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  1. #1
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    Default 2x shoulder dystocia - preg with 3rd

    Hello all,
    I'm having some inner struggles coming to terms with a probable c-section. Now I know they are fine most of the time, but I am very much into the old "push 'em out" way.

    With both my first and second (both girls, 1 = 3.6kg, 2 = huge 5.2kg) the shoulders got stuck. The first was an early induction (horrible) and I had an epidural. The result was a 3rd degree tear which wasn't pleasant but I recovered pretty well and quickly with not much discomfort. The second was an overdue induction but only gel and breaking waters. She was massive and posterior until she popped out, so it's not surprising her shoulders got stuck also. I had an episiotomy and tore but only 2nd degree so all ok there. But her collar bone broke coming out... something had to give. It never caused her pain, surprisingly. She didn't cry coming out (which frightened me at first but she was perfectly happy and peaceful... wish I could say the same about her now at almost 3 years old!).

    I recently had a consult at Canberra Hospital (we live in a rural area about 1h45 from there) and was originally told that if at 34 weeks the scan showed baby a normal size and i was going ok in terms of weight and BP etc then I could probably go to due date and be booked in for an overdue induction if I happen to go over again. Meaning, if I didn't go into labour before then I would be induced in Canberra when overdue.

    My local Dr has said she's ok to do a c-section here, but if it is to be a vaginal delivery she wants it to be in Canberra. Basically because the shoulders are likely to be stuck again which can cause all sorts of possible issues.

    Anyway, after the Dr at Canberra told me this she went out of the room to consult with the other OBs and when she came back she said he had said I should be booked in for a c-section and not allowed to delivery vaginally. In his opinion.

    So at this stage that is the plan. I told myself weeks and weeks ago that if I was advised that c-section was best then that is totally fine with me. But now that it's an actual reality I have been having a hard time accepting it. It's not that I'm afraid. I'm not sure exactly what it is. I have done more reading since then about shoulder dystocia and its risks but also natural ways to help release baby (with positioning). Surely if baby isn't big, it's less of a risk? But the Canberra Dr told me there is no guarantee that a smaller baby wouldn't get stuck also.

    I just don't know what to think. I have to either have a very compelling argument to talk to my Dr about next thursday or just get over it and accept a c-section.

    Call me insane, but I like to work, and hurt, and push, and struggle to get a baby out. :/ What's wrong with me? At the time, of course, I don't feel like that. Ha! "I can't do this anymore! Just get it out of me!"

    Does anyone have any past experience with repeated shoulder dystocia and words of wisdom to share?

    Thank you.

  2. #2
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    My DD has a permanent injury due to a shoulder dystocia delivery. Im pregnant again now and after much self procrastination im opting for a c-section. I'd love another vaginal delivery but I'd give anything to go back in time and have an un-injured child

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    ThenThereWereThree  (31-05-2015)

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    I'm very sorry to hear that, PinkPopsicle.

    A risk like this is the one thing drawing me to c-section.

    Thank you for sharing.

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    My first baby was born at 36 weeks and was a shoulder dystocia, she wasn't injured though luckily. And I'm glad she came four weeks early!

    While pregnant with my second I considered a c-section, but being a midwife I felt a bit guilty and wanted to labour again. I was induced, but terrified the whole labour about him getting stuck, luckily or unluckily I didn't get to that point. After 12 hours his cord prolapsed and I ended up with a really scary c- section under general anaesthetic.

    Third time around I really couldn't cope with another emergency during my birth so I booked in for an elective c-section and didn't regret it for a minute. I am sad I didn't get to have another vaginal birth but I'm happy there were no complications third time around and both my baby and I were fine.

    Good luck with your decision @mumofbabes, I can really understand how hard it is!

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    My ds had shoulder dystocia also. He was born one week early weighing 4.24kgs. He didn't suffer any permanent injuries however, he did have a very serious head injury from the vacuum which was used in conjunction with the Robertson manoeuvre to help him pass through. He had a brain haemorrhage, but thankfully the bleed stopped and he made a full recovery. I guess if the vacuum wasn't used they may not have been able to get him out in time. It was incredibly traumatic for me and ds. I'm currently 23weeks pregnant with #2 and my Ob has suggested a c-section due to the high risk of having shoulder dystocia again. I agreed on the spot because I felt I couldn't risk having another baby with a birth injury. I'm happy with my decision and feel confident it's what's best for my baby. Good luck with your decision

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    My third child had shoulder Dystocia (quite severe) After trying everything else my OB resort to basically shoving her arm up inside me next to bubs head to dislodge the shoulder. It was seriously the scariest thing I have ever had to endure. The pain was immense (I had no drugs, my labour was only 3 hours and I was in a optimal position for birth - on my knees bent over the back of the raised bed) and looking over to see them doing tiny little chest compressions to get my bub breathing was horrifying.

    My recovery was long (for months I felt like my insides were going to fall out when I walked) It took me a while to bond with him as we were separated for a while after the birth. He has some mild issues due to lack of oxygen to the Brain (Behavioral).

    To be honest, as petrified as I am of ever having a C section, I think I would have jumped at the chance to have one for #4 if I was told to. They ended up inducing him early and he was a lovely 7 pound 4.....

    Good luck. Birth is such and unpredictable thing.

  8. #7
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    bunkx is offline Being happy doesn't mean that everything is perfect. It means that you've decided to look beyond the imperfections
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    I had that with my 4th lucky he was ok and that the midwife delivering him was very good :-)
    he was going to be a Caesarian because he was breech but I really didn't want one has I had a very active 19month old so we tried a ecv and it was successful :-) but honestly if I had known he was going to get stuck and was over 4kg I would have gone with the c section

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    I had shoulder dystopia with my second who was 4.1 kg at 39.5 weeks. I was petrified of it with my third but the hospital wasn't too worried. She ended up coming at 36 weeks of her own accord, an easy VB with 6 pound 15 ounce baby (can never remember the kg's).
    With my fourth the OB at the hospital decided that I was not going to go past 39 weeks and would be induced. Assessment for that began at 38 weeks but whilst my cervix was very favourable baby's head was too high. Basically this continued until I was in my 39th week when they decided that they would have to try something despite the high head. So I was induced with gel then ARM once babies head descended enough and DD was another VB at 3870g.
    Obviously my story is different to yours though, I had already birthed my first (3560g) without any shoulder issues. I think for me the issue might have been positioning but that's really just a theory.

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    My dd was born 5.03kg. I knew she was bigger than my first (4.5kg) so ended up booking a section at 41+3 (42wks by my dates). I had nightmares of her getting stuck. It was my ultimate fear! I had a traumatic delivery with #1 but i couldn't even begin to imagine how traumatic that would be. What were the possible reasons for SD in your previous deliveries? Positioning of bub and yourself or your build etc?
    If positioning, have you looked into hiring a doula? I met with a couple during pregnancy and they mentioned that they receive a lot of training in regards to SD and labouring positions.
    Also, having a c-section is still hard work 😉

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    Thank you, everyone. Your personal stories are really helping me think through this.

    BlackDiamond - I don't know what the reason is! I want to know! I do know that bub 2 was posterior but being naive the first time around I have no idea if bub 1 was posterior or not. I can't remember. She didn't come out posterior, but neither did bub 2 (she turned SOMEHOW before she came out). Does posterior increase chance of SD? I haven't researched that part so I don't know.

    My build? I'm broad so I assumed I'd be roomy enough down there but obviously I'm not. :/ I'm overweight, and I know that increases the chance of SD. Both bubs were born with me on my back. First one coz I had an epidural and couldn't move (uggggh I hated that!) and second one I could move but her head wasn't getting down enough (posterior! big fat head in wrong position!). I felt like I needed to push but once I started pushing it felt like I didn't need to. :/ After a couple of hours like that the Dr decided to change the bed and put my feet into the stirrup things. And that's how I delivered. He was going to use the vacuum thing, showed it to me, explained. But I didn't want it so somehow I pushed much more and bub got out without it.

    Maybe it's my perfectionism in me... but I want a 'normal' labour and delivery. I know that sounds stupid. But I have no idea if my body can do this thing it's made for or not. I have never gone into labour naturally. I thought I was last time, but it was a false labour - POSTERIOR > I don't even know how my body would work 'naturally' and bub positioned best way. I would love to experience it but I know that's not a huge deal. As long as baby and I are healthy then that's most important. Part of wanting to experience this part of pregnancy/delivery is because I have daughters and I want to be able to share things and teach them things from my experiences when they're pregnant.

    Aaanyway... sorry to ramble. I really do appreciate all of your stories, ladies. Thank you so much.


 

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