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Walcher's

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Walcher's is thought to first have been described in Italian Obstetric literature but seems to have been more widely known after it was described by Gustav Adolf Walcher in the 1800s. It was a technique used to help reduce the need for high forcep use during birth. Helping to open the Front to back diameter of the pelvis, by moving the pubic symphysis further from the sacral promontary at the back.

Walcher's is best used as the last option for helping a baby to engage at the brim of the pelvis, as it is usually extremely uncomfortable. If a baby is OP, it is more helpful to make space for them to turn into a position where there is more space for them to engage rather than trying to force engagement. Please first try Harmonics, Abdominal lift and Pelvic tilt, walking, sitting and doing circles on a birth ball, stair walking and side stair walking and/or sacral, abdominal and diaphragm release. FLI or open knee chest may also be helpful.

If it is going to help, a difference is usually noticed within 3-4 contractions, if the birthing person is able to hold for this time.

Alternatives include Froggy Walchers and Reverse/Water Walchers which is generally more comfortable due to the support and soothing effect of being in water, also Flying Cow Girl if someone is in the bed and unable to have the legs off the side. Please remain close and supportive at all times when doing this technique as it can be tough on the birthing person, they need a lot of love, care and support here as this technique can be highly effective but tough to endure.

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If the baby is high, they may be over the Pubic Symphysis and not angled into the pelvis or they may be posterior or with their chin not tucked in. If the pelvic inlet is narrow AP then walchers can also help to increase this diameter in the pelvis.

NOT appropriate in pregnancy or if the baby is low in the pelvis. If this is too uncomfortable of the person is hypermobile, they can try Froggy Walchers instead where the legs are supported.

 

Use when the baby is -3 or above and not engaging with strong regular contractions

 

Use for three contractions in a row, holding in between if possible. If things do not improve after this time, it is likely not an engagement issue.

 

Legs hang off the bed from the bottom crease of the buttocks, birthing person is laid back.

If the bed is not high enough to allow the legs to hang freely, a roll of towel, bedding or bolster can be placed under the top of the thighs to help form the position as shown below.

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The arch of the lower back and forward tilting and thus opening of the pelvic brim can be exaggerated by lifting the arms above the head. This also lifts the ribcage to allow for more space for rotation of the baby.

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For the more athletic, there is an adaptation of Walchers using a birth ball to arch over. Though this is a more extreme postion a similar effect can be done with a mattress topper or large blanket or firm pillows rolled up as a larger bolster like with the trochanter roll which can be used directly on the floor if a higher surface is not available. With all techniques, the idea is to bring the knees away from the abdomen to help to tilt the pelvis and open the AP diameter of the pelvic inlet.

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