Water Birth, can you have baby monitored throughout?????

[jkb]

Hi

have posted many times on here recently about different things...
I Am hoping my consultant will want me to have a c section (see other thread on reasons for this..I almost lost DS due to pelvis problems, fetal distess,akward positon in womb & it not being detected etc..).....
however, if this does not happen (if I go into labour before planned c section or they actually decide not to do one) I really feel a water birth would be good for me...
I could be in an upright position (which would help with my pelvis misalignment i think? & hopefully help baby out )?????????? anyone got any advice on this??

However, the BIG drawback/worry for me is losing my baby! as I nearly lost my DS last time, one minute he was fine, next minute his heartbeat dropped & he was got out with cut & forceps just in time...I am so frightened this could happen again & so would want babys heart to be constantly monitored? As this was the only thing that saved him last time!
However, is this possible in water? I know they have waterproof dopplers, but thats no good as I want somthing thats checking her the whole time im in the water??? does anything like this exist?

[StripeyKnickersSpottySocks]

Yes it does but not at every hospital, infact most hospitals don't have them.

I have worked at one hospital that did have them and would love it if my current hospital bought one. Think you would need to check with your local hospital(s).

[jkb]

Thank U
whats the equipment called?

[StripeyKnickersSpottySocks]

You need a waterproof CTG machine. Good luck.

[jkb]

Thank you so much... bet they dont have one!!?!
what do you think about the whole waterbirth thing??? do you think im safer to have the c section?

[SnowlightMcKenzie]

jkb Hope you don't take this the wrong way, but can I ask if you KNOW for sure that you nearly lost your baby? Have you seen your notes, were you debriefed?

I think it would be helpful to you if you haven't, to do both of these things to get a grip on the level of emergency it truly was in order to go into the next birth feeling positive. IME there are many different types of emergency, and some of them aren't as dire as others.

hth

[jkb]

Yes they went through things with me after.
...The midwife there was in tears, the consultant had to use 3 sets of forceps, cut me twice & then when my son came out he had to be resusitated...his heart had dropped to 20 Beats per min.. I have read my notes.. it says severe fetal distress, large cut,extended cut,problems with shoulders, etc... thats why they are probably going to put me for a c section... but just in case (if I go into labour before) i wanted to check this out?

[StripeyKnickersSpottySocks]

I haven't seen your other threads so don't know about your pelvis problems.

But standard advice is that a VBAC is the safer option than a repeat C-sec. Obviously if there is any medical history that may make a VBAC less safe for you or the baby then your consultant will advise a c-sec. If you wanted to request a c-sec then you would be "allowed" to have one. Your consultant may feel you would benefit for psychological reasons from a repeat c-sec as it certainly sounds like you had a traumatic time.

It is very unusual for baby's heartrate to be OK one minute and that low the next. Normally there are warnings during the labour that baby is coping as well as could be expected.

What I'm trying to say is that just because its happened once does not mean that there is any reason it would happen again. Unless there is a suggestion that he got stuck becasue of pelvis problems, but again that is very unusual. BAbies are more likely to get stuck due to their position and again that is more of a one off rather than something that is likely to happen again.

[jkb]

Thank you.. I didnt have a c section last time..so it wont be a repeated c section or VBAC..
they cant say 100%, but they think my DS akward position was due to my pelvis & leg length difference (making me slightly lopsided).. He was also a fair size.this is the problem, they do not know for sure.. they didnt pick up DS was in the positon he was in untill it bacame an emergency..
There were NO signs of distress..nothing atal.. then bang- the CTG went down & down in a matter of a minute..everybody there was clearly panicked-even the consultant who got him out ..

[jkb]

Just called my Delivery suite.. they do NOT have a mobile /waterproof CTG machine.. if you have a water birth, they will only listen to babies heart every 15 minutes... so.. I dont think this would be any good.. it also sounds like they will only allow a water birth if im low risk & i think due to problems before they will prevent me from having one?!

[StripeyKnickersSpottySocks]

Duh, sorry I'm been thick. Obvious if you got cut, etc, Am very tired.

Ok, so it wouldn't be a repeat lscs.

So yor choices are to have a lscs or to try for a vaginal birth (non water) with constant monitoring of heartrate.

Or try another hospital if there are others near enough.

Did you progress well in your labour (cervical dilation)? I think that this can often be a good indicator to see if there is a problem or not? If cervix doesn't dilate well and/or baby doesn't descend well then there is a problem - either with baby's size, position or your pelvis.

Could one option be to wait and see - see if you think this baby feels as big as last one when you're at term. And wait and see how labour progresses - if you make good progress and heartrate is fine then carry on, if progress is slow then move to a lscs? Is that something you would think about/ ask your consultant for advice on?

[SnowlightMcKenzie]

jkb That sounds very scary. Do you know if you are considered low/high risk this time?

I know the distress came on very suddenly, but afaik, they monitor the baby every 5 minutes at the most risky time, and 15 minutes in early labour. However, when the baby is deep down in the pelvis (just before birth), there is no way of monitoring as I understand it.

Being upright does help with the positioning of the baby. What position did you labour/deliver in last time?

Would you consider labouring in water and then delivering upright on dry land?

[jkb]

Ok- really good question about me dilating.. this is the weird thing...
I was examined by the lead consultant at 37 weeks & was 2 cm dilated- having had NO contractions, not even any braxton hicks i was aware of... however i was not even 1/5 engaged-which he was quite confused about. he was quite shocked by this for a first baby & said I was going to have a very very quick birth & to not hang around when labour started.... however, despite strong, regular contractions, i was quite slow to dilate once I got to 5 cm- so they put me on a drip to speed it up... this didnt help too much either & DS continued to NOT decend- I recal that even at 10 cm i was not even 1/5 engaged & they were all puzzled by this.so they left me for another hour before they allowed me to push (as had then given me an eperdural) hoping he would come down- he still didnt..& it was after the 3rd push all the problems happend with his heart & the emergency occured????? what do you think? I cant help think they should have picked up that he was back to back & that despite me dilating etc.. he wasent coming down & that somthing with amiss??

[Lulumama]

my DDs heartbeat was monitored until she was actually delivered IIRC. although my perception of the moments of her birth are slightly altered.. but i thikn i do remember teh MW holding the CTG pad low down on me and hearing her HB as she was being born

if your baby did not descend at all it could be to do with

his position/size/ head circ/head position

your pelvis

a combination of the two

have you had any scans of your pelvis that would indicate any problems?

a back to back baby is not necessariyl going to get stuck and not be able to engage

you might need some more info and if you do have pelvic issues, then you need to really think about the likelihood of the lack of descent again

altough surely he must have come down a bit to be able to be reached with forceps?

you need to talk it thorugh with MW/consultant

[jkb]

Hi Lulumama

No scans of the pelvis- I have got a leg length difference of 1cm for which I now have a wedge in my shoe & so this makes my pelvis out of line- I also have curviture of the spine....

baby had a small head- but large shoulders.

he must have come down a bit once I stared pushing- however, I had a massive cut- inside & out, alsmost into my bottom- when the consultant was cutting me - he cut a bit- then said im so sorry- this baby is in trouble & i really need to get him out NOW & am going to have to give you another very large cut- I remember crying out dont worry about me, just save my baby & so he did-#I also remember bleeding LOTS- he had to do lots of pressing the bottom of my tummy as blood was coming out very fast & he was having trouble with the placenter.
after all the stitching & lots of blood loss & the epidural wore off- I was in soooooo much pain- to the point where I almost gave up breast feeding (as they couldnt give me strong pain relief cos of the BF)glad I didnt give up though as BF for 2 years in the end.. I was incontinent for about 4 days & got a kidney infection!

I have an appointment with lead consultant in 3 weeks- but am so confused- if only i knew I wouldnt have these problems again!

[StripeyKnickersSpottySocks]

Ok, I am NOT giving advice as I wasn't present at your brth and haven't seen your notes.

However......

To have got to 10cm and not be 1/5th engaged is extrememly unusual and indicates a problem, at 5cm and not 1/5th engaged I'd have been wanting to know why and thinking that there was a problem. Most women with their first babies will be 2 or 3 fifths engaged at 40 weeks pregnant. Now wheter this was because he was stuck in an odd position or because of your pelvis is impossible (now) to tell.

Hindsight is a wonderful thing and looking back it seems that not having the drip and looking at other things would have maybe been a better option. But its easy for me to say that now and may not have been so obvious at the time.

Did they rupture your waters at 5cm, or did they go by themselves prior to that? A baby that is back to back will find it easier to turn if the waters are still intact.

It isn't always possible to pick up that a baby is back to back - I've been suprised by some coming out looking the wrong way! And there are plenty of back to back babies that descend and come out fine. I think with that lack of descent I'd have been wondering if baby was a brow presentation, etc.

I think it is unlikely to happen again but there are no guarantees. However the signs that something wasn''t right were certainly there and if you did decide to have a vaginal birth then its something you can say that if it looks at all like history is repeating itself then you want to stop and go to theatre.

If this baby engages well, descends and you dilate well then you will know that last time baby was in an odd position. Though in 2nd pregnancies baby may not engage until labour sometimes. If however you go into labour and baby doesn't engage then you should start thinking perhaps it is your pelvis?

I have looked after a lady who had a very badly damaged pelvis, her legs were different lengths, etc. She had 2 normal births.

[Lulumama]

stripey is forceps even possible with a non engaged, non descending baby, even with a huge episiotomy.. surely the baby has to have moved down a bit.. so it is reachable?

sounds like a terrible experience, and one i am sure you are anxious not to repeat

i suppose it depends if your second labour starts to follow the same pattern

[jkb]

They broke my waters...
I agree that its strange & worrying that no one thought to question WHy my baby wasent decending????? I had a very young midwife- newly qualified- however, you would think she would have wondered why he wasent coming down??
without being too crude, all she did comment on was how swollen my Vagina was!! the most swollen she has ever seen, she showed me in a mirror & i was shocked !! & i remember her saying that ds was just not dropping down & that the pressure was causing the swelling??

[jkb]

the consultant did say i needed an emergency C section, but he said there wasent time- he needed the baby out & quick... they didnt take me to theatre to do the forceps (which is what they normally do at my hospital) they did it there & then in delivery room as they said there was no time..
I had to push & push too while he had the forceps (used 3 different sets)
& i remember then shouting at me that this was very serious- to push as hard as i have ever pushed as my son needed me to help- I pushed so hard the catheter shot out!! yes.. shot out- right in the consultants face!! he said that had neve rhappened to him before! they then left me for 3 hours without a catheter- they forgot !!!! when they did put a new one in, i almost filled 2 bags!! i think this is what caused my incontinence & infection!

[Lulumama]

sounds horrific

[Lulumama]

i thought a swollen vagina and cervix was a sighn of obstructed labour?

am baffled that thigns were going so badly and so questionable from so early on that you were allowed to labour with synto and push with no descent throughout labour

perhaps you should be going back over this with the relevant peopel

[Lulumama]

actually, think it is a sign of pushing before full dilation.

anyway, to me, it sounds like a very traumatic and horrible situation. regardless of why it happened

[ShowOfHands]

Oh gosh it sounds horrific. Congratulations on his birth. I'm sorry it was so difficult for you.

I had a similar problem in terms of descent. I pushed for 6 hours and dd did not shift a mm. She was however 2/5 engaged, but this was still too high to use forceps. You poor thing, they must have had to force them to work. At this point my dd was not distressed so I was taken to theatre and they gave me an episiotomy that sounds similar to yours (inside and out, right back as far as possible without actually reaching the anus) and tried with a ventouse. They also tried a manual rotation. She would not move and at that point her heart rate dropped right down and then became untraceable. Thankfully I was in theatre and had a spinal for the ventouse so they proceeded straight to emergency cs. I have asked a lot of questions about what happened and have worried and worried and worried that there's something wrong with my pelvis. I know that dd was in 'deep transverse arrest' so was facing the wrong way and she also had her head tipped to the side and was coming out ear first. None of this was possible to diagnose until they started the caesarean.

Sorry, I'm running on I think. I understand the concerns about your pelvis. I have a long standing hip problem and one leg is 1 inch shorter and it's never occurred to me that this may have caused a problem. They certainly didn't say my pelvis caused the problem and I was told by the surgeon and midwife to try a vbac next time but I do wonder if my hip and leg length is in any way implicated after all. It says in my notes that there was no barrier to vaginal birth next time. Does it say nothing about recommendations for next time in your notes?