A mute but informative demonstraton...

That was very interesting.

Thanks J ™

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Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

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This really illustrates how difficult it is for the baby to pass through the pelvis in this position.

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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

Deep Transverse Arrest is horrific, but that video really doesn't illustrate the genuine difficulties of an occiput posterior starting position. Let's look at the FACTS (as far as they are known) about OP. (Evidence-based statements from Penny Simkin, Occiput Posterior: How Little We Know)

OP at onset of labor: various estimates, from 15% to 24% to 32% (mixed parities)

OP at birth: 5.5% overall; 7% for primips; 4% for multips

Fetuses change position frequently in labor from OP to OT or OA and back again (Lieberman, ‘05)

– BUT 68% of OP at del were OA at onset of labor (Gardberg)

Most fetuses who are OP at onset of labor will rotate to OA before birth

Only 5% of fetuses are OP at birth.

What is the incidence of DTA? And what is the purpose of bouncing the hand up and down on the doll? The pelvis looks to me like a normal gynaecoid pelvis, and they have 'struggled' to get it into a transverse position to demonstrate DTA. The fetus take the path of least resistence in the pelvis. If they had used a platypelloid in which there was no resistence to the descent in transverse, the DTA would be more realistic....but that can happen from either OA or OP starting point in that type of pelvis.

Wow you know your stuff!!
have you a better video you could recommend???
If so a link for it would be greatly appreciated x

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I don't know of a video, but you don't really need a video to understand that birth mechanism is controlled by the relation of forces between fetal skull (in cephalic presentatin) and pelvis (bony pelvis and the soft tissues), and that this relationship is responsible for both flexion and rotation. For types of pelvis see Frye, Holistic Midwifery I (antenatal care), p. 464 [I don't go along with her clinical pelvimetry, but this is a very good diagram of the differences in pelvic types, not just the brim, but along other planes/axes.