2 c-sections due to asynclitic heads- Need a game plan for VBA2C! - Page 2

[cairomama]

When I've seen it done, the MW puts a small hole in the bag during a contraction with the hope that the force of the contraction will break the water the rest of the way when the baby is at her lowest and hopefully the baby will stay down. I've seen it work very well. Mom was fully dilated for 16 hours but baby was still high and waters were in tact. It was a VBAC attempt and she'd been going for 40 hours at that point. In the time they knew she was fully dilated until they broke the water they did things to try to rotate the baby, baby moved down immediately, but still still had to push (with her urges) for more than 3 hours and eventually gave birth to a 9 lbs baby. 

It doesn't always work and it is better for the waters to release on their own, but at a certain point, most people want to do something. What point that is, depends on mom's state and baby's health. In the hospital, they tend to start interfering too early (as soon as you get there), but for me, personally, after 48 hours of labor most babies are born and I would not want to get to 72 hours without a baby one way or another. That is definitely something you have to decide for yourself.

Originally Posted by SAMarshall 

Originally Posted by neveraim 

I just don't even know if creating a small leak instead of breaking the water is even reasonable.  Sounds like she didn't know what she was doing.  Here's why...there's already a ton of pressure on the amniotic sac even when you are not in labor....once your cervix starts to open all that pressure is pushing on that one area where there is some give.  If you are squeezing a balloon (which is much thicker and than the amniotic sac) and you try to create a "tear" vs. "breaking"....I guess I don't even know how one would reasonably not 'break' it no matter how gentle or how small the hole is.  Even if you did accomplish a small tear....one contraction is going to squeeze all the water out and break it anyway.

You know, that's a good point. I guess it just seemed reasonable at the time. I wish that my doula would have had more knowledge about that. I would have listened to her if she would have explained it. My doula, however, agreed (although hesitantly), with the midwife. That is definitely a big regret I had with my last labor. It was the one and only intervention I had (until the c-section), and I wish I could have taken it back. Thanks for that explanation, though. I'll be prepared if that comes up next time!
 

Also, on the chiropractic care and other body balancing techniques, I think starting before you are pregnant will give you the best chance if you have a severe issue.

[neveraim]

I guess that's really what I was thinking...that the water would break quickly after a "leak" was created...Must take some incredible skill (or luck) to be alble to just 'tear' the bag....In my case...I'd been laboring for 4 days when I finally went to the hospital and was surprised to find my cervix was at 6 cm already (contractions were never much closer than 10 minutes apart).  They broke my water (baby was still high) and it took another 12 hours to get to 9...then swelling, then a c/s.  It certainly didn't help me.

I guess the bottom line is: that baby really needs to be lined up perfectly if someone is going to break your water...even if it is just a small tear.  I'm going to ask some of my midwife friends about this and see what they say.  I'm really curious now.

Anyway, don't beat yourself up either way.  We just do the best we can with what we've got.  I shouldn't have let them break my water either....but you live and you learn. 

Originally Posted by cairomama 

When I've seen it done, the MW puts a small hole in the bag during a contraction with the hope that the force of the contraction will break the water the rest of the way when the baby is at her lowest and hopefully the baby will stay down. I've seen it work very well. Mom was fully dilated for 16 hours but baby was still high and waters were in tact. It was a VBAC attempt and she'd been going for 40 hours at that point. In the time they knew she was fully dilated until they broke the water they did things to try to rotate the baby, baby moved down immediately, but still still had to push (with her urges) for more than 3 hours and eventually gave birth to a 9 lbs baby. 

It doesn't always work and it is better for the waters to release on their own, but at a certain point, most people want to do something. What point that is, depends on mom's state and baby's health. In the hospital, they tend to start interfering too early (as soon as you get there), but for me, personally, after 48 hours of labor most babies are born and I would not want to get to 72 hours without a baby one way or another. That is definitely something you have to decide for yourself.

[rosenmom1]

Finding a midwife who knows Penny Simkin's models, or is willing to read about how to help you move an asyclitic baby. (Spinning Babies website is great!)

I just gave birth and my baby was asynclitic.  She is my first and I birthed at a birth center, not a hospital.  A hospital would have had me in the OR faster than I could say cesarean once they found out she was asynclitic.

Here is how moving her went down:

My midwife said she needed to create a pelvic floor in order to give the baby something to move against.  So, on the bed I was on one knee, the other leg was Captain Morgan style... With a birth ball my midwife positioned me upright with my elbows helping to support me on the birth ball. (I'm sure it looked a little cookie with a big birthing ball on a bed!)

She then put her fingers up there... and I could feel the baby move, she kept this for three contractions (during resting periods in between contractions as well).  After those were done I had gone from 4cm-7cm and things went quite quickly...  Baby just needed something to push against to get her big ol' body moved into the right position to be born! The hematoma on her little noggin' is pretty intense, proof that she was trying to come out sideways!

Just know that moving a baby that is asynclitic is hard, but a) so is labor and b) it is worth it for a vaginal birth! 

Also, know your rights, you dont' have to consent to anything that you don't want to do... Don't be bullied into interventions that you don't need!  Asynclitic babies CAN move!

Edited by rosenmom1 - 5/6/11 at 3:01pm

[TiffanyToo]

Originally Posted by rosenmom1 

She then put her fingers up there... and I could feel the baby move, she kept this for three contractions (during resting periods in between contractions as well).  After those were done I had gone from 4cm-7cm and things went quite quickly...  Baby just needed something to push against to get her big ol' body moved into the right position to be born! The hematoma on her little noggin' is pretty intense, proof that she was trying to come out sideways!

You might want to see a chiropractor DD was asynclitic and had a catput too. She needed an adjustment because of being asynclitic positioning had her banging on my pelvis which made her all out of alingment.

[Monkey Keeper]

Originally Posted by rosenmom1 
A hospital would have had me in the OR faster than I could say cesarean once they found out she was asynclitic.

Not always ;)  I VBACd a 9lb, 5oz asynclitic babe in a hospital after a very "atypical" labor (protracted with closely spaced contractions throughout)...it all depends on your provider!

But congratulations on your hard-won vaginal birth, and I agree with Tiffany's recommendation to get your little one to a chiro--my guy's neck was wonky for a couple months afterward.

[cinderella08]

Asynclitic babies can definitely be birthed vaginally!  My VBAC baby was posterior, and asynclitic - talk a bout a combo!  Labor was hard, hard, hard and getting him to come down was even harder.  But we did it.  He had a nice hematoma as well on the side of his head.  He was adjusted several times after birth by a chiro.

You have gotten great suggestions - I second what all these other great ladies have!

Here's my little guy with the proof on his head he was trying to come out with his head turned all kinds of crazy ways.