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Would like to have VBAC / told I have pelvis "issue"

post #1 of 60
Thread Starter 

My first-born came via c-section after 20 hours in labor.  At my 38 week appointment, my OB told me that my pelvis wasn't "relaxing and opening" the way it should at that point in my pregnancy, but that often during labor everything resolved itself.  He was very supportive and knew I didn't want a c-section.

 

Well, after 20 hours of labor I made it to a 9, but still my pelvis didn't yield and I was having horrible pain as my little guy was in there with his head slanted off to the side (sorry, I forget the technical term for this), causing horrible shooting pain down my leg.  I was trying to hang in there when I had an abruption, thus an emergency c-section.

 

I'm now 24 weeks pregnant, and seeing a different OB (my husband is working on location, and we should be back in time for my regular OB to deliver, but it's not 100%).  At this point my OB is telling me I am a very bad candidate for a VBAC because if my pelvis didn't accommodate before, it isn't likely to this time, either.  Also, she says because I made it to a 9 and things didn't work that means my percentage of success is very low (under 10%).

 

Having the c-section was devastating to me, though the result was a beautiful baby boy who is healthy and the light of my life.

 

I am torn because I honestly do not want to go through all of that labor again to only have the same kind of result.  I lost a lot of blood because of the abruption and my recovery was long and painful.

 

But I also want to birth my baby naturally and see her come into this world.

 

Has anyone had a pelvis issue and then had a successful VBAC?  Is this possible?  I feel like it should be, but wonder if I am simply being stubborn.  I already get teary thinking that I'll have to have another c-section, but feel like I need time to mentally prepare for it all if that is the path I truly have to head down.

 

Thanks in advance for any advice or wisdom you can share...

 

Stacy

post #2 of 60

I thought that if you had dialated with your previous birth that your chance of a VBAC was higher? I dialated to 10 and baby got stuck at +1 - she was born via cesarean. We are planning for a homebirth this February.

post #3 of 60

I don't know...but maybe looking into chiropractors and squats might help. Not so much a pelvic issue as position but DS was stuck trying to come out my left leg. Granted I wasn't allowed to move as much as I wanted and maybe it could have been fixed, but I had also stopped seeing my chiropractor and I think that made a huge difference for me.

 

Also, If you are going to go for a VBAC I'd find a new OB, you don't want negativity. I truly believe the reason I had a C/s with DS was because my OB wasn't supportive of natural birth, he didn't see a difference between c/s and vaginal and when it came down to the line his views on birth won out over mine.

post #4 of 60
Thread Starter 

Yeah, I thought if I had dilated further that would be a good sign, too, but the way she explained it was that since I made it that far and nothing relaxed/opened up, it's an indication that it is "just the way my pelvis is," meaning it likely wouldn't yield the 2nd time around (according to her). 

 

I've never seen a chiropractor before so am not sure about that or whether our insurance would even cover it ... I know I couldn't afford it otherwise.  Although something to consider...

 

Both of my OBs have said they would let me try for a VBAC, and I know my regular one back at home will ... he truly did let me go as long as possible with the first birth; it was the abruption that changed everything.  He came in afterward and just held my hand; he knew I was very upset and told me I had done everything I could so I shouldn't feel bad.  The OBs here, however, I don't know.  They say one thing, but I don't know them well enough to say with any certainty how they would be when it comes time to "go."

 

Regardless, I'm just trying to figure out the likelihood, or if I should even try for a VBAC. 

post #5 of 60

My very first thought is...you made it to 9, yes, but there was am emergency and no time to see if baby would have rotated properly in time!  Did they label you as failure to progress?  How long were you at 9?  Because what if more time was available next time, ya know?  Maybe that's all you need next time, is more time!  Obviously that was not an option with abruption, but if mama and baby are healthy next time, time can be your key...it was mine!

 

First, have you been to www.spinningbabies.com ?  GREAT resource for babies in not ideal positions...wish I would have put more time in here!!  AND, have you considered a chiropractor?  Mine found a muscle that connected my pelvis and hip and could very well have been the cause for my "misshapen" or "misaligned" pelvis.


Anyway, my story is, yes, I'm gonna go ahead a label myself as having a pelvis issue, although I'm eager for my 6 week follow up to discuss it all with my incredibly awesome OB!  But, my background...my first baby I had an epidural, pushed for 2 hours and THAT OB made me feel like I could do no more.  My second baby, a new OB I decided I needed movement on my side and opted to go naturally.  However, 1 1/2 hours into pushing, this new OB started to make me feel pressured by the clock and told me we needed to do something.  So with an epidural, he reached up there and rotated my baby for me, followed by another hour of pushing.

 

This all brought me to a very supportive OB who said he saw no reason to put time limits on me, if mommy and baby were doing well and that he's pushed for 4 hours with women before if that's what they needed.  So, with my #3 (now 2 weeks old), I pushed for 3 hours.  I had support, major support through it all, which meant I could continue on with no interventions, at all.  My OB did not push me for any time related reasons and let my body work towards its goal.  Because my baby needed that time to align himself so he could exit!  Sure, pushing 3 hours is not ideal, but it also proved to me that my pelvis, while possibly not ideal in it's alignment, is not broken and my body just needed that extra time to have my body and my baby work things out and eventually work through things to get baby out!

 

Hopefully that helps a little!  :)

post #6 of 60

I might be thick, but i wonder how s/he knew nothing was opening?  I mean, how could they tell that the pelvis wasn't opening normally?  The baby wasn't descending?  But you say he was malpositioned (asyclintic?) - that in itself would greatly slow descent.  And then you had an abruption - that isn't related to pelvises, that is a separate issue and can occur any time during pregnancy or labour.  I'm not even sure how a birth professional could tell, without an x-ray, WHAT the pelvic bones were doing during labour.  I have so much room my babies come out direct OA (don't turn to get their shoulders out, just come out with them side-to-side) and i have really wrenching cracking "opening" sensations as the head descends and is born, so i don't think the horrible pain you had was anything to do with your pelvis, more to do with his head being asyclintic (and thus pressing on nerves and so on inside).

 

The baby wasn't coming out - you weren't dilated fully yet...

 

I don't know, and i am not a birth professional, but to me it sounds like you had an abruption in labour and they had to do a cs (which is fine and necessary) BUT i cannot read anything which rings true about the dx of a "problem pelvis" y/k?  20 hours is not "long" for a 1st labour, and it would probably have been less than 24hours overall given you were at 9cm when the abruption occurred.  I might be really thick!  I'm just not getting how the doc came to this conclusion...

post #7 of 60

I hope you don't go see that doctor again.  She is ignorant, I'm sorry--just plain ignorant and is clearly not too comfortable with VBAC.

 

But before you decide to go ahead with a repeat C based on her very dumb comments, go to ican-online.org (international cesarean awareness network) and click on the White Papers link,  There you can read about the dangers of repeat C, during, after, and in the years/pregnancies to follow. 

 

Good luck!

post #8 of 60
Thread Starter 

MNHall - thanks for the website recommendation ... my babe was asynclitic, and actually, was positioned like that for a quite a while before labor ever began and never straightened out. It's wonderful to know there are exercises you can do to help "open" the pelvic floor ... I had no idea, and it's been made to sound like such an absolute. I'd like to think with more time and no abruption that he would have been born naturally. My OB wasn't pushing me for a c-section and was letting me decide, so I'd like to think he'd be just as agreeable the second time around.

 

For those of you that have seen a chiropractor: is that safe to do during pregnancy? Pardon my ignorance, but I've never seen one regardless, so of course would be hesitant to start something new like that during my pregnancy. But if it would help I would certainly do my best to make it happen.

 

MSBlack - I tried to visit the ican website, but it's not working? I'll have to try back some other time ... thanks for the recommendation.

 

I'm feeling more optimistic now that maybe I could be a good candidate for a VBAC. Of course nearly everyone tries to talk me out of it, but I would really hate to put my body through all of that again. My hospital stay post c-section was miserable. I couldn't get out of bed for 24 hours, they'd barely even let me sit up, etc. Breastfeeding got off to a horribly rocky start (though we eventually recovered, thank goodness) and my body just took a long time to heal. I'd like to be healthier post-delivery and have that time to bond with my baby immediately. The whole thing makes me so emotional and anxious, but learning more is helping to ease my worries, so thank you all for that.

post #9 of 60

A few things from my opinion. 

 

First off, I had a CS with my first after 27 hrs labor and only to 7 cm.  My second was a planned HB, dilated to 9cm, 36 hrs, transferred due to extreme back pain and wanted an epidural, and got there had some signs of fetal distress and suspected abruption, decided to have another CS, found out there was an abruption and am glad we made every decision we did, mainly trying to VBAC.

Second, the statistics for a VBAC mom to had her prior CS for Failure To Progress (FTP) is actually 50-60% success.  Now, if you hadn't had the abruption, maybe you could have vaginally birthed.  No one knows, but the REAL reason for your cesarean was abruption, and with those reasons, the chances are more like 70-80% of successful VBAC. 
 

Third, acynclitic babies are really tricky.  If you have had one before, you may very well have another, you may very well not.  I'd hire a Doula either way, who is experienced with acynclitic babies.  Some babies NEED to enter the pelvis in this position and then wiggle around and figure it out and mom and baby birth fine.  Others need to be corrected, and the pelvic floor release on the spinningbabies is a great tool to use and usually works.  Also, lunging with one foot on bed, one on floor and lean into leg on bed.  Opens your pelvis.  Squating is great, but tricky to do if a baby is suspected to be acynclitc because it can cause him/her to get stuck in that position further into the pelvis.  Again, they are tricky babies.  Again, if I were you, I'd hire a Doula.

 

Chiro is totally safe, SOME things.  The webster technique is great as it helps to align the pelvis with the spine and neck, etc.  Make sure the Chiro you see is trained with this technique.  Spinningbabies talks more about this too. 




Happy Birthing!  Much Love to You!!!

post #10 of 60

I would say you have a pelvic issue as much as I do - MEANING - there is work I need to do this time for positioning, posture and aligning my pelvis better so that babe will descend BETTER and more efficiently. So, it's all in what you call a pelvic issue. With ligaments? Yes, at least for me. With permanent bone structure? VERY UNLIKELY. 

 

And say away from that OB!!  Seriously.

 

So then, my work involves the way I sit when I relax, regularly seeing a chiropractor for webster maneuvers, good stretching of my glutes and hamstrings (which are sooo tight). I have years of poor pelvic posture and I think that played into my labor with DS with him apparently being posterior partway into labor. I also got to 9 (maybe even 10) pushed for an hour and a half (could have kept going, who knows what DS would have done in the birth canal).  I am grateful and encouraged that I dilated - you should be too. Hopefully for both of us our next labor will be nothing like the first one and smooth sailing :)

post #11 of 60

Check out http://icpa4kids.org/  to look for a chiro in your area who specializes in maternity/childhood chiropractic! 

post #12 of 60

I also wanted to say (even though it was already said), that yes, chiro work can be done safely....just make sure you see someone that is specialized or has worked with pregnant women.  The webster technique has brough many many women great success.  The chiro I saw does not do webster, BUT, she's basically THE chiro that anyone goes to while pregnant...probably half of her clients are pregnant and go specifically to her for the fact that she's very well known for working on preggos.  So, just as long as you go to someone trained to deal with preggos...give it a try!  :)

post #13 of 60

You've GOT to read this article by Gloria Lemay - Pelvises I Have Known and Loved

 

The fact that you dilated is a good thing.  The c/s sounds more related to the abruption, but leave it to an OB to blame your pelvis for you.

 

I'd recommend changing providers.  I can't imagine going forward with an OB who already didn't believe I can use my pelvis.

 

Oh, and my pelvis was blamed for my 1st c/s.  Yeah right.  I'm 5'10.5" and my baby was only 8lbs 2oz.  The medwife broke my water, and my baby got stuck in a bad position.  The rest followed.

post #14 of 60

labortrials:  I love that article!  Thank you joy.gif

post #15 of 60

Was your pelvic "disorder" CPD (Cephalo-pelvic disproportion)?  If so, lots of us supposed CPD mamas have gone on to have wonderful VBACs.  CPD is often used as an excuse by an OB as to why a perfectly healthy mom had to get a csection.  Reality in my situation was the OB's failure to wait and forced cascade of interventions.

post #16 of 60

This description below sounds like asynclitic presentation which could be enough to keep him from coming out.  There is a good book called Optimal Foetal Positioning that discusses this.  The way to correct it would be to get up and walk sideways up the stairs or do side lunges up onto a chair or footstool.  That would get the head back in better alignment and the baby would most likely come out quickly. 

If you can get a better positioned baby next time (use a chiropractor, check out spinning babies, read the book Optimal Foetal Positioning, etc.) I think you would have an excellent chance at VBAC.  Also, since you got to 9cm you can expect to labor like a second time mother instead of a first time mother.

 

Quote:
Originally Posted by MilkMachineMom View Post

 

Well, after 20 hours of labor I made it to a 9, but still my pelvis didn't yield and I was having horrible pain as my little guy was in there with his head slanted off to the side (sorry, I forget the technical term for this), causing horrible shooting pain down my leg.  I was trying to hang in there when I had an abruption, thus an emergency c-section.

 

post #17 of 60
Thread Starter 

Thanks, everyone.

 

I'm looking into getting a Doula ... and also into going to a chiropractor.  I spoke with my acupuncturist, and she just cautioned me that chiropractic adjustments can cause you to go into labor and to ask LOTS of questions of the chiropractor to make sure they have plenty of experience.  Did those of you that went to a chiropractor wait until later in your pregnancy or did you go throughout? 

 

Either way, I feel like with adequate support and more prep work (meaning if the baby isn't positioned correctly and we know that ahead of time) before labor I will be in a much better position this time around and hope the labor will be more productive.  If the baby comes close to my due date we'll be back in L.A., and I'll have my normal OB, who is willing to let me try for a VBAC.  Now I just need to find a new OB here who is more understanding just in case I go in to labor very early (hoping that's not the case, but need to be prepared).

 

I appreciate the support I am getting here ... unfortunately many of my friends and family do not understand my resistance to having another c-section and think I'm "crazy" for wanting to try again.  Thankfully my husband is 100% on board and behind any decision I make, but it's nice to have others out there encouraging me orngtongue.gif

post #18 of 60
Quote:
Originally Posted by MilkMachineMom View Post

Thanks, everyone.

 

I'm looking into getting a Doula ... and also into going to a chiropractor.  I spoke with my acupuncturist, and she just cautioned me that chiropractic adjustments can cause you to go into labor and to ask LOTS of questions of the chiropractor to make sure they have plenty of experience.  Did those of you that went to a chiropractor wait until later in your pregnancy or did you go throughout? 

 

Either way, I feel like with adequate support and more prep work (meaning if the baby isn't positioned correctly and we know that ahead of time) before labor I will be in a much better position this time around and hope the labor will be more productive.  If the baby comes close to my due date we'll be back in L.A., and I'll have my normal OB, who is willing to let me try for a VBAC.  Now I just need to find a new OB here who is more understanding just in case I go in to labor very early (hoping that's not the case, but need to be prepared).

 

I appreciate the support I am getting here ... unfortunately many of my friends and family do not understand my resistance to having another c-section and think I'm "crazy" for wanting to try again.  Thankfully my husband is 100% on board and behind any decision I make, but it's nice to have others out there encouraging me orngtongue.gif



 I was seeing a chiropractor about once a month before I got pregnant, once I was pregnant I increased it to about once every 2-3 weeks (depending on how I was feeling) and starting around 32-34 weeks I will start going weekly or even twice weekly.

post #19 of 60

I just wanted to add, for what it is worth, that there are times when a woman's pelvis is not adequate to allow passage of the baby.  I used to work labor and delivery in a large medical center that allowed and was supportive of VBAC.  I remember caring for a woman who had her first baby c-section for exactly the scenario you described with your first.  I was caring for her during her second labor and VBAC attempt.  She was progressing fairly well, and was about 4cm when I took over her care.  I checked her progress a few hours later and made two discoveries 1.) she was approximately 6cm and 2.) she had the narrowest pelvic opening I had ever encountered.  I went off shift shortly after my exam, and found out later that she did not continue to progress, the baby began showing signs of distress, and she went on to have a 2nd c-section.  It is kind of a chicken-and-the-egg scenario--did the baby's malpositioned head cause failure to descend/failure to dilate or was it a small pelvis that would not allow proper head engagement hence the malposition.

 

I agree with you, I have felt that laboring to complete then having a c-section is a true injustice smile.gif  When I was having my own kids this is the scenario I dreaded the most!

 

Good luck and best wishes to you as you welcome #2!

post #20 of 60

I know the pp meant well in explaining another side, but I hesitate to put any stock in that because it is SO RARE. My m/w hinted at the same thing that SOME women have that issue, but NO ONE can see inside the pelvis during birth to see that it "can't" open.  NO ONE can tell you without an informed exam which isn't really possible, that you can't fit a baby.  There are women who had previous injuries, scoliosis, etc that give context to difficult births and needed c/s, but that is by far the exception.

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