# midwife/home birth & stargazer ?



## AnnJayTwins (Dec 10, 2007)

i have a question for those of you "in the know."

i delivered twins recently and the first was kinda "stuck" in the birth canal despite mymonumental pushes. turns out he was a stargazer", looking up instead of down. The OB turned him and he popped out.

Here's my question: is turning the only response in this situation? If I were having a home birth, would the midwife have turned the baby, or would something else be done?

I've been wondering about this so I'm finally asking "the experts" here!

ETA: by stargazer, i mean facing wrong, as in "not facing the mother's back, but instead is turned toward her abdomen (occiput or cephalic posterior)"


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## Kidzaplenty (Jun 17, 2006)

If baby was facing mom's front, it is called posterior, and I delivered a posterior baby with no help at all, so it can be done.

I believe a "stargazer" is a face coming out first presentation? (But I could be wrong.) That would be most difficult to deliver, though, that too has been delivered without turning for some.


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## Sage.Naissance (Feb 5, 2008)

I imagine it would really depend on how the practitioner felt about the particular situation, I could see it go either way circumstantially. I mean babies certainly can come out that way (I call it 'sunny-side-up'), I know someone who had three come out that way, pushing was hell but they came out.
I guess it would depend if the baby really really really didnt seem to be coming facing up then a midwife would probably turn it, but not if it wasn't necessary.


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## courtenay_e (Sep 1, 2005)

Were you pushing on your back or in semi-reclining? The midwife COULD turn the baby, if she knew how, with her hands, but she would probably change your positions and ask you to move around, do lunges, go on your hands and knees, everybody has their "favorite" way to turn a baby, I think, generally ask you to work with your baby and your body to help THEM work to turn the baby.

In most cases, if the baby doesn't turn, I think they just help mom to push effectively...open the pelvis to it's fullest potential!...and then they give you TIME to push the baby out THAT way.


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## applejuice (Oct 8, 2002)

My ds1 was posterior, deflexed head, with ascynclitism. The midwife reached up at the height of a contraction while I bore down in a hands/knees position and she tilted his head. This took about five or so attempts. It was terribly painful.

I am Not sure if this is the stargazer position you are talking about. A facial presentation is referred to as a "mentum" or chin presentation rather than an occiput, and sometimes indicates a birth defect. The baby's face is often swollen and bruised with this presentation.


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## paquerette (Oct 16, 2004)

From what I read in Thinking Woman's Guide, I understood stargazer to be a variation of breech, where a breech baby's head is tilted up. Goer said that it would be dangerous to attempt a vaginal birth with such a position, as the baby may get stuck by the chin and possibly do a lot of neck damage. I don't think the same issue applies with a head-down baby, though.


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## AnnJayTwins (Dec 10, 2007)

hmmm you raise some good questions. i was pushing for at least 3 hours, maybe more, and my son was real pale when he came out. i was reclined. when they said "stargazer" i thought that meant looking up, but i'm not sure now. he doesn't have any deformities, though he did look like a ringer after birth. he was basically stuck and labor wasn't progressing from 9pm until around 2:45am when he was rotated. at the time i remember thinking what a relief that was when i could finally push him out.

what women you are to be able to push a posterior baby out!
i am very impressed.


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## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *AnnJayTwins* 
what women you are to be able to push a posterior baby out!
i am very impressed.

Well, for me, I have to admit, that my posterior baby was baby #7. I am thinking that that was the reason I could "easily" push him out, my body had already done the "pushing out" six other times. So, I don't really think of it as an accomplishment for me, just a variation of normal.


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## sacredmama (Dec 27, 2007)

My boy was posterier. I attempted a homebirth and after 40 hours and my midwife trying everything she knew, we transferred to the hospital. I pushed him out with some help from pitocin. (I'm one of the only people who is a fan of pitocin!) I'm impressed with myself as well, Thanks!! Do you think your babe might've been posterier? I'm impressed with you, birthing twins!!


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## applejuice (Oct 8, 2002)

Pitocin, like many drugs, is great when it is used judiciously and when needed.

That means it is not given to every woman who shows up at L&D.


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## MotherWillow (Nov 11, 2007)

My DD was born face up or occipital posterior. She was a freestanding birth center birth with a midwife.

The midwife tried and tried to turn her and couldn't get her to turn. It hurt like heck and I finally kicked her and told her to let me alone.









I decided that baby was coming out one way or another LOL. I just moved around into different positions, rocked my hips, and somehow or other managed to push DD out still face up after about 30 minutes or so of pushing. (I think it was 30 minutes, it is all kind of foggy for me because it hurt so bad







)

Out of the four presentations like that they had that month at the center mine was the only successful vaginal delivery. I feel very lucky!


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *paquerette* 
From what I read in Thinking Woman's Guide, I understood stargazer to be a variation of breech, where a breech baby's head is tilted up. Goer said that it would be dangerous to attempt a vaginal birth with such a position, as the baby may get stuck by the chin and possibly do a lot of neck damage. I don't think the same issue applies with a head-down baby, though.

I remember years ago when I trained to be a CCE, a doctor who was experienced in doing breech deliveries lectured to us about breech deliveries; he said that he would wrap the baby's delivered body in a blanket to keep it warm, reach up, pull the arms down, one by one, put his finger in the babies mouth, and flex the baby's chin and head down to prevent this "stargazing", so that the head could be delivered.


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## Sage.Naissance (Feb 5, 2008)

I







a doc who delivers a breech.


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## AnnJayTwins (Dec 10, 2007)

funny - my 2nd twin was delivered breech.
she had been head down, but lifted her little arms over her head.

fortunately this ob felt comfortable w/ vaginal births and didn't just say c-sec like most wouldhave done. later, one of the nurses (initially from NW Africa) said that in her country no doc would do a c-sec, that these births were no big deal.

personally i think that's great except for the small percentage of women who truly eed a life saving measure. my grandnother's sister died in childbirth.


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