Non-engagement

[madcol]

Has anyone needed a C-section because the baby never engaged?

I was delivered at 42 weeks + 4 days because head never engaged so contractions never started despite induction.

I don't know why baby didn't engage and I'm too scared to have another baby in case the same thing happens.

Has this happened to anyone else?

Happened to me - DD wouldn't engage and was posterior, after 14 hrs on drip they decided she wasn't coming that way. Problem was apparently both hands up by her head.

I did contract but it was such a high setting to get a contraction that DD didn't cope with it v.well and her heartrate kept dropping so it ended up as emcs.

Can you go through your birth notes with a midwife?

Asked to see the consultant as this was 18 months ago but feel I have never been properly explained the reasons for it happening. I am concerned that I would be anxious all the way through a second pregnancy.

MMH are you small/short? Iam 5 foot 1 /155cm and wonder whether this is the problem?

DD engaged very early in pregnancy then popped out as she got bigger. Her head never quite settled back and consequently she did frequent rotations late in pregnancy. I ended up with a cs for other reasons but quite often in inductions the baby doesn't get into a great position because it's not the same - the contractions are much stronger and often double peaked and it doesn't build up in the same way. Chances are your baby would have come in it's own time - DD was 43+6 when she finally came out the catflap though.

True cephalo pelvic dysfunction is very rare unless you have had rickets. It is much more likely you were just unlucky.

My DS didn't engage because I had polyhydramnios. So I had to have a CS. It wouldn't put me off having another baby though - I know what to expect now. AFAIK it's quite likely I'd have the same thing again.

If you have to have a CS, you have to have one, you still get a lovely new baby at the end of it

But I'd do as missingmyheels suggests and get a copy of your notes and discuss them with a mw if you can.

I am smallish (5ft3) but don't think that was related in my case as until 40 weeks she was pretty much fully engaged and in perfect position - had DD at 41+5 following induction and she had totally changed position - think it was the induction process and being overdue for me.

I would try and see a birth counsellor and maybe get a doula for your next preg/birth?

I've had three babies and none of them engaged before labour started. The first two ended up being CS for failure to progress. I've just had my third vaginally - I was nervous that he hadn't engaged either and I thought history would repeat itself, but he was born without problems about 12 hours after the first contraction and it was fantastic . I'm 153cm (5'3"?), by the way.

My ds never fully engaged in my induction despite 23 hours of full-on contractions and getting to 6cm dilated. I heard one doctor saying to another that they couldn't understand why the baby was "still at minus 1 station".

Had an emergency cs in the end.

I was told that the main reason was my uterus was blocked by fibroids, so the baby's head couldn't get round them. I would have thought there must usually be a mechanical reason if you get to this stage of labour with no head engagement. I would definitely recommend looking getting to see your notes and discuss them with a midwife or consultant.

Please don't put off having another baby for this reason! Your second birth could be so different. I had an elective cs for my second, which I loved and would hugely recommend, but plenty of women go on to have successful VBACs if that is more your thing.
The important thing for you now is to get all the information together so that you can make your decision.

Thanks - sounds like I have to find out reason for this happening, then work out if it likely to have been a one off or its unfixable and will happen again.

How long overdue should I go waiting for head to engage or labur to start naturally though if I do get pregnant again?

That's a tricky one because the baby often doesn't engage in a second or subsequent labour until labour starts, sometimes not till halfway through labour.

I would do the research now rather than waiting till your next pregnancy.

my ds2 was in perfect OA position all thru pregnancy. at 40 weeks he went OP but head did not engage. i went into labour spontaneously at 42 weeks, after 36 hour labour (at home as wanted vbac) i was 5/6cm dilated but his head was still at -2.

went to hospital for CS, he was in deep transverse arrest, where head is wedged sideways in pelvis. he was 9.5 lbs and i'm a petite 5'2", and though i suspect i might have got there naturally eventually i think it would have involved forceps and a lot of stitching! but i really believe every pregnancy/baby is different, and wouldn't be put off going for the natural birth again for number 3, if there is one!

Thats my problem, if head doesn't engage second time around is that because second time around or is it because of some original problem. Don't fancy trial of labour to find out but don't wan unneccessary surgery.

Thats my problem, if head doesn't engage second time around is that because second time around or is it because of some original problem. Don't fancy trial of labour to find out but don't want unneccessary surgery.

Sounds like my first birth. DD didn't engage because she was literally wrapped up in and suspended by the cord (I found this out after the crash section that followed failed induction and foetal distress). However, I was quite happy to have a nice peaceful planned sect for DS two years later.

If you ask and find out that your DC was wrapped up in the cord, it is quite unlikely that that will happen again. I had a 36 week scan with DS and asked them to check the position of the cord. They did. And it was most certainly not wrapped around him. But, I managed to convince them that they should give me a section anyone on the basis that I didn't fancy any risks of the scar tearing.

Madcol - some good info here. Ignore the fact that it's a homebirth site, the info is still relevant and it's very well researched: www.homebirth.org.uk/highhead.htm and www.homebirth.org.uk/ofp.htm

I went into labour spontaneously with all three of mine despite the head being so high and quite punctually too: 40+2, 40+3 and 39+3, so it doesn't necessarily mean you'll go very overdue.

Thank-you.