Shoulder dystocia in last birth and gestational diabetes in current pregnancy-help

[AntoinetteCosway]

Reposting from the pregnancy board.

When I had DD she had shoulder dystocia. I was overweight but not obese and had none of the other risk factors. I had the GTT because my dad has early signs of Type 2; it was all clear. She was an average size. I ended up with PTSD as a result of the birth, DD was born blue, never latched on-it was all a bloody nightmare and it took me two years to get to the point where I would consider getting pregnant again.

This pregnancy I have been signed back to the midwives from the consultant because I want to have a normal birth if possible-there was pretty much no discussion, he just said ok and that was that. Now I've just had the GTT again (same reason as before obviously) and my post lucozade reading was 8. Apparently the cut off for normal is 7.8. This doesn't seem that high to me but apparently it's high enough. I don't know what it's out of and can't find the answer. Ironically I am far healthier this pregnancy than I was in the last one. Much slimmer, normal BMI, plenty of exercise, largely great diet etc.

So last time I had no risk factors for SD but did have it. This time I have two risk factors-I've had it before, and I have GD.

I have to go back next week to discuss it with them. My nightmare scenario is that I end up back under consultant led care, am induced (happened last time and I'm convinced was partly to blame for the SD), continuously monitored and not allowed a pool birth (which I wasn't allowed last time because my waters went first and then I had 'failure to progress', hence induction etc) or worse, told I must have a Caesarian. I know it's ludicrous but I am absolutely shit scared of c-sections. I cannot bear the idea of it. I had an epidural last time after the induction and it didn't work properly. The idea of the anaesthetic failing literally gives me nightmares.

I hate that I have to wait until next Tuesday to discuss all this. I was so blasé this morning-I really thought it was ridiculous that I had to have the test at all.

Has anyone been in this position and does anyone know what the hospital's likely recommended course of action is going to be?

Would it be naive and stupid for me to go in ready to argue for a normal, midwife led birth? I obviously don't want to give this baby SD. But I also don't want to set off the same train of events as last time by having an induction-a train which led to SD anyway.

I'm so confused and sad

[cravingcake]

I had shoulder dystocia with DS and had a very traumatic experience ending up with forceps, 4th degree tear, episiotomy, SD, baby born blue so can relate. I was diagnosed with pnd & ptsd at about 16 weeks post partum. I recently had DD (15 weeks ago) by elcs and it was such a different experience. Calm, relaxed, minimal pain - being discomfort having epidural put in etc.

As you really want to try for vaginal birth you could be very specific in your birth plan, for example if they want to induce you early due to GD then you will attempt but if after x hours no further along you go straight to c-section. Obviously you are at a slightly higher risk of SD. Theres no right or wrong answer and its not an easy decision.

What i will say is that recovery from elcs has been much easier (mentally & physically) than it was from DS vaginal birth, which took months and months physically and still plays on my mind. I would assume you had counselling for the ptsd and during that probably asked yourself what you would have done differently if you had a chance. Put it down in writing what you would want to be different and once you are happy then argue your case and remind the midwives/consultants/health care professionals that it is your body that has to do it, not theirs.

As you say the epidural didnt work properly, i had this too with DS and was also diagnosed as hypermobile, which can cause problems during childbirth and make anesthetics not work properly. It would be worth checking to see if you also have this, i'm on my phone so cant link but google hypermobility or look up hmsa to see i you if you have any of the signs/symptoms.

[AntoinetteCosway]

I'm sorry you had such an awful experience craving. It's quite soul destroying isn't it. Interesting about hypermobility, though I don't think I have it as I'm not very flexible. Did they do a spinal for your c-section then?

I'm really hating the idea of being induced early. To my mind, early induction of a baby that's not ready to be born yet is only going to lead to trouble-plus the induction and epidural nightmare last time I'm convinced was partly to blame for the SD. But I equally hate the idea of a c-section, though yours sounds lovely! Ideally I just want to be left alone to go into labour naturally-but I don't want to live with regretting that decision for the rest of my life if we end up with SD again.

It's so hard.

[cravingcake]

I totally agree with you that early induction of a baby who isnt ready is likely to lead to problems, and when you have previous SD thats quite worrying.

I had epidural for the elcs and it was uncomfortable while it was being done but they are in no rush so will take all the time you need to make sure it is working properly. I personally would recommend it, especially with your history & situation. Recovery was much easier than after DS.

Speak to the consultant with an open mind, ask if you can be left alone to let baby come naturally for as long as possible, ask for minimal monitoring so you can still move about if you do go for induction to try to get baby into best position etc. you dont have to decide immediately and can always change your mind closer to the time.