Cervical lip and presenting hand

[springbabes]

This is really more my curiosity than anything else. My sister just had her first baby yesterday morning after a 27 hour labor, a completely drug-free hospital birth. She was almost fully dilated save for a lip of cervix at 2:30 am. They tried position change and pushing the lip out of the way but nothing worked. She was like this for 3 hours and pretty much feeling like she needed to push the whole time. Finally they just decided to let her push through the lip. 20 minutes later the baby was born with his hand up by his head, weighing more than 9 lbs!

My questions--Is there any risk to pushing with a lip? Why would they make her wait 3 hours if it's possible to birth the baby with a lip? It seems like in a more natural setting she would have just pushed when she felt like it rather than waiting until she had permission, yk? I know that often lips are caused by malposition. In this case (since pushing went so well), do you think the presenting hand caused the lip?

In doing a little research on the web yesterday, I think she is lucky that it turned out so well. I thought she might be a little traumatized from such a long, painful labor, but she is just damn proud that she did it all med-free .

[MsBlack]

The only problem w/pushing against a lip is when it doesn't work--I tell moms w/lip who want to push--go ahead and try, we'll see what happens.

If baby is well enough positioned and ready to come down, pushing can make the lip disappear. However, if baby is really not ready to come down, pushing will waste energy and cause lip to swell. I've never seen a problem with trying to push--usually, within a few tries it becomes very obvious whether or not that baby (and the cervix) is going to move w/pushes. I know mws who will have moms push for hours against a lip, also using her fingers to push lip away while mom pushes--but this is stupid since it is seldom a small piece of cervix keeping the baby up there--it is baby's positioning and/or moulding issue (sometimes baby will stay high for awhile, even if well-positioned, while head slowly moulds to right fit for mom's pelvis). If pushing is not effective pretty soon, then it's back to helping mom manage breathing through ctx and finding positions for her that help baby find it's best position for birth.

[pamamidwife]

usually an anterior lip is a normal part of dilation and will not hold a baby up or swell. if the baby isn't positioned "right" - asynclitic, hand up by the head, etc., this can cause the lip to swell and make it hard to get the head through the cervix.

time is usually what is needed, along with positions to help move the head into a better position.

[Maggi315]

I agree with above posters. I have had 2 births recently with this same problem. (one yesterday!) The first one, we were able to wait, switch positions, slowly bear down (to stretch, not to actually push), it was long (17 hours labor) but it worked!

Last one, mom was having unresistable urges to push, lots of pain, so I "held" cervical lip out of way as best I could. She did have lots of swelling which worried me, but we worked through it and baby and mom were fine!

[nurnur]

I think one difference when talking about cervical lips is does she feel like pushing. It's rare that the body will lead us astray. If there is a lip and she is having the urge to push I have seen it melt away as she follows her body, but if there is a lip and she is not pushy yet ~ TIME TIME TIME as Pam said. I had a lip, was not feeling pushy and the mw wanted to try to hold it back during a few contractions....OUCH, that was the worst part of labor for me and really started to steer things in the wrong direction, it took me a while to get my bearings again. But I second the notion that your sis was lucky, they have sectioned many a women with a stubborn cervical lip.