cerclage and shoulder dystocia questions (2 separate ?)

[lola731]

Hello-

I always post here when I have questions, and everyone has always been so knowledgable, so thank you! I have 2 questions:

1. once a cerclage is removed, is the labor any different (i.e. shorter) than for moms who did not have a cerclage? I know it varies between women, but just to get an idea in general would be nice

2. i'm working with a mom who is pregnant with her second child. her first birth was natural, 6 years ago, but the baby had shoulder dystocia. her doc is concerned about that happening again, and is talking about a c-section for her, and i think even recommending she get an epidural, because if this baby is positioned the same, then he/she would be easier to rotate...what are your thoughts on this?

thanks a bunch for your insights!

carrie, mama to jake and lola

[lola731]

for question #2, her doc is suggesting an epi. for a vaginal birth.

[MamaTaraX]

1. A cerclage labor can be faster, slower, or just the same as without. They tendto go into labor faster (i.e. once the cerclage is removed). Like if you have one removed at 35 weeks, there'sa slightly higher chance that you'll deliver at 36 or 37 than later. But, there areplenty of women who have had a cerclage in place for months only tohave it removed and go post-dates. Labors themselves tend to vary.

2. If afirst baby is a shoulder dystocia, there is a higher liklihood that second or subsequent babies will have shoulder dystocia as well. That doens'tmean that it will happen. Having an epidural won't help your client's chances much, so I'd try to educate herout of that. It sounds like the doc wants her to have an epidural so that it wil be easier to talk her into a c/s for a shoulder dystocia that may or may not occur. As for anepidural making it easier to "rotate" a shoulder dystocia baby, that's a bunch ofbunk. Epidurals don't makeit easier for ANY baby to rotate. In fact, the only way inwhich "epidural" and "rotate" go well in a sentence is if you are talking about doing a version (external or internal), that's not whatthe dr is talking about though. Having an epidural greatlylimits her ability to push and her body's ability to move in sucha way that her baby can move onit's own, therefor necessitating the need for outside help (i.e. the doctor with his magic forceps/vaccum) I'd strongly urge her to try for a natural birth, or to atleast hold off ongetting an epi until she really thinks she needs one, notjust get one "just because"

Namaste, Tara
mama to Doodle (7), Butterfly (2), and Rythm (due at home 1/06)