Question for midwives, doulas, or other birth experts....

[zipworth]

Hi, I have a question. But first, some background:

I have given birth twice. Both were in hospitals. I learned the hard way why some women choose home birth instead of hospital birth! The hospital births were kind of scary experiences. The first time, I don't think I was prepared for the amount of pain I felt. I felt blindsided, as I chose only to focus on the stories of those who had two-hour pain-free labours. I made it to 9 cm dilation, but I had no idea that's how far along I was. My nurse was young and inexperienced, and was in disbelief that my contractions were so continuous. I was in intense, panicky pain, because I didn't know I was in transition. So I caved for the epidural. I was 9 1/2 cm dilated: . I pushed for two hours and made no progress. He was stuck, so they delivered him via vacuum extraction.

The next time I went to give birth, it was like the birth of my son happened yesterday. I felt fear this time, my body wouldn't relax. I was so afraid of all the procedures! I caved for the epidural at 5cm dilation. I pushed and pushed, apparently my baby was stuck again, this time they delivered via forceps.

My question is; am I doomed to having stuck babies? My doctor thinks I should schedule a c-section if I have another child. Could all of this be due to the fact that I had quite a lot of medical intervention? Is there something I could do differently to have a more natural birth? I feel as though I don't know enough here........:

[stacey2061]

i'm not an expert but i did have a birth that took way too long due to my own anxiety and stress caused my being in a hospital with unfriendly nurses and drs. my son was born via vaccuum after 2.5 hours of pushing and i know in my heart it was because i didn't feel good about where i was. you are entitled to at least try for the birth you want. have you thought about planning a homebirth or at least going with a midwife next time around? good luck

[zipworth]

Thanks, I am thinking about it, but now I am afraid that my body is somehow defective and it causes my babies to get stuck. That is what my doctor has told me, and she has given birth herself naturally, with no interventions, 3 times. Sigh.

[SublimeBirthGirl]

There's no way to know for sure but I'd guess if you'd been at home, comfortable with a trusted midwife who supported you through transition instead of drugging you, your babies would have come out just fine. If your doctor recommends a cesarean, I'd certainly switch, at the very least, if you have another.

[AKmoose]

I'm just going to guess that you were pushing on your back, legs up? Lithotomy position, standard hospital-style, right? Physiologically this is just asking for baby to have difficulty being born - and asking for a "stuck" baby! Without an epidural and poor pushing position, you could have assumed better positions for letting baby come out - ones that let gravity work!

I also completely agree with the pp re your doctor. I think anyone who so casually recommends major abdominal surgery doesn't deserve your business!

I highly recommend reading lots on positioning (i.e. Janet Balaska's Active Birth) and what interventions can do (i.e. Henci Goer's Thinking Woman's Guide to a Better Birth) and pursuing midwifery options around you. There are physical manuevers (i.e. Gaskin Manuever) that can be used at home in the extremely unlikely case that another baby was "stuck" (basically, getting you to hands and knees). I've heard from many moms that just working through past births with a midwife, and understanding that they can assist you in the off chance of problems, can be quite freeing.

Good luck and take care.

(p.s. sorry, also not a birth "expert," just a mom of 2 with a lot of research into birth practices...)

[christifav]

I had my first in the hospital and after 3 hours of pushing the doc went to grab the forceps. Luckily the nurse warned me and gave me the strength I needed to push the baby out before the OB got to me. My daughter was 7lbs 12oz.

I had my son at a birth center with a midwife and he literally popped out with no pushing at all. He was 9lbs 6oz. I absolutely think the reason my larger baby was an easier delivery is because of the birthing environment.

I'd put my money on you having a natural delivery if you plan it that way. At home or at a birth center. Having a midwife in attendance (as opposed to going unassisted) can give you the security you need so you don't worry. If baby truly gets stuck, the midwife will be able to diagnose in time for a safe hospital transfer. You can relax and enjoy the birth without fear.

Good luck!!

[Jster]

I'm not a birth "expert" either, other than years of reading, talking, and my own two birth experiences.

But interventions and positions have tons to do with whether a baby descends quickly or not. And a truly "stuck" baby really is only when part of the baby can't descend...sometimes it happens in shoulder dystocia, when the head is born but the shoulders have trouble fitting through. If the baby has already descended far enough for vacuum extraction or forceps to work, the problem was not with your body, obviously, but with the environment and support.

I'd strongly recommend, in addition to you considering a different birth environment, is getting more prepared to handle labor pains without medication. If you try a serious natural childbirth class (like the Bradley method) or hypnobirthing, you will be much more ready to make it to second stage without being confined to one position, having only limited sensation, etc., like you did with your epidural births. And maybe a doula or other support person who can help you through the labor, reassure you that it's normal and that you will meet your baby soon, etc.

But be reassured, you can have a natural vaginal birth! Women have vba2c, you can do it, too!

[zipworth]

Nak

I just wanted to add that I tried the birth bar (squatting), and sideways, but never on hands and knees. Both of my children's heads were sideways in the birth canal.They (the obs} said I have a 'pelvic anomoly'. that causes my children to get stuck. What does this mean exactly? I have read 'birthing from within', and a book by Ina May Gaskin.

[sweetsadie77]

Your babies fit out of your pelvis. Forceps and vacumns don't change the shape or size of your pelvis nor do they make the baby smaller. I don't see any indication for a scheduled c-section the next time around. You and your babies were fine after the birth?
An unmedicated birth may help you move into a position that will help you push that baby out, it may also help you feel the pushing urge less. You could also consider a less medicated birth (with entonox or fentanyl) where some of the edge is takes off but you are still mobile. If you are planning a hospital birth still try to stay home as long as possible (your environment and furniture are more comfortable and comforting). The less time you are in the hospital the less time you have to be put onto their charts and measures for progress. Hire a doula, change providers, use water for pain relief, read more, make a plan, imagine deviation from your plan...
Best of luck to you,
sadie

[zipworth]

Thanks Sadie! So there is no way a baby can be stuck?On my pelvis?Why wouldn't the birthing bar have worked? Sadie, are you a midwife?

Could someone also tell me what the negative effects of an epidural are, induction of labour, and a cesarean. I have read these things many times, but seem to have put it out of my mind.

Thank you so much......

Natalie

[amyro]

Epidurals actually cause babies heads to get stuck in the pelvis in the OT or OP position. You said your baby was stuck side-to-side which means it was stuck OT. This is highly associated with epidural use. See the second summary in this group of summaries.

It is true that some women have a pelvic shape that encourages babies to descend in OT or OP, but in your case I think it was much more likely to be the epidural combined with your high level of anxiety. If you are going to have another baby, I highly recommend reading "The Labor Progress Handbook" by Simkin and Ancheta. It's written for doulas, nurses, midwives, etc. but very understandable by people who don't have a medical background.

The pushing part of labor is very different in most midwife-attended births compared with what you might have experienced. The midwife gives calm reassurance and assists with position changes, supports your own urge and instincts with pushing, and provides perineal support and comfort measures if you need/want them, etc. Most of what happens in the typical hospital - coached pushing, bright lights, strangers coming in, not to mention the epidural, can really impede progress and put more stress on the baby.

I hope that helps!
-Amy

[cottonwood]

Like a PP said, if your pelvis is big enough for your babies to be born with a vacuum extractor or forceps, it's certainly big enough for them to be born without it. I'm assuming that they had you start pushing at full dilation, and that might have been part of the trouble, because full dilation does not mean your body is ready for the baby to be born and can interfere with the body's natural functioning, i.e., making second stage longer and more difficult than it would be otherwise.

[applejuice]

I am not an 'expert" either, but I have had four children at home, I was witness to the birth of seven of my eight siblings, and I also have been honored to have witnessed the birth of kittens and puppies many times.

A female mammal cannot and will not give birth if that female mammal does not feel safe. Labor will stop cold if the female mammal feels fear and does not feel secure about her environment.

If the progress of your labor stopped because you were in fear, then you know you did not feel safe. Just a wild guess here.

Few women do feel safe in the hospital which is why there are so many interventions performed there. Just an educated guess.

[Juvysen]

I would find another doctor (or a *midwife*) that has some understanding of how fear works against labor and how interventions (and telling you you should schedule a C) works to increase your fear and decrease your success.

[lechepatito]

Chiming in to agree that your positon during labor, and the baby's position during pg and labor, probably caused the diagnosis of being "stuck." Failing to progress during a long labor is a classic sign of a posterior baby - check out this article for more info:

http://www.plus-size-pregnancy.org/malpositions.htm

[lunaleau]

I am a doula and midwife in training and a mom, ( expecting #2 vbac in a few weeks!) I had a c-section with my first baby, it was a planned hb then transport then c-sec and I think a lot of it had to do with not trusting my hb midwife. In hind sight I can say I am glad I was not at home with her because I do not think she would have been able to handle my son's presentation and size. ( I think that biog babies can be born vaginally it just takes very proactive positioning and effort, my son was 11lbs plus ) With that said I work in a hospital setting and I find it amazing that you did not get sectioned with either of babies! Dr's are so cut happy these days! Be thankful that you didn't! My current midwife is big into assesing the best ways for babies to descend and helping me achieve that.


1)I would echo many of the other posters and add that a supportive care provider is sooo important be it midwife or dr, interview, seek out what is really the best place for you home or hospital where you can feel the most safe.2) get good chiro care in pregnancy, not just at the end, find someone who specializes in pregnancy and webster technique 3) Use a birth tub!! You will never regret it! 4) surround yourself with positive birth images, watch videos of unmedicated birth and see another way of birthing, notice the proactive positions and yes notice how hard it may be for some moms but also how they are successful! See if there are any doulas around you who may let you shadow and see what is normal in birth.

Risks of c-section: babies are 2x as likely to die and mothers are 3x. Though they are rare. Any risks associated with major surgery, infections, cutting through other organs ( bladder, bowel), reaction to anesthesia, never the recovery SUCKS!!! If you can't guess I am not a huge fan unless it is absolutely necessary. It was irresponsible for the dr. to undermine you confidence in such a way, her experience is not yours and should never be compared. Good Luck you will find your way.