40 weeks head still not engaged 2nd baby

[lsmama]

Help!  I'm a little freaked out b/c I'm 40 weeks today.  Baby is still up really high.  I'm 1-2 cm, had my membranes swept twice this week, lots of on and off cramping, but that's it.  I go back to m/w Tues. If no change at that point, we'll likely be discussing more invasive measures.  1st baby was big, born sunnyside up, and had a BAD shoulder dystocia.  This baby looks a bit bigger so far and is now 1 week farther along.  Midwife is hoping for spontaneous labor before then, but I am braced for some big decisions next week.  Given my experience with my first, I am comfortable with taking a more medical approach if need be.  However, in the meantime I am wondering if there is anything I can do to get baby to engage. 

Baby has been head down and laying on my left side for many weeks, though I think he/she often switches back and forth between LOA and ROA.  As of yesterday's appt, midwife did not think baby was posterior, but went for an ultrasound and the tech said the baby was face up (though I don't completely trust her b/c she did not know what posterior meant when I used the term)

Any suggestions would be much appreciated. 

[wombatclay]

Hope your inner child is an outer child soon!

Although many first babes do engage prior to labor, once you've had a child things are a bit "stretchier" in there.  LOL  Often a second, third, fifth, etc babe wont engage until labor has begun.  It can be nerve wracking if you're counting the days or have some sort of external "deadline".  (my second child had a serious SD and while she recovered nearly perfectly I had a 4th degree tear and pelvic organ prolapse so I know what you mean when it comes to the stress of making more "maybe medical" decisions).

I'm assuming you've tried the various less invasive "labor starts" like sex/semen/orgasm, pineapple or papaya enzymes, nipple stimulation, stair climbing, walking, swinging (like on a playground swing), spicy foods, enemas, EPO (vaginal as well as ingested), and RRL tea.  Have you tried acupressure or acupuncture, or maybe chiropractic or massage?  Do you think some stress/worry from your first birth experience might be holding you back?  I found meditation to be a big help for processing some of my fears about a repeat SD/tear and I went over my birth plan with DH and my doula till I was confident they "got it" (I wanted to move straight to a cesarean if the pushing phase went wonky the way it did with dd2... I did NOT want to risk a second SD/tear and once I felt I'd planned for everything I felt better emotionally).

Also, are you doing any of the exercises from Spinning Babies or Optimal Fetal Positioning?  Those might tweak things enough to get labor started.

Good luck and happy birthing!

[lsmama]

Thanks, wombatclay.  I have tried all of the above (RRL, more sex than I've had in my life, EPO, enema, pineapple, acupuncture for 90 mins 2X this week, crawling around my house on hands & knees).  Baby actually feels way lower to me this morning, so hopefully we're making some headway.  Midwife is thinking we may go straight to a c-section if no action by Wednesday.  I am so hoping for a spontaneous labor, but I think I've made my peace with this decision.  I think induction at this point, based on my history, seems a little scarier. I feel like  my midwife has been patient, calm, and open-minded throughout this whole pregnancy, especially since she was the one who resolved the crazy shoulder last time, so I don't feel like I'm being coerced.  I'm just hoping, hoping, hoping for this one to tuck his/her chin and begin the journey so it doesn't come to that.

[wombatclay]

It's not an option care providers really like since it makes scheduling difficult, but if the babe looks ok would they wait on a scheduled c/s until labor starts on it's own?  That way you don't run the "risks" of a repeat SD but you know the babe is ready for action.  This was one of the options suggested by my care providers... basically waiting till labor started and then heading to the OR instead of the birth suite.  My own final decision was to wait till labor started and then play it by ear... any slowing or stalls or prolonged anything was my exit point.  I did NOT want another SD or tear.  As a VBAC mom the rc/s option is sort of always on the table and I knew I didn't "want" another c/s but I'd rather have a controlled injury (c/s) and known risks for my babe than an uncontrolled wild card that risked my babe's life and my own health. 

In the end the birth of ds went fast and furious and although he had slightly sticky shoulders there was no true dystocia and the 2nd degree tear along the existing scar line was pretty minor compared to a 4th degree!  Oh, dd1 was 9lbs6oz at 42 weeks, dd2 had the SDF and was smaller at 9lbs even at 40 weeks, and then ds was 9lbs8oz at 41/42 weeks.  I'm pregnant again and plan on using the same birth team/hospital... but I know I'll be taking a hard look at the odds come August/Sept.

I hope that babe doesn't keep you waiting, and that everything goes smoothly and safely for you both!

[MarleneCPM]

With all the things you have tried, I didn't see you visit a Chiropractic pelvic adjustment. That's what I'd try. Bet you anything your pelvis is out of alignment. Once your DC gets it lined up straight, your baby will come down &out in no time! happy birthing! I'd call 1st thing in  the morning, if I were you!

Marlene

[lsmama]

Thanks, Marlene.  You're right.  I have not had a chiro adjustment.  I saw a PT throughout my pregnancy to prevent this scenario, but I haven't been in a while.  I got a rec. for a chrio from the same PT.  I will call first thing.  Thanks for the suggestion!