Today I am pleased to share with readers this third installment of the interview that Babies and more has done to the gynecologist and psychiatrist Emilio Santyou. On this occasion we have talked with him about some issues about the best posture to give birth, gestational diabetes, the glucose test, the way in which a woman who has lost a pregnancy can face the next one and finally, her recommendations for indispensable readings for the woman who will give birth.
What reason is there for women to stop lying down?
There are two reasons why hospital delivery takes place supine. The first reason is the continuous monitoring of the fetal heart rate. It was invented in the fifties and became widespread in the seventies, in the belief that it was a system for detecting cases of suspected fetal distress.
Continuous monitoring is apparently harmless but involves marked interference in childbirth, on the one hand because of the need to maintain a fixed, immobile posture, because if the woman changes her posture, the probe is removed and stops detecting, and it is also a emotional interference because the attention of the woman and the midwife becomes centered on a machine. The other reason is the supposed priority necessary for the doctor to have a comfortable posture at the time of "removal" of the newborn.
What posture do women prefer that you attend?
I, in the 250 births I have attended at home, encourage women to be guided by their instincts when choosing the position they prefer. I can say that giving birth lying on your back is a rarity. When the woman stops in a free position, she usually chooses other positions: squatting, kneeling, on all fours, sitting in the water cup or sitting in a low seat.
In normal birth in the human species it is not usual to lie on your back. Scientific evidence today allows us to affirm emphatically that childbirth is safer in free posture than in forced posture.
What valid reasons can a doctor give for the face-up delivery?
It should be considered that most of the hospitals are planning to give birth lying on their backs, but this is not a medical reason. The doctor needs the supine position if he has to perform maneuvers such as Kristeler, episiotomy, shoulder rotation in a dystocia, or he has to apply a forceps or a suction cup.
Is gestational diabetes overdiagnosed?
When gestational diabetes goes away with a diet we probably shouldn't have considered it a diagnosis, we should have considered it simply a risk factor.
Keep in mind that the diet with which gestational diabetes is treated is the diet that every pregnant woman should carry out, and not just every pregnant woman, is the diet we should all do: avoid sweets, and minimize other carbohydrates Quick absorption A gestational diabetes that disappears with the diet that, in fact, every pregnant woman should take care of, should not have been named as diabetes, but need a diet; we should not give it a name of disorder; Once disappeared with the diet, it does not influence anything harmful to the baby. We are calling women who are not sick.
The only gestational diabetes that should really be considered a disorder is one that does not go away with the diet and that requires insulin. These do matter to us and it is important to detect them because they can cause problems for the baby.
Should you always have the glucose test?
The glucose test, also known as the O'Sullivan test, consists of administering 50 grams of glucose. The glucose curve should only be performed for those women who are positive in O 'Sullivan. The Spanish Society of Gynecology and Obstetrics recommends that it be performed in the second trimester of pregnancy. In northern European countries, it is performed only in the case of overweight or history, that is, who are overweight, have a body mass index greater than 30, or a history of diabetes of some kind. Each of these two protocols has its advantages: in which it is applied in Spain there will be fewer cases of undetected gestational diabetes; in which it is applied in the United Kingdom, it will "annoy" a smaller number of women.
How can a woman who lost a baby in childbirth or pregnancy face again the gestation of a child without feeling fear?
Spontaneous abortion and the loss of a pregnancy are events that we must understand as something that happens in nature, a seed can produce a beautiful plant or it may not germinate or do so but not progress. Nature is like that. We have no choice but to accept nature as it is.
When a woman has suffered an abortion she needs to go through an emotional process that can be hard, but that is also a maturation process, an acceptance process. The good professional knows how to respect the importance that this process entails for women. A very common mistake on the part of professionals is to try to help forget or try to help minimize this process.
What should be done to help these women?
The mistake he was talking about translates into well-intentioned but wrong phrases such as: "You'll have another baby," "This is nothing," "Forget it." The woman who has suffered an abortion has lived it as something very impressive and very important.
He needs his grieving time, his time to digest it, his time to accept it, and his rituals to give that lost baby the importance it deserves. When that woman has another pregnancy, it will be a different one; it cannot be pretended that a mother replaces a lost child with another child to come. They are different beings and each one must have their place in the minds of their loved ones. Otherwise, certain psychological disorders can occur in the new child or in the parents themselves.
Recommend us the most indispensable books on pregnancy and childbirth.
The book that I recommend today is the compilation of articles that few years ago we made of Doña Consuelo Ruiz Velez-Frías and that we published with the title "To give birth without fear". It is a book that shows from personal experiences and, from specific cases, the reality of what childbirth is lived and enjoyed. It is a book that helps eliminate all the concepts learned and wrong that we have in our society about childbirth. Consuelo Ruiz was my mentor in the assistance of the delivery at home and from her hand I entered this world that I now defend as the best option for normal delivery.
For those with a scientific mindset, all Michel Odent's books seem fabulous. And "The Revolution of the Birth", by Isabel Fernández del Castillo seems very good for women located in the Spanish environment.
So far it is third installment of the interview with Dr. Emilio Santos, I hope it serves to clear as many doubts to our readers as it has helped me to do it. There are many issues related to hospital care that have yet to be treated and we will try to clear them in the future.
