. The lithotomy position decreases the pelvic outlet. It isn't rocket science to figure out that the smaller the opening of the pelvis, the more likely for a baby's shoulders to get stuck. This isn't the same as saying having a small pelvis equates being at high risk for SD, but it does mean that being immobilized in the lithotomy position increases SD for a mom/baby vs. mom being able to move.

[lncooper]

@Carabin33fr Aside from symphysiotomy & the zavanelli maneuver, the "tricks" (position changes) to free up SD are available at home with a trained midwife. Trained midwives have emergency training and all of the first line of medications & assistance necessary for a mom/baby that may be in trouble that you'd find in the hospital. They are trained to know when transport is necessary or when something is out of their ability to handle.

[lncooper]

@Carabin33fr SDs are generally handled better at home than in hospital- less perineal trauma, less chance of the baby's clavical being broken, the lack of immobilizing medications makes mom able to be more of an active participant in freeing a stuck baby more quickly whereas at the hospital other attendants flip mom around or default to breaking baby's clavical because other positions can't be tried with an immobilized mom if the McRobert's maneuver doesn't work.

[lncooper]

@Carabin33fr I'm done debating with someone who uses incomplete sentences and words like "learnt." It's simple to use Google or talk with a care provider who practices the midwifery model of care (not necessarily all midwives; some rare gem OBs practice this model of care as well) to learn more about how immobility impedes birth progress & can lead to complications, SD just being one of them.