Reasons for midwife pulling baby out to deliver body

[Zimbah]

Couldn't think of how to word my thread title better. DD2 was born two months ago, a successful VBAC (hurray!) but I did have a third degree tear. I was pushing for 2.5 hours. When I finally pushed DD's head out, apparently she looked huge and had massive fat cheeks. There was then a pause of several minutes without a contraction until the midwife rubbed my belly. I was not aware at the time, but my doula subsequently told me that the two midwives were looking quite worried at that point and with my next contraction pulled very hard on DD's head while I pushed, and she was born with that contraction.

Her hand was up by her neck and she weighed 9.1lb so it's likely that I would have torn whatever. But I'm just wondering why the midwife pulled her out without waiting to see if I was able to push her out myself. I'm guessing it could be dangerous for the baby to be in that tightly compressed position for any length of time?

hiya, it sounds like the midwife was thinking you were going to have a shoulder dystocia. 2.5 hours of pushing is a long second stage (particularly if you had got all the way in your first labour). Added to this, the sight of the large baby, they were probably quite worried. They rub your belly to start off a contraction - which they need to deliver the baby. It can look like they are pulling the baby out, they aren't really, they are just trying to deliver the shoulders with the help of you pushing. You are right that it could be dangerous to the baby to have the head delivered for too long without the body. The third degree tear was probably largely down to the size of the baby, hand up by the head and length of second stage and (possibly) from traction caused delivering the shoulders.

Thanks for your reply. The only reason I know the midwife pulled DD is that the doula told me - she said the MW pulled hard and as she's seen an awful lot of births I imagine that that was the case (i.e. not just that the midwife was helping to 'guide' the baby out).

My CS was ELCS for breech so essentially this time round it was a first labour. Having read a lot of threads on MN I feel quite lucky that I wasn't pressured into intervention during my long second stage. I don't know why pushing took so long although apparently the first hour I wasn't pushing effectively and the baby wasn't moving at all, something I feel quite guilty about although I know that's silly particularly as the only person who suffered from that was me!

It sounds like you may have needed a little help to get the baby out ..... but the issue as I see it is the lack of communication. It would have been nice if they had explained what they were doing.

Congratulations on your vbac though.

x

If the midwife suspected a shoulder dystocia and was pulling on your dd's head to try and avert it - well, that's the last thing she ought to have done. In fact it's the number one thing to do if you want to make the problem even worse and cause a birth injury.