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If you've had a baby after a previous shoulder dystocia...

(9 Posts)
NoRoomForALittleOne Fri 28-Nov-14 18:37:26

What was it like? Did you have any interventions? Do you think that you had good, evidence-based advice?

If I manage to get to term (another long story) then I'm facing giving birth after a previous shoulder dystocia. It seems that different doctors have different views on how to deal with the increased risk of shoulder dystocia in this birth. I'm having a GTT and a series of growth scans (although if they just listen to me this time, I'll be able to give them a good idea of whether DC5 is big or not).

I've been doing some research about whether either an induction at 38 weeks or ELCS (the two proposed ideas so far) are actually a good idea and evidence based. The problem is, the evidence I've found is all based on women suspected of carrying a large baby but not necessarily a history of shoulder dystocia. I also managed to have a 25 minute labour/delivery including resolving the shoulder dystocia last time and I live 20 mins from the nearest hospital so this does complicate things a bit!

I'm intrigued as to what has been suggested to other women and how it has worked out. I'd dearly love to give birth in a nice, quiet room without an audience but I'm not convinced that will happen.

monkeymamma Thu 04-Dec-14 21:30:30

Dc5 wow! Congratulations. Reading this with great interest as I'm expecting ds2 any day now (currently 40+1) and had shoulder dystocia with ds1 but there has been no suggestion it would be an issue this time round. At my booking in the midwife suggested they'd do a late sizing scan this time based on the fact ds1 was 9lb 7oz (and I'm quite small). However later they said there was no need for concern re size as ds1 was under 10lb - so that was all a bit confusing. (So I've had no scans since 20weeks.)

Like you OP I'm a fast labourer (30mins last time including the shoulder dystocia and resolution) and live a similar distance from the hospital.

Will watch this thread with interest and also let you know what happens over the next days/weeks!

monkeymamma Thu 04-Dec-14 21:34:32

Ps know what you mean about an audience! They also threw me onto my back when dystocia happened and no one propped me back up so I couldn't manage to hold DS and dH got all that lovely bonding time while I missed out :-(

Waitingforsherlock Thu 04-Dec-14 21:49:49

Hi both. I had a shoulder dystocia with my dc2. She was back to back and basically came out looking at the ceiling. It was a text book induced birth up to that point and very rapid until she got stuck. Her APGAR was 1 and she had to be rescuitated, we thought she had an Erbs Palsy. Fortunately that wasn't the case and she has full use of her arm. When dc3 was on her way I felt that our local hospital did not take my worries seriously. I sought a second opinion and decided to pay for private care in a NHS hospital; this meant that I could guarantee that a Consultant Obstetrician would be present in the room when I gave birth. I didn't opt for a C-Section although had it been readily available I probably would have done. Dc3 didn't get stuck; she was the biggest of all of my babies at 9lb 2 but the only one who wasn't back to back presentation. My first was ventouse/ forceps so I obviously have trouble birthing the size of baby that I produce. My advice would be to seek a second opinion if you are not satisfied with the choices you are given. I did a great deal of research and knew that a predisposing factor for a SD is a previous one. It didn't happen to me again but I suppose it might well have done. Find a doctor that you trust and follow their advice.

NoRoomForALittleOne Fri 05-Dec-14 10:05:33

Thank you ladies. I'm in hospital at the mo so I hadn't spotted your replies until now. I read recently that a multiparous woman is the best judge of the size of her baby. I could feel so much grinding as DC4 tried to settle in to a good position that I had a nagging feeling about shoulder dystocia that wouldn't go away. I know that I'd felt some 'grinding' as previous babies turned but this was so much worse and different.

Anyway, I'm currently 19 weeks and in for rehydration because of hyperemesis plus I'm bleeding so I'm not expecting to grow such a large baby this time but who knows...

*Monkeymamma' please do come back even if you can just manage one short sentence to tell us if you had another SD or not! Good luck!

littlejohnnydory Fri 05-Dec-14 16:03:03

I had a shoulder dystocia with dc1, who was 8lb7. It was quite easily resolved using mcroberts manoeuvre and he was just a little bit bruised down one side. I blame the syntocinon drip for speeding labour up artificially so that he didn't have time to turn.

He has three younger siblings, all higher birth weight (two of them over 10lb) born naturally with no shoulder dystocia. Two were born at home, another in hospital for reasons unrelated to the shoulder dystocia.

It might be worth looking at your birth notes and asking someone to go through them with you so that you can be fully informed when you make decisions about your next labour. Caesarean section was never mentioned to me as an option but then DS wasn't a severe case of dystocia.

monkeymamma Sat 06-Dec-14 19:59:37

Johnnydory thanks for the positive stories with your subsequent dc and the good advice.

So sorry to hear you're poorly OP, hyperemesis is absolutely miserable and so many people misunderstand what you're going through. hope you are feeling better soon.

I'll be back to update once this baby comes out. Having real difficulty getting any kind of antenatal care atm! Midwife referred me to post dates complimentary therapy clinic which sounds lovely but you have to organise it yourself. The one I booked onto was cancelled and the others are full so I'm a bit on my own which isn't what you want during the 40weeks plus bit of pregnancy! I did leave a message for my midwife (to try and least set up a checkup for next week when I'll be 41 weeks) and was told she'd call back Friday. Hasn't happened though :-(

When it does I'll try and ask about shoulder dystocia and why no one has discussed with me. Maybe we can go over some options although she's very much of the 'It'll all be fine' school of thought which can be positive but also can be a bit too breezy if know what I mean. Last appointment she forgot I was multiparous and I had to remind her I had a child already, which I can understand (they are so overworked) but I have seen her for every appointment since 5 weeks (most of them my ds has also been there!) so I was a bit disappointed!

Vitalstatistix Sat 06-Dec-14 20:16:25

Hi. I had sd with my first and it left him with erbs palsy.

When I had my second, the consultant stayed right through and there was a team on standby in case I needed a cs.

I had an epidural which I hadn't first time, so that if a cs was needed, it would be all good to go.

They did make very good plans, I must say.

As it turned out, although he was bigger than my first (first was 10lb4oz and second was 10lb5oz) there were no problems relating to sd at all.

Because it had happened and it had been a very serious emergency situation, they were very keen to ensure they were on the ball.

NoRoomForALittleOne Sat 06-Dec-14 21:24:39

So, I've just had a couple of night's in hospital on the maternity ward (oh the seemingly never-ending joy of hyperemesis) and chatted with one or two midwives. It seems that the idea of induction or ELCS is probably due to a combination of the previous SD plus precipitate labours and increased risk of bleeding. Essentially they would prefer that I give birth in hospital. I've also had an interesting print out put in my notes for a fundal height chart (ridiculous idea!) that has the weights, genders and gestation of all four previous babies plus their exact weight centile. As I've had some early babies, it turns out that two are officially LGA and another just under the cut off so I can see why they might be bothered about me getting further on in a pregnancy and producing a large baby. I do know that not all large babies have SD and many smaller ones do. But, in my case, the largest baby by birth weight was over 2lb heavier (9lb 13oz vs 7lb 9oz) than the next heaviest baby so I do think it is a factor. Also given that she was my fourth and I'd previously delivered three babies without any interventions I know that my pelvis is <ahem> well-tested! I did have one lovely midwife reassure me that he had only delivered 4 SD babies in 12 years because it is so rare. Goodness knows how they manage to find so many to feature on OBEM.

I think for now I'm just going to hope to get through my 20 week scan and on to 24 weeks. I'll think about the GTT, growth scan and follow-up appointment after that.

I do really want to know how Monkeymamma gets on grin

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