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Did anyone else have an ELCS because babies head wasn't engaged at all and baby was estimated to be over 8lbs?

(23 Posts)
Ninunina Tue 02-Apr-13 08:24:01

My DD is now 16 months and we're staying to think about ttc #2, which has got me thinking about my last birthing experience.
I had a fairly easy pregnancy with no complications (other than a strange pain in my pelvis that didn't sound like SPD). I was dead set on having a natural birth and mentally blocked out the option of having a cs. I moved out of the UK when I was 35 weeks pregnant and was consultant led for the end of my pregnancy (because that's the way things are done where I live now).
At 40+3 I was told that my baby's head wasn't engaged at all and they were concerned since they were estimating the weight to be 3.9kg (was actually 3.77kg). My consultant wasn't willing to take the risk of me laboring naturally and immediately admitted me into hospital for a elcs the next day.
After the section my doctor told me he felt he made the right decision since my dd head was very high up and he really struggled to get her out (used forceps). He said I would have had a very long and painful labour and it would most likely have ended in an emergency cs.
I was wondering if anyone had a similar experience to this? I can't help but wonder how things would have gone if I remained in the uk. Would I have been allowed to go into labour naturally? Has anyone had a successful VBAC after having an ELCS for this reason.
I am not unhappy with my experience and I that my dr wasn't willing to take any chances with my baby (neither am I), but I can't help but feel disappointed that I didn't give birth to my child naturally.

Ninunina Tue 02-Apr-13 08:36:49

Sorry about all the typos. My phone loves adding and changing words.

EdithWeston Tue 02-Apr-13 08:41:12

Sorry - can you explain exactly what happened. You had failed forceps, then EmCS?

It doesn't make sense for forceps to have been used during a ElCS, especially as non-engaged baby is easier to lift out. It wouldn't have happened in UK, and I am wondering if there has been a miscommunication here.

Ninunina Tue 02-Apr-13 09:07:04

I had an ELCS. I didn't go into labour at all. I may be mistaken with the forceps since I assumed they were used since dd had a blood shot eye that looked like it was done because she was squeezed or from being stuck. My consultant is a man of very few words, so I don't have my many details, but he certainly struggled to get her out (took a good half an hour or so).

catlady1 Tue 02-Apr-13 09:30:53

My baby's head still wasn't engaged at 41+2 and she had been measuring bigger than average. She was born naturally (albeit after a very long back-to-back labour) at 41+6 weighing 3.65kg, so over 8lb but smaller than expected. There was never any mention of a cs. I'm in the UK.

quietlysuggests Tue 02-Apr-13 09:36:36

Message withdrawn at poster's request.

Ninunina Tue 02-Apr-13 09:55:08

I'm 165cm (I think that is 5ft 5?), so not tall, but not that tall either. The mark could have been from another instrument.
catlady that is very interesting that a cs wasn't even considered in your case. Would you aim for a natural delivery if you do it again?
I met someone who happens to also be a doctor (not oby though). She has witnessed many births and begged her doctor for a cs when her baby didn't engage. She seemed to think that they are always very long and painful labours too.
I also have a friend who gave birth in the uk and baby didn't engage. She had a very long labour which ended up being a forceps delivery (though they advised an emcs). She around 5ft so you may be right about shorter women.
I guess what I'm trying to see is whether I should fight harder for a natural birth next time if I end up in the same situation.

Ninunina Tue 02-Apr-13 11:36:40

meant to say not that short eitherblush

TuttiFrutti Tue 02-Apr-13 13:05:36

No, but I wish I had! I was in same situation as you but in UK.

They let me go 11 days overdue, then induced me, and I had a long, slow and very painful labour which ended in emcs. The baby never engaged despite strong, drug- induced contractions. Two midwives said to me afterwards "we knew you'd need a cs as soon as you came in", but because of NHS guidelines they couldn't offer me one till inducing a trial of labour.

It turned out afterwards there were reasons ( fibroids) which prevented baby's head descending. So no pressure on cervix, so no natural onset of labour. I think you were lucky!

Ninunina Tue 02-Apr-13 13:58:49

tuttifrutti I'm sorry to hear you had such a difficult labour. It must be very frustrating to go through all that then end up with a EMCS.
I can't complain about my recovery with an ELCS. I was up and about the next morning and was in hardly any pain at all, so I guess it wasn't a bad outcome.

Panzee Tue 02-Apr-13 14:14:49

I had forceps during my first ElCS too. It's not unheard of.

RunnerHasbeen Tue 02-Apr-13 14:21:26

I had forceps with my ELCS, it's not completely unheard of. I think if you are in the same position again, and the doctors say the same thing, a section is the best course of action. If this is just about some sense of failure, I think you need to deal with that separately. I can't see that a long period of pain, an almost inevitable EMCS, longer hospital stay, complications and risks to the next baby would alleviate this feeling. If you go against advice and it is unpleasant in some way, you are just as likely to blame yourself and feel guilty.

Saying that, I have always known I would need a CS for any children I had, so can't relate to the feeling of disappointment I know is common. If you are expecting it more this time, it is possible you won't feel you are in any way to blame, as I don't. I think you need to think about what you would be fighting for, and why, in wanting a natural birth, but you should go into this one more realistic choosing at what point you would want a CS and being prepared for it. No reason to think it will happen again, but other things might.

dreamingbohemian Tue 02-Apr-13 14:22:21

I had the same experience as Tutti (no fibroids though). Awful long painful labour, induction didn't work, DS never engaged (was also a big baby). Ended up with EMCS. I had asked for an elective but was told to 'give it a go'. For 2 days!

I know you may feel a bit disappointed but you never know, it might have been so much worse.

HolidayArmadillo Tue 02-Apr-13 14:28:22

Which country were you in? I've got to be honest this seems a little bit nuts, private healthcare I'm assuming? The story of the section doesn't add up either, half an hour to get out an unengaged baby?? I'd be asking serious questions about that, even in sections where the baby has been so low I've had to push it back up from the vagina I've never been in one that has lasted that long in terms of time it has taken to get the baby out. Very very strange.

Ninunina Tue 02-Apr-13 15:15:03

Not private health care. I did see the consultant privately during the pregnancy, but the delivery was done at the local hospital so I know it wasn't a money making thing. I'm in Malta. My consultant is very well respected here and is known to not take any risks. The health care here is excellent but is known to be over medicalised. Most people are consultant led throughout the pregnancy and you don't see a midwife outside the oby and delivery ward. It has pros and cons, the still birth rate is the lowest in Europe but c section rate is one of the highest.
I can't say I'm unhappy with the way things went, but I often wonder if I could have avoided the section. After reading some of the stories below it sounds like I was actually very lucky and it could have been a lot worse.
With regards to timing, I don't know why it took so long to get her out, but I think my surgeon is very very careful and gentle. I recovered very quickly compared to a few of my friends so that might have something to do with it.

MrsPatrickDempsey Tue 02-Apr-13 15:40:46

Hope to clear up the confusion about the forceps. They can be used abdominally during a Caesarian usually when the baby is in a tricky position. It facilitates the delivery of the head, especially if the head is engaged.

Otherwise, they are used as most people are familiar with: during the second stage of labour to assist vaginal delivery. This can only be done if the head is optimally positioned and engaged in the pelvis. If not, forceps may be abandoned and a CS performed.

DangerMousey Tue 02-Apr-13 16:46:20

My DS (first child) was not engaged at all at 40+3 and a scan at 36 weeks predicted he would be v big, with a head circumference off the scale! MW was not concerned and said that women rarely grow babies too big for their bodies, and that once I started labour, a few good strong contractions would "soon force his large head down into my pelvis" hmm

Evidently she was right: I went into labour at 40+5 and gave birth 12 hours later to a 9lb3oz baby boy, with gas and air only, a small tear which healed quickly, and no intervention. Never any mention of CS or any assumption that my body wouldnt be able to birth him. I am in the UK.

LadyMedea Tue 02-Apr-13 17:54:26

I'm assuming (hoping) that you have the right to see your notes. In preparing for no.2 it might help you to go though them, ideally with your consultant, to find out what actually happened.

ShowOfHands Tue 02-Apr-13 18:19:55

My experiences are different to yours but perhaps relevant.

My dd engaged v early at 31 weeks and stayed there. I had a 31hr, difficult labour, blue light transfer, 8hr second stage with attempted ventouse, attempted manual rotation and an emcs (difficult like your elcs, dd was v v stuck). It turned out that she was less engaged, more stuck. She was OT and asynclitic so she was facing my hip and had her head on one side, trying to get out ear first. She had some muscle damage from the position and the prolonged labour/intervention. My waters had broken slightly early which prompted labour and my cons suggested in a debrief that her odd position had ruptured my waters.

I wanted a vbac with ds but he didn't engage at all. I had a couple of scans near the end and my consultant said ds was in a similarly odd position, trying to engage but with his head twisted. He suggested that I might consider an elcs. I didn't. I tried for a vbac. My waters broke spontaneously (my cons suggested they would as ds was in a crappy position and I am v short and he was getting v squashed in an unnatural position) and I laboured for three days. DS didn't engage at all. They tried to get his head to descend and it wouldn't lower at all. I had an emcs in the end and they found that I have a twist in my pelvis and it was all related to that.

Weight is pretty irrelevant in general terms. I had a 6lb baby and a 7lb baby, both stuck, both unbirthable. Head circumference and position are the key indicators for natural delivery.

If you want to talk about disappointment or your feelings about your first birth, I'm happy to chat. I've been there and it was a sensitive road to acceptance.

DolomitesDonkey Tue 02-Apr-13 18:25:48

I had an elcs for other reasons but I'd never felt him engage. During my section they found him so wedged in he was pulled out with a ventouse. The two surgeons smashed their heads together as they pulled him out. When doing a home follow-up my v experienced mw said in all her career she'd never seen bruising like it and the section was the only way.

In the old days of course I'd have died because the baby was unable to get out. If I'd had to labour it would've been emcs anyway.

monkeysbignuts Tue 02-Apr-13 18:31:28

All 3 of my children have been on the larger side. I'm only 5ft 2 & my last baby was 8lbs 15.5 delivered naturally with just gas and air.
First was an assisted delivery because hewas sstuck high up the birth canal. Again done with gas and air plus a very painful episiotomy.

FreckledLeopard Tue 02-Apr-13 18:46:43

DD never engaged until during labour - she was biggish (8lb 4). Never any mention of a section. Not exactly a fun labour but not the worst ever. Could you ask to see your notes?

louschmoo Wed 03-Apr-13 22:33:35

My DS2 was born by ELCS 2 weeks ago. He never engaged, and the midwives weren't at all concerned as they said that 2nd babies often don't engage till labour. The ELCS was booked for other reasons. However the surgeons found whilst delivering him that he was so far up in my abdomen that they couldn't reach his head to pull him out, and so they had to turn him in the womb to get him out feet first! He had the cord round his neck, arm and leg and this may have been preventing him from descending. I'm very glad I had the ELCS as a VBAC could have been very tricky.

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