I remember once carrying out a literature search on shoulder dystocia for a homebirth emergencies workshop and coming across this fabulous quote by Sister Morningstar (2011) in Midwifery Today. She had taken a rather different approach to that of most of the medically-focused papers that had come up in my search, and noted that:
“The mother wants the baby out. The midwife wants the baby out and there’s a billion years of nature that want it all to work. Sometimes, beyond the intellect, beyond the textbook, beyond the steps one, two and three, there is a way. The way out of somewhere stuck and the Way in to peaceful freedom is what working with shoulder dystocia is all about’ (Morningstar 2011: 33).
Her article also included all manner of other useful information, including bullet points detailing predisposing factors, step-by-step assessment and thoughts about the resolution and evaluation of shoulder dystocia. Many of these were similar to those covered in the more mainstream articles and courses, though the language differed a bit. But the sections that really struck me were those in which Sister Morningstar suggests that, after the baby is born, the midwife should, ‘stimulate the baby, cover with kisses, cover with a dry, warm blanket and assess for primary and/or secondary apnea’ (2011: 34). She also suggests that it is important to, ‘thank the mother for her strength, courage and cooperation’ (34) and concludes with the following words of wisdom:
‘Do not elicit fear in a mother, no matter what is going on. Elicit her conscious awareness and active participation. Her love for her baby has the most power and motivation to help’ (34).
How very, very awesome.
I’ve been on quite a few emergency skills study days and courses, mostly in the UK, and none of them placed any importance on love, kisses or thanking women for birthing their babies. (Is it just me?) Neither can I find any reference to such things in the NICE guidance, and to my knowledge the only Cochrane review which mentions love is that evaluating early skin-to-skin contact for mothers and their healthy newborn infants (Moore et al 2007), which looked at maternal affectionate love and touch during observed breastfeeding.
Love, it would seem, isn’t quite as all around us as Hollywood would have us believe. In fact, despite its importance, it’s often lacking in modern maternity care. I would wager that very few of the women who give birth today – with or without the need for extra attention to pushing their baby’s shoulders out – will be thanked for their courage and strength. In fact, our culture has somehow managed to make women and their families think that it is they who should be thanking us, the professionals, who allegedly did all the work with our mnemonics and manoevres! I don’t want to devalue midwives, doctors and other birth attendants, of course, but it is women and babies and families who do the real work here. Love still gets most babies in, love can get babies out and, with the greatest respect to the scientific model, I suspect that love plays a greater part in making the world go round than our modern approach to life would have us imagine.
Moore ER; Anderson GC; Bergman N (2007). Early skin-to-skin contact for mothers and their healthy newborn infants. The Cochrane Database of Systematic Reviews
MorningStar S (2011). Shoulder dystocia – the perils and possibilities. Midwifery Today (99):33-35