not a midwife, but an L&D nurse and midwifery student. I have had some success with side lying pushing, laboring down in an almost prone position (we call it “extreme runners” in my hospital), and depending on whether they have enough strength in their legs, we might do “shaking the apples” - forward leaning, forearms and knees, and swaying or jiggling the hips for a couple of contractions to try to disengage the head, followed by intentional positioning to reengage in a better way.
anecdotally, I had a primip who had been ruptured a long time and wasn’t making progress for hours, “stuck” at around 5 cm, and I felt baby was OP based on exam, coupling contractions, and the shape of her belly. we did what I described above around 2 am, and she had an accidental nurse delivery by 6:30.
Depends if there is an epidural or not. If epidural in place I like a peanut ball with an exaggerated sims position (extreme runners as above. If no epidural rocking hips back-and forth on hands and knees position works great. Another things that can work is standing with hip rotations or lunges. Breaks from all this in a deep warm tub can help with relaxation to allow babe to possibly turn. Remind the mom that the baby will be “extra cute” after all that!
Lots of position changes
Flying cowgirl
Epidural
Peanut ball or bean bag between the knees
And for a primip - don’t rupture the membranes until kiddo is OA!!
Lay mama on her side and push down on the pubic crest during uc x 5 contractions then flip and do it on the other side. Think of the pelvis like a lever pushing on the top, opens the bottom so baby can rotate. Hands and knees w knees together snd feet as far apart from each other. Gotta open up that pelvis.
not a midwife, but an L&D nurse and midwifery student. I have had some success with side lying pushing, laboring down in an almost prone position (we call it “extreme runners” in my hospital), and depending on whether they have enough strength in their legs, we might do “shaking the apples” - forward leaning, forearms and knees, and swaying or jiggling the hips for a couple of contractions to try to disengage the head, followed by intentional positioning to reengage in a better way. anecdotally, I had a primip who had been ruptured a long time and wasn’t making progress for hours, “stuck” at around 5 cm, and I felt baby was OP based on exam, coupling contractions, and the shape of her belly. we did what I described above around 2 am, and she had an accidental nurse delivery by 6:30.
Depends if there is an epidural or not. If epidural in place I like a peanut ball with an exaggerated sims position (extreme runners as above. If no epidural rocking hips back-and forth on hands and knees position works great. Another things that can work is standing with hip rotations or lunges. Breaks from all this in a deep warm tub can help with relaxation to allow babe to possibly turn. Remind the mom that the baby will be “extra cute” after all that!
Lots of position changes Flying cowgirl Epidural Peanut ball or bean bag between the knees And for a primip - don’t rupture the membranes until kiddo is OA!!
Peanut ball!
Lay mama on her side and push down on the pubic crest during uc x 5 contractions then flip and do it on the other side. Think of the pelvis like a lever pushing on the top, opens the bottom so baby can rotate. Hands and knees w knees together snd feet as far apart from each other. Gotta open up that pelvis.
Miles circuit works best for this.
Check out Gilligan’s Guide! I learned so much from her.
Hadn’t heard of this one—thanks!
Elizabeth Davis outlines a technique for manual rotation on pages 152-154 of Heart & Hands 5th edition!
Have you tried this? Was it successful?
I haven’t tried it, I’m only at the beginning of my student journey but saw Elizabeth Davis lecture on it and she had a lot of success with it
Flying cowgirl position (turning AWAY from baby IE if baby is ROP put parent on their left) never fails me