Preparing for a Gentle Birth

The Pelvis in Pregnancy

Blandine Calais-Germain, Núria Vives Parés

• Publisher: Healing Arts Press
• Year: 2012
• Print ISBN: 9781594773884
• eBook ISBN: 9781594778131
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

An illustrated hands-on guide to the dynamics of the female pelvis for expectant mothers, midwives, and birth professionals • Provides fully illustrated exercises to help the expectant mother prepare her pelvis for birth and gain confidence in her body's innate ability to birth her child • Details the anatomical intricacies of the female pelvis and its capabilities for expansion and return to its original form • Presents movements and positions to ease discomfort, enhance the productivity of contractions, aid the internal expansion of the pelvis, and prevent and treat issues that may arise such as "failure to progress" The dynamic power of the female pelvis is the key to a gentle birth. Throughout pregnancy, hormones soften the ligaments and joints of the pelvis in preparation for labor, a time when the four bones of the pelvis--the two ilia (hip bones), the coccyx (tailbone), and the sacrum--do their intimate dance of release, rotation, and counter-rotation around the soon-to-be newborn. In this hands-on guide based on 15 years of research and workshops in maternity wards, movement teachers and health professionals Blandine Calais-Germain and Núria Vives Parés detail the anatomical intricacies of the female pelvis and its capabilities for expansion and return to its original form. Providing fully illustrated exercises to help the expectant mother prepare for this pelvic transformation and gain confidence in her body's innate ability to birth her child, they also present a variety of movements and positions for use during the different stages of labor to ease discomfort, enhance the productivity of contractions, aid the internal expansion of the pelvis, and prevent and treat issues that may arise such as "failure to progress." Ideal for the expectant mother and her birthing partner, this book will be a welcome addition to the library of every midwife, obstetrician, doula, and movement professional who teaches pregnant women.

1

WHAT IS THE PELVIS, AND WHAT DOES IT DO?

Our description of the pelvis is not complete but targeted. It is intended to explain the way in which the pelvis moves and changes shape during childbirth. At this time the woman’s pelvis is touched, mobilized, pushed, and pulled.

There are some important landmarks to know, such as the places from which we can influence the shape of the pelvis. But the fetus crosses the pelvis in certain internal areas, and though these areas change shape to adapt, for the most part we cannot touch them.

The general form of the pelvis

The bony pelvis

How we imagine the pelvis

What does the iliac bone look like?

The iliac crest

The front and back of the iliac bone

The ischial spine (back of the iliac bone)

The ischium (bottom of the iliac bone)

The ischium and the iliac crest are part of the same iliac bone

The ischio-pubic ramus

The outlet of the two iliac bones

The sacrum

The anterior sacrum

The coccyx

The bones of the pelvis articulate with one another

The sacroilac joints

The many ligaments around the sacroiliac joint

The pubic symphysis

The pelvis articulates with the neighboring bones

With the spinal column (the sacrolumbar joint)

The hip

The ligaments of the hip are strong

The pelvis is connected to the trunk by many muscles

The hip is covered by numerous muscles

THE GENERAL FORM OF THE PELVIS

The Bony Pelvis

At the union of the trunk and the lower extremities (the legs), the pelvis is like a large bony ring with irregular contours.

On the inside, the pelvis looks like a basin or bowl without a bottom. The “bowl” holds the abdominal viscera. On the outside, the pelvis serves, above all, as a joint for the femurs at the hips. This area is called the exopelvic surface.

The pelvis is made up of four bones:

• The two iliac bones, situated in the front, on the sides, and even a bit in the back
• The sacrum, situated in the back and in the middle
• The coccyx, which extends the sacrum toward the lower part of the pelvis

The sacrum and the coccyx are part of the vertebral column (the spine). The two iliac bones belong with the lower extremities.

Locate on Yourself

The Totality of the Pelvis

To get a rough idea of the volume of your own pelvis, you can feel it with your hands. The area that is easiest to find is the highest part: the iliac crest. You can also feel for the lowest region: the two ischial tuberosities. The anterior part of the pelvis, the pubic symphysis, joins the two iliac bones. And the posterior part, the sacrum, continues lower to form the coccyx.

How We Imagine the Pelvis

Presenting the pelvis might seem superfluous to the professional obstetrician, and off-putting for some women who will read this book in preparation for childbirth. Is it really useful to describe again the structure of the pelvis? We think it is.

For fifteen years, at the beginning of our workshop sessions, we have asked our participants to draw a picture of a pelvis on a blank piece of paper without a model. We have assembled more than eight hundred drawings, almost all of which were done by those having studied the anatomy of the pelvis. Despite the talent of the artist, which we were not concerned with, we concluded that the shape of the pelvis was not well understood— even by those who work daily with this area of the body. We saw that sometimes parts were even omitted. And in some cases it was impossible to imagine the passage of the fetus through the pelvis, or even the movement of its bones.

Often we proposed that participants do another drawing at the end of the workshop, after having seen and touched the model and having felt, palpated, moved, and recogn...

Table of contents

• Cover Image
• Title Page
• Dedication
• Epigraph
• Testimonials
• Table of Contents
• A Note to Doctors, Midwives, and Mothers
• Foreword by Carmen Barona Vilar
• How to Use This Book
• Testimonials
• Introduction: The Pelvis in Motion
• Chapter 1. What Is the Pelvis and What Does It Do?
• Chapter 2. The Parts of the Pelvis
• Chapter 3. How Does the Pelvis Move?
• Chapter 4. How Does the Area around the Pelvis Move?
• Chapter 5. The Pelvis Changes Shape during Childbirth
• Chapter 6. The Principal Positions of Childbirth
• Chapter 7. The Movements and Transformations of the Pelvis
• Chapter 8. The Three Star Positions: Standing, Sitting, Kneeling
• Anatomy of Movement Certification Programs
• Footnotes
• Bibliography
• About the Authors
• About Inner Traditions • Bear & Company
• Books of Related Interest
• Copyright & Permissions