Previous shoulder dystocia due to large baby- elcs?

[Bunsouttheoven]

Considering pushing for a elcs after experiencing shoulder dystocia with dc2. Anyone have any experience with this?

My first dd was born at 40 wks 8lb 5oz, ventouse, episiotomy, stitches etc etc.

Second ds was also born at 40 wks. I had him in the birthing pool he was 9lb 12 oz.

When his head came out the midwife realised there was a problem & that he had shoulder dystocia. The room was suddenly swamped with people. The midwife managed to get me into a different position & did get ds out. He had the cord wrapped around his neck & looked lifeless. He was ok after some oxygen etc but obviously the experience really terrified us. My poor boy was so bruised his face was all swollen, eyes had rings of blood shot around them, body all bruised etc. Midwife said 'well that was scary!' Fortunately though we were lucky & he had no lasting effects.

So now I am pregnant with dc3 (unplanned we had decided no more after ds's traumatic birth). The midwife told me there is an increased chance of this baby having SD too & that babies do tend to get bigger.

She said I will get extra size scans if I measure over my dates. I said I never have measured over with ds so I have't got much faith in that as an indication of size.

She agreed to refer me to the consultant,I will see him at 24 wks.

I am thinking of pushing for an elcs as I am really worried we might not be so lucky this time. I am all for natural births & have only had gas & air on previous deliveries. I don't think I'm being precious about this birth & wonder if I will be taken seriously. Ultimately I just want to ensure as much as possible that my baby is born safely.

Has anyone any experience with this or similar ?

[banana87]

No experience of shoulder dystocia, but DD was forceps, stitches, etc weighing 8lb 4oz at birth, 39 weeks. I am pregnant again and measuring 4 weeks ahead so having a growth scan (today!). My co sultans had already said if the baby is big he would like to induce early. I think discussing a 38-39 week induction may be the way to go as opposed to CS.

[Flisspaps]

No advice on what to do, but even scans can be very unreliable as an indicator of size - up to a pound or two either way.

banana87's suggestion of discussing early induction isn't a bad one if you'd rather attempt a vaginal delivery?

[Catsmamma]

Ds1 got stuck with this, I was rattled down to theatre for an emergency cs, but while we were down there they found the big laundry tongs decided to try a forceps delivery which worked.

Helpfully, although obviously I was aware we had had a problem no one bothered to explain what had gone on and I did not even hear the term shoulder dystocia until I was sat in the hospital in front of the head obstetrician pondering my course of action for my now well underway second pregnancy,...thanks for that!

Any hoo, dd (smaller) and ds2 (much much bigger) all popped out with very little bother at all. Although for both I was induced early due to the promise of big babies and having GD.

[Rikalaily]

My second baby (dd1) was a shoulder dystocia, she wasn't massive (8lb 11oz) but my first baby had got slightly stuck too at a tiny 4lb 15oz (he got stuck at my cervix) so the consultant was freaking out at me sticking to my guns about having a homebirth with dd2, I was offered a C section for dd1 as ds got stuck and they offered again with dd2 because of the SD, I said no way.

Dd2 was born no problem and was 8lb 15oz, no hint of SD. Alot of SD babies get stuck due to thier position, not thier size, it's just easy to blame the size when the baby is bigger than average. My SD with dd1 was confirmed by the midwife to be her position and I felt her in the wrong position while I was pushing too. She was back to back and didn't turn properly during her decent down the birth canal before her head was born.

Please try not to worry so much, it may not happen again. I would concentrate on getting baby into a good position in the final trimester and if the baby is thought to be bigger than your previous babies (although scans can be way out) and in a bad position in the later weeks you could request a C section then if you really want one. My 4th baby was only 7lb 9.5 (all the midwives said she would be around the same weight as 2 & 3) and was the latest gestation, they don't necessarily get bigger.

[Bunsouttheoven]

Thanks for the replies so far, hopefully it's not all doom & gloom. However, at the moment I am coming down on the side of asking for a cs. It's not something I ever thought I would choose but knowing that the chance of SD is increased quite significantly I am finding it hard to face the risk.

I know cs are not without risk but it seems they are more for me & less for the baby. Also this will be our last child so I feel some of the risks are not so significant.

I have the appointment through to see the consultant in January. Does anyone know if it will take alot to convince him to do a cs? I hate making a fuss & generally much prefer the suffer in silence approach but for this I might have to be more pushy.

[banana87]

The consultant probably won't like the idea of a cs, because you have given birth to two rather large babies before naturally. That said, you did have a horrifying experience of SD. I think it will very much depend on the consultant and your local NHS. I know they try to keep cs rates down due to costs...and induction in your case (early) will cost them less than a cs (also early). A consultant will know better than me though, as I never had SD, I am just going on my "big baby" experience and the fact that my consultant is much more open to early induction than elcs.

[banana87]

Actually, having just found this: www.rcog.org.uk/womens-health/clinical-guidance/difficult-birth-what-shoulder-dystocia

They may give you an ELCS if you push for one. Hope that helps! Good luck!

[Bunsouttheoven]

Thank you for the link banana it is very interesting to know their guidelines. I suppose I just have to sit tight & talk to the consultant to see what he says & try not to worry.

[sryan]

I had exactly the same experience, an absolutely terrifying shoulder dystocia birth with my dd, she wasn't breathing and had to be rushed away out of the room and resuscitated. I was soo traumatised by the whole thing and so like u went into panic mode about wheter they would allow me an elcs! I have had such a wonderful response from every consultant/ midwife I've seen, no one has questioned my choice, in fact I feel they 100% think I'm making the right choice! And im booked in for 1 next wk. Its Enabled me to relax and prepare, rather than be a bag of nerves! All have agreed it is one of the most frightening situations to find yourself in, so just be honest about your fears and hopefully they'll be supportive!

[Bunsouttheoven]

Thank you sryan for Letting me know about your experience. I'm so pleased to hear that your worries have been taken into account & you are going to have the birth you want. I hope my hcps are equally as supportive. We shall see, initially the midwife was a bit thin lipped about my worries but did soften when I explained fully blubbed

[mrsbossyboots]

Had a similar experience with DD (9lbs 4oz) and was put under consultant care quite early with DS. I had regular growth scans and was told he was going to be big but not exceptionally. I felt I was being encouraged to have a CS by my consultant but was adamant I wanted a vaginal birth as DD was 2yo and we have no family around to support while I recovered. DS was only 8lbs 5oz and was forceps delivered as he went into distress on the way out. In hindsight, I think I should have listened to the consultant, had a CS and persuaded a not so supportive family member to help out!

[Wickerbasket]

I had SD with DS1(9lb11) and had exactly the same concern. DS2 was also measuring big for dates. I was monitored with lots of growth scans (which said baby was not big btw in the later scans) and had high risk over my notes. I decided not to have elcs as did not think DS2 was as big and DS2 was born a whopping 10lb 15 but all was fine, in fact I healed much better than before. The midwife and consultants on duty were all very very aware of the risk and talked me through procedures etc I was closely monitored and everything was ready should there have been a need of intervention. For me with the benefit of hindsight because I was cloesly monitored etc I am glad I did not push for an ELCS. I researched it too and someone said the size of baby increases the risk but it is the position of the baby which is the important factor. Good luck it really is not an easy choice.

[Bunsouttheoven]

Thanks mrs & basket glad you both had healthy babies, it is reassuring to hear. 10lb 15oz, now that really is a whopper!

Think I would feel better if the growth scans were more accurate but I know no one who has had them that have had their babies weight predicted correctly. Guess it is still rather an unknown science still.

My ds was supposedly in a good position & his SD was caused by his size in relation to mine. I have pretty narrow hips (though covered in a good deal of fat these days).

I do have family that could support me after a cs though I know I would find it hard to let them as I hate people doing stuff for me bloody fool. I know in the short term after birth it will probably be harder after a cs but wonder if it's worth the trouble to ensure peace of mind for us & a good outcome.