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    Default Should midwife have known baby was posterior?

    My son was born 9 months ago via emergency c-sec due to him being posterior. I did not find this out until I had been pushing for an hour and an OB was called in and did an internal. My question is shouldn't my midwife have picked this up if not at my antenatal appointments but from the internals and checks she was doing on me as I was in labour for several hours at the hospital?
    I was and still am disappointed that I didn't get another smooth sailing natural birth and the questions still play on my mind everyday.


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    Last edited by lexim; 08-04-2014 at 13:26.

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    Not sure?
    My ds2 was posterior. I was checked by a few midwives and no one picked it up.

    I was only in labour for three hours and I managed to give birth vaginally though after an hour and fifteen minutes. So I wasn't in labour for as long as you and didn't have as many opportunities to get checked.
    As for prenatal sure it can get picked up my ds1 got picked up but he turned eventually. I was under the impression that can turn either way at any time. So bubs could have been the right way then turned at the last minute iykwim?

    I don't know how easy/difficult it is to tell if bubs is posterior once labour is established?

    Sorry you didn't get the birth you wanted though

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    My baby was anterior for my entire pregnancy, until I was in labour, then she flipped posterior. Sometimes they move around so it can be difficult to pick up. My entire labour was 1hr47min and second stage was 17min.

    Posterior is head down but facing up and generally doesn't mean a csec, Do you mean breech (bum down head up?)

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    To tell if bub is posterior in labor they can feel the fontanelles on the baby's head, one is bigger than the other so they can tell which way bubs head is

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    My midwife picked up in antenatal exams that bub was posterior but she turned before I went into labour. However no one could tell me how she came out as the midwife and doctor disagreed about her delivery presentation
    Anyway, I think they can turn during labour so may not have happened til last minute and you would have no warning.

    I am sorry you are unhappy that you ended up with a caesar, bub must have been in a pretty bad position to go to that, as I think sometimes a vacuum or forceps would be used first? It must have been the best option at the time to keep you both safe and doesn't mean you can't try for a vaginal birth next time if you want. I had a successful vbac which was very healing.

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    Both my girls were posterior labours and both missed by Mw and OBs. Only after a prolonged 9-10cm stage did they work it out.



    wifey of hubby who is always away. mother of two girls who are always amusing.

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    Your baby can continue to rotate throughout your labour so you baby may have been anterior to begin with and so there would of been no issues - babies can flip from posterior to anterior quite easily and vice versa.

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    Babies rotate constantly. Depending on the position of baby's head and also cervical dilation it may not have been possible to feel the fontanelles/sutures in baby's head. It can also depend on the woman's comfort during the vaginal examination. If a woman is really struggling to tolerate the examination it can be hard to get the chance to actually have a good feel. An examination is much more than putting a couple of fingers in, having a quick feel then pulling fingers out.

    Depending on your position during labour as well that can affect baby's position. Eg, if you were laying on the bed with an epidural for most of the labour, that can contribute to baby turning posterior.

    Sometimes a baby is just naughty! A posterior position isn't an automatic indicator of needing a caesarean. More often than not babies who have been posterior in labour will rotate during the pushing stage. It is just unfortunate in your case that baby wasn't coming. It is likely that bubs head was slightly acynclitic as well, so instead of coming out top of the head first, was actually coming out with a slight tilt, so off centre.

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    Quote Originally Posted by mummabear13 View Post
    My son was born 9 months ago via emergency c-sec due to him being posterior. I did not find this out until I had been pushing for an hour and an OB was called in and did an internal. My question is shouldn't my midwife have picked this up if not at my antenatal appointments but from the internals and checks she was doing on me as I was in labour for several hours at the hospital?
    There are two ways to determine fetal position. Abdominal palpation and vaginal examination.

    On abdominal palpation you're feeling for the position of baby's back (or lack of in posterior position) which can be difficult if your palping during labour (discomfort for the woman) or if the mother is overweight on obese.

    On vaginal examination you're feeling for the position of the sutures and fontanelles in relation to each other. This can be difficult due to
    a) cervical dilation
    b) maternal discomfort - it takes a good bit of feeling around to determine the position and if the woman is very uncomfortable during vaginal examinations due to labour then sometimes you have just enough time to get cervical dilation before the woman is asking you get your fingers out
    c) swelling on the baby's head (normal during labour) that prevents you from feeling the sutures.

    The next question is what exactly would you have liked the midwife to have done if she did identify that baby was posterior antenatally/during labour?

    Apart from spending a lot of time on your hands and knees instead of on your back, there's not much you can do to turn a posterior baby apart from wait for it to turn by itself.

    If the doctor determined that a caesarean was indicated after 1 hour of pushing there must have been other factors at play. Baby might have been too high up to attempt a forceps or ventouse delivery. Did you have an epidural? Where you pushing effectively and well for that last hour?

    Perhaps you need to go back for a debrief at the hospital you birthed at, as based on your OP you seem to have a different idea of what the midwives and doctors should/could have done for you.

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    CitrusRainxxx  (08-04-2014),mummabear13  (08-04-2014),Purple Lily  (08-04-2014)


 

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