Shoulder dystocia

[soulem]

Anyone here know much about this??

My friend is expecting her 2nd baby in October ( ) and her first child was 10lb 12oz and her shoulders got stuck on delivery. Luckily my friend eventually managed to give birth naturally to her.

This time round the consultant has said she may need to have a section in case shoulders get stuck but seeing as she managed naturally before then she is able to try and see how it goes so long as she has epidural so they can top her up if section looks like it's needed.

Well, my friend's concern is that if she goes natural, which she wants, and the shoulders get stuck once she has the head out, how would they perform a section?!?! She's worried they would try to push the head back in?!?!

Hoping someone may know the answer!! I haven't googled it yet as probably get horror stories!!

 

[Suzie and Faith]

I don't know about sections but my midwife said that one of the worries women homebirthing (like i plan to) are often over worried about this happening. It doesn't always happen with big babies.

Midwives are generally very good at manipulating the baby whilst it's inside - i think it involves lifting the mothers legs way over her head and then getting swapping her position back and forth etc until baby dislodges. My midwife has helped deliver a 11lb 12oz baby with shoulder whatsit at home and all was ok

I guess if they couldn't then they made need to pop babies head back in to get the baby out via a section - but hopefully that'd be a last resort.

xxx

 

[Sherlock]

I've discussed shoulder dystocia at length with my MW as I am hoping for a homebirth and having a possibly biff biff baby. But large baby does not always mean shoulders get stuck. It can be because of the womans pelvis and the position of it at the time. Therefore as I understand it there is the first course of action (and this usually works and all MW's are trained in it) the McRoberts maneouvre.

Ditto what BabyBee said about MW's being able to manipulate baby so as it can be born.

To use someone elses words about the McRoberts...

'the woman is pushed onto her back and her knees are pushed up high under her armpits, and the midwife using a hand to free the baby's trapped shoulder.'

This is usually enough to allow baby to be born. My MW has done this a number of times in her career and each time baby arrived safely.

FWIW, what I read just now on what your friend thinks might happen told me the following

'There is only one maneouvre which can be carried out in hospital and that is virtually unheard of in the UK - the Zavanelli maneouvre, where the baby's head is pushed back up into the mother's body and the baby is delivered by caesarean section. Because of the time it would take to do this, circumstances where it might save the baby's life are vanishingly rare.'

I seriously doubt this would be done here in the UK. Your friend needs to discuss what course of action would be taken with her Consultant and MW so as to put her mind at rest. Something as potentially worrying as that is best heard from the horses mouth and not read about online etc IMHO. I have never heard of anyone having the Zavanelli maneouvre used fwiw. My MW told me it was the McRoberts maneouvre and possibly a episotomy if she has had an epidural, but don't quote me on that bit ok. It might vary from area to area and MW to MW.

 

[LucyBee]

My consultant wouldn't allow me to labour naturally as they knew Tom was so big and shoulder dystocia was a big concern.
So he was born by c-section instead.
Lucyx

 

[smile]

as sherlock mentioned there is the Zavanelli maneouvre but it is very rarely used and is a 3rd line option after

1) McRoberts
2) Either internal maneouveres (ie moving baby while it is still inside - for this you need a good epidural as it can be painful) or the all-fours position which is usually very successful.

It is best that your friend discusses this with her consultant but it is likely that the option of trying labour before deciding about a section is related to seeing how labour progresses. Poor progress in the first stage of labour is a risk factor for shoulder dystocia as is contractions stoping half way through - they will add all these things up and put them together with possible biffness of baby to work out what is safest for mum and baby...

They would also want to keep a close eye on her afterwards if it did happen as serious tears and blood loss are more common so it is good that they are discussing this and considering the possibilty first - forewarned is forearmed and all that

 

[trixipaws]

i think i read about this and i thought they do push the head back up? idk cant remember frightened me to death!

 

[Redshoes]

Having an epidural could very well effect the labour so it does result in a c-section, whereas naturally she has the opportunity to control her labour, and ALL births are unique, to suggest this could happen again just because it has before is a bit much, sorry, she should labour and birth how and where she wants, she certainly knows the condition better than most

 

[Sherlock]

i think i read about this and i thought they do push the head back up? idk cant remember frightened me to death!

This is where reading on the internet gets scary. Best not to take it as gospel IMHO

soulem, I really do suggest your friend discuss all this with her consultant and the MW as they are the best people to advise her on it. The consultant for the medical intervention aspect, the MW for the things that she can do should it happen during labour.

From the sounds of it they won't let her get to a stage where the baby is coming down and would opt for a C section sooner (ie if labour does not progress and baby does not come down) but please get her to discuss with professionals.

 

[soulem]

Thanks all for your replies!!

She's going to write down her questions for consultant for next time, said she was too caught up in what he saying last time to ask anything about it!!

I shall show her this thread next time she is round!

Thanks again!!