As a midwife for many years, we have been coaching women to push in a c-curve with their chin to their chest and their knees up. I have found there is considerable resistance to changing this tradition. I really appreciate the effort The Tummy Team is making to reach out to midwives. I continue to learn from and use the skills and knowledge you shared at the workshop I attended in Spring of 2013.
First I want to give an update on my personal rehab. After the instruction you gave at the workshop and my private Skype sessions, my
diastasis completely closed -- down to 1 finger shallow, and I was able to
wean myself completely off the splint. But daily life and the fact that
the new is not as
good as the original contributed to a slight re-injury at the navel. It
was a good reminder for me to wear my splint whenever I am working.
When I last measured, my waist was 31". I no longer look 7 months
pregnant. I can wear clothes without being concerned with whether my
belly will be concealed....but most importantly, I feel connected to my
own body. It works much better.
Professionally, I assess everyone in my practice
for diastasis. This includes women I see only for Maya massage, who may
or may not be pregnant, and all of the homebirth midwifery clients. I
generally teach the core breath during childbirth classes or at a
prenatal clinic visit. If someone has a major issue I send them to The Tummy Team site and I am now so excited about the online programs as I work many hours from your clinic. Otherwise, I supply them with an abdominal
splint and practice the breathing and other training you gave us in the workshop.
There are two recent case
studies I would like to share with you. This first is a third time mama
who was a professional competitive athlete. With her first baby, she was unable to
push out her first baby after 4.5 hours of pushing, so her doctor used a
vacuum. With the second baby, after 3 hours of pushing, she had a
cesarean. She came to us late in care (34 weeks) with her third. On
initial assessment, I was unable to find the margin of her abdominal
musculature. Her diastasis spanned about 10 inches across, from her ribs
to her pelvis. She was attempting a VBAC. I taught her the core breath, sent
her to get a splint, and referred her to a local PT who also trained with The Tummy Team. She got PT 2x/week for
a month, and then went into labor...It took her 10 minutes to get
completely dilated. She spent the next 4 hours not pushing, but using
position changes, relaxation, visualization, active coaching and support
before her baby was low enough for her to engage her pushing reflex.
She stood up between contractions and squatted during them. And after 30
minutes of that, she gave birth spontaneously at home. No c-curve
pushing! No ankles by her ears! We wrapped her up in the
splint before we even got her back to the bed and she started doing her
core rehab exercises right away.
The second case study was a birth that
happened the very next day. This mama was having her second baby. She
had no diastasis. Her uterus was anteflexed and we used some maneuvering
to help her baby descend into the pelvic inlet (Walcher's technique).
After that, she had 3 contractions with no urge to push as her baby
moved down the birth canal. With the next strong contraction I reached
around her from behind to pull her uterus up and back( as the transverse abdominis should when engaged). While holding her
uterus, I felt her transverse muscle fully engage and wrap around her
like iron as it literally squeezed her baby down. That was the
irresistible urge to push or ejection reflex in action. Her body pushed
like that for 30 minutes (without any support from me) and she gave
birth to a 10 lb baby. So now I understand that the ejection reflex IS
the transverse being stimulated. She only added to the
pushing as much as her body asked her to. She was at risk for post
partum depression, and after I wrapped her up on day 1, her tears
evaporated and she was all smiles. She loves her splint!
women experience the irresistible urge to push and others don't. Could
it be diastasis that causes the failure of the ejection reflex? I love
peeling the layers and exploring the depths.
I am so excited to become a Tummy Team affiliate and further direct my clients to your online programs.This information is so valuable. I
envision sending both pregnant and non pregnant clients your way. I
would still send serious cases to our local PT as needed, but a 6 week series with you and The Tummy Team
to help prepare for birth is a great value. Even though I teach the
basics in my classes, I can't spend that much time on it, and many
people are not integrating the information. As for non-pregnant clients,
if they do not need ongoing PT, your program gives them a lot for the
Thank you so much for this work.