Shoulder dys.... (can't spell it!) in the birthing pool?

[Kayano]

Can it happen?

What would happen in that situation?

I'm due my first in 2 weeks, have requested water birth and am low risk but I worry about the baby getting stuck and being stuck in the water!

Any experience?

Shoulder dystocia can happen anywhere. A true shoulder dystocia needs 'manouvres' (a set protocol of intervention the MWs will follow) to deliver the baby.

Very often with shoulders which are tight rather than impacted and stuck behind the pubic bone can be recified with simple intervention like mummy standing up (if in the pool), or getting the knees as close to mummy's chest as possible.

The MW can often see a shoulder dystocia happening before it becomes a problem. The head delivers extremely slowly, or not properly at all, and there is a very long pause before the next contraction comes. A true shoulder dystocia happens, but not very often - tight shoulders are often described as shoulder dystocia incorrectly.

The MW wouldn't allow your baby to be stuck under the water. If the shoulders were tight, or stuck, you would be standing up and / or out of the pool very quickly. I would discuss your fears about shoulder dystocia with your community MW and particularly with the MW who is at your delivery as she will reassure you throughout. You don't want to worry so much you inhibit your natural labour.

HTH

Suzy x

That really helps actually. I was just worrying like hell wondering what should happen

I do get very anxious

This happened to me. I had been laboring the whole time on my knees with my arms over the pool. When it became clear baby stuck they quickly got another midwife and turned me whilst contracting on to my back and he came out. I asked what would have happened if he hadn't and the midwife told me they would have tried a large episiotomy and they had an ambulance on stand by to take me to hospital.

Changing position often helps, it just nudges the pelvis into a different position and dislodges the shoulder. Not all SDs need an episiotomy, but obviously each one is different. I forgot to say there are risk factors for SD which are assessed in antenatal care. But, like many things, some happen for no apparent reason at all!

Sounds like you did a good job whensteaready :)

I had ds in pool, his head was born but shoulder was stuck. Midwife & another managed to pull him out, after making me change position. It was recorded as shoulder dystocia but consultant now describes it as 'difficult shoulder'. Ds was 9lb 12oz.

Consultant does not advise water birth for dc3 (I'm 29wks pg).

not an expert, but also, my understanding was that even if the head is out, baby doesn't breathe air until he/she is fully born (i.e. has come right out), and takes first breath (which they don't do underwater) and stops getting o2 from the umbilical cord?

I think the trouble with dystocia is that the cord can be crushed & therefore no oxygen supply for baby.

I have delivered lots of babies in water and never had any problems with the shoulders. With my own second baby the shoulders were a bit tight but I just pushed hard while my midwife applied gentle traction (which you don't normally do with a waterbirth) it didn't put me off having another water birth a few years later (with the same fab midwife ).
As has been said already most shoulder dystocias occur after long labours and long second stages and most will resolve with a change of position in the mother.

Hope it all goes well for you, try not to worry as it won't help your labour to progress if you spend it worrying!

I had shoulder dystocia but not a water birth. FWIW it is quite rare, only 1 in 200 births. Definitely tell your midwife your fear and she should be able to tell you before you get into the full swing of labour how she would deal with it and what position she would ask you to move into.

I've just written my birth plan and have had to include a full page for my phobias and anxieties.

I listen to hypnotherapy and count and breathe daily lol

Pregnancy low risk and straight forward so hopefully nothing to worry about. All my issues with this pregnancy have been psychological

I had a home water birth and had a bit of trouble getting my sons shoulders out so the midwives just stood me up and he came straight out. One of them did say that I should think carefully about having another water birth though.

kayano I have no advice but having had a psychologically tough pregnancy you're doing the right thing informing yourself and then you'll be in the best position to work with the MWs rather than panicking

It's still very unlikely though!