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Perineal Injury and Maternity Practices in Ireland
Pelvic Floor injury in Ireland today
Pelvic floor injury is not a given in childbirth. Mums can stack the odds in their favour of emerging from childbirth whole, healthy and intact.
Perineal trauma in Ireland has become
so common place that women almost expect that they will need some
'help' in this last very important part of birth. Hollywood has
us convinced that all that purple faced pushing is normal. The 2nd
stage of labour becomes a frantic race to get the baby out as quickly
as possible – suggesting to women that their own body is a danger
to their baby. But hang on a minute - your body has grown your baby
from 2 cells to a perfect baby...knowing exactly where each
fingernail should be placed....where your baby's tiny ears should be
placed....down the the perfect number of hair follicles on your
baby's head...with no conscious input from you.....no 'fetus growing'
classes...just the intelligence and wisdom of your body. Your body
knows how to finish the process.
Nobody told this Mother that holding her breath for long periods of time was putting her baby at risk. Nobody told her that 'purple pushing' could damage not only her baby, but her bladder, her pelivc floor and perineum. In fact the antenatal classes encouraged it and other women told her to 'listen to your Midwife - she'll show you how to push'.
There are a number of studies comparing coached vs spontaneous pushing In 2003 the WHO recommended removing coached pushing from practice. Research from 1957 describes the damage to the muscles of the vagina and support ligaments after coached pushing so the new research is reaffirming what we already knew to be the case - that 'purple pushing' is harmful for women and their babies and the more Mums can educate themselves about Irish maternity practices the better. I often hear Mums say not to focus on the birth as it's 'just one day'.....but that's not the case for those women who are living with incontinence for the rest of their lives. Information is power.
Midwife Penny Armstrong describes her experience of episiotomy.
"One becomes accustomed to routines - including cutting of the flesh - and can get in the habit of not questioning their necessity. But if you are not accustomed to it, it is shocking to see vibrant muscle cut. I think of muscles as being strung out on our bones like strings on a cello - vibrating with potential, as if for an extended concert. I dream about a baseball player with his shirt off and the graceful cresting of power tha curves up from teh small of his back, across his shoulders and down his arms. to interrupt that progression of movement is an esthetic crime, and I feel sure we wouldn't do it if it were avoidable. If a professional athlete was on a table in the operating room and if there was no other remedy but surgery, the prospect of cutting his muscles would still be sobering...seeing him prepped and draped, we would know that everything possible had been done....physical therapy, massages, slings...Only then would they resort to the knife. Maybe we don't think of these women's muscles with the same regard because of where they are located. We don't see them crossing and gliding as they make our hips swing; we don't watch them spreading into broad ribbony bands when we squat down. Because we can't see them, maybe we think of them as a static crude vessel fit only for containing entrails, bowels and other oozy organs. Maybe that's what makes them easier to cut... But I have seen the muscles in women. In the delivery room, when the cut was made across three or four major muscle groups, and I've seen them retreat and lie there, shrunk back into themselves, and I felt the same way I would if the athlete's muscles had been cut. The same way I feel when a cellist's string snaps during a concert. The music of the body, the resonance and the potential for rapture are interrupted"