S. A. F. E. stands for Subclavicular Activation for Flexion and Expulsion, a variation of Frank Louwen's technique, which I learned in Ottawa in 2009.
The S. A. F. E. manuever is not force. S. A. F. E. is a physiological activation of the nerves at the site of the thin subclavicular muscles in the dip just under the clavicles where the bra strap or farmer's suspenders would cross.
Adrienne C. Caldwell, friend, advisor on anatomy, and a breech mother herself, is a licensed therapeutic massage therapist. Adrienne gives an anatomical description of stimulation of the nerve signal to create head flexion.
Here's the history of the technique: Dr. Frank Louwen (Frankfurt, Germany,) introduced a manner of bringing out a deflexed breech head when the mother was on hands and knees or "knee-elbow" position. Betty Anne Daviss (Ottawa, Canada) called it Frank's Nudge.
There is a short video from my iphone of me asking Frank Louwen specifically if the push, a touch really, was on the clavicles, and he clearly says "No, never."
I had perceived Frank's Nudge as a quick, brief stimulus in the area of the dip under the collar bone, and not as a shove. The S. A. F. E. maneuver resulted from combining my assumption with Adrienne's genius.
Over time, Frank's Nudge has been renamed the "Shoulder Press." A once gentle movement of baby's shoulders is now too often seen with quite a bit of pushing of the baby's shoulders or even chest in an attempt to get the head out. The continuous shove into the symphysis is sometimes repeated. I perceive dangerous vigor in both the Shoulder Press or "Rock and Roll" an attempt to rock the head out which looks akin to shaking the baby. This is not how Louwen taught it.
The shoulder press is a mechanical approach, not a physiological one. I believe it is worth taking a careful look at the physiology of a more gentle, more safe way of releasing the extended or deflexed breech head in the pelvic outlet.
Adrienne gives a plausible explaination of why a rapid, but relatively gentle jab in the dip underneath the clavicals results in head flexion.
You'll see photos of the first two breech births in which I used this technique. It is a wonderful technique either way. Flexion by the SAFE way is so gentle and instantaneous to free the breech baby's head stuck in the outlet.
This technique does not work if :
A.) The baby's head is stuck at the pelvic inlet. Then, using an index finger go in and turn the chin to the oblique diameter. This turn of the chin allows the head to spontaneously descend to the midpelvis.
B.) If the head is turned in the oblique diameter at the midpelvis flexion can't occur completely. So, turn the chin back to the center, baby's nose will be inline with mother's tailbone, so the head can flex and, now, pass through the outlet. Press on the fundus if waiting for a contraction or the contraction doesn't bring the flexed head.
You are invited to explore free information on SpinningBabies.com. To learn more techniques, buy the Breech Quick Guide ebook at spinningbabies... or take the Breech Basics Online Course, found at our shop at www.SpinningBabies.com
Permission for music given.
Негізгі бет Spinning Babies presents Adrienne Caldwell on a S.A.F.E. Help for the Breech
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