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Birth after Shoulder Dystocia(22 Posts)
I'm thinking of trying for my second baby in the next few months and have been thinking about birth. I was wondering if any of you could share experiences of subsequent births after a traumatic birth with shoulder dystocia? I'll explain my first birth - will probably be long, sorry! I should say that I strongly believe my birth and recover led to me having post natal anxiety which 14 months on I am just about recovered from.
My DD was born after a terrible horror show of a labour. My waters went naturally and then nothing happened for 24 hours so I was induced. Gel first, the on the drip six hours later. The drip wasn't put in properly so the medicine all pooled in my arm. A few hours later they redid the drip and contractions finally started. However, after this all the fluid in my arm was absorbed and I was hit with full on contractions with barely any breaks (as in 30 seconds to a minute) but was only 1-2 cm. baby was back to back too. After a couple of hours I was allowed an epidural. 12 hours later I was ready to push. 2 hours of pushing and nothing was happening so I went to theatre for an assisted delivery/potential section. I had 3 goes of forceps, one to turn and two to pull out, and an episiotomy. The head was born and then thy discovered a significant shoulder dystocia. The doctor basically had to reach in and pull DD out by hand. She was left with awful bruising including a full on black eye, bless her. I then had a retained placenta and had an op here and then to get it out, followed by a haemorrhage where I lost 2l of blood. Bad tears inside and out despite episiotomy, lots of stitching.
So not a nice experience at all, and the recovery was awful. My milk was several days late arriving due to blood loss (which no one told me about, caused all sorts of feeding issues, on top of DD being so sore it hurt her to open her mouth to latch). I was in hospital a week and all in all it took me a good three months to physically recover and stop bleeding. DD recovered well. The day after the birth the ob who did the delivery came to see me and told me in 25 years she'd never seen an obstruction like it and that she recommended that any future deliveries should be by elective CS. I went for a birth debrief with her when DD was 3 weeks old and she reiterated the same, and sent me home with a letter explaining his for next time.
Has anyone had a good experience of birth after SD? Safety is my paramount concern, I'm aware that a CS is no walk in the park but I'm just wondering what my options are really.
Sorry you had such a terrible experience but it sounds like it was well managed and I'm glad your DD was fine. I'm not clear what it is that you're asking. Surely you'll be having an elective c section. I suspect you'll find the recovery a hell of a lot easier than your previous delivery!
Sorry, i should have been clearer. I was speaking to one of the midwives at our local children's centre the other day (who'd seen me when pregnant) before and she was saying they try to get mums to go for v delivery after SD as most go on to have a 'normal' birth. I wondered if people do/have here. I've got to go under a consultant next time and obviously if the advice is to have a section I will - I definitely don't want another birth like my last one that's for sure. I've got my letter from the ob anyway of they tried to make me have a v delivery and indidjt think it was safest.
Ignore the midwife. Just have the section. Imagine how you'd feel if you had a VB and another shoulder dystocia and the outcome wasn't so good. My elective section was a walk in the park, the recovery was very quick.
I would just have the section, why risk it? I had a back to back labour, failed ventouse then emergency section with DD. My recovery was still far easier and quicker than the vaginal birth I had with DS.
I had a similar experience at first - waters went, no labour so induced. Then we differ because all those horrible drip contractions had no effect so after 22 hours and only 3cm dilated I had an emergency cs as baby was getting distressed and I was knackered. Baby was 10lbs and very wedged. I was born with shoulder dystocia, and if labour had gone more smoothly, I bet my son would have been too.
I'm pregnant with my second. Larger babies run in my family and I am small, and since my main concern is to avoid another emergency situation, I have opted for an elective csection. My consultant readily agreed. While I have the added complication of previous csection, I would expect with your history, you won't face much opposition if you opt for a csection.
It's true, the recovery is not easy. But I'm told planned is usually much easier to recover from than emergency. Also while I found the first 2 weeks very difficult, I was surprised by how quickly I felt better after that. I was certainly functioning by 6 weeks, although not doing anything strenuous. Good luck whatever you choose.
PS, my mum had two far less complicated birthday after me, but that was a different time and I'd be having a cs if I were you.
My son was born with a shoulder dystocia. Labour was very quick for a first baby, no risk factors so was allowed to be in the pool and I think that hindered them realising he was stuck as he was born so quickly, he didn't have time to turn properly. When I stood up, gravity brought him out via a third degree tear. The discharge letter I received from the hospital explained the circumstances and recommended an elective section for any future births due to the increased chance of it happening again.
There might be a middle ground... you could plan for a vaginal delivery but refuse induction, augmentation (the drip) or intervention (forceps or ventouse). I.e. Insist that if things start going wrong you go straight to a nice calm non-urgent emcs.
This was my birth plan (approved by the consultant) for different reasons. I felt it allowed the best of all worlds, the change to avoid csection if all went smoothly but if the past showed any signs of repeating then straight to plan b.
Hi there, I had a terrible sd with my first child, emergency birth, had to be resusitated, special care etc etc. We were terrified it would happen again but I had a vag birth with the second one (insisted on resusitator in room, 2 senior midwives etc) but he shot out easily without any complications. DC3 however did get stuck with another SD, but it was much better managed and the midwife managed to manoeuvre him out. Looking at them now you can see why 1 and 3 got stuck and 2 didn't, 2 has a much smaller head shape and circumference and is much narrower with slimmer shoulders than the other 2 chunky ones.
So the upshot is that is most probably won't happen again but if it does, it can be much better managed if they are expecting it and it doesn't have to be another emergency situation. They won't let you anywhere near a water birth or anything but probably a good idea to be in the labour ward anyway after a previous sd.
Thanks ladies. Do you generally have to stay in long with a section? I was in for a week last time, admittedly I was in a private room which was lovely once I got out of high dependency after a day. They had put me on a ward for three hours but after hearing DD scream from hunger constantly disturbing all of the other quiet babies, they moved me. OH was allowed to stay with us too, once we were in the private room which was a godsend. In hindsight there are many things I'd do differently - like insisting on some formula or donated milk faster when mine failed to appear (it didn't come in until day 8, thank god I copped on and gave her some formula before then!) and not just accepting it when the midwives repeatedly said 'whatever you make is enough', It wasn't. I had an nearly 9lb baby and 1ml a day of hand expressed colostrum did not satisfy her! But I suppose with your first you just don't have a clue do you! I just want to go into in feeling a bit more in control and together I guess.
My second baby had a shoulder dystocia. I laboured normally until the pushing stage. He got stuck and the emergency team ran in and manually pulled him out. He was blue and barely breathing but he recovered quickly with no ill effects.
I had my third baby last year and was worried about the possibility of a repeat shoulder dystocia. I read extensively about it and took a long time to reach a decision. In the end I went for vaginal delivery as I felt it was right for me and I had a successful delivery with no shoulder dystocia. I chose to be induced the day after my due date so that the baby wouldn't be too big.
However the medical team were happy to offer me a c section and discussed the risks with me at several appointments, as it was something which worried me. They quoted me around a 10 per cent chance of recurrence.
I had a registrar in attendance for the pushing stage along with the midwife which was extra reassuring for me.
I had a good vaginal delivery after shoulder dystotia.
It's too long to write down (I just tried). Do you want to PM me, I'm happy to talk over the phone if you like?
My first birth ended in SD. I opted for elcs for my subsequent births and the reason was twofold. Firstly, statistically it's more likely to happen again and I just couldn't face it. Secondly (and I'm not saying this to scare you, it's just my honest experience) I know two people who had three babies born with shoulder dystocia. One lady had a child who was deprived of oxygen too long and that child is severely disabled. The other lady had SD with her first child and the outcome was the same as my DD, she was perfectly fine. Her second DD was significantly larger and she unfortunately didn't survive.
If I was you I would take the advice of the medical professionals who have been involved with your case and not someone who doesn't have that in depth knowledge.
There is definitely a drive for more vaginal births in the trust where I live. But not for those who medically need it. I didn't have a letter saying that I would need a elcs and it no problem when I requested them. In fact, I've not heard of that before, so perhaps that's a sign of just how serious things were for you. It does sound like you had a horrendous time.
On the plus side, my sections were very straightforward, positive experiences. My recovery (more so with my first section) was far quicker and easier than my vaginal birth
I could have gone home the day after my section but DS was 5 weeks early and needed monitoring so we were in 3 nights. Most people I know who had sections stay one or two nights.
I had a normal water birth with my first normal sized baby. My second birth was an attempted water birth to a very large baby which ended in shoulder SD. There was buzzing, people running, screaming and DS was born unharmed with the help of a skillful MW. I was left with prolapsed organs after that and now thinking back on it with a mild depression, it took a very long time to recover from that physically and emotionally. 3rd baby was always out question until we were blessed with my daughter. I had concerns about the birth, asked about the c section for large baby very early on. She was in transverse position for a while so c section was considered but she turned head down but back to back so we went ahead with vaginal delivery, although I always had inkling that she will come via csection.
I ended up going into labour naturally and was in labour for several hours until I was given a csection due to failure to progress so my very large dd can be born.
Compare to my scary SD birth it was a bliss. I was given a very good care and had a speedy recovery. I even thought that having CS for my other births would of been nice since my lady bits are in shreds now and I require an operation. It was such good, controlled and peaceful experience. It also gave me a sense of closure to my previous traumatic birth experience.
I think it is a personal decision but cs is a very good option after a traumatic birth.
I think that's actually what does appeal to me babynelly. Calm and in control. I never had an official diagnosis of PND (just anxiety) but I did have several checks which showed low mood up until DD was about 10 months although I think that was due to the birth firstly, then the fact that just as I was recovering I got terrible labyrinthitis for 2 weeks where I could barely move, OH had to do everything for her I couldn't even hold her to feed, I just expressed and OH fed her, then she developed silent reflux and refused feeds, breastfeeding was a total bust. She was medicated in the end and it went at 7.5 months but I ended up combi bottle feeding with F and expressed milk for 5 months before fully FF and she would only ever dream feed which was v stressful and basically meant I barely left the house. On top of all that she developed 3 infantile hemangiomas which required more medication which could have made her very ill if she didn't eat properly - when she hated eating! So all in all a bad birth set off a tough year for me - I guess I've got it in my head that if I can have a god start next time, it might not be so hard! Though of course any baby could have those issues. Sorry, gone off on a bit of a tangent there! I should say, she's fine now at 14 months, off all meds, drinks zero milk but eats food like a trooper.
The consultant who was involved in your first delivery knows far far more and is more qualified to advise on future deliveries than the midwife is. Much more predictable course of events for you and baby to have a cs, and in all likelihood both your recoveries will be much faster than your first traumatic delivery. I was out from hospital after one night after cs, and completely back to normal after a week. Brilliant experience.
I had an ELCS as am type 1 diabetic and was terrified of SD, which is apparently more likely in babies of diabetic mothers. I have to say the whole experience was great - calm, planned, relatively painless - but be warned your milk does take a little longer to come in so you can prepare for that. (I actually expressed colostrum beforehand and froze it although in the end I needed to top up with formula for other reasons).
My first was a horrendous shoulder dystocia transferred in labour after starting out as home birth. Over sixty hours in labour with a very uncomfortable lower half postnatally, to say the least.
The next five were fine. Second was a big 10lb 2oz boy who had a reasonably comfortable and short labour.
After that they more or less popped out despite being big babies. Third and sixth I was out of hospital within two hours of delivery. I did a Tesco shop on way home with sixth.
Four and five were twins so smaller but they just wanted to us to be monitored for a few extra hours so I stayed overnight.
The milk dud come in later with cs. Dd was very hungry but bounced back quickly once milk came in.
I hope ur second time around is much better, it sounds like ur first time was hell of a time. Also in regards to mws I agree better not waist time and talk to constants, ask for referral.
My third birth resulted in a severe shoulder dystocia, DS2 was an unstable lie so they should've been more prepared for difficulties especially since DD's birth resulted in a 3rd degree tear less than 11 months earlier! Nothing in my notes apparently. Had real difficulties getting him out, he was blue and we were warned he would more than likely have some brain and nerve damage due to the time it took to get him out. By some miracle he was unscathed apart from a small bruise on his arm (I however developed an infection directly due to the nature of his birth and was readmitted for IV antibiotics when he was a few days old).
When I fell pregnant with DS3, both me and my husband were terrified of history repeating itself and decided that a elcs was the only option for us. At the consultant appointment at 16 weeks we were first of all told that "elcs was not an option following shoulder dystocia" at which point I burst into tears so the junior whatever we were dealing with went to speak to the actual consultant. She was gone for 10 min and we could hear all sorts of scary medical terms being bandied about, she then came back, apologised unreservedly for what I had gone through and of course I could have a elcs! It was a good call too as DS3 was 10lb 15.5oz born and would definitely have gotten stuck (DS2 was only 8lb 6oz). The section was fine, painful recovery that took longer than my vaginal births but I was prepared for that.
Sorry this was so long, I haven't told many people the full extent of DS2's birth before!
I think you'd be mad not to have an ELCS. There seems to be some debate what the c-section rate "ought" to be (10%? 25%) but the woman who had the most obstructed delivery a consultant had seen in 25 years definitely ought to have had a section!
Your first birth sounds hideous and extremely traumatic, as well as physically damaging; the fact that you're thinking about what to do before even getting pregnant surely shows a (completely rational) degree of anxiety about the whole concept of another pregnancy. I have had two c-sections, neither especially straightforward, and I had a hemorrhage with the second. I had been considering having a VBAC but am so glad I didn't. The consultant said that I would have most likely have haemorrhaged in a vaginal birth too, and that would have meant surgery, the transfusion would have been more difficult to do, matched blood not waiting on tap etc. After both sections I was walking a mile or so easily within a week, and not in any pain at all after two weeks. (I have a very low pain threshold!)
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