Episode 115 - Spinning Babies® with Gail Tully
Mel:
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD. And each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey. Welcome to the great birth rebellion podcast today i have a treat for you if you've been in the midwifery world for a second you will know the name gail tully because she is the creator and midwife behind spinning babies we are going to talk all things spinning babies midwifery and Gail Tully. And in the interest of keeping this podcast free to you, the listener, I would like to take a moment to thank the sponsor of today's podcast, The Birth Sling by Dr. Jess Michaels. The Birth Sling is a new take on an ancient birthing tool designed to support women to remain upright and active during labour and birth, which can decrease the risk of interventions, including cesarean section.
Mel:
[1:12] It's simple and easy to set up without any need to drill holes in the walls or the roof. All you need is a door that can be securely closed. You can do it at home or at hospital, wherever it is you are. This makes it a great labor tool regardless of where you choose to give birth. The birth sling can also be used to support your prenatal exercise and mobility in the months leading up to birth, as well as gently returning to movement in the postpartum period. The Birth Sling by Dr. Jess Michaels can help you feel supported as you intuitively find labor positions that work for you and your baby. Embrace this ancestral wisdom to empower your modern birthing journey. Use the code GBR24 for a 10% discount at thebirthsling.com. All the details are in the show notes. Welcome everybody to today's episode of The Great Birth Rebellion. I'm here with Gail Tully. And Gail, let's jump into it. Who is Gail? And what have you done through your career?
Gail:
[2:19] Wow, let's talk about it. So I often say there are two Gail Tullys. There's the one that people think of when they say are you gail tully and i don't know exactly who that gail tully is i know the one that lives at my house so i'm a i'm a home birth midwife, i'm now involved with spinning babies full-time so i don't go to too many births but i got to go to a little breech birth yesterday so i do get to go to a few breech births the midwives will invite me to come because I have a love for Breach Birth and a lot of focus on it. And, So I was a home birth midwife, and I would go with many midwives.
Gail:
[3:07] I didn't have an apprenticeship, per se, because that wasn't around in those days in my area. So I learned by attending births with whoever would let me come and help. And then parents would ask me to help them. And so I would bring another midwife with me that I had been attending births with them. And that's kind of how we did it here. We'd help each other. I started to ask a question, what makes birth easier, especially about posterior birth? Because after seven years of attending births, I was at the first birth of a posterior baby that wasn't coming out before the mother was asking, why won't this baby come out? And working with her back pain and just wondering what was going on. She had expected to go into labor at night and give birth that morning, and she had told me that's what she was going to do. It just wasn't the morning she expected. So she went through a couple of nights.
Gail:
[4:12] And then she had her baby. The baby rotated on its own and came out. And I was thinking about that birth. I was there as a doula, and I was thinking about that birth. What can we know? Because I had done the four things that were known in the 1980s in my area of what to do.
Gail:
[4:33] And they didn't seem to offer any particular help to this person. And in those days, rocking chairs were like the new innovation in childbirth and the hospitals where she was giving birth. And yeah, so I started to collect things. And when you ask, what did I do for my career? It was really a calling for me. I didn't think about going into a career. I was considering going into nurse midwifery, which in the States is a college degree. And so I got a four-year degree. I was also interested in psychotherapy. And, you know, how do we transform our lives? Birth is a transformation, and there's an inner birth that we go through. My motivation was more of a calling, a relationship, a spiritual calling in a sense that really was about grounding physiology, and getting my ego out of the way as I could attend to the person giving birth. So I would say what I've done for my career is to continuously reflect and let go of assumptions.
Gail:
[5:51] Return to the attitude of how can I be helpful, how can I be of service.
Gail:
[6:00] I really believe that everyone giving birth has that inner wisdom within themselves. And we have a lot of social constructs that hold that down or deny that. And I think labor is a wonderful way of letting that shed away and find that truth inside each of ourselves. And it's a physiology. It's not a mental construct. We have to get rid of the frontal lobe and get into birth in the deeper parts and in our hearts. So that's what has helped me the most in my career, is trying to unlearn and be present.
Mel:
[6:44] So that posterior birth that you mentioned from year seven of your midwifery journey.
Gail:
[6:51] Well, from my doula journey, really. It was 1987, I believe. And, well, the first birth I went to was 1979, and the mother was covered in drapes and had her feet in stirrups. And a little square to show her vagina where the baby came out. But she had spoken to the doctor about not having an episiotomy. And this doctor was about to retire, and he had never attended a birth without an episiotomy. So he went to the sheep farmers in our area and said, how do you help the lambs come out without an episiotomy?
Gail:
[7:38] And I think that's very admirable that he knew that he couldn't go within obstetrics in 1979, not in his town, and find answers. So he went outside his profession and found out the answer. And mostly he needed to know that this is totally possible. And so my friend of the family gave birth without numbing drugs, like without pain medication, without drugs. She wanted natural childbirth with no episiotomy and was able to hold her baby immediately and put the baby to breast, skin to skin. And that was just mind-blowing to the whole hospital staff and changed his paradigm just before he retired.
Mel:
[8:32] So you were around then when birth was very, very different.
Gail:
[8:37] Yeah. Is it? That was just starting.
Mel:
[8:40] Yeah.
Gail:
[8:41] And I gave birth in 77. I was a teenage mom.
Mel:
[8:46] And then. Do you think we're getting better at caring for women in labor or worse?
Gail:
[8:53] Both. Better because there are so many who are caring for birth that are seeking more information. Remember that partners, fathers, had to handcuff themselves to their wives to be present at the birth in the 1970s or threatened to call the newspaper.
Gail:
[9:18] And have the newspaper on the phone while their wives were pushing. And if you weren't married or if you weren't a male partner, what were you going to do? These were 1970s. I had a nurse midwife in a hospital, and so I was seeking a natural childbirth. I had what was considered a natural childbirth. I was one of the few at that time, but that was the 70s for most people. But what's worse is that when this information is so readily available, information about the bagel nerve complex, information about physiology, information about how important skin-to-skin and breastfeeding is and not interrupting the mother-baby-infant connection, with all the information we have about that, it's not universal care. The the data proves so much and there's much about birth that isn't researched right because we have this cul-de-sac kind of an idea of just researching what's already been researched research what's easy to research research single variables we don't have the.
Gail:
[10:41] Because why would you study physiology? That's the human expression of birth. You're supposed to study the interruptions in natural birth and human birth so that you can prove that you're not harming. That's what research is supposed to cover. But what we find is we have to research what's normal, what's natural to our body in order to face industry that would take that away for profit? And to reduce fear. But why is there so much fear in birth? Because there was a lack of understanding of physiology.
Mel:
[11:22] So why did you create Spinning Babies? What inspired you to create this?
Gail:
[11:28] Yeah, it was that exact posterior birth because I wanted to know more about posterior labor. You know, of course, many posterior labors are spontaneous, and the baby rotates eventually, and is born. But some are two, three days long. And some of those babies are not going to come out without a cesarean, and then the cesarean becomes a lifesaver. So what's the difference between this eight-hour posterior labor and this three-day posterior labor. I was very motivated by hearing women say, why didn't my baby come out? What's wrong with me? And that's so heartbreaking to hear someone land on that conclusion about their birth. I wanted to know more I was hearing something that was was disheartening and that is if someone did have a cesarean sometimes the midwife would say whether she was at the birth or not she would say well she was just uptight and you know.
Gail:
[12:46] She has to let go. She has to learn how to let go. So in other words, over in the hospital, the doctor's saying the baby's too big or the pelvis is too small. And over in the home birth, the midwife was saying their thought process was too big, that they've got an issue in their head. One midwife said, and it's a funny saying, there's only room for one head in the pelvis, and it's the baby's. And you know I did pull that line out at a at a professional midwife's birth because she was trying to have a v-back and she was just spinning her head and I finally said it and she laughed and her baby came up but so there is an element of emotion there is an element of of holding back.
Gail:
[13:38] But I think there's more likely when our physiology isn't freed by function, by, let's say, we have an extra amount of tension or sometimes the ligaments get into a twist because of an accident or sports. You know, we're twisting our abdomen and making a sudden jolt. And that can twist the uterine ligaments and so the uterus is now in a twist if you think about a water balloon and if you twist the two parts of a water balloon it make a little waist line in there and the baby can't get through that until you untwist it and.
Gail:
[14:21] This is known in veterinary medicine, but it's just starting to be written about a little bit more now. So we have more opportunities for sudden stops in gravity. That could be a fall, that could be a sports action that causes a little bit of a torsion. And it's usually a little bit that can slow down the birth or send the baby's head off into the other direction. It doesn't necessarily show up on ultrasound. People are, you know, obstetricians are not looking for this. But how do we know this is occurring besides a little uptick in case studies and the literature? We notice that if someone does one of Dr. Carol Phillips' forward-leaning inversions and then comes up.
Gail:
[15:12] This gives the stretch to those ligaments, which means that they're going to lengthen temporarily. And in coming back up, the uterus resets itself. And now it's more aligned with the pelvis. And baby says, oh, thank you. Now I have room to aim my head through, tuck my chin and come out. And we see the success of that. And then we postulate. But it's being studied now. And so it's been a fantastic technique for a variety of situations, helping babies have room to be head down, helping babies have room to be head down and have their chins tucked, which is so important for a straightforward birth.
Gail:
[16:02] So really asking that question, what can help posterior labors be easier?
Gail:
[16:12] Because I felt that the blaming the cesarean on babies that were too big, pelvises that were too small, or women who were too uptight were not correct reasons. I was spending time with women who had the same motivation and the same intention to have a straightforward birth. They wanted, maybe they wanted a home birth or maybe they wanted a natural birth in the hospital. They did the same preparation in general. They took their childbirth class. They took walks. They had support from the community. They had supportive practitioners. They had all the time they needed. And one person would have a, you know, an eight or 12-hour labor and one person would have a two-day, three-day labor. And then Gene Sutton's book came out, Understanding and Teaching Optimal Fetal Positioning. I read that and wept. I was like, I wish I would have known this information. And what I noticed was Gene Sutton's recommendations to sit up on your sits bones, let your belly be forward like a hammock, open the brim in labor by particular birth positions, which were basically sitting up for her. Those were quite effective in the 1990s.
Gail:
[17:36] And I did the workshop because I wanted to check my ideas out with my midwife peers, with other doulas, some of the labor and delivery nurses came. At first, the midwives didn't like me. And there's plenty of midwives that still don't like me. They think I'm meddling, fear-mongering, you know. But what am I doing? I'm saying you have the innate ability to give birth, but our society doesn't support your physiology. Other people are taking care of the mind-body connection of having positive thoughts, of having confidence, but we don't reach confidence until our physiology, our vagal nerve complex, our nervous system, is functioning. If we're in our sympathetic nervous system, fight and flight, activating because we live in a society that is not conducive to human beings, you know.
Gail:
[18:43] And so we can activate the fascia, the connective tissue, the fascia receptors. We can balance the body by helping muscles that are too tight become more long and supple we can help muscles and the neurophysiological system which means the nerves in your muscles the nerves in your connective tissue to communicate better throughout your body so your muscles connect so your legs do what you think they're going to do so your bladder can stop peeing when you're not meaning for it to pee so your pelvic floor is more lively and not so droopy maybe um we can activate this with jiggles and stretches jenny blythe a friend of yours uh brought to spinning babies the jiggle based on much more complex teaching and techniques that she's developed in birth work in Australia. And a lot of that coming from orthobionomy, which is a lovely practice for body work. Very gentle. I think our body work should be very gentle. I think our exercises can be gentle.
Gail:
[20:04] A very nice prenatal yoga with support for alignment using props. Props are not to be considered crutches but rather something to relax one muscle so another one can activate and your body can relax into the pose. And having the prenatal adaptations to yoga that understand alignment and holding a pose for a minute to two and a half minutes sometimes, is going to allow those muscles to lengthen, and now they're going to function more effectively.
Gail:
[20:46] We put out something we call Daily Essentials, which is a video of a friend of mine that's a wonderful yoga teacher. In her pregnancy, going through a system where I thought, what's above, what's below, front and back of the uterus, what are all the players in the community of supporting this body, this pregnant body, and this birth. And if each of them gets some room and some length, we have more ease and more function. We're activating the innate ability in the body because our civilization doesn't. So it makes sense to me.
Mel:
[21:28] Yes. This was something that I wanted to ask about because I'm a home birth midwife as well. And, you know, the language is, yeah, yeah, our bodies are capable, our bodies are strong. And if we just left them alone and don't interfere, then they will give birth. But that's not always what we see because I've seen women use all the physiological birth positioning. they're well healthy as far as as many boxes i can tick
Gail:
[21:56] Yes and.
Mel:
[21:58] As you said before you know then all of a sudden they have these horrifically painful posterior labors that take ages and that require forceps or vacuum or cesareans and episiotomies to help get the babies out and you think man she
Gail:
[22:12] Did everything.
Mel:
[22:13] You know when when they asked me at home what else can i do i'm like you're doing it you're currently doing it
Gail:
[22:19] Why you as a midwife sorry to say because you're lovely melanie but myself too yeah we weren't reading the signs we were missing they were invisible to us and so we're going through the pregnancy with this wonderful person, missing the alarms that say we have some over tension we might have torsion we might have some looseness midwives usually can spot looseness in the abdomen or tension in the abdomen but once we get down in the hips we haven't been taught to spot that, So the body is telling us, the baby is telling us, and we're hours into it waiting for what, distress? Waiting for vital signs to show that there's a problem. This is the problem with physiological breech birth. As a practitioner doesn't know how to listen to the baby or listen to the uterus. And there, the uterus has been talking to us through the whole pregnancy. But we're not taught to listen to that because we have ideology to leave it alone.
Mel:
[23:33] Well, this is what, I mean, this is what we're told. other cultures do put their hands on bellies. In Western cultures, we've lost the skill of touch and massage and actually we're quite scared to touch a woman's belly sometimes.
Gail:
[23:50] It's a crime. It's a crime against midwifery. You as a midwife have the human right, the human heritage, and it is your right to have this knowledge. The hands on touch, the skills for breech birth, the skills for long labor, herbs, all this is your human heritage. It's not owned by a government or a profession. It's your human heritage for this knowledge, women to women, caregiver to caregiver, you know, through the history. Who are the healers and the midwives? This is world heritage. And nobody has the human right to take that away. But we want to have integrity and we want to have skills and we want to be smart. So we have to learn the signs that are not taught in the university.
Mel:
[24:48] What are the signs? What are we looking for, Gail? Because every midwife has just peeked their ears to the podcast and said she's going to tell us what we need to look for.
Gail:
[25:01] We have to see with our hearts, first of all, because we're not going to do it with our frontal lobes. Knowledge is important because it takes what we learn from our heart-to-heart presence. What I mean by being seen from the heart is to be present with this woman. Okay, so now we're present. Our knowledge that we've gained gives us a place to go with our intuition. We have this intuition that if we're not talking about it or giving it words, we might not know how to find out more information or serve this person, find out some nutritional support or some movement support for this person. Okay, so we're being present. And then my question was, if my body felt like her body, what would be going on inside? And that's how I developed the what to do when of spinning babies that had not existed in the world before which people don't get that this it's a kind of a line but it's kind of a circle right so it's a spiral so spinning babies but that's about the baby's rotation not about my thoughts but my thoughts happen to match so.
Gail:
[26:20] What is physiology? That's our question. What is healthy physiology? So if somebody's pregnant and they're in a situation where their body's at risk, that's probably obviously not healthy physiology. We have that extreme. So where can we support physiology and help bring them back? Okay, let's raise their iron. Let's help with nausea. Let's come back to stability in their body.
Gail:
[26:53] What if they have pain in pregnancy? That's often considered to be a normal part of pregnancy. Well, this person can't lay down. They can't walk. You know, if they were out in the savanna with the lions, this would not be considered normal, right? You have to be able to move your body. so why we can go into why they can't but what's more important is how do we help bring about a stability we want a balance of flexibility and stability because that's where the sweet spot is somewhere in between the extremes too much stability you're not in pain until labor starts right and then it's like wow is this pelvis going to move And then if you have so much flexibility, your symphysis is grating when you walk or you're full of aches and pains. And a little bit of each of that. So where is that leia center, that sweet spot in the midst of this journey of pregnancy?
Gail:
[28:02] Well, the body workers teach us about muscles that might not be firing or might be too tight. So we can do a lot with movement. There's a lot of self-care movement a pregnant person can do. And then there's some really gentle techniques that midwives can learn and pass on to the parents.
Gail:
[28:25] Um, so pain, uh, if they can't eat, so is this person under threat psychologically? Are they very anxious? They're not able to sleep. This could have a root in physiology. Do they have distortion in the, uh, it could be pelvic floor, it could be respiratory diaphragm, or it could be the tentorium, which is the pelvic floor of the brain. And these are diaphragms that get twists and then they put on pressures and then that affects the hormones so it really comes back to balanced body let's go to about 30 weeks 26 to 30 weeks 32 weeks depending on is this a first time mom i would expect a little bit earlier is has there been In many babies, well, then 32 weeks would not be surprising that now the baby is moving head down. But we're expecting a vertical baby by the end of the second trimester. We're expecting a head down baby 32 weeks. Does that mean that there's something wrong with breech? Not necessarily. Some breeches are complex and some breeches are perfectly beautiful.
Gail:
[29:41] Some head-down babies have complex births, and some head-down babies come sliding right out. So, breech is not in and of itself the problem, but we do tend to expect that the heavy head of the baby is now going to bring that body head down because gravity works in the womb. It's not a gravity-free zone, people say that, that's silly.
Gail:
[30:11] So we're looking for head down, and if not, is there something that we might notice? Is there a tension? Is there a torsion? If we don't know, but the person goes through the kind of activities that would unwind something that's wound up too tight in their fascia, they do some balancing activities, and baby goes head down, then we reverse understand that it was due to anatomy, the anatomy being in a holding position that wasn't giving the baby space to move head down. What about onset of labor? We're expecting onset of labor somewhere around 41 and a half weeks. If anybody gets a chance to be pregnant that long these days, some people are fine going into the 42nd week and some people are not. We're not just looking at the calendar to tell us oh I have a mother and a sister, who both had babies at 44 weeks, documented pregnancies 44 week pregnancies you know so I have a lived family experience that that can be a thing and those babies came out just fine, I also know somebody who gave birth at 44 weeks and their baby almost didn't make it because it was really post dates, so out!
Gail:
[31:35] Now we're thinking about onset of labor. What's the baby's position? Is baby snuggling down into the brim of the pelvis? Is the shoulder right at the brim? Is the baby matching? The baby's head matches the pelvis like a 3D puzzle because baby's head is longer front to back and pelvises are either longer side to side or longer front to back or some are triangular. So a baby it's going to match that brim to come into the pelvis and they're then they're going to tuck their chin so midwives can tell if they're palpating now this is a doll right and we're holding this up above the pelvis but the pelvis tips forward and the baby comes out forward and And so we find the shoulder right by the brim of the pelvis. So this baby, in fact, you might be seeing it backwards, but this is a baby coming down from the left. The back is on the left, but the head is facing the right, or the head is in occiput lateral, lateral or transverse.
Gail:
[32:47] The baby's facing that hip because that's the most space. So the baby is a puzzle piece to the pelvis. And if the baby is coming in and sitting in a different direction, sometimes their head makes a bridge across. And this is the thing about posterior, is the chin is away from the tummy, the chest of the baby. Putting that long part of the head into the pelvis makes a bit of a brim. And baby's having a hard time descending and rotating through this pelvis now. The pelvic floor can extend the baby more when they come in with the big dome of the pelvis coming onto the pelvic floor first. If the baby tucks its chin, the forehead comes into the pelvic floor opening, which is like a buttonhole, and then the head will turn to drop deeper into the pelvis. The body guides the baby's pathway, and if we can help our anatomy be in balance, It's going to help baby's chin duck. It's going to help baby come through. Now, again, I'll repeat, some posterior babies are born, you know, in 8 hours, 24 hours, 36 hours. But some are related to more pain and longer labor, sometimes a couple of days, sometimes three days, more pressure on the perineal. And the baby's head is trying not only to go through a curve.
Gail:
[34:17] But also to turn at three places, one to get in, one to get through, and one to come out. The baby's head turns in three places, like a key in locking birth. And we're going to lubricate that keyhole. And I guess that could be a sexy reference. But what I mean is fascia, our connective tissue, is hydrated with having enough fluid and having enough movement.
Gail:
[34:47] And it's not that we're shaking the baby out. No, a jiggle is not a shake. But it is the movement of walking, the movement of dancing, the movement of yoga, the movement of breathing, and relaxing our nervous system is going to make the way easier for the baby and more connection in the hormones, right? More confidence. We get our confidence from our physiology. We don't get our physiology from our confidence.
Mel:
[35:19] I'm hearing that there's some real challenges to physiology, potentially just by our modern lifestyle.
Gail:
[35:27] Yeah, it's nobody's fault.
Mel:
[35:29] Yeah.
Gail:
[35:30] We're just doing what everybody else is doing.
Mel:
[35:32] Yes, but as you said, you know, we're in cars, we're sitting on chairs, we're leading excessively sedentary lifestyles, we're not appreciating functional movement, we're not living subsistence lives in a sense that we're bending down and planting and collecting our
Gail:
[35:50] Own vegetables.
Mel:
[35:50] Most of us
Gail:
[35:51] Climbing trees we would be our ankles would be moving and in different directions almost every step right but now we have these hard-soled shoes and over exercises is the other extreme.
Mel:
[36:09] Some of the arguments that I hear against spinning babies is, well, we're pathologizing every pregnancy by trying to apply these strategies to what seems to be a well, healthy woman.
Gail:
[36:23] I'm so glad. I'm so glad that you asked that question.
Mel:
[36:28] You must hear that all the time.
Gail:
[36:31] No, I don't hear it too much. Well, I do often enough, so I know it's out there. Yes. The midwives didn't like me at all, but the doulas brought so much spinning babies into the birth of the midwives started going, how did you do that? They were like, I learned this spinning babies. It's I made up a few of the techniques, but most of the techniques are coming in. What I've done is been the interpreter and the ambassador for lateral knowledge into the birth world, whether it's a midwife, a doctor or a nurse. Okay, so I like to talk about two paradigms. And in birth, we know the paradigm that is sort of like birth is an emergency waiting to happen or birth is an emergence. But let's broaden that paradigm. And we could look at nonviolent communication that puts needs before strategies.
Gail:
[37:35] And if you develop that even more, there's a wonderful person named Yvette Erasmus that I would recommend everybody to listen to this communication, Yvette with a Y, Erasmus. And she talks about communication for connection or communication for control. And if we think that birth is an emergency about to happen, and the shoulder of responsibility is upon the obstetrician, then all the schooling and the expectations, the licensing, the employment on that obstetrician is to control the birth. And we have this idea that there's good and bad when there's control there's if you if you do a good job we have safety if you do a bad job somebody dies or somebody's hurt so good and bad, gets to be part of that kind of control communications now some things needed to be controlled if you are in an emergency we try to control the situation let's get you out of the ocean if you're drowning let's keep you from getting hit by cars if you're crossing the street those you know and I might say to my child stop do not go in that street right and I'm gonna have control communication.
Gail:
[38:58] Connection communication. So as midwives, we want to connect because safety is in the relationship. Home birth midwifery, a lot of safety is developed in our relationship of trust. So connection communication is ideal. And if we're talking about something that somebody could get alarmed about, like a baby that can't get out of the pelvis, well now midwives well let's let's even say that midwifery has a lot of emphasis on trying to give an alternative to the ingrainment of control whether it's in obstetrics or it's hospital birth or it's in corporate birth how you know i don't want to blame it i've met obstetricians who are wonderful midwives, MDs, midwife in disguise. And I met midwives that say I'm a midwife because it was too expensive to go to obstetrics, but I don't like midwifery. So we have a lot of the midwifery is in response to give women an option to that crazy control environment or thinking.
Gail:
[40:12] A lot of home birth midwifery started in response to we want to have a family-centered birth experience then we can't get at the hospital okay so midwifery is often based on against the control and therefore a lot of midwives are looking at anything that doesn't sit well, is it's like talking about posterior birth must be in that paradigm of pathology an emergency waiting to happen because it doesn't fit well in the.
Gail:
[40:53] Just give time and let birth happen. And these are called polarities. These are two values that are important. We must have some control in an emergency. Let's say a cord prolapse. And we ask the person to get in a particular position until the cesarean can be done.
Gail:
[41:14] Well, we could do that with compassion and connection for sure, but we have to take care of an emergency. But over here, we have all these births that can be spontaneous, beautiful experiences of connection if we just keep our pathologizing out of the way, right? And those are two realities and two values that are both true. It's both true. Freedom is a need and structure is a need. Control is sometimes a need. And I guess I would say freedom is a need. But there has to be some emergency birth skills and there has to be a lot of physiological birth skills. We have two human needs. So what we're trying to do is pit one human need against another. And that's ridiculous. Spinning babies gives a third perspective to say, what are the needs that both members are trying to uphold? These are valuable values, human needs.
Gail:
[42:29] How do we have an individual relationship, to the person giving birth and the person being born and attend to their needs. Now they have a, they have a physiology and that physiology might be functioning spontaneously. They might need a little reassurance. They might need a little unpacking of social.
Gail:
[42:57] Social ideas about childbirth. You know, is it safe? And they might need to unpack some of that And that's fine, but we have to take a look at this individual's needs. And if we can support their physiology, then suddenly a lot of those needs are met within. I think there's a social need in birth. I'm not saying that every person giving birth should be able to go out and do it on their own in their, you know, in the laundry room with their kittens. I was one of those that wanted to go and have my baby, just me and my partner. And I had my midwife come after the birth. So I get these needs. We're trying to see another point of view through the idea of good and bad.
Gail:
[43:46] If it's our ideology, it's good. If it's not, it's bad. If we don't understand it, it must be that they're pathologizing. I'm not pathologizing. There is a lot of medical literature on the disadvantages of the posterior fetal position. I am, by ignoring that, I am asking this person to gamble that they're not going to have the difficult, the one-third of those posterior labors that are problematic. I'm going to gamble that they're in the two-thirds that are going to eventually work themselves out. And some of those are going to be at the end of day three. Now, why would I do that? It's because I don't know the signs. It's because I don't know physiology as much as I think I do. That's what I think. That's tough. Yeah.
Mel:
[44:48] I mean, yeah, so that's the dichotomy that we're in, is that some people leave it alone, stop meddling with it, But then there's some serious regrets if you get to the birth and you think, ah, there was some things that I could have done for this woman that we chose not to because I was philosophically stuck believing that nature will just work it out.
Gail:
[45:11] Yes. And those midwives call me and maybe it's about a breech birth. I took the training. I understood that the baby was stuck, but I didn't act because it's against my values to act too soon. And I would rather we had regrets about acting too soon than acting too late. Preparing for birth or doing these physiology techniques in a labor are not on that same level of knowing brief skills. It is.
Gail:
[45:48] Understanding that ease is within our physiology, how can we activate it? Some people will have signs of pain, of delayed onset of labor, of long labor. We could wait until we see those signs. It's better to think, is there an invitation to do something, pain, length, fetal position? Or do we wait for vital signs to go down? Do we wait till the person says what's wrong with my body how come I can't do this like my neighbor did or the midwife to look at this person who's saying is this normal and the midwife wants to say yes some labors are like that but inside is a not sure how this is going to end those are invitations to act yeah.
Mel:
[46:42] And i feel like it's a western midwifery idea not to do anything to prepare the body for birth not that i mean that's the extreme end but traditional cultures did engage in regular sometimes daily um
Gail:
[47:00] Massage bathing foods warm foods jiggling.
Mel:
[47:06] Like you said like shaking the woman's belly shaking her body
Gail:
[47:10] Her buttocks you know we don't teach shaking the belly because there's some nuances in that but uh wonderfully that if you have a relaxed person they're in a nice position for their pelvis to be stable you could jiggle their buttocks and in five minutes the ripples through their connective tissue are going to reach their peritoneum, their broad ligaments, their round ligaments, around the uterus, nobody's touching the belly, you know, you're jiggling this pregnant person's buttocks. And those ripples are going through. You're not shaking because it's osculation that makes the ripples. So if you were to move your hands in a tub of water, what would make ripples and what would make splashes? Figure out your rhythm that makes the ripples and apply that to thighs, buttocks, around the bones of the pelvis sometimes in the back. And that will radiate and ripple through the body, creating wonderful relaxation and helping the nervous system and helping the connections of nerves between the muscles to correct themselves.
Gail:
[48:27] They're the healers within the body, but this is not what we're doing to the body. We're not changing babies. We're not spinning babies. We're creating a movement and whether that's the person doing it in their own body or whether we can be their helper it depends on the technique and the desire of the person and.
Mel:
[48:49] I think I neglected to really give you an opportunity to explain fully what spinning babies is the philosophy behind spinning babies we just delve straight into it
Gail:
[49:01] Midwives create a warm and trusting birth environment by our being present and grounded. Maybe we're knitting, maybe we're sitting quietly listening. The way we breathe, the expression on our face, how we touch.
Gail:
[49:22] We create this sense of safety as well as doulas creating this emotional environment exterior to the person birthing. And what spinning babies is recognizing is that with some activation of the fascial receptors i didn't know they were called fascial receptors when i started this but now there's studies, and what i was looking at is what are the techniques that have lasted the centuries that are around the different regions of the world or new ones coming in through body work that seem to be effective that are easy enough for parents to do themselves or easy enough for a doula or midwife to learn we have spinning babies offers a higher level of training for body workers or people with a hands-on scope of practice like midwives could do some of these and the respect for the nervous system because we don't do this to people we're facilitators so the philosophy of spinning babies is that fetal rotation is a key movement of the baby through the pelvis because we have these different openings in the pelvis in different shapes.
Gail:
[50:33] And muscles and ligaments that are rather not too tight not too loose and not too twisty they don't have to be perfect but there's let's say they're supple let's say they're accommodating now some people have that already.
Gail:
[50:52] Uh, some people don't, and they don't know it. And I don't always know it. I'm not, I don't think I have to assess everybody. If that person is interested in saying, well, some of these techniques are reduce pain and length of labor. And that sounds good to me. They reduce tearing. Uh, they actually, we found that some of them reduce hemorrhage. So uh reduce rectal fistulas um the sideline release and forward leaning version are being researched right now the idea of that is if you have good circulation through your hips you're going to regulate your fluids in your body well you can open up your hips with with different exercises that you learn yourself uh it's the balance between flexibility and stability and helping the fascia to regulate your fluids so we're creating an interior environment, by understanding our own physiology myself as a pregnant mother can attend to my interior environment it's it can be done in a loving relationship with my baby with my body and, With my loving partner, my midwife, my doula, my sister. This is physiology. We understand certain physiology. Get enough rest. Put your feet up.
Gail:
[52:20] Have enough fluids, you know. Why is it okay to attend to a pregnant person's physiology with nutrition and just saying it's good to be walking, but it's meddling to do a sideline release or forward-leaning version? I don't understand that. We're understanding the physiology, we're activating it, whether it's with self-care or midwife assistant or a professional body worker. We have a window of opportunity for our babies to be born. For some people, that window's wide open. Whatever they do, they're having their baby. For some people, that window is not very wide open, and they have a lot to overcome. For whatever reason, their connective tissue is not as flexible by whatever reason that makes fascia more tight than other fascia.
Mel:
[53:18] Yeah. What other objections have you encountered to the spinning babies techniques?
Gail:
[53:26] Um, well, definitely. Is it meddling? Is it, um, is it pathologizing? Babies have been born 120 million years. Why, why should I prepare?
Mel:
[53:40] But I think too, you know, people saying, oh, people, women have been giving birth since the beginning of time without this meddling inverted commas. But midwifery was a hands-on skill historically and there were care techniques and nurturing techniques that probably were applied as in a midwifery you know in a nurturing sense like you said in the same ways you would give a woman good nutrition and you would encourage her to move I think actually historically these kinds of therapies were just part of everybody's pregnancy so
Gail:
[54:24] If we have our midwives saying we just have to trust birth, And birth will take care of itself. And we have so many cesareans that women are now dying because of over-intervention from and subsequent siblings as well, right? Because of problems with placentas and scar tissues and ruptures. Not very often, but as a whole population. So it doesn't make any sense to me. I'm not pathologizing birth, but I'm not ignoring the fact that 100 years ago, there were risks to childbirth that went away because we had good nutrition, blood replacement, infection control, fewer children, more support.
Gail:
[55:19] Better health care, both health care we give ourselves and health care in the medical system. Now, we have worse healthcare. We don't have continuity of care. We don't have the country doctor. We don't have the midwife that gives continuity of care very many places in the world. We have money-making medical systems that separate the types of care. Nobody's talking to one another, and the skills have disappeared. They don't put hands on the belly, and they're doing cesareans left and right. So we have a rise in mortality rate we can we know that if we take a group of nurses we have nurses in our hospitals do you have nurses in your australian hospitals.
Mel:
[56:11] We have nurses yeah we have in australia it's slightly different you train through university to be a midwife and so the birth units and the postnatal ward and the antenatal ward are for the most part filled with midwives.
Gail:
[56:28] Okay.
Mel:
[56:29] Yes. And so you can get maternity nurses sometimes in more rural settings where they need to have a dual qualification, but predominantly if you're a woman going in for pregnancy or birth care, you'll be cared for by a midwife.
Gail:
[56:44] Okay. So in the States, we have labor and delivery nurses. We only, only 9% of American births are attended by a nurse midwife in the hospital and only about one, maybe a little more than 1%, 1.5% of babies are born at home. And most, most of the home births are with midwife.
Gail:
[57:05] And we have different kinds of midwives and different kinds of nurses. So most, so I, so when I say a room full of labor and delivery nurses, I mean, for you, it would be midwives. So we would have nurses, midwives, and a couple of doctors. They'll get a 7-8 hour training in spinning babies approach with some of the basic techniques that we recommend they're not all spinning babies techniques they might be Carol Phillips they might be Jenny Blythe they might be, somebody else's technique. But the understanding of how the baby moves through the pelvis, when do we do what, what do we do first? It varies according to individuals, yes, but there's also some general practicality. They will reduce their cesarean rate consistently. If they say yes to this program and they're on board, 35 to 50% consistently, again and again, hospital after hospital one day training when the midwives or nurses of a hospital take on spinning babies it just takes three of them they can get that cesarean rate down under 10 percent, within a month have.
Mel:
[58:18] You tested have you tested that is that how you know how do you know that's going to happen i'm curious as to what
Gail:
[58:25] The because the nurses come back and tell us mm-hmm like for instance Whittier California three nurses came got the training went back got an eight percent cesarean rate Miami Baptist had a 66 percent cesarean rate you spinning babies brought it down now they brought it down I think 22 percent but in a culture of a 66 percent cesarean rate that's pretty good and.
Mel:
[58:55] So did they take on spinning babies with the intention to reduce their cesarean rate was that yes
Gail:
[59:02] Because the nurses and midwives have had enough they are like there has to be something else i see another person go back for cesarean i just can't believe that this baby's too big or this pelvis is too small again what what can we learn about these babies that are coming into the pelvis a little crooked. They're facing a different way. Their head is just not lined up. We're seeing more and more of that these days for a variety of reasons. But they have to do with how we live in our bodies in this modern day, but also low iodine, poor soil. You know, our nutrition is not as good as it used to be, and birth is a reflection of metabolism.
Mel:
[59:47] Yes. Whoa, okay. I'm trying to work out where to take us next because I realize I've taken already over an hour of your time.
Gail:
[59:54] I am being a fire hose here. You are inspiring me with your openness. And, you know, I'm maybe feeling a little bit of the battle of ignorance, you know, the battle against ignorance to say, activating our physiology is not meddling. It it is the it's welcoming and inviting the innate physiology within our bodies, and we are moving into a new era of understanding better how our nervous system our vagal nerve complex but also our fascia works incredible.
Mel:
[1:00:37] All right let's i'm going to do one more question I'm trying to think what would be what do you think the best question to ask Gail is?
Gail:
[1:00:46] What is the future of birth?
Mel:
[1:00:49] What is the future of birth Gail?
Gail:
[1:00:59] We're seeking a tipping point of bringing physiology first into regular medical practice. Understanding the physiology better and seeing the effects of activating the physiology reduces fear in the midwife and the obstetrician. It opens them up to understanding of birth, where they see birth in ways that they've never seen it before, which reduces their stress. They understand what's going on on the inside so they can help the baby. And by understanding these new indicators and how to apply physiology as a, yes, as an intervention, for sure, in that hospital setting or in the home birth setting, then we're going to see what happens is the person says, I did it. This was my birth and I did it. And I got the support that I wanted. And that's the power of physiology first and I think that we can together reach a tipping point where that becomes normal, Right. Yeah. That's what I think the future of birth is, is we have to normalize it. We have to normalize our bodies, unfortunately.
Mel:
[1:02:19] Normalizing physiology. It's just an extreme idea, Gail. I don't know if I can get on board.
Gail:
[1:02:27] Right. Because where's the money in that?
Mel:
[1:02:32] Believing in our bodies.
Gail:
[1:02:33] I mean, we're going to have to have an advertising campaign. I mean, it's what kind of thoughts are these? These are radical.
Mel:
[1:02:41] It's too much Gail. It's even too much for the great birth rebellion. I mean, we're being, we're being, yeah, tongue in cheek here.
Gail:
[1:02:50] I love the title, the great birth rebellion. And I would say that I am here to bust some ideology because I don't want our, our birth transformation. I want us to rebel. Why? For transformation, But not in response to the rigidity of the system, but rather to the suppleness of our inner beings.
Mel:
[1:03:15] Yes. Nailed it. Amazing. Oh, Gail, thank you so much for your time.
Gail:
[1:03:24] I'm really delighted with your energy and your stand for women and your stand for birth. Thank you so much for the work you do, Melanie.
Mel:
[1:03:35] Oh, thanks, Gail. That means a lot coming from you who's worked so hard.
Gail:
[1:03:40] Yeah, we are.
Mel:
[1:03:42] What's in your future, Gail? What are your plans?
Gail:
[1:03:45] I want to develop the content more. I started the workshops to check with my peers if my ideas about birth made sense to them. And I've been busy for 24 years now, just, you know, figuring out how to fulfill workshop requests, which I've never been able to meet the demand. I need to get the books written so that when I retire, there's a record of what was spinning babies? Because a lot of people say, oh, I did pelvic tilts. I did spinning babies. I did pelvic tilts and it didn't work. It's like, no, that's not. Spinning babies is a whole approach. It's not a particular technique. So when people say I did spinning babies, that's not even the paradigm.
Mel:
[1:04:33] Well, I think they're thinking with this medicalized mindset that it's like a pill, you take the pill, then you get the result. And then if I took the pill, but it didn't work, that means there was something wrong with the pill. Whereas midwifery is different. It's not a magic bullet. And neither is spinning babies in a sense of like you take it three times a day for three months and then this is the result that you're going to get.
Gail:
[1:05:02] It's a connection and we're asking, you know, people do use spinning babies like a method and it's not wrong. It just has so much more potential. So there's potential in that relationship.
Mel:
[1:05:17] Gorgeous. Thank you for your time. And I do have you on again to the Great Birth Rebellion.
Gail:
[1:05:23] I'm here for you. The Great Birth Rebellion. I love your title.
Mel:
[1:05:28] Please write the book, Gail.
Gail:
[1:05:29] Thank you yeah i need people to keep telling me that i did i i made an illustration today for the book so to.
Mel:
[1:05:40] Get access to the resources for each podcast episode join the mailing list at melaniethemidwife.com and to support the work of this podcast wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com follow me mel @melaniethemidwife on socials and the show @theGreatBirthRebellion. All the details are in the show notes.
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