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Hoping for a VBAC after "CPD"

post #1 of 18
Thread Starter 
Hi ladies

I had a cesarean in September 2008. I was induced for postdates at 41 weeks (mistake #1!). My ob/gyn missed the obvious signs that my baby was OP--I had a long, slow labor with excruciating back pain. I ended up getting an epidural at 4cm (mistake #2!). I dilated all the way and pushed for maybe 2 hours and ended up with a c/s because my daughter was stuck and started passing meconium. She was 7 lbs 10 oz and had 8 and 9 Apgars. My section itself was a horrible experience. I really feel like it affected my ability to bond with my baby and caused me to have PPD/PTSD.

My OB told me later that my pelvis was too small and the only way I could ever have a vaginal delivery was if I had a preemie. It made me feel like I am defective. But I think her malposition, my pushing position and the epidural had a lot to do with why I couldn't push her out. I never had an urge to push and I couldn't feel myself pushing at all. I remember when I was pushing in a squatting position, the nurse said she could feel the baby's head moving down and that she was at a +1. Then my OB came in, had me get on my back and said she couldn't feel the head moving at all and that she was only at 0 station and that I needed a cesarean. It seemed to come out of nowhere and was very surreal. At the time, I thought that the nurse was wrong but now I wonder if the change in position might have narrowed my pelvis enough to make her seem stuck.

Anyway, I am about 4 weeks along with number 2 and I really want to have a VBAC. I have learned a lot about what might have gone wrong last time and I'm looking around for a supportive midwife or doctor. I'm strongly considering having a home birth. I'm really trying to get past the feeling that my body isn't made right to have a vaginal birth--I'm terrified that I will push and push and just end up with another stuck baby. I know that studies show that even with a prior CPD diagnosis, the majority of women can still have a VBAC, but it's hard to get the OB's words out of my head.
post #2 of 18
Your story sounds very similar to mine. I was induced at 39.5 weeks (mistake #1), let my OB break my water as soon as she could (mistake #2) and got the epi at 2cm (mistake #3)!

Anyway, I too dilated just fine, but pushed for about 2 hours when my OB also approached me with the c/s idea...basically making me feel like if it hasn't happened in 2 hours, then it's not gonna happen!

Well, fast forward to my DD, I VBAC'd her....but also pushed for 2 1/2 hours! But, she did come out vaginally.

Now fast forward to this pregnancy. My 3rd OB and when I tell him my story of my 2 births he rolled his eyes when I mentioned the 2 hours of pushing a c/s! I loved that! Because to so many OB's 2 hours is THEIR time limit, but that's so not fair to put a time limit on a mama and baby (especially a first timer where pushing for 2 hours is not uncommon)...if mama and baby are fine, why is there this magical 2 hour time limit??? So, my new OB continues to tell me that putting a time limit on a woman is silly and he has pushed far over 2 hours, at the time he told me that he pushed for 4 hours with a woman because that's what she needed.

Now granted, the idea of pushing for 2-4 hours isn't fun...but, it's better than a c/s!

So, hopefully my story helps you since we seem to have very similar 1st births! And, obviously a VBAC IS possible!
post #3 of 18
I too, have a similar story. Water broke, went straight to hospital, pitocin, epidural and 2 hours of pushing = c/s and "CPD" diagnosis. Now I am 30 weeks with #2 and hopefully will have a successful VBAC.
post #4 of 18
I'm sorry, mama!

CPD is one of the most common dx given for c/s and yet the actual numbers of true CPD are insanely small. Unless you've had an accident where your pelvis was broken or you were malnourished as a child, you probably don't have a problem. This article may be helpful. In your case, it definitely sounds like it was due to the position of the baby and your inability to move around and assist the baby with getting in a good position. Flat on the back is a recipe for c/s, as are the numerous interventions that are common in hospitals.

I know it's hard to shake it when someone tells you you're broken, but it can be done! You can VBAC! You just need to do lots of reading and talking to others that have BTDT. Check out your local ICAN list or the national ICAN list. You can also check out http://www.theunnecesarean.com/ and http://www.vbac.com/ and http://www.ican-online.org/
post #5 of 18
http://www.midwiferytoday.com/articles/pelvis.asp

Here is a great article. I found lots and lots of reassurance from it.

I would also say that your instincts are great in that yes, it very well could have been the position you were in, squatting opens up your pelvis further than normal, and laying on your back actually closes your pelvis further than normal. So YES, you are absolutely right in thinking the way you are thinking.

Oh, and there is an argument out there that (even with an epidural sometimes) if you are pushing without the urge to push, it's pretty much pointless, as you basically waste your energy pushing, and you are not going to make any more progress than if you would just wait for the urge.

As I'm sure someone else will say, your pelvis is meant to open up and stretch, and when you wait for labor to start spontaneously, the hormones that loosen your pelvic ligaments (relaxin) is at it's highest and all 3 ligaments help to open you up further. Also, with a malpostioned baby, they usually are not pressing on those ligaments evenly so it can inhibit the opening of the pelvis, and a malpositioned baby can also just mean the baby wasn't in the best spot for him/her to mold most efficiently.

I think CPD does happen, but it's with women who have rickets, polio, dwarfism, major trauma to pelvis, etc. Otherwise, it's simply a diagnosis of malpositioned baby, and an uneducated attendant fixing that and supporting mom. Usually, other cases are very very very very very very very rare.
post #6 of 18
what you probably had with your last labor was 'relative CPD' - i.e. you couldn't push the baby out in the position she, and you, were in. That's what I had with DD #1 - I wasn't induced, but my water broke early in labor (I was 2 cm with regular, but very easy, contractions). I went to the hospital as soon as my water broke. After about 6 hours they started pitocin, a couple hours later I got an epidural, attempted 2.5 hours of pushing while laying flat on my back, voila c-section.

The GOOD news is that I recently delivered DD #2 by VBAC. I think my success was due to several factors: 1) learning about how maternal positioning during pregnancy affects fetal position. Basically I stayed off the couch altogether after about 30 weeks - if I sat down it was on a regular kitchen chair or a balance ball. I used pillows to help position myself on my side to sleep. I walked a ton, did tons of pelvic tilts and other exercises to help the baby into a better position. 2) I was really mobile in early labor, moving around my room, rocking on the ball, etc. 3) I put off the epidural until 8 cm 4)I had a KICKASS L&D nurse who really listened to my desire to push in different positions despite the epidural. She and DH helped me roll from side to side during labor, and gradually baby girl made her way out (still 3 hours of pushing, but totally worth it!! )

Best of luck to you!! If you don't try homebirth, I would defniitely research a new OB - if they told you your pelvis was too small your old OB isn't going to be supportive of a VBAC. There are good supportive OBs out there, and good hospitals to deliver in, you just have to look for them! I was very pleased with my OB and hospital delivery.
post #7 of 18
Thread Starter 
Thanks everyone! It's great to hear about other "CPD" mamas who had VBACs.

I ended up having a m/c, unfortunately, but I have met with some practitioners and am feeling more optimistic about VBAC. Hopefully we will be pregnant again soon!
post #8 of 18
So sorry for your loss mama.

I am another "cpd" mama, and my HBAC was quite fulfilling and validating. It helped heal a lot of the anger and fear.
post #9 of 18
I was not induced, but our experiences are very similar. I am resentful that no one ever mentioned that she might have been OP even with so many signs. They said nothing until after the surgery. We found out last week that I am pregnant and we are planning a homebirth this time. I want to have a provider who is with me the whole time, not just coming in while I am pushing. I want to know that even if I need a repeat C/S, that we tried all our other options first.
post #10 of 18
The sound has been disabled on this, but it is still an awesome video:

http://www.youtube.com/watch?v=roFVkDV45MM
post #11 of 18
I was also "diagnosed" with CPD, my water broke, labored, pushed for 2.5 hours with no progress and ended in c-section.. I'm due in February and planning a HBAC now.
post #12 of 18
Quote:
Originally Posted by Libelula View Post
I ended up having a m/c, unfortunately, but I have met with some practitioners and am feeling more optimistic about VBAC. Hopefully we will be pregnant again soon!
I'm so sorry for your loss. Wishing you healing both physically and emotionally. And looking forward to hearing when you are pregnant again so I can hear about your optimistic and supportive provider!
post #13 of 18
I understand how you feel. And take heart that true CPD is extremely rare, and I DO NOT believe an OB can just say, your pelvis is too small. There is too much to know about an individual's pelvis to make that call!

I very much agree with your circumstances significantly playing into the end result. I was similar in ways, and for me, I think the key was pushing before I was ready, and I firmly believe my 9lb 2oz DS just needed more time to mold and come down. Apparently, he was in a somewhat posterior position, but his molding looked pretty typical when he was pulled from my belly. I just needed to give him more time. And we both had a c/s with lack of distress...even so, I'm thankful there never was distress, ykwim?

A lot of what happened with DS's birth is shaping my approach to this birth (7wks pg). Also, I too am very concerned about the provider I choose, and almost have it all worked out. I also expect to push a while, like a first-time mom, since this will be the first time a baby will pass through my pelvis.

I have heard that The Pink Kit can help you map your pelvis and discern certain ways to labor, mabye that would benefit you and help calm some anxiety about the shape/size of your pelvis.

ETA: I read the other posts...so sorry for your loss. Stick around, your time will come!
post #14 of 18
Quote:
Originally Posted by dezprincesscc View Post
The sound has been disabled on this, but it is still an awesome video:

http://www.youtube.com/watch?v=roFVkDV45MM
Thanks for posting this, was going to if nobody had yet!
post #15 of 18
I was induced due to preeclampsia at 38 weeks with my daughter. Diagnosed with "Failure To Progress" and "CPD" and "Baby Too Big" and had a section after 20 hours of labor.


Fast forwards 20 months later!!


I was induced again due to preeclampsia at 39+4. Labored for 9 hours, pushed for 1 hour and delivered a baby boy who was 6oz larger than my daughter! Med-free as well!
post #16 of 18
Thread Starter 
Thanks everyone! It's great to hear that other mamas in this situation have had VBACs. We recently found out that we are pregnant again--hoping this is a sticky one!

post #17 of 18
congratulations!!!! Sending sticky baby vibes your way, mama...
post #18 of 18
Quote:
Originally Posted by Libelula View Post
Thanks everyone! It's great to hear that other mamas in this situation have had VBACs. We recently found out that we are pregnant again--hoping this is a sticky one!

That is fantastic news!!!
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