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Childbirth

Share experiences and get support around labour, birth and recovery.

Elective C section after shoulder dystocia?

49 replies

dinny · 27/06/2008 13:36

Newly pregnant with third, early days but am already panicking at thought of delivery as my ds (2nd birth) got stuck and am so scared of what could happen if it happened again.

I'm mainly scared because we have moved area away from the hospital where I had my first two children (St George's) and our nearest one has v bad reputation (East Surrey)

Can I book with St George's for an elective? on NHS? Or even privately...?

Thanks.

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sabire · 27/06/2008 13:39

Sorry for you that you are feeling so scared.

My second was SD too.

Do you know why your baby got stuck? Was he very big? What position were you in when you gave birth? Had you had an epidural?

Hecate · 27/06/2008 13:43

Hi. I can't answer your Q, sorry, but your thread caught my attention because ds1 has Erbs Palsy due to sd. Does your child have Erbs?

fwiw, I went on to have ds2 naturally 15 months later with no probs, (and he was 10lb 5oz where ds1 was 10lb 4oz!) so if cs is scaring you - it's really not your only choice. If it is what you want though, then talk talk talk. They'll want to take a lot of care with you!

dinny · 27/06/2008 13:44

Hi, Sabire

DS was 9.3, not sure why he got stuck other than size. Had had excellent birth up until then - and it WAS easily resolved with McRoberts but it has made me v scared of it happening again (have you had a third?)

No, I had no pain relief at all and I was kneeling up on knees leaning on bed when pushing. His waters broke just before his head crowned, and shortly after mw shouted "SD", rang bell and did McRoberts

makes me have goosebumps thinking about it, especially if didn't have such a good mw this time round...

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dinny · 27/06/2008 13:46

Hecate, no, ds had no ill-effects other than compression

is EP ongoing with ds1? amazing your next baby didn't get stuck too, isn't it?

Will they really take notice because I had SD? I expect them to say it's Ok because it was resolved with no ill effects...

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Hecate · 27/06/2008 13:53

Yes, he's had 2 operations but they say he's recovered as much as he's going to. He's 9. He can't ride a bike without big stabilisers, or swing a bat or lift his arms above his head or do up tight trousers or fiddy buttons etc etc (not going to bore you with big list ), but he copes very well day to day, he's found his own way round stuff

Ds2 shot out! He didn't get stuck because ds1 was doctor error (as it normally is!!). They were BLOODY careful with ds2! The fact there'd been sd was noted and so they had it all in mind, they had plans, they ran through it all. It was noted as a risk. Being prepared is key. It's being caught unawares that is most dangerous. Talk about it with them.

dinny · 27/06/2008 14:02

he sounds ace!

yes, the fact ds was ok was down to EXCELLENT midwife who knew instantly he was stuck and instantly did Mc Roberts

had she been someone else, things may have been different

what did they do differently with your next birth then?

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cyanarasamba · 27/06/2008 14:04

I had an emergency CS at East Surrey. C-sections is what they do best in my opinion (+30% CS rate, 4 out of 6 of my NCT group had one).

If a CS is what you want, you should be fine there, and I'm sure they'd be happy to oblige.

However it seems a shame to go through such major surgery with no 3 when you have otherwise coped well in the past. Could you find an experienced doula for backup?

dinny · 27/06/2008 14:12

hello, thanks for your post

I had a doula with ds, she was great and I would book her again if I have another vaginal delivery (though not sure she'd come this far out)

so, the bad reputation of East Surrey isn't for C sections? I just have image of them being really inept or something....

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dinny · 27/06/2008 14:12

wow, that's amazing 4/6 of your NCT group - where they all emergency?

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sabire · 27/06/2008 14:13

Hi dinny,
I wonder if you've been traumatised by your midwive's display of panic and fear. Women are intensely vulnerable during labour, but particularly during second stage and around the moment of birth. Displays of intense anxiety by caregivers and partners almost burn themselves into your brain if they happen at certain very sensitive moments in the labour, and can cause lasting distress.

I had quite a bad SD at my homebirth. My son was 10lbs 12oz and got stuck for a good 6 minutes. I was also kneeling when his head was born and was put into McRoberts.

The difference for me was that my independent midwives didn't display ANY panic and there was no shouting or pfaffing around. Both midwives had a go at extracting him - the second one succeeded and they calmly resucitated him on the bed in front of me. I was fine after the birth, as was my son. I look back on that day as one of the most wonderful days in my life.

I was a bit nervous next time around but went ahead and booked another homebirth (same independent midwives), but ended up delivering in hospital as labour was very long. The actual birth was completely straightforward.

I think my midwives reacted with sensitivity because they were very well prepared. They knew my baby was a biggun and that SD was more of a likelyhood. They'd revised their SD 'drill' and so were able to smoothly go into the procedures without any delay or hysteria.

You'll see a consultant during this pregnancy and he or she will go through the options with you - picking carefully through the notes of your last labour. If you decide to opt for a vaginal birth you're likely to have two experienced midwives in with you who are well prepared to act quickly and quietly in the event that the SD occurs. It is worth you remembering that the vast majority of SD's are resolved with McRoberts without significant damage to mum and baby.

I would second you talking to someone knowledgeable about your first birth - really having a good debrief. You can also debrief as much as you like on mumsnet - there are always many of us here who want to listen. I was also wondering whether it'd be worth your while seeking hypnotherapy for your anxiety if you decide to go for a vaginal birth. Th supervisor of midwives at our local hospital gave me the name of a therapist from the London College of Clinical Hypnosis who specialises in childbirth issues. I'd be happy to pass it on to you if you are interested.

dinny · 27/06/2008 14:19

Sabire, thanks so much, am feeling tearful as I read your post

um, when I say mw shouted "SD" and hit the button for anither mw, it wasn't that she panicked, more that she was reacting with urgency to a situation that needed to be dealt with - until that point all had been very chilled (with Morcheeba playing!) and just one mw and doula present.

BUT, you are right in the fact that her urgency (which was appropriate in my mind) has imprinted on my mind

will I automatically see a consultant this og? even though am at different dr, live in different area? I just thought they'd just make me get on with it....

funnily enough, have been seeing hypnotherapist for fear of flying, and she is also a birth hypno, so would definitely consider it...

when I say to dh I can't give birth he is amazed and says - "but you are so good at it", bless him

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dinny · 27/06/2008 14:19

btw, your independent mws sound amazing

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dinny · 27/06/2008 14:38

bump for other C-section thread readers/posters

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sabire · 27/06/2008 14:38

What a lovely comment from your DH!

Yes - you ought to see a consultant this time around.

Insist on it.

And my IM WERE amazing!

dinny · 27/06/2008 14:40

thanks Sabire - insist when? have just booked first app with GP next week...

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Hecate · 27/06/2008 17:16

sorry Dinny - went off on school run!
What did they do differently? They planned and they were prepared, they did risk assessment etc. SD can be easily sorted. What happened with ds1 is that the doctor panicked. you can read about it here

ds2, well, it couldn't have been more smooth. They kept a theatre on standby for me, the consultant stayed to be on hand and they were prepared for anything!

Also, I had an epidural - they insisted, in case I needed to go down for em cs, whereas with ds1 I had gas & air & 1 (useless) pethadine (sp?) late on. So I wasn't as tired.

As it happened, after suffering 10lb4oz ds1, I had a fanjo like a wizards sleeve and ds2 shot out no trouble . He had the cord round his neck and his heartbeat was dipping with each contraction, but not enough to worry about, apparently, and a couple of pushes and he was out. I was surprised how big he was because it was really easy!

ILikeToMoveItMoveIt · 27/06/2008 17:29

Hecate - sorry if this is a nosey question, so if you feel it is please ignore me.

Do you think being induced plays a factor in the sd? Your ds didn't come when he was ready so wouldn't have been in an optimum position for labour and birth?

MrsMattie · 27/06/2008 17:35

I think once you've had a traumatic birth experience you should in theory be able to talk things through with a consultant - and I were you, I'd insist on it. You need to be able to debrief your birth experience, too, so am thinking perhaps a doula might help you with this?

I have a very good friend who had a very similar experience to you with her first baby. She was under consultant care with her second pregnancy and was offered an elective section asone of her options(although she went for a VBAC with a doula present after lots of soul searching).

Hecate · 27/06/2008 17:36

I think it's very very possible. He did NOT want to come out! Even after several days of that gel I was only 1 cm dilated when they took me to del suite and shoved a crochet hook up my watsit!

However, by my calculations he was actually still 2 weeks early when he was finally evicted so I shudder to think how big he'd have ended up if he'd been left any longer!

OTOH, I could feel some weird stuff like grating for several weeks, I can't explain how I knew, but I KNEW he was going to get stuck, it was in the way it felt. They just dismissed me, sadly.

ILikeToMoveItMoveIt · 27/06/2008 17:41

Thanks for answering Hecate.

As the saying goes 'mum knows best', if only HCP's would remember that.

dinny · 27/06/2008 17:57

wow, Hecate, going to have a proper read of your story when have more time - thanks for your post

fwiw, ds was definitely ready to come - in fact, the labour was really really good, had no pain relief, was really in control, he came right down in his bag of waters (which I was really pleased about as was Group B Strep) Then waters went, head crowned and I started making REALLY weird noises even I could hear were not right, can vividly remmeber hearing how WRONG they sounded compared to normal pushing noise I had been making. that's when mw knew something was up and then did the SD drill.

I suppose I feel because it happened so fast and was resolved with mw only (no obs involved at all) they sort of won't even notice it in my medical notes...?

Hecate - they sound like they did an amazing job the 2nd time!

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Hecate · 27/06/2008 18:00

They did.

Weird noises? That's really odd. So did I! Half growl half moo! What were yours like?

dinny · 27/06/2008 18:01

oh my God, Hecate, have just read that terrible terrible account of your ds's birth

that BLOODY doctor - for God's sake. that is EXACTLy the same scenario I had EXCEPT the mw knew the drill and did it straight away. I am so so sorry you didn't have a competent mw there instead of the doctor.

you sound an amazing mother and you are SO brave to have had another baby, especially so soon.

Dinny xxx

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dinny · 27/06/2008 18:03

I was already doing "normal" mooing but then it turned into some weird ungodly sound that was the sound of something going very wrong, I suppose - can't describe it except sort of baying/screaming in-between pushing contractions

that noise is what made my mw check for SD, I think

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hatrick · 27/06/2008 18:07

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