Vbac failed for dd, want to know why :(

[Crumbsinthecarpet]

I know this is probably something I will never get an answer to but it's bugging me so much

I tried for a vbac in September for dd which I failed to progress despite long strong regular contractions, I got to 1cm after 24 hours in labour (the last 10 with long strong 3 in 10 mins contractions all about a minute long) my cervix still wasn't fully effected, and was posterior and dd had to be fished out with forceps during c section. Oh and I was doing hypnobirthing so relaxed active breathing etc

Ds was born nearly 3 years ago now where after 52 hours in labour, the last 12 or so with syntocinon, I hadn't dilated further than 3cm

I don't know if I'd have another baby but I want to know if I'd ever be able to birth naturally, is it my cervix that will never dilate? Is my pelvis the wrong shape? Has anyone ever had an answer to this?

I don't know the answer to your question OP, but I do have a friend who has had 3 sections because her cervix simply doesn't dilate, so it is possible!

My DIL didn’t dilate beyond 1cm with all 3 pregnancies, despite strong contractions etc.

Bloody hell, after 24 hours you certainly gave it a good shot. I’m so sorry it didn’t work out in spite of all that. It doesn’t seem fair really.

True cephalopelvic disproportion is rare but not as unusual as many natural birth proponents would suggest. It means that essentially your internal hips (not the bit you see, but the bit they actually have to corkscrew through like a shape sorter) are too narrow to allow a baby to sit snugly on your cervix - so even with contractions, it’s not being stretched. The fact it remained posterior would point to that. Also, to go through 10-12 hours of strong 3:10 contractions, but (happily) no signs of distress to your baby suggests to me that they perhaps weren’t getting lower in your pelvis. One of the reasons babies are monitored so closely when syntocinon is used is because we expect being squeezed down the birth canal to put stress on them. That’s not an argument against synto by the way - it has its place and most healthy babies are able to compensate for this, but we monitor to be on the safe side.

There are also lots of other unusual shapes and tilts to your pelvis that make having a back-to-back baby more likely - that position also doesn’t always stretch your cervix as effectively. However, for a back-to-back baby, they would normally still eventually descend down onto your pelvic floor of muscles, the resistance would eventually turn them and your cervix would dilate.

Another remote possibility is if you’ve had a loop excision/Lletz on your cervix. It’s not something I found clinical evidence for the last time it happened, so purely anecdotal, but shared by many other midwives and obstetricians I’ve worked with as seemingly linked with not-dilating.

Your best bet is to contact the hospital where you had your baby and ask for a debrief with a Consultant/Midwife who will be able to look at descent, position etc and give you a more definitive answer.

I'm very glad it's not just me! Well obviously I wouldn't wish it on anyone but it's good to know you're not an anomaly haha :)

@AsMuchUseAsAMarzipanDildo love the name by the way 😂 as far as cephalopelvic disproportion goes, is that something they would have definitely spotted during pregnancy/labour or could it have gone undetected? My son had a slightly erratic heart rate towards the end of the days long labour but I don't think either of them were fully engaged, in fact my son's ear when he came out looked like it had been jammed in a hole that was too small! Also neither of them were particularly "cone heads" for want of a better word, they've both had very spherical heads their whole lives! Could that indicate that they didn't descend/couldn't descend?

Not really, childbirth is a notoriously unexact science, obs and midwives can’t see the internal diameters of your pelvis. They also change in pregnancy due to hormones relaxing your ligaments. You’re right that when babies descend into your pelvis they usually have a bit of a cone head.

I hope it helps to know that there’s nothing you did/didn’t do. You grew and nurtured two beautiful babies. Compared to most other mammals, humans have big heads and narrow pelvises. For some birth is straightforward, but for about 30% babies need to come out the sunroof!

Sounds similar to me, although I got to fully dilated with DC1 but he still came no where close to coming out that way. When the doctor got in there for a c section she said there was no way he would ever have got out that way. She gave me a 50% chance at best of a successful vbac and strongly advised a planned section for DC2.

Your body usually does the same thing each time in labour which is why a vbac is much more likely to be successful if your c section was because the baby was breech rather than because you didn’t dilate.

I think sometimes we have to remember how many women used to die in childbirth, it's probable failure to dilate was one of them!

I have 4DC and was induced for being way way overdue for all of them, for some reason my body doesn't go into Labour on it's own and then once I do the dilation is super quick just bloody days to get through the various 1-10 Bishops Score first

It sounds like your babies were possibly just in the wrong position and there was not enough pressure from their heads on your cervix to dilate it. Totally not your fault.

I had home births with all of mine but badly tore each time. Two out of the three required surgery. Probably due to their massive heads but it took a long time for me to stop blaming myself.

@Crumbsinthecarpet It’s so hard when something is bugging you that you may never get an answer to 😓 At the end of the day OP, labour and delivery is one thing you can plan and plan for and your body will do what it wants to do anyway 😓

I had my first DS in November. 39 hour induction. Waters broken after 24 hours at 1cm dilated - cervix still sitting quite high and far back. Hormone drip for 14 hours - after 10 hours with it I was 2.5cm - they wanted to take me for a section but I asked to try a bit longer so they left me 4h and checked again and was still only 3cm. Doctors told me it was going to be a c-section. While they on the phone - I’m assuming getting theatre etc sorted - I told the student midwife looking after me that I needed examination because something felt different. In the 10 minutes between examinations I had gone from 3cm-10cm and DS was born about 20 mins later. Obviously if baby is showing signs of distress etc then they need to do what’s best but I do think sometimes they’re a bit too quick to jump to using other interventions. If I’d gone along with their plan then DS would have been born by section after 10h on the drip but really my body just needed a bit more time and went through the final stages very quickly 😅

You might never get the answer you’re looking for but maybe your body works like mine and you just weren’t given enough time 🤷🏻‍♀️ Either way, you grew and delivered 2 beautiful babies ❤️