Tuesday, March 3, 2009

Anatomy of the pelvis

Last week at the staff development workshop we went over ways to encourage an active birth and avoid being flat on the back on the vinyl labour table with legs in stirrups while birthing. Its interesting because in Uganda, women are encouraged to walk around and be on their own for most of the birth process, but the moment they feel like pushing, their instincts are silenced and they are pulled up onto that big, black, metal labour table. Things usually go downhill from there.

I knew that I needed to come up with something tangible to combine with what we had discussed last week and remembered one night when we made a pelvis out of paper in our midwifery study group at home. So yesterday I bought a few large pieces of hard paper and this morning we took the paper pelvis I had brought, traced it onto the new paper and during the workshop all of the staff traced, cut, taped and folded their own paper pelvis. That was all that was needed! We all used our pelvis’ to understand the various positions we had practiced last week and point out the elements of the pelvis and how they are involved in the birth process. As I was leavings the workshop, I ran into a few of the midwives who were not able to attend and together with them made more paper pelvis’ and again we got down on the floor and compared the many ways a woman can birth. It really helped with so many of the reasons that are used in Uganda to blame the mother for any problems that come up in the birth process – statements like ‘her pelvis is too small’, or ‘she is too fat’ are often comments used to justify a cesarean section. The paper pelvis helps to show what is actually happening!

Just today Sister Ernestine mentioned a conversation she had with one of the student midwives who had had quite a challenging birth the night before, but made a comment about how she still had much of what she learned in the last few staff development workshops fresh in her mind which made a big difference in her ability to support the birthing mama!

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