Shoulder dystocia

[Mon2468]

Hi all, been having growth scans due to slight polyhydramnios and size of baby, they believe he is larger than average and have offered me an induction at 39 weeks, currently 38+5 to prevent shoulder dystocia which has got me nervous. First baby and was hoping to go naturally which they said they don't have a problem with but said about the risks of nerve damage/brain damage etc if shoulder dystocia did happen so it's made me worry. Just wondering if this happened to anyone and all was ok?

You are absolutely entitled to decline an induction and request a c section instead. Even without the risk of shoulder dystocia you would be entitled to request this!! Just to be clear, this is NHS guidance. (The term ‘maternal request’ is used).

If your midwife tries to tell you that you chant have a c section, ask to speak to the consultant /someone else instead.
Best of luck to you .

@Choppingonions

I had a shoulder dystocia

You didn't really. Your description is nothing like a baby who is properly stuck. It would be helpful if more women were aware.

It's not your place to tell the PP that she "didn't really" have a shoulder dystocia. The medical definition of shoulder dystocia is when baby's shoulder gets stuck during delivery, whether it is resolved quickly and easily or whether there is more difficulty and trauma as a result. The experience and outcomes are different but either way it's still shoulder dystocia.

I am truly sorry that so many mothers and babies on this thread suffered as a result of shoulder dystocia. DS and I were lucky in that his was mild and quickly and easily resolved (like the majority of SD cases, statistically) but it was still SD.

I would have thought it obvious that a doctor is inducing before they reach full term so clearly you are not comparing like with like. Yes, it would be very odd to induce a full term baby on this basis.

either way it's still shoulder dystocia.

She has no idea of the scenario the op's HCPs are trying to avoid or she wouldn't be so blasé about it and question their guidance. She has no business to do that unless she has experienced it.

And yes name change you were extremely lucky. So lucky that you don't have personal experience of how wrong this can go. Doctors do.

@Choppingonions

I would have thought it obvious that a doctor is inducing before they reach full term so clearly you are not comparing like with like. Yes, it would be very odd to induce a full term baby on this basis.

I'm not comparing anything, I'm saying there are risks with induction at any stage, and IMO the risks are higher when inducing early, as the woman's body and baby are less likely to be ready. The positive induction stories I've heard are when induction happened around or after the due date and things progressed well. The horror stories I've heard are when induction was early or when it wasn't progressing and the decision to do an EMCS instead wasn't made soon enough. This is just my opinion though. As I've already said I would advise everyone to do their research and make an informed decision.

www.mumsnet.com/Talk/guest_posts/4035904-Guest-post-If-I-had-known-Sam-would-have-been-born-unharmed this was a pinned MN thread when I was pregnant and being told I had a large baby. It ABSOLUTELY convinced me to go for ELCS and the section was totally fine

For all the people claiming I don’t know why I’m talking about, here is the RCOG definition of shoulder dystocia - it literally means the shoulders get stuck during birth.

That is not to say it isn’t an incredibly serious thing, I was just clarifying because some pps seemed to imply it was something in their or their babies’ physiology that could have been picked up before birth, which is wrong.

www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-shoulder-dystocia.pdf

@Choppingonions
Who are you to say I didn't really have shoulder dystocia? My medical notes say I did - and the midwives and doctor who were there might be a better judge then you...they had to do a manoeuvre to get the baby out safely.
Is my experience not valid because the manoeuvre was successful? I know shoulder dystocia can be really scary and dangerous and cause injury. I'm really sorry for the people on this thread who had traumatic experiences. Most shoulder dystocias are safely dealt with and I thought it might be worth sharing a more positive experience in case anyone on this thread is ever in labour and it happens to them.

The other stuff I said is based on what research articles and the RCOG guidelines say (which is that induction of labour does not reduce shoulder dystocia for non-diabetic women who have big babies). I'm suggesting that it may be worth the op reading up on it herself and discussing with her midwife/doctor, not saying what she should do.

Most shoulder dystocias are safely dealt with

What on earth is that supposed to mean? So you think the NHS is itching to do CS sections? Has it occurred to you that if most are safely (whatever you actually mean by that - don't know how safely is defined or what interventions and tears you consider a success) dealt with, it's because others are prevented???

Shoulder dystocia nearly cost my daughter her life. It terrifies doctors which is why you don't have to beg for a c section despite the expense if you're at risk. If you were a midwife it would terrify you too. Before you go handing out advice, you really should watch This is Going to Hurt. It is tame compared to what happened to me. You are in no position to weigh up risks and encourage a mother to dismiss medical advice unless you have been in a room with a SD that wasn't "safely dealt with" and "easily resolved".

I have midwife on Monday and decided I want to go for the c section as scared as I am but reading your experiences I think this is the safest option for myself and baby. Let's hope I don't go in to labour before I get to have the conversation with her as I don't know what would happen then. As I said before, the only reason I started this thread was down to the consultant telling me there was a risk due to his size (even tho the growth scans may not be accurate) not sure if she's taking my frame in to consideration also as I am quite petite. Thanks again all for your comments and sorry again most of you had a traumatic birth.

I had an EMCS and thank goodness I did as baby was much larger than expected and I have a small pelvis. The consultant told me we 100% would have experienced shoulder dystocia so severe baby would have needed to be pushed back up and a crash section. It absolutely haunted me and i am grateful every single day I got stuck at 9cm dilated.

I would push for a planned section personally x

@Mon2468 they said exactly the same to me - did I want to be induced at 39 weeks etc risk of shoulder dystocia. I’d done loads of reading and said no. Anyway I ended up being induced at for reduced movements and having a c section after two days of labour. Luckily for me as she was an 11lb + whopper so even bigger than expected. Only thing I would change about my delivery is not messing about with two days of failed induction and having a planned CS. Next one I am absolutely having a CS. Hope it all goes smoothly for you whatever you decide!

I didn’t know what Shoulder dystocia was so Iv just watched a video on YouTube whihc was taken from one born every minuet and it looked terrifying for everyone involved. I wouldn’t absolutely not want to chance going through that if I was told that may happen

I was induced and ended up with an emergency c section as I wasn't progressing and baby was distressed. She was predicted to be much bigger (around 10 pounds) but was 8.5. Out of my small pool of friends who gave birth around that time and after, I have absolutely had the easiest recovery and ultimate birth despite the emergency section, would infection and small epidural complications. So if there is any chance of you having complications like dystocia, I really would consider the advice to book a c section.

@Nikki037297 I was the same, I haven't watched any videos on it though was bad enough hearing everyone's stories on here 🥺 .. definitely going to ask for the c section so any positive stories on that would be great 🙈 I'm such a worrier.

@ricketybeauty wonder why they offer induction a week early even if there is still a risk, when I never knew the extent of shoulder dystocia and told them I would rather wait and go natural they didn't seem phased 🤷🏻‍♀️ my midwife is amazing though so will have a good talk with her on Monday.

@ExactlyThis that's what I'm going to do x

Thanks all

This is Going to Hurt isn’t a documentary though - it’s a tv drama.

Lots of bad things can happen in childbirth. Things can go wrong in c sections too. The OP should read the actual stats and evidence on this - there’s loads of scaremongering on this thread.

@zaffa

I was induced and ended up with an emergency c section as I wasn't progressing and baby was distressed. She was predicted to be much bigger (around 10 pounds) but was 8.5. Out of my small pool of friends who gave birth around that time and after, I have absolutely had the easiest recovery and ultimate birth despite the emergency section, would infection and small epidural complications. So if there is any chance of you having complications like dystocia, I really would consider the advice to book a c section.

Sorry just to say I am one of only two who had the EMCS unfold the way that it did. Others were either very traumatic natural births or EMCS that were proper emergencies, the kind where labour started naturally and went very wrong and were rushed in. Mine was much less dramatic, I had a student midwife who monitored me relentlessly and picked up DD distress very early which was due to the drip for the induction - once they stopped it she was fine but obviously the Labour was then not progressing so they gave me the option of waiting or switching. They'd prepped me for it by restricting food for the previous 12 hours already (although I was not at all interested in food!) and giving me iron injections but I was already on supplements so had good readings. Good luck OP x

21 years later the trauma of my sons birth still stays with me . Induced at 38 weeks due to lack of fetal movement ..the cord was round his neck three times so he was becoming distressed , as his head delivered and they freed the cord it was like everything stopped .. I pushed and nothing happened, he was my third baby so I wasn’t prepared for it at all . I just remember my bed being thrown back, the emergency button pressed and my knees literally pushed round my ears while the room filled with people , The urgency was really Somehow he was delivered with a midwife on either side of me literally pushing my legs back and a doctor with a ventouse , my ex husband fainted (said it looked like a scene from all creatures great and small ) . DS was delivered , 9lbz 8.. shocked and grey , resuscitated and then twenty minutes later rushed to SCBU …. He WAS ok. And is about to turn 21 . I wasn’t .. I developed PND and wouldn’t even let anyone hold him .. I was so anxious .. plus my bits have never been the same since .. I did go on to have two more quick vaginal deliveries with no issues but I would never wish what I went through on anyone , if your medical team feel SD is a big risk .. personally if I had my time again I’d have had a CS if it had been offered

@Mon2468 that’s exactly what I said to them! At 39 weeks they’ll be what, a half a pound smaller!

Hope Monday goes well for you and you have a plan you are happy with!

@watchtheglitterdustswirl

I should say too, I know you were hoping to go natural, but a planned CS is better and easier than a rough 'natural' birth whether you labour naturally or are induced.

I should know, I've had both! So just explore all of your options fully.

This, with knobs on.

@Spacecadetagain I actually spoke to a friend who had a similar experience to you, her baby was 10lb 5 she said it was the worst experience of her life and it traumatised her partner and mum, there is obviously a risk if they are bringing it up to me.

Hopefully midwife appointment will go well, I'm due next Saturday so let's hope he stays comfortable at the moment until I have a plan in place, couldn't imagine anything happening between now and Monday and they don't know I want a section, don't think it would be easy to go in with contractions and say ok just give me a section 🙈

@Choppingonions

Most shoulder dystocias are safely dealt with

What on earth is that supposed to mean? So you think the NHS is itching to do CS sections? Has it occurred to you that if most are safely (whatever you actually mean by that - don't know how safely is defined or what interventions and tears you consider a success) dealt with, it's because others are prevented???

Shoulder dystocia nearly cost my daughter her life. It terrifies doctors which is why you don't have to beg for a c section despite the expense if you're at risk. If you were a midwife it would terrify you too. Before you go handing out advice, you really should watch This is Going to Hurt. It is tame compared to what happened to me. You are in no position to weigh up risks and encourage a mother to dismiss medical advice unless you have been in a room with a SD that wasn't "safely dealt with" and "easily resolved".

I'm really sorry you had a terrifying and traumatic experience.

What I am saying is what the RCOG guidelines say- i.e the standards for clinical practice written by obstetricians. I'm not making up stuff - I've been reading a lot about it because I'm considering my options for giving birth this time.

Most times shoulder dystocia occurs healthcare providers are able to deal with it without the baby being harmed (see RCOG guidelines). I'm not saying it's something to take lightly or flippantly. I am scared it happened to me (at the time everyone seemed in control so I wasn't then but when I read about risks later I was). No one wants it to happen. But when it will happen is not predictable. There are some risk factors that make it more likely but most of the time it can't be prevented as you don't know it will happen.

The chances are that the ops baby won't get stuck if she waits for labour because most babies don't. There's interesting research re. big babies linked earlier in this thread - link is not clearcut. It's down to the op to make the decision about what risks she is most worried about and how she feels about the stats- and she needs to talk through with health providers who know her specific circumstances. I'm not advising ignoring advice.

It sounds like she has made a decision she is happy with which is that main thing.

@zaffa thank you. Glad the student midwife was on the ball with you. It's all so scary isn't it, A few weeks ago I'd be in bed saying to my partner ohh I wonder when I'll get contractions, wonder what I'll be like, wonder where I'll be IF my waters do go was kinda exciting but now I'm like oh no don't move until Monday until I speak to midwife 🙈 x

@BrownOrange @Choppingonions I understand where both of you are coming from. Hopefully on Monday they will agree to a section and it all goes smoothly (wishful thinking?)