I attended one of Jean's study days a couple of years ago. It was a good day. She is very dynamic and passionate about her work. But, some found it a little frustrating that her work is not research based. It is purely anecdotal. Personally I believe she is one of the true "wise women" of our profession, so I we should listen to what she says and learn from her years of experience.

I don't remember everything said on the study day, but a few things do stick in my mind:

She talked about the woman's pelvic shape. In her experience women with flat sacrums are more likely to carry their baby OP. (You can see this pelvic shape when the woman stands side-ways on.) They labour well, but get stuck in second stage. She advocates the woman lies flat on her back and gives a few pushes in this position, which helps the baby down into the pelvis and the woman can then adopt a more upright position for the birth. Personally, I've not been brave enough to try this in the hospital setting!

Another point that she made on the day, that I have carried into my practice, is not to disturb women in the intensity of labour, with small talk and by asking them questions. She suggested having drinks & flannels handy for the woman to easily reach and help herself to, without having to verbalise what she needs and without the partner or midwife saying "do you want a drink?" etc.

On this point, women may not respond to a reasoned argument as to why they should change position during labour, to help the baby to rotate, as has been suggested in some posts. I cared for a women just this weekend whose baby was OP and I did suggest that she turned to all-fours to help the baby to rotate. But, she was having none of it! It took her about an hour to go from 8cm to fully dilated and a further 30 mins until her baby was born. The baby descended OP, but could be seen to be rotating with pushes and was delivered OA. (She was a multip.)

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