baby won't descend?

[GracesMama]

A friend of mine just had a baby and she had planned a homebirth. After being dialated at 7 for 7 hours, she transferred to the hospital because the baby just wouldn't descend. The baby never showed any signs of distress, from what she shared, and I'm not sure exactly what happened once she got to the hospital, but she ended up with a c-section. Now I'm all freaked out thinking that could happen to me.

So, what are your options if the baby won't descend? Is that truly an emergency?

[Sijae]

If she was only dilated to 7 then descent wasn't the issue. You didn't give very many details about her labor but from what you shared it sounds more like a failure to wait for labor progress on the part of her attendants than a failure of any kind on the part of her body/baby.

[MsBlack]

Originally Posted by Sijae

If she was only dilated to 7 then descent wasn't the issue. You didn't give very many details about her labor but from what you shared it sounds more like a failure to wait for labor progress on the part of her attendants than a failure of any kind on the part of her body/baby.

Yeah--that.

Hard to know, from such sketchy details (tho that may be all you have right now).

But often these 'failure' stories--medically-named 'failure to progress' or 'failure to descend', are mostly about failing to be patient, failing to apply all known methods of keeping mom's energy up and methods of pain coping. It's also true that women's pain tolerance varies, and so does their willingness to eat, drink, try different pain-management or baby-positioning techniques. Some women are happy enough to 'try for a homebirth' in the same way that some hospital moms are happy enough to 'try for an unmedicated labor' but make a choice for pain relief when strong labor arrives. No judgement there of mamas or providers--just mama-preferences in play--and we all have the right to choose if/when we are done trying for a homebirth and ready for transfer. Or--maybe her mws just didn't have enough training/experience on that particular issue? Lots of factors could be in play.

[pearl2]

I have some strong opinions on this that do not resonate with the other posts in this thread, which, quite frankly, sound REALLY REALLY judgmental.

I do agree that in the medical model of birth, several doctors will call it FTP or FTD or whatever and will go on and do a section.

HOWEVER, I would like to share my story of a true failure to descend.

After 42 hours after my water broke, and even more of being in labor, my baby did not descend past a -1 station. Was it because I was impatient? Hell no. Was it because my midwife/birth team was ignorant? Hell no.

What I did during labor to encourage her to descend:
*birth ball
*nipple stimulation
*shower
*walking flight upon flight of stairs
*walking outside
*leaning on back of toilet
*extremely deep sumo squats in the middle of contractions
*black and blue cohosh
*belly sling
*lying on side
*several yoga positions
*trying to just rest
*being on hands and knees rocking
*slow dance/swaying

All this for about, oh, three straight days. So NO, it was not because I was impatient.

I did a transfer because I wasn't able to keep anything down and for obvious reasons didn't have much strength left. I was only at 6cm and my pain level was completely manageable. Her heart rate was fine the whole time. We thought perhaps an epi would allow my body to rest, seeing as how I had tried LITERALLY EVERYTHING to get her to descend, and I was literally delirious at that point.

After I was 100% effaced and over 9cm, she was STILL at -1. She had started to mold into the birth canal trying to get out, but something was preventing her. Her heartrate was still fine the whole time.

When we went for the C-section, which was actually a relief and was a very positive birth experience as it could get, they found her hand had gotten completely stuck up over her head, preventing her from coming down. She was not budging and literally could not be jolted out of position. No vacuum or hand could reach up to help her out.

So yes, it could have been the only option left at that time that was not necessarily caused by interventions. And I really hope that people do not go around calling other women impatient or implying they or their birth team were incompetent.

That being said, I do not have any expectations that this upcoming birth will be in any way the same as my first, as I am having an HBAC.

[MsBlack]

I'm sorry you read me as being judgemental of a mama's patience... that is not what I was saying. And of course, it is sometimes true that a baby will not descend no matter what is done nor how much time is taken. Still, I stand by what I said..."But often...", because often, it IS true that care providers fail to be patient, apply all possible methods of helping mamas get through a long hard labor. Not every time, as your story shows...but, often.

[lunarlady]

Sometimes babies really won't decend. It can be due to poor positioning, as a PP had in her story, or sometimes other strange factors come into play. If baby's heartrate is fine, then in isn't really an emergancy in a "call 911, rush to the hospital" way, but yes, you can spend hours and hours in hard labor and get nowhere.

In your friend's case, from the details you supplied, there is no way to know if another 7 hours at home would have resulted in a sucessful HB, or if they simply would have ended up in the hospital and c/s anyway. You could ask her if the doctors told her at the time of her c/s if they saw a reason for the baby not decending. (Assuming you have that sort of friendship.)

So while I think you can end up with a true failure to decend, I also think this type of complication is rare, and therefore unlikely to happen to you. If it does, know that you will have hours (or even days like the PP!) to decide on what you want to do about transfering to hospital care.

[Amynf1]

I just had an HBAC in July. Total labor was 44 hours long. I was dilated to 10cm for nearly 20 hours with an intact water bag. The baby started out LOT and slowly over the course of hours with lots of encouragement from my positioning, she rotated to OA. The baby was -2 the whole time until we broke the bag at which point I immediately began pushing. After two hours of pushing the baby descended to 0 station and after two more hours of pushing she was born.

Sometimes we just need time.

[Amynf1]

Originally Posted by pearl2

I have some strong opinions on this that do not resonate with the other posts in this thread, which, quite frankly, sound REALLY REALLY judgmental.

I do agree that in the medical model of birth, several doctors will call it FTP or FTD or whatever and will go on and do a section.

HOWEVER, I would like to share my story of a true failure to descend.

After 42 hours after my water broke, and even more of being in labor, my baby did not descend past a -1 station. Was it because I was impatient? Hell no. Was it because my midwife/birth team was ignorant? Hell no.

What I did during labor to encourage her to descend:
*birth ball
*nipple stimulation
*shower
*walking flight upon flight of stairs
*walking outside
*leaning on back of toilet
*extremely deep sumo squats in the middle of contractions
*black and blue cohosh
*belly sling
*lying on side
*several yoga positions
*trying to just rest
*being on hands and knees rocking
*slow dance/swaying

All this for about, oh, three straight days. So NO, it was not because I was impatient.

I did a transfer because I wasn't able to keep anything down and for obvious reasons didn't have much strength left. I was only at 6cm and my pain level was completely manageable. Her heart rate was fine the whole time. We thought perhaps an epi would allow my body to rest, seeing as how I had tried LITERALLY EVERYTHING to get her to descend, and I was literally delirious at that point.

After I was 100% effaced and over 9cm, she was STILL at -1. She had started to mold into the birth canal trying to get out, but something was preventing her. Her heartrate was still fine the whole time.

When we went for the C-section, which was actually a relief and was a very positive birth experience as it could get, they found her hand had gotten completely stuck up over her head, preventing her from coming down. She was not budging and literally could not be jolted out of position. No vacuum or hand could reach up to help her out.

So yes, it could have been the only option left at that time that was not necessarily caused by interventions. And I really hope that people do not go around calling other women impatient or implying they or their birth team were incompetent.

That being said, I do not have any expectations that this upcoming birth will be in any way the same as my first, as I am having an HBAC.

Your story doesn't sound too unlike my HBAC that I had in July. Have you ever mapped your pelvis or had any analysis done? Pelvic shape could be at play here. I have an anthropoid pelvis which means that it is hard for my babies to descend by once they do I can get them out. HERE is my birth story if you want to read it, maybe it will help you as you plan your VBAC. Also, there is a position called the Walcher's position that Gail Tully from spinningbabies.com said is very beneficial in these types of situations and can make the difference between vaginal birth and c/s. It's obscure and a lot of providers aren't familiar with it. I'm definitely putting this one in my tool box for next time. She said it can shorten labor when moms have a hard time with descension.

[GracesMama]

Thank you everyone for your responses.

I did forget to mention that when they did the cs, the cord was wrapped around the baby's neck. However, isn't that true of about 25% of births? Could that have caused the problem?

[lunarlady]

Both my babies were born with the cord around their neck. Unless the cord was also unusually short, that should not have caused the problem.

[Galatea]

Originally Posted by lunarlady

Both my babies were born with the cord around their neck. Unless the cord was also unusually short, that should not have caused the problem.

My sister's first never descended after 3 days of labor (part at home, part at hospital.) It turned out he had a 4x nuchal cord which did prevent him descending and she did actually need a section, but that is super-rare.

[lotus.blossom]

My first baby was tangled in his cord. Neck, body and leg. I never dilated past 6cm. I was stuck there for a long time. He did have decels which led to the c/s. I was concerned that it would happen again but my second labor was quite fast and I did get to the pushing stage. Although that labor had its own complications.

You can really work yourself up listening to other peoples birth stories. Every birth is unique and you can just hope and plan for the best. Getting freaked out about cord issues is not going to prevent it from happening! Try to focus on all the things that you can control and leave the rest up to fate!

Goodluck!!

[HeatherB]

There are absolutely times when babies don't descend for being held up by one thing or another. It is, however, very uncommon (unlike diagnoses of FTP or FTD). I remember one story of a mama (a midwife, even) who labored for a very long time doing everything you can think of and then some. Baby was eventually born by c/s and they discovered an *extremely* short cord that was attached high up. Baby just couldn't get further down than she did and the c/s was clearly necessary.

Remember that about 10% of mamas/babies will need a c/s, but that means about 90% will be able to have smooth births if well-supported.

[erin_brycesmom]

I've had three babies and one of them have descended into the birth canal until I was 10cms. Well, I didn't have any cervical checks with my third but it's safe to say that I was probably 10cms when baby descended because he didn't descend until the last 4 minutes of the labor (3 day long labor).

I agree with MsBlack. That said, regarding poor fetal positioning, I highly recommend the Webster Technique a couple times a week towards the end of pregnancy. If you are worried about positioning effecting the birth as it sometimes can prevent baby from descending easily, I would definitely go for Webster!

[jdepp]

Wow to the mama who labored 42+ hrs!  I labored for 30, fully dialated for half that time,and she wouldn't descend. I never found out why....I am scared to try again but your story is hopeful.  I'm due October 2012. Has anyone had a sucessful vbac after the baby didn't descend the first time?

[motherhendoula]

Baby can get totally caught up in the cord - not just wrapped 'around the neck' - around the trunk is more worrisome!  When the cord is wrapped up , sometimes the baby wont descend because the cord will pull against the placenta -  or at the belly button possibly detaching....if its that tight - which isnt so common.    Sometimes time is on mamas side and waiting through the 40+ hour labor gives the baby time to untangle himself - sometimes not.   

[JudiAU]

It just sounds like she had a slow labor. I was dialated to ten for five hours before the baby descended which is pretty rare. No distress. Had a vaginal birth with a very competent midwife.

I had the webster technique and a lot of chiro ligment massage with my second, who was breech for awhile. She practically shot out of me.