Breech Presentation

I recently attended a HypnoBirthing study day. For those of you unfamiliar with HypnoBirthing it is antenatal teaching deep relaxation, visualisation and breathing exercises which allow mothers to birth their babies calmly and comfortably. For more information please see my website. www.apexpractice.co.uk

One of the lectures was from a wonderful midwife called Mary, she must have been in her sixties and her midwifery stories dated back over the last thirty-five years. Mary works as an independent midwife caring for mothers in their homes and will confidently deliver babies known to be in a breech position. That is head up rather than head down. Her approach is rather unusual these days, many health trusts will do an elective caesarian section of a breech presentation and will discourage mothers from a normal vaginal delivery of a breeched baby. Please note though, that if a woman wishes to have her breeched baby delivered vaginally the hospitals have a duty of care to provide a midwife who will deliver her. Though in practice, pregnant women are vulnerable and are easily swayed towards a caesarian section.

The reason for preferring a caesarian section is that it is deemed safer because the umbilical cord never gets squashed. Let me explain, when a baby descends head first through the pelvis and vagina, the cord which is attached to the placenta in the top of the womb, is trailing behind. The cord, supplying oxygen to the baby only emerges with the baby's body which is very much smaller than the head and at no time is the cord squashed. If the baby descends body first, the cord is up past the head and if is it squashed by the head the oxygen supply to the baby is cut off. Usually, the time without oxygen is short and the baby is fine. There are rare occasions that the cord can be squashed long enough to harm the baby. To avoid this rare occurrence hospitals do caesarian sections, which unfortunately are much more harmful to the mother than a normal vaginal delivery.

So, a midwife undertaking to deliver a breeched baby at home is unusual these days. However, Mary's attitude is that, if the baby is descending nicely then there is nothing to worry about; the baby can be delivered safely at home. And, if the baby is not descending nicely there is no rush, the mother needs to be taken to hospital for a caesarian section; in neither case is the baby endangered. The preference for elective caesarean section has meant that now few midwives are confident and skilled in delivering breeched babies. This is something that Mary is trying to redress with her training day on breech presentations entitled 'A Day at the Breech'.

The Triune Brain

I spent the weekend reading ‘A General Theory of Love’ by Tomas Lewis, a psychiatrist. He writes beautifully; it’s the sort of engaging, readable popular science book that I just find irresistible. Fortunately there seems to be a never ending stream of these books; enough to keep me satisfied for a long time.

Lewis describes the brain as ‘triune’. That is to say, split into three parts, the reptilian, the mammalian and the human brains.

The reptilian brain is the brain stem: this part of us has existed, in evolutionary terms, before we even became mammals. It is responsible for the regulation of our bodily systems, heart rate, breathing rate, hormone levels and so on.

The next part is the mammalian brain. This is the limbic system wrapped around the top of the brainstem and tucked underneath the big outer part. The limbic system is the bit that is difficult to make sense of in diagrams of the brain and is responsible for our emotions. This part allowed emerging mammals to care for offspring and form communities.

The final part is the human brain which is the largest part. The big outer layer of grey cells with its delicate convolutions and complex white matter is the image that people think of when they think ‘brain’. This is the thinking part, the part that gives us language, maths and abstract thought.

Ever wondered why one can think one thing and feel another? Why they seem so separate? The answer is because they are. They are entirely different sections of the brain. It is the emotional, mammalian brain that gives rise to our emotions. ‘Emotion’ is derived from the Latin word to move. It is our emotions, not our thoughts, which generate our actions on the whole. This is why self-help books rarely work (reading is a human brain activity) and strategies like hypnosis really do. By appealing directly to the emotional brain under hypnosis it is possible to bring about change in behaviour quickly.