Notes From Pelvis Class

On Friday I gained a wealth of knowledge on the subject of women's pelvises, thanks to Gloria Lemay and her fabulous Midwifery Education Classes. Facts I acquired include:

• There are four bones in the pelvis

• The pelvis is not fixed/locked during pregnancy and birth

• The pelvis is fixed/locked in non-pregnant women

• You don't have a pubic bone, you have a pubic joint. It may feel hard, but this is cartilage, not bone.

• Pelvis is not just a pelvis, there’s a whole woman attached to it: legs and spine!

• Pubic arch narrower in a man, wide angle in a woman

• Between the pelvic bones (where sacrum and iliac crest come together and where the two sides of the pubis come together at the front and centre) there are squishy joining places like chewing gum when a woman is pregnant.
  

• During birth these chewing gum joining places of the pelvis open as wide as they need to be for the baby to pass through. It will not open so far as to be floppy, it will just allow the bones to ease out of the way as much as it needs to: will cradle the baby's head as it passes through.

• The three Ps of obstetrics: powers, passage, passenger contrast with the three Ps of midwifery: patience, patience, patience.

• Every woman alive today is the end point of evolution: we are the best that mother nature has designed for birthing babies.

• The medical model talks about two kinds of pelvises: "adequate" and "contracted". Midwifery has two models of pelvises too: "ample" and "could fit a pony through."

• NEVER judge a woman's ability to birth by the shape and size of her body. Best example of this are Pygmy women who average about 4ft in height but birth 8 pound babies. That's the equivalent of a 5ft7 woman giving birth to a 14 pound baby.

• A woman who hasn’t had any surgery on her pelvis will have a pelvis that knows how to birth perfectly.
  

Quote of the class was most definitely "The size & shape of a woman's pelvis is as relevant to birth as the size of her nose." This is because a pregnant woman's pelvis is not fixed, and during birth the "chewing gum" parts of her pelvis will move the bones where they need to go in order to fit whatever sized baby inside needs to come through.

The image above shows the section the baby travels through. You can see the pubic joint which stretches to make the opening bigger if need be.

Thinking about the joints in the pelvis as being like "chewing gum" clarified how the pelvis works, for me. I also found Gloria's timely reminder that a pelvis is not just a pelvis, it's attached to a whole woman transformed my thinking. As silly as it sounds, I did tend to think of the pelvis as a fixed bone, floating in space, hard to imagine such a thing being able to move and open. But realising it is an unfixed set of bones and "chewing gum" inside a woman who moves, made women's anatomical perfection for birth really clear to me:

We also learned about the baby's head being molded during birth and the differences between a neonate's skull and an adult skull. As well as some dos and don'ts birth attendants can take from various obstetric practices during labour.

Prior to class I had read about the pelvis in midwifery textbooks, but always felt more confused about what parts make a pelvis etc. Gloria clarified this for me and made the previously-confusing jargon accessible.

You can learn about pelvises from Gloria by reading this article: Pelvises I have known and loved

Next week we're learning about medical terminiology. For $7.99CAD you can join me in class.