Absence of Tens

...as in ten centimeters

This may be anecdotal, but I have witnessed and heard of a number of women who do not progress beyond nine centimeters. I'm not sure why. I have heard of first-time and experienced moms who stay dilated to 9 for hours. One client of mine was at 9 cm for 10 hours before she ended up having a c-section (there were other complications at this birth).

I have a number of theories, but I'm not sure how to find out if there truly is a common cause:

• lack of movement/activity: too much laying in bed prostrate doesn't help the baby's head apply pressure to the cervix and aid dilation;
• posterior baby: wrong birthing position and the baby is unable to rotate because of mom's failure to be upright and moving around (see above);
• interventions (like epidurals) given too early, interrupting labor's progress, and dilation doesn't occur because of uterine exhaustion.

I don't know what the reason is, but I have heard of more and more moms who don't progress past 9 cm and never feel the urge to push.

...as in TENS unit

In many childbirth books and resources, references to TENS units abound. TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a small machine that delivers electrical currents through wires to specific places on the back, and the sensation tends to block the perception of deeper pain (like a labor contraction) and causes the body to release endorphins (natural painkillers). It does not alleviate all of the discomfort, but usually helps to significantly reduce the sensation of pain.

There is no documentation of side effects, and the machines can be small enough to carry in your palm. As far as I can tell, there is also no restriction of movement, though the unit would of course need to be removed for labor tubs or shower use. They are often used for physical therapy and to alleviate the pain of arthritis and fibromyalgia.

However, I have never heard of a US hospital employing the TENS unit for labor. I have never seen one, nor have I heard of anyone personally who has used this method.

Why not??

No side effects, freedom of movement, pain relief...why not?

Hypnobirthing might be dangerous, but we aren't sure why...

Article here.
The New York Times on Thursday examined hypnobirth, a childbirth technique that does not use drugs to control pain but instead uses a combination of relaxation, breathing and visualization techniques to control pain, according to Linette Landa, a hypnobirth teacher. According to the Times, "hypnobirthing" is meant to relax women through contractions so "that there is no screaming to tire the mother or alarm the baby, and labor is shorter." The American College of Obstetricians and Gynecologists allows physicians to decide whether they will permit hypnobirth, and, although many hospitals permit the technique, some physicians have concerns about the process, the Times reports (Olson, New York Times, 4/27).

Very strange. I wonder what the concerns are? Why not "permit" hypnobirthing? I checked out the New York Times article, and it became stranger, and scarier:

While many hospitals now permit hypnobirth, doctors are wary because they fear litigation. The American College of Obstetricians and Gynecologists leaves it up to the individual doctor's judgment.

Oh, of course. Because they might get sued for something.

Such techniques are not a surefire way to avoid pain, but rather "adjuncts and not the end-all to birth," said Dr. Jeffrey M. Segil, an obstetrician who offers the HypnoBirthing option to every patient in his practice in Dover, N.H.
"Women should not be set up to feel that they've failed if they can't follow through to a totally natural delivery," he said.

Don't even bother to set goals, pregnant ladies, if you aren't completely sure that you can reach them.

It doesn't work for everyone: Jennifer Richards, 29, said she gained self-confidence from hypnobirth methods, but had an epidural because of the intense back pain during her 30-hour labor.

I have said many times before that with back labor, all bets are off. But that might just be me.

I have so many questions about this that I don't know where to begin.

• What's wrong with learning relaxation techniques? Why does that have to be equivalent to setting oneself up for failure? What about women for whom epidurals have no effect - aren't they also in danger of relying on "adjuncts and not the end-all to birth" by planning on using methods that might not work?
• Why isn't this decision left up to the mother instead of the "individual doctor's judgment"?
• What potential litigation are the doctors really worried about?

Seems like we could do more good helping the childbearing women in other countries than worrying about whether or not hypnobirthing is going to mysteriously make something go wrong.

I Swear I Am Not Making This Up

Obstetricians are using a pregnant robot to practice attending births.













Named Noelle, the gestating automaton, hooks up to a laptop and can approximate breech births and failure to progress. It can be given IV fluids. The baby robot can be programmed to be born healthy and pink or blue and not breathing.











With this amazing innovation, doctors can practice cesareans, instrument delivery, suturing...

...and they never have to see the natural pattern of undisturbed birth, progressing on its own.

When I heard about this, my first thought was, Why? Is any obstetrician lacking in human births to attend? Is any OB short of practice regarding medical interventions?

We are getting farther and farther from knowing what normal birth looks like. Whatever situations our plastic-and-metal friend Noelle can imitate, undisturbed childbirth allowed to progress on its own, remains a mystery to those in medical training.

No one is asking me. But I think that obstetrical training should involve rotation through a homebirth practice. Just so they know that birth can be left alone and turn out well, so they know that women can give birth without medical assistance.