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Entries in Cervical Lip (1)

Monday
Jun042012

"Stretch"

I asked folks to “Toss Me a Birth-Related Word” on my Navelgazing Midwife Facebook Page and “Stretch” was the one of the words. Here, I’ll use it as a springboard from which to jump.

When I was pregnant, I really needed to stretch a lot. I have a short waist and grow big babies (uh, with the diet I had, I grew big babies), so had kids packed in a small area. I was thrilled when I learned to put one arm over my shoulder with my hand on my back and the other arm around my waist with that hand on my back, too, and how that opened my chest up considerably.

I loved doing that move several times a day and try to show it to clients.

I also loved doing pelvic tilts. They were a total Bradley thing; we were taught to do 80 three times a day. Seems like a lot, but really did strengthen my lower back when I was carrying 10-pound Meghann. Pelvic tilts are often done incorrectly, so I learned a way that helped me and others know the correct way to do them. Doing them the right way saves your back, including the lower back because if you sway your back, especially pregnant, it can pull a lot of muscles. So, instead of arching like a cat and swaying down (the “Cow” yoga move), go on hands and knees, back like a table top… parallel to the ground. Now, pretend you have a tail on your tailbone and then pull the tail between your legs. That’s the pelvic tilt movement that will help your lower back get some tone and stretch. After pulling the tail in, the let the tail relax, back going parallel to the ground again. No sway back! Do the tail-pulling as many times as you can… slowly and with purpose… this isn’t to be done quickly. Nice. And. Slow. Pullllll… stretch inward. Releeeaaassseee and relax. Over and over. 80 times is as long as a 3-minute song. Impossibly long if you have kidlets, I know. But, even 10 a few times a day would be a great start.

When thinking of the word “stretch” with birth, we can’t help thinking about the vagina stretching, right? While there’s a belief in perineal massage in order to help the stretching birthing vagina not tear, I am not a fan of that at all. I believe women stretch just fine and have found the less they (women) are messed with, the better they do. When hands are all over the vagina, stretching it, “massaging” it… “ironing” it… the tissues swell and tend to tear more. I’ve found women rarely tear when they birth in tubs, too, and gee, no one can manipulate the vagina from that position. I believe the vagina knows what to do and, without futzing with it, is going to tear or not, depending on the baby’s head’s position.

Now, I have helped women with the speed of the head’s delivery and that can be good for saving some tearing, but that’s different than perineal massage; that’s perineal support.

And what else stretches in birth… ah, yes… the cervix.

I’ve recently discussed my feelings about stripping membranes (which involves the cervix directly), but what about the cervix stretching on its own?

The cervix is amazing. It can be tough and thick, like a soft piece of plastic, and it can be thin and stretchy, like a rubber band. While the majority of cervices (plural for cervix) get thin and stretchier as labor progresses, not all do. But, in my more hands-on days, have lifted a stretchy cervix over a baby’s head, helping the mom get to second stage quicker. It’s as if you took dough and used a glass to cut a hole in the dough (like for biscuits) and then put your finger inside the cut-out hole and pulled on the dough. That’s what a stretchy cervix feels like and depending on how thick you make the dough, depends on how effaced she is; the “shorter” the dough (the thinner), the more effaced mom is and it’s usually easier to stretch the cervix back and over the baby’s head.

Now should we be stretching the cervix over the baby’s head? Usually not. In fact, usually you can’t. But, there are times when it can be a kind and loving thing for mom to minimize the urge to push, if it’s been going on for a long time. What’s typically happened for me is that I didn’t do vaginal exams, but would listen to mom’s urges to push, letting them lead the way. Then, when there was no progress after some time… usually a long time… I would do an exam and find the “cervical/anterior lip” (the small part of the cervix left over from the rest of the dilated cervix), stubbornly keeping the baby from coming down and into the mom’s pelvis. I’ve never figured out why some cervices do this… positioning, timing, size of the baby… it all seemed so random. But, when it happened, I thanked the Universe when the lip was stretchy and not thick and tense. Then, hooking a finger under the lip (like lifting that swatch of dough) and lifting it up, usually during a contraction, would bring the baby right down through the rest of the cervix. True, sometimes it would take a couple/few contractions and manipulating the cervix isn’t comfortable at all, but it is better than transferring to the hospital and either having the hospital folks do the same thing or having a cesarean for failure to progress. As with anything, moderation is the key.

Can you think of other stretchy things in birth? Thoughts on what I’ve written? Have you had your cervix lifted over the baby’s head?