To think I shouldn't have to make this decision on my own?

[Jane054848]

I am 38 weeks pregnant. With my last baby, I had a shoulder dystocia, which means the baby's shoulders get stuck behind your pubic bone. If this happens it's an emergency situation because the baby is deprived of oxygen until its shoulders are born. There's some increased risk of it happening again if it's happened before. (It all worked out fine last time).

My problem is that I CAN'T get the doctors to advise me about whether I'd be safer having an elective caesarian, or not. I asked if I can have a caesarian if I want one and they said "yes", but that they can't give me any advice at all on whether I should. The registrar I saw more or less told me that they don't want to give me advice on what to do in case it turns out wrong and I sue them. She says that the decision is entirely up to me.

Is it just me, or is that completely sh*t? I'm not the one with 7 years' training and 10 years' clinical experience! And how am I supposed to make a decision if they won't give me any stats to base it on?

Does anyone have any ideas about how I can get them to give me some more helpful guidance? Or, is it possible to get them to guarantee they will provide extra support, eg have a doctor in the room for the final few minutes of delivery?

Have you asked them for stats, or just generally for advice? I can't see why they shouldn't at least give you some bare facts so you can make an informed decision. Surely that wouldn't be grounds for suing if things went badly?

Sadly, I don't think they'll give you any extra guidance, I think they're trying to cover themselves in case something goes wrong, in either scenario.

I don't know if you'd welcome and opinion rather than advice, but if it would help, I would opt for the elective c-section. I had one, it wasn't the easy option that is sometimes portrayed in the media, but I would have another, for my own peace of mind

I had shoulder dystocia With Ds1.
My midwife said to me (whilst pg with Ds2) that it won't nessicarily happen again.
Yes there are risks that it could, risks like anything else, but they can't say for sure that that is what will happen.

As it was with me I tried my best to have a natural birth, and Ds2 probably would have been fine. However I had an emergency cs as his cord was round his neck.

Before the birth was given the choice and it was up to me to decide. If the midwives/doctors know your situation then they will have the support you need on hand, as with any problematic birth.

All they want is for you to have a birth that you feel comfortable with. If you feel a cs is the way for you then go for it.

They don't know whether you wll have dystocia again, they don't know if it will be full dystocia or just just "stuck shoulders". They also can't say for certain that you will have an ordinary vaginal birth that will not need an emergancy section.

What i am trying to say is that they have no idea what will happen in your labour and any decisions relating to the nature of the birth should lie with you and you wil be supported whatever you decide.

Hi I had shouder dystocia with dc2 and they did advise a planned c-sec for dc3 and for me that was the best option, recovery was quite quick and i was in good shape post surgery, well enough to hold baby and breastfeed immediatly.

I do sympathise with you as you must feel like you have sole responsibilty for this decision.
Either way, you will get the support you need but it's not easy.

I had a situation with DD1 where I wanted advice as to whether I needed an elective c section due to previous surgery.
Absolutely no one professional could give me anything nearing an opinion as to whether it would be ok to progress with a natural birth.

The docs were happy to do an elective c which made me think that there was an element of risk to a natural birth.
But who knows, it may have been overcautiousness.

At 30 weeks though, at least I had time to decide.

It's worth asking about the presence of staff near to labour but could you risk the possibility of no one being available?

Thanks very much, all of you.

I was in the same situation as you, shoulder dystocia with DS, when pg with DD I was constantly pressurised to have an elective cs even though it was totally against my wishes.

Was it ever established why you suffered shoulder dystocia? With DS he was a large baby and this was the main cause of his dystocia, DD was much smaller and I could feel the difference before she was born, so I knew it was unlikely to happen again. If you knew why it occurred, it might help you come to a decision.

If it is any help, I was being asked to consider opting for a cs because if I asked for an elective cs and something went wrong, I had no grounds to sue as I'd chosen to have the procedure. If I went ahead with a vaginal delivery (which I did) and shoulder dystocia occurred again, and they failed to resolve it quickly enough to prevent the baby suffering from oxygen deprivation, I could have potentially claimed that they were negligent and could have done more.

They agreed to me having a vaginal delivery but insisted a consultant was present at delivery, unfortunately DD was born too quickly for them to have one there in time! She was fine though. Good luck with your decision Jane, do ask for a consultant to be there as my mw and consultant definitely though this was a good idea.