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Cori Cross, MD: Insights. This is Expert Insights with the Carl Foundation Hospital. I'm your host, Dr. Kori Cross. Today we are discussing a very exciting topic, spinning babies. Spinning babies is a physiological approach to pregnancy and childbirth that focuses on ways to enhance maternal and fetal positioning with the end goal being an easier birth.

We are joined by two wonderful guests, Liz Munoz, who is a doctorally prepared certified nurse midwife. and a nurse midwifery educator, and April Hine, who is a labor and delivery nurse educator. Thank you both for joining us. Good morning. So let's start by discussing why is there a need for spinning babies?

Can you tell us how and why this technique originated?

Guest 2: So spinning babies has actually been around for many years. But became popular for our hospital when we entered into something with our Illinois Perinatal Quality Collaborative called Promoting Vaginal Birth. And what Spinning Babies is helpful for is it's giving not only the nurse but the patient tools in their basket to help again promote that vaginal birth and decrease the risk of C sections.

Cori Cross, MD: I read a lot about spinning babies because I, although I've had three babies, none of them have been spun. So I needed to educate myself a bit. Could you tell us a little bit about the three principles of spinning babies, which I understand to believe they are balance, gravity, and movement?

Guest 1: Sure. And I can speak a little bit to this, that the three principles, balance, gravity, and movement really look at optimizing the fetal position within the maternal pelvis.

To help facilitate the natural movements, we call them the cardinal movements, of the fetus through the pelvis. And by using the maneuvers or the principles of the program to reposition someone who may or may not have an epidural in use, what we can do with these maneuvers is. Mimic what would happen if someone was up and moving about through their labor.

So it's really about creating the optimal alignment between the baby and the bones of the pregnant person. And if you think of it as teamwork, if you really think of childbirth as teamwork between the two.

Guest 2: Or sometimes more, if you have twins, right, between the

Guest 1: bodies involved, they really do have to work together for the process to go well and spinning babies was really created to promote these movements in people who couldn't move as well with things like epidural in place.

You can use them absolutely in any pregnant person who is already up and moving, you can do these. Movements and positions to release ligaments, for example, that might be tight in the maternal pelvis. So it really can be for anyone, which is nice because in medicine and in childbirth, it's not usually one size fits all.

Cori Cross, MD: Now, is spinning baby something that is done solely when you come to labor and delivery or is this something that you learn in classes while you're pregnant? That's a

Guest 2: great question. We actually really need it to happen while you're still pregnant before you're coming to the hospital to touch on what Liz just said, those ligaments and everything that will help us be able to create more space.

To help our babies descend, that work can begin as soon as the second trimester, basically. And those of us who have had the privilege to carry a baby, we all know that pregnancy can be really uncomfortable also. And so spinning babies and some of the techniques can help with those just everyday discomforts of being pregnant.

So it's really good for both.

Cori Cross, MD: Now, April, you're touching on something that I think I read about, which was called resting smart. And so I was just curious if you could talk a little bit about maybe how our lives are different now than maybe, maybe they were back in the past. And I know Liz, you spoke a little bit about how it's a relationship between the baby and the mother in this birthing process and that moving around was something that.

people did before they were attached to an epidural. Could you talk a little bit about how our lifestyles sort of create this need? Sure.

Guest 1: I'm happy to. Just very simply, we sit a lot more than any other previous generation of humans. Sitting is something that I'm very thankful for as someone who works the desk job.

But you know, your body is not meant to be stationed. Everything within the human body functions better with movement. Anything from digestion to even relaxation really can be improved in specific types of movement. So, what we're doing with programs like spinning babies

Guest 2: or even just encouraging ambulation

Guest 1: or walking during labor is just pushing individuals toward the movement that can benefit them.

And if you think of, it's not only moving the bones and the muscles and the ligaments, but also the fluid within the body. And so much of our bodies are water. But in pregnancy, we have that lovely amniotic fluid to cushion the baby. And so as there's movement, there's also literally spinning of water happening, and it can facilitate not only descent of the baby, but also rotation because

Guest 2: babies are born more easily.

Guest 1: If the back of their head is to the front of the mother's body, we call that occipital anterior position. And so we would love it if every baby would choose to arrive in that position. That is just the way that physiologically can happen with most babies without as much force, for example, pushing. So if we have a baby whose head is turned sideways or rotated posteriorly, spinning babies is another piece that we can use to help again.

Not only help baby come into the pelvis, but be in the best position the baby does. So, you know, when you say spinning babies, people think, like, literally a top spinning, but really it's spinning the fluid. But then the baby joins in and moves a little. Just like we do when we're in the bath through the pool.

Cori Cross, MD: Thank you, Liz. That was great. And I think you touched on this a little bit, but how does this technique really benefit both the baby and the mother? Have you noticed that there are less complications, less need for forceps or C sections since you've introduced spinning babies to your center?

Guest 1: And I'm happy to start with that and then I'll have April add to it if she can.

I, just in my anecdotal experience, yes. What we see when spinning babies is used by the staff. is that we have decreased, not necessarily the use of the epidural, but when it is used because if someone is able to reposition, then maybe the epidural gets placed a little bit later in labor, which again, just allows more time for the baby to get in a great position before movement is changed.

But what we see really with using spinning babies, is that we think that a baby deeper into the pelvis before we start pushing. So it's decreasing the maternal effort. So we don't see the four hours of pushing as frequently. We see more, we see shortened pushing times, which means shortened labor times, which can have big impacts for that family.

From If you push a shorter duration of time, you can have less likelihood of a hemorrhage because your uterus didn't work as hard. So we can see big impacts of something. As simple as encouraging movement during pregnancy and positioning during intercourse.

Cori Cross, MD: That's amazing. April, would you like to add

Guest 2: something?

Yeah, I feel like Liz covered that pretty well, but what we are seeing at Carl specifically, definitely decreased pushing times. And another, like, beautiful thing I'm seeing is just, like, Not only teamwork amongst the nursing staff, but teamwork with the patients. Like, how would you like to try this? What do you think about that?

And just giving so many more options to our patients, giving them that beautiful thing called choice. You know, we are also bringing in other nurses to help facilitate position changes and. Well, what do you think of this? Or it's a lot more collaboration that we're seeing, and it's a beautiful thing.

Cori Cross, MD: Yeah, and as someone who has brought three beautiful children into the world, you can have a wonderful birthing plan, but nature sometimes changes your plan.

And so the more you have tools and people there to help you along the way, I'm sure it's very appreciated by the mothers and actually by the staff to have this to offer. Are there any deliveries that might not qualify for this

Guest 2: technique? We do not typically try to deliver breech babies in the hospital vaginally, and so we probably wouldn't try to spin in the hospital a breech baby.

However, spinning babies is actually very well known for helping turn a breech presentation baby, so that could be something that you could do outside of the hospital. And what about multiples? That's not something we're trying in the hospital right now either, so that's a great question. But again, it's, that doesn't mean that it can't be done outside of the hospital setting to try to ensure even just that the balance and the jiggle aspect of spinning babies, those are all things that could be used for anyone.

But as far as the hospital setting is concerned, any mother with any placental issues, we definitely would not want to spin them. We would definitely proceed for a C section if there were maybe something called a placenta previa. Any contraindications to delivering vaginally we wouldn't be using.

Cori Cross, MD: And that makes perfect sense.

So for women who are interested in spinning babies, is there anything they should be doing before they come to Carle Hospital? Is there a place where they can get sort of plugged into this if this has piqued their interest?

Guest 1: Yes, there's of course the materials that are available on the internet about spinning babies.

There are even videos that you can watch on the Spinney Babies social media and YouTube channels. But we hope to very soon have some patient education available within the clinics at Carle, so that clients have access to this information and can pick it up. at their visit or scan a QR code that might be in the clinic room.

But of course, if they would like to ask their providers or clinicians about spinning babies, they can. The nurse midwives at Carle are very aware of what spinning babies is and have, some have attended the trainings. For example, I attended a training way back when spinning babies was brand new. That would have been in the early 2000s.

But we've all had various degrees of training. But look for more information in the clinic soon.

Guest 2: Liz gave the great avenues of using social media and the Spinning Babies webpage has all sorts of information and even classes that you can sign up for if you are expecting. So, I think Liz covered it very nicely.

Well,

Cori Cross, MD: I'd like to thank our two wonderful guests, Elizabeth Munoz and April Hine, for being here today and sharing their abundant knowledge with us. This has been such an educational conversation. Thank you for being

Guest 1: here. Thank you. Thanks so

Cori Cross, MD: much. For more information and to get connected with one of our providers, please visit www.

carl. org. That's W W W C A R L E Or, for a listing of Carl providers and to view Carl sponsored educational activities, head on over to our website at carlconnect. com. Be sure to check out the entire Expert Insights podcast library for other topics that might be of interest to you. Please remember to subscribe, rate, and review this podcast.

And don't forget, if you found this podcast helpful, please share it on your social channels. And that wraps up this episode of Expert Insights with the Carl Foundation Hospital. I'm Dr. Kori Cross.