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Old 09-01-2009, 11:03 AM   #1
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Question about labor and delivery with your second (and after

I guess this is really more a two (or three really!) part questions, but I was wondering if most of you 1)went into labor earlier with subsequent pregnancies and/or 2)had a shorter labor?
Also, if that is the case, I know it is because you body knows what to do so speak already, and has had previous practice. With DS I was induced at 42 weeks, and after 23 hours of pitocin induced labor, and 5 hours of being fully dilated had a c-section(DS's cord was wrapped around his neck and prevented him from descending) . Since my body technically went through labor just not birth, should I be prepared for an earlier/shorter birth, or would it still be like my 1st birth? (I'm having a VBAC this time.) Thanks!

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Old 09-01-2009, 11:23 AM   #2
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Re: Question about labor and delivery with your second (and after

I asked my midwife the same questions I wasn't induced - went into labor on my own at 42 weeks and had a c-section after a full labor and 6 hours of pushing.

She said since I dilated completely and pushed, that she would expect a shorter labor like any second time mom based on what she's seen.

Didn't ask about going into labor though.

Good luck on your VBAC!
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Old 09-01-2009, 11:34 AM   #3
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Re: Question about labor and delivery with your second (and after

My first birth was 7hrs, including 2hrs pushing. It probably would've been shorter had I not been in a hospital and had a slew of interventions.

My 2nd birth was 2.5hrs and maybe 2 pushes. He was born less then 5mins after arriving at the birth center. It was an awesome painless birth!

Im just wondering about your previous birth and the nuchal cord. Nuchal cords happen in 1 in 4 births and usually present no probelms. You had pit for for 23hrs+, so I assume you also had CEFM, therefore assuming you were immobile. Did you get an IV meds or an epidural? How does your provider know for sure the nuchal cord was keeping the baby from descending and it wasn't the pit and lack of mobility?

I did attend and HBAC not long ago and I prepared for to be like a primip birth because her first c/s was scheduled. It was a 4 day labor. Sinces you've already labored and been complete before I *assume* your next birth should be shorter, especially if you birth OOHB with midwives.

Where are you having your vbac?

Good luck!
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Old 09-01-2009, 11:42 AM   #4
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Re: Question about labor and delivery with your second (and after

Here is some information about nuchal cords and umbilical cords. Enjoy!

Important information on umbilical cordspamela on Nov 25 2008 at 5:56 pm | Filed under: articles, evidence-based research, good websites, second stage

I’ve written on umbilical cord issues before, but it’s nice to have more information on this topic for parents and providers. I hear stories all the time of babies that were “strangled” by their umbilical cords and by deaths that were attributed only to nuchal cords (cords around the neck).

It’s important to remember a few things about umbilical cords around the neck:

Intrauterine babies do not breathe. Having something around their neck is very different from us having something around our neck. We forget that intrauterine beings have a very different physiological process than we extra-uterine beings do.

Umbilical cords, when moms are healthy, are strong, super-durable and very, very resilient (the article below describes, in fabulous detail, all the protective mechanisms built-in to protect our babies)

Cords that are around a baby’s neck rarely cause an issue - the uterus and placenta (and therefore the cord insertion site) follow the baby down the birth canal. It’s not like the baby is bungee-jumping to be born. Many times with a short, tight cord labor is not typical (usually contractions are spaced farther apart than you’d expect, but are strong enough to dilate the cervix) and has no complications aside from variable decelerations in the heart rate which are typically not an issue.

There is no need to remove a cord from around a baby’s neck before the body is born.

If the cord is tight, holding the head close to the moms body and allowing the baby to “somersault out” is helpful. Cutting the cord before the body arrives effectively “suffocates” a baby and makes them more likely to have a difficult transition.

Removing - or even checking for - nuchal cords with the birth of the head is often painful for the mother and unnecessary. Unwrapping baby after the birth of the body is easy to do.

Cords around the neck prevent cord prolapse (when the cord slips in front of, or alongside, the baby’s head before birth)

Babies who are more active have longer umbilical cords. The stretching of the cord accommodates those busy little babies - and there are bound to be some wraps from these active ones.

Hopefully this information, from a perinatal pathology website, will offer some new insight about umbilical cords and their design for those interested.

I’m fascinated and so impressed by the creation, design and function of both the placenta and the umbilical cord.

(pictures above are not from my own practice, just found online. I’ve seen numerous true knots in cords, one cord with TWO true knots and endless cord wraps of various types including a five time nuchal cord wrap!)

Another article by a friend of mine Cord around the neck is NOT an emgergency
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Old 09-01-2009, 11:43 AM   #5
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Re: Question about labor and delivery with your second (and after

I think from my understanding of how things work you should labor like it's your second birth but since you did not actually push the baby out you will push like it's your first birth.

I agree with Cindy and question the cord wrapped around the neck diagnosis for why you were unable to birth vaginally. A very large number of babies are born with the cord wrapped at least once around the neck and it really is no big deal. They just unwrap the cord and the rest of the baby is delivered. Was the cord wrapped multiple times? Did they say that you had an exceptionally short cord? You said you were fully dilated for 5 hours but of that time how much of that did you actually spend pushing? Where you able to change into different pushing positions (i.e., squatting, hand and knees, side laying) or where you on your back? If you had fetal monitoring was you baby having any decels during pushing that he was not recovering from between contractions?
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Old 09-01-2009, 11:48 AM   #6
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Re: Question about labor and delivery with your second (and after

Thanks ladies for your responses and good wishes!

Cindy, I really don't know for certain the exact cause of why my son never descended. I had different care providers with his birth, that were very useless in trying to get answers from. (Although right at the time, I didn't even ask many questions....) I did have CEFM, as well as IV, and an epidural, so I do believe that it was a combination of all of those factors. (Plus, I just wasn't as informed as I now wish I had been.)

We are birthing in a hospital, Allegheny General, in Pittsburgh, but with a group of midwifes and a doula. I would have preferred to birth at their freestanding birthing center, but they do all their VBAC's in the hospital. During our tour, the head nurse even told us though that the hospital has a different set of rules for the midwife patients.

Thanks again for your responses! I'm just trying to decide at what point to leave to go to the hospital (which is over an hour away), and when and where to meet up with our doula, and realized that I wasn't certain if my previous labor and pushing meant that we would most likely have a shorter labor or not.
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Old 09-01-2009, 11:59 AM   #7
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Re: Question about labor and delivery with your second (and after

Unfortunately it's really hard to say how long your labor will be as every labor is different. Even for a mom that usual has incredibly short labors you can't be certain that she won't suddenly have a very long labor. Since you are VBACing in the hospital I would suggest having your Doula come to your home so you can labor there as long as possible before going into the hospital. She will be able to help read the signs of your labor and help you to make a good decision on when to go in.
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Old 09-01-2009, 12:07 PM   #8
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Re: Question about labor and delivery with your second (and after

Terra, Thats is what I would love to do, or to labor at the birth center before transferring to the hospital, but because we live farther away, and the midwife center has had bad experiences allowing that to happen neither are an option for us. I'm meeting with our doula again tomorrow, and she had previously mentioned that she would be open to us going to her house before the hospital, so I'll look into that option also. I just don't want to get to the hospital too early, knowing that the longer I'm there the greater the chance of unneeded interventions, but I also don't want to wait too long either!
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Old 09-01-2009, 12:10 PM   #9
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Re: Question about labor and delivery with your second (and after

Quote:
Originally Posted by alybeth View Post
Thanks ladies for your responses and good wishes!

Cindy, I really don't know for certain the exact cause of why my son never descended. I had different care providers with his birth, that were very useless in trying to get answers from. (Although right at the time, I didn't even ask many questions....) I did have CEFM, as well as IV, and an epidural, so I do believe that it was a combination of all of those factors. (Plus, I just wasn't as informed as I now wish I had been.)

We are birthing in a hospital, Allegheny General, in Pittsburgh, but with a group of midwifes and a doula. I would have preferred to birth at their freestanding birthing center, but they do all their VBAC's in the hospital. During our tour, the head nurse even told us though that the hospital has a different set of rules for the midwife patients.

Thanks again for your responses! I'm just trying to decide at what point to leave to go to the hospital (which is over an hour away), and when and where to meet up with our doula, and realized that I wasn't certain if my previous labor and pushing meant that we would most likely have a shorter labor or not.
When we know better, we do better I agreed to an induction for low AFIs(3.6), if I knew what I knew now I would've said no thank you.

I would find out more information what "the different set of rules" entails. Do you know what their vbac success % is, repeat c/s % is, etc?

Does your doula leave near you? Closer to you or the hospital? I would later then sooner honestly. I lived over an hour away from the birth center I went too. I left too late if you ask some people, he was born less then 5mins after we got there. I wouldn't change a thing though. I was prepared to birth him in the car
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Old 09-01-2009, 12:15 PM   #10
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Re: Question about labor and delivery with your second (and after

Well, my second and third were both inductions (my first I went into labor on my own) so they were shorter. My third, however, took longer than my second, even though he was an induction. They told him his size + my narrow pelvis meant he had to be "just right" to descend and finish dilating me properly.

Not sure if it applies, but the pushing time got shorter each time around...Less than 8 minutes for DS, so I expect this baby to just fall out, LOL.
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