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-   -   Shoulder dystocia = c-section now? (http://www.diaperswappers.com/forum/showthread.php?t=1432745)

Rainfall 08-16-2012 11:54 AM

Shoulder dystocia = c-section now?
 
I'm so upset and just want to hear from other mamas that have experience with shoulder dystocia.

My babies have gotten progressively larger each time (7.10, 8.9, 8.14) and this baby is right on track to be another chunker. I'm 33 weeks now and just had my checkup with my OB (who I normally love but am starting to think she's a c-section pusher).

My last kiddo had shoulder dystocia and I nearly ended up with a c-section. I was induced at my due date because he was measuring huge, I'd already been to L&D for an NST because he wasn't moving much anymore, and then my impatient DH started his vacay early and I just agreed to induction. My water was broke right away of course and by the time I was at 5 or 6 cm on full pitocin I opted for an epidural. Well, I stalled out at 8cm for HOURS and DS was in distress the entire day. I had to be on oxygen, laid up on one side kinda propped and couldn't even get up to pee because DS' heartrate was erratic if I moved positions. Just as they were gathering the forms for the c-section my OB checked me and I was at 9.5cm and I just decided to push anyway and was able to get him out. But he had shoulder dystocia and his cord was strangling him (probably the cause for the erratic heartrate in labor).

So with all of that said...at my appointment today my OB said that she wanted me to go for another growth check u/s at 37 weeks. If baby is measuring really big, she wants to talk to me about scheduling a c-section because I have a history of the shoulder dystocia. I asked her to explain what happens and the birth complications and now I'm freaked out. Freaked out to have this baby vaginally and freaked out at the possibility of needing a c-section. :cry:

I know in the end all that matters is a healthy baby, but I feel like the c-section talk is just thrown out like it's no big deal. But then I start thinking, if I refuse this and stand my ground and try another vaginal birth and something DOES happen to the baby, it'd be all my fault and how the heck could I live with that?

Ugh, I'm just such a mess right now. I've had 3 kids and all 3 ended in inductions. My pregnancies are wonderful, complication-free. I'm one of those freaks that just love every bit of being pregnant and EVERY single time it comes to getting them out, all of this stress and negativity comes up. :cry:

It just feels like my body WON'T go into labor on its own, or if it does, it would be really late...and babies would be even bigger and there would be more risks. I get scared into inductions and end up with epidurals because the pain from the pitocin is so bad I can't manage.

I just want so badly to go into labor on my own, avoid meds, and have my baby. But NO.

I don't know what I'm looking for, this is a mess of a post. If you have experience with shoulder dystocia though, I'd love to hear your story and if subsequent pregnancies resulted in bigger babies and more shoulder dystocia.

keen1981 08-16-2012 11:56 AM

Don't.

My best friend just got that same trip. Assured her, for months, her baby would be huge (btw, your babies aren't huge, to me) they promised complete accuracy, with the high tech machines. 11 1/2 pound baby.


Guess what she got? 9lbs 9 ounces. Completely should have been given a trial of labor.

Our healthcare system honestly scares me. Lies everywhere.

lenagirl 08-16-2012 12:07 PM

I'm not sure I can help, but my son was 9#1oz, and his shoulder got stuck, and my midwives were able to adjust him so quickly that I didn't even realize he had gotten stuck behind the pubic bone. Hospitals seem to have a hard time dealing with shoulder dystosia, but i read that midwives have figured out that switching positions from back to all fours gets baby unstuck almost every time...but that would not work with an epidural..

stringbean02 08-16-2012 12:12 PM

Re: Shoulder dystocia = c-section now?
 
Quote:

Originally Posted by keen1981 (Post 15552425)
Don't.

My best friend just got that same trip. Assured her, for months, her baby would be huge (btw, your babies aren't huge, to me) they promised complete accuracy, with the high tech machines. 11 1/2 pound baby.


Guess what she got? 9lbs 9 ounces. Completely should have been given a trial of labor.

Our healthcare system honestly scares me. Lies everywhere.

I totally agree.

I also want to add that YOU matter too, your wishes and your birth matters, mama. The baby being healthy in the end is very important, but your comfort and psychological well being is very important too. In the end if a c-sec is really needed, then it is, but don't let them push you around and don't feel like your emotions don't mean anything just because the baby is healthy. Us mamas matter :hugs:

And though I guess this is anecdotal, I was a 9# bebe, shoulder distocia, nuchal cord..born completely naturally with no complications. Dr unwrapped the cord and adjusted my shoulder, my mother said she didnt even know until they told her.

melyndie 08-16-2012 12:17 PM

Quote:

Originally Posted by lenagirl
I'm not sure I can help, but my son was 9#1oz, and his shoulder got stuck, and my midwives were able to adjust him so quickly that I didn't even realize he had gotten stuck behind the pubic bone. Hospitals seem to have a hard time dealing with shoulder dystosia, but i read that midwives have figured out that switching positions from back to all fours gets baby unstuck almost every time...but that would not work with an epidural..

This is EXACTLY my story three weeks ago, except my baby was an ounce bigger! My midwife had me get on all fours in the tub (the "Gaskin maneuver"), and she actually had to pull as hard as she could to get him out still, but--believe it or not--I had no idea he even got stuck until she told me the next day! Baby was perfectly healthy, and I didn't tear from the procedure or anything. I imagine my next baby could be bigger still--or could be small like my first baby. There really is no telling. I just know I should hire my experienced midwives again for next time, and all should be well. :)

lenagirl 08-16-2012 02:26 PM

Quote:

Originally Posted by melyndie

This is EXACTLY my story three weeks ago, except my baby was an ounce bigger! My midwife had me get on all fours in the tub (the "Gaskin maneuver"), and she actually had to pull as hard as she could to get him out still, but--believe it or not--I had no idea he even got stuck until she told me the next day! Baby was perfectly healthy, and I didn't tear from the procedure or anything. I imagine my next baby could be bigger still--or could be small like my first baby. There really is no telling. I just know I should hire my experienced midwives again for next time, and all should be well. :)

Yeah I was surprised I didn't tear either! I plan to have all my babies with these midwives!! And actually reading Ina May Gaskin's Guide to Childbirth helped me understand the value of instinct, and mindset, and the normalcy of birth, and a woman's right to not sacrifice control for safety, no matter the setting.

weesej 08-16-2012 02:33 PM

Re: Shoulder dystocia = c-section now?
 
The shoulder dystocia had more to do with being flat in bed with an epidural than your ability to get baby out. You only have average sized babies...they all have gotten out. A shoulder dystocia is far more often a position issue than a size issue.

Greenbabybottoms 08-16-2012 06:04 PM

Re: Shoulder dystocia = c-section now?
 
I had a history of 2 shoulder dystocias. My first was 8 lbs 4 oz, she had shoulder dystocia. It was something that was noted in my charts and my midwives were aware of but I was told 1 shoulder dystocia doesn't really mean much, it could be positioning problems, weak contractions etc. My 2nd birth (9lbs 6 oz)also resulted in shoulder dystocia where she was stuck for several minutes. They flip flopped me all over the place trying to get her out and were prepping the or to perform a crash csection because she wasn't budging when they finally got her shoulder pushed under my pubic bone. That is the birth that sent up red flags and they did some xrays and I saw lots of doctors and discovered I had a platypelloid shaped pelvis. I was actually birthing the wrong way for my pelvis.

My 3rd birth we were more proactive, we knew my body and the position she needed to be in. We learned that upright squatting and hands and knees were not good positions for me due to my pelvis shape. Actually on my back basically in "mcroberts" wa best for me. I was induced early to prevent another large baby, I cut out all sugar, dairy that wasn't organic and almost all carbs my 3rd trimester. I had a completely normal, easy birth where my dd came out in one easy push. She was 8 lbs 7 oz so not my smallest either.

So basically 1 shoulder dystocia would not make me jump to a csection. It's something you are aware of, something your providers are aware of and something you can be proactive about. Even with the 2 shoulder dystocias I definitely considered a csection. I thought a lot about it and had a lot of anxiety about it but in the end I felt like I just needed to try and I'm glad I didn't go with a csection.

And as a disclaimer I am in no way suggesting you birth flat on your back or anything. I have a pelvis that I was told less than 3% of women have and according to my midwives the few women with my pelvis shape have more progress flat on their backs.

my2sweets 08-17-2012 08:20 PM

That happened with dd2. At my appt 2ish wks ago I asked my doc about it. My babes have done nothing but get bigger and Ive had to be induced each time so I totally understand where youre coming from! The 1st thing my doc wanted to know was if we were done having kids b/c if so we could let baby cook until the full 40wks, not worry about size, lungs, and she'd tied my tubes. I told her I didnt like that idea. So then she said we'd start looking at his size closely at 37wks then I had some choices. If he weighed over 8lbs we could test to check his lungs and have him at 37wks. She also suggested we could still check at 37wks and then again at 38wks to see the size difference. If he was over 8lbs at 38wks we'd induce then, if not check again at 39wks. Im torn on going before 38wks(need to look up pros/cons of the test to check the lungs) but dd2 was 10lbs6oz at 39wks....Good luck mama :hugs:

songbird516 08-19-2012 07:35 AM

Re: Shoulder dystocia = c-section now?
 
If you want to avoid a shoulder dystocia it's a good idea to birth without an epidural, and not on your back. Like another poster said- generally it's a positioning issue, not that the baby is actually too big. And size is only one predictor. I would bet that if you went into labor on your own and make sure that you're eating a reasonable diet with not too many carbs that your baby will come out just fine on your own.
I'm not a fan of all of the extra monitoring. The more monitoring they do, the more "problems" they will find. That's just what they do. If I were you I would either do a bunch of research and convince myself that it will be okay with no c-section, or do that AND find a doctor who is more supportive. You've had 3 children vaginally; why oh why would she jump to a c-section?!

Here is a great article on shoulder dystocia that you might find helpful
http://midwifethinking.com/2010/12/0...he-real-story/


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