Shoulder Dystocia?

Lexii2385 · March 2014

So my OB is out until next week due to a death in his immediate family. One of the other OBs called me today and said based on my Estimated Fetal Weight US last week they put the data through a computer program and to tells them the risk for shoulder dystocia. She said that as of today I am at intermediate risk and was rattling off statics. She said i have the choice of a csection or having her vaginally the decision is mine. I was so confused my due date is next Friday and my dr and I discussed Tuesday that we would plan on vaginally. I asked her what her suggestion is and she said anytime there is any potential risk she suggests a csection and can do it tomorrow if I wanted . I'm just so confused and don't know what I am supposed to do. I don't want to put the baby at risk but I don't want to have a csection if it's not necessary. I was very upset on the phone kits been a rough day stressing about stuff and last night I found out one of my friends coworkers died after her csection so that just made even more crazy and stressed with the thought of a csection...just had to get this off my chest if anyone has any suggestions or have been at an intermediate risk id appreciate feedback. I asked the nurse to have the dr to call me later and possibly if I can go in and talk to her face to face to see the paperwork she's looking at since the numbers were just jumbled in my head. I just wish my dr was around to discuss as I feel more comfortable with him and he would give me his opinion with back up as to why he feels that way

ksulli · March 2014

Personally I'd still go with a vaginal delivery. *if* baby really is too big for you to birth, you can always be sent for a c-sec. However, the weight/size estimates are just estimates, and if you haven't given birth before they really don't have much 'data' on the size of your pelvis or how it will expand.

my DD was quite large (9lb10oz, 21.5") and I am not (5'6", size 4 or 6 pants), and ahe was born with shoulder dystocia, but my OB maneuvered her out without an episiotomy and with no damage to DD's shoulder/collar bone. It was a little scary when we realized her shoulders were stuck, but turned out just fine.

with this LO, due to DD's arrival, we did a L2 u/s at 37w and believe this baby to be a tad smaller than dd was. We're inducing me at 39w to cut a week off of baby's growth and reduce the risk of dystocia.

Good luck with whatever you choose!

Rrrrrachel · March 2014

Here's some good info on big babies, shoulder dystocia, and the risks that might help you decide. https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/ I would not sign up for a c section just because they thought I was having a big baby. The ultra sound estimates aren't reliable enough.

pete0121 · March 2014

Ok I'm in this situation right now. My DS was born with shoulder dystocia. I had to have a forcep delivery and he was fine thank god. My dd was born with a chromosomal abnormality so was low birth weight, therefore we can't use her birth as data. I hve a different dr than delivered DS. He's talked about CS since my 32 week u/s. Shoulder dystocia can be very dangerous. I don't want to harm my baby or myself. I also was to avoid a CS if I can. I have a u/s Tuesday and decisions will be made then. I will be induced at 39 weeks or CS then regardless what we decide.

Rrrrrachel · March 2014

Keep in mind that even when shoulder dystocia occurs there's an actual injury less than 25% of the time (sometimes way less, depending on the size of the baby, see the link I provided for a break down by size) and then in the majority of those cases any injury resolves on it's own. So you have a baby that may or may not be big, and even if it IS big is really only at a small (<10% or so) chance of shoulder dystocia (if you don't have gd this drops drastically) and even IF it gets shoulder dystocia is unlikely to experience actual injury caused by it.

adheaton1387 · March 2014

Im in a similar situation and have one doctor pushing c section more than others. I have made it clear that I would like to labor and try to birth him vaginally and if we find he does not fit and the safest way to get him here is a c section then I will do it. But saying there "might" be a chance his shoulders are too big is too much of an unknown to me to just elect for a c section. Ultimately do whatever you wish because this is YOUR baby and YOUR labor but the doctors have no way to predict how your body will respond to labor.

amhah09 · March 2014

pete0121 said:
Ok I'm in this situation right now. My DS was born with shoulder dystocia. I had to have a forcep delivery and he was fine thank god. My dd was born with a chromosomal abnormality so was low birth weight, therefore we can't use her birth as data. I hve a different dr than delivered DS. He's talked about CS since my 32 week u/s. Shoulder dystocia can be very dangerous. I don't want to harm my baby or myself. I also was to avoid a CS if I can. I have a u/s Tuesday and decisions will be made then. I will be induced at 39 weeks or CS then regardless what we decide.

I had shoulder dystocia with DS and was subsequently induced with DD at 39 weeks - her delivery was flawless! I send you the same well wishes. Good luck! As an aside, there was no talk of induction this time since #2 was so great; their only reservation was leering me labor in the tub too long and risking a tub birth.

amhah09 · March 2014

OP is there a reason this OB in particular ran these numbers? Has your OB mentioned any of this to you previously? I definitely wouldn't just schedule a CS but if this is a genuine concern for a legitimate reason I wouldn't be so opposed to an induction. However, as others pointed out, him being big isn't necessarily a reason I would worry about SD so much as a prior experience with it, which you don't have. I think requesting to speak directly with her was a good idea but it sounds like she might be a bit fear mongering anyway. If she pushes anything, I would go with induction hands down before I would schedule a CS for a POTENTIAL shoulder dystocia risk.

Lexii2385 · March 2014

It's part of there practice to do this test. I am going tomorrow to have someone sit down and go over the results in person because I am not making a decision based on this drs convo with me she said anytime there is a potential risk she suggest a csection but there are risks with any delivery and also risks with csections. Thank you all for your words and information.

AcaAwkward · March 2014

She seems a little c-section happy to me. I think you're smart to go and talk through the numbers with someone else. Do your research! Admittedly, I don't know much about shoulder dystocia, but I think I'd be pushing for a vaginal birth. Small women birth big babies perfectly all the time; plus, sonography just really isn't that great at guessing size!

Lexii2385 · March 2014

Thanks everyone! I'm researching online and after we talk to the other dr tomorrow SO and I will discuss it together and make a decision but I really think I'm leaning toward vaginally and if it doesn't work and she isn't going to fit then do a csection but I feel like I need to try.

Rrrrrachel · March 2014

I'm a little weirded about by the whole "and she could do it tomorrow" thing. Like it's a decision to be made so lightly.

Lexii2385 · March 2014

NoLaLinz said:

Rrrrrachel said:
I'm a little weirded about by the whole "and she could do it tomorrow" thing. Like it's a decision to be made so lightly.
Or a money thing.

That's what really got to me too. I'm going to discuss everything tomorrow and we won't make a decision until we have all the facts and time to think about it.. Thanks again everyone for the support and advice it really does help! xoxo

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