Episode 83: Biomechanics of Birth with Molly O’Brien
Molly O’Brien
Molly O’Brien is an experienced midwife. She’s also been a hypnobirthing instructor, birth preparation teacher, and associate university lecturer. She has campaigned for midwife led birth units and been a passionate student and enabler of physiological birth.
Over the years she witnessed hundreds of undisturbed physiological births working in a Midwife-led unit. She attended home births as part of an integrated midwifery team in a hospital that had a high home birth rate.
Working in these environments and observing a myriad of complex births whilst working in an obstetric unit, gave her the opportunity to systematically examine midwifery skills and observations that can help resolve long difficult labours caused by malposition.
The techniques and strategies that emerged from this time helped her to revolutionise her own practice. She began to regularly witness rapid progress during what would all-too-often be termed “difficult labours”. When people would say “Molly, I see you’ve worked your magic again”, she’d reply, “this is not magic, these techniques and skills are based in science- Biomechanics - the study of human movement, everyone working in the birth world should know this information”. Molly teaches her course ‘Biomechanics for Birth’ all over the world, offering gentle and effective ways of resolving malposition using interventions. This is her contribution to change the narrative in childbirth.
In this episode, we talked about:
Biomechanics is the study of human movement and it isn’t currently applied to the study of birth
Molly has seen many women and birthing people suffer long and difficult births. Her curiosity took her to explore physiology and she started investigating
Molly’s first baby was ‘back-to-back’ and she had a long birth. Her other births were very different, and her third birth was painless
3 main disruptors of the physiological process: fear, medicalisation of birth (attached to drips and monitoring, often on a hospital bed etc, how the baby comes through the pelvis
It’s important to consider biomechanics in pregnancy with more walking and movement . We need the pelvis to be as balanced and healthy as possible
Molly describes a balanced pelvis in regards to having minimal restrictions
Even if the baby is in a ‘sub-optimal’ position, 80% will turn during labour. However it’s possible to avoid a long, difficult labour.
83% of women and birthing people are giving birth on a bed
24% of unassisted births were in lithotomy position (legs in stirrups) - which is biomechanically hindered and against gravity
The impact of falls, knocks and injuries in the lower limbs that causes imbalance in the pelvis and body
Treatment pre-pregnancy or during pregnancy can help to find balance in the body
Choosing a midwife-led unit if possible and use floor mats or birthing balls to facilitate movement
The impact of the environment on the birth process
It can be put in the birth plan to have the bed aside and not the focus of the room. Wireless monitoring if needed and movement
Birth in the community
Campaigning for midwife-led units
Recreating the feeling of safety and comfort of the home environment within a hospital environment
A cosy, warm, oxytocin-enhancing, protected cave
When someone has privacy and autonomy, they instinctively move in ways and positions that relieve tension
There are pelvic-releasing movements that can help, but focus on freedom of movement and trust in the process first
Avoiding replacing a restrictive medical model with prescribing techniques and positions
Understanding how movement of the pelvis opens and changes dimensions and frees the sacrum
The issue of ‘big babies’
Birth as a feminist and political issue. The language that’s used is very discriminatory
Issues with growth charts - are they causing more issues than the problems they are solving?
The language of anatomy is clear and practical and therefore a common thread with other fields
Cephalopelvic Disproportion ‘CPD’ is a rare occurrence but is given as a reason for birth difficulties too often
Moving birth more into the community- an opportunity in the Covid-19 pandemic
The issue of experienced, Independent Midwives not being brought in
Non-hierarchal learning
The importance of fascia, or connective tissue and how it affects other tissues
Margaret Jowitt, author of ‘Dynamic Positions in Birth’ has suggested that the clitoris may have a birthing role and not just as a pleasure centre
Molly’s final tips: walk and move everyday. “Believe in yourself, trust your body. Use a position that feels right for you. Demand a right to move in birth.”
Resources:
Moving For an Easier Birth Course
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Sign up for my free course ‘5 Days to Wellness with Ease’
I hope you’ve enjoyed this episode. Just to let you know, there are now over 80 episodes of Speak From the Body. From next month, there will be 2 episodes a month instead of 4. I’m aware that there is so much content out there and it can be overwhelming to keep on top of it all. I hope you enjoy having more space to breathe and I have some great guests to bring you in the next few months.