is it possible for cervix to 'un-dilate'

[ARGH]

DS was born 4 months ago and it was an awful labour/birth resulting in emergency c-section. I have just received a copy of my maternity notes so that I can try to understand what happened and deal with it all.

I started at a midwife unit where it is clear in my notes that I was fully dilated and I was pushing for quite some time. I was then transferred to a hospital and when I was checked, I was still fully dilated. They recommended go to theatre for possible forceps and/or c-section. Ended up with cs. According to notes, it was because I was only 9cm and therefore couldn't use forceps.

Is it possible that I went from fully dilated to only 9cm before baby was born? Or were 3 midwifes/doctors wrong when they said I was fully dilated? Totally confused...

Also, does anyone know of a good site somewhere to help me translate the acronyms in my notes?

TIA

[ledodgyrobespierre]

I wouldn't have thought you could un-dilate as the plug would have come away. I do know mw use there fingers to see roughly how many cms you are dilated so maybe one of them had fatter or skinnier fingers!

[ledodgyrobespierre]

*their fingers

[harpsichordcarrier]

hmmm, I think it is likely that the midwife just estimated incorrectly (9cm/10cm). sometimes at the end of the first stage it is possible to have an "anterior lip" i.e. a bit of the cervix that has still not retracted, and if you push agains that it can become swollen and impede progress. do you think that might have happened?

[ARGH]

In the notes, it does mention a 'rim' at one point it says it was "felt but not swollen" then later (just before being transferred) it was gone completely... I feel like they decided on c-section before I even got there and they've just put in the notes that I was only 9cm just to give them an excuse... I'm just curious if it could be right as if it's not, then I can make official complaint as they obviously messed up my care...

[3andnomore]

Argh...I really don't know if you can "un-dilate" but have never heard of such occurance, personally!
But I can understand your feelings of mistrust very well, as that is just how I feel with ds3...because there are a few points in my notes that didn't add up...forinstance I was told and it said in my notes that I had a "ring of contractions" which apparenlty translates to Bandle Ring (Sp?) but my m/w that had been with me at home (I attemtped a Homebirth)and then took care afterwards told me that she was not told it and that it was highly unlikely and that she doesn't beleive I had it....well, at the afterchat with a Consultant I mentioned this, and she just said....oh , if it is in the notes then it must have happened...which didn't convince me at all....seeing that she also felt that the Consultant in the Hossie, had also the right to treat me badly because he was tired (wtf) and other stuff!
Maybe you could get an appointment to speak to some m/w's Docs that were there and go through your notes with them....I think most hospitals have a Patiens liasons person...can't rememeber right now what they are called properly!
The best way to overcome a traumatic Birth is to talk about it...Homebirth org is a good online website that really helped!

[binkacat]

It is possible to go from 10cm to 9cm. If you're 10cm and pushing, but baby isn't descending (possibly due to malposition) then your cervix can become swollen (bit like being bruised) and therefore give the appearance of being 9cm again. And yes they would have to cs you.
Its unlikely that 3 midwives/doctors all got it wrong.
They wouldn't make it up just so as not to do forceps. What makes you think they'd already decided on a cs.?
Even when a woman is 10cm they can't always have a forceps you know, sometimes the head is too high up. Seen that before and although its upsetting for a woman to be at 10cm and still have a cs, the docs do whats safest for the baby.

[3andnomore]

Binkacat...hm....sorry, but I am personally not that trusting anymore!I do believe sometimes they do CS for protocol, etc...i.e. woman to long in labour and other nice things!I felt like that before my last experience but going through what I did last time only reenforced that!Not saying all docs and m/w's are rubbish or bad or whatever....but some are, and the protocols to get women in and out quickly and wotnot really do not help!A woman should be treated as the individual that she is, protocols don't have a place in that scenario!

[Mum2FunkyDude]

Hi, it happened to me too, what happened was that the cervix started thickening again, due to swelling. Apparently that happens (I was told).

[binkacat]

I totally agree with you that women should be treated as an individual and I know that obviously there are protocols in palce saying that women shouldn't be in 2nd stage (full dilatation to birth) more than one hour (2 if you have an epidural). However in such situations I have only ever heard the doctor be honest with the woman - we think you've been pushing for too long, etc. And these protcols are truely in place for the benefit of the baby not to get women in and out quickly.
Most doctors will let the woman carry on for longer than protocol as long as the baby is ok, mum is ok and progress is being made. But if there's no progress then a ventouse or forceps will be tried, cs as a last resort.
I'm sorry you feel that you can't trust what you've been told. Does your hospital run any sort of debriefing service?
BTW if you need any help translating any acroynms let me know, I can probably help ;)

[Emskilou]

Hello after a long labour (21 hours) I was 10 cm dilated with ds, forceps were tried but failed because he was too high up then resulted in an emergency cs, which then lead to me being put under ga as the spinal block wore off and I felt all that they were doing oh and they had knicked a main artery so I had to have a blood transfusion!

The consultants, midwives and aneathetists(sp??!) were astounding, I couldn't have asked for a better team they were amazing. This is just to reiterate that the majority, IMO, do not decide on doing a cs without trying their utmost to prevent one, after all it is more work for them surely??

It is so sad that you feel this way and I know how an emergency cs can affect us, but by talking you will feel better about it and hopefully we can all help too

[3andnomore]

Binka, in my case to late now, did have a chat with a consultant afterwards, but I found her to be unhelpful, to say the least...! I am alright by now anyway, I still think about it,but am getting on with my life...well..ys is 2 now, would be sad if I wasn't I suppose!
As for a proper debriefing and notes etc....I had ds in Northern Ireland but am back in England now, so, it just would be to much hassle!
Got to say, watching that one Hospital Drama (about the gyno unit somewhere in london, which was pretty badly run, etc...) probably didn't help....I mean I realise it was a drama, but it was based on real life events...and that was pretty scary stuff!
Like I said, by no means am I suggesting that we are lied to in general or that info is withold all the time, but it does happen, iykwim.

[Needtoseelight]

3andnomore - I had a traumatic birth experience with DS1 and the midwife was happy to come and talk to me a year and a half later - worth asking if you think it might help.

[ARGH]

thank you for info. Sorry for not replying earlier but DH hijacked the PC

so, reason I think they decided on CS before I got there - kinda complicated. while pregnant, I refused all tests - no scans, blood tests, urine tests etc. medical staff not very happy about this and kept harrassing me to 'co-operate'. it seems when I was at midwife unit, they had to keep consultant up to date with all progress as he wanted to know when he could intervene. It feels like they are just saying "told you so" - that could be me being paranoid, although going from what I've read in notes, I don't think I am. Other reason was during transfer, the midwife I was with told me to keep pushing if I felt the need but as soon as I got to the hospital they said "don't push, there isn't any point"

as for acronyms, I haven't been through all the notes but if you could help me with a couple Binka, that would be great.

NAD (as is 'vagina NAD')
PP (this is mentioned a few times in relation to cervix and seems to be different stages of PP but no idea what it is)
ROT (no idea what this is in relation to, hard to read writing but think it says after it 'capul +moulding)
FBS (nothing else written next to that)


Also, this isn't an acronym and I can't find it in the notes now but something was said about ectopic echoes heard when using sonicaid... Any ideas what this means?

TIA

[Toady]

Maybe worth joining the ukmidwifery list, they will be able to answer all your questions.

here

[2plus2plus1]

NAD normally means Nothing Adnormal Detected
I think they mention caput something & moulding WRT the head being a bit swollen. Was told this was nothing to worry about and mearly meant the MW couldn't tell which position the baby was in (i.e. facing).

From googling:

ROT - right occiput transverse (positioning term I think).

PP - presenting part? i.e. bit of body that is coming first. Don't know why they would mention this more than once.

[ellasmum1]

I don't know if you have found answers to acronyms but I use them at work.
NAD just means nothing abnormal detected
PP usually means presenting part of baby eg cephalic(head) or breech (bottom)
ROT refers to position of baby's head felt according to the suture lines/ fontanelles ,in this case right occipito transverse(unsure about spelling!).Babys may become stuck in this position, a "deep transverse arrest" can be an indication for c/section.
FBS may refer to fetal blood sampling where they take a small blood sample from fetal scalp.
Don't know about ectopic echoes.

[binkacat]

Yep the acroynm translations are spot on. Right Occiput transverse means that baby wasn't in a good position when coming down, could well be a reason why they couldn't do forceps and would explain the "undilating". Also explain the caput and moulding

When you say PP (presenting apart) is at different stages it'll be refering to descent.

Ectopic echo is when the baby's heartbeat has a funny rythem when heard on the sonic aid. This sorts itself out in the majority of cases after birth and I'm sure that the paed will have checked for this.

FBS would be fetal blood sample.

[ARGH]

thank you all for all the help with that. Seems to make more sense now.

Very much appreciated