i have a friend who is looking to do a vba2c with an ob. she's in a unique situation that i hope you ladies can help give some insight on.
the first major thing is that she has a congenital spinal anomaly where several of her vertebrae are either missing or fused together. with this her ribcage also shows anomalies, but her pelvic bones and legs are normal. she has carried three babies to term, though not without some discomfort. since she doesn't have much room in the abdomen, everything has to get out of the way more so than most, in order to give the growing baby room. and we believe that this is the root of the problem.
she birthed her first child (9 lbs, 24 inches long) vaginally, and after that pregnancy, her uterus never settled back into her pelvis. when she has routine gyn exams, she has to push *hard* on the top of her uterus in order for her cervix to pop down low enough to be seen. her second child settled into a transverse lie, and she had a c-section after a version and immediate induction did not work. after this birth, her uterus fused to her abdomenal wall, compounding the issue of her uterus not settling into her pelvis. her third child likewise settled into a transverse lie, and was born by scheduled c-section.
now she's pregnant with her fourth, and after looking for a long time, found an ob who is willing to work with her goals of having a vaginal birth. he's very liberal, as ob's go-- he was shocked/disgusted about why her first two c-sections were done, and does not schedule inductions before 42 weeks. his c-section rate is in the single digits, and he's one of the few ob's in our area that does vbacs.
so here we are. he's talking about scheduling a c-section because the baby's transverse and he's concerned about how her head will engage, since my friend's uterus is *outside* her pelvis. he seems willing to work with her and try a version if she comes to him already laboring, but at 41 weeks, he's doubtful that the baby will be able to turn on her own, given the size of the baby (comparable to the previous three) and the fact that there's very little room for it to happen.
we *know* she can birth vaginally. given that, do you have any suggestions for encouraging the baby to turn, and stay turned until labor starts? or would my friend be better off waiting until labor starts to encourage turning? or would going ahead and trying to turn the baby encourage effective contractions? she's been dealing with weeks of painful bh contractions already.
help?
thanks in advance,
christina
the first major thing is that she has a congenital spinal anomaly where several of her vertebrae are either missing or fused together. with this her ribcage also shows anomalies, but her pelvic bones and legs are normal. she has carried three babies to term, though not without some discomfort. since she doesn't have much room in the abdomen, everything has to get out of the way more so than most, in order to give the growing baby room. and we believe that this is the root of the problem.
she birthed her first child (9 lbs, 24 inches long) vaginally, and after that pregnancy, her uterus never settled back into her pelvis. when she has routine gyn exams, she has to push *hard* on the top of her uterus in order for her cervix to pop down low enough to be seen. her second child settled into a transverse lie, and she had a c-section after a version and immediate induction did not work. after this birth, her uterus fused to her abdomenal wall, compounding the issue of her uterus not settling into her pelvis. her third child likewise settled into a transverse lie, and was born by scheduled c-section.
now she's pregnant with her fourth, and after looking for a long time, found an ob who is willing to work with her goals of having a vaginal birth. he's very liberal, as ob's go-- he was shocked/disgusted about why her first two c-sections were done, and does not schedule inductions before 42 weeks. his c-section rate is in the single digits, and he's one of the few ob's in our area that does vbacs.
so here we are. he's talking about scheduling a c-section because the baby's transverse and he's concerned about how her head will engage, since my friend's uterus is *outside* her pelvis. he seems willing to work with her and try a version if she comes to him already laboring, but at 41 weeks, he's doubtful that the baby will be able to turn on her own, given the size of the baby (comparable to the previous three) and the fact that there's very little room for it to happen.
we *know* she can birth vaginally. given that, do you have any suggestions for encouraging the baby to turn, and stay turned until labor starts? or would my friend be better off waiting until labor starts to encourage turning? or would going ahead and trying to turn the baby encourage effective contractions? she's been dealing with weeks of painful bh contractions already.
help?
thanks in advance,
christina
