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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

Shoulder Dystocia 1st birth - now petrified of my second birth...

44 replies

Lolabelle · 19/10/2006 12:01

I had a shoulder Dystocia occur when i had my DD1 and now i am pregnant with my second i am aware from the internet that there is a risk of having a SD again but am petrified of a ceasarean. Then again I am petrified of a SD hapening again as it can cause brain damage and even death to my baby but it is only a risk...

I'm SO unsure what to do - has anyone else experienced one??

OP posts:

Are your children’s vaccines up to date?

Set a reminder

McWitch · 19/10/2006 20:46

ha, well spotted, Lockets

in honour of Rentaghost, this Halloween...

McWitch · 19/10/2006 20:47

she used to be a reg in my dad's shop when we were kids and she was LOVELY. (sorry for hijack)

lulumama · 19/10/2006 20:48

how so binkacat? never heard that...sounds interesting...

booge · 19/10/2006 21:02

I gave birth to DD at home last Thursday and had SD, DD was 9 lb 13 so quite big. I had two very experienced midwives who put me in McRoberts and used pressure on my abdomen to free the shoulder. They dealt with it all so calmly and profressionally I didn't realise the gravity of the situation until my MW told me later.

DH then remembered DS's shoulder had stuck too but I wasn't aware of it at the time and it wasn't in my notes or I wouldn't have had a home birth, I do remember them putting me in the McRoberts position though and I tore both times. My midwife has said if I have another it is likely to be big and SD again is a possibility. I can sympathise with your fears, knowing what I do now I'm not sure how I would want to approach a 3rd delivery

From my reading on the internet I understand that "the McRoberts maneuver alone is believed to relieve more than 40 percent of all shoulder dystocias and, when combined with suprapubic pressure, resolves more than 50 percent of shoulder dystocias". My midwife said they all practice a manouver where by putting their hand in to rotate the baby and deliver. Breaking the clavical would be a last resort and I'm sure being aware of the risk you will have a very experienced people on stand by who would know exactly what to do if SD were to occur again.

lulumama · 19/10/2006 21:11

McRoberts ! knew it had a name...legs round your ears! thank you for that post booge....and for the reassurance for the OP!

lulumama · 19/10/2006 21:12

and congratulations on the safe arrival too.....

Original poster

Lolabelle · 19/10/2006 21:13

Thank you all so much for your advice, i had heard somewhere that a ventouse can possibly be linked but they also listed a few other things like diabetes and obesity which didn't apply so its so hard to know if it was that as many women have ventouse deliveries without this - i do need 'closure'(always amuses me that term!) Lulumama i'm sure because spending the rest of this pregnancy scared stiff of the birth date would be stupid. Ignorance was bliss the first time, i had no idea what to expect so didn't really fear it plus i was overdue so i was SO dessie to meet my baby - this one quite frankly can stay in there as long as it wants!!

Seriously though i need to speak to the Obs guy and express my concerns, i want him to know i'm really, really concerned and not to just write me off as an elective c-section just because of these fears as being cut open acros the stomach isn't my idea of a pleasant experience either . Plus i have a boisterous DD1 that will no doubt fling herself at me when i get home - god i'm wincing at the mere thought!!

I never thought i'd say i want a natural birth after last tme but actually i think i do, i think part of my fear is that they are going to say theres a high risk of it happeneing again as i think i'll fall apart at that prospect without wanting to sound melodramatic...

OP posts:

lulumama · 19/10/2006 21:17

welcome lolabelle!!

if you feel in your gut you want to go for a vaginal birth...do...i had a VBAC and it was the right decision for me..i knew it from the moment i got pregnant

hope all goes well with the obs...let us know!

Original poster

Lolabelle · 19/10/2006 21:21

Thanks Lulamama - tried talking to DH, helpfully said 'well have a c-section then'..tried to explain the trauma but i think that men can't possibly understand the whole experience whether good or bad so i don't hold it against him!!

My best mates dh advised her to 'get over it, its done now' after a particularly traumatic and quite dangerous birth - maybe what they witness affects them in such a way they also can't face up to it??!! Bit freudian but better than realising they are insensitive pigs!!

OP posts:

lulumama · 19/10/2006 21:22

so helpful !!! have a c -section!!

i think you know what you want and how to get it...so go for it!

asleep · 19/10/2006 21:24

DS (second birth) was 11lb 1oz and got SD during natural birth for about 30 seconds at most. the midwife and DP pulled my legs up (think it's that McRoberts) and DS came unstuck. he had fast breathing a few hours after birth and was in the neonatal for a few days. i had no idea he'd be such a big baby. DD was 8lb 8oz, so i expected him to be similar. i have a big fear that i'd have another big baby if i were to get pregnant again in future.

SPACEdoutzombieCADET · 19/10/2006 21:25

my ds2 had shoulder dystocia, when he was finally free he wouldnt breathe and was rushed to special care, when i found out i was pregnant with dd2, they monitored her size closely during pregnancy and induced me at 38 weeks, she was born really quickly and easily, 2 midwifes attended my second stage in case it happened again and they dropped the end of the bed away because apparently it helps the shoulders to come out.

poppynic · 20/10/2006 11:23

SPACE - how big were your first and second babes - was their estimate of size for the second right?

SPACEdoutzombieCADET · 20/10/2006 19:34

poppy, my first 2 were 8lb 9 and 7lb 14 respectively, the 7 lb 14 er was 3.5 weeks early!
ds2 who got stuck was 9lb 7 at 38 weeks.
dd2 was estimated to be about 9-10 lbs if she went to term and she was 8lb 3oz when i was induced at 38 weeks. with ds2 they said he was going to be 7lbs! ha ha!

muppety · 21/10/2006 12:19

I had sd with ds1. he was 71b 14. I think he was stuck for about 5 mins and they did mcRoberts and suprapubic pressure. I had vetouse/episiotomy.

When pregnant second time I was exactly the same as you. The midwife was not worried at all which made me panic more that not being taken seriously. Eventually saw consultant at 39 weeks had growth scan which showed bigger baby and he told me I should have a c section which I did. Ds2 was 9lb 5oz. I still torturre myself with 'what if' as I so wanted a normal birth and dis struggle emotionally and physically aftwards. If I have another I would actually consider a vbac but its a difficult decision as its not like other complications whether you can bail out to a c section at any point!

There seems to be relativley little info or evidence out there for delivery after SD but evidence does seem to be against induction to avoid it as does not seem to work. Good luck!

binkacat · 21/10/2006 21:48

Lulumama - ventose or forceps is one of the biggest risk factors of shoulder dystocia although noone is 100% sure why. An educated guess on my part would make me think it's to do with baby not been given the chance to restitute into a good position for delivery of the shoulders, leading to the anterior shoulder getting impacted under the pubic arch.

lulumama · 21/10/2006 21:53

therefore, would the shoulder not already be jammed and the intrumental attempt at delivery jams it further? or would it be needed as big baby possibly, not in an ideal position, so the instrumental delivery excacerbates the problem? rather than as you say, waiting for the baby to come down adequately alone....

it is certainly an interesting point...might have to google that at some point...!

binkacat · 22/10/2006 13:44

The shoulder wouldn't already be jammed, it gets jammed afetr delivery of the head. There's a lot of papers been written on the subject and an insturmental delivery is an acknowledged risk factor for dystocia. Of course looking at each individual birth there is no way of telling if the dystocia would have occurred anyway, due to large baby, malposition, etc. But looking at the stats for shoulder dystocia it is more likely to occur with an instrumental.

With a nautral birth, the shoulders restitute after the delivery of the head, so they twist around to a better position. With a ventouse/forceps they don't get the time to this as the doctor is there tugging away.

Doctors like to bang on about large babies been a risk for shoulder dystocia, however more than 50% of babies who had a shoulder dystocia are not classed as large. Having had a previous shoulder dystocia does increas the risk for a 2nd birth. The best way to avoid it is not to give birth on you back, try on all fours, standing, kneeling, on your left side - all of these positions will increase your pelvic capacity.

lulumama · 22/10/2006 13:46

thanks binka- that is really very interesting..thanks....just seems to suggest that intervention actually stops mother nature / and the mother & baby doing the right thing by themselves...

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