Labour debrief needed - bit long, sorry!

[abracadabra]

Hi, my dd is 11 mths now and we are starting to think about TTC no.2. Although her birth was basically a good experience there are still a few things going round in my head about it that I would appreciate discussing. Story in brief is that when first examined I was 4 cm dilated - 4 hrs later contractions had slowed down a bit and I was still only 4 cm. Midwife then broke my waters which brought contractions on strongly again - but after another 4 hrs was still only 4 cm. Syntocinon drip was then recommended - at this point I opted for an epidural. Apart from scary bit when they were worried about dd's heartbeat and took a blood sample from her head, things then went smoothly and dd was born thankfully without further intervention. However she had some problems breathing and was given oxygen for 4 hrs, first in delivery room and then in SCBU. She was fine after this. Basically my questions are:

a) why do cervixes 'get stuck' like this? (I was active and upright up to epidural so don't think this was the problem). Is it likely to happen again if/when I have another baby?
b) if I had opted not to have my waters broken, what would have happened? Could I have gone home and waited for things to start up again of their own accord?
c) any ideas as to why dd had breathing problems? (since that initial blip she has been the healthiest baby imaginable by the way!). One midwife said it might have been due to long labour, another that it might have been because she was small (6lb 8oz), but I do wonder whether syntocinon and/or epidural had something to do with it.

I know all this sounds a bit obsessive, and as I said it was overall a good experience, but I just feel talking through these issues would help me to look forward to labour number two in a really positive way IYSWIM.

[mrsmalumbas]

Hi there. I'm sure others will chime in but here's a few thoughts. First off, what had been going on up to your first exam - had you had a long early labour? Were you getting a bit tired maybe? Maybe your body just wanted to rest and that's why the contractions slowed down. So something to eat and drink and a sleep might have helped, or maybe you could have got into a bathtub or pool if you had access to one to help you rest. Maybe your baby was not quite in the position she wanted to be to be born, and that's why things were slow to get going as well. Of course then without the cushioning of the amniotic fluid it can be harder for bub to change position if this is what they need to do. Did anyone palpate your tummy to try and see how she was lying? Sometimes if the head is asynclitic i.e not quite lining up nicely against the cervix you can have contractions without dilatation. Was it the same midwife who examined you each time? Sometimes different people will give different measurements, which can give the impression that things are "stuck" when in fact they are not. It can be helpful to think not so much in terms of labour being stuck or arrested but just to think of it in terms of being paused for some reason, who can say. Perhaps a tincture of patience on the midwives part might have helped! Anyway yes technically you could have opted just to go home instead of having your waters broken, but it's easy to see that in retrospect isn't it - am sure at the time that you were keen to progress things and have your baby born. In terms of the breathing difficulties, yes, long labour, maybe the drugs did affect her a little bit - there is some morphine type drugs in the epidural but only in a small concentration, which is said cannot cross the placenta but sometimes babies can be a bit less responsive after epidurals. Good luck with #2 - remember that every labour is different, your cervix has now been fully dilated so chances are it will dilate quicker and more smoothly next time.

[Klaw]

a) it's possible that baby still needed time to turn round to OA and only then does the head 'fit' the cervix properly to encourage dilation so

b) if you had not had your waters broken baby would have had more cushioning to aid rotation. And yes you would have been within your rights to go home and rest, to wait for labour to continue, whether you would have been 'allowed' is another matter, but you could have insisted! These breaks in labour are your body's way of asking for time to rest. It is important to listen to your body and your gut instincts!

c) drugs from epidural do cross the placenta and can depress a newborn's reflexes which means that it might have trouble breathing, feeding and bonding

That's my initial thoughts on your circumstances as you told them.

There is nothing wrong with getting your head around your previous birth and I beleive it's vital! You could get hold of your birth notes also! Call hospital, ask for Medical Records dept and ask them to send you form to fill in, max charge will be £50, most likely less (I wasn't even charged for either of mine)

[lulumama]

2 exceelent birth trauma links on this thread

[lulumama]

and you;ve had some great words of wisdom from Mrsm and Klaw !

[abracadabra]

Thanks, this has been so helpful. Mrsmalumbas - yes I did have a long early labour (4 days!) so it makes perfect sense that my body would have needed a rest. With hindsight I would not choose to have my waters broken - but as you say at the time I was just keen to get on with things! Interesting to know as well that the epidural could have affected her breathing - will definitely try to do without next time.