Interlude from my story to other stuff-
A few times in the past year I’ve had occasion to use a positioning trick that I’ve once heard called the Texas Rollover. I’m going to christen it the Simkin Rollover, since that’s where I learned it. Penny Simkin is the Grandmama of doulas-more professionally known as the founder of DONA-and on my short list of personal heroes.
Let’s say a woman is having a protracted active labor or, more tellingly, has a persistent cervical lip. Or any reason to suspect a fetal malposition. Really, I use this whenever I’m helping someone through a protracted labor. I’m not all that great at diagnosing a specific malposition-“Ohhhh, the baby’s head is twisted 29 degrees to the left and is slightly more extended than is optimal!”-but if a woman is having a protracted active phase, chances are good the baby is malpositioned somehow. So the rollover technique is an excellent strategy. If anything else, it gives us something to do while the baby is trying to negotiate the best way out.
Dying of suspense yet?
Here it is:
My tweakings are that the semi prone position, with the knee sharply flexed, is a bit more dramatic-the shoulder she’s laying on is actually pulled back more so she’s almost facing the bed, the leg she’s laying on is so straight it’s pointing, and the knee is flexed up as far as her pregnacious belly will allow. (Pregnacious. What a pretty word. That’s my made up word of the day. You’re welcome.)
Earlier this year this trick had oh-my-god, startlingly good results. This mom was pretty incredible-she’d had about two days worth of early labor. She could take three and four hour naps here and there, but had a ho hum contraction pattern. She never complained-well, except for the one time she said, “This REALLY sucks”-and just labored in what I figured to be a reflection of her personality-super easygoing.
Her labor continued to be easygoing. She got to six centimeters and had a good contraction pattern, so she got in the tub. The contractions almost immediately slowed down.
Lather, rinse, repeat.
We did that a few more times.
Her acupuncturist was across the street, and she’d been in contact with him throughout the day. He said he’d come over when he was done with his patients. About an hour before his appointment end time, and about the time most of us were beginning to have “hospital transfer” in the back of our minds (though we didn’t admit it to each other until after the baby was out), I suggested we start the rollover. Three contractions in each position.
Well, with contractions six to ten minutes apart (again), this took awhile. She appeared to be napping a few times; maybe she was. When we got to position number four or five, I was antsy enough that I offered to go across the street to collect her acupuncturist myself. I needed to stop watching the pot. And, I told myself, if the acupuncture doesn’t work, I’ll suggest a transfer, though I still had a few more tricks yet.
When I came back she was done with the rollover and was in the shower-and her labor sounds were different. Lynne and I did that thing we do-had an entire conversation with our eyes in a matter of seconds. Me: “YIPPEE!” Her: “I KNOW!”
I chatted with her acupuncturist. Great guy who used to regularly do labor support acupuncture until his practice got so busy he didn’t have the time or energy to do on call anymore. Boy, I can sympathize.
She got out of the shower and he “needled” her for about 30 minutes, and her new level of labor continued. She and her husband later said it was the positions that did it-the acupunsturist could take credit if he wanted (and I’m sure it helped to amplify what was already happening), but the positioning was when things REALLY kicked up a notch. She added that every time she shifted to a new position, she felt a TON of amniotic fluid come out.
The last chapter of the story-about an hour later she began spontaneously bearing down. She was on the toilet and I asked her if she could check herself. She obliged by doing so, and pulled out her finger and indicated up to where her finger met her hand. About fifteen minutes later, she checked again, and indicated up to her first knuckle.
Ohhhhh KAY then. Into the tub now, shall we? (“We” in the metaphorical sense, of course. She and her husband. Lynne and I remained land lubbers.)
And a baby came out another fifteen minutes later.