Tag Archives: Canada

Second stop: Tillsonburg, Ontario

Celebrating Norfolk Roots Midwifery!

Celebrating Norfolk Roots Midwifery!

From Montreal, it was on to Tillsonburg, Ontario, ‘near Toronto’ — because in Canadian terms, within 3 hours is ‘near.’ The places around Tillsonburg are confusingly called things like London, Norwich, and Cambridge. The lovely Norfolk Roots Midwifery team gave me one of their bags to remember my visit. Can’t wait to take it back to Norfolk, England with me!

 

Midwife Joanna Nemrava came from British Columbia to share breech skills!

Midwife Joanna Nemrava came from British Columbia to share breech skills!

Again, the training was attended by midwives who came from various places throughout Canada and the US, including Alberta, British Columbia and Michigan, south of the border. I was privileged to meet Stacia Proefrock, a breech-experienced midwife from south-central Michigan. In addition to attending breech births, Stacia has experience teaching others about physiological breech birth and is the current president of the Michigan Midwives Association – a great person to be in touch with if you would like to organise a study day of your own in this area.

 

Teaching in Tillsonburg; photo: Sheila Stubbs

Teaching in Tillsonburg; photo: Sheila Stubbs

While in Ontario, I picked up a Deverra birth stool for use in teaching and births. The stool is visible in the photo to the right. I love their design, which features a wooden seat and 360º visibility. The Deverra birth stool is also completely portable; the legs unscrew and it comes in its own carry bag. When professionals are making the transition to active breech birth but can’t quite wrap their heads around facilitating a breech birth from behind the woman, I often recommend a birth stool as a good compromise — the woman remains mobile and upright, while the baby emerges facing a direction familiar to the attendant. While other birth stools are available, I am quite happy with this one, another reminder of my trip to Ontario!

At the end of each study day, we spend some time discussing how professionals acquire breech experience when breech births are not very common, including the concept of ‘attracting breeches,’ emerging in my current research. I know several of those attending this study day have sharpened their skills, reflected on the experiences they have already had, and are open to attracting breeches, so I look forward to seeing what happens among this group. Of course, in Ontario, activists have a great model in the Ottawa-based Coalition for Breech Birth and Midwife Dr Betty-Anne Daviss, who have worked together to enable midwife-facilitated breech births in hospitals in that area. Join forces with each other and work together for change!

practising

practising breech manoeuvres

The training was held in the house of author, speaker and birth activist Sheila Stubbs, who holds regular Birth Nerd gatherings in her home. The warmth and sisterhood in this community was very strong, and Sheila reminded me of Norwich’s beloved doula mother, Rachel Graveling. Thankfully, Sheila gave me a signed copy of her book for the Norwich Birth Group lending library.

Thanks also to Christine McGillis, who organised this training in Tillsonburg. ❤️

Tomorrow: On to Philadelphia, and the start of my Father-Daughter road trip!

Shawn

a walk around beautiful Tillsonburg

a walk around beautiful Tillsonburg

First stop: Montreal

Earlier this month (May 2016), I completed a road trip from Montreal to Atlanta to share the results of our international consensus research (Walker et al 2016), explain how it can be used to guide practice and education, and deliver physiological breech birth training based on that research to approximately 130 health professionals and other birth workers.

Wall mural depicting the Maison de naissance, Côte-des-Neiges

Wall mural depicting the Maison de naissance, Côte-des-Neiges

The goal was to enable these professionals to learn new skills, equip them to continue learning using an on-line Virtual Community of Practice, and empower them to disseminate the knowledge to others in their local communities. I met so many wonderful people, and feel confident they will work to extend the availability of skilled support for planned vaginal birth. I am going to tell the story of this amazing road trip in a blog mini-series. I hope you will join us … there is a special surprise at the end! 😉

The first workshop was attended by Certified Midwives from Quebec, Ontario, Maine, and Massachusetts, as well as doulas and CPMs from these communities. In Quebec, midwives work mostly in community settings and are not legally able to attend breech births except in emergencies (undiagnosed). However, some of the midwives have begun to work with obstetricians who will accept planned breech births, and they are working towards woman-centred, physiological care for these women. They also want to ensure emergency skills training is up-to-date, including physiologically-based strategies appropriate to midwifery-led settings.

Certified Midwives Sinclair Harris, Mounia Amine, Sylvie Carignan, and Sylvie Saunier

Certified Midwives Sinclair Harris, Mounia Amine, Sylvie Carignan, and Sylvie Saunier

As physiological breech birth gradually becomes the standard of practice, especially for midwives, breech skills will increasingly be taught by trainers who may or may not have much breech clinical experience themselves, much like they are now. It is therefore important that trainers be able to become ‘qualified’ to teach physiological breech methods, in the same way they teach supine-based emergency delivery techniques, and that they are teaching methods underpinned by research and consensus. Several skills trainers from throughout Quebec attended the workshop, and by using the resources made available, hope to disseminate the training to others in their local communities. I especially enjoyed meeting Sinclair Harris, the grandmother of this midwifery community, who has nurtured so many young midwives and is still actively teaching. Sinclair completed her RN training at St Mary’s in London. ❤️

Anyone in Quebec interested in receiving training

in the facilitation of physiological breech births —

 contact Andrea Houle, the RSFQ Agente de Formation.

(contact form below)

Certified Midwife Bronwen Agnew

Certified Midwife Bronwen Agnew

The midwives told me that use of ‘prayer hands’ in rotational manoeuvres to release the arms struck a chord with them. The shoulder press manoeuvre also made sense, but some midwives felt that the two disctint versions of this manoeuvre needed independent descriptive terms, to capture subtly different techniques which are applicable in various circumstances. This cluster of manoeuvres have been taught as “Frank’s Nudge,” in honour of Frankfurt obstetrician Professor Frank Louwen. But because research indicates eponyms (named after people rather than descriptive terms) can lead to confusion and inadequate documentation, we try to use a description which ‘does what it says on the tin’ in the Breech Birth Network training, and we continually listen to feedback about what works to help novices learn breech better. More on the distinction between these manoeuvres coming up in a future blog …

CPM and doula Rivka Cymbalist with the world's youngest breech catcher

CPM and doula Rivka Cymbalist with the world’s youngest breech catcher

Following the workshop, midwife Bronwen Agnew was kind enough to take me on a tour of the Maison de naissance, Côte-des-Neiges. This local birth centre is housed in a wonderful old rectory building, complete with wooden floors. It reminded me of my grandmother’s house, warm and simple. A beautiful place to give birth! Thank you, Bronwen.

The Montreal workshop was organised by Montreal doula and CPM, Rivka Cymbalist, and held at Studio L’équilibre en mouvement, ave Van Horne, a wonderful venue. We also enjoyed lunch at Rivka’s cafe, Caffe della Pace. Thank you, Rivka and family for your hospitality! If you are ever in Montreal, I also recommend relaxing at La Société Textile, a crafts shop / café where you pay by the hour to hang out, work on your knitting/sewing project, and drink unlimited tea from the kitchen. What more could a midwife ask for?

The current plan is to provide a 2-day breech train-the-trainers course in Toronto in late July / early August 2017, involving myself and some of the midwives who have taken the training this year and will be disseminating the skills in their communities. This is due to abundant feedback from the participants that they would like the training to be longer to allow for more discussion, reflection, fellowship and hands-on practice — of course we support all of the above! Follow this blog or the Breech Birth Network Facebook page to keep updated on our plans.

Tomorrow: Join us as we travel to Tillsonburg, Ontario!

Shawn