shoulder dystocia--ignorant question asked in good faith - Page 2

[Jane]

From many of the stories I've read, it seems to be the "flip" that helps.
Hands and knees used to seem the answer to me, but I've heard of quite a few now that happened in that position to start with. (thanks for the story, carrots)
I think that there is a lot to just trying what you are NOT doing right now. A reversal, or sorts, to one of a few maximizing positions. To find the release that will allow the baby out.

[BusyMommy]

Boy, this has been a scary thread. I knew it was serious from the mw' tone of voice, but deliberately never sought out more info. after.

Guess it was the "flip" that did it for us.

[Jane]

Boy I'm feeling talkitive tonight, but I think that's one of the coolest things about having a midwife, you know when her voice is serious and commanding.
Seems like you can tell when it's a request and when it's an order, but in a nice way. That make sense?

[BusyMommy]

Oh yeah, her words were totally normal but something about her voice was like cracking a whip. I jumped out of the tub and onto the bed so fast they hadn't even put a sheet down yet. :LOL

[Greaseball]

So, if you think you may have a large baby, should you just start out pushing on your hands and knees? Will this prevent most s/d cases?

[CarrieMF]

My dd got stuck when she was born. Her case was more urgent because her heartrate had already gone down to 13 once and was around that low again(fetal scalp monitor)when she crowned. I had 2 nurses and the dr yell at me to get my legs back as far as I could, before I could react they did it for me. She crowned with her hand up by her face. The dr reached in and pulled her out. She was 2wks overdue and only 6lbs 5oz. He did not need to cut me or break her collarbone.

About 3 weeks before I had her, an online friend had her son. He was stuck and they had to break his collarbone. When it healed, it caught a nerve and he still has limited mobility and pain in that arm.

[Defenestrator]

Originally posted by Greaseball
So, if you think you may have a large baby, should you just start out pushing on your hands and knees? Will this prevent most s/d cases?

I think that moms should be able to choose their own positions for pushing, no matter what the size of the baby is. Moms will naturally choose positions that alleviate pressure that they feel internally, so they will have an advantage over any midwife or doctor in picking the position that works best for them. Certainly pushing in a squat or a hands & knees or sidelying is better than semi-sit in most cases because the pressure is taken off of the tailbone, but I think that when we impose a specific position on a mom because we are afraid of a complication, it can be counter-productive.

Positions that open up the pelvis help, but there is a varient on nearly every position that achieves this. For semi-sit, mom can be tilted back for McRoberts. For sidelying, if there is a tight fit, you can bring up one knee to simulate a lunge. For squatting, squatting deeper or wider can help (though squatting itself does a lot already. For standing, lunging can help. For hands and knees, doing the runner's stance helps. A lot of times, when there is a tight fit, the mom will feel the internal pressure and shift on her own, if she is in an environment where she feels comfortable doing so.