NO! IT JUST CAN'T BE CALLED THE 'SUNNY SIDE' OF LIFE!

As a preamble to what will subsequently be opined in this blog, I want to strongly underline the fact that the few days leading up to my daughter's birthday usually have me thinking back to my incompetent Jokewood doctor, Dr. L*b*m*f*. Now, as fate would have it, I was already 2 weeks post-dates on January 8th, 1980 and had gained 50% of my very early pregnancy weight of just 90 lbs. Here is part of the problem: Dr. L. had forgotten how tiny I naturally was and never suspected that I was carrying a 10 lb. baby. This was a bona fide case of cephalo-pelvic disproportion and my bungling doctor was at a total loss. I would learn years later of his battle with alcohol and suspect that he was likely 'hung over' the night I went into hard labor. The truth of the matter is, however, that my first pangs of labor actually began on a Saturday and my daughter did not arrive [mid-forceps extraction style, no less!] until the following Tuesday. Yet my doctor simply failed to read the writing on the proverbial wall.

THE DREADED 'SUNNY SIDE UP' FETAL PRESENTATION

The worst possible thing that can happen in a 'posterior occiput' labor is when the water breaks (or is intentionally broken by medical personnel to try to hasten labor) and uterine contractions are both suddenly and rather dramatically enhanced; the baby's head automatically descends a little bit more, merely worsening the whole situation. Now, in order for the occipital component of the fetal skull to become anterior (as it must be for a normal delivery to take place), it is necessary for the infant's head to go through an extended rotation of approximately 180 degrees. (Normal rotation requires only up to a 90 degree turn). Moreover, if the baby's head descends too deeply into a comparatively undersized pelvis before any such rotation is effectively completed, the risk of a 'deep transverse arrest' increases, greatly reducing the chances for a successful vaginal delivery.

What's more problematic is that if the nurses or doctor(s) do not adequately diagnose this unfavorable fetal head position until far too late within labor, the only recourse may be to offer a para-cervical block or epidural anesthesia. You see, it is now virtually impossible for the mother to relax enough and permit the deep muscles of the pelvic floor to fully 'loosen up' and consequently allow the baby to sufficiently turn; and this is the ONLY way for a successful delivery.  And nothing in this world can prepare a mother for the severely excruciating and unremitting pain that accompanies labor when the baby is in an occiput posterior position.

However, the main tip-off of this potential situation is that the labor typically begins with short, painful, but 'irregular' contractions. This constitutes a warning sign of cephalo-pelvic disproportion; in the past, many women died from this unfortunate circumstance! Yet, this key sign is often shrugged off by incompetent medical personnel as "false labor."

In reality, it's that this type of labor is basically just not productive enough: the rather ill-fitting posterior head is not properly applied to the maternal cervix, even while the mother IS experiencing great discomfort! She is often sent home to wait for "real labor" to begin but is unable to sleep and often unable to eat, as well (because of the pain), sometimes even for several days. So,  adding to the stress of a painful back labor, we begin with a mother who is already exhausted! I have heard women describe the pain as "it felt as though someone were literally sawing the back of my body in half" or, "I couldn't even tell when I was having contractions because my pain was so excruciating!" All attempts to ease the pain will have little effect [without medication] and the labor is a very long and hard one.

 "Many midwives attending out-of-hospital births have not been taught to help correct a posterior presentation either and, despite their best efforts, are forced to transport the woman to the hospital while the mother is begging for pain relief, or after several hours of pushing have resulted in little progress, or a large caput succedaneum has now formed on the baby's head. Then, there is the mother who finally delivers her baby after a 36+ hour labor and is so fully exhausted by the ordeal that she has difficulty effectively bonding with her baby. What's more, the process of postpartum involution is frequently delayed by a protracted labor; furthermore, mothers may suffer from urinary tract infections due to the prolonged pressure upon (and swelling of) the anterior vaginal wall. Oh, did I fail to mention all those nifty lacerations?"

SAID BY A MIDWIFE: "I would love to see this picture changed. As a midwife, it is my goal to do everything that I can to help the mother to achieve an optimum birth outcome, to use my skills to alleviate unnecessary pain and suffering and to help a new family begin in safety, peace and joy".

Yes, it's a land 'down-under' where women go and make "thunder"

www.youtube.com/watch?v=XfR9iY5y94s