Wwyd? - Page 7

[liseux]

"Yet in 85% of shoulder distocia cases, simply going on all fours solves the problem within minutes."
RomanGoddess

As someone who has researched S.D. tirelessly, I have to say that this is true for sticky shoulders, but not for a severe s.d. My s.d. did not respond at all to Gaskin maneuver. An episiotomy could become necessary if breaking the clavicle is the goal (last effort really,before Zavinelli--which has a horrible record) and the attendant can't get her hands in far enough. A truly severe s.d. becomes very apparent when hands and knees does nothing at all, then you know its really bad.

As for the hospital, honestly, I had an incredibly skilled mw who had lots of experience with s.d. and she couldn't free my baby. There's no way to know how bad it can be. I don't feel that an OB would have better luck with a bad s.d. in a vaginal birth. So, I chose surgery. The advantage the hospital has is really powerful resuscitation. Midwives don't carry heart drugs and defibrillators. It can get that deep & O2 is not always enough.

Ruthe, I agree completely. I had to give up all of my ideals and it can be very lonely. I'm OK with it now. Its excruciating to visit your child for 7 weeks and spend the first 4 being blamed by every NICU nurse for choosing hb. I have had great c/s recoveries, tons of skin to skin and continue to have healthy children, so I am very grateful.

[Ligmom]

I voted arrive late at the hospital, but after thinking about this since yesterday, I really feel I would elect to have a c-section. i don't say this lightly as I have had a c-section and vaginal births (1 in hosp., 2 at home--all post c/s), and I am also a doula and natural birth advocate. I simply think that you have had two births and both times you have had the same complications--not a small complication--but very serious, life-threatening complications. I wouldn't risk placing myself in the same situation again.

And in my experience healing from my c/s was a breeze compared to healing from my 1st homebirth. I hemmorhaged following the homebirth and was tired and weak for weeks-- I also had delayed lactogenesis due to anemia from the pph. I still opted to homebirth again, but hemmorhaged a second time. We are done with having babies, but if I were to have another it would probably be in the hospital.

hugs to you...hoping you find peace with your choices.

[Romana]

I would choose to have a c/s. I would not want to take the risk of a repeat . . . with that history, I would feel that SD was too likely for any other birth to make sense. I'm supportive of homebirth in general, but I think that risk-outs are there for a reason. I think with that history, though I wouldn't be happy about it, I'd consider myself "risked out" of vaginal birth - or at least, my babies risked out. I want a live, healthy baby. With the knowledge that things had been difficult twice, with one good and one terrible outcome, I think that I would choose to have a c/s.

Good luck to you. You have time to think about this. Do you have anyone you can talk to about your options and what would feel right for you? I hope that you do.

[Om Girl]

Seeing as how both of your labors had shoulder dystocia and PPH I would avoid arriving late to the hospital, as there wouldn't be anyway to prevent these things from happening en route. Besides positioning during second stage labor can help with shoulder dystocia immensely. Have you had pelvimetry done and know what kind of pelvis shape you have, as well as Webster chiropractic care to help your pelvis and ligaments settle into an optimal place for baby with either pregnancy?

Before TTC again I would definitely considering nutritional counseling to get your iron levels above average and having pelvimetry done and complementing your pregnancy with prenatal yoga and Webster certified chiropractic care to give yourself the best possible chance of a vaginal delivery.

[kittywitty]

Well, I know your stories and I would either hope to move somewhere more midwife friendly or where there is a birth center, or maybe check out going to the Farm for the birth. Or I'd UC. I would never have an elective c/s. Especially not with your history.

I had a pph for the same reason as your first (doc yanked out the placenta and shoved hands up me), and a pph with my UC (little bit of placenta stayed inside and could have been easily dealt with if I knew to take more angelica and not more shepherd's purse and do more massage). I would never submit myself to the trauma of a c/s or a hospital birth voluntarily after my 3 hospital births.

C-sections are serious abdominal surgery. If you have pph from your natural births what is to rule out any extensive bleeding from your uterus being cut open unnaturally? It still has to heal and cramp down. I don't see how people would vote for an elective c/section. Especially for reasons that aren't prevented by them. You had one dystocia/compression and one healthy birth followed by some bleeding that was stopped. Neither seem to be related, though some nutritional work and building up your blood would be good bets for the future.

http://growingyourbaby.com/2006/08/3...ter-c-section/

"Some complications that can occur during or after a C-section include heavy bleeding, damage to the bladder or intestines, major infections of the uterus, kidneys, lungs, or other areas, opening up of the skin incision, blood clots around the uterus or in the leg veins or lungs, an inability of the blood to clot, and damage to the uterus that makes future childbirth more dangerous. The uterus is a large, muscular organ that has an enormous blood supply. When an incision is made into the uterus, there can be a lot of bleeding. Modern doctors have medications and stitches to stop this, but even so, there are some women who need a blood transfusion during a C-section. (Others, on rare occasions, need a hysterectomy to save their life).

Most women who undergo a C-section need to take oral iron pills, since the blood loss is at least twice as much as during a vaginal delivery. A number of women develop uterine infections, requiring extra days in the hospital and powerful antibiotics. "
http://www.childbirthsolutions.com/a...rean/index.php

[dinahx]

I say natural minded CNM with Groovy Doctor backup. I sincerely hope you can find this in your area!!! I wouldn't go to the hospital at the last minute, I would just go to the crunchiest hospital you can find locally.

[wbg]

Big hugs to you...
I would definitely go to hospital. You have many months to prepare yourself and your body for your next birth. I would find the most supportive doula and birth team, and then try to create the most empowering, natural birthing environment within the hospital. I know this is easier said than done, but I think with your history it is worth a little compromise in placing yourself within extremely close proximity to advanced life support. I also would not show up late to the hospital. It seems to me that you have a valid reason to be there early. You can still avoid unnecessary interventions. You know your body and can tell when signs of a real emergency warrant an intervention. And defs, work on nutrition over the next few months and on building higher iron levels. Enjoy your little one and I wish you all the best of love and smiles and warmth on your journey to build your family.

[madiesmommy]

I voted other. I would try to find an OB/CNM for a hospital birth, but the problem I think will be finding one that doesn't push for a schedule section because of the s.d. I don't think they'd be comfortable inducing you either, due to the pph issues, so that is why I think you'd be pushed to a scheduled section. Only you can decide if that is right for you! If it was the only way I was comfortable having kids after the issues and loss you have had, I would go for it in an instant to hold another babe in my arms. But I am not you.

Because I have to know all available options, I would probably look for an undergound mw or two to interview also. With your history, I don't know that they would take you on, but it never hurts to ask. I would then want to know about any and s.d. cases and their plans for that and pph... In your favor is how close you are the hospital and your experience now with s.d.

I would NOT show up pushing at the hospital though..although, with your length of labors that might happen anyway! You definently could not overcome s.d. on your back and I think without knowing or having a doc you have a relationship with, you'd be a section in a heartbeat...

Hugs to you and good luck in your healing!!

[Hallielynn01]

I think I would have to say, in your case, that a hosptial birth would be the safest choice, you know, three strikes....... as others have said, it doesn't have to be a terrible experience. Plan your team well! the following is just my personal opinion.

I am not of the camp that believes "a healthy baby is all that matters" while that is the main goal, I believe in the power of the process and the way it changes a woman. That said though, if you are putting yourself at a risk to do it, I'm not sure its worth it, since you can achieve a peaceful, beautiful experience, in a hospital setting. I've been to many.

I would say no to a UC, which I have to admit, while I support a woman's right to do it, I've never been a fan of it myself, even through out history, there was normally an experienced woman nearby to help in the process. But you don't have a track record of uncomplicated birth. As for the homebirth part, well, I really mean no offense, but right now in our country, homebirth is under attack, and being called unsafe. There is what is considered "Safe" homebirth, and I feel that we need to protect this right, and make sure that birth is kept in the safest place. Home or birth centers for healthy women, but for women with pregnancy related problems, history of problems in previous births, those women should birth in a hospital. Groups are taking statistics of births out of hospital, and using them to form their case against allow us to continue birthing where we choose.

So ultimately its your choice, I support your right to choose. It just seems to me, with your history, the safest place would be the hosptial. I wouldn't recommend showing up pushing, but perhaps with the help of a doula, you can go in at a time when you are in good active labor, and not needing much if any intervention or augmentation.

[yarngoddess]

I voted other. I don't know what to say. If I really wanted more biological children I would birth in the hospital. I would be a PITA patient- and my doc would at least be prepared to justify E.V.E.R.Y. little thing. I would ask my last MW (assuming you still like her) to be there with you.

I also would be comfortable not having more children too- as I've read your story about your beautiful little girl. I was so happy for you when I saw that you had Brodie!

I think that you and DH really need to wait, first. Then in a few years if you want more children I would explore all your options at the hospital. I would meet all the doc's in the area.

And, WHO know's if you will be there when you have another- or start looking into it. You may be in a place (location) that's got better laws about home birth and find some amazing midwife that you love and is comfortable with your situation.

[Dmitrizmom]

First.. s to you OP. I am sorry for you loss.

Second: some posters have mentioned the baby being large as a primary cause of sd. In fact, most cases of sd are in babies of normal birth weight (source - this article has some interesting information about the c/s option and induction).

I chose other- as many other posters, showing up in labor/pushing does not appeal, nor does c/s. Adoption is a wonderful option. The thought of a UC with your history is terrifying to me - too many risks. While concerned with the health aspects (would she even have access to the meds to treat a potential pph? - I don't know), I also must express concern over the legal issues of homebirthing with an unlicensed midwife.

I have not been faced with this decision and wish you wisdom as you make the choice that is right for you and your family.

[Rockies5]

I only read the first page or responses.

I voted "other" because the options were limited.
-Why is the only choice for MW underground (assuming this means uncertified)?

I only have the details you've givn on the first page, but I don't see how either complications were the fault of the place of birth the first two times.
Since you asked what I would do...I'd give it prayer and time. I'd allow the decision to be a process not a reaction.

I'd see what other options are available that would be comforting to me.

Wishing you : joy and healing. Prayers for your little ones.

[liseux]

"If you have pph from your natural births what is to rule out any extensive bleeding from your uterus being cut open unnaturally? It still has to heal and cramp down. I don't see how people would vote for an elective c/section. " kittywitty

I had pph with s.d. and then I had 2 c/s with minimal blood loss. I have never needed iron and my milk was in at 24 hrs pp. I think maybe you're thinking about emergency c/s. Scheduled c/s involves stopping the bleeding of each vein as it is opened, its controlled and quick.

I can tell you how someone would vote for elective c/s, and I can also understand where you are coming from.

Before I had lost my son to s.d., while I was still pregnant, I remember talking to a LLL leader about tandem nursing. She told me she had had 3 c/s. One was typical intervention caused, the second was a Zavanelli manuever in the middle of a VBAC with a fatal s.d. The 3rd (and she was very lucky to have her uterus after a terrifying & violent Zavanelli) was a peaceful, scheduled c/s. Natural birth friends still recommended VBAC to her. She felt totally alone in her mom-friend community, yet her 3rd c/s was amazing & healing & she and the baby left 24 hrs later.

I also didn't understand choosing c/s. And then it happened to me, and for me, I realized homebirth was never about me. I wanted no separation from the baby and no fights, while in labor. With my 2 c/s I got that, so for me I am Ok with it. Its not easy, but its possible to have a beautiful, peaceful c/s if your mind is open to it.

I also learned that when you are the horror story the only ones that understand are ones that have been there. I would never judge any mothers choices in birth, ever again, & I once did. We all have to live with our choices and the pressure on each other needs to let up.

[Romana]

Originally Posted by liseux

"If you have pph from your natural births what is to rule out any extensive bleeding from your uterus being cut open unnaturally? It still has to heal and cramp down. I don't see how people would vote for an elective c/section. " kittywitty

I had pph with s.d. and then I had 2 c/s with minimal blood loss. I have never needed iron and my milk was in at 24 hrs pp. I think maybe you're thinking about emergency c/s. Scheduled c/s involves stopping the bleeding of each vein as it is opened, its controlled and quick.

I can tell you how someone would vote for elective c/s, and I can also understand where you are coming from.

Before I had lost my son to s.d., while I was still pregnant, I remember talking to a LLL leader about tandem nursing. She told me she had had 3 c/s. One was typical intervention caused, the second was a Zavanelli manuever in the middle of a VBAC with a fatal s.d. The 3rd (and she was very lucky to have her uterus after a terrifying & violent Zavanelli) was a peaceful, scheduled c/s. Natural birth friends still recommended VBAC to her. She felt totally alone in her mom-friend community, yet her 3rd c/s was amazing & healing & she and the baby left 24 hrs later.

I also didn't understand choosing c/s. And then it happened to me, and for me, I realized homebirth was never about me. I wanted no separation from the baby and no fights, while in labor. With my 2 c/s I got that, so for me I am Ok with it. Its not easy, but its possible to have a beautiful, peaceful c/s if your mind is open to it.

I also learned that when you are the horror story the only ones that understand are ones that have been there. I would never judge any mothers choices in birth, ever again, & I once did. We all have to live with our choices and the pressure on each other needs to let up.

Just wanted to this as it bears repeating and is beautifully said. I thankfully do not have a horror story, but having given birth twice I'm awed by the power and relentlessness of the experience and so much more respectful of the risk and how each mother's choice may be different.

[channelofpeace]

Originally Posted by liseux

I also didn't understand choosing c/s. And then it happened to me, and for me, I realized homebirth was never about me. I wanted no separation from the baby and no fights, while in labor. With my 2 c/s I got that, so for me I am Ok with it. Its not easy, but its possible to have a beautiful, peaceful c/s if your mind is open to it.

I also learned that when you are the horror story the only ones that understand are ones that have been there. I would never judge any mothers choices in birth, ever again, & I once did. We all have to live with our choices and the pressure on each other needs to let up.

Thank you for this perspective.

[essnce629]

I didn't read all the other responses and when I first read your OP I was going to vote for a hospital birth where you show up pushing. But then I got to thinking and mostly if you experience a shoulder dystocia in the hospital they're just going to section you anyways. I think your last midwife was extremely qualified and it looked like she handled everything perfectly, both the dystocia and the hemorraging. So I voted for "find an underground midwife," basically one with just a much experience or more than your last midwife. If you couldn't find an excellent underground midwife experienced in shoulder dystocia and hemorrage then I'd opt for a hospital birth and try to find a doctor or midwife who also had hands-on experience with shoulder dystocia and could overcome it without jumping to a c-section immediately.

[Jilian]

I didn't read all of the replies but I would likely give birth in the hospital with the MW as my doula and stay home as long as possible. Find the best CNM you can and make sure she's on board and experienced in delivering a dystocia.

I remember reading about your loss I didn't realize you had another dystocia, that must have been so scary for you. I'm glad you and your baby are ok. I know how much it sucks to kind of be forced into delivering in a hospital when your heart says homebirth. We will be facing the same kind of decision when we try for our third baby because of DS2's heart defect.