It's such a scary position to be in, isn't it? My first was stuck for a while too, with "turtling" after her head was born and quite a wait before we were able to deliver her body (at the hospital) and I was definitely worried about it happening with my second. My first was 10 pounds 7 ounces, and my second (just born!) was 11 pounds 2 ounces despite the fact that I am fairly small and I didn't gain excessive weight with either pregnancy. My second was a tiny bit sticky on the way out, but nothing like my first (to me it felt like my second just slid right on out, but my mw said she felt a little sticky). With your first birth, what maneuvers/positions did they try in order to get your baby out?
I did a bunch of research after my first was born and realized that although the doctor who was there did a bunch of stuff, it was really quite rough and there may have been other techniques that would have worked better without requiring such a rough start.
Here is a great website that helped me both in coming to terms with birthing vaginally again and in evaluating my mw's qualifications in dealing with dystocia: http://shoulderdystociainfo.com/shoulder_dystocia.htm
I especially found bullet #10, where they detail the techniques, very useful. I felt that knowing these techniques and their effectiveness helped me feel much better about dealing with a dystocia even if it did happen again. I also really quizzed my mw about her dystocia procedures during our interview. She mentioned each one of these techniques listed and told stories about her multiple, multiple experiences in dealing with dystocia. She seemed very comfortable and relaxed about dealing with it while at the same time treating it with the seriousness that it deserves.
BAH--they've changed the article since I read it 4 years ago! It used to list the Gaskin maneuver (which they now call "the all fours") as one of the main techniques, but are now presenting it as a fringe midwifery thing that is isn't practical (since most women will have an epidural and won't be mobile enough to get on all fours) DESPITE the fact that it was the most effective of ALL the maneuvers that they listed (82% effective!). Idiots.
Also, here is what the article says about recurrence of shoulder dystocia: "It appears from the literature that the risk of recurrent shoulder dystocia is substantial: 10 to 15%. Moreover, women who have had a shoulder dystocia delivery that resulted in injury to the fetus have an even greater risk of having a recurrent shoulder dystocia and subsequent fetal injury." So not as high as the 25% chance your mw listed, but not as low as the general population, which this article lists as .5% risk.
However, they also say "The bottom line is this: In the past, nowhere in the literature were there studies that showed that the sensitivity or positive predictive value for predicting shoulder dystocia was high enough to justify obstetrical interventions in hopes of avoiding it." So scheduling a cesarean (which has its own risks) to avoid sd wasn't recommended as far as I can tell.
But there's apparently some brand new technology that can help predict it??? That's new stuff that's up there since I read this article back in 2006. Here's what they write: "As mentioned above, there is new research that has linked maternal size and fetal weight to the risk of shoulder dystocia. In addition, Dr. Emily Hamilton and her team of researchers in Montreal have developed a tool, based on sophisticated statistical and mathematical analysis of large numbers of shoulder dystocia cases, that can identify the majority of those mothers and fetuses destined to experience a shoulder dystocia.
The factors involved in this analysis of risk are maternal height, maternal weight, parity, gestational age, baby’s estimated weight, and maternal history of gestational diabetes or previous shoulder dystocia. Dr. Hamilton’s formula has been tested against several large independent samples of patients who had experienced shoulder dystocia with permanent injury. The data—some already published, some in the process of submission—shows that it is possible to consistently identify 50-70% of patients destined to have a shoulder dystocia with a false positive rate (rate of additional cesarean sections) of only 2.7%. (Dyachenko, Hamilton 2006)
Dr. Hamilton’s shoulder dystocia risk prediction tool has been commercialized into a web-based application by LMS Medical Systems and labeled CALM Shoulder ScreenTM (patent pending -- see www.lmsmedical.com
Anyway, sorry for the novel. Good luck with your decision.