Leopold's Maneuvers

Today I palpated my first, second and third pregnant belly! It was utterly amazing. I could feel- really, truely feel- those babies move in response to my hands. I could even- sort of- feel where the baby’s head was and how he or she was lying inside its mama! Heads are hard and round. Butts are somewhat softer and almost feel like triangles that fit into the L of your thumb and pointer finger! A friend and somewhat more experienced student, Nicola, suggested I walk my fingers across the belly from left to right (or vice versa) to find the smooth, hard back. The side where the feet, legs and arms lie is more mushy feeling. It was totally cool.

It was almost a shock to watch and really, truly feel the baby move and shift inside. I couldn’t help but think of it as a little alien inside there, settling in and trying to get more comfortable. Telling me to back off or push harder. Making his or her presence known! And then, I have to admit that seen from Alien popped into my head. You know, the one where the alien bursts out of that person’s stomach? These little ones, though, weren’t ready to come out yet and were quite happy to snuggle inside their mamas just a few weeks more.

I definitely need some more practice… I was repeatedly told, “It’s okay to push harder. Really feel where that baby is!” But that advice is slow to sink in. I feel so hesitant, like it may hurt the mom or the baby, even though logically I know it won’t.

Using the side of my hand I palpated down from the umbilicus to each mother’s symphysis pubis utilizing the first mother’s advice to make it more comfortable since it is made of softened cartilage during pregnancy and can be very tender. Then I measured fundal height from the symphysis pubis to the top of the uterus (another mush feeling place). Afterwards we compared what we each measured and had quite a range. Fundal height, an indicator of gestational age in the 3rd trimester, is quite prone to error between different measurers.

Prior to this belly lab, I was kind of wondering when and how I would feel like I was actually learning something. After all, I am now nearing the end of my 2nd of 11 quarters of midwifery school. I should be learning something practical, right?

Well, I’d had a couple of glimpses that we were learning something. On the first day of our first onsite (my midwifery program is hybrid online and onsite) upon first meeting my 12 classmates, we were practicing taking vital signs, doing breast and pelvic exams…on each other! So we got to know each other fast and intimately. Then I had to observe an initial prenatal visit.

And I discovered I knew all the questions to ask and how to perform the complete physical exam! The first physical exam includes:
· Vital signs (temperature, pulse, blood pressure, respiration rate)
· Check overall health (skin, eyes, ears, mouth and nose)
· Check reflexes and edema
· Breast exam
· Bimanual exam
· Speculum exam
· Pelvimetry (Assesses the pelvis to see if there is room for the baby’s head to pass through when it is time to be born. Almost every pelvis has enough room, but we do it to provide first time moms with reassurance that their body is made for birth and everything will probably go just fine.)

Thank goodness I didn’t have to do those physicals, though. I am not sure I am ready.

Leopold’s maneuvers, however, I can handle. Quite happily!