Hi,

How many of you are encouraged to be hands on?
Is anyone told to be hands on the perineum or just hands on the head?
Are there many mentors encouraging a hands off approach?
Do you think practice differs between the younger mentors and older mentors?
Lastly, what do you think your future choice would be?

Just finding this an interesting area as there are so many differing ideas despite the research....

Ta muchly!

I've never seen anyone practice hands off as yet, and so I've always been encouraged to do the hands on approach. I really dont think i have the confidence to just stand back and watch just yet! I'm aware of the arguments and incidences of perineal trauma (or not!) of both approaches but i guess i need to practice both ways before i make up my own mind. I might be wrong, but i think in our unit hands off is not really encouraged?
x

__________________
Site Administrator, Student Mentor Scheme Manager

STMW 2nd year - no, really!

Please help us raise funds for a bereavement room in Honey's memory by taking part in the SMNET Auction & Raffle here thanks x

Both of my labour ward mentors are a bit old school and generally have hands on.... but I personally prefer hands poised. I have worked with some midwives who are hands poised, and it has given the confidence to do it now. I generally leave my hands well off for the head and body, which is lovely to see a woman push her baby out completely on her own, without someone yanking away at the baby's head. It's a really lovely sight, letting them reach down and deliver the baby themselves. And if it's well controlled I have found no difference in tears, like the research suggests.

__________________
3rd year Student Midwife

The midwives I have worked with have all been hands on, I have been taught to guard the perineum, or to put it another way to protect the baby's from possible faeces when the head is delivered. Also to be hands on during delivery.

I don't have enough experience yet to know which approach I prefer, as I have only learnt one way so far.

__________________
Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

Please help us raise funds for a bereavement room in Honey's memory by taking part in the SMNET Auction & Raffle here thanks x

Nope, its hand on all the way from me too. It seems to be practice here really. I had the honour of working with a midwife once who did not interfere with me not being particularly hands on, which was nice. The woman was having her seventh baby and was pushing beautifully on her own, the birth was very slow and calm, so I did nothing at all, except support and encourage her very slowly and quietly.

The HOOP trial was very flawed, though I haven't read it yet though, just what I have read in other places

__________________

We have an Midwifery Led Care unit alongside the Labour Suite, and it tends to be a straight split between the two - poised on MLC, on on Labour Suite! The only time I've found it vaguely helpful to be really hands on is when the descent of the fetal head has been very rapid. But even then, I have no idea if it made any difference as far as perineal outcome is concerned.

__________________

MM - I was interested reading your quote about protecting the infant from the mothers faeces during birth - I have been told by a midwife at my unit on a training day that contact with the mothers faeces can be beneficial for the infant as they can get a 'dose' of vitamin K from it.

Has anyone else been told this or aware of it? It's the sort of thing that looking back I do wonder if I have dreamt it, so please feel free to tell me to pinch myself!!

__________________
waving, not drowning!!

I certainly haven't been told that, but it would be interesting to see what other's say on it.

__________________
Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

Please help us raise funds for a bereavement room in Honey's memory by taking part in the SMNET Auction & Raffle here thanks x

Well what a good topic!! I do not "guard the perineum" as I imagine a guard to be in full metal clad at the end of the bed!! I know some who warm an anal pad to place on the perineum, but personally, I am hands poised, in particular with a multip (more than one birth) as sometmes those deliveries can be so fast, and its just to stop it coming out really quick, however that said I do not and will not put pressure on the head as it descends to slow it, as I feel, and its researched that this is potentally detrimental to the fetus. I have worked with many midwives throughout my training, and have been repeatadly told to "get my hands on" or "guard that perineum" I calmly tell them that evdence does not support guarding, you know there is a mdwife in leicester who has been followed throughout her practice as in 30 years or so she has barely had a woman with a tear, she is not hands on, but very good at forming relationships with women, and getting women in tune with their bodies, and by her words of advce and support throughout. Needless to say I aspire to be like her!!

__________________


Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

Whether it might be beneficial or not, I think that most women would be mortified if you handed them a baby smeared in their own poop! We have two 'anal pads' in our delivery pack and I use these the just rest against the anus to try to keep baby and poop separated.

__________________