Shoulder dystocia with 1st baby. Will it happen again? - Mothering Forums
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#1 of 10 Old 10-17-2010, 10:58 AM - Thread Starter
 
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Hi all. I delivered my daughter (now 3) naturally in a midwife-attended hospital birth. She got stuck pretty badly but thanks to the dexterity of my fabulous midwife, she arrived safe and sound. Blue, a bit banged up, with low apgars, but fine. No NICU needed, we went home on time and that was that. She was born at 39 weeks and weighed 8.10.

Now I'm pg with #2 and using the same midwife who I really do like and trust. She offered me the option of scheduling a C-section b/c there seems to be a 25% recurrence rate for shoulder dystocia. I refused that up front and I think I am ok with our compromise plan - - ie. we make a determination once I hit 38 weeks based on u/s and fundal measurement. I have followed her advice of starting low (in terms of my weight) and staying low (in terms of weight gain). I started about 10 lbs lower than I did with DD and have only gained 8 lbs so far and I have just hit 20 weeks. That said, I stayed quite fit with DD and gained 30 lbs so it's not like my weight gain with her was insane.

Anyway, sorry for the novel, but I am looking to hear from anyone who had shoulder dystocia with #1 but went on to have a successful natural birth/healthy baby with #2. I would also love to hear from anyone who heard similar info to what I am hearing and ended up with a C. I am trying to stay open minded but clearly will do anything I can to fight hard for a natural birth without being foolhardy.

Thanks!
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#2 of 10 Old 10-17-2010, 11:31 AM
 
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Well, I've had two with SD and two without. Neither SD baby was born while I was on my back, which they say can be a risk factor, but the common thread was that I was directed in my pushing and instead of doing what my body wanted to do (as in, lots of purple-faced pushing).

My non-SD babies were born in a reclined sitting position (so, probably not the best for compressing my pelvic outlet, but still not problematic) and side-lying (which I actually liked the best). My two SD babies were born in a supported squat and on all fours. All of mine were between 8 1/2 and 9 1/2 lbs.

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#3 of 10 Old 10-17-2010, 12:15 PM
 
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Did your midwife have you move to hands and knees when the SD became noticeable???
My opinion is that I think it is completely ridiculous that your midwife would even consider a c section for the possibility of SD especially based on U/S measurements (which are notoriously inaccurate). From what I have read SD can definitely occur regardless of birth weight-I've known very petite women giving birth to 11 pound babies with no SD.

For what it's worth my son was born with SD (10 lbs), and he came out easily when I went to hands and knees. I have no fear with babe #2 and neither does my midwife

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#4 of 10 Old 10-17-2010, 12:22 PM
 
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From what I know SD is a lot more about babies position and not necessarily size. Fat compresses easily.

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#5 of 10 Old 10-17-2010, 12:41 PM
 
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Hello
My DD was born with shoulder dystocia. I had a natural water birth at a birth center. My husband was suppose to 'catch' the baby, but my midwife had to abruptly step in to get her out. I didn't know there was a medical term for this until our one-week follow-up appointment where she told me about the SD and also that we couldn't have our next baby at the birth center. I was heart-broken and scared but she assured me that there is no reason we can not have a natural birth with our next baby at a hospital setting with a midwife. Never did she mention a C-section as a possibility. I do not believe you can determine if you baby is going to have SD until it is in the final stages of birth. I am still nervous about our next birth, but more so because I will have to be in a hospital and not the wonderful birth center where I had my first. And I was a healthy weight before pregnancy, gained only 30 lbs during and my baby only weighed 7lb5oz, so I don't think weight really is a strong factor (although it is always good to have a healthy weight throughout the pregnancy). Good luck and keep us posted!

-Nicole, mama to DD 11/09
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#6 of 10 Old 10-17-2010, 12:43 PM
 
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I had a shoulder dystocia with #1, and went on to have a successful natural birth/ healthy baby with #2, who also had a shoulder dystocia.

I had DS1 at a birth center with midwives. He had a moderate shoulder dystocia, resolved with the Gaskin Maneuver and some manipulation. He was 9lbs. 9oz.

I wanted a homebirth with my second, but also knew that I was at risk for having another shoulder dystocia baby. I sought out an experienced midwife. I tried to not gain so much weight. I went to the chiropractor, did various exercises, and labored in appropriate positions. But, DS2 was much more stuck than DS1 had been - severe shoulder dystocia. It took longer to resolve, but it was resolved with the Gaskin Maneuver and some manipulation as well. He was 10lbs. 8oz.He was bruised, and needed oxygen for about an hour to help him perk up. My husband, sister, and midwife took him to the pediatrician at the hospital to make sure he didn't have any broken bones, but he just needed a chiropractic adjustment. He's 3.5 years old now, and doing just fine.

I'm glad that I sought out the perfect midwife, and that I didn't go to the hospital. I don't believe that we would've had a better outcome in a hospital.

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#7 of 10 Old 10-17-2010, 12:58 PM
 
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I have had 3 home births. my 2nd was a 10.5 lb SD baby (head born in water, body born on land with me on hands and knees), my 3rd was a totally perfect water birth where i caught her myself. i dont think one SD baby means you will necessarily have another im planning another home birth and have no worries about SD.

 

 

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#8 of 10 Old 10-17-2010, 01:40 PM
 
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Quote:
Originally Posted by hotharmony View Post
From what I know SD is a lot more about babies position and not necessarily size. Fat compresses easily.
I agree with this. It's why I think directed pushing was the culprit in my case because I wasn't letting the baby get into the position it needed on its own.

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#9 of 10 Old 10-17-2010, 04:18 PM
 
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my 2nd was born with SD with an ob delivering him. the ob immediately told me my next children would HAVE to be born via section, but i refuse to believe that since i have read a lot about the situation and agree it usually has to do with positioning. i have since been seeing a MW that says in the chances of SD again, we will have the option for a natural birth but since i am going to be in the hospital, if a section become necessary, we will already be there.
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#10 of 10 Old 10-17-2010, 08:53 PM
 
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My first had SD, and her clavicle was broken in the process of getting her out - but the hospital downplayed it, and she healed quickly and was really fine in spite of the incident. In fact, I had no idea how serious it was until I told my OB when I was pregnant with #2, and she freaked out and insisted that we induce on my due date (different OBs with all of my kids because we move frequently for DH's job). No SD with #2 - all was fine. With #3 the OB I initially saw wanted to induce me at 39 weeks based on the SD with #1, so I changed OBs because the research that I found said that induction not only will not prevent SD, but can actually cause it. No SD with #3. Now I am 39 weeks pregnant with #4, and my OB is not at all worried about the SD that occurred with my first. She is not insisting on induction (or C-section for that matter), and I'm grateful. So, long story short, just because #1 had a dystocia, it doesn't mean that you need a c-section with all subsequent babies. At least, that has not been my experience. Hope this helps.

tara
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