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Old 08-19-2012, 08:05 AM   #11
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Re: Shoulder dystocia = c-section now?

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Originally Posted by songbird516 View Post
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/
Exactly this! Cutting out processed carbs and eating mostly protein, veggies, and fruit can help a lot and being up moving around during labor even on a ball to keep your pelvis open and baby moving down. I have had an 11lb 1/2oz baby in an unmedicated vaginal delivery. He was 11 days past the due date and I had an NST 2 days before with a sizing ultrasound. They had no idea how big he was. I watched a documentary once that compared sizing ultrasounds to trying to measure someone for pants who is floating in a bathtub in the next room Not super accurate.

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Old 08-19-2012, 08:29 AM   #12
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Re: Shoulder dystocia = c-section now?

Well, I am going to go against the grain a smidge here.

You have a history of babies getting bigger. You have a history of labor being difficult. You have a history of of at least one baby betting stuck. I don't think it's entirely unreasonable to consider that a vaginal delivery might potentially carry a few more risks for you this time around than the average mama. I am not a doc, I do not have experience with thousands of births, only my own 3 very non complicated births.

The thing is, no one else here is a doc either. There are very few if any women on this board who have the experience and training your doc does with having babies. Which means that the person most likely to have accurate knowledge of the risks involved is likely your doc, and not us on a message board.

That DOES NOT mean that I am IN ANY WAY suggesting you blindly follow your doc. Do your own research. Look up real medical information and statistics. It could be that there may be increased risks for you but that the increases are wrong. It could be your doc is right. It could be just a 50/50 crap shoot and your risks are equal. In the end, no one, not us not your doc not you, no one can truly predict how it will go, and it's really difficult to know that you are making the right choice or not.
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Old 08-19-2012, 10:43 AM   #13
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Quote:
Originally Posted by happysmileylady
Well, I am going to go against the grain a smidge here.

You have a history of babies getting bigger. You have a history of labor being difficult. You have a history of of at least one baby betting stuck. I don't think it's entirely unreasonable to consider that a vaginal delivery might potentially carry a few more risks for you this time around than the average mama. I am not a doc, I do not have experience with thousands of births, only my own 3 very non complicated births.

The thing is, no one else here is a doc either. There are very few if any women on this board who have the experience and training your doc does with having babies. Which means that the person most likely to have accurate knowledge of the risks involved is likely your doc, and not us on a message board.

That DOES NOT mean that I am IN ANY WAY suggesting you blindly follow your doc. Do your own research. Look up real medical information and statistics. It could be that there may be increased risks for you but that the increases are wrong. It could be your doc is right. It could be just a 50/50 crap shoot and your risks are equal. In the end, no one, not us not your doc not you, no one can truly predict how it will go, and it's really difficult to know that you are making the right choice or not.
I think the three points you listed applies to a lot of moms who have had two children.. My two both got stuck behind my pelvic bone (big nasty bruise to show for it. My first, 7-4 my second 7-11. My labors are back agony, almost passed out during my last one.

So.....

I guess I'm just saying you brought up facts that mean kinda nothing....? No offense....
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Old 08-19-2012, 11:35 AM   #14
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Re: Shoulder dystocia = c-section now?

First of all, it is a myth that hospitals are less skilled at dealing with shoulder dystocia than homebirth midwives. Maybe even a lie, depending on who is mouthing the words.

Obstetricians are aware of the hands and knees position. It isn't magic, and it doesn't "almost always" resolve a dystocia. It is one tool that can be tried, and the degree to which it has become venerated in online natural childbirth culture is insane.

Have any of you seen a shoulder dystocia drill in a hospital?

Second, anecdotes where someone had and SD and then didn't in their next pregnancy mean not a fig more than anecdotes where someone didn't and then did. The recommendations made by medicine are not lies; they are based on population level data that your average CPM doesn't even have access to, much less the ability to synthesize and make recommendations of her own.

They aren't scare tactics, and it makes me nearly cry every time I read a young mother being told to ignore the collective hundreds of thousands of hours of experience of modern obstetrics because some pseudoscience sounds convincing to people who don't know any better.

Please, discuss this with your physician.
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Old 08-19-2012, 11:43 AM   #15
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First of all, it is a myth that hospitals are less skilled at dealing with shoulder dystocia than homebirth midwives. Maybe even a lie, depending on who is mouthing the words.

Obstetricians are aware of the hands and knees position. It isn't magic, and it doesn't "almost always" resolve a dystocia. It is one tool that can be tried, and the degree to which it has become venerated in online natural childbirth culture is insane.

Have any of you seen a shoulder dystocia drill in a hospital?

Second, anecdotes where someone had and SD and then didn't in their next pregnancy mean not a fig more than anecdotes where someone didn't and then did. The recommendations made by medicine are not lies; they are based on population level data that your average CPM doesn't even have access to, much less the ability to synthesize and make recommendations of her own.

They aren't scare tactics, and it makes me nearly cry every time I read a young mother being told to ignore the collective hundreds of thousands of hours of experience of modern obstetrics because some pseudoscience sounds convincing to people who don't know any better.

Please, discuss this with your physician.
They also have bills to pay. So to act like your best interest is their ONLY concern is being naive. No?

Best close friend was just forced (yes, she had a choice, but of course once they mentioned fetal demise, she was putty in their hands) into a second due to size of the baby. What a joke. They were SURE. POSITIVE. WITHOUT DOUBT. That she was carrying a 11.5 lb baby. She was seeing a midwife and an OB (for an unrelated issue) and the midwife said 'no. I do not agree. Ultrasounds are off by 2lbs often!!!' and the OB, a specialist, was offended. They ARE specialists, after all.. Her baby? Cut from her? After all she wanted was a water birth? 9pounds, 9ounces. Talk about heart break for her. And her OB??? Forgot all about those promises.

Sure they are very educated and has an insane amount if experience but I am not ignorant to how this medical system works. Our c section rate is sky high due to other countries. Why do you think that is? Dumb luck?
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Old 08-19-2012, 11:44 AM   #16
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In response to comments about it being size vs positioning, I'm not sure what the data is on that. I DO know that larger babies can be harder to free when they're stuck, and are at higher risk for birth injury or death. Especially if they have larger chests than their heads. This body type is characteristic of "fetal macrosomia" and these babies tend to do very poorly when they get stuck.
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Old 08-19-2012, 11:53 AM   #17
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Re: Shoulder dystocia = c-section now?

My last birth was traumatic, to put it lightly. My first two were 8.12 and 8.6 respectively. I had a c-section with the first, VBAC second. With my third I did have an epidural but it was turned way down for me to push. I was ten centimeters dilated but Alannah had not come down into the birth canal. It was suggested to me to get on my hands and knees and push (this came from the OB) for a half hour. If I succeeded in getting her into the canal we would use the vaccuum to help get her out. Well a half hour later we were trying the vaccuum. Her head came out and then everything came to a standstill. They called for an operating room. Luckily at the last second they got her out. She wasn't breathing right away and they didn't let me see her for almost an hour. I had an episiotomy but still tore. I was in shock from the delivery and I didn't even want to see the baby who caused me all this pain. The delivery broke my tailbone and bruised my bladder so bad that I had microscopic hematuria for about a year after and several infections. My dd was 10.14. She had to have physical therapy for a year and occupational therapy for three months. Had I the chance to do it all over again, I would have gladly taken the c-section. And I HATE c-sections. My daughter almost died, or at the very least could have had brain damage. I am damn lucky and so is my dd. Just another perspective.
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Old 08-19-2012, 11:57 AM   #18
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Re: Shoulder dystocia = c-section now?

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Originally Posted by MDever View Post
Exactly this! Cutting out processed carbs and eating mostly protein, veggies, and fruit can help a lot and being up moving around during labor even on a ball to keep your pelvis open and baby moving down. I have had an 11lb 1/2oz baby in an unmedicated vaginal delivery. He was 11 days past the due date and I had an NST 2 days before with a sizing ultrasound. They had no idea how big he was. I watched a documentary once that compared sizing ultrasounds to trying to measure someone for pants who is floating in a bathtub in the next room Not super accurate.

Some studies have indicated high protein diets also build big babies. A balanced diet low or free of processed foods along with regular exercise can make a big difference in babies size.

I too wouldn't jump to a c-section delivery because of one episode of shoulder distocia. My 5'2" sister delivered a 21" 10lb 13oz baby naturally at home. No tearing. As several other posters have already mentioned usually the problem is positioning not size. Flat on your back feet in stirrups is for the benefit of the doctors not the mother and baby. Unless of course you are in that 3% a previous pp mentioned.


Ultrasound weights are also just guesses. Sometimes they are rigt but not always. My sister was told by ultrasound her baby was going to be a small 8lb baby. A friend was told she was going to have a big 8-9lb baby so was induced 2 weeks early and ended with a c-section. Her baby was barely 6lb.Weather an 8pm baby is big is subjective. My sister has had two 10+lb babies. I have had one10+lb baby. So 8-9lb sounds nice and small to us.
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Old 08-19-2012, 12:24 PM   #19
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Re: Shoulder dystocia = c-section now?

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I think the three points you listed applies to a lot of moms who have had two children.. My two both got stuck behind my pelvic bone (big nasty bruise to show for it. My first, 7-4 my second 7-11. My labors are back agony, almost passed out during my last one.

So.....

I guess I'm just saying you brought up facts that mean kinda nothing....? No offense....
I only bring up the facts because generally speaking history can be helpful in making an educated guess. The reality is that NO ONE, not the mom, not you, not me, not the doc, NO ONE can make a 100% accurate prediction as to how it will go. The mom could end up having 6lb 3oz baby, with a totally fast and easy vaginal delivery. She could end up having a 13lb baby who doesn't fit and need a c-section. None of us can predict that. BUT, the history of a mother CAN help an educated and trained specialist make their best guess. And the best guess of an educated and trained specialist is certainly better than any guess you or I could make based on a post online.
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Old 08-19-2012, 12:29 PM   #20
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Re: Shoulder dystocia = c-section now?

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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.
I agree with this. I imagine laying flat in a bed with just your legs up would get any baby stuck really. I don't have any experience with this since all of mine were c-sections but I think reading up on positions will really help.
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