MW freaked me out re shoulder dystocia, now worrying

[MissHairspray]

Hi there, am currently pg with dc2. DC1 was a fairly typical first birth I think, two weeks overdue, long labour (made worse by anterior lip), almost got transferred from the birthing unit to the main hospital 20 mins away. Anyway, all fine in the end and delivered without intervention despite him turning out to be 9lb 12.
Despit all this I have been dithering about whether to go back to the birth unit (have already posted before so sorry if already read this). After DC1 I spoke to the midwife who told me that had I been at the hospital and had an epidural I probably wouldn't have been able to push him out on my own and would have ended up with shoulder dystocia and forceps. Had never even heard of SD before this, but after some unwise googling have read that having a large baby is a risk factor for this. The thing is, the MWs don't seem to think that having another large dc would be a risk, and I never had a growth scan with dc1 despite being fairly petite with an absolutely huge bump. But then reading mn it seems really common for people to be induced or offered cs becaue of concerns about the baby's size and risk of sd.
Sorry a bit rambling, but I guess my questions are: do you think I'm worrying unecessarily about sd, and/or would it put you off going to a midwifery-led unit rather than a hospital? Thanks!

I would trust your instinct and your body and go to the MLU.

I had a similar experience with my first - she wasn't quite as big, but it was a long hard labour (as first labours often are) and my midwife told me afterwards that had I been in hospital, I would probably have been pushed towards an epidural, which in turn would increase the risks of further intervention.

For me, it totally confirmed my belief that a MLU is the way to go. Your second birth is likely to be shorter and easier anyway - even if its a big baby, your body has laboured before, and managed fine.

Macrosomia (large baby) is a risk factor for SD. However, you didn't have SD! So your pelvis was perfectly adequate to birth your 9lb 12oz baby. Are you measuring large this time? Previous large baby that birthed OK is NOT a risk factor for SD this time.

Also, we have a very low specificity rate for detecting SD. So we know that large babies, or previous SD etc is a risk factor but actually the vast majority of SDs happen in the absence of any risk factors. This means midwives see SDs relatively often, and we have to always anticipate an SD. We are drilled very regularly on the manoeuvres to resolve one and no special equipment or drugs are necessary.

Size is not a huge risk factor for SD, 48% of SD cases are in babies less then 9lb 13oz, which is the size they class them as being clinicly large.

I had a SD with DD she was only 8lb 4oz. SD was probably due to her being pulled out with forcepts back to back.

My consultant is quit happy for me to have midwife led care and go for a natural delivery again this time round. Don't worry to much my last MW appoint the MW tired to scare me with being induced early to prevent SD as bigish baby first time roung but accourding to all the guidlines she was completly wrong. They don't recomend early induction as inducation can acctualy contribut to SD.

DD1 had SD and she was 7lb 9ozs so not big either.
She was also Back to back and born with forceps and failed vontouse.

Had DD2 6 weeks ago (7lb 12) and her labour was MUCH easier and quicker. 6 hours compared to 27 with DD1. Totally agree that your body knows what its doing second time round and copes better. I had no pain relief with DD2 but everything with DD1.

I wouldnt worry to much about SD.. Theres nothing you can do to prevent it anyway.

Thanks for your replies, sorry that some of you actually did go through this but it is reassuring to hear from you. hardertokidnap your last line about no special drugs or equipment being necessary is massively reassuring as suggests even if it does occur, it would make no difference where I was when it happened.
Thanks again

My first baby has erbs palsy as a result of sd. He was 10lb4oz.

My second baby was 10lb5oz and he came out fine.

imo, it is more to do with the competence of the staff, their training, their risk assessment and them being prepared. There are several things they can do.

Ask questions but try not to worry.