Monday, November 4, 2013

Testimony from a Tummy Team trained Midwife- her personal and professional journey!

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*:( sad. 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!

Some 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 money.

Thank you so much for this work.

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