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Old 11-20-2012, 07:38 PM   #11
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

My first 2 had dystocia, the second much worse than the first. When I got pregnant with number 3 we did talk a lot about a csection, some of the midwives in my practice (freestanding birth center) did push a section, some thought I should do a trial labor. I went back and fourth a lot and in the end decided I had to at least try. We worked with a peri and a group of obs in addition to my midwives to try to come up with a plan we were all ok with. We learned the dystocia was being caused by a platypelloid shaped pelvis. The plan we came up with was to induce at 39 weeks, change up my pushing positions and they were only ok with me pushing for an hour ( pushed for 3.5 hours and 6.5 hours with my first 2). And like someone else said even 1 red flag and we would do a section. My 3rd birth was my most medical, I ended up asking for an epidural for the first time and had almost every labor intervention possible but I pushed 1 time and she was here. They think the epidural allowed her to turn to a better position. With my first 2 I had the urge to push pretty much as soon as I was completely dilated a d while they were in a great position for most women (left occiput anterior) but the best position for me was occiput transverse.

So for me 1 dystocia would not be enough to make me automatically go to a section but i would be a bit more cautious during labor. Even for me 2 dystocias were not enough to make me go to a section.

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Old 11-20-2012, 07:59 PM   #12
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My sisters first had this so with the second they did recommend it and she took the opportunity. Then her second baby weighted more than 2 lbs less than her first, so she some what regretted it.
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Old 11-21-2012, 07:41 AM   #13
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

I forgot to add a few details to my original post. My first baby apparently had shoulder dystocia also. But from my memory (I had an epidural for that one), it was not as bad. The nurses sort of pushed on my tummy and I got an episiotomy. He was not injured at all.

Then I went on to have 2 more babies without SD.

My fourth (most recent), had SD- he was stuck for a few minutes but eventually I miraculously pushed him out. He seemed fine at birth, but 2 days later the Pediatrician said he had broken his clavicle. It was minor, though, and healed on its own. He never really had any problems with it. Apparently broken clavicles are not that rare for difficult births.

Anyways, I'm certainly not being "selfish" in my desire to avoid a c-section (IMO). A c-section is major surgery and carries significant risk to mom and baby. If I can deliver on my own I would much prefer it...
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Old 11-21-2012, 07:56 AM   #14
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

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This. I wouldn't consent to a section or early induction (pre-42 weeks). JMO.
This.

My DS had some dystocia. He was 9lbs 3oz. It was not a serious problem, thankfully. When we realized he was stuck, we just a changed positions and he came out within a few pushes.

My next baby was 7lbs 8oz and there were no issues.

I think dystocia can be caused by position as well as size, not size only. I could be mistaken though. That would explain why smaller babies can have dystocia, too.

I don't think a previous experience with labor/birth is a really great reason to have a major surgery, or consent to tons of interventions "just in case" .... EVERY birth can be so so so so different.
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Old 11-21-2012, 08:01 AM   #15
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I had a 9lb 6 oz baby with mild.SD. when I talked to my midwife she said there is no reason to think it would happen again. It could but it's not likely.
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Old 11-21-2012, 12:15 PM   #16
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

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Originally Posted by steph410 View Post
I forgot to add a few details to my original post. My first baby apparently had shoulder dystocia also. But from my memory (I had an epidural for that one), it was not as bad. The nurses sort of pushed on my tummy and I got an episiotomy. He was not injured at all.

Then I went on to have 2 more babies without SD.

My fourth (most recent), had SD- he was stuck for a few minutes but eventually I miraculously pushed him out. He seemed fine at birth, but 2 days later the Pediatrician said he had broken his clavicle. It was minor, though, and healed on its own. He never really had any problems with it. Apparently broken clavicles are not that rare for difficult births.

Anyways, I'm certainly not being "selfish" in my desire to avoid a c-section (IMO). A c-section is major surgery and carries significant risk to mom and baby. If I can deliver on my own I would much prefer it...
I didn't mean to say you are being selfish. I definitely mourned my having to have c-sections. I just meant you should be open to the possibility of the need presents itself (some moms I've spoken with are so anti them that I would worry they would put their desire not to have them over the health of the baby... eek. that is rare though). Anyway, with the history you just wrote, I would be even more open to a c/s. Given that this is your second s/d and that this time the baby was injured; I would be concerned next time (esp. if the baby is even bigger) that there would be even more of a serious injury I have had some complications with the c-sections (the 2nd with adhesions and the 3rd c/s with a bladder injury and adhesions) so I know there is risk (I wish I didn't know!haha) and yet my oldest son is 5 years old and still dealing and living with the result of his s/d. Everyday he works so hard and his whole life was changed. Just some things to consider.

Did you have many red flags in your labors? If so, would the doctor be comfortable monitoring size and any potential red flags? Maybe he would agree to a Trial of Labor if you signed waivers and really wanted to try a vaginal birth this time. Every Brachial Plexus Mama I've talked has said the doctors have told them they were "automatic c-sections" (even second opinion ones) and yet I did find my ob/gyn who was willing to let me TOL with the 2nd kiddo. So maybe yours may be comfortable with that. If you didn't have any red flags, that might make him more nervous though.
Did he say how tight he felt your lo was wedged in? My midwife said she could not get a finger in between #1 and I to when she reached in to try to manipulate his shoulders after changing positions did not help. I have no doubt his was not positional.

Jaelynsmommy- From what I've read and heard in conferences, there is a 7x greater risk of it happening again to you. Not saying it will (I certainly hope not!!!), but it is more likely to happen again since it happened before, so make sure she stays up on being trained in maneuvers to dislodge the baby and having other emergency equipment out "just in case" it's needed.
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Old 11-21-2012, 12:26 PM   #17
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

what do you mean by red flags?

Do you mind if I ask if your son who was injured, was it your first child? Only asking because I wonder if having had multiple babies vaginally makes a difference to how a doctor would treat me.

I certainly need to discuss with my doctor. I know that BP injuries are quite serious and SD is very dangerous. I want to do the right thing, but if I can avoid SD through labor position or other means I would prefer that.

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I didn't mean to say you are being selfish. I definitely mourned my having to have c-sections. I just meant you should be open to the possibility of the need presents itself (some moms I've spoken with are so anti them that I would worry they would put their desire not to have them over the health of the baby... eek. that is rare though). Anyway, with the history you just wrote, I would be even more open to a c/s. Given that this is your second s/d and that this time the baby was injured; I would be concerned next time (esp. if the baby is even bigger) that there would be even more of a serious injury I have had some complications with the c-sections (the 2nd with adhesions and the 3rd c/s with a bladder injury and adhesions) so I know there is risk (I wish I didn't know!haha) and yet my oldest son is 5 years old and still dealing and living with the result of his s/d. Everyday he works so hard and his whole life was changed. Just some things to consider.

Did you have many red flags in your labors? If so, would the doctor be comfortable monitoring size and any potential red flags? Maybe he would agree to a Trial of Labor if you signed waivers and really wanted to try a vaginal birth this time. Every Brachial Plexus Mama I've talked has said the doctors have told them they were "automatic c-sections" (even second opinion ones) and yet I did find my ob/gyn who was willing to let me TOL with the 2nd kiddo. So maybe yours may be comfortable with that. If you didn't have any red flags, that might make him more nervous though.
Did he say how tight he felt your lo was wedged in? My midwife said she could not get a finger in between #1 and I to when she reached in to try to manipulate his shoulders after changing positions did not help. I have no doubt his was not positional.

Jaelynsmommy- From what I've read and heard in conferences, there is a 7x greater risk of it happening again to you. Not saying it will (I certainly hope not!!!), but it is more likely to happen again since it happened before, so make sure she stays up on being trained in maneuvers to dislodge the baby and having other emergency equipment out "just in case" it's needed.
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Old 11-21-2012, 01:12 PM   #18
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

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Originally Posted by steph410 View Post
I forgot to add a few details to my original post. My first baby apparently had shoulder dystocia also. But from my memory (I had an epidural for that one), it was not as bad. The nurses sort of pushed on my tummy and I got an episiotomy. He was not injured at all.

Then I went on to have 2 more babies without SD.

My fourth (most recent), had SD- he was stuck for a few minutes but eventually I miraculously pushed him out. He seemed fine at birth, but 2 days later the Pediatrician said he had broken his clavicle. It was minor, though, and healed on its own. He never really had any problems with it. Apparently broken clavicles are not that rare for difficult births.

Anyways, I'm certainly not being "selfish" in my desire to avoid a c-section (IMO). A c-section is major surgery and carries significant risk to mom and baby. If I can deliver on my own I would much prefer it...
Even with this, I still personally would not consent to a c/s.

Maybe it's brutally mean or something, but I'd rather risk having a newborn with a broken cervical - which will heal quickly, and they will not remember the pain - than have major abdominal surgery.


You had one with the issue, which was easily resolved, two without any issues, and then one with the same issue, which was (IMO) again easily resolved.

Your next 5 births could have NO dystocia. There's just NO WAY to know.

If there is a true emergency and your baby is crowning but is stuck in a major room, they can do a c/s at that time. But to plan for one, on the idea that something *could* happen that *MIGHT* not be able to be remedied any other way.... seems a bit unfair IMO.
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Old 11-21-2012, 03:47 PM   #19
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

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what do you mean by red flags?

Do you mind if I ask if your son who was injured, was it your first child? Only asking because I wonder if having had multiple babies vaginally makes a difference to how a doctor would treat me.

I certainly need to discuss with my doctor. I know that BP injuries are quite serious and SD is very dangerous. I want to do the right thing, but if I can avoid SD through labor position or other means I would prefer that.

Not the poster you quoted but I can tell you what my midwives were looking for during my 3rd labor.
-Long labor with little to no progress for long periods of time (with my 2nd birth I kept stalling where I would not progress for hours at a time) I was in labor a total of 36 hours and before going into labor I was 5 cm.
- She did not descend or engage the way they would have expected her to. She did not engage in my pelvis until I had been pushing for 4 hours (and that was when they were putting me on the gurney to transfer me to the hospital). Before that she was still high,
-Long 2nd stage (I pushed for 6 1/2 hours with my second and 3 1/2 with my first). My second never got to the "crowning" point until they attached the vacuum. Once she engaged she just kind of stayed where she was for almost 2 hours. I pushed and she did not budge at all. With my first I was pushing and we could see her head but it just wasn't descending. We would see it try to descend but then turtle right back up.

Those are just some of the red flags they were looking for with me. I was fortunate that my second tolerated the dystocia very well, she was stuck for almost 5 minutes but still somehow maintained nearly perfect apgars. My first, though she was stuck for almost 1/2 the time did not tolerate as well and had low apgar scores and took much longer to get her stable.
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Old 11-21-2012, 03:50 PM   #20
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Re: Anyone had previous shoulder dystocia & large baby- did you doctor suggest c-sect

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Even with this, I still personally would not consent to a c/s.

Maybe it's brutally mean or something, but I'd rather risk having a newborn with a broken cervical - which will heal quickly, and they will not remember the pain - than have major abdominal surgery.
You had one with the issue, which was easily resolved, two without any issues, and then one with the same issue, which was (IMO) again easily resolved.

Your next 5 births could have NO dystocia. There's just NO WAY to know.

If there is a true emergency and your baby is crowning but is stuck in a major room, they can do a c/s at that time. But to plan for one, on the idea that something *could* happen that *MIGHT* not be able to be remedied any other way.... seems a bit unfair IMO.
I am in no way for jumping right to a csection but shoulder dystocia can cause complications much worse than broken clavicles. I think this tends to be the opinion of many, I was told by so many people when I was debating with my third what to do that a broken clavicle wasn't a big deal in a newborn. But they never seemed to acknowledge that there could be much worse outcomes with a dystocia.
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