XP - Pushing CSection after Shoulder Distocia with 1st

soxvyanks · February 2013

Hi ladies -

I originally posted on the Working Moms board after I looked at the C Section board and it scared the bejeezus out of me. Some of the women there suggested I post here. So thanks in advance for any thoughts you might have.

I had my first 4 years ago vaginally, but she had shoulder dysplasia, though was out in under a minute. I'm 5'2" and overweight, but not awful. My daughter was 9lbs 7 oz and there was no gestational diabetes. (My husband comes from a long line of big babies.)

Fast forward to today, I'm 30 weeks pregnant with my second and my docs have been pushing for the C section since i got pregnant. I saw a doc today and she was really concerned about it. She brought up the notes from the delivery with my first and mentioned that many procedures had been done prior to finally getting her out, even though it's within one minute she was out. (The one that got her out quick was when the doctor basically elbow dropped to maneuver DD's shoulder, then she immediately popped out). I tore, but it wasn't awful. Painful on days 3 - 5 at night, but honestly, it was fine.

If anyone has any thoughts or insight as to how to make the decision, please also let me know. I'm desperate and there's no going back now, so at this point, I'm just petrified either way which isn't helping. I have an abnormal fear of surgery. I have only had one minor surgery and that was traumatic for me. Yes I want the baby out safe.

Thanks so much in advance!

meltoine · February 2013

Get a copy of the procedure notes and take them to another OB for a second opinion. Preferably, find one who is known in your area for being NB-friendly. The "Find Your Tribe" boards on mothering.com are a goos resource for recommendations if you can't find anything on your local board here.

pdilly2b · February 2013

I'd definitely get a second opinion, and potentially switch to a different OB office or a hospital-based midwife if you think that you're OB is pushing a c-section and that's not what you want. Many of us on this board have switched at 30-34 weeks, so that is on option if you think that is best for you.

It's my understanding that with shoulder dysplasia, pushing position matters a lot. The best in on the hands and knees (google "Gaskin maneuver"), and I actually think that is best for pushing regardless of shoulder dysplasia risk. Though to push in that position, that likely means you wouldn't be able to have an epidural. If you do really want an epidural, perhaps pushing on your side would be possible and help to open up the pelvis. Basically, the on the back position makes the space for the baby to come out really small because your tailbone can't move to get out of the way since you're laying on it. Doing things to get the baby in the best position possible before labor would probably help too - like sitting in straight backed chairs, avoiding lounging back, avoiding crossing your legs, and doing sets of pelvic tilts multiple times a day. www.spinningbabies.com is a good source of info about good fetal position and https://www.doula4birth.com/ofp.htm has some good advice too.

Shouldn't it also help that your daughter, in essence, "paved the way" for your new baby? I would definitely ask around to see if there's any evidence that shoulder dystosia in one baby was predictive of it in the next one. Good luck!

pdilly2b · February 2013

P.S. I'd run screaming from any person who would even suggest that you don't want your baby out safely, just because you'd like to avoid unnecessary surgery. Actually, I'd probably throat punch them, then run screaming.

MrsBigTime · February 2013

pdilly2b:
P.S. I'd run screaming from any person who would even suggest that you don't want your baby out safely, just because you'd like to avoid unnecessary surgery. Actually, I'd probably throat punch them, then run screaming.

This - ha!

It sounds like you think you can do it - go with that! I'd take your procedure notes to a natural birth friendly provider (a Midwife would probably be your best bet) and tell her your story. Know your options, especially about positioning, and establish a game plan for if this baby has the same issues (they may not!).

Have you read Ina May's book? There is a section on shoulder dystocia and it has some good information.

Don't let someone pressure you into a decision you are not comfortable with, follow your gut and your mama instincts, you'll know what you need to do!

nosoup4u · February 2013

meltoine:
Get a copy of the procedure notes and take them to another OB for a second opinion. Preferably, find one who is known in your area for being NBfriendly. The "Find Your Tribe" boards on mothering.com are a goos resource for recommendations if you can't find anything on your local board here.nbsp;

I would get a second opinion also, and probably look for a new provider. You're saying that your daughter got stuck just for a minute when she was coming out, right?
If you have a local ICAN board, I'd contact them for local doctors not that you're a VBAC mama, but they usually know the "good" providers. Or a local doula.

And I think that if you've have had a 9 pounder w light no complications, you can definitely do it again. Your second might not be as big. Good luck!

ncbelle · February 2013

I'd find a new provider. I had a shoulder dystocia with Eleanor (who was 10 pounds). Callum (my 1st) was only 8lb6oz no dystocia. I also had no GD or any other risk factors (E was 10 days "late" whereas Callum was "on time"). Eleanor was born in 3 pushes despite the dystocia - the Gaskin maneuver was key! No injuries and I didn't even tear.

Although I will be going straight for hands and knees for pushing if I'm blessed with a third, otherwise, I wouldn't change a thing. I do feel strongly that not having an epi saved me from a c-section (E was acynclitic for a long time and only turned at the very end due to all the moving I did). And having midwives that knew and used the Gaskin maneuver made a big difference as well I think.

Having one dystocia does increase your risk of another statistically. But I think if you work with a provider who is open to alternative birthing positions that's still miles safer than a c-section.

A37licia · February 2013

I don't have any info for you except to say it's absolute RUBBISH to suggest a c/s bc of previous SD. A friend had that, and all that was necessary for the next birth was awareness that it could happen again, and being darned sure your care provider knows what to do. It doesn't have to be a big deal, at all, if the birth attendant knows what they're doing. My friend had another birth just fine and is planning her third back at the birth center.

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XP - Pushing CSection after Shoulder Distocia with 1st

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