Wednesday, September 12, 2007

Gloria Lemay classics

Here are two classic articles by Gloria Lemay, a birth attendant in British Colombia:

Pushing for First-Time Moms

Pelvises I Have Known and Loved

In "Pushing for First-Time Moms," Gloria exquisitely describes the stages of pushing. I experienced many of the sensations she discusses. I first had small abdominal pushes that felt exactly like throwing up, except in the opposite direction. I call it "throwing down." I could hear my voice catching in the back of my throat, but I wasn't making any audible sounds.

At that point, I reached inside for the first time to see if I could feel anything. Sure enough, there was the baby's head, still kind of far inside and more backwards than upwards if that makes sense. I felt a small, thin anterior lip of cervix. It felt exactly like the neck of a t-shirt. Because I had read Gloria's article, I knew the lip was nothing to worry about and that I just had a little more dilating left.

I also experienced a sensation of being "stuck" and some frustration that the baby wasn't moving down--especially when my pushing urges changed from mild and slightly pleasant to irresistible bearing down sensations that I had roar through.

Gloria has this to say about the baby's head being "stuck":
I recommend that midwives change their notion of what is happening in the pushing phase with a primip from "descent of the head" to "shaping of the head." Each expulsive sensation shapes the head of the baby to conform to the contours of the mother's pelvis. This can take time and lots of patience especially if the baby is large. This shaping of the baby's skull must be done with the same gentleness and care as that taken by Michelangelo applying plaster and shaping a statue. This shaping work often takes place over time in the midpelvis and is erroneously interpreted as "lack of descent," "arrest" or "failure to progress" by those who do not appreciate art. I tell mothers at this time, "It's normal to feel like the baby is stuck. The baby's head is elongating and getting shaped a little more with each sensation. It will suddenly feel like it has come down." This is exactly what happens.
Given time to mold, the head of the baby suddenly appears. This progression is not linear and does not happen in stations of descent. All those textbook diagrams of a pelvis with little one-centimeter gradations up and down from the ischial spines could only have been put forth by someone who has never felt a baby's forehead passing over his/her rectum!
My full-on pushing urges lasted about two hours, and towards the very end Zari's head descended fairly quickly, exactly as Gloria has described. At this point I was sitting on the toilet and supporting my tissues. Eric says I got very quiet. He thought that labor had stopped. Little did he know that she was starting to crown!


  1. Amazing...I love the comparison of baby's head to art. At the same time I'm frustrated because now I have even more proof of how quick docs are to diagnose a false "failure to progress." :(

    -Jill (nsi)

  2. Great articles :D Thx for bringing them up and comenting :)

  3. Ahh...brings back memories. Hopefully next time I will remember that and not freak out/get impatient as much. =)

  4. Reminds me too of an interesting thing that happened at both my births, right before pushing sensations. I did these involuntary anterior pelvic tilts. Like the opposite of 'curling' the back... As I sat/supported squatted, my abdomen moved forward, and I arched my back. It came in heaves, like the 'throwing down' you describe, but it felt more like I was a marionette and someone was pulling my strings to make me perform a bizarre underwater bellydance...

    My guess is that it was meant to change the inner dimensions of my pelvis to accommodate my babies' head.

    I would be grateful to anyone who can illuminate the specific details of that process, and why I needed to wriggle around like that to accomplish it! :)

    I am just SO glad I was free to do my little bringing-baby-down dance.

  5. Makes me sick sick sick everytime I think about how I was ever possibly suppossed to have my 12 pound son on my back.

    Remembering all the funky dances I had to do when I had my homeboirth, and how rediculously opposite it all was from back-lying.


  6. Learn something new everyday!


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