Birth story - small pelvis, would be interested to see if anyone has the same!

[babyignoramus]

I gave birth last week and would be interested to know if anyone else has a similar experience.

Cx started at 12.00 midnight. straight away were about 3 mins apart and strong. I rang the hospital, was told not to come in yet as I might not be in established labour. Went in at 2.00am, was sent home as only 2cm. I had no idea that you were only classed as being in established labour once 4cm - without DH sticking a ruler up there, how am I supposed to know?

Went back in at 6.00am despite being encouraged to stay at home over the phone - by then cx were every 2 -3 mins and I was unable to find a position that relieved them in any way. I was panicking a bit that I might be getting nearer the end and end up having an impromptu homebirth!

Luckily waters went on the way back to hospital, but when we arrived there was meconium in them. Cue me being monitored constantly and attached to the bed. They gave me gas and air and pethidine, neither of which relieved the cx at all! I was also feeling a strong urge to push. At which point I demanded an epidural. 10 hours later at 9 cm, given syntocin to speed things along, an hour later still 9cm. DS dropped his heartrate and I was given an emergency ceasarian.

Anyway, since then several people (including my community midwife) have commented that they thought I'd end up with a cs as I'm really small and they thought I'd have difficulty delivering naturally. (NB DS was only 7lbs 60z - not exactly a whopper). My midwife has suggested that should I have anymore I should go for elective c-section.

I've no frame of reference as its my first but from comparing notes with my mum, sister and MIL it would seem that my labour was longer and harder than the average first timer. TBH I'm quite relieved at the thought of an elective c-section next time as I would be frightened to go through the same pain again - and I had an epidural at 5cms. The thought of continuing with that pain for another 11 hours is unbearable and I'm so glad I didn't.
I'd be interested to know if anyone else has has a similar issue with pelvis size? Do you think it affected the labour itself?

There are people with small pelvises but it's quite rare nowadays to grow a baby that is too big for you to birth. It was much more common many years ago because of the poor lifestyle people had (rickets was a big cause of pelvis size problems).

I'm only 5ft and had a 7lb 3oz girl with no problem. I admit I was worried about being small but no-one ever mentioned it being an issue.

There could be other reasons why you didn't get to 10cm - baby's position for example. Might be worth getting a copy of your notes to see what actually happened.

Agree with nutty. I was told my pelvis was too small but I think they say that a lot these days to excuse the number of sections, some of which are caused IME by over management of labour. Not saying that in your case at all but it really is supposed to be quite rare to grow a baby too big for you. Am awaiting correction by lulumama but I read up on it when going for VBACs.

I had a very similar birth and whilst I am not particularly small (5ft6 size 12-14) I do have a small pelvis, infact, I was told by the obs consultant that it isn't size of pelvis but shape and angle.

My daughters head didn't engage throughout the whole of my 4 day induction at almost 42 weeks.

I do know of two people who are tiny, less than 5ft, size 6-8 who had 10lb plus babies so it is very much dependent on you as an individual.

Personally I will be having an elCS for my next baby (if/when I have one) and don't blame/ you for wanting to do that either!

Congratulations though, hope you enjoy your lovely baby now

Yes it affected both my labours. First was about 36 hours established and second about 10 hours established but both preceeded by long and very painful pre-labour phases so very exhausting. Was offered elective for second birth but didn't go for it as didn't want lengthy recovery period. So I opted for late growth scans instead, and they suggested ds2 was about the same size as ds1. He was actually quite a bit larger but head circ not much larger. If I did it again I would go for cs though. My community m/w, who now works as a nurse at our surgery, gave me a smear between my 2 pgs and said she was amazed I didn't end up with a cs first time as my pelvis is very flat (I am also small width-wise, and only 5 foot tall with small feet). Both my dses were around 50th centile for head circumference, weights were 7lb 8oz and 8lb 5oz.

PS I'm another whose baby's head didn't engage throughout labour (ds1). He was eventually born by ventouse in theatre as I was prepped for cs if they couldn't manage with ventouse - his head was stuck very high they said. I think my lengthy painful pre-labour with ds2 was while his head was engaging. Delivery was normal in the end.

i would ask for an MRI scan or some such to determine pelvis size as , as has been said , true CPD ( cephalo-pelvic disproportion ) is rare.

your baby might have been unable to descend due to being malpositioned

at your 6 week check, you should be offered a debrief as to exactly why you had a c.s

if it is the case the baby was not in a great position then that is a totally different scenario to the one described

you need proper answers, based on facts, not the supposition of a MW, unless there were concrete indications your pelvis was too small/baby too big ,in which case, you think someone would have mentioned it before labour

congratualtions on the birth of your little one

To be fair, I have to say that I was kept informed and at no point did I feel like I didn't know what was happening.

The official reason for my emcs was 'delayed delivery after rupture of membranes'.

Basically I got stuck at 9cm, - the back of my cervix failed to dilate fully, and when i had a practise push it caused the heartrate to drop.

The doctor apologised for the rush but he was concerned for DS's safety.

I'm sure I could have a VBAC next time but I'd rather not risk it.

I had a similar experience with DD1. Contractions started at 5 mins apart. After about 4 hours at home they were 2 to 3 mins apart so I went in to hospital (and was sent home as only a cm or so dilated). Another 5 hrs at home with contractions 2 mins apart before I could bear it no longer and went in again. Still not much progressed, but admitted. Over the next 12 hrs I had contractions every minute to minute and a half, 3 shots of pethadine plus gas and air (useless), but I was not really dilating. After about 28 hrs of this I had an epidural and finally got properly looked at and monitored. DD1's heart was stopping with every contraction, her blood gasses v low, merconium passed and the consultant said my pelvis was tiny and unfavourably shaped and he very much doubted she would come out naturally, so I had a section. DD1 was only 6lb 14oz. With DD2 I had an elective - I was told that due to the shape of my pelvis there was a greater than 95% chance of me ending up with another section therefore I had no desire to try for a VBAC. Elective this time too in a couple of weeks.

I understand that there are 3 main shapes of pelvis, mine is an 'android' or male shape pelvis, which is the least favourable type. Still, most people with an android pelvis can give birth naturally, but the more pronounced the shape the harder it is. My mother had very similar problems too.

"Cue me being monitored constantly and attached to the bed. They gave me gas and air and pethidine, neither of which relieved the cx at all!"

I reckon the clues are in that sentence alone!
Being flat on your back or even sitting semi reclined does not allow your pelvis to open up to the 28% it can when upright and mobile. Baby is not given the space to descend and exert pressure on your cervix to complete dilation.

Read up on Optimal Foetal Positioningand learn about the 4 types of pelvis.

and also check out Caesarean Myths Exploded

i think it is more relevant how far the baby descended or not, for you to make up your mind.
you are only a few days post natal, so far too soon to even think about another delivery!

I think Lulumama's point re how far the baby descended is a v good one. DD1 was in optimal position. I had spent all of my labour until I had the epidural (28 hrs in!) in an 'active' birthing suite using birthing ball etc. DD1 was descended as far as it was possible for her to get. She was finally pulled back out during the section as a complete cone headed alien from trying so hard to squeeze through my pelvis and it was all of this that was what made the consultant give me such a poor prognosis for the possibility of a VBAC for me.