Possible cephalo pelvic disproportion?

[Vmama]

hello i'm a first time poster who has just had her first beautiful baby boy. I had been hoping for a natural birth after a straightforward pregnancy and went into our local midwife led centre. After more than 30 hours in labour i still wasn't fully dilated and was transferred to the main labour ward where i was given an epidural (by now i was screaming for it) and then induced with syntocin drip. I then became fully dilated but apparently baby was lying back to back and face up so no chance of him being born naturally. They tried a ventouse delivery to see if they could turn him but no go so ended up having a c-section after a spinal (there was a window in epidural).

DS was born after 38 hours in labour and weighed 8lb 9. Since then we've struggled with breastfeeding (tho getting the hang of it slowly) and I've felt very sad about the birth. Was wondering if this could have been CPD and if so why it wasn't diagnosed earlier -could i have been saved this labour? Also will this mean I can't have a VB in the future? I'm terrified of going through this again but have always wanted two children.

sorry so many questions but this site has been my saviour in the last few weeks.

Congrats on your baby

Not heard of CPD before (assume it is small pelvis/big baby head) but babies can be born back to back and face up naturally so maybe you were just unlucky

Someone else might know more. Have you tried talking to your MW about the birth?

Congatulations on a beautiful healthy baby!!!!
i am not medical but i do know from personal experience that babys' have a mind of their own, despite our plans. Previous postings on mn have had ladies give birth "naturally" after having a c-section.Do you have an understanding m/w who could talk you through your experience and answer any ?ions, i know where i live there is a service for this for up to 6 weeks post birth. I too found it tough bfing, as do lots of other mums, just look at the postings on here! but did eventually get the hang of it, cut yourself some slack and put your feet up with lots of choccy, and enjoy your beautiful baby

ohhh dont mean to be blase , but i had a horrible labour too...... 5 mths later I am finding it difficult to remember just how horrid it was.

Hi

A back to back labour is HARD! Dilation is long and slow, as baby is trying to rotate the long way round. If waters have gone then there is reduced chance of turning as there is nothing left to cushion with.

Unfortunately, we are offered all these things like epidural and induction/augmentation as if it will help but they end up being a slippery slope to further intervention and emCS.

I wasn't in labour so long with my first but otherwise yours sounds similar to mine. They kept questioning CPD, and this was written up in my birth notes. I had a miserable recovery emotionally, managed to successfully bf fortunately.

I had a VBAC with forceps in June 2005 and, although elated, I am now begining to find fault with my mw management. I realise I managed a VBAC in spite of the HCPs rather than because of the care I received.

However I do know now that CPD is not an issue and plan to HWBAC nect time.

Did you know that reclining or sitting back results in your pelvis not being able to open fully during labour. It you were to squat, stand or use all fours your pelvis will open up 28% more? It is VERY rare to have true CPD, as it usually caused by malformed pelvises due to poor diet or injury.

I am confident that by doing your research you will have an excellent chance of VBAC next time. So start Googling VBAC now!

And don't feel guilty about your feelings, it's important to acknowldge them and please know that you are not alone.

Best places to start:
www.caesarean.org.uk/
www.aims.org.uk/
www.caesarean.org.uk/articles/VBACOnWhoseTerms.html
www.radmid.demon.co.uk/vbac.htm

If you have trouble coming to terms with your previous CS:
www.plus-size-pregnancy.org/CSANDVBAC/csemotionalrecov.htm
www.birthtraumaassociation.org.uk/
www.tabs.org.nz/
tinyurl.com/5gscd "You should be grateful"

Shoulder Dystocia, a very long link to read through with links at the bottom:
www.radmid.demon.co.uk/shoulders.htm

HTH!
www.sheilakitzinger.com/ArticlesBySheila/BadBirthHaunts.htm
A Relevant Book Review: www.birthpsychology.com/healing/breview11.html
and another brief overview: tinyurl.com/p6cto

Doesn't mean it was CPD, sounds far more likely that it was due to baby's position. Back to back babies are far more difficult to birth - especially when its your first.

Next time you're unlikely to be as long in labour, less likely to need synto, therefore less likely to have an epidural. So even if baby does start off OP it will have more chance of turning in labour if you're upright and mobile rather than on a bed with an epidural (although I totally understand why you needed the epidural, especially with the synto). But there is no reason why next time your baby will be OP.

sO you should be able to have a VBAC next time.

I also had an OP baby (back to back), epidural and a c-sec. I never got further than 6cm though even after 27 hours.

Well done for getting there with the breastfeeding. Try to be positive and think of all the good things, rather than dwell on the not so good. But if you're really down about it, it may be worth talking to someone - does your hospital have a maternity debriefing service?

thanks so much for all the information and experiences -at the time of the labour/immediately after birth I was saying i wouldn't have another one but now less than 2 weeks on I am thinking of how I can rather than not wanting to so I guess that's progression.

Would I be monitered more in next pregnancy as a result of all this? My mw is good but has said i would prob have an elective c/s next time.

anyway at thye moment my priority is getting better and trying to be the best mum i can to my beautiful boy. It's taken me til now to feel bonded and to take in the fact that I have a child it was all so vague after the delivery. I'm lucky I have an amazing husband and he's helped me through a lot -not sure how i'll cope when he's back to work next week guess that's the true test!

I was suspected of CPD (being 5 foot married to 6 foot 2), and ds1 was 99 centile for head circumference. I had several scans (including one in a tube thing which I'm guessing was an MRI one?), and the consultant decided that I had 2mm clearance (which didn't sound very much to me, but of course the pelvis does expand a bit in labour - more so if you're in the right position!).

In the end ds1 (a healthy 9lb 3oz) was also back to back, so it was not going to happen - when we was born by emergency section you could actually see marks where he had been pressing down on the cervix and his head was getting trapped! So I don't think that you can necessarily rule out CPD in advance, especially if the baby is the wrong way round on the day, and I'm not sure that being warned that I had a big baby etc particularly helped me through labout (I can't remember the number of hours now, but started Sat morning, and ds1 was born 5am Mon morning).

I had a slow start to feeding - tbh I think that it can be difficult for the majority of mums, but each in a different way (and some don't have their difficult patches right at the start, but someties later down the line). Take it in small milestones - if you manage the 1st week, then that's great, and he will have had so much goodness - if you make it to 3 weeks even better. I found that by 6 weeks it felt normal and natural - but I guess that means it took over 400 feeds to get to that!

With my 2nd pg I also had plenty of scans,and was warned of another large baby (estimated at around 9 lbs at 39 weeks). I opted for an elective, and ds2 was born 7lbs 4 oz! But at least I didn't have labour and a c/s!

Unless there was another problem you've not mentioned then I can't see why there is any reason you would need an el c/s next time. Research shows that a vagninal birth is safer than a repeat c/sec.

They will want to monitor baby more closely in labour, via a CTG monitor to keep an eye on its heartbeat.