Epidural and Shoulder Dystocia - what's the chances?

[squashie34]

Hello,

I've suffered with huge anxiety (verging on Tokophobia I would say) about a vaginal birth since I've been pregnant and was adamant that I was going to try and push for a section if I could. I have nightmares and constant thoughts that the baby will get stuck and be stillborn and it's causing me panic attacks just thinking about it. I met with my consultant last week and asked about csection options, to which he said due to my previous 6 surgeries for endometriosis and scar tissue risk, a vaginal birth would be safer- however because of this scar tissue (especially on my bowels) a vaginal delivery will be very painful so he advised an epidural straight away.

I've been doing the positive birth co course to try and help with this anxiety and thought i was actually getting there until they advised watching positive birth videos, so online I went with a specific focus on epidural births and I saw a delivery where the shoulders got stuck. This caused me to have a panic attack again and now that fear is back but 10x worse 🙁 I then started looking into SD and heard it is much more likely with an epidural and induction (both of which id have due to having cholestatis) because you're on your back. I honestly don't know what to do now. I'm petrified and it doesn't help my friend had a stillbirth 2 weeks ago.

Can anyone share any info on how likely this is with an epidural or maybe some positive epidural birth stories? I feel so helpless right now.

[squashie34]

Oh I should probably also add I had to go into labour triage the other day as I had awful stomach pain from my endo, was standing at the maternity reception (to be fair I did look like I was in labour as I couldn't stand up straight and was very pale) and a random stranger in the queue turned and said, good luck- but don't get an epidural whatever you do! 🙈 really didn't help!

[BeautyAndTheBump1]

You need to try and focus your energy on the positive stories.
How many birth videos have you watched that have been positive compared to ones where things have gone 'wrong' ...I imagine the majority are all positive, so try not to focus on the odd negative one.
People always talk about horror stories no matter what the circumstances. You dont share the stories of how you drove to work safely everyday for 20 years but the first time you have an accident it's all you talk about.
The person in reception should NOT have said that. That is just absurd.
Out of all the people I know who have had babies, I'd say 80% of them had an epidural. No horror stories from any of them, and some of them were induced too!

[MichelleOR84]

I don’t know if this will help as I did not have an epidural but my baby did have shoulder dystocia . I needed an assisted forceps delivery and had a spinal after 2 hours of pushing . I went into labour naturally but had to go on the drip after slow progress and nearly all of active labour was on my back. So I was a prime example of a typical shoulder dystocia case .

It wasn’t traumatic in the slightest . I knew about shoulder dystocia and how serious it is but midwives are trained for this . It’s serious but not uncommon . My DS was stuck and the room went into emergency mode . It was impressive how everyone knew exactly what to do . My DS was fine , no injuries to him .

I am pregnant again and have no issues with another vaginal birth .

[squashie34]

Thanks ladies- I'm trying so hard to get out of this petrified mindset and did think I was getting there but I now don't think I am 🙁 and I know fear is the devil in a vaginal delivery as it causes adrenaline and much more need for medical intervention - it's a vicious cycle!

[MrFlibblesEyes]

I had an epidural. It was absolute bliss as I'd been in labour a long time and was getting exhausted. I literally can't describe how good it felt when the contraction pains faded... Planned to get some sleep but as it relaxed me I went from 4cm to 10cm in 40 minutes (painlessly). I did have a ventouse delivery in the end but I think it was more to do with the fact I was to tired to push effectively. I had an episiotomy which I couldn't feel as I was numb, baby came out perfect and my episiotomy was stitched immediately and painlessly as I was still numb. I would do it again in a heartbeat.

[Moonflower12]

With my 2nd I had a similar story to @MichelleOR84 and my DD had shoulder dystopia. She was deliver by a very slick team with no injuries to her at all. She is a healthy 23 year old now.

[RandomMess]

I had 4 inductions (and some HUGE babies) and had an epidural for the first 3 but never had an assistance with delivery or tears etc.

It's bliss to not feel any pain! They let the epidural "wear off" to deliver but only to the extent that it hurt not that it was agony!

[b0nnieN]

I had the epidural with my first born, nothing negative to say about it at all. I enjoyed the birthing experience far more because of it. 5 years on, I haven't experienced any pain or discomfort that you get with epidural horror stories x

[NameChange30]

Hi OP, like PPs I didn't have an epidural but I did have shoulder dystocia and it was resolved very quickly with no injury to the baby (the vast majority are). I was bruised afterwards but I'd had an episiotomy so that was a factor too. No long-term injuries for either of us.

I believe that some hospitals offer a "mobile epidural" which must be a smaller dose or different method of administering it, as you are able to move around - it could be worth asking your midwife if that would be an option.

[Lostvoiced]

I had a fantastic epidural experience, and I was previously very worried about having an epidural. I also had to have the spinal block because I went from 3 to 9cm in about an hour. I was also induced.

I had no pain but still had sensation, the anesthesiologist was really good, and really fast in getting it in and both me and baby were fine. A little bit of extra numbness afterwards but it went away.

I think a lot of people look down on epidurals but mine was great.

[squashie34]

@NameChange30 thank you for sharing that - did you feel utter panic at the time when it all happened?

Unfortunately my hospital trust doesn't do mobile epidurals as I've already enquires about this. I wondered whether giving birth kneeling up leaning over the back on the bed would help open the pelvis more? (I know the midwife has to get you in this position)

[NameChange30]

No, I didn't panic. I found the whole birth experience very strange, almost as if I wasn't there - I did use gas and air so that might have been why! But I also feel as if my brain kind of went elsewhere - I don't know if that makes any sense. I found the pain overwhelming (no epidural) so maybe I would have been more "with it" if I'd had an epidural and not used gas and air, who knows.

DH did panic - i think it was more stressful for him than for me! But as I said it was all dealt with very efficiently so no harm done in the end.

Definitely talk to your midwife about birth positions and include it in your birth plan if it's important to you. I agree that ideally you would avoid lying on your back but there are women who do it with no problems.

[Sipperskipper]

I did hypnobirthing and although it was great for helping me get into a positive frame of mind, I found it was quite 'anti' intervention, particularly epidurals etc. I was scared of having one for the reasons you described. Ended up with one after a long back to back labour, and it was BLOODY BRILLIANT! Wish I'd asked for it as soon as I walked in. I even fell asleep at 9cm dilated!

I was worried about shoulder dystocia too, as DD was measuring big on all scans. Read up lots about it and everything sort of said that its a well known 'emergency' type situation and is managed pretty calmly and straighforwardly.

Ended up with an emergency section (totally unrelated to epidural!) which was also positive.

[squashie34]

Thanks so much for this everyone, hearing some positive epidural and shoulder dystocia has really helped. Although what does happen if they still can't unlodge the shoulder? I know I'm catastrophising but that's what my anxiety just seems to do.

[NameChange30]

You might find this reassuring:
www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-shoulder-dystocia.pdf

The important thing to focus on is the minuscule risk of shoulder dystocia (1 in 150 or 0.7%) and the fact that the vast majority are resolved with no issues.

Have you discussed your anxiety with your midwife? You might find some CBT helpful.

[troppibambini]

I've had four births. 3 were with an epidural I had really good positive births with all of them I had no major issues with any of them and one of my epidural births was a 10lb 8 whopper I had a normal birth with him no intervention or stitches.

[squashie34]

@NameChange30 I broke down to the midwife at my 28 week appointment the other day and just said how frightened I was about stillbirth and my nightmares I've been having every night and panic attacks- this just happened to fall on the day I found out my friend had given birth to her baby sleeping so it was all heightened for me too. She has referred me to the perinatal mental health team but I haven't heard from them yet 🙁

[NameChange30]

Hope they contact you soon. Very sorry about your friend's still birth

[RandomMess]

@squashie34 I delivered on all fours with my epidurals, you can still move your legs etc with #2 I spent most of he labour kneeling up as it was the most comfortable!

[3isthemagicnumber3]

I had shoulder dystocia with my first daughter. I was prepped for c section and given a spinal, they performed a forceps delivery but she got stuck, they immediately reacted and after a few sections they got her out using the mcroberts manover and a bit of tugging and pulling! It was quite frightening at the time but overall it was over quickly and they reacted immediately and professionally. My daughter was born safely and I went on to have another birth which went without problems or complications.