I am 7 weeks pregnant due November 15 with my second child. My first child was born 2 days early. I had a 14 hour labor. Water broke in the morning, I was at the hospital within 1 hour of it breaking.. They started an epidural within an hour of arrival. Pitocin was hung within 1 hour of epidural. I started pushing at 8PM delivered at 10 PM. He spent a lot of time rocking back and forth right in the edge of the birth canal. We could see his head and hair for most of the time I pushed. I just couldn't get him to advance. She got forceps and literally he was out in less than 30 seconds. I felt his head come out with the tearing, then I felt his shoulder pop as she pulled him the rest of the way out. She no longer delivers babies, only gyn work. They did lots of pressing on my belly, lots of legs up around my ears. I did tons of vomiting during the 2 hours of pushing. My son was then delivered with forceps. I broke his clavicle and had a 3rd degree tear.
I do not want this birth to look anything like that. I switched medical practices. I am seeing only the 3 midwives not the OBs. I saw the first one today. She informed me that the OBs in this area would strongly recommend a c-section. I told her I want to avoid an epidural and pitocin at all costs. I really do not want a c section. Frankly, I am completely blindsided by this conversation. I did not expect to hear a midwife suggest c section. Is it really standard to say c section after the kind of birth I had?
I really think that the forceps were because I had the epidural and was flat on my back for 12 hours of the labor. Baby couldn't get properly positioned. He was born posterior. So any advice? I am at an absolute loss of what to do. I don't want a c section, forceps or epidural.
I am going for a second opinion at my original office (the one that delivered my first son) tomorrow. I live in a very small town. I could drive 45 min to a different town but that worries me for delivery. So I was thinking finding a doula from that town to come support me would be a better option.
I've done some reading up on shoulder dystocia and it appears that is a bit of a serious thing. I honestly did not realize it could be such a big deal. I know my pediatrician was really upset about it. He said they should have called him in the night of my delivery and they did not do so. I really do not think c section is a good idea though. Am I being naive? I just really think since I birthed a good sized baby first, we should be fine. Especially if I stay away from pit and an epidural.
Wow! That's sounds like a lot of things that didn't need to be done. I say if the midwives are already mentioning c-section I would switch providers ASAP. I bet everything that happened to you could have been avoided had you been able to move around and change positions. I suggest find a home birth midwife and go that route unless you are still planning on getting the epidural then go with a different medical provider. to be honest going without an epidural will be your best bet on getting a birth with out all the interventions. My first was induced, epidural, ending with a vacuum and 3rd degree tear. My second birth, a hospital birth at the same hospital, completely natural spontaneous labor, walked around and did what felt good for the 2 hours I was there, and pushed out with a second degree episiotimy after about 20 minutes, tops,of pushing. I think everything that happened with my first birth was due to all the interventions.
DS1-7/18/08, DS2-2/23/10, DS3 1/18/12
TTC in fall/winter of 2014
Hi and welcome! Congratulations on your pregnancy!
It sounds like you had a pretty serious shoulder dystocia and they had to use several techniques to help get baby out. A true shoulder dystocia is one of the scariest complications that can come up in a delivery. The important thing though it that baby did come out!
A genuine dystocia is rare (but serious). How much did your first baby weigh? Did you have diabetes (I only ask because in a healthy environment it is rare for a baby to be "too big", but diabetes can essentially make the baby bigger than it was *supposed* to be).
I totally agree that the epi and laying down during your labor might have affected the positioning on your baby. And they certainly didn't help with any optimal positioning.
I had an undiagnosed dystocia with my first. The doctor only realized how serious his "sticky shoulders" had been afterward when we discovered his fractured clavicle. He was 10lb 6oz. My next two babies were precipitous and weighed 9lb 13oz and 10lb 6oz again, delivered with no trouble. My fourth had a "body dystocia" lol. She was 12lbs, but wasn't actually stuck, I just had to keep pushing - nothing just slipped out! (no diabetes)
I guess all this is a long way of saying it might be ok. I think a reasonable approach would be to keep an eye on baby's growth and play it by ear at this point. (I know someone who had a serious dystocia with an 8lb 3oz baby, then it became obvious her second was WAY bigger, she had the c/s for a close to 10lb baby - which I think was a good call, but would have likely been unnecessary if baby had been 7lbs). If growth seems ok, and your mw are comfortable with going for a vag birth, then do that with lots of focus on positioning.
I completely understand not wanting a c/s, I was very much against it myself, and am sooo grateful to never have needed one.
Keep us posted on how things go and feel free to chime in anytime!
ETA Some positions are better than others for dealing with or preventing a dystocia... Hands and knees is good. As you know pulling the legs way up helps. And of course, generally being mobile during labor always helps
Last edited by kris_w; 03-29-2011 at 09:31 PM.
As PP's have mentioned, I would be terribly hesitant with any medical practitioner who mentions c-section when your only 7 weeks. C-sections 'should' be used only in extreme cases where there are considerable obstacles that can't be overcome. I've never had a baby with shoulder dystocia, but my first was poorly positioned so I know how much of a beast that can be!
Honestly I think your on the right path as it is, staying informed and positive, so long as you know what YOU want out of your birth experience it shouldn't be hard to find a way to achieve it. Clearly you know already where things went wrong with your last, and avoiding that is the first step on the road to a happier birth experience.
As far as the midwife, was she saying that the OB's of that practice would push for a section? Or that she thought you ought to consider a section? If the first is more accurate she could have been trying to prepare you for the uphill 'battle' many women face trying to achieve natural childbirth. If the second is more accurate... run... LOL
I hope everything works out for you, and Congrats on your little one! Stick around and say hi, all the ladies around here are GREAT for support!
Adam and Eirinn
Ashleigh Jun 3 2000, Mackenzie Sept 21 2001, Jayde Jul 9 2006, and Liam Jun 9 2011
This was my first reaction to your post.As far as the midwife, was she saying that the OB's of that practice would push for a section? ...she could have been trying to prepare you for the uphill 'battle' many women face trying to achieve natural childbirth.
This too! But do keep researching as your pregnancy advances. Finding a compatible doula is an excellent idea.I think a reasonable approach would be to keep an eye on baby's growth and play it by ear at this point.
Ivy (4) visits Nana
Congratulations on your new pregnancy! I think the PP made a lot of good points. Personally, I'd keep an eye on baby's growth and see if you can try to go naturally. I recall reading somewhere that positioning can make a huge difference. I'm not entirely sure the number is correct, but I think I saw that pushing squatting can open the pelvis an additional inch over pushing semi-reclined. Anyone know if that's true?
I've never had a baby with shoulder dystocia, but my Dec '07 baby got "stuck" in about the same place and ended up needing a vacuum (water broken, induced, with epi, pushing semi-reclined, 3rd degree tearing). In our case it was because he had his hand up by his face. It was tough and scary and he needed oxygen then ended up in NICU for a few hours. But, he did come out and my second delivery (with an identically sized baby without the hand by the face) went smoothly naturally even though I pushed semi-relcined again (what the Ob wanted). This time am seeing a MW who discourages that postion.
big boy 12.8.07 @ 39+2 7lbs 8oz, 20.5" BFed for 13 months
middle boy 8.12.09 @ 39+4 7lbs 9oz, 21" BFed for 13.5 months
little boy 4.26.11 @ 38+4 6lbs 14oz, 19.5" BFed for 26 months
baby boy 10.25.13 @ 41+0 8lbs 15oz, 21.5"
8.16.12 & 12.16.12
How big was your son who got stuck? Pushing in a semi-reclined position can close your pelvis off by as much as 30%. Ina May Gaskin has a maneuverer that they use for shoulder dystocia called the Gaskin maneuverer. I would make sure your midwives are aware of this and know how to do it. I would just watch babies growth and have a good team of care providers that won't force you onto your back for pushing. Like the other's said I am unsure about the comments from the mw at this point. I would ask them specifically how they feel about it.
Christy birth doula, Hypnobabies instructor, small business owner & most importantly MOMMY.
Do you feel like your midwives are going to push for a medicalized-type birth OR like others said above - they are just warning you? Something that I consider "normal" for midwives (and of course there are exceptions) is that they will help you try new positions and natural methods BEFORE medical alternatives including c/s. Since the midwives are seeing you, it doesn't seem as though they have passed your off to OB care and said they can not handle your delivery. In my two experiences, if the MW's had decided I couldn't medically have a natural birth, they would have transfered my care immediately.
I highly encourage hands and knees position. I delivered in the hospital with the bed tilted up. I was on my knees and holding on to the top of the bed. I delivered a posterior baby pretty quickly this way. She wasn't overly large or anything, just posterior yet quick to make an appearance. I'm not sure I'd ever agree to delivering on my back if I didn't absolutely have to.
I'm going to be a odd one out & say that I doubt you had a true shoulder dystocia. The thing with forceps delivery is that they can maneuver the baby's head, but not the rest of the body. In a normal, natural delivery, the baby's head rotates, comes through, then the body rotates, and comes through. When you forcibly pull the head out with forceps or vacuum, the body doesn't always make the necessary rotation. It's not so much shoulder dystocia as it is just flat out that the baby's whole body is stuck from not rotating properly.
Your best bet this time is to avoid an epidural & pitocin, so that you aren't forcing your baby out to begin with, and you can get into the best pushing position that your baby needs. If homebirth isn't an option, then I would absolutely get a doula.
Also, I wouldn't read too much into what the midwife said. Most docs don't enjoy suturing a 3rd degree tear, it's technically difficult, and even the slightest mistake can lead to painful intercourse for years in the future. They'd much rather deal with the nice straight, flat incision from a c-section, and in that case they'll probably let a resident do it anyway. And some women who have a traumatic vaginal birth opt for a c-section, for emotional reasons or in the hope that abdominal surgery hurts less than vaginal surgery, or whatever. Since you said no thanks, I would expect it to not be an issue again. Good luck!
Join the revolution & take back our holidays!
Change Black Friday into Buy Nothing Day, and don't take your credit cards to work on Cyber Monday.
Shift Your Shopping from mass marketers & big box stores to your local independent retailers & small artisans.
Practice a Buy Nothing Christmas. Instead of buying more things, give gifts of your time, your energy, and maybe even some unwanted things around your home; organize a used items gift swap among your family and/or friends.
Either way, there is absolutely no reason at all to book a c/s now!