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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

27 replies

Jaysthird · 30/01/2008 21:12

Have posted on a few threads about this, but now am asking a specific question.

Has anyone had a baby with the shoulder dystocia complication, that was quite heavy in weight, and then gone on to have another big baby. Did you suffer the same complication? did you opt for a section?

My first baby, 9.5lbs, no complications, second baby, 11.2lbs shoulder dystocia, currently 36 weeks and scan showing baby is 9.2lbs. I have said to the consultant i want to go for a natural delivery ( although am willing to be flexible) and he seems ok with this, but went into details about, how it IS an emergency situation and what can happen, extreme case, fetal mortality... so i have come home and read up a bit about it. I didn't realise it was SUCH an emergency situation and now am having second thoughts.

advice and experiences please?

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fingerwoman · 30/01/2008 21:21

hmmm, well having had big babies I was warned about shoulder dystocia, though didn't actually have it with eithyer.

I would say though that the guesstimates of baby's weight from scans are notoriously bad. HP's readily admit that they can be up to 20% out either side. if you search for big baby threads you'll find so many people who were told baby was going to be huge and it wasn't, so i wouldn't necessarily assume that just because baby 2 was big that baby 3 will be as big/bigger.

there are certainly people on here who have had shoulder dystocia with one baby who have then gone on to have more babies without suffering the same complication.
If you read about it there is a lot of discussion on what exactly constitutes a real shoulder dystocia as well- some people think of it as simply when there is a gap between baby's head appeariong and the rest of it, which isn't a real dystocia (ie shoulders actually getting stuck)

have a look on the homebirth website, I know you're not necessarily asking in regars to having a HB, but there are a lot of stories about SD on there. One lady (doris) had an 11lb 12 baby with SD. Her next was estimated to be at least the same weight, but he was 9lb 2. (anbother getting the weight wrong)

Lulumama · 30/01/2008 21:27

was your shoulder dystocia resolved easily? the RCOG recommends mcrobert manouvre as the first thing to do.. legs up round the ears....or all fours.....it can be dangerous and can have implications , but it is not neccesarily bad in all cases...

Original poster

Jaysthird · 30/01/2008 21:32

it was resolved with the mcroberts and the suprapubic pressure there was no need for the internal maneuver, so i guess it was resolved quite easily. I wonder though, if next time it might be more serious, and i know its not something that can be predicted.

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Original poster

Jaysthird · 30/01/2008 21:36

thanks for the info fingerwoman, i know that scans can be wrong, but based on my experience of them and the size i am now, i don't have any reason not to believe it!

Good to hear though, that there are women that have had subsequent births, but not suffered the SD!

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lucysmum · 30/01/2008 21:38

I had it with DD3 (9.2lb) so not huge but the biggest of my 3. She was overdue which is apparently another indicator. I too researched it after the event and it is pretty scary but I guess there are degrees as with most complications. Mine was resolved quite easily - I was not really aware what was happening although my husband said the midwife hit the red alarm button and suddenly the room was full of people. So no advice really but I suppose I am saying depending on your internal measurements it could happen with a smaller baby too.

hatrick · 30/01/2008 21:41

This reply has been deleted

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carmenelectra · 30/01/2008 21:42

Jay,
There are degrees of dystocia depending on how easily it is resolved and what manoeveres were necessary to deliver the baby.Do you know what the midwives/dr's had to do to get baby out?

I wouldnt get stressed as it may not happen. The 'sizing' of a baby is notoriously inaccurate! Having said that, you are at increased risk of having one if you have had a previous one. However, the staff will be aware of this and you will in safe hands as they will be on their guard and there will probably be an senior midwife/registrar hanging about.

Original poster

Jaysthird · 30/01/2008 21:53

carmen, i had mcroberts and the pubic pressure (mentioned below) so it wasnt to severe.

My consultant today did say that a registrar would be on hand and that everyone would be made aware of the situation. He also said that i would more than likely have to deliver on my back on a bed with legs up ( in prep for the mcroberts). I suffer with SPD also and was hoping not to have to be in this position as i was in agony after DD1 (legs in stirrups ) just wondering if there were any good positions to give birth in?

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Lulumama · 30/01/2008 22:01

all fours is a great position for you, it is better for SPD and good for opening up the pelvis

carmenelectra · 30/01/2008 22:08

Oh sorry jay, i didnt read properly!

I would encourage you to be as mobile and upright as possible in labour even if the midwives want McRoberts for the actual birth. Or a hands and knees position. Anything to open up the pelvis.

carmenelectra · 30/01/2008 22:08

Lol ive just what lulu said1

Wotz · 30/01/2008 22:09

LULU????

Lulumama · 30/01/2008 22:09

great minds carmen

Lulumama · 30/01/2008 22:10

WOTZ??

Wotz · 30/01/2008 22:10

can you help with some advice here?

PND, etc I am at a loss

carmenelectra · 30/01/2008 22:10

Oh yeah!

Lulumama · 30/01/2008 22:14

ok, will have a look momentarily.... might be tomorrow, as DH has just got home x

Wotz · 30/01/2008 22:16

OK, good night lulu, thanks

Snaf · 30/01/2008 22:22

Also, remember that shoulder dystocia isn't always to do with weight anyway. 50% of shoulder dystocias occur in babies under 4kg.

Imo it's a bit ridiculous for your cons to say that you should deliver in lithotomy (stirrups) 'just in case' - this is more likely to encourage problems with the shoulders, as he should well know

As lulu and carmen have said, you are best off in an upright position which will open up your pelvis, not flat on your back and lying all your weight on the very bits that need to move! If you need help with the shoulders, you can always move into McRoberts or all fours then (and the very act of moving may well solve the problem anyway).

I would try not to dwell on it too much - easier said than done, I know! There's certainly no reason to think that another one would be more serious and harder to resolve. As long as everyone is aware of your history, the best thing you can do work out a good birth plan that insists on keeping you mobile and upright to minimise the risk, and help your SPD too.

Have a lovely birth

barbamama · 30/01/2008 22:22

not quite the same situation as i had sd with ds1 but he was only 8lb 3 - also a week overdue though. ds2 was smaller - 7lb 13 and flew out no problem with 10 mins of pushing. I too was v aware of positioning second time just in case and delivered standing up against the bed then squatting being held under the shoulders by dp. Worked very well for us. I think you should be fine for a natural birth as long as you are upright and mobile and the hospital know so can have the docs on standby just in case.

barbamama · 30/01/2008 22:25

just seen snafs post - this is exactly what happenned to me with first consultant. utter, utter bollocks. I switched to a better consultant who was fine wit upright, no CFM, just a few more intermittent check on baby and team on standby. My advice would be do not, under any circumstances, agree to lying down never mind stirrups. Old fashioned nonsenes. Good luck! I was really worried about it hapenning again (my ds1 required a lot of resusitation and it had a lot of knock on effects for feeding etc), but it was fine.

hatrick · 30/01/2008 22:26

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Original poster

Jaysthird · 30/01/2008 22:40

Wow, good advice and experiences, thanks ladies. IMO id rather not be on my back anyway, so i will go with the being mobile as much as possible.

I am really not stressing over it all and am quite laid back, i just feel that its better to make informed choices, rather than go into something blind.

I will just continue with my 'research' till the time comes!

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hatrick · 30/01/2008 22:44

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Original poster

Jaysthird · 30/01/2008 22:56

i will be sure to let you know! still have a few weeks to go though, so be sure to look out for my report back!!

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