Dear Obstetrician,

Dear Obsetrician, I am a birth educator. I see the full range of women in my work, some women feel safest with midwives in a birth centre. Medical equipment can make them nervous. Some women birth at home, they feel safest there.

But many, many women choose obstetricians – this is how many women feel safest.

This is a big compliment to doctors and I wonder if you have ever thought about this great honour and trust bestowed upon you?

Do you realise the huge influence you have over the path of this precious, life-giving ceremony?

How it starts, unfolds and ends…

Image depicts a ‘birth simulator’

As the days are unfolding close to birth, do you trust her – as strongly as she trusts you?

Do you give her a safe space, with patience and warmth and then keep your hands in your pockets unless in a true emergency?

Do you practise faith and observe with unbiased eyes?

She has come into your space to have her child ‘delivered’ safely.

She fully believes that you have the skills and knowledge to guide and assist her to labour in such a way to lead to the best birth outcome possible.

She does not know that when she steps into a hospital she steps into a world of ‘medical anxiety’, where many staff may unknowingly be harbouring exaggerated fears of the body malfunctioning and her, or the baby, dying. She does not know that this will affect her birth experience.

She does not know that your tension and your doubts, can lead to nervousness in her body and lead her to tighten her body. And that tight, tense bodies lead to slower, restricted descent of babies (have you spent much time reflecting on these somatic and subconscious issues affecting birth?).

(Do you warn your pregnant women that this material is not covered in the hospital-run, antenatal courses?)

She does not know she has a 33.3 % chance of being steered towards major surgery, often times under strong emotional pressure (where the urgent recommendations from medical staff are coming from a concerned and caring place – but are often also mingled with quite a bit of underlying medical fear).

She does not know that most often it is the lead-up care that causes the distress to baby and mother.

When healthy, low risk, women walk into their first appointment, do you or your midwife team members warn her of the high risk of chemical and surgical interventions awaiting her?

Are you a birth enthusiast, a birth passionate?

Have you read widely and passionately in this field? Are you familiar with the extensive work of the worlds’ leading Obstetricians and midwives like Micheal Odent? Ina May Gaskin? Hannah Dahlen? Andrew Bisits? Dr Grantly Dick Read (deceased)?

When you work with a woman, please know that she came to you to be safe and that this can best be achieved by a baby being born naturally and smoothly (unless in the case of a true medical emergency). The body is wise and functions completely differently from what you commonly see – but to see true, pure birth – labour must be allowed to begin, progress and complete – unhindered.

The women I work with, if you allow them, are eager and willing to demonstrate pure birth to you.

And you can become the next world famous OB leading the way in positive birth for women and be eagerly recommended by birth educators like myself 🙂

obstetrician

Sincerely,

Natalie Meade

GradDipC, GradDipPsyc, GradDipEd, Bsc (Hons), CCE, CH

Low Lying Placenta

Worried about your ultrasound? Told you have a low lying placenta?

So many women are told this at their early ultrasounds and then asked to check back at about 32 weeks.

They spend the next 10 weeks of pregnancy worrying and panicking, thinking they may need a caesarean or that there is something “wrong”. Only to be told at the next ultrasounds that “its okay” , “its moved up”.

Congratulations on finding and reading this blog! You will be able to understand the situation now and see that the chances of your placenta being any problem for birth is extremely low – it is most likely that all is very normal and very well 🙂

What IS happening?

Following conception, the placenta implants itself somewhere in your uterus, in no specific position. It may implant low, high, posterior (back) or anterior (front).

In your first and second trimesters, the uterus still has much growing to do, so an ultrasound late in your third trimester (after the uterus has finished growing) will give you and your doctor or midwife a better picture of what’s really going on.

An ultrasound may show that a placenta is near the cervix in early pregnancy. But, only a few women will develop true placenta previa. It is common for the placenta to move away from the cervix as the uterus grows. Only two to five percent of placentas that are “low lying” end up grade three or grade four previas by full term.

If the placenta does remain near or over the bottom of the uterus neck at the cervix, then there can be signs or symptoms to look out for:

Sudden, painless, bright red vaginal loss, usually in the later half of the pregnancy
Painless vaginal bleeding after sex
Uterine cramping with bleeding
Bleeding during labour

How Close To The Cervix Can My Placenta Be?

Doctors have different limits for how low they are happy for the placenta to be before they will tell you that you shouldn’t have a vaginal birth. It can be useful to get second/third opinions on a low placenta if you would like to avoid a caesarean section. Some doctors will be happy with the placenta to be above 2cms (20mm) from the os (cervix) and some prefer 3cms (30mm).

Get informed, find out what distance the placenta is from the cervix and ask your doctor or midwife if they would be willing to support your wishes for a vaginal birth (should it not move, as well as what measurement they want it to be).

What else you can do?

Insist on a tansvaginal scan to get a thoroughly accurate picture of what’s happening.

Transvaginal ultrasound scan is more accurate to assess placenta previa, trans abdominal scan usually over diagnosis it in up to one-fourth of the cases.

MRI: Can clearly outline the location of a placenta previa, but it is much more expensive and less readily available.