helping baby to descend;avoiding a section?

[inkedmamajama]

im trying to help my friend find ways to help her baby to descend...she is 40 weeks, her doc wants to section her at 41 weeks(no induction, just a section)

any ideas on helping her to encourage her baby to engage into her pelvis so she can avoid a section and have her fifth baby naturally? (fourth pregnancy-last pregnancy was twins)

tia

[SublimeBirthGirl]

Fire her doctor, hire a homebirth midwife, and wait. If she stays she'll probably end up with a cesarean even if she goes into labor. He's got her labelled.

[Lynnette]

If she is not having contractions, then there is no reason for baby to descend right now. Is there some other kind of malpresentation going on? I am not sure why a doc would just section without giving contractions a chance. sounds like bias against a woman having more than two pregnancies. I am not sure what can help. Maybe some time on hands and knees, crawling around, hand scrub the floor, belly binding with a sling, etc.

[Paige, CPM]

Jumping Jacks.

Sorry, I couldn't resist...Just what pp said...fire the doc and go to someone else who has a low (10% or less) c/s rate. Otherwise, step back emotionally and know that it is all her choice and love and support her in this choice.

Best of luck!

[inkedmamajama]

let me clarify-my friend, A. is looking for ways to avoid a c section and help her baby descend into her pelvis. she is 40 weeks, has been contracting regularly for some time, but when she gets to the hospital her contractions stop and she is sent home. this is her fourth pregnancy, her first was a c section and then she had a vbac and then a vbac with twins.

its simply not helpful to suggest she fire her doctor and hire a homebirth midwife at 40 weeks, as pro midwifery and homebirthing as i am, even i can see that. only a small, small percentage of women would even consider that, and the amount that would follow through successfully is even smaller-thats simply the reality, and when you add in that midwives are illegal in our state-thats not a helpful idea.

if you had a client that was having excessive prelabor contractions(not progressing her cervix, but definitely hard, painful, unable to breathe through and yesterday they were two minutes apart for over two hours) and she wanted to help the baby to descend into the pelvis, would you recommend squats? hands and knees position?

tia

[sweetsadie77]

I don't think anyone was trying to be unhelpful, the doctor is just being so outlandish with his plan that it does seem like the best way to avoid a c-section is to not see this doctor. It is so normal for a baby not to descend until active labour, the more so the more babies one has. Another way to avoid c-section and not change care providers is not to show up for a booked c-section. I
If she is having on again and off again contractions, the babe might be in a funny position (posterior). You could show her spinningbabies website. Suggest forward leaning positions like hands and knees, knee-chest, leaning over or sitting on an exercise ball. When resting, avoid reclining on couches, instead rest in side-lying. Homeopathic pulsatilla might help with the positional stuff, homeopathis caullophyllum can help settle down the contractions that are not changing her cervix, or help turn them contractions that will cause some change.
Good luck to your friend.

[Paige, CPM]

I am sorry if you felt that was unhelpful. You are correct when you say that very few women would switch, but the truth is that is the best thing one could do when they have a doc like hers. It sounds like you know this and were looking for something more...

And btw, my friend did some slow JJ, skipping and lunges to try to help change her strong bhx ctx that occured every day for two weeks before the babe came.

Just what you suspect, doing exercizes for positioning may help. It is hard when you have someone who has close together ctx and then they just go away, it is hard to know when it is real labor or not. She could go to the hospital when they get close but just not go up to L n D until she was really hot and heavey or even pushy, this way she would not have to deal with anyone until it was really time. Are you her doula, is someone helping her and going to the hospital with her who can help her determine when to go uo tp L n D? Sometimes it is just plain easier with someone else helping to determine other than the one in labor.

Good luck!

[MsBlack]

It is really not unusual for the baby to stay high when mom has had a few babes already. It is not a problem or a dysfunction, and it may be that nothing except real labor will bring the baby down. I have seen this--not women who did jumping jacks, but certainly who were quite active physically--gardening, going up and down stairs with loads of laundry, chasing toddlers, etc--whose babies stayed pretty high until the day real labor hit. Last time this happened, Mama only had about 4hrs of labor.

Your friend probably will not change care--but she certainly has every right to refuse to be induced or sectioned. All she has to do is say 'no thanks', and just not go to the hospital. WIth Paige, I'd suggest she not go into hosp again until things are really heavy, or even pushy.

[SublimeBirthGirl]

My point was, if she stays with that doctor it doesn't really matter if the baby drops. Odds are very high she'll get a section. She can try walking, squatting. But some babies don't drop until labor, or even until the END of labor when the mother starts pushing. If she stays with this doctor, he'll find a reason. She needs to stop going to the hospital when she has a few contractions and wait until she's in true active labor. Her hormones stop flowing when she goes in too soon.

[inkedmamajama]

we talked more about this today, and she really worries that the doctor is using fear tactics with her. he says the baby is too big. he says the baby is resting on her previous c section scar and will cause a rupture if he doesnt descend. she is demoralized to say the least. im going to help her with some relaxation and visualization, and wish on every star in the sky that her labor starts on its own before her doc can schedule a section.

thanks for the tips.

[Jyotsna]

Bumpy car rides, sex, nipple stimulation to get labor started up more seriously, and deep squats to help baby descend pelvis.

However, as pp pointed out, unless baby is ready to decend, baby won't. Some babies don't decend until they are being born.

Has she tried red raspberry leaf tea? What about seeing a chiropractor or acupressurist? There are many points on the body that when pressed will help get labor started if it is just nearly ready to start.

Also, while it might seem silly, your client does need to relax, do some deep breathing (in nose as deeply as possible, and out mouth while blowing). Yoga, stretching, walking, bouncing on a birth/excersise ball.

I would talk to her about her patient rights while she is under the care of a doctor or in a hospital (go to ICAN.org and look for patient rights).

Sometimes it is all she needs to know that she has the right to refuse treatment, and the right to leave if she truely wants to leave the hospital. Perhaps she won't, but don't hold back on information for her, as she will need to be the one to make her decisions.

Remain supportive of her, allow her to express her emotions, remind her to be sure and get plenty of rest, and stay well hydrated. The emotional and physical state is very important right now, as she is likely feeling overwhelmed.

HTH's

[Paige, CPM]

Inkedmamajama,

I am guessing you did offer her the names & numbers of the best care providers in your area? I know you said it is rare for someone to change but I do know of several people who have... Never hurts to try. Boy that doc is awful, I wouldn't want him to touch anyone with a 10 foot pole, unless they needed surgury, then he's probably pretty good at that.

Best of luck...I am sending peaceful birthing vibes.

[multiplemomma78]

see a chiropractor

I would suggest that start TODAY to see a chiropractor that can do something called the Webster Technique. It's usually for breach babies, but can also help an Posterior baby turn around. It basically releases the tendons on both sides of the uterus that can hold the baby in an awkward position-making it difficult for the baby to turn on it's own. Or her pelvis could be tilted just a tiny bit that would make baby's descent hard or impossible. True CPD is very RARE-only 1% of diagnosed cases of CPD (pelvis too small for the baby) is really CPD. My suggestion is that she do all the suggestions on spinning babies and see a chiropractor as many times as she can before she goes into labor. And possibly even a accupuncturist can help, too. Best of luck!!!

[amygoforth]

Originally Posted by inkedmamajama

if you had a client that was having excessive prelabor contractions(not progressing her cervix, but definitely hard, painful, unable to breathe through and yesterday they were two minutes apart for over two hours) and she wanted to help the baby to descend into the pelvis, would you recommend squats? hands and knees position?

Just wanted to chime in that I would not recommend squats at this point, if the baby isn't yet engaged in the pelvis. Sqauts, while they significantly open the pelvic outlet, will decrease the opening of the pelvic inlet. So the babe would be less able to move down. Make sense?

All other positions are good ones though... hands/knees, lunges, stair-stepping, etc. Good luck to this mama. I hope you're able to help her find her innder strength and wisdom to just say no to this doc.

[onlyboys]

With her fifth baby, I seriously doubt the baby will descend too much into the pelvis before labor begins. It's silly for the OB to be suggesting c/s...it sounds like the all too familiar bait and switch to me.

With my 4th, my baby didn't enter the pelvis until labor began.

I know these suggestions may not seem helpful, but honestly, combatting against an OB who is hell-bent on a scheduled cesarean birth, there's not a lot she can do except say NO. NO. NO. and then repeat herself.



Edited to Add: VBAC labors are often like you're describing. There's a really good thread here where a mama went through VBAC labor online, or updating regularly and it was very similar to what you're describing--start and stop labor for days.

[ckhagen]

Originally Posted by SublimeBirthGirl

My point was, if she stays with that doctor it doesn't really matter if the baby drops. Odds are very high she'll get a section. She can try walking, squatting. But some babies don't drop until labor, or even until the END of labor when the mother starts pushing. If she stays with this doctor, he'll find a reason. She needs to stop going to the hospital when she has a few contractions and wait until she's in true active labor. Her hormones stop flowing when she goes in too soon.

ditto. ditto. ditto. all of it.

This Dr. has already made his decision. If he isn't aware of the fact that not all babies drop before or even during labor, then he doesn't know what he's doing. If he does know that and is pressuring her anyway, then he's just out to cut her. Lose, lose.

My VBAC baby didn't drop until I was pushing. He was "floating" until well after I started pushing and only dropped in the last...ehhh... 30 minutes or so out of 80-90 minutes of pushing. It takes an attendant who knows this, trusts this, and wants you to succeed to allow this natural progression to take place. Unless you're UCing, you've got to have a supportive CP in this situation. If I hadn't had such a supportive CP, I would have been sectioned hours, days, or weeks prior, no doubt about it.

If she's not going to switch, she's just going to have to stand firm and wait it out. Hands and knees, inversion, and such won't hurt. But they may not be a magic solution either.

[Jane]

When she actually goes into labor - the baby will come down. There's a lot of room in her uterus - she had twins, after all. And, it's not a first or second baby, after all. When contractions start and cannot be stopped by comfort measures like showering, drinking lots of water, or resting, and cannot be stopped by intrusions, like going to the hospital...the baby will come. She just hasn't gone into labor yet.

While I like the suggestion of a HBAC, perhaps she needs a montrice - a person who checks FHT's at home, so she can comfortably labor at home without worrying about rupture.