Podcast: Your Baby, Your Pelvis and Labour Dystocia with Midwife, Molly O'Brien

Your Baby, Your Pelvis and Labour Dystocia with Midwife, Molly O'Brien

Season 2, Episode 3

Ever heard of a back to back baby, but not sure what it means?

When is a long labour TOO long and what might be causing it?

Do we have influence over the unfolding of our births, even in pregnancy?

The answers to these questions and more as I'm joined by the wonderful Molly O'Brien to discuss all things 'Biomechanics for Birth'. Put simply, it's the process of your baby fitting through the bones of your pelvis. How do they do that? And how can you help them?

A MUST listen for anyone who is currently pregnant, there are some game changing takeaway tools which might just tip the balance from complicated to straightforward birth.

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TRANSCRIPT

AI GENERATED

I wanted to take the opportunity, before this episode kicks off, to tell you a little bit more about Birth-Ed.

At Birth-Ed, we have supported thousands of parents to be in over a hundred countries around the world in their preparation for birth through our antenatal and hypnobirthing courses in person and online.

As you will hopefully be starting to gather from these podcast episodes, our aim at Birth-Ed is to provide you with evidence-based information about your birth, your body, your baby, and your choices so that you can move forwards feeling like, yeah, do you know what?

I do trust myself now.

My eyes have been opened.

I trust myself to make decisions.

I trust my body to tell me what's going on.

We can do this.

Our online course is just £40 or $49.

And if you happen to be listening to this before 7.30pm on Thursday, the 26th of May, 2022, this is your official invite to join me for our live introduction to HypnoBirthing Session.

It's totally free.

It's all online.

And I'll pop a sign up link in the show notes.

And hopefully we can meet in real life, which I would love.

Anyway, ready for today's episode?

I'm Megan Rossiter from Birth-Ed and you are listening to the Birth-Ed podcast.

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Ready to meet today's guest?

Hi everybody, welcome back to the birth-ed podcast.

Today we are focusing on something called Biomechanics for Birth, and we are very lucky to be joined by the wonderful Molly O'Brien.

Molly has been a midwife for over 20 years.

She has a wealth of experience supporting undisturbed physiological birth in the home and birth centre environments.

She is an associate lecturer and teaches biomechanics for birth in master's degree normal birth modules at universities across the UK.

And through the years, she has worked as an antenatal and hypnobirthing teacher and now runs the organisation Optimal Birth, which provides something called biomechanics for birth training for care providers and parents alike.

Molly is going to talk us through what on earth biomechanics for birth actually is.

But to preempt any questions that may arise following the episode, I wanted to share right at the start of this podcast, just the philosophy underpinning optimal birth and the concept or practice of biomechanics for birth.

So the organisation Optimal Birth assumes the benefits of undisturbed physiological birth as optimal for health and well-being for the majority of women and their babies.

Interventions are welcomed and accepted as life-saving for those that require them.

And the right of each woman to have freedom to choose the type of birth that fits best for their individual needs and wants is not in question.

So Molly, welcome.

Thank you so much for joining me today.

Oh, thank you for inviting me, Megan.

It's a delight to be here.

So I suppose a really helpful place to kick us off.

Some people might have kind of seen the title of this episode and been like, what on earth are you talking about?

What do you mean when you say biomechanics for birth?

Well, biomechanics is the study of human movement.

It studies the structure, the function, and the motion of the mechanical aspect of a biological system.

So the physiological process of birth is complex.

It's absolutely incredible.

And we know we have hormones and we have a pelvis that a baby passes through.

And that's the part that I think we need to know more of because we've ignored it for a long, long time.

And it's time to look at it because it actually matters how the baby physically passes through that pelvis.

It's going to, in a sense, dictate the kind of experience you're going to have, the kind of birth experience you will have.

So it's an understanding of what motions a baby goes through to pass through the pelvis.

And what are the kind of things that you are teaching parents and care providers?

What is it?

It's not exactly that.

There's the difference.

It's not about the baby's position necessarily.

It's the mother and the baby are working together.

We have to always remember that the baby responds to the mother's movements, to the space that's available in the pelvis.

And then the mother needs to move as well, preferably instinctively.

I mean, that's what we're hoping, but there's lots of reasons why that doesn't happen very often.

So they work as a duo, a dynamic duo, the mother and baby.

And the mechanics of that is, it's very important that they work together to ease that journey.

Now, the reason why people get stuck and get into trouble in their birth, is that the pelvis, this is the root cause, is the pelvis is imbalanced.

So it's a really helpful thing to point out at this point, if people are listening, and this is kind of the first introduction they've ever had to it, is we sometimes think of the pelvis as one bone.

But do you want to just explain what the pelvis actually is?

Absolutely.

See, there you are, Megan.

That shows you just how neglected this area has been.

Because a lot of people do believe that, you're absolutely right.

They think it's one bone.

In fact, it's several bones.

Two big hip bones, there's the coccyx, the sacrum, and there's the pubis and the cartilage at the front there.

That's not bone in itself, but they meet together at the front, and the symphysis pubis, which has got cartilage between those two big bones at the front.

Now, it moves around.

It's held together with ligaments, and it's meant to move around.

And it's meant to move around a lot more in the birth.

And that's why we have a hormone called relaxin, so that that can take place more easily.

So it can expand for the baby to come through.

And this is, it's an articulated architectural structure within our body.

It is absolutely awesome.

I get really excited when I talk about it, because it is a really exciting piece of equipment.

And we don't give it the respect it's due, and we need to know more about it.

So we're kind of not knowing how this moves, not having an understanding of what happens when there's an imbalance.

It means that we don't understand labor dystocia.

And labor dystocia is one of the leading cause for intervention.

So when you say labor dystocia, can you just explain what labor dystocia is?

Well, there's a thing again.

I mean, this is interesting, because there is no consensus about that.

But in directly translated, it means difficult birth.

That's what it actually means.

Difficult dystocia, difficult birth.

Now that will come about because perhaps there is fear.

I mentioned the hormones before, and I know that you do in your work, the oxytocin must be able to have the right environment to drive labor and so on.

And if you have fear, that will be disrupted.

And that will cause, so there will be a labor dystocia because of that.

There will also be a labor dystocia, which is mechanical.

That's what I'm interested in.

Because actually, we do know this, it is one of the leading causes of intervention and caesarean section, mechanical labor dystocia, how the baby is passing through the pelvis.

So because of our ignorance, there's lots of flame attributed to the baby, to the poor wee baby who's trying to make their way through this lovely structure and finds it difficult and then gets into, for example, a back-to-back position.

Well, yes, a back-to-back position is dissociated with difficulty, but not always.

Some people will have pelvis that are made that way, and the baby is actually taking up the optimal position for that particular pelvis.

So a back-to-back position in that case is not an issue and doesn't cause a problem.

Yet it's got a very bad reputation, and it's unfair because that isn't where we should be focusing.

We should be focusing as how is her pelvis?

Is it balanced?

Has she had difficulty?

Has she got activities that increase the possibility of imbalance?

Has she fallen, as so many of us have done, on our backside, and really bashed our sacrum and our coccyx, and there's a little bit out of kilter there.

So are these things that somebody might be aware of either prior to pregnancy or prior to giving birth?

Yes, yes, absolutely, absolutely.

Which is why I've got a birth preparation class called Moving for an Easier Birth.

It highlights these activities and accidents that you might have or injury that you might have before you get pregnant even that may impede.

It doesn't mean it will.

So if you've had a fall on your backside, it doesn't mean that you will have problems.

It just means there is a heightened chance of that happening.

And what has that, if somebody had a fall or something in their life before falling pregnant or during pregnancy, what does that mean when you say the pelvis is imbalanced?

Well, it depends on the injury.

Of course, in an accident, we all have that in our lives.

We do fall and we adapt very well and we do things that can help.

We help ourselves like we become more active perhaps and we go to yoga and Pilates.

We might even see body therapists like chiropractors, osteopaths and so on that help us get back into balance.

Now, what happens is it's not even an accident to do with the pelvis.

If you have a knee injury or an ankle injury or an imbalance in your ankle, maybe you've got flat feet, for example, that's going to have an impact on your pelvis and how it sits in the body.

So an imbalance might be that one hip is hitched up higher than the other hip.

An imbalance could mean that there's been damage after an accident where the sacrum is slightly twisted, where the sacroiliac joints are imbalanced.

And that's actually something that any physiotherapist or any body worker would tell you is the most common complaint, is an imbalance of the sacroiliac joints.

So these things happen.

Now, it depends on the extent of them, whether they're going to impact the birth.

Bearing in mind coming from the bony pelvis is all the ligaments and muscles and connective tissue that actually hold everything in place inside the pelvis, your abdominal muscles, which include, of course, the womb.

And they hold that in a pretty good position.

It's not going to be perfect because life isn't like that.

It's not even symmetrical because life isn't like that.

But it's going to be pretty good for the requirements and needs of your life and your physiology.

So when you're having, you're able to pee and poo and so on.

And when you're having a baby growing in there, it should be in a pretty good state for the baby to access enough space to tuck its weak chin in and head on down through the pelvis and come out reasonably, comfortably and without issue.

But if there is a pulling on one of the ligaments that holds the uterus in place, you can imagine that's going to bring that uterus around a tad, the womb.

This is going to twist it around a little bit.

It's going to make a bit more less space for your baby, and the baby's going to say, oh, where am I going now?

Oh, right, well, I'll just cock my head to the side like this, and I'll have to just squeeze in here right now.

And in fact, it's not in properly.

It's in an awkward position.

What you could see, mild position or suboptimal position.

Yeah, and I think there's often a focus, sometimes people think, you know, well, my baby's back is towards the front, so therefore they are in a good position to give birth.

And it's more complex than that, isn't it?

Like you mentioned, kind of expecting baby's chin to be tucked into the chest, so that the presenting part of their head is the smallest part.

So, you know, we talk about how brilliantly designed the pelvis is, that it can move and it can kind of reshape itself.

And the same goes for the baby's head, doesn't it?

That's also not one solid bone, like we might expect.

Exactly.

Absolutely.

And it molds those plates and the skull mold over each other.

And that's wonderful, and it's meant to do that.

But most of all, what we are talking about is space.

It's actually making space, and it's as simple as that.

If we need to simplify it, that's how we do it.

Have you got enough space in your uterus, in your womb, for the baby to get into a good position to make its way down?

And then you've got complexities about our current maternity system, where there's a lot of intervention and there's a lot of sitting around, and there's a lot of lying down on the bed and being strapped to things.

Now, how would a woman be able to get up and move around instinctively in that situation?

It's going to impede on her birthing process, the whole medicalization issue.

So that doesn't help.

She may even be able to resolve the problem herself, which is actually the optimal solution by her own instinctive movement.

We see that sometimes.

You lift her leg up and you just twist yourself around, and you just know that that feels good, and suddenly, oh, something's happened.

Oh, now the baby's coming.

So you can do that yourself.

Not always, of course.

It doesn't always, but that should be able to happen.

At least that opportunity should be there.

And sadly, it isn't, because 83% of people and women are giving birth on a bed, and the majority are in a semi-combatant position.

So basically, Megan, the majority of women are not choosing their own birth position.

Yeah, and this is something that we talk about a lot in the work that I do.

It's one of the most important things, really, for your birth, is that you are in an environment where you can behave in a completely uninhibited way.

And as you said, in the kind of modern maternity system that most of us give birth in, we're usually in a room that we've never been in before ever.

So it takes a lot to be able to behave in an uninhibited way in a space that isn't our own.

And when a woman kind of is truly uninhibited, undisturbed, able to respond to her body, would it be right in saying that we see these things resolve themselves without us necessarily actively deciding to do anything more than in the kind of the standard situation that we tend to picture when we think of labour and birth on a labour ward or in a hospital, for instance?

Oh, I would say that that's highly likely.

But of course, that occurs less often because those environments that we're talking about, Megan, is home birth, isn't it?

And a home birth rate is not that high.

And also birth, midwife-led units.

And again, it depends if it's a standalone or alongside midwife-led unit, but it does, even that environment, it supports physiology much better than the biomedical model of care that most people give birth in.

So it would have an impact most definitely.

So simple as in make space for your baby and do things in your life that are going to create, to support and optimize your physiology.

But then you've got the narrative that runs through our lives is that birth is too difficult, and you won't be able to do it.

And again, that biomedical model of care instills fear and distrust in the physiology and your ability to give birth.

So that's going to have an impact.

So then women are less likely to tune in, connect with themselves and use instinctive positioning.

Yeah, absolutely.

And we are like conditioned, particularly as women, I would say, our entire lives to completely disregard what our body is telling us.

How often, if you're listening now, think how often have you needed a wee and thought to yourself, oh, well, I won't go now because I'm doing this, that or the other, or I'm in this room or...

And you don't respond to that instinct.

The same with period pain or a time of the month where you're feeling tired and you want to rest.

We, particularly if you have children already, are very used to completely ignoring our bodies and trying our very hardest not to listen to them.

So something that is like just really great practice in pregnancy is to actually just start listening to your body, just take pregnancy as a time to practice, responding to what you are feeling.

And so when we're...

I was actually teaching a group course yesterday in person, and one of the things I just say at the beginning is, if you need a wee at any time, just get up and go for a wee.

If you need to sit on the floor, get off your chair and sit on the floor, you don't need to ask permission to do these things.

But we're so used to doing that.

It's sort of school and everything, like the whole of our lives, we're conditioned and prepared to not tune in to our bodies.

So pregnancy is a really good time to actually go, do you know what, for the next six months, nine months, whatever stage you're listening, I'm going to try and respond.

Every time a body tells me to do something, whether that's stretch, whether that's move, whether that's rest, I'm going to try as much as I can to listen to it and to tune in.

And it's such good practice for labor and birth.

That is absolutely vital advice there, Megan.

And one of the things I suggest in my class is, because it can be fun.

You know, this is not like hard.

It may seem hard work to somebody who doesn't do that.

You think, well, where do I get the time to do that?

But you know what?

Put your funky music on in your living room, at home, and dance.

Move your body, move your pelvis.

And when you're pregnant, and really feel how your bones are moving and how the pelvis moves.

Do some sexy moves.

That is what you...

It's as simple as that.

And then you could replicate those in the bathroom.

They're the same sort of moves that we want to help our baby move through by moving.

And you can change the shape of your pelvis when you move it.

You know, you make room on one side if you lift your leg up a little bit.

If you turn your thigh around inwards, you're changing the shape of your pelvis.

And if your baby needs a little bit more space, these are the kind of movements that would be very beneficial to make that space for them.

So I've got a bit of an anecdote that is going to lead on to a question, hopefully.

So when I was a student midwife, I think it was probably...

It was one of the first births I'd seen.

So it must have been kind of sixth, seventh or eighth birth that I'd been supporting.

And it was on a birth center, and there was a mother having her first baby.

And she came in.

In labor, things were intense.

They were picking, you know, going quite quickly.

But the midwife that was mainly supporting her offered to give her a vaginal examination, which she accepted.

And I think at the time, her cervix was kind of about two centimeters dilated was the kind of in terms of measurements.

And she, you know, the midwife could see that this is, you know, she was in intense labor.

She had, she was in a kind of inward kind of state.

She wasn't engaging in conversation.

It was, you know, labor was really kind of kicking off.

And the mother wanted to get into the pool.

So she said, Okay, do you know what might help you relax, might help you adopt some different positions, you get into the pool.

And then we just sort of stood back in to the side of the room and just kind of let this mother be.

And what then happened was this mother who was birthing started making some sounds that sounded like sort of pushing, sort of like nudgy pushing.

And the midwife said to me, she said, Megan, just observe, just look at what this mother is doing.

And it sort of looked like she was pushing, but it wasn't the like kind of bearing down expulsive stage of labor.

It was a very much kind of nudge nudge instinctive, little tiny kind of sounds that she was making.

And this midwife just said to me, I think her baby was back to back, but the baby will have turned now.

And, you know, lo and behold, an hour later, there's this first time mom in the pool with a baby in her arms.

And what kind of initially could have looked like early labor.

Actually, this mother had this experience that she was just left to respond to, no one even, you know, I was told that she was making these noises, but the mother wasn't informed that this is what she was doing.

She was undisturbed.

And then her baby was born.

And so the advice that this midwife gave me, who honestly has gone on to completely change my entire life and my own experience of birth, was she said, look, Megan, a mother's body or a woman's body, a person's body doesn't lie to them in labor.

And this experience I then had for my first baby had an induction, and I had these very early sort of niggly, pushy sensations.

And I remember the midwife saying to me, oh, no, you're not even in labor yet.

And in the back of my head, I just had this midwife saying, no, Megan, a woman's body doesn't lie to her in labor.

So, you know, in my head, put two fingers up to this midwife, who was telling me not to do anything and just again responded to my body.

And again, within kind of three hours after that moment, having not been in labor in inverted commas, there I was with a baby in my arms.

And so what I suppose the question that I would like to ask is, what might a woman notice in herself or a person giving birth, what might they notice in themselves, either in the kind of story or journey of their labor, how it is unfolding or some sensations that they might feel, that might be an indication that actually their baby isn't in the best position.

Can I just refer to your story just before I go on to that?

The whole issue of don't push or not fully dilated is not based on, well, I think it's based on nothing, really.

I don't know why you're not fully dilated then.

Don't push, pant, pant, pant.

Rachel Reed, I would refer everybody to Rachel Reed's blogs, Midwife Thinking.

She's written a lot about that and actually she quite rightly suggests that actually those instinctive little pushes that are happening, as you well described in your anecdote there, are perhaps the mother sortiness herself.

And those early little pushes are really helping resolve the situation.

So us midwives stepping in and thinking they know better than the mother can actually impede that process because she's sorting it out herself and I think she should be left to it.

I definitely concur with what you said.

So what do we know?

Well, first of all, and this really narks me, we talk about women's sense of care, and yet one of the things actually that women complain about most is not being listened to.

Yeah.

If we don't listen to her, then we're putting down in her head that she has information that's worth knowing, and straight off, that's a difficulty.

We need to listen to her.

She needs to listen to herself.

And if women say to us, this doesn't feel right, and they do, this doesn't feel right, there's something, I feel like the baby is stuck.

Then it might well be that the baby is stuck in a part of the pelvis that's making everything a lot more difficult.

Now, if she can pay attention to that and then try and get upright, move around, take up some positions that might actually expand her pelvis a little bit more, she can sort that out herself.

But otherwise, she's going to feel, apart from that instinctive feeling of it's not quite right, something's up, this baby's passing through my pelvis, I know what it feels like, she may feel pain in her pelvis.

So a lot of women who, when they're in labour, they don't have the intensity and power of the contractions in the same way as somebody who's baby is passing through unimpeded, everything's fine, they actually feel it in their pelvis a lot more.

So it's in the pelvis, one hip, maybe both hips, a lot in the back.

Although you can have back pain, it doesn't necessarily mean there's an issue, because we do have that in our lives.

Running down the legs and the groin and those areas are a very strong indication that the baby's head is in an awkward position.

I do want to reassure everybody that that doesn't mean that the baby won't come out, because the majority are going to come out without any surgery or anything like that.

But you do have to take up certain positions that will help make some expansion in your pelvis, even just moving around and tuning in, as we said before.

But there are other positions that you can take up that will help open up certain parts of your pelvis where the baby might be having trouble pass through.

And what about in terms of the kind of the journey of labour, people who are having very long early phases of labour, or it's really taking a while to pick up?

Can that be a sign?

That's another sign, yeah.

I mean, there's the whole spectrum, just as there's a spectrum of normal physiology unfolding, the usual birth process, so there's a whole spectrum for individuals, but although it's slightly different, it's the same with a labour dystrophy, a mechanical issue.

It's going to be a spectrum.

Some people will have that long, long build up, and it's exhausting.

So, again, these aspects are complex.

The whole idea of the baby passing through and needing more space is not complex, but actually being able to identify it is slightly more complex.

So you could have a long latent phase.

Now, a long latent phase, what does that mean?

Some people are going to have that, and it's going to be perfectly normal for them, as long as they are well.

And there's the key.

As long as they're having little rest, they're eating, they're mobilizing, and it's been going on for a whole day and maybe even a night, but they're okay.

Whereas somebody else is having that, and they are not okay.

They're actually really struggling.

And then they go to hospital and get examined, and they're like, oh, you're only two centimeters.

And only is in inverted commas, by the way.

So there's an issue for them that they're struggling.

The pain, and it is pain, can be much more intense in those early stages than you would expect them to be.

Yeah.

I just want to go back to that situation that you mentioned, because this is for quite a lot of women, a situation that they do experience, and it can be a very difficult situation to find yourself in, where actually, yes, you've been having surges or contractions, and they are intense, and you are at home, and you've reached a point where you're going, do you know what, I'm not managing at home anymore.

I want to be, I want something.

I want some kind of support, one-to-one support from a midwife.

So I'm going to go to hospital, or I'm going to call, it doesn't happen so much with calling a midwife out to home, because they do tend to have slightly different techniques, and they tend to have a bit more time to sit and observe you.

But when you turn up to triage, which is what the majority of people given birth in the UK at the moment will do during their labour, or even in cases of something like an induction on an antenatal ward, what you're not having at this point in time is one-to-one care from a midwife.

So they have a quite short period of time to kind of assess what is going on.

And so there is this reliance on a vaginal examination, where actually a holistic picture of watching somebody's behaviour and all the things that we would hope would come into defining whether or not somebody is kind of at what stage of labour they are kind of in.

And if we find this, so the magic number that hospitals like to have is four centimetres.

If your four centimetres are over, great, you've got the magic key, you can go and have your one-to-one support from a midwife.

If you're under, then we do even hear the phrase, you're not in labour, when somebody is quite obviously feeling painful sensations, and there are contractions there and things are definitely going on.

And so there's two real situations that I tend to see or tend to hear women's experiences in this situation.

And this is one of the situations you'll probably say that the biomechanics techniques are particularly helpful things to potentially reach for.

So what we tend to see is either you're not in labour, go home, have a rest, come back, which can be helpful if actually you just needed a little bit of reassurance that you're doing a good job, and everything is well.

And actually going home, the longer you can be out of the hospital environment, the better in terms of reducing interventions.

And actually then if you feel, okay, that's fine, I can go home, we can have some dinner, I can try and get a rest, have a bath, and then we'll come back.

So there are situations where actually it's the right thing to do.

The other thing that then happens, if women really don't feel like they want to go home, is they get told, well, you can have some pathodin.

So that you can get some rest here, but we can't give you the kind of one-to-one care on a labour ward just yet.

And that tends to be the two situations that we see, unless somebody is incredibly insistent, which ideally they kind of shouldn't be.

So talk to me about the kind of the third alternative, which hopefully as you are training more and more midwives and obstetricians and people who do live supporting birth, hopefully this is now becoming a go-to alternative in this situation.

But what is the biomechanical alternative here?

Yeah, it would be to do some specific positioning that's going to make space in the pelvis.

So it's always going to be that.

Now, as we mentioned, we must never forget the ultimate solution is one that the woman finds herself through our own movement.

But we know that's a little problematic sometimes.

But certainly doing some of the positions.

Straight away, there's at least three that come to mind immediately, which is abdominal sifting using a scarf, which is a gentle massage on the abdomen.

But you do need to know how to do that.

And midwives are learning this on my course and in other courses too.

And that expands the broad ligament that covers the uterus, the womb, and helps everything expand.

It's actually a really, really comforting thing to do as well.

It makes a wee bit more space in the abdomen for the baby to rotate or tuck its little head in and start coming.

So there's that.

And there's also something called forward leaning inversion.

But that does come with contraindications.

So if you've got high blood pressure or a lot of water around the baby, for example, it wouldn't be advisable to use that technique.

But that's a specific technique that if you do yoga, it's a wee bit like downward dog, but not exactly the same, but it's an inversion.

And that proves to be very, very helpful.

But one that you could do, which is quite safe to do by yourself or with your partner, is something called shaking the apple tree.

And that's again, using a scarf around the buttocks.

And I've seen this in Spain, and they call it the caramello because that's what it looks like.

So the scarf engages with the buttocks, with the big muscles and your butt muscles, your glutes, and then gathered up tightly at the hips.

So it just looks like a big sweetie, you know, those tins of sweeties you get.

And then you jiggle vigorously.

So you're jiggling all those muscles, all the connective tissue, and some of those muscles are actually attached to the pelvic floor.

And that gives everything a good jiggle, and that is a really good thing to use as well.

And there's another one called the sideline release, which I think is basically the queen of movements.

It's incredible.

But again, you do have to do it quite precisely and know what you're doing with that.

Not suitable for women who are hypermobile, but certainly a very, very useful one.

You can do even lying on the bed.

You're lying down on the edge of a bed or wherever your sofa.

And then you can lift your top leg and let it hang gently from wherever you're lying.

And that stretch is called a myofascial release, actually, because it's stretching the connective tissue, and it's pulling out and stretching those muscles.

And it's also accessing the pelvic floor.

And it's just giving everything a wee bit more space there.

And it can have incredible results.

I'm going to say, OK, it's not the scenario that you're talking about here, Megan, but it can work very well in that scenario.

I've seen people be very comfortable after they've used it and go home and get on much more easily and everything's straightforward.

But on the other hand, I've heard obstetricians talking about using it in the operating theatre before they're going for a cesarean section and the baby's born in the theatre using this technique.

So it's really a very effective position, but you do need to know how to do it properly and safely, obviously, because you're very close to the edge of a bed to do it.

So we've got these kind of things going on, these positions that make more space and have an impact almost immediately on your situation.

Yeah, absolutely.

So I suppose a good kind of final question would be, have you got any sort of like favorite examples or stories where somebody has either been supported by somebody that knows these techniques or has learned these techniques themselves in their pregnancy?

I mean, you've given a few kind of as we've gone, but have you got any kind of favorite stories that you'd like to share the effectiveness of them?

Oh, gosh, to choose one.

That is hard.

I'm going to go back to your scenario that you were talking about in that early part, because I think that is...

Well, they're all different.

If labor is difficult, it's difficult, obviously.

But for me, I think it's really challenging when you present in early labor, and you're told it's two centimeters, and you're actually really struggling here.

That's incredibly hard, because there is no guidance for that.

The model of care that's available at the moment doesn't recognize that you are in labor.

And that is a travesty, because that's so disheartening for you, and you're struggling already, and then to be told, oh, you're not in labor, what a blow.

But I had...

I walked in to work one day, and I saw somebody, a woman, standing outside a room, clutching her pubic area.

Now, that's one of the places where you could feel a lot of pain and be two centimeters, and you're really struggling, and you actually clutch that area and bend forward.

That's a very typical thing that could happen when the baby's just banging off that part of your pelvis there, and it's really...

It can be sharp, it can also be dull, but you clutch it, and she bends forward.

And I saw that, and I walked in, didn't know her at all, and I thought, that baby's not in a great position.

And I was told that she had been there all morning.

She wasn't in established labor, and she was going to be going home.

And I said, well, I think I can help her, so I'm going to go in.

I hadn't done any assessment, didn't know her name.

I only saw the way she was moving, and I could tell that that was an issue for her.

And we did a forward leaning inversion, as I just talked about.

Well, before that, we did a nice aromatherapy massage, which is also really beneficial for relaxation and optimizing the possibility of her instinctive movement, because she's more relaxed.

So we did that, and then we did a forward leaning inversion, sideline release.

And after about 20, 25 minutes, she stood up and said, you know, I think I can go home now.

Well, that is a result.

She feels that she can go home.

She's not struggling.

She's not got a little tear in her eye when she's got her contraction or her surge.

She's actually feeling like she can do this now.

She can go home.

And she did.

And that to me was an absolute result.

And I phoned up the next day to find out how she got on.

Not a peep from her overnight.

She came in at lunchtime the next day, fully dilated and had a baby.

Yeah.

I mean, it's...

When you know how that story would have gone without those tools.

And I think a lot of people will be listening to this, particularly if they've given birth already.

And just like light bulbs going off in the head of like, oh, yes, I had that, and I felt like that, and this is maybe why.

Exactly.

And when I teach it, Megan, when I teach it even to the birth professionals as well, there's loads of people go, oh my God, you've just described my birth.

And that was what it was.

It's really important that you understand if you've had any history of an imbalance or you have activities like you're a fitness enthusiast, you're going to probably have a tighter pelvic floor, that later on in your birth could pose an issue for you unless you do pelvic floor releasing exercises in your pregnancy.

So there's those sort of things you can do for yourself.

So if you're a runner, a gymnast, a dancer, any other sort of or horse rider, high impact, you can do something for yourself by doing the pelvic floor releasing exercises, so you're relaxing that tight pelvic floor, making it easier for your baby to pass through.

So there are things you can do in your pregnancy.

If I could gift something to women who are pregnant, I would gift an appointment or a series of appointments with chiropractors or osteopaths of women's health physios to balance your pelvis before you get into labor, which will help you straight away.

So make sure that everything is in good order.

Just like we watch what we eat, then let's pay attention to how well balanced our pelvis is.

And if you could, I know it's hard because it's expensive and you have not expensive, but you know, you have to have money to access that.

But a birthing ball would be the other thing because that's a tenner.

I'll get on that birthing ball.

I'm sure somebody will end you.

So you could do that.

If you can't afford to access a body therapist, get yourself a treatment to make sure everything's in good pelvic health balance.

And then if you can't get access to that, then a ball and get yourself moving and using a ball in your pregnancy.

Yeah, thank you so much.

So we've kind of talked through, you've kind of mentioned some specific techniques and things that people can use.

Now, obviously over a podcast, we can't even show you a picture of these.

So if people have, you know, it's really sparked an interest or a chord, and they are thinking, actually, I would really like to get to know this, either as we have kind of health care providers listening to this, but mainly kind of pregnant mums and parents to be.

Where can they find you?

How can they do a course?

How can they find out what these techniques are and how to use them?

Well, they can access my website, which is www.optimalbirth.co.uk.

And there's some blogs on there for women, pregnancy and so on, and some videos that show some of the techniques that I've just talked about.

I do teach this course, this birth preparation course called Moving for an Easier Birth, and I'm a bit sad that I haven't, I've stopped teaching it because I've put it as a standalone course online, and it's not quite ready.

And I thought it was actually going to be imminent like in the next few days, but I'm going to have to look, I think there's a few glitches.

So that's not going to be ready, but I feel like because if there's any delay in that becoming ready, I might actually put on a course so that people can access it if there was enough interest.

So do message me or on the website.

Me and my husband did Molly's parents course when I was pregnant with our youngest, Lockie, and my husband thought it was absolutely brilliant and hilarious.

So definitely want to take a partner to as well if you can.

Yes, it's for the partners exactly for you and your partner.

But apologies.

I actually took off all the dates.

Well, I didn't put any more dates in for teaching it because I thought the online version would be up and running by now.

By the time we go live with this podcast, it may be up and running.

So I'll put a direct link to that in the show notes as well.

That would be great.

Perfect.

Well, thank you so much for joining me.

Thank you, Megan.

Thanks for listening to the birth-ed podcast.

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