Shoulder dystocia with 1st baby... now pregnant with 2nd and worried.

KHTW

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Hi Ladies,

DD was born in 2015. It was an induced labour with epidural. I was on my back all through the labour. DD's shoulder got stuck and we ended up with forcep delivery and 2 midwifes pushing on my belly to get her out. She was fine, not a scratch on her, weighting juts over 9lbs. I took about 3 months to fully recover down below. Needless to say it was a traumatic experience.

I am now 30 weeks pregnant with my 2nd daughter and I am worried that she may also get stuck. I am consultant led and they have explained that there is still a higher risk but with it being my 2nd the risk is lower than 1st time. I was also given the option of an elective c-section.

We had a scan today and DD is measuring on 50th centile so if you believe this is accurate it is good news and it makes me feel a bit better about vaginal delivery. However I am aslo feeling guilty for taking the risk if I were to choose vaginal delivery. What if she gets stuck and this time there is more complication? What if she gets hurt?

Should I go for a c-section and basically make sure she gets delivered safely and then just suck it up during recovery?

I honestly am scared of both options and have no idea what to do. Having another scan at 35 weeks but I expect she will still be in 50th centile and I will be non the wiser then.

What would you do???? x
 
I had EXACTLY the same experience as you with my daughter.

She was of a similar weight, I had a long protracted back to back labour which ended up with hormone drip to move it on, episiotomy/forceps and turning of the baby at the mid cavity (in theatre) as she wouldn’t descend properly into the pelvis. Then on delivery I had to have mcroberts manoeuvre and the baby was born limp and lifeless with a poor apgar score. It was actually terrifying. We had stretched nerves and reduced movement temporarily and many months of physio but a healthy daughter in the end.

My second pregnancy I was terrified of the same thing happening. I spoke to the consultant at 16 weeks about it but I had low pappA in this pregnancy so they were scanning for growth issues anyway so I’d get a rough idea of how big he baby was. I was convinced it was size related. So at 28/32 weeks the baby was right at the top of the charts an dlooking to be massive again so my options were induction at 37 weeks or csection at 39. I didn’t want a section but that was the option that removes the risk entirely but has other issues obvs. My 36 week scan revealed a drop in the growth rate so they booked me in for induction at 38 weeks.as it happened I went into labour naturally on the very day of the induction.

I’d read about spinning babies to ensure optimal positioning for birth and was doing abdominal lifts during contractions which I’m convinced helped. That and sitting up straight on the bed. No laying down. Anyway the second labour was an absolute breeze. I had like a few hours of strong pains some g&a and the baby was born with like 3 pushes.

So it might not be all bad!!
 
Oh and just to add - my baby was 7lb 13oz at 38 weeks.
 
Firstly I don't think you should feel guilty whichever you choose. Personally I'm terrified of a section. Baby is going from transverse to breech so if my option ends up a section I'll be hysterical. So for me I'd try natural but I've not been in your shoes. I tore but never had anything traumatic happen like you did with yours.

Isn't it a option that you could say you want to start with a vaginal delivery with the knowledge that if a time any point they think it's not going to happen with the shoulders, you can then get a section? Surely everyone knowing that in advance would take the emergency out of it, with you stating that no ventouse or forceps be used?

Can't you say "I'll try pushing but I don't want anyone forcing her out, pushing on me etc. If she's not coming then I want transferred up to theatre" I'm not sure if that even helps or is a viable option to be honest hun . But they do say elective sections are a lot easier than emergency ones. And if that ends up being an easier recovery and less emotionally traumatic then feel free to go for it with no guilt. Xx
 
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Thanks ladies.

Torino, reading about you experience with DD and how poorly she was makes me want to go and book a section tomrrow!! You must have been so frightened! X

Shan, I think if baby gets stuck they have something like 8minutes to get them out, that is not a lot of time to get to theater for a section... And yes, elective c sec is already a major op with risk so i can only imagine emergency section x
 
Yes it was terrifying. But I view it as the outcome was ok in the end - if not for the mental scars. The consultant said to me there is a chance of it happening again and risk factors being a big baby and induction but more likely it won’t happen again. So I read the spinning babies thing and tried whatever I could to get the baby in the right position - and I didn’t Labour llying down on the bed which I reckon helped.

A fair few people told me to have a section but I really wanted my body to do the right thing and a section would have caused logistical problems and was better if it could be avoided. I hope you get the experience you want this time xx
 
What I read from your post is that a series of interventions caused your traumatic labour and the shoulder dystocia. Being induced probably meant the baby was not in the right position before labour began. Being on your back narrows the pelvic opening and an epidural limits your movement making it hard for the baby to turn into the right position. Of course sometimes interventions are necessary but if it is possible for you to have a more active, natural labour this time that might be enough to solve the issue. MWs who are experienced with birthing positions can also be a great help. Studies have shown that 80%of shoulder dystocia can be solved by simply moving the woman into a hands and knees position without any further interventions (try Googling The Gaskin Maneuver). Obviously the choice is totally yours and I can understand why you might choose a CS but it is worth considering your options.
 
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What I read from your post is that a series of interventions caused your traumatic labour and the shoulder dystocia. Being induced probably meant the baby was not in the right position before labour began. Being on your back narrows the pelvic opening and an epidural limits your movement making it hard for the baby to turn into the right position. Of course sometimes interventions are necessary but if it is possible for you to have a more active, natural labour this time that might be enough to solve the issue. MWs who are experienced with birthing positions can also be a great help. Studies have shown that 80%of shoulder dystocia can be solved by simply moving the woman into a hands and knees position without any further interventions (try Googling The Gaskin Maneuver). Obviously the choice is totally yours and I can understand why you might choose a CS but it is worth considering your options.

This!

Obviously no one would dare to blame you for whichever option you chose! your primary focus is your babies and we all feel for you I'm sure <3

But there is a significant amount of evidence to suggest that inductions, hospitals, unnatural positions can all drastically increase the need for interventions... It sounds like in your heart you don't want to have to resort to a section but obviously you have to do what you feel is best anxiety during the labor is going to slow things down anyway x
 
Thank you both x

I should also have mentioned that I am not labouring without the epidural... I found out with DD that my pain threshold down below is way way below average, I had to be examined with gas an air!!!!!! I am not a wimp normally but when it comes to my lady parts and babies I am a big wimp! x
 
Maybe inquire about a walking epidural and positions other than your back that you will be able to try.
 
Second labours are often much much quicker.. you may find there is no time for one!

Have a read of the spinning babies website. Xx
 
I will ask the question and visit the website for sure. Thank you again for all the advise xx
 
My first baby was back to back, 9lbs 4oz, cord wrapped around his neck twice and got his shoulder stuck.

I didn't plan on having an epidural but 3 days labor, i was shattered and asked for one. Im glad i did in the end as i had forceps and episiotomy which healed perfectly. I remember at the time the surgeon said it better to have that than to tear and I just said, " you do what you think is best" and im glad because she was wonderful.

I am 12 weeks pregnant and I too have been worrying about what this time round will bring. My midwife says that even with what happened with my first I am extremely low risk and is really encouraging me to have a home birth. She says, second births are usually a lot quicker and easier.

Because I am a worrier, I said I want to give birth in hospital but I am willing to try naturally. I will however go with the flow and if i want an epidural, i will have one. I work in maternity theatres so i have some knowledge, i certainly wouldn't have a C-Section unless it was an emergency but thats just me. It is major surgery. Also, all the lady anaesthetists i work with have ALL had epidurals.

My advice would be to follow the knowledge and expertise of your doctor and do what you think is best for you.
 
That's the thing HGM, I wish they just told me what to do! If they said to me 'forget c-sec, your risk is low' I would not even consider it. And of course I understand that they don't have a crystal ball, nobody does but I really wish they could make that decision for me. All I know is that I want my baby to arrive safe into the world. I don't want her to be pulled out with forceps. I don't want to risk her being hurt in the process. I have my appointment on the 31st, but this time instead of saying that I am unsure of how I want to labour I will just say I decided to have a section and I will say this only because I want to see the reaction and hear what they say then x
 
Im so sorry that you are feeling anxious and unsure what to do.

Were you offered a C-Section because you are worrying about the delivery of this child? Or were you offered a C-Section because they think this is the best/safest way to deliver your baby?

There is a big difference between the 2.

If it is because of the first reason, then maybe you need to take a step back and get the facts straight and not let worry frighten you into a decision. My midwife told me straight away that I am considered low risk with my 2nd even though I had a terrible time with my first. She followed this up with statistics. You need to ask your consultant whether you are low or high risk and explain your concerns to him.

If they have offered you a C-Section because they think it is safest then do that obviously.

This can be such a scary time and we are not really in control of any of it, but we can manage our minds and how we cope. Seems like you were traumatised with your first labour and you might possibly we worrying it will turn out the same or worse but I believe that second labours are much easier and straight forward than the first.

I wish I could help you. I would just make sure I had all my questions answered so that i could make an informed decision. I also trust my Doctors, they really are fantastic at what they do.
 
Thank you HGM xx

I never asked to have a section, the consultant offered it as an option for me to decide. They said they did not consider me to be high risk but never called the risk low either.

I spoke to my MW briefly about it and told her I really didn't want to face the longer recovery time with the c-section and the fact that it is an operation was off-putting but then she asked me for my recovery time after 1st labour and we worked out it was even longer! She also asked me not to forget about mental recovery. I felt like she was trying to convince me to go for a section. Whereas the consultant is not trying to convince me to go for either, I feel like she is telling me that whatever option I pick is OK.

As I mentioned before the only reason I am currently considering c-section more then natural labour is baby's safety. If somebody could assure me that my baby will be born healthy by vaginal delivery I would forget the c sec right away but the problem is nobody is making me feel like the v delivery may be smoother this time around, especially if I get induced again and with having epidural (which I must have, otherwise I am not giving birth at all) xx
 
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You could always refuse induction and go straight to CS if it comes to that.
 
I will definitely talk ALL the options and scenarios on the 31st with my consultants x
 

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