very bad eyes -14 and -9.5...possible to give natural birth?risks of retinal detachment?

[senem]

My doctor does not recommend me natural birth beause she thinks I might have a retinal detachment.The searches I have been trying to make on the net are not enough.Beause this is a very speific problem there is not much written about it.Some say there is no problem some say there is.Do you know how I can deepen my research? Or have you had any similar problem? What did you decide on?

I think you firstly need to know for sure if you do have a detached retina, my friend has and had a problem free natural birth

My friend had a similar problem, and on recommendation by her eye doctor got the consultant ob/gynae to arrange an elective section at 39 weeks.

At the moment I don't have a detached retina. I think most doctors are going for a elective section in this case but when I asked them about medical literature they couldn't answere me. I think they recommend this from what they have learnt at school and most doctors are not up to date beause this is a very speific issue. And most women tend to just give in what the doctor recommends. I really want to know the updated info on this to give a decision.

I had a quick search on Pubmed (which contains searchable abstracts of all published medical papers, and there seems to be an agreement that there is no need to do anything different in labour if you have severe myopia.

can I just ask if your doctor is from the former Eastern bloc? ? The reason I ask is I found this was, having lived in Kazakhstan for 4 years I often heard this from Kazakh, Russian and Baltic states doctors, all my friends were advised that there was this risk with myopia and labour. And it was not considered a problem in Europe...

Hi Senem, interesting thread. I had a detached retina in March this year and required scleral buckle surgery. I'm now 5 months pregnant with #2 and was very concerned like you about the risk of further damage to my eyes from labour. I'm a high myope too, -9 in both eyes.
The last time I was at the eye hospital the consultant (not my usual one, unfortunately) said there were no increased risks associated with vaginal delivery unless the surgery had been very recent and this seems to be supported by others' experience. I actually posted on here about it so if you do a message search for retinal detachment/childbirth the original post should come up.
I am still going to write to my consultant to ask for written advice before I feel absolutely secure in going ahead with normal delivery as the recovery time from my eye surgery was a lot longer than post-CS recovery would be.
In your case I would suggest you have nothing to worry about, but keep an eye (ha ha) on any suspected changes to your vision (floaters, flashing lights) as your poor eyesight means that you are generally at more risk of getting a detachment. Minor retinal tears can be patched up pretty easily with laser surgery, it's only when they require more involved surgery that things get a bit more complicated.
Best of luck and congratulations on your pregnancy.

Hi Senem - I too had torn retina in both eyes requiring surgery, and intensive laser therapy on both eyes. I have severe myopia (-15) in both eyes.

I became pregnant with my ds 3 years ago, and was obviously worried about the 'pushing' stage and the effect this would have on my delicate eyes! I wrote to the consultant who performed my surgery to seek his guidance as I was petrified of CS - and thankfully was advised to 'go with nature'. I delivered in a birthing pool - and no ill effects to my eyes (8lb 11oz baby!)

Dear All,
thank you for sharing your experiences with me. my doctor is actually educated in Germany but I live in Istanbul and doctors can be a bit weird here.

Dear Superdinky I have read your post but the thing is that my retina is not detached. They just say there is a risk of detachment with natural labor and the pushing stage. I would also like to ask how your retina got detached? Just like that or did you do something and after it was detached?

I am wondering if there is somebody with high myopia that gave natural birth and detached the retina during birth?

It just happened - when I eventually went to hospital to have it checked they said there had been a tear there for a while, and it had gradually got worse over a period of weeks or months. I don't think it had anything to do with giving birth as my son was almost 2 by then!
I think in the UK the idea that labour might bring on retinal detachment is seen as a bit out of date. I was certainly warned not to do any contact sports or go bungee jumping but no doctor has ever mentioned risk factors involved in having a baby - just if you have had recent eye surgery you might require a managed labour.

senem, by "doctor" do you mean your obstretician, opththalmologist or GP? I would think an ophthalmologists opinion is really what you need here
I am an optometrist and only one of my highly myopic patients was advised to have a CS but she was -28.00 and had already complications in one eye. The others mainly seem to have been able to go through labour naturally.

My opthalmologist said so but when ı asked him about any cases he couldn't answere me. I think because this is such a specific issue most doctors are not up to date. Also there haven't been many researches made on this matter.

If you do have a natural birth you might want to do a bit of research around second stage. Some midwives are very out of date iwth their practice - lots of coached pushing, prolonged breath holding, supine positions for birth .... all of which things will make second stage much harder work for you - not a good thing surely in your situation?

I don't think that doing research on pushing or retinal detachments is going to be beneficial. You either have a retinal detachment or you don't - and there is little evidence to suggest that retinal detachments happen in any stage of labour. I know - I did enough research when I was so concerned with mine!

I am still at risk of my retina detaching/ tearing 10 years on from my first operation (I had 3 in total) and always will follow my hospitals guidance for not lifting heavy weights, bungee jumping, contact sports or scuba diving. However - when it came to my pregnancy and birth, they had no specific guidance to give me. This is because it could be a rare occurence, or you would have to be of an unusually high prescription to make them consider this a risk.

I was advised by my midwives to keep the letter from my Opthalmic Surgeon in my ante-natal file, in case I did ever come across an Obs doc who thought it may cause problems during the birth, and would want me to have a CS - which I was dead set against.

Actually I would be interseted in more effective ways to push ) I think with or without a risk if there is a method for pushing, it would be to every pregnant womans interest.

And yes all the things I could find suggest of little evidence so why is it that some doctors just want to go for CS?

I am trying to talk with opthalmologists who are speialist for retina matters. If you know a good one it would be great if you asked him/her. So that people who have this concern can read more about it

Oh and something else I would like to ask you if, lets say I had a retinal detahment during birth, how is the surgery? Is it a very long one?Cause I would have to new born baby and go for the operation. Do I need to worry about it? How is your vision after the retina was buckled? or attached? How long was the operation? How long did it take to recover?

Effective pushing... don't push with your face, you push with yhe muscles around your stomach. It sounds odd but I remember coming to the sudden realisation at the end of my labour with DS1 that I was pushing with entirely the wrong part of my body. Try it when you're having a poo... your face shouldn't go bright red

I had a retinal hemmorhage at 32 weeks with my first child. I lost my eyesight due to a blood clot sitting immediately in front of my retina .. it took 8 months to totally go leaving me an extremely small blind spot.

I was up at Moorfields eye hospital and had 5 consultant seeing me (rare case) .. 2 men, 3 women .. all women said no way would I risk natural labour, the men said you could try for assisted delivery.

I WOULD NOT risk my eyesight for labour. I did not. Had a section, followed by another one and have never regretted it.

senem, most patients are only in hospital for a day or two after surgery these days but depending on the type of detachment and its position, you usually have to "posture" or stay in a one position, sometimes face-down while in hospital. I would imagine this could be a bit awkward if bfing but not insurmountable.

Twig, do you have diabetes?

What an interesting thread.

I am a -12.5 in both eyes and had a detached retina which I didn't know about several years ago. I subsequently had cryotherapy on both eyes.

No-one ever mentioned anything to me about natural birth and possible issues.

I have just been told no contact sport - can't really see myself playing rugby!

No I have no diabetes all my test are great and everything is fine I am at my 28th week of pregnancy.

also we agreed with my GP that I would get my retina checked few weeks before birth to see how everything is going.

When I went to see my opthalmologist 2 weeks ago he said that the retina is thin but it has no damage.

what is cryotherapy? And don't you have a bad vision when your retina is detached? they told me I have to have surgery in 24 hours time if my retina is detached or else I might go blind.

I had a peripheral detachment so it was not obvious at all. It only showed up when I went to talk to someone about corrective laser surgery.

Cryotherapy is a laser treatment which basically "freezes" the retina by creating scar tissue. They didn't fix the detachment per se but have stopped it from detaching further using the cryo treatment.

Touch wood, no more problems.

DosentChristmasDragOn - so true! I pulled all the muscles in my neck and ended up in a neck brace with my first birth from pushing with the wrong muscles!

senem - time is of the essence when a detachment is discovered as the tissue of the retina does not regenerate - and effectively 'dies'. From when mine first developed 3 days had elapsed and I required surgery the next morning. The longer the detachment is there for, the more at risk you are from possible loss of vision. The result for me was after 3 pneumatic retinopexy operations was that I did suffer from some loss of vision. Also the subsequent laser surgery means I have now no peripheral vision. But to me that is a small price to pay for virtually being a week away from losing my sight. But please remember my tear was quite severe - it does not follow that if you do not have surgery immediately you will go blind! I know a few people with detachments who have had 1 successful laser therapy treament and have had no change to their prescription or loss of vision.

Some doctors may prefer you to go for elective CS, because if they consider you to be a risk (however small)they are mitigating against that. With myopia a thin retina is the norm. Some people will have absolutely no problems, and some people will.

Thank you very much fr sharing all this infrmation. I think if everything goes well I will go for natural delivery )