Help! Shoulder Dystocia Experiences?

Israfel · April 2014

Hi everyone-- I'm really freaking out over possible complications due to potential shoulder dystocia, and I'm hoping to get feedback on personal experiences.

Here are my details-- I have GD, I'm overweight, latest ultrasound today shows baby weighs 8lbs15oz... Which, with the +/- 1pound rule at this stage could mean he's actually 9lbs15oz.... Putting the baby at juuuuuust the cutoff for an elective C-Section at my hospital. Ultrasound also shows the baby's shoulders and abdomen are larger than his head-- which is what REALLY worries me.

I see midwives at my hospital-- I like most of them, there are a couple I'm not super fond of. One of the ones I'm not super fond of is scheduled to be at my induction and she is the one I spoke with today about the possibility of a C-Section. She said she spoke with the Ob/gyn and because I'm under the cutoff a C-Section is not warranted. She also bragged a bit about how she's an expert with Shoulder Dystocia, and how she's even in a video about how to deliver babies with SD. This actually makes me MORE worried as I feel like she's thinking she's got something to prove.

My main worry is coming from more research tonight which is telling me that one of the complications of SD is that if the head is delivered, but the body is not delivered within 5 min it can lead to permanent brain damage. To me, given the size of his shoulders and how close the baby is to the cut off, it seems like it's not a risk worth taking!

Don't worry, I'm not just relying on strangers on the internet for this... I left a message with the midwife telling her how concerned I am and asking if a C-Section was totally off the table.

My question to all of you I guess I two-fold.... Am I overreacting? Would you also be feeling like a C-Section is the safer option? Or would you go for the induction (on Wed!) And, do any of you have experience with SD as a complication? If so, how did it turn out?

Right now I'm just feeling that while a C-Section is generally not the first choice, but in this case I feel like if there is even the hint of a risk of brain damage, why go there!? I'm feeling super anxious and upset about this possibility and I know if anything happened I would feel like I could never forgive myself when it could have been easily prevented with a C-Section.

ksulli · April 2014

DD1 was 9lb10oz and delivered with shoulder dystocia. I did not have GD and am rather petite, so other than family history of big babies, I had no risk factors, and the risk wasn't identified because I never measured that large (I have a very long torso, so I guess part of LOs size was hidden?).

Anyway, once her head was out and it was apparent her shoulders were stuck I was told not to push on the next contraction and my OB pushed dd around to get one shoulder out ahead of the other. I pushed for 30-45 min total. DD was perfectly fine- no broken collar bone, no pinched nerve, and certainly no brain damage.

with DD2 they monitored more closely due to my history and I had a growth scan at 37w putting her just over 7lbs. Babies gain about 1/2lb a week and I was induced at 39w to cut off some growth- she was 'only' 8lb1oz, and she had very slight SD, but delivered super fast (3 contractions, 9 pushes). Again, no worse for the wear.

The risks are real, and they are scary, but even with shoulder dystocia (which you don't know will happen until it does), the complication rate is pretty low- like 10% of SD babies, and that 10% includes broken collar bones- which is absolutely sad in a newborn, but not life altering.

personally, I'd still go with a vaginal delivery, but good luck with your decision.

Rrrrrachel · April 2014

There's a great article about evidencebased birth about big babies and the risks. Even with gd the risk of shoulder dystocia is still low, and the risk of serious or permanent injury due to shoulder dystocia is even lower. Did they say what percentile the abdominal circumference was? https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

EnFuego12 · April 2014

Both of my previous kiddos were 10lbers and were delivered vaginally. I'm not GD, they were just that big. We didn't have any problems with SD. I was induced at 39 weeks with #2 due to #1's size. I'm following that same track with #3 (expecting another big one!) and will be induced at 39 weeks.

My advice would be to plan on a vaginal birth and if your doctors see anything that makes them think you need a C-section, they'll tell you. You will be amazed at what your body can do! I'd never have believed my 5'4" self could deliver 10lb babies!

alyssa0410 · April 2014

So I'm a FTM and they were worried about SD with my baby so they did a CALM Shoulder Screen. They gave me ratios of how likely he is to have SD. The chances of him being stuck but being able to move him around to get out was very very high. They also gave me the ratio of him getting stuck and then something terrible happening (breaking a shoulder, damaging the nerve, even death) the odds were still high but not that bad. I know it's possible and probably more probable that I would deliver him with no issues but after hearing about the risks, I don't see how I could chance it. My Ob highly recommended a csection but it was ultimately my choice. I elected for the csection and I'm scheduled for Thursday. Good luck in whatever you choose!

amhah09 · April 2014

I had shoulder dystocia with DS. He was stuck under my pubic bone but also had a nuchal cord. The OB in the room actually ended up cutting his cord once his head was out but then apparently his shoulder was still stuck so we were definitely time crunched to get him out. I ended up with a couple nurses in the bed with me helping to open up my pelvis and he eventually came out. He didn't suffer any other complications from it though. I had an epidural.

I probably wouldn't go straight for the CS but would take the induction. Even with him being a bigger baby and projected bigger shoulders and such it doesn't necessarily mean you WILL experience shoulder dystocia. Obviously you're voicing your concerns to your medical team so I would trust their opinions on this. And I would feel much more comfortable with a midwife with experience with it.

Jesster11 · April 2014

Same boat too. Based on the abdominal circumference (35 cm) at my last ultrasound, my ob recommended a c-section due to the risks of SD (I have GD too, but my numbers have all been in check and diet controlled).

I was really, really set on a vaginal birth and wanted to avoid a c-section at all costs, so I am really struggling with the decision right now. It sucks to have over 8 months to prepare for birth and then 3 weeks out have to wrap your head around this possibility.

I'm having another u/s Thursday to look at the numbers one last time, review them with an ob and make a decision.

alliedoe · April 2014

I was in a similar position with my son. He was projected to be 9 lbs 2 ozs. He didn't make the cut off but we went for the c section due to the potential shoulder issue. I'm glad we did he was 9 lbs 3 ozs when born.

Israfel · April 2014

Thanks everyone. Well, my midwife still has not gotten back to me-- doesn't look like she's going to. *sigh* like I said, she's not my favorite at this practice, it just so happened she was the one on the schedule for tomorrow, when I'm supposed to get induced. I've just been crying off and on all day-- probably hormones/stress, but I really feel like she's not taking me seriously. When I go in tomorrow I'm going to ask again about an elective c-section. I feel like it's easy to tell myself I need to advocate for myself in this position, but in real life I feel just overwhelmed and inept at doing so. I'm soooooooooooooo nervous for tomorrow.

LBStewart · April 2014

DD2 (born last Saturday) had shoulder dystocia. Prior to this experience, I had never heard of it. I went into labor at 37w5d and the baby's size had never been brought up previously as a concern. It definitely was not a pleasant experience and I totally get why you would be concerned after educating yourself about it. With the help of several nurses, they were able to get DD2 out. She has a broken collar bone and possibly some nerve damage in her arm. My ob/gyn said that if I have another baby she will definitely recommend a c-section. I know that it's easy to stress about this, but just know that the medical professionals are trained for this sort of situation and everything happens so fast that you don't really know what's going on until afterwards.

Jodash24 · April 2014

My first son was 9lbs 1, no delivery problems not even a stitch, this time around I have GD and have been having regular growth scans, at 36 weeks he was showing 6lbs 4 and have my next scan Monday, they are going to decide what's going on then depending on growth, but the dr did say she was happy with growth, and that I would probably get induced due date week, I'm so nervous this time around, everything is freaking me out

pdilly2b · April 2014

I pushed on hands and knees for my son because I wanted the largest possible pelvic dimensions to get him out, even though I wasn't specifically at risk for SD. May be something to look into (Gaskin maneuver) since you are worried.

pineconey · April 2014

pdilly2b said:
I pushed on hands and knees for my son because I wanted the largest possible pelvic dimensions to get him out, even though I wasn't specifically at risk for SD. May be something to look into (Gaskin maneuver) since you are worried.

I was just going to suggest this!! Hands and knees is recommended by Ina May.

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