Asked my midwife about water birth and shoulder dystocia

wheelsonthebus · March 2012

I had a very minor shoulder dystocia with DS. They didn't have to push on my stomach or have me change positions, but the dr did have to twist and pull him out. I wasn't able to hold him right after he came out. Yesterday, I told my midwife that I was interested in having a water birth, but wanted to know how they'd handle a shoulder getting stuck. She said that with a history of shoulder dystocia, they would have me deliver out of the tub. She said I'm welcome to labor in the tub, but that it's safer to have the delivery "on land." I'm really dissapointed that I won't be able to try the water birth, but glad to labor in the tub. :-(

elviebird · March 2012

When I took my water birth class at my hospital, the nurse explained what the procedure was in case of shoulder dystocia... they make mom stand up and put one foot on the edge of the tub and do sort of a forward lunge. They said they've only had to do it once in 10 years and it got the baby right out. Granted, you're not really "in" the water at that point but they don't make you get completely out and in bed.

CTri17 · March 2012

it's ok mama! I labored in water with my DD ( a homebirth) but she started to have some decels, so I got out and gave birth on "land" and she had dystocia (for about 3 min)

So this homebirth we are planning on laboring in the tub and getting out to birth on land just as a precaution. The tub is GREAT and will help so much and you can stay in until you crown, by that point you'll have all the benefits of the water helping to stretch you and so you should do great!

wheelsonthebus · March 2012

CTri17:

it's ok mama! I labored in water with my DD ( a homebirth) but she started to have some decels, so I got out and gave birth on "land" and she had dystocia (for about 3 min)

So this homebirth we are planning on laboring in the tub and getting out to birth on land just as a precaution. The tub is GREAT and will help so much and you can stay in until you crown, by that point you'll have all the benefits of the water helping to stretch you and so you should do great!

This makes me feel better! Also, I can't imagine having the baby stuck for three minutes! That must have felt like an eternity. With DS it was only a few seconds and I was so eager to get him out! haha

wheelsonthebus · March 2012

elviebird:
When I took my water birth class at my hospital, the nurse explained what the procedure was in case of shoulder dystocia... they make mom stand up and put one foot on the edge of the tub and do sort of a forward lunge. They said they've only had to do it once in 10 years and it got the baby right out. Granted, you're not really "in" the water at that point but they don't make you get completely out and in bed.

I've heard about this position as well. I will talk to her and see if that is an option here!

frlcb · March 2012

elviebird:
When I took my water birth class at my hospital, the nurse explained what the procedure was in case of shoulder dystocia... they make mom stand up and put one foot on the edge of the tub and do sort of a forward lunge. They said they've only had to do it once in 10 years and it got the baby right out. Granted, you're not really "in" the water at that point but they don't make you get completely out and in bed.

I think we had the same teacher I am in Atlanta as well, are you delivering with IM at AMC? I had a water birth there and it was awesome.

Jessimurph · March 2012

This was a big concern of mine because this boy is big and i really want a waterbirth. My mw said it was fine. I would like to be on my hands and knees in the water as much as possible and she said her team could help me up to a standing position if needed. My understanding is that as long as they are under water they don't take their first breath, but i know it can be a long process if they are having to help the babies shoulders out. She didn't seem at all worried so I'm not worried about it.

CTri17 · March 2012

Jessimurph:
This was a big concern of mine because this boy is big and i really want a waterbirth. My mw said it was fine. I would like to be on my hands and knees in the water as much as possible and she said her team could help me up to a standing position if needed. My understanding is that as long as they are under water they don't take their first breath, but i know it can be a long process if they are having to help the babies shoulders out. She didn't seem at all worried so I'm not worried about it.

I *believe* that sometimes if there is any distress then they may try to breathe as soon as they are out.

My DD was already breathing as soon as she was out and on the perineum but still in the dystocia, so for ME I'm not comfortable with it (especially at home)

I'd just do a lot of research and then make a decision

pinksweetpea2 · March 2012

With my last birth I delivered the head in the tub and when she didn't come out in the next two minutes, my MW suggested I get out of the tub because she was concerned that the shoulders where giving me some trouble and she was having a hard time seeing what was going on beneath the water.

In the process of me climbing (being assisted) out of the tub, my MW thinks the shoulders were loosened and she pretty much came out on the next push on dry land.

I can't really comment on what you should do since I didn't really have to deal with dystocia, but I really do believe that every baby and birth is different and if you want to try to give birth in the water, then you should do it.

elviebird · March 2012

frlcb:

elviebird:
When I took my water birth class at my hospital, the nurse explained what the procedure was in case of shoulder dystocia... they make mom stand up and put one foot on the edge of the tub and do sort of a forward lunge. They said they've only had to do it once in 10 years and it got the baby right out. Granted, you're not really "in" the water at that point but they don't make you get completely out and in bed.

I think we had the same teacher I am in Atlanta as well, are you delivering with IM at AMC? I had a water birth there and it was awesome.

No, I'm delivering at North Fulton. Hmmm. Makes me wonder if the hospitals are just using the same script. LOL

frlcb · March 2012

elviebird:
frlcb:

elviebird:
When I took my water birth class at my hospital, the nurse explained what the procedure was in case of shoulder dystocia... they make mom stand up and put one foot on the edge of the tub and do sort of a forward lunge. They said they've only had to do it once in 10 years and it got the baby right out. Granted, you're not really "in" the water at that point but they don't make you get completely out and in bed.

I think we had the same teacher I am in Atlanta as well, are you delivering with IM at AMC? I had a water birth there and it was awesome.

No, I'm delivering at North Fulton. Hmmm. Makes me wonder if the hospitals are just using the same script. LOL

Are you with Janet? The nurse who taught our course at AMC also teaches at NF. They are both Tenet hospitals.

Jessimurph · March 2012

This is what I found on it.

Shoulder dystocia is considered an obstetric or midwifery emergency by most practitioners. Protocols require mothers who are anticipating large babies to leave the bath. Now there is a growing body of experience that suggests that shoulder dystocia can be managed easier in the pool. Canadian midwife, Gloria Lemay, has written a protocol for management of shoulder dystocia in the water. It appears that tight shoulders happen more often because of practitioners or moms trying to push before the baby fully rotates. Position changes in the water are so much easier to effect and the mother doesn't panic but remains calm. A quick switch to hands and knees or even to standing up with one foot up on the edge of the pool if shoulders are really tight can help maneuver baby out.

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