Small pelvis/pubic bone & shoulder dystocia?

novilise · May 2011

Well, I thought I was going to have to plan my RCS, but I have more time to decide, so my husband and were talking more about at least trying to wait until labor starts to have another c-section or even just going ahead and trying a TOL, at least for a short time.

Will many doctors work with this kind of plan?

I'm also wondering if perhaps they will do a scan as I approach my due date to see if this baby anterior? My last was posterior and turned a bit and got stuck in my pelvis, thus the c-section. The doctor said I have small pelvis and a midwife told me I have a small pubic bone, too.

I know if the baby is anterior this time, though, it could make it much more likely to come out.

My main question and worry is:

If the baby is anterior, will I be at a great odds for shoulder dystocia because of my smaller pelvis and pubic bone? This is my biggest worry. - That if the baby is positioned better, it may make him even more likely for something scary like shoulder dystocia. And then that could even increase my risk of uterine rupture, too.

Does anyone have information about this or experience or stories?

Thanks!

Brownie_222 · May 2011

I can see you feel worried. That is a really tough place to be. When I find myself worrying about "what ifs" I just pose my concerns to my midwife. She takes a lot of time to go through concerns. She doesn't ever say she can't guarantee something won't happen, but she tells me what she'd do if that situation arose and tells me what the odds of that situation happening are. Maybe a conversation like that with your OB would help ease your anxiety? Is your OB very conversational at your appts? A good provider will be receptive to listening and answering your questions. I think some OBs will definitely accept a wait and see approach as it comes to TOL. Some, however, will not and will wait a definitive plan penned out. You probably have to ask them directly and see what they say.

FWIW, other women have been told their pelvises were too small and have gone on to push out healthy (and sometimes bigger) babies than their c-section babies. As you said, positioning has a lot to do with it. I don't think posterior presentation is a situation that's likely to recur. If it helps put your mind at ease, you could research optimal positioning techniques on spinningbabies? Anything you can do to help feel more control will be helpful (at least it helps me).

GL! I hope you get a break from worry soon. I know how hard that can be.

Harper'smom · May 2011

I have similar concerns. While we wait to ttc I've been debating between switching to a new O.B. Vs. a free standing birth center. I've been reading Ina May and there are several birth stories where dystocia came into play. It seems the chances for the dystocia to result in a birth injury are greater in a hospital birth attended by a O.B. than a birth attended by a midwife. This could be a key reason I end up going the birth center route. I found the birth stories I mentioned very reassuring.