Why didn't I get past 2 cm

[verybusybear]

Hi and sorry for long post.

I am trying to 'prepare' for my VBAC meeting with a consultant midwife. I'll point out now that I don't actually want a VBAC but this is a hoop I have to jump through in an attempt at getting the hospital to agree to an ELCS.

I think their agreement will hinge on two things. Firstly how traumatised I wsa by last times events (this may be reason enough). But if not, why I didn't get past 2cm dilated.

My waters broke when I was 13 days overdue and a couple of hours later contractions kind of started. That night in bed they felt quite strong - I had the TENS machine on and had to ramp it up a couple of notches. Don't know why I tried to lie in bed all night and get some sleep anyway - it was pointless! Anyway, when I got up in the morning the contractions literally just stopped.

We then went to hospital as I was booked in to be induced that day anyway (9am). They tried one dose of putting the tablet up me (sorry - can't remember what that was called!). Kept sending me for walks round the hospital then back to be monitored. The monitor picked up mild contractions, but I couldn't feel them.

At 5pm I was put on the induction drip. I have a vague recollection of being checked at some point just before or after this and I was 2cm. 8 hours later I was begging for an epidural as the contractions were so strong and couldn't have been more than 45 seconds apart. They checked at that point, optimistically thinking I'd be at 8cm or more, and I was still at 2cm! I beli9eve that normally the drip gets you to 10cm within 8-12 hours.

Anyway, anaesthetist came thankfully, but shortly afterwards DD's heart rate dropped. They took me off the drip so her heart rate picked up. They then hoped I'd carry on contracting by myself, but gradually they died away, meaning they had no option but to do an EMCS.

I'll mention that this wasn't the traumatic bit. That was when they pulled DD out and she was blue and not breathing (despite the heartrate being ok pre-delivery). Took well over a minute to get her breathing with us genuinely thinking we'd be going home without her. I personally feel that the whole process had just gone on too long for her.

Does anyone out there (especially anyone with medical knowledge) have an idea why I didn't dilate well? I joke with people that my body didn't like the idea of giving birth, but I think a more realistic reason would be that DD just wouldn't fit into my pelvis well. She was 8lb 8oz while I'm fairly small (BMI just under 20, size 4 feet, 5'3). One midwife told me that next time I'd probably have no trouble but I'm not convinced!

Thanks in advance for any help.

Have you ever had any treatment on your cervix to remove dodgy cells (following smear tests?).

We discovered my cervix was scarred up after I tried to give birth to DS. 1cm dilation and constant contractions for 12 hours then an EMCS. Should have known better really, my periods wouldn't come out properly but I never considered it would stop a baby coming out! Was told to have an ELCS with my second, which I did quite happily.

Hi Meglet,

No - never had any kind of treatment to my cervix. Had smear tests obviously, but that's it.

Stress, quite simply stress and anxiety will delay you from dilating and it sounds like your experience was unpleasant enough to cause your mind to effect your body in that way. The adrenaline released by feeling afraid inhibits labour, it can stop it altogether for as much as two weeks.

You were in pre-labour not fully established labour and if you find this happens again stay at home, the sight of a hospital is enough to stop some people's contractions. I talked this through with my midwife and she said that it was advisable to stay at home until the contractions are much closer together (3mins) or stay near the hospital in town or go for a stroll round a park until you are finding it hard to walk if you find your contractions slow or stop at the prospect of going into the hospital.

I have recently read the NICE guidelines here on induction as unfortunately I am going to be induced at 38 weeks tomorrow for medical reasons, and you shouldn't have been put on the drip if only 2 cm dilated, the idea is to use a pessary tablet or gel to dilate to 4cm (you can have up to 3 doses 6 hours apart) then break waters and only then use the drip if labour is not progressing. The drip does not induce labour, it doesn't cause dilation if this is not already occurring, only prostaglandins in the pessary or gel form are recognised as methods for inducing labour - starting the dilation process. The only exception to this from what I have read is if your waters have broken early in labour. The oxytocin drip causes contractions.

It is very very unlikely that your small frame had anything to do with it. Stories of women not being able to birth large babies are hangovers from Victorian times when people were malnourished and rickets was common causing deformities to the pelvis. I have several friends who are 5ft-5ft3 who have had babies over 8lbs with no problems.

I'm really sorry you had such a crappy experience and I think your birth was not managed expectantly which basically means wait it out as things will happen of their own accord, there was no immediate reason from what you say why that shouldn't have happened, it sounds like the midwives/doctors got twitchy because you were over your due date and launched into a mass of procedures you could well have done without. This happens when medics pay more attention to protocols than people.

Another possible cause is that the baby was being held up by her cord. This could be because it was around her neck or that it was very short.

In my case dd3 had a shorter than average cord and although it didn't stop me progressing I was told it was slower than it would otherwise been because the cord was acting like a bungee and pulling her off my cervix between contractions.

This could be another possibility.

It could well be to do with baby's position. My first labour with DS was very similar to yours - contractions all day, went to hosp, checked and only 2 cms, put on Syntocinon to speed things up but when checked hrs later only 3-4cms, despite horrendous contractions!! I was devastated when I had to have an EMCS tho the rational part of me knew it was for the baby's sake.

I think the position is known as OP - (back to back) and this is known to slow labour down and make it very painful.

I wanted to try for a VBAC but was very nervous and ended up with Elective CS instead, and it was much less traumatic and as my GP pointed, given the size of my DD, I could have suffered some 'damage' down below!!

I had a similar situation, I was in latent labour (regular contractions) for 2 days and only got to 2cm, 4 hours on synto only got me to 4 then we went to emcs. The reason they gave me was the position, the baby's head needs to rest on the cervix to help it open, my baby was a brow presentation and hadn't engaged properly, he was still very high in my pelvis, so there was no head on the cervix.

I had same as futurenannyogg - 4cm only after 48 hours solid contractions then synto which did nothing. I'm also little and believed it was small frame was issue. It wasn't - consultant pointed out he was probs back to back. Brow of head banging on cervix rather than top so not as effective. Ds2 was 7 hour vbac and ds3 was 4 hour vbac - spent time on ball getting both into good position. Was totally oblivious to impact of poor position with ds1.

Similar here too, 48hrs of stop-start contractions only getting to 2cm dilation but put on syntocinon drip (waters already broken). I think they had it turned up too high as I was fully dilated after 3 hrs of excruciating torture with no pain relief. I did get DS out somehow but he was back to back & I've since learnt on here that this can really stuff things up. I will certainly not try to vaginally deliver a back to back baby again.

Hi all and thanks for the replies.

I don't think she was back to back - at least in the weeks leading up to the birth at my regular midwife checks, she didn't seem to think so (and I remember asking her specifically each time because I'd read so many bad stories about back to back births!). Of course I realise that it's perhaps not always easy for them to tell so she might have been wrong.

I did meet with a consultant midwfie when DD was about 2-3 months old to go through my notes. I would have thought they'd have mentioned in there if she was back to back when they pulled her out, but perhaps not. The notes offered no explanation really. The midwife said that even though I was only 2 cm, if I'd been able to have another hour on the drip I might have suddenly gone to 10cm. Apparently that does happen sometimes?! But of course we'll never know.

Unfortunatelyfor some strange reason the hospital that I'm at for this pregnancy can't get hold of my notes from the old one. Don't know why!

OP, you poor thing, that sounds like such a stressful marathon. If its any consolation your labour really doesn't sound like it was due to a stuck baby. That normally becomes apparent in the pushing phase, after you get to fully dilated, albeit sometimes at a slower pace. Could your dates have been a little out? It sounds to me very much like they were trying to induce a baby when it just wasn't ready to come out. The stress of that, and frankly the hamfisted medical approach that is induction would be enough to stop your body getting beyond 2cm. Your body didn't feel you were in a safe place to give birth so it made sure it wasn't going to. If it's any consolation - if you VBAC they can't induce you so you'll be spared this ordeal again. However if you want an ELCS I hope they grant you one quickly so you don't have to spend the rest of your pregnancy worrying. Good luck.

VeryBusy, I had a very very similar experience to you. My heart goes out to you.

I was told that there was no obvious reason for not going past 2 cms. But thank goodness my community midwife advised me to have an x ray at the 6 week check with the hospital. The x ray showed I had an usual pelvic "outlet" [sorry don't know the proper term]. I would never beable to give birth normally. 3 years later I was able to have an elcs with DD2. A much happier expierence.

I would just keep pushing for an elcs, until they give in!

OP, Poppet and Quicklook thank you so much for your posts, they've been very helpful to me.

I had a similar experience to you Verybusybear, I'm now expecting DS2 in October. I've opted for VBAC but am nervous. I don't know why I didn't dilate much despite being on a drip after my waters went and having an epidural to relax me. My mum had 3 cs because her pelvis wasn't wide enough for a natural birth, I'm wondering if I'm the same. Of course the hospital has lost my notes so my new consultant can't advise me very accurately. Hey ho!