Halifax hospital aims to prevent unplanned C-sections through 'empowering' technique

There's a superstition in health care that more babies are born under full moons, and now a Halifax hospital is using a strategy named after the lunar phase to try to deliver more newborns without unplanned caesarean sections.

The so-called full moon circuit is a series of labouring positions meant to result in "shorter labour, less pain, less fetal distress" and encourage "more spontaneous vaginal births," said Jennifer Jollymore, a clinical nurse specialist on the birth unit at the IWK Health Centre.

Jollymore and a charge nurse challenged staff to start using the technique in 2023. Over the course of three months, the IWK's rate of unplanned C-sections — when a baby is born through an incision in the patient's abdomen and uterus — fell to 16 per cent from 24 per cent. While the IWK can't definitively link that drop to the full moon circuit, Jollymore said there's reason for optimism.

"We knew that we were just beginning to sort of capture the potential," Jollymore told CBC Radio's Information Morning Nova Scotia on Tuesday.

The IWK said in a news release it's looking at creating a "full moon challenge toolkit" for other Canadian hospitals in an effort to lower the rate of unplanned C-sections, which it said can put stress on the patient as well as staffing levels.

Frequent position changes

During the full moon circuit, nurses help their patients through a circular sequence of lying on their left side, moving to an upright position, lying on their right side, and finally shifting into a forward-leaning position. The sequence helps labour progress by positioning the baby in the pelvis.

There's simple science behind the technique: gravity. And while it doesn't actually have anything to do with moon phases, it's a fitting name.

"The full moon represents a circle, just like the cervix is a circle and you want to put pressure from the baby's head all around it to help it dilate open," Jollymore explained in a text message. "Plus ... it's a little cheeky, pun intended."

Jollymore said there are a number of reasons that a patient might have a C-section, including having the procedure in previous births. Another cause is labour dystocia, when labour has stopped progressing for any number of reasons.

Working with epidurals

The full moon technique is especially helpful for patients who've had an epidural and may not feel the same need to change labouring positions as people who labour without pain medication, said Jollymore. 

"Discomfort or pain in labour is adaptive; it's telling us what we need to do next," she said. "Unfortunately when we introduce regional anesthesia, our labouring folks are not feeling those same prompts.

"Sometimes epidurals get a bit of a bad reputation for 'slowing things down,' when really ... they're tools and we have to work with them."

In her role, Jollymore helps people prepare for their births, especially those with bad past experiences. She said the response to the full moon approach has been "very positive." 

"Being really active participants in their labour and feeling, you know, that there's things that they can do to help promote their progress is very empowering for people," she said. "They really appreciate it."

There are some 4,500 births every year at the IWK Health Centre.