Help! Want a VBAC but have SPD - snowball's chance???

[mcmudda]

Hi

I'm now 32 weeks pg and was diagnosed with SPD (the pelvis splitting thingy) about 6 weeks ago and I'm in loads of pain.

Until the pain really started getting unbearable at about 20 weeks, I was pretty confident that this birth had a good chance of avoiding a section.

But now, having read up a little on SPD it seems to be at odds with increasing my VBAC chances.

Walking is very painful, so an active labour is out of the question in terms of keeping mobile. The thought of a birthing ball (which was great in early labour first time round) makes my eyes water. And because of my emergency section last time I can't even sniff a water birth which apparently could have made a big difference.

Pain relief is also crucial - if I want anything more than TENS or gas and air, my physio has warned that the relief can make such a difference that I might get complacent and start labouring with legs akimbo and cause lasting damage to my pelvis.

Long post sorry, but is there anyone with some experience and/or advice??

My Sil had a VBAC and she had a c-section with twins 7 yrs ago.
She was so adament that she wanted a natural birth with her 2nd pg, unfortunately she too developed SPD. My little neice was born just under a year ago vaginally, so there is hope

There was a lady on here who had terrible spd (wheelchair bound), but she had a splendid birth experience. You can read about her in this thread and this one .

mcmudda - sorry to not be up on your situation, but is this your first?

Either way, I would go for the option that offers the best chance of causing you no more problems than necessary. Don't want to terrify you, but I know of some poor woman who ended up on crutches for ages after the birth - so, whatever your consultant/physio suggests, maybe you should just go with the flow? Keep sight of the most important thing - namely that you are your baby are delivered safely. How that happens is secondary. It's so easy to get hung up on how we want our birthing experiences to be, but the more I learn about all this the more I realise that, sometimes, we just have to embrace our circumstances and do what is for the best, even if that isn't what we originally set out to do. That said, maybe you should seek a second opinion? Even if it turns out that everyone is of the same opinion, you might find it helps you to come to terms with the fact that you aren't going to have the birth you had your heart set on.

Whatever happens, I wish you better soon; I'm wincing just thinking about you!

ZebraX - thanks for the links to Pie's threads - I remember reading them at the time and thinking how I'd never heard of SPD and assuming it must be really rare.

I'm not likely to end up in a wheelchair unless I do something really stupid so my SPD is obviously nowhere near as severe, but walking is already really difficult .

Willow2 - ds was born in Sept 2002 by emergency section ~(fetal distress). I found the recovery afterwards really difficult, so would like to avoid another section. Obviously if I do have to have another section to keep baby safe then that's fine.

I noticed that Pie avoided a section by getting a water birth, but that's been ruled out for me because of my last section. (But maybe possible for baby no3 if I fancy going through all this again!)

Just bumping this for Saturday evening

Thanks Sally - btw have you always had an englebert in your middle??

Message withdrawn

Hi Mcmudda, I had SPD with 2nd baby and had a wonderful birth.

I don't get the no use of water for previous c/s. Get on to your head of midwifery or consultant - I am a doula and have recently supported a women who had a previous section - she spent most of her labour in the pool, you just need to go to your caregivers and be forceful! Contact AIMS for support if you need to and arm yourself with the relevant info.

I haven't had a C, but had SPD with my 2nd pg. AFAI am aware, SPD is not an indication for C-section. Of course, active labour might be more difficult, though as another poster said, once you're labouring the pain from the SPD becomes fairly irrelevant . I experimented with many positions, and foudn that the best one for me during contractions was kneeling with my elbows on the birthingball and rocking/bouncing slightly, while dh (or anyone else who was around if he wasn't) squeezed my hips together. Towards the end I wanted such strong pressure on my hips that he stood astride me and squeezed with his legs.

The most important thing I think is your posture during delivery. I delivered on my left side, my knees tucked up as high as I wanted, and with my legs barely apart (about 30-40cm, IIRC). My right knee was supported by dh and my right foot was on the midwife's shoulder. An excellent position, much more comfortable than the sitting leaning back position I was put in for my first birthing.

I got good info from the Association of Radical Midwives . Try entering 'spd mary cronk' in the search field. The 1st item should be Symphisis Pubis Disfunction - UK Midwifery Archives. Click on that and you'll get to some good info. Mary Cronk is a veteran midwife and she describes attending a birth where the mother had SPD and delivered lying on her left. Also that search brings up other Q&A re SPD.

HTH

This is sounding hopeful! Will investigate the water possibility further - thanks Rickman and Gish

I was meant to be in the pool for ds, but everything went pearshaped and I was whisked out of the midwife led unit into the horrible labour suite - I could hear my pool being filled as the lift doors closed -sob

Must be more forceful!

That's a good site PrettyCandles - thanks.

I completely forgot to mention water. I used Tens right through (can't remember when I took it off), except for a couple of 20-30 min sessions at home when I sat in the bath and poured water over my belly during contractions...sheer bliss.

I had really hoped to have a water birth, having been to slow for one with my first baby, but missed it again the second time because I was too quick!

Some consultants do recommend a C-section/early induction for really severe SPD (actually, some recommend against a waterbirth too, for some strange reason), but in fact everyone I talked to, when I researched an article on it, had a vaginal birth.

CAT me for the article if you like, loads of lovely MNers helped me with it.

Hi mcmudda, I had SPD symptoms with my 1st, he was delivered by emergency c-section following a long induction (overdue). Then with my 2nd I again had SPD (physio helped loads), I went into natural labour, I was prept for another C-section just in case, but all went well, and really fast, didn't even have time for an epidural, I had no unexpected pelvic pain afterwards.

Good luck, just do what feels right for you.

I was told that because of the increased chance of me having another c-section, if i was in the water they would not be able to monitor the baby quite as closely as they would like?????

One midwife told me that because my pelvic bone was softening loads, then labour should be alittle easier, for me she was dead right.

McMudda - I was with Pie and to an extent with Rikman at their birth. I was their doula.
I had SPD too BTW...
The pain of teh SPD is not the issue (believe me!) in labour.... however you do want to do as much as possible to avoid making the pain worse.
I tend to suggest to avoid an epidural (as it masks the pain and therefore you don't know how far you can go) with SPD but as you read Rikman did have an epidural.
As this is your 2nd child you are likely to have a fairly quick labour. How dilated were you when you had your section last time?

mcmudda - just to let you know that we have had women with previous C/S using the pool. If all is well with baby and labour is progressing there is no reason why you cannot use the pool. I really dislike hearing women being 'not allowed' to do certain things in labour. You have the right to make your own informed choice, whether it is hospital policy or not. HTH.

Thought I'd resurrect this thread as I'm just over 38 weeks now and baby could turn up soon! (Have a dodgy i/net connection so apologies for the gap in replying!!)

Mears - I don't think my hospital has a pool anyway(Princess Royal in Glasgow). When I spoke to the consultant last week she was pretty emphatic about me going straight to the labour suite for monitoring on a bed - any way of staying upright for that or will I have to be lying down? Anyone got any ideas?

Pupuce - I got to 8cm last time round before ds got too distressed to wait any longer.

Any more advice or shouty assertive techniques I can use when the big day comes?

I had severe SPD & sciatica with my 2nd. It left virtually imobile and the consultant considered inducing at 38weeks as I was in so much pain. However I managed to disuade them and carried on until 40 wks + 10days & was induced. Throughout my pregnancy I ensured notes were written all over the place for the midwives & medical staff to ensure they knew I couldn't walk, & couldn't lie on either side. My physio insisted my husband knew exactly how far I could stretch my legs etc so that in the situation of being told to do something by the mediacl team while in labour he could intervene and say no on my behalf!!! Anyway - a previous reply has already stated the pains of labour shadowed the pain of the SPD & Sciatica and as it happens I was only in the delivery suite 25minutes before out popped my 9lb 7oz 2nd daughter! All natural with only gas and air.
The literature you are given to read about SPD scares the pants off you (!!) leading you to believe a Csection is the only forward. But it isn't - just be prepared and ensure everyone around you knows about your condition!

Bets of luck - hope all goes well

personally I was in loads of pain from spd last time, but during labour I didnt really notice the spd as tbh I was in so much pain from the contractions

Have time to kill and just found this ancient thread!!

Gorgeous DD was born on 12th June entirely naturally with only one teeny tiny stitch (that didn't dissolve - long story)

Midwives were fab and kept telling off the doctors for making me stretch my legs too far. Consultant had long standing bet that I would be a c-section, but dd defied all the odds (despite being distressed/meconium in waters etc) and came out the front door instead of sneaking out the emergency exit like her big brother!! 8lb 7oz.

I hope the midwives made some dosh out of dd, cos they were brilliant and reallt fought my corner.

Felt fab afterwards and felt like I could shout from the rooftops! What a rush!!

6 months on, the pain is finally subsiding (unless I do anything too strenuous).

Thanks everyone for your advice and thanks also for all the ancient threads about SPD that were so reassuring to trawl through leading up to the Big day - you're all stars!