Shoulder dystocia and subsequent births - trying to work out what happens next

[NinthWave]

My DS was born in 2007 weighing 9lb 6oz. It was a normal vaginal delivery in hospital, but he had a shoulder dystocia which took a couple of minutes to resolve. He's fine, thanks mainly to my excellent midwives.

I'm now 23 weeks pregnant with DC2, and have had varying opinions on what will/should happen this time round. Both the MW and the consultant ruled out home birth (not sure how I feel aobut this TBH) but the MW said I'd probably be induced around my due date in baby looked big.

Consultant said this wasn't the case, and I could wait for spontaneous labour, use the pool, no continuous monitoring etc. but a consultant would be present just outside the labour room for my second stage, and all MWs on the unit would be briefed to make sure they're up to date with their SD training.

This sounds good enough to me, but I am interested to hear what others did second/subsequent time round after a shouler dystocia. Were you continuously monitored/was C-section pushed on you during labour etc etc?

I've just finished reading Ina May's Guide to Childbirth (which I loved!) and plan to put in my birth plan that I want to be on all fours to deliver/put on allfours immediately should it look like another SD is occurring. Anything else I should be mentioning?

I know it's a bit early to be planning all this but I am nervous already,and really don't want to be! Thankyou

Bump...

I had SD with second DD weighing 9lb12oz. Third time around TBH nobody even mentioned the previous delivery??? and I went on to deliver another 9lb12oz DD vaginally wih no problems with SD.
I have just had DS 3 weeks ago and when I asked my consultant if I could be induced on my due date, and not be allowed to go over (as I had previously done) he said that induction increases the risks/chances of SD reoccuring.
I was induced eventually 9 days over, and again delivered a 9lb8oz with no complications.
Don't know if any of that helps, just to reassure you that it wont necessarily happen again, but good that you are well informed.

Best of luck xx

Thankyou - that really is reassuring! I think I'm worried that I'll panic when it comes to the pushing stage, as the cons made it sound a bit like everyone would be on 'red alert'

Congratulations on your new DS, too

Better that than all the staff going for their break though eh? [SMILE]

Well yes!

Anyone else? I'm also wondering what the likelihood is of the SD recurring in the first place.

Yes. My eldest has erbs palsy as a result of the doctor pulling on his bloody head instead of following proper sd procedures He was 10lb4oz btw.

my second - 'pill baby' (I was so traumatised I didn't intend to have a second child!) was 10lb5oz and there was no sd. The staff were prepared!

ime, what happens is that they are bloody careful! I had the consultant deliver my second baby and a theatre on standby at some minutes to midnight!

I'm 26week's PG with seconed after a SD with DD who was only 8lb 4oz. But she was back to back, they got her out quickly with no problems.

I've done a lot of research and have seen consultant to, who was in aggrement with me, to go for a natrual delivery this time round. Inducation can increses the risk of SD and a midwife really upset me when she said I should be induced early to prevent SD. When all the facts show that it's a bad idea to do this. Also contery to most people's belife only 52% of SD are in large babies so having a big a baby doesn't increase the risk by much.

I've been told I should be attended my an experianced midwife. Note sure yet if they will let me give birth in midwife led unit which is what I'd like.

My dd was only 8lb at birth but had severe shoulder dystocia. We were lucky she was okbut I was advised to consider c-section for second delivery but was given freedom to decide for vaginal birth if I preferred. I had a scan at 35 weeks and dc2 was on 97th percentile for abdomen size so opted for c-section. At end of day I thought if it happened again and baby was damaged (palsy/oxygen deprevation etc) it wouldn't.t be worth it and I'd never forgive myself. Best decision ever as Honestly I felt like I'd been assaulted after the steps the docs had to take to get dc1 out to the extent that recovering from c-section with dc2 felt like breeze. Loved it!

here is my thread on this. Was really worried right up to having DS that it would happen again.

I had a good consulatation with a consultant who said I had a one in 10 chance of another SD, and of those there was a one in 10 chance of a problem of some sort - in the end i decided i was happy with those odds over a section.

Def go for an on all fours delivery if i was you - I found it loads better - DD was 18 days late, 9 lb 9 and proper stuck.

DS was 5 days early, 9 lb 4 and 3 cms to out in a hour, not even a graze in sight. It was in my notes to call a consultant in the second stage but in the event no one bothered as it was all so quick. My midwife recommended googling optimum fetal positioning/jean sutton which may help. I swam a lot on second preg and that helped i think somehow, Best of luck what ever you decide.

Have just dug this thread out again to ask for more experiences - Hecate, MigGril, Raejj and 10lbs, thankyou for your posts.

Have a consultant appointment tomorrow when I'll be 32 weeks and hoping they'll offer me a growth scan to check the baby's size - I've had glucose in my urine samples (but passed the Glucose Tolerance Test) and am measuring 3 weeks ahead so may well be another big one.

10pounds your thread is very reassuring, thankyou! Crossing my fingers for a similar birth :)

I should add that with dc2 I actually went into labour 3 weeks early and my consultant advised me that as such he would be smaller than if I was in labour at full -term (er obviously.....) but I still opted for my cs as mentioned above. It turned out there was quite the family history of SD which no-one had bothered to tell me about until after I too experienced it (thanks everyone ). Plus my ds went from lying on my right hand side (not ideal) to oblique back to back (even worse) and I just strongly felt if I tried a vg birth it was going to end badly. Just my personal instinct but i reckon most times one should follow these. My little girl went back to back a few weeks before giving birth and nothing but nothing would persuade her to rotate to optimal positioning and I'm sure this had something todo with my SD experience with her.

For what it's worth I was super nervous about my cs but I found it a far more positive experience than vaginal. That's just me but either way hope you get the birth you want and good luck tmro!

Induction on the basis of it possibly being a big baby is against NICE guidance. Induction raises the risk of complications and interventions.

Do be aware that growth scans are notoriously unreliable if your baby is above average. All they can reliably say is that the baby is likely to be above average weight, which you'd probably know anyway!

Definitely look into positioning - I've been doing some research as big babies run in my DH's family. All on fours is best, but there's a special manouvere (can't remember the name, sorry) for SD where they flip you on your back and help pull your legs to your chest which gives the maximum possible pelvic space (it's not a position you could hold so only used if really needed). The midwives and doctors should know about it, but I prefer to know in advance what might be suggested to me.

I think you might be referring to macroberts japhrimel? That was one of the procedures they did to get dc1 out. My husband swears he could hear my hamstrings ripping as they got and held me in that position with little warning. It took stirrups and four people holding me down to keep me there. Ouch! Still, it went towards helping her come out!

japhrimel it was McRoberts (the one you describe) that got my DS out, after a bit of a battle - that combined with the Woodscrew maneouvre, where the MW basically reached in to physically turn DS and try to free the stuck shoulder.

I was very lucky in that my consultant went through my birth notes with me at a previous appointment, so I know just what happened and how long it all took - in my memory, it was over in seconds, but actually took nearer 2 mins for DS to be freed.

Saw consultant today and she has booked me for scan at 36 weeks, she is not keen on c-section or induction but described it as being a bit of a Catch-22 situation if baby does look big at scan.

She mentioned that growth scans can be unreliable - they will only consider early induction etc. if he looks REALLY huge. Apart from that, she has recommended sweeps from 38 weeks as long as baby's position is good.

We'll see, I suppose! Thanks all :)

ninth wave I had that too! Fortunately I'd had an epidural otherwise I bet it would hurt. Did you have one? My aunt had both these procedures but only on gas and air. She said it hurt like blazes!

No epidural but I had been given pathidine. I screamed like I have never screamed before, it was hideous. Amamazed I escaped an episiotomy - I did have a 2nd degree tear though so maybe that gave the MW enough room.

Amazing how you forget all that and decide to do it again!

You are a far braver woman than I am! I had pethidine and it did nothing for me so I moved onto epidural. Just couldn't do it without it but she was back to back and I'd done 12 hours and just couldn't do it anymore.
I still contemplated a vag birth for dc2 briefly since it was 3 weeks ealy but once my contractions got going I though 'hmmm actually no, this is going to hurt and actually I think I'd rather not'....

Update and bump for anyone who's been in a similar position...

I had my 36-week growth scan yesterday, they estimate baby's weight to be about 7lbs so somewhere around 8-10lbs at full term. The consultant is happy that I can manage this as my first baby was 'big' - this one's head circumference is on the 50th centile, he's got a bigger-than-average abdomen but apart from that looks OK.

I'm very happy with this as it saves me lots of arguments and persuasion! The only problem is that I'm a little nervous about the actual delivery - will have to re-read my Ina May book I think!

All the best!