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babies who get stuck...(29 Posts)
Hi all. I was wondering if anyone can shed a bit of light on this...
my ds (my first) was born by not-very-urgent emergency caesarean for failure to progress/arrest of descent. He was the right way up and facing the right way etc (the registrar wheeled an ultrasound machine into the delivery room to check!), but it took me 17 hrs to get from 4cm dilated to 9cm, at which point the consultant thought enough was enough.
the thing that i don't get is, although he was a decent size - 9lb 12oz - i was only 4oz lighter at birth myself and am a strapping lass with what i'd (ironically, as it turned out) always thought of as childbearing hips.
could anyone explain this and/or tell me whether i'm likely to have a similar prob next time?
I don't know if it's the same thing but I had a very long labour with ds1 (40hrs). He was 9lb 8oz. I didn't have a c/s (although it was very close!) and ds1's shoulders got stuck on the way out. He was pulled free and was okay. With ds2 it was on my maternity notes that it was possible that this might happen again. Ds2 was iduced early so that he didn't get too big (he was 9lbs). The labour was relatively fast (6hrs) and although he did get his shoulders stuck there was already a doctor waiting to help him out. It was definitely a lot easier the second time around.
There's a thread I started called "Failure to dilate in labour....why?"
Lots of v interesting contibutions on there if you are interested .
puff, i am probably being a muppet, but i have searched for your thread and can't find it anywhere...
glad you had a better time of it the 2nd time, coppertop!
pupuce - no, i wasn't induced, but i did end up having an epidural. i'd be glad of the benefit of your experience, so here is what happened in a bit more detail (sorry if it's a bit long):
contractions woke me up the day before i was going to be induced and carried on for the next 24 hrs without seeming to go anywhere, iykwim, even tho i was mobilising and staying upright like a good girl. i wanted a bit of reassurance about what was going on cos the contractions were coming about every 5 mins but didn't seem to last v long, so went to hosp and was told i was 1cm dilated and to go home and come back in 12hrs if not before, cos my hindwaters had just broken. still mobilising lots. anyway, it all got a bit more intense and i went back to hosp shortly before the 12 hrs was up. was then 4cm and got put in a room off the postnatal ward cos the labour ward was overflowing. dp and i spent the next few hours hassling the MWs to get us a room on the labour ward (not quite sure why we thought this was so important,,,) and meanwhile my forewaters went and i got in the shower (still v upright and pain not too bad). but i got stuck at 6cm for a couple of hours and then developed an urge to push (still at 6cm) which was a bit distressing and v hard to resist. at this point they did stick me on the labour ward, and i spent an hour trying to walk around without pushing - i asked about doing a knee-chest position but was told the docs wouldn't want me to carry on any further without intervention, so the hour of walking was a compromise to try and get things going. my cervix didn't budge at all tho, so i was given an epidural and syntocinon (this was definitely not on my birth plan but i was so knackered by then that it was actually a big relief). 8 or so hrs later, i'd got to 9cm with a lip that the consultant couldn't shift (and boy did he try,,,) so into theatre i went.
that's the link to the thread puff mentioned
Just as a matter of interest, what is the first letter of DS christian name ?
arrrggh!! what a muppet! i've actually read that thread already . was v informative, ta
Well, this may be of no relevance to you, but ds1 got stuck. Long labour, had epidural when about 7cm dilated as so tired (had been mobile up till then), syntocinon drip etc, got to 10cm and was in second stage for 4.5 hours according to notes. They let the epi wear off so I could push but I had no urge and screamed the place down so they eventually wheeled me into theatre to attempt ventouse with a view to doing c/s if necessary...luckily ventouse worked (nothing against sections but didn't fancy having an episiotomy and still ending up with a section). ds 1 was 7lb 8oz but I am short and not hippy, IYSWIM, and his head was quite large and definitely got stuck as it hadn't really descended at all.
Anyway, onto ds2. Long labour again. No epidural (although I wanted one!! Anaesthetist was `in theatre') (for avery long time IMO!!). Got to pushing stage but again no real urge to push. After 1.5 hours they were about to do ventouse (although his head was almost out...I just couldn't seem to finish the job!) when I suddenly got the urge to push and he popped out. 8lb 5oz and with an even bigger head than ds1.
that sounds like a nightmare 1st time. i guess not having a c-section the first time meant you had the chance to deliver ds2 vaginally tho - I don't think i'd be allowed to do another long labour now even if i wanted to. can i be nosy and ask if you found the second labour any easier? it doesn't sound like it was much fun...
Sorry - been away.... so when did they rupture your waters?
i had a v long labour with dd and failed to progress - she was largish (8lb9) and ended in em c/s. With ds the hosp decided at about 29 weeks that he was even bigger and virtually insisted on an elective c/s at 37 weeks - he was 8lb 12.
You obviously have big babies so if you're worried about similar probs next time, im sure your consultant with discuss your worries with you
Jampots - it is interesting how one health professional will have 1 view on one woman and another might disagree.
A colleague of mine had an emergency section for her 1st and her baby was 9lbs 8 - he wrote in red on her notes that next time she should have an elective as he said her pelvis could not tgake such a large baby... so second pregnancy came along and it was a given that she would have an elective... but she changed her mind, hired an independent MW, had her baby vaginally in water.... 11lbs... no tear at all !
CarolinaMoon, the answer is yes and no!
First time was actually shorter from first contraction to birth (50 hours). I agreed to the epidural after 36 hours and my notes show that dilation slowed after I had it, despite the syntocinon drip. I was told that was probably because I was immobile. The ventouse was a tricky one (so they told me) as his head was still so high, so they prepped me up for a c/s and took me down to theatre to do it. I had to have a large episiotomy and stitching took forever.
Second time was longer as I said. 3 days of `pre-labour' contractions. Only TENS for pain relief and virtually no sleep! `Established labour' was about 10 hours though (as opposed to 27 hours established labour with no.1). I asked for an epidural when I was 8.5 cm (had taken 4 hours to get from 6cm to 8.5 cm) because I was so tired I didn't think I could possibly push him out. But I didn't get one! This may have made the difference between a natural delivery and another ventouse or even a c/s though as I stayed mobile. I did tear, quite badly, but this took a lot less time to stich than the episiotomy with no.1 and the stitches were less uncomfortable (it seems that I had a lot of internal stitches first time whereas the tear was superficial).
ds1's head was on the 50th centile, ds2's on the 75th. I am 5' and smallish as I said.
I was actually offered an elective c/s with no.2 as labour no.1 was so awful. We agreed (after late growth scans suggested no.2 was no bigger than no.1 - ha ha, don't believe the growth scans!) to go for a trial of labour. I don't know what they'd do in your case if you had a long pre-labour phase but I don't think many people experience that.
Sometimes I wish I'd gone for the section! But then I remember how I was driving again straight afterwards, and how I was able to look after my 3 year old as well as the new baby.
One thing I did differently second time was that I scrubbed all our floors on my hands and knees during the week or 2 before the birth and I did feel the head getting well down in my pelvis after that, which I never felt with no.1.
Good thing I did clean them so thoroughly - I've hardly had time to do any cleaning since (ds2 is now 15 weeks old).
Sorry to ramble on. Hope it was useful.
gingernut, you really have my sympathy! 27 hours established labour?? thanks for the floor-scrubbing tip - I spent hours sitting on a swiss ball in the last few weeks of labour in the hope of opening things up, not that that helped. ds's head didn't engage until well into the early-labour phase, and then only cos i did lots of squatting and hip-wriggling. I could feel it kind of grinding its way down - not sure if that is normal tho (?). you are totally right about recovery - it took me a v long time and a bit of the scar opened up and got infected and just wouldn't heal for weeks.
pupuce, my waters went of their own accord. I would love it if I could do what you colleague did - i suppose that's why i'm trying to work what happened, to see if it will repeat. if i'd end up with another section i'd rather do what jampots did and hopefully then i'd recover more quickly.
Carolina..... first of all I would say that in a second labour what ever happens with regards to the 2nd stage you would probably have a much faster dilation, once contractions are strong and regular of course. This is to do with the fact that the oxytocyn receptors are now well established on your uterus and make the job more efficient.
Why the baby didn't descend,..... I do wonder if his head was really well positioned... certainly being on your back does NOT help an anterior lip to shift adn it is VERY difficult to manually remove it on a first time mum (I would have thought he can damage your cervix trying to do that actually!) ....
I think your knee chest idea was the right one ! There is something called reversing the chi...
Reversing the Chi
by Dot Parry
Reproduction here giving full credit to "Midwifery Matters" Issue no.98 Autumn 2003
I'd read about a technique called "Reversing the Chi" in an e-mail edition of Midwifery Today. I filed the information in my mind and never really expected to use it.
ONE VERY BUSY NIGHT on our hospital's main delivery unit, I was assigned to care for "June", a woman having her first baby. I had cared for June on the previous night shift since when she had been in active labour. I was told that June would be taken for a caesarean section as soon as it was possible, but that the theatre was in use and there was no rush as the baby was OK. An obstetrician had examined June an hour or so before and her cervix was said to be 7cm dilated with the baby in an occiputo posterior position with a deflexed head. There had been no change since the last examination three hours before despite a syntocinon infusion. The syntocinon had been turned off as it was having no effect and it seemed cruel to continue since the decision to perform a caesarean section had been made.
I went in to June and re-introduced myself to her and her family. She had been supported throughout by her partner "Steve", and by her mum. Her supporters were in very low spirits. They were absolutely exhausted and told me so in no uncertain terms: "How much longer will we have to wait?" they complained.
June was sitting on a chair beside the hospital bed leaning on a pile of pillows - a position she had found very comfortable the night before. She had been using entonox since 6 am. It was now 10pm and I was amazed she had the energy to work the entonox valve for 16 hours and to still be upright. She had chosen not to have pethidine and had declined an epidural. I sat next to her and tried to chat to her between contractions. She was still in good heart and felt that she had been well supported by her midwives through the day to do all she could to birth this baby. But we kept being interrupted by the moaning supporters and I began to feel they were really draining June's energy and positivity.
I listened to the fetal heart which was reactive and a similar baseline to when I had gone to my bed at 8am - so I agreed with the obstetrician on one thing - there was no rush to get this baby out.
My next priority was to change the energy in the room. I asked Steve and June's mum if they had had any tea - they hadn't, so I suggested Steve order a pizza for them to share. I said I didn't want him fainting from hunger in the operating theatre! Steve went off to organise the pizza and mum went for some cold cans of pop from the machine. Sadly it was not really appropriate to feed June as I knew she was going to theatre shortly. Once Steve and mum were eating, their spirits lifted and the mood started to change.
It was now after 11pm and June had been having strong, regular contractions since I had come in the room two hours earlier. I was wondering if she could have made any more progress and was glad when she asked me to check her cervix to see if she had got any further.
On vaginal examination I found her cervix to be fully dilated but the head transverse and at the ischial spines. She had been feeling some urges to push but had resisted them as she thought she was imagining it. For the next hour or so we tried another trip to the toilet, some changes in position and a little bit of pushing when she felt she needed to. Throughout all this the baby's heartbeat gave no cause for concern.
The situation on the delivery suite had deteriorated as women with more problems occupied the rest of the staff including the doctors. I kept the midwife co-ordinator informed about how June and her baby were doing. I guessed we might get our turn in theatre in another couple of hours, all being well.
At 1a m June requested another vaginal examination to see if the baby had moved at all. The baby's position was almost exactly the same as before. It felt like we were really and truly stuck. The mood of despondency was returning and June was getting very tired indeed. I decided we needed to try something else and reversing the Chi was all I could think of.
I told June that for the next half an hour she should lie on her left side and avoid pushing altogether even if she really wanted to. I told her that instead, every time she got a contraction I wanted her to pull her baby up towards her throat. She nodded as if this was completely reasonable and made perfect sense. I didn't really think it would work at all, I still felt I was buying time and that soon we would be on our way to theatre. I stifled my doubts by focusing on the supporters, getting them to say positive things again and stop looking at their watches! For the next three contractions June had a look of deep concentration on her face. She had put the entonox down and was totally focused on pulling her baby back out of her pelvis. She didn't use her hands, the effort was all internal, but she was definitely trying to do something. After the third contraction she started getting uncomfortable and said she needed to stand up again. She got off the bed, did two or three high sideways leg lifts with alternate legs and shouted, "It's coming!"
I went and sat behind her on the floor and was delighted to see a thick head of hair advancing gradually, then a lovely little face and moments later I was passing June's baby to her. That woman, that amazing woman, was still standing, still strong. The look on her face was one of pure female power - it was primal and beautiful. I will never forget it.
About half an hour later as June was suckling her beautiful daughter, I popped out of the room to make some tea and toast for everybody. The exhausted registrar saw me and apologised for the delay: "Just give us a few minutes to clean theatre and we'll do your girl."
You can imagine the look of pride and joy on my face when I told her that thanks, that wouldn't be necessary! When I told her later how we had "reversed the Chi," she said, "B**cks!" But you could tell she was thinking about it.
I felt that grinding feeling too, in fact it felt as though my pelvis was going to break. First time, I had lots of BH contractions in the last couple of weeks pushing his head into my pelvis, ouch! I was worried at the time because it always seemed to pop back out again - mentioned it to m/w but she was unconcerned. Second time around I felt the grinding again, but the head did seem to move right down into my pelvis and stay there, and I also felt the `lightening' where the baby moves down out of the rib cage, which I never felt the first time. So I concluded that the head didn't engage properly first time (and so his bum stayed up in my ribcage) but did the second time.
gingernut, it's interesting that your ds2's head engaged more easily even tho bigger. i wonder if your (i.e. anyone's) pelvic joints/ligaments get stretchier the 2nd time?
pupuce, tbh i think the mw had a point. i had been stuck at 6cm for about 4 hrs by then despite being upright, sitting on the loo etc the whole time. afaik, the knee-chest position would have slowed things down even more. the doc who did the scan at the end used one of those vaginal probe things (nice!) which showed a view of ds's head as circular rather than oval, so it seemed likely the presenting part was his crown.
jampots, i just saw an old post of yours - you are the lady with the 62 hr labour? (I take my hat off to you too!) can i ask if you found the elective c/s easier to recover from? and did you find your ds was any different for being born slightly early? (i'm asking cos i've heard overdue babies find life on the outside a bit easier to adapt to)
pupuce I think your story with June was lovely. I had emgency C-setion first time round (incuced at 40wk, 12hr labour with failure to progress, baby in destress, op position and head not in pelvis. Told by doctor my pelvis was too small) and i have been major panicked through this pregnancy and have been pushing for an elective which I am booked for on the 29th March. But in the last two weeks since looking on mumsnet and reading all the info along with having the feeling that the baby is going into my pelvis ( which I never had on ds ) and lots of Braxton hicks I would really like to try VBAC. I have gone out to buy massage oils and rasberry leaf tea and spend a lot of the day on all fours. Hearing these storys really changes how you think and be more open to the whole experience. I think anybody who has had a horrible labour or delivery should be made to go on mumsnet for a different view.
tiny, I hope you get the birth you want - good luck!
I think your pelvic ligaments probably do get stretchier or never quite go back after pregnancy and birth, hence why SPD tends to get worse with each pg.
tiny, good luck with the birth.
jampots - a bump in case you have a mo to answer my quick Q below...
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