Category Archives: midwifery practice

The Anterior Cervical Lip: how to ruin a perfectly good birth

Updated: February 2022 Here is a scenario I keep hearing over and over: A woman is labouring away and all is good. She begins to push with contractions, and her midwife encourages her to follow her body. After a little … Continue reading

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VBAC: making a mountain out of a molehill

VBAC (vaginal birth after caesarean) is big. A google search for ‘vbac’ results in ‘about 795,000’ results. Reviews, guidelines, policies and statements are being produced by every organisation with an interest in birth. Support groups and networks are growing. I am … Continue reading

Posted in birth, intervention, midwifery practice | Tagged , , , | 348 Comments

In Celebration of the OP Baby

Updated: February 2022 How many times have you heard “I had to have an epidural/c-section/ventouse/etc. because my baby was facing the wrong way”? An occipito posterior (OP) position occurs when the baby enters the pelvis facing forward with their back … Continue reading

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The Placenta: essential resuscitation equipment

Updated: August 2022 Premature cord clamping/cutting Premature cord clamping (clamping before placental transfusion is complete) has been the norm since ‘active management’ of the placenta became routine. In recent years, research has highlighted the harms caused by cutting the umbilical … Continue reading

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The Human Microbiome: considerations for pregnancy, birth and early mothering

This post was co-authored by Jessie Johnson-Cash and based on her presentation at the USC Midwifery Education Day. The human microbiome is rather fashionable in the world of science at the moment. The NIH Human Microbiome Project has been set up to … Continue reading

Posted in baby, birth, midwifery practice, pregnancy | Tagged , , , , , , , , , , | 119 Comments

Perineal Protectors?

Updated: September 2019 Most women will sustain some damage to their perineum during birth (AIHW 2018). Around 50% will have a tear or graze in the skin and/or vaginal wall (1st / 2nd degree). Occasionally (1% of non-instrumental vaginal births) … Continue reading

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In Defence of the Amniotic Sac

Updated: May 2022 Artificial rupture of membranes (ARM) aka ‘breaking the waters’ is a common intervention during birth. However, an ARM should not be carried out without a good understanding of how the amniotic sac and fluid function in labour. … Continue reading

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Asynclitism: a well aligned baby or a tilted head?

Asynclitism is when the baby’s head is moving through the pelvis ‘tipped’ to one side. This is usually diagnosed by a vaginal examination in labour. However, asynclitism is rarely caused by the baby having his/her head tilted to one side … Continue reading

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Supporting women’s instinctive pushing behaviour during birth

This article was published in The Practising Midwife journal in June 2015 along with ‘practice challenge’ questions for midwives (not included here). Introduction Clinical guidelines recommend that women should be guided by their own pushing urges during birth (National Institute for Health … Continue reading

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Shoulder Dystocia: the real story

Updated: August 2019 There is a lot of unwarranted fear about ‘big babies’ getting stuck. The media reflects the usual story – that women are creating a problem that doctors have to fix. The incidence of shoulder dystocia does increase … Continue reading

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