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Small frame and narrow pelvis

(38 Posts)
charleypops Thu 18-Nov-04 11:35:18

Hi,

I am 5ft, one and a half inches tall, with size 1.5 feet (I know, I'm a freak!). And I have a very narrow pelvis which, incidently, I have been told is slightly twisted - one hip bone is about an inch higher than the other. I am 10 weeks pg with 1st. I would like to know if anyone who is a similar size has had any problems with normal delivery? I asked my doctor about the size of my pelvis and he told me not to worry, as relaxin will allow bones to separate for the birth. However, I forgot to mention to him about the twist. I will probably go back to the doc with this, although he's so busy and I don't like to bother him, (and I'm sure he'll say the same thing anyway), because I've been worrying about it. I am particularly worried because the hospital it looks like I have to go to has a really bad reputation with chronic staff shortages.

Also (sorry!), I'm on BUPA - does anyone know if BUPA would cover me if I have to have a cs? Does it cover for elective cs? I worried (again) if I ask them at this stage they will exempt me.

I'm not normally a worrier at all, honest, but I think at the moment my name should be Worrypops!

By the way, if anyone from the June thread is reading this - Hi! I'm keeping up with you all, just can't post, threads gotten too long for my darned computer again!

motherinferior Thu 18-Nov-04 11:53:20

I think - without wanting to worry you further, honestly - that your twisted pelvis might put you at a higher risk of symphisis pubis dysfunction (a really common pregnancy related condition loads of us have had, honestly). Which need not necessarily affect your delivery chances AT ALL, but means do keep an eye out for any pains in your pelvic area. I am a total SPD bore, sorry, do CAT me if you want further info culled mainly from the wisdom of MN on this!

gingernut Thu 18-Nov-04 11:57:45

Hi! I'm shorter than you (about 5' and half and inch) with narrow pelvis although have massive clod-hopping feet in relation to yours (size 3.5!). But I do have a low pubic arch (which means my pelvis is flattish and not a great shape for childbearing).

I think it's hard to predict until you're in labour...a lot depends on the size and position of the baby as well as how much your pelvis `gives'.

My first labour was looooong. ds's head (which was on the 50th centile) was probably not fully engaged so despite strong contractions my cervix dilated very slowly. They told me after the first internal that I was a high c/s risk due to low pubic arch and wouldn't let me eat. I got exhausted and ended up requesting an epidural, which slowed things down even more because I was no longer mobile. After about 48 hours in labour (although not all of that was officially `established labour'), ds was finally born by ventouse. It sounds really awful, but in fact although I began to wonder if he'd ever be born, I didn't feel I'd suffered and I was pleased with the outcome (I do think if I'd ended up with a c/s after all that effort I might have been a bit p*ssed off though!). TBH I think a lot of people have similar labour stories to tell, even those who are not small and did not have largeish babies. Maybe mears or pupuce will be able to post on this as they have lots more experience of labour and birth.

I'm now 39 weeks pg with no. 2. I had a growth scan at 36 weeks which predicted that this baby is a similar size to ds. So, I am going to try for another normal delivery, but with the proviso that if things aren't progressing then we may opt for a section sooner rather than later. Also, they do not want me to go too long overdue because obviously the baby will be growing all the time, so I am due to be induced if I go a week over . You could keep an eye out for my birth announcement to get the gory details!

HTH but I suspect that my experience is necessarily a predictor of what will happen to you.

And, sorry, but I have no idea about the BUPA thing. What does it say in your details? I had to have some treatment during my last pg through my company's private policy, and the policy documents were clear on what was covered and what wasn't.

Good luck with the pg and birth anyway.

fio2 Thu 18-Nov-04 12:01:55

I have an odd shaped pelvis and i opted for an elctive for my second child. My daughter (first) was born by emergency section before there was any question as to whether my pelvis would cause a problem iykwim. Just make sure they x-ray your pelvis first and scan to see the baby doesnt get too big for you to pass

Chandra Thu 18-Nov-04 12:03:46

Bad news here... If I remember correctly we cancelled our BUPA policy because it didn't cover pregnancy or any related problems.

I am 5ft8" and a mixture of small/big frame, and though I insisted that caesareans or early inductions are common in my family for lack of space for the baby to come out, everyone assured me that because I was tall it would be fine... It's wasn't, ds suffered some distress during birth and I found it very difficult to deal with the pain for a month afterwards, when I visited my gynec. in my original country (long wait here) he was horrified they were still determining the space by height and frame. It's a practice that is in disuse in most countries since years ago, so it is not really a good measure to predict wheter you will have problems or not. Have it checked if you can.

charleypops Thu 18-Nov-04 13:03:32

Hi

Motherinferior - just looked on the SPD site - what a nightmare! "Exquisite pain!" no less - you poor thing! My partner reckons I have an oddly shaped sacrum, so this, as well as the twist might well make me a likely candidate, but at least I'm aware of it now, so thank you!

Gingernut - all the best with your delivery, I shall certainly keep an eye out for your announcement + full details . Sounds like you did really well with your 1st after everything. I guess you're right, it is hard to predict until you're actually in labour because there's so many factors that play a role. I just want to do all I can to try and avoid a horrid lengthy labour only to have a cs at the end of it.
I don't think 3.5 size feet is exactly cloddhopping btw

fio2 - I'll definitely ask for a scan just before I'm due. Thanks

Chandra - sorry you had such a horrid time. Bit of a shock to learn space determination is so outdated here .

There is a paragraph in my BUPA booklet that says you're covered "...for delivering a baby by caesarean section if it is medically necessary" so, I might be ok coverwise if I have to go down that route. Hope it doesn't have to get to the crash stage though before it becomes "necessary".

I guess I'm going to have to bother my poor doctor again and ask if I can maybe have a consultation soon with an osteopath or something. I guess if I wait too long, I'll be too big to examine properly?

motherinferior Thu 18-Nov-04 13:22:19

The pain does vary from person to person. Oh, and despite being shorter than you (but with size 3 feet and a size 10 jeans size) I have had two vaginal births, the second one at home.

You may do better requesting an obstetric physiotherapist rather than an osteo (some GP practices will refer to osteo but it depends on the practice). Do CAT me for stuff I've written on this, if you'd like.

handbagaddiction Fri 19-Nov-04 19:15:05

Charleypops,

Also have a slightly twisted pelvis - one hip often higher and then other and further forward than the other too - although am 5'4 with size 5 feet so average there!! SIL is a chiropractor with experience of treating pregnant women. They can help throughout pregnancy to try and resolve the twist for you - although if it's anything like mine, it's been twisted for so long that eventually the muscle definition aorund it always shifts it back to where it started from!!

Anyway - probably worth checking out as it may just help a little - certainly shouldn't do any harm !!

heymissy Sun 21-Nov-04 03:34:17

Hi there - not sure that it helps but I am 5'5 and narrow framed / skinny if you prefer and there was no mention of this affecting ability to deliver naturally. Our frame runs in the family as does high bp in pregnancy. It's the high blood pressure in pregnancy that has always played up at delivery stage rather than narrow frmae. When I was pregnant I rang BUPA and they said they had no packages that catered for pregnant women. I asked my GP about private healthcare during my pregnancy and she also said there was nothing out there unless you have the same financial resources as the Beckhams. Strictly Harley Street affair. In addition if you have any complications in pregnancy or delivery this adds £1000's to any private care costs during pregnancy. I developed very high blood pressure and was hospitalised for a considerable amount of time with scans on my heart and my baby bun three times a week and a whole host of tests. An emergency c section followed though it had been on the cards from about 5 months of pregnancy. If we had been cared for privately the cost would have blown our socks off - just something to bear in mind when there's a possiblitily that something may disrupt an otherwise straightfoward delivery

heymissy Sun 21-Nov-04 04:04:46

can you believe it - I forgot? After the emergency c-section which was very pleasant, great music, top consultants, fantastic dp I had postpartum haemorrage (probably incorrect spelling) - I lost a lot of blood, original blood count of 12 went down to 6 I remember going into shock and seing so many medical staff around my bed sticking things everywhere to try and stop the bleeding and continuosly calling my name to stop me falling asleep which seemed the most natural thing to do - oh o!! Following this had to have massive blood transfusion and spend two days in HDU (one down from intensive care). Trust me it sounds much worse when I say it out loud than it actually was going through it if that makes sense. Point is that this would have cost an even bigger bomb if care had been private?

honeybunny Sun 21-Nov-04 09:24:38

I'm 5ft6, narrow pelvis (3.5-4sized feet) and a family h/o big heads! ds1 was 98th centile for head size, never engaged and ended up being born as a semi emergency CS. Was induced at 42+2, cervix dilated v slowly, waters broke spontaneously but caused concern incase the cord prolapsed as head was so high and then heart rate started to dip. Ended up with CS. Obst said after that ds1's head was still v high and unlikely to have dropped being so big and may well have got stuck, so CS was by far the safest option for everyone and done at a time when no slashing and grabbing was necessary. All v calm and relaxed and a brilliant post op recovery. Home in 48hrs and digging the garden by 4weeks. Paid for the garden efforts later as my nice flat scar line did re-unflame and bruise for a few days after. Only 11 days away from my 3rd CS!!! Bring it on!

honeybunny Sun 21-Nov-04 09:25:50

"re-inflame" sorry my typing is a bit like my brain this am, scrambled!

jabberwocky Sun 21-Nov-04 10:25:53

I've known some really small women who have had fabulous births. That said, I am five feet tall with a fairly narrow pelvis and, my whole other birth story notwithstanding (baby was undiagnosed breech) the surgeon who did my c-section commented at my 6 week check up that, based on how slowly I was dilating he wasn't sure I would have been able to deliver vaginally even if ds had been in the correct position. That probably doesn't help you at all. I guess what I'm trying to say is, if labour turns into an extremely long, drawn out affair, consider discussing a c-section and read up on them beforehand (I wish I had).

pupuce Sun 21-Nov-04 10:39:01

BUPA does not cover elective caesareans.
If you are that concerned, ask for a referral to an obstetrician... he/she may well agree to it. But I agree with others there are plenty of petite women who have whoppers vaginally.

jabberwocky Sun 21-Nov-04 10:46:12

My insurance was the same. You might check to see at what point (i.e. hours of labour) you would be diagnosed as "failure to progress" at which time a c-section is deemed medically necessary and would be covered. It's just nice to know things like this ahead of time (jabberwocky says with the value of hindsight...)

prufrock Sun 21-Nov-04 10:55:31

charleypops. I had a c-section on my health insurance (not Bupa) which was only covered if it was medically necessary. They are quite strict on what is and isn't - my consultant had to write to them to say that I had to have a c-section, and it had to be authosrised by their own consultants.
If you do want to go down that route, your first task is to see a consultant - ask your GP for a referral because of your twisted pelvis (but make sure they get you an appointment with a consultant or obs. physia, not just at the consultants clinic - because there you will probably just see a SHO) . They can then talk you through your options.

charleypops Sun 21-Nov-04 21:14:24

Motherinferior - my partner's physio is going to give me details of a couple of obstetric physios she knows, so I'll ask my gp to refer me to them. Thanks again for all that useful info you sent me!

Handbag - did you have any probs delivering? Thanks for chiro suggestion - I'll see what the physio says about seeing one.

Heymissy - You poor thing! does that mean you lost half the blood in your body? . Glad to hear you had such a great sounding team with you!

There's no way we could afford to pay for all that stuff either unless we're definitely covered. I wonder why BUPA didn't cover the costs of your emergency cs though? I guess I'll have to ask them for further clarification of that particular paragraph.

Honeybunny - not sure what "centile" means, I'll look it up - it sounds BIG though . dp and myself have fairly large heads too.... Your cs sounds like a pleasant experience in the end. Thanks for sharing the digging exp with us - I'll remember that should I end up having one Good luck with your 3rd!!

Jabberwocky - Thank you very much for your reflective advice, I will make sure I read up on css just in case, also you have clarified the terminology with which I can approach the insurance company

Pupuce - ooh, I don't like the use of the words "whoppers" and "vaginally" so close to one another!! . I didn't think BUPA would cover electives, thanks for confirming though, as it's not clear at all in the handbook.

Prufrock - Thanks for your advice. So if a consultant writes and says a cs is necessary, then that's not an elective is it?

Thank you all for your advice . I now have a very clear plan of action and feel a lot less confused. x

Uwila Mon 22-Nov-04 10:02:36

Hi Charleypops. I was wondering why you haven't posted on the June thread lately. Maybe Santa should bring you a nice PC upgrade?

You mentioned your hospital way down onj this thread? What happened with that? Did you succeed in getting away from St. Peters? If not, youknow if you flat out refuse to go there, your GP is responsible for finding you another hospital... whether he likes it or not.

I did manage to get into Queen Charlotte. So, I am definitely not setting foot in St. Peters... yippee!!!

Also, if you are considering do this "naturally" (i.e. pusshing this bub out the itsy bitsy little hole God gave you), you could always just show up at another hospital in labour. You may wish to find one that is very far away from St. Peters so that they don't try and transfer you back there.

lulupop Mon 22-Nov-04 12:37:58

Hi, and congratulations on your PG. I also have a narrow pelvis. My mum had 2 c sections, her mum also had one. I was very worried about this, and asked for a pelvimetry before I got PG, but was refused as they now say actual measurements are not nearly as important as position of baby, and position of mother while birthing!

Nonetheless after 24 hours at home (planned home birth with DS), I had an emergency c section 3 yrs ago. Followed by elective this time round.

They later told me there was no way either of my babies would have come out the usual way without a 3rd degree tear

my sections were positive experiences though, and as my midwufe pointed out, nature doesn't usually give you something you can't manage - otherwise all those tiny ladies in Asian countries would be having a lot of trouble!

BUPA does not cover standard pregnancy care. They only pay for the things that can go wrong.

charleypops Mon 22-Nov-04 12:50:31

Hi Uwila!

A computer upgrade would be very nice, but dp says no - he reckons that as my computer is a G4 Mac and hardly 18 months old it's all my fault because I've got so much c**p on it! So i guess I'll have to try dumping some stuff. I'm a bit scared though, because knowing me I'll get rid of the operating system or something. I might be able to persuade him I need more memory....

Shockingly, I didn't get into Frimley Park after all. My gp was very surprised as he'd never had difficulties referring women there in the past and he certainly didn't mention that there would be a possibility I'd be rejected. He's trying Royal Surrey in Guildford now.

Good for you getting into Queen Charlotte, it must be such a relief! Is that where you had your NHS scan? Thanks for your sneaky tip re showing up any-old-where in labour .

Made another appointment with gp for Friday morning to see if i can get a referral to a obstetric physio. You never know, I might just HAVE to have a nice calm private cs then I can stop being such a worrypants!

Pleased to see you have had such positive scans! Was there any difference in the nuchal assessments between your two scans?

Branster Mon 22-Nov-04 12:57:39

Hi charleypops

Try not to worry too much about the birth, especially at this stage and enjoy your special time.
The baby will come out somehow and in my experience the doctors in this country don't consider CC to start with unless for obvious reasons.
I would advise you though, to talk it through cleraly with you doctor and midwife as sometime they have a tendency to not get into details to much (again own experience)

Although I am taller than you, I have a very narrow pelvis and waist and I was very concerned about a vaginal delivery especially as my mum ahd CCs. But teh midwife and doc kept telling me I don't need a CC although I never had an internal examination or anything like that.

In the end I had a ventouse delivery and if this happened a few hundred years ago the baby would have not got out otherwise, but thank God they have all these techniques nowadays.

It may be a good thing to make it clear to your doc about your pelvis shape as this might affect the delivery in other ways than it did mine.
But it is tru that the bones become flexible during pregnancy to prepare you for the actual delivery (well, cartilagies actually i think).


And don't worry too much about the pain. Put it in perspective: it's only a few hours out of your life and everybody goes through it. You can choose from a selection of pain control methods and since you are so well informed, you will know what is right for you.

Good luck with your pregnancy and enjoy it!

Branster Mon 22-Nov-04 12:59:33

Oh yes, I did have a 3rd degree tear as well but although it sounds frightening it all mends itself. I was very, very tight down there that's why it happened I think. I try and look at it from a positive point of view that I'm not like a bucket now at least

charleypops Mon 22-Nov-04 13:05:11

Hello fellow "pop"

Glad you're reporting good experiences with your css. 3rd degree tears!! I didn't know they came in degrees! Thank goodness you didn't have to go through that!

Does any know if you can choose to have an arranged cs 1st time round?

Uwila Mon 22-Nov-04 13:07:36

Charleypops, if you want to go somewhere other than St. Peters, you can but you have to refuse St. Peters NOW. If they see you passively going along with the plan, then they have no reason to sort anything else out for you. Also, if you think you may be interested in seeing a consultant and possibly a c-section, an understaffed hospital with long waiting times is the last thing you need.

Have you considered Epsom? I had DD there (we lived in Epsom). I knew several people in my prenatal class who had elective caesareans just because they wanted them (no medical necessity). Mine was an emergency c-section due to foetal didtress after being induced more than a day earlier.

Oh, and I too have Bupa, but it only covers a caesarean if it is medically necessary. And, it's up to Bupa whether or not it is medically necessary. I'm not going to try that route because I think I could end up with a whopping bill I couldn't possibly afford.

prufrock Mon 22-Nov-04 13:09:18

It can be a medically necessary elective.

Elective simply means that you have chosen in advance to have a c-section. That could be because you just want one, or because there is a medical condition that makes it either advisable or essential.
Emergency means that you decide whilst in labour - but even then it's not necessarily a full emergency - my first was an emergency as my induction (which had to be done at 37 weeks because of a condition I had) failed to progress, but I had to wait a further 8 hours because I'd had breakfast.

I'd just like to echo others though and say that being small doesn't mean you won't be able to deliver naturally.

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