Quick Reference

A trainer in your pocket!

Gail Tully and the

Spinning Babies
Approved Trainers
Quick Reference Cards
2015 ©Maternity House Publishing, Inc.®
ISBN-13: 978-0-9776793-8-6
Spinning Babies’ Quick Reference: A trainer in your pocket!
Gail Tully, CPM
10545 Humboldt Avenue South
Bloomington, MN 55431
gail@SpinningBabies.com

Cover photo by Philip Perkhov. Prenatal Activities (except Sidelying Release by Chris McBride).
Rebozo series, and upper left, Forward-Leaning Inversion by Tanya Villano Photography. Both pictures on the right for
Forward-Leaning Inversion are by Kaidi Lin. Sidelying Release with Tammy Ryan is by Jennifer Wakefield.
Editing help by the trainers, Rachel Shapiro, and Julietta Appleton; the contribution of friends upholds our highest purpose.

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Prenatal Activities
Daily
• Walk, calf stretch, squat, forward lunge, etc.
• Hip opener, side lunge, leg swings, leg circles, etc.
• Forward-Leaning Inversion*
*Avoid if high blood pressure or other risk of stroke; avoid after eating.

http://spinningbabies.com/start/in-pregnancy/daily-activities/
http://spinningbabies.com/product/daily-essentials-digital-download/

Weekly, or more frequently

• Rebozo sifting on all-fours
• Sidelying Release (myofascial static stretch technique)
• Standing Sacral Release
• Personal needs for balance w/bodywork, chiro, etc.
http://spinningbabies.com/start/in-pregnancy/weekly-activities/
http://spinningbabies.com/product/parent-class-digital-download/

Providers: Make it fun, make it safe. Teach 1-2 activities per visit.
Review previous technique and encourage regular practice.

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How to Do Rebozo Sifting on All-Fours
Carlos and Laura explore making gentle
circling motions with the rebozo scarf.
Photos: Tanya Vallano Photography
This relaxing technique may reduce discomfort from pregnancy weight and
ease fetal rotation in labor. Sift for 5-20 minutes. Ligaments and muscles relax.
1. The rebozo is wrapped around the pregnant woman’s
abdomen, a little above her hips (photo top right).
2. She kneels and rests her upper body on a chair or exercise
ball (birthing ball). Hugging a pillow makes it cozy.
3. The helper’s knees should be close to mother’s hips. Position
hands with thumbs up, wrists straight. Knees are gently bent.
4. The helper lifts the full weight of her belly and makes bicycle-
like circles. Keep the lift steady while jiggling, avoid chafing.
Encourage the mother to breathe into the “hammock.” The sift-
ing rhythm relaxes abdominal muscles and uterine ligaments.
What not to do: Gail Tully does not recommend jerking the cloth to
force baby to change sides. In the case that the baby’s face does not line
up with the chest, a jerk may turn the baby’s head too far. We are not
trying to force baby to change position. It’s the rhythm, not the force.
http://spinningbabies.com/learn-more/techniques/the-fantastic-four/rebozo-sifting/
http://spinningbabies.com/ 2
How to Do a Forward-Leaning Inversion
Move carefully off a firm surface. Have a
helper hold your shoulders at first. Raise
your shoulders when coming up. Photos:
Tanya Vallano, Kaidi Lin, Gail Tully.
The benefit of Forward-Leaning Inversion (FLI) seems to be the static stretch
of uterine ligaments to untwist any potential restriction near the cervix. An
inversion a day may be beneficial with head-down babies as well as breech.*
1. Kneel at the edge of a firm surface: Bed, couch, stairs.
2. Use a helper to avoid a fall. Move carefully and don’t jolt.
3. Walk down with one hand at a time. Helper is guarding you.
4. Then, bend one elbow and rest on it; then bend the other.
5. Tuck your chin. Do not rest weight on your head.
6. Remain for three breaths (about 30 seconds), if able.
7. Walk back up with hands. Push up to a kneeling position.
8. Rise up on knees for 1 breath. Sit on heels to catch breath.
When not to! Avoid with high blood pressure, glaucoma, recent head,
shoulder, or back injury or other health risks. Head pounding may
occur the first few inversions and is not dangerous by itself.
Consult with provider before inverting.
*If baby is not head down by 30-32 weeks, is lying sideways (transverse lie), or
is breech, then doing 5-7 FLIs in 24-48 hours (not 5 daily) might help baby reposition.
Learn more from Dr. Carol Phillips, DC, at www.DynamicBodyBalancing.com
http://spinningbabies.com/learn-more/techniques/the-fantastic-four/Forward-Leaning-inver-
sion/
http://spinningbabies.com/ 3
How to Do a Sidelying Release Properly
Begin SLR on either side; always do both sides for balance.
The helper presses hip firmly against the edge to prevent a fall. Helper turns
to allow leg to hang. Mother’s alignment is what makes this stretch successful.

1. Get ready in steps 1-6: Head is level on a pillow, not tilted.

2. Mother holds a chair or table near the edge of the couch
(or, put bed rail up if in a hospital bed)
3. The mother scoots her hip to 2” (5 cm) from the edge of the
bed. A fully pregnant belly extends over the edge.
4. Shoulders: Top shoulder is straight above the lower shoulder.
5. Legs: The mother straightens her lower leg. Toes are flexed
towards knee. The helper must not pull the leg straight!
6. Hips: The helper holds mother’s hip (front and top; ASIS)
presses snugly down. Goal: Prevent hip and ribs from tilting
back or forward or this won’t work. Slightly rock hip.
7. Doing the passive stretch: The mother lifts her top leg 30
degrees up and brings it forward over her lower leg. The
Tammy Ryan, Spinning Babies Approved
Trainer, shows hand position on hip. top leg drops, hanging loosely towards the floor. Wait 4-10
Mother holds a chair. Hips are not tilting. minutes until leg lengthens. Repeat other side!
Photographer Jennifer Wakefield.
http://spinningbabies.com/learn-more/techniques/the-fantastic-four/sidelying-release/
http://spinningbabies.com/ 4
Fetal Position

Flexion is more important than position.

Position is more important than size.
Babies coming into the pelvis from the
left may be more likely to be flexed.
http://spinningbabies.com/learn-more/baby-positions/belly-mapping/

Pubic bone is
further out
than head

Head is further
out than bone
Tip to tell if baby is overlapping the pubic bone
5
 Belly Mapping
Follow the clues
The firmer side may be the baby’s
Key to the Belly Map back. Is it a smooth back or
bumpy limbs? Limbs are opposite
the back! Is the firmness from a
Firm side = contraction? Check when soft.
Kicks are often opposite the back.
Bulge to the top =
Wiggles may be the hands.
Stronger kicks = K
What is in each quadrant?
Littler wiggles = W Kicks only in upper womb may
mean baby is anterior.
Head = Small parts opposite the back
may be occiput transverse.
Heartbeat =
Small parts on both sides of cen-
Learn more at ter line may mean posterior.
www.SpinningBabies.com/
baby-positions/belly-mapping/ An anterior placenta may cover
parts of the baby hiding the clues.
http://spinningbabies.com/ 6
Where Is Baby? Think in Levels

Inlet is stations -2, -3, -4

The most room is often side-to-side in
the transverse diameter.
Goal: Make room in the back.

Midpelvis is stations -1, 0, +1

Stations of the Pelvis
The most room is in the diagonal.
Goal: Make room to the side.
Outlet is stations +2 and lower
Goal: Make room in all directions.
Feel for baby among the levels:
Inlet - High
Midpelvis - At the spines
Outlet - Low; almost, or can, see baby

Baby turns to fit the pelvis like a puzzle piece dropping into place. Open the pelvis by choosing the
technique or maternal position that opens the pelvic level where baby is waiting. Baby is likely to
rotate and descend, or is more likely to descend if unable to rotate, with regular, strong contractions.
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 Labor Pattern Reveals Level
Symmetrical Labor Pattern: Progression
Asymetrical Pattern: Ask, Where’s baby?
http://spinningbabies.com/
Baby engaged: Progressing labor
• Contractions start mild, gradually stronger and closer
Baby not engaged? Non-progressing characteristics
• Contractions are more intense at 1-3 cm than 8 cm
• Strong contractions that may not dilate cervix
• May, but not always, feel pain on pubis, hips, or midback
Posterior Presentation?
• Double peaking or clustering contractions (lower left)
• Pressure not on cervix, head may not be on cervix
Stall between 5-8 cm (often 7 cm) with no further dilation
• Baby’s head remains facing a hip; occiput transverse
• Strong contractions were regular and then weaken
• May occur after a progressing labor pattern until now
• May follow asymmetrical labor pattern but now regular
Tip: Assess by station (level) rather than rely on dilation.
8
 Inlet: Ask, Is Baby Engaged?

Stations of Inlet: -5, -4, -3, -2

Notice signs that baby is high

• Baby’s head overlaps mother’s pubic bone, or
• Baby is high above pelvis even if not overlapping
• Baby is misengaged and stalled at -2 station (OP in android pelvis)
• Pelvic pain is high-- on pubic bones, in hips, upper lumbar
• Water bag emerges like hour glass during pushing

Asymmetrical or non-progressing labor pattern

• Start-and-stop labor unrelated to dehydration or nighttime
• Contractions are mild and unchanging, or erratic for hours and/or
strong as transition and unrelenting but no dilation
• Seems like transition and so needs assessment

Mom may be in her logical brain, not in instinctual “labor land,”

as the hormonal shift to the midbrain may be less likely if unengaged.
http://spinningbabies.com/ 9
 Inlet: Suggested Solutions
There is already room side-to-side; so open the pelvis front-to-back.
Balance First
• Rebozo sifting, FLI, and SLR
• Standing Sacral (myofascial) Release, Psoas Release

Open the Pelvic Inlet

• Posterior Pelvic Tilt with contractions
• Abdominal Lift and Tuck (attributed to Janie King) through 10 ctx. Rest in between
• All-fours in a birth tub with knees on tub floor and feet completely out of the water

Invert (these solutions are only if -2 station for >2 hours in active labor)
• Open-Knee Chest (knees are hip width apart and thighs far away from spine)
• “Shake the Apples” (jiggle buttocks) w/FLI - See also, Midpelvis Suggested Solutions
• Let contractions rotate baby - this is only safe with a head-down baby
Avoid flipping a head-down baby: Keep inversions under 5 minutes unless there are regular
contractions. If baby is breech, in the last 6-8 weeks, do the breech tilt 10-20 minutes daily.
ROTATION GOALS: Flex head for
Only after trying above, or if an epidural prevents standing engagement. Rotate to LOT for the
gynecoid or platypelloid, to OA or flexed
• Walcher’s off the edge of the raised bed (feet do not touch the floor!)
OP for anthropoid; to LOA for android.
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 Midpelvis: Is Baby in Oblique?

Midpelvis is at stations -1, 0, +1

Baby navigates the midpelvis by the occiput rotating to the oblique (ie., LOA)

Notice the signs that baby is in the midpelvis

Baby’s parietal bones, are near or at, the ischial spines at 0 station

Identify a stall in active labor

• 2-4 hours at any dilation between 5-8 cm with strong ctx
(classic stall in the midpelvis occurs at 7 cm)
• Sagittal sutures remain in the transverse diameter without further descent
(head will rotate after balance and opening if the issue is the pelvic floor;
or, if head remains on ischial spines a manual rotation or cesarean is needed)
• Pressure felt may lead to panic or to maintain control to hold off progress
• If cervix is open more on one side after 5 cm, suspect asynclitism

http://spinningbabies.com/ 11
 Midpelvis: Suggested Solutions
The most room in the midpelvis is the oblique, but the midpelvis can be
opened side-to-side. Soften the pelvic floor, then open the hips and sacrum.

Relax the Pelvic Floor

• Sidelying Release .
• “Shake the Apples” (jiggle buttocks)

Gravity and Movement

• Diagonal lunges while standing
• Invert with open brim and “Shake the Apples” - See also, Inlet: Suggested Solutions

Open the Midpelvis

• Diagonal lunges standing or in bed (both opens and moves)
• Internal rotation of femur (knees in, feet out)
• Peanut ball, or calf in stirrup, on either side; use above tips

Major Interventions
• Epidural may relax pelvic floor for progress – or cause malposition
• Ask provider about availability of a manual rotation to OA
• Rupturing membranes is not helpful if head is in transverse or OP diameter here. ROTATION GOAL: Rotate to LOA.
http://spinningbabies.com/ 12
 Outlet: Is Baby Low?

Outlet is Station +2 and lower

Baby is “almost visible,” or a bit of baby is seen

Baby is just inside

Being fully dilated, or wanting to push, isn’t proof that baby

is in the outlet, or even in the pelvis: Look to station, not dilation.
Is baby low or still high? If high, go back to the Inlet page.

Related issues that aren’t about outlet size include:

• 9.5 cm or a cervical lip
• Perineum has good blood return and is stretching fine (good enough)
and baby is visible but not descending - check for a shoulder at the
inlet, flex the head, or use birth stool.

ROTATION GOAL: Rotate to direct OA.

http://spinningbabies.com/ 13
 Outlet: Suggested Solutions

The most room is front-to-back; but also open side-to-side.

Balance First
• Forward-Leaning Inversion • Sacrotuberous Ligament Release

Open the Pelvic Outlet

• Anterior Pelvic Tilt with contractions (can add to squat)
• If baby is still high during pushing, do a Posterior Pelivc Tilt w/ ctx
• Internal rotation of the femurs during a contraction
• Squats during 3-6 subsequent ctx, with feet flat and knees over ankles

Pushing Tips
• Birth stool and other upright positions to “Make Room for the Baby”
• Respect emotional triggers and give support and privacy
• Stop active pushing: Rest on side, knees closed, pant through 3 ctx
• Directed pushing on birth stool (or toilet), exhale pushing

Rotation Tip
• An OP baby may rotate after the parietal bones pass the tuberosities, open them
Anterior Pelvic Tilt
• Ask provider about manually flexing and rotating baby’s occiput to OA to open outlet
http://spinningbabies.com/ 14
 Cervix: Help Without Force
More important than dilation is the application of the baby’s head.
Help the head apply by opening the pelvis at the level where baby waits.

Balance First
• Release ligaments and muscles that are tight and labor may resume spontaneous progress SIGNS OF PROGRESS
• Softening
Solutions for when there is no further dilation despite the presence of strong contractions • Moves to the front
1. Forward-Leaning Inversion is ideal for cervix. Sidelying Release is ideal for ctx. • Effacement (shortens)
2. Calm the environment, remove distractions. Provide privacy, and a bath, if possible. • Dilation
3. Comfort: Feed the mother! Rest Smart with the pelvic level opened.
Asymmetrical dilation
• Is baby asynclitic in midpelvis? See midpelvis page Rather than pressuring with
Lip (9.5 cm, anterior lip, etc.) Pitocin or Syntocin
• Forward-Leaning Inversion, raise mother’s hips higher than head we address
• Swelling - Same as for lip, apply ice (in glove), homeopathic arnica, gelsemium anatomy and physiology
Scar tissue
• Provider can massage adhesions in labor (with or without evening primrose oil)
with gentle solutions.

Regression? Retro-dilation may occur after water breaks, if baby repositions, or during
extreme stress. Time and good humor help the cervix to open again quickly.
http://spinningbabies.com/ 15
 Review Spinning Babies

Spinning Babies suggests, “Let’s make room for the Baby!”

• Balancing activities during pregnancy may add comfort before and during childbirth
• Mom’s job is to dilate; Baby’s job is to rotate - making baby’s job easier may make mom’s job easier, too
• Balancing in labor can be effective for most, but may not always succeed: overworked core, scoliosis,...
Spinning Babies asks, “Where’s the Baby?”
• Flexion is more important than position
• Baby’s position matters if position stops or delays the descent of baby through the pelvis
• Match the pelvic level to a technique that opens that level and softens the muscles and ligaments to it
Spinning Babies encourages bonding
• Nurture the mother and you nurture the child
• The MotherBaby dyad is physiologically reflective; listen and watch to learn and serve
• Introduce any needed interventions in ways that empower, validate, and support maternal behavior
• Calm the parasympathetic nervous system; wake the maternal brain where birth & breastfeeding flourish
The 3 Principles of Spinning Babies: Balance, Gravity and Movement
• Reduce force and increase ease and comfort through restoration of soft tissue physiology
• Spinning Babies is not a set of techniques; Spinning Babies is an approach to birth
The Most Important Thing Is Love.
http://spinningbabies.com/ 16