Right Occiput Transverse - Will it happen again? - Mothering Forums

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#1 of 22 Old 02-15-2008, 03:59 PM - Thread Starter
 
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I finally got my birth records regarding my daughters birth.

Here is the general break down of events:

"Recent ultrasound noted LGA Fetus, increased amniotic fluid volume, and she had significant edema"
Apparently this was the reason she was pushing induction.

I was admitted on 2/4/06 at exactly 38 weeks gestation

2:45 am : SROM

3:00 am: contractions started

6:00 am : admitted to hospital, 3 cm dialated, 80% effaced, vertex, -1 station

11:00 am: still coping well 7 cm dialated, 100% effaced, 0 station

1:45 pm: 8 cm dialated, 100% effaced, 0 - +1 station

4:00 pm: 9.5 cm dialated, 100% effaced, 0-+1 station

5:00 pm: 1o cm dialated, 100% effaced, +1 station
Anterior Lip only, directed pushing
It's also noted at this time that I got "panciky" and continued that way until the spinal was given to me.

6:30 pm: Patient has been pushing in many positions. Anterior Lip not reducing, Baby in ROP? Unable to turn baby to reduce lip.

8:30 pm: Agrees to proceed to C/S. Consent Signed

Becca was "born" at 9:04 pm, 7 lbs 7 oz, 19.25 inches long.

Becca's position was ROT (right occiput transverse).

Based on the documents I have, I don't see any reason why a VBAC isn't a good idea. There weren't any complications from the surgery, and I do believe it was a positioning error.

My final documents say

1. Term pregnancy, delivered.
2. Failure to progress.
3.Cephalopelvic disproprtion.

*sigh*

So, from my understanding it was her position that caused her to get stuck so well... I don't know if there was anything else I could have done to fix the situation, if I had labored longer would she eventually have corrected her position?

What is the likelihood of baby #2 ending up in the same position?

I didn't realize how difficult it would be to read back and digest the notes and papers leading up to my ceserean.

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#2 of 22 Old 02-15-2008, 04:05 PM
 
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my first babe was "stuck" and I had a c/s for "failure to descend" after about 5 hours of pushing in many postions. his head was transverse and he had a little cone on one side at birth.

VBAC w/ second no problems. I was vigiliant in positioning from about 32 weeks on though!

I think chances are very slim it will happen again!
good luck!

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#3 of 22 Old 02-15-2008, 04:43 PM
 
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No reason it will happen again...IF you get a decent doc this time!!!! Or a midwife who knows baby positions. My 1st dd was posterior and huge; I was sectioned for ftp. 2nd dd was also posterior; after an incredibly long labor, I transferred to the hospital where my back up doc (who is so freaking awesome it should be illegal) turned her after I got an epidural. I rode to the hospital at 10 cm with this huge ol' baby turned the wrong way; he got me the epi, waited until it kicked in, reached in, felt her suture lines on her head, pushed her back up and turned her. And out she came, a few hours later! He let her head re-mold and just patiently waited until my body was ready to deliver her. How awesome is he????

Anyway, my midwife was not as knowledgeable about baby's positions as the doc was; if my doula had realized what was happening, she would have been able to help me turn her before we went to the hospital, but the mw was pretty interfering and the doula didn't realize what position my dd was in.

All that to arrive at ds's birth...completely awesome and totally different than the girls! I posted here a few days ago about it; he was posterior throughout most of my pg. He came out perfectly LOA, though! I did a ton of hip swaying/thrusts/movements during labor. Although my labor was short, I know that all the belly dancing/swaying stuff I did flipped him because he came out so quickly and was in a perfect position!

So, I think you might have a tendency to carry babies a certain way, but that doesn't mean they'll stay like that through labor.I carried all three of mine the same way. And if you were confined to a bed with an epi, it's no wonder your dd didn't turn. Not that the epi is horrid; I had to have one with dd #2 for the doc to turn her. But get a doula/midwife with a lot of baby positioning knowledge, or a doc, and you'll be just fine. Your body can grow 'em, your body can birth 'em! And trust me, a vbac is totally worth all the trouble!

Perdita, wife to J, mom to Bridget (6), Ivy (4) Trace (2) and Fiona, my 3rd vbac baby, born 12/2/09!
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#4 of 22 Old 02-15-2008, 04:47 PM - Thread Starter
 
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I am currently researching midwives as the one I had for my first birth didn't know what position she was in.

I didn't have an epi, nor was I confined to bed... I moved all during my labor and tried many different positions to encourage baby to move... It didn't work.

Okay, so basically, I need to make sure I have a midwife who knows baby positioning and I need to research to do what I can to help baby into a good position.

Thank you for your post, and congrats on your new little one!

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#5 of 22 Old 02-15-2008, 04:51 PM
 
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I had two posteriors at home.

They cause labor to be long and very difficult, The hospital responds to this with drugs and surgery. At home, midwives use time and loving encouragement.

You can do it. There is really no reason for the first caesarean, based on what you have put in your post, other than the fact that you were in the hospital and the fact that is the way difficult labors are handled. Note your doctor wrote "CPD" as a reason, which another doctor may not question. Doctors really do not know how to palipate or determine fetal position without using a u/s; it is a lost art.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#6 of 22 Old 02-15-2008, 04:51 PM
 
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the best thing is for YOU to learn and to know baby's position, don't pass that important task off to someone else!!!!

www.spinningbabies.com is a good place to start.

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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#7 of 22 Old 02-15-2008, 04:55 PM
 
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wow that is pretty contentious to deem someones c/s as uneccessary when you weren't there. a transverse head is a little different than OP. no? I happened to have a MW for my first birth before going to the hospital. they abandonded me. MW's are NOT always knowledgable just because they are MW's. mine failed me horribly and left me sitting in a birth tub for 12+ hours ALONE no food, nothing to drink,etc.. if I had gone to the hospital off the bat instead there is no doubt in my mind I would have had a vaginal birth as the nurses there were MUCH more knowlegdable than my mw's!!!

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I had two posteriors at home.

They cause labor to be long and very difficult, The hospital responds to this with drugs and surgery. At home, midwives use time and loving encouragement.

You can do it. There is really no reason for the first caesarean, based on what you have put in your post, other than the fact that you were in the hospital and the fact that is the way difficult labors are handled.

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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#8 of 22 Old 02-15-2008, 04:58 PM
 
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Well, then take the doctor's word for it since they were there. Why even ask anyone else?

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#9 of 22 Old 02-15-2008, 04:58 PM - Thread Starter
 
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Quote:
Originally Posted by rainbowmoon View Post
the best thing is for YOU to learn and to know baby's position, don't pass that important task off to someone else!!!!

www.spinningbabies.com is a good place to start.
I have a lot of homework ahead of me, thank goodness for the internet!

I'm also discovering that it's important to know how experienced my midwife is in determining position. Through my records I have discovered that the CNM I had last time wasn't experienced in that area.
I've just emailed the midwife that I'm considering using to find out what her knowledge is in this area.

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#10 of 22 Old 02-15-2008, 05:01 PM
 
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ETA- ahh I get ya now AJ. not being snarky. just saying there are crappy MW's too! positioning would help reduce the c/s rate if it was knowledgable by EVERYONE.

btw my water broke WAY before my c/s (like 20+ hours before) it did not help matters at all as it was hard for baby to turn after that apparently. he never turned or descended.

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#11 of 22 Old 02-15-2008, 05:06 PM
 
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there is a wonderful doula book on positioning by Polly Perez. I think every pg mom should read it (sorry I forget the title offhand) Also look for Optimal Fetal Positioning.

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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#12 of 22 Old 02-18-2008, 07:39 PM
 
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Only 3% of babes that have been transverse will still be transverse during labor. So, that should be reassuring. I don't see any reason not to VBAC. The only thing I didn't like about the records was they listed CPD as a reason for the section. A transverse lie doesn't mean your pelvis wouldn't let you birth your baby, so don't pay attention to that. Good luck to you.

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#13 of 22 Old 02-18-2008, 09:04 PM
 
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Hi Ladies,

ok...I need to add this because it just sounds like my births...I have three kids...first one was a c-section for deep transverse arrest (same story like you...fully dilated...water breaking early in labor..baby being 'stuck' at ischial spines)...second baby was a vbac home water birth...third baby again c-sec for deep transverse arrest...

My babies are big...9lbs14, 9lbs15 and the last one 10lbs11...but the second one I birthed at home in 3 hours with no problems...why the c-sections for the other ones?? Because of 'transverse arrest'...
And btw...I had midwives for all three of my kids...knowledgable midwives...just having a midwife doesn't mean you will never ever have a c-sections...sometimes there are VALID reasons...

One of them being 'transverse arrest'...even if you read the book "Optimal Fetal Positioning" it says that if the baby gets stuck at ischial spines in the transverse position there's not other way out then a c-section....I recommend reading this book...OP is not the same as OT...

The distance between ischial spines is usually 9.5 cm and the baby's head (no matter what the weight of the baby) in the transverse position is usually around 11.5 cm...so yes...if the baby gets stuck at this point and doesn't turn...a c-section is necessary...

Now two of my births were like this...and the one common thing they had together was that my water broke early in my labor for the first baby and way before ctx started for my third baby...so without the added cushion of water around the baby it was very hard getting this baby to turn...
For my last baby I was fully dilated over 5 hrs and pushed in different positions for over 2 hours without the baby budging at all...
My baby (2 months old now) has facial nerve palsy due to birth trauma and being truly stuck...

I had chiropractic care during the pregnancy...did all the 'right' positioning things...the baby was in the right position during the last few weeks and even at labour start...but every baby has to complete something called 'cardinal movements' and my babies got stuck in the transverse...

I think, no matter how disappointing, the reason for your c-section was valid but it doesn't mean it will happen again...

My second birth was an awesome home birth water birth and the baby was even bigger than my first baby (c-section)...

Sorry for the rambling...basically what I am trying to say is that yes, positioning matters...and sometimes there is no other way than a c-section because of the positioning...even if you do all the right things...major key being the water breaking early and not leaving baby enough cushion to turn...

PM if you need more help...it was hard for me having the c-section for my third baby...but really we tried everything we could...

Tema (a midwife herself)

PS. Previous poster said that transverse lie is not a reason for a c-section...transverse lie is the baby's body being transverse in uterus...but occiput transverse means the baby's head is transverse in the pelvis on the descend to the birth canal...
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#14 of 22 Old 02-18-2008, 09:13 PM
 
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tema-yup my water broke early in my labor too w/ my c/s babe (before contractions started) I was under the impression this didn't help things. he was also 9.5 lbs. MY vbac baby was under 8lbs and I had no problems really just a long pushing phase!

he was aclyntic with his head transverse.

I asked if they could push him up and turn him and the answer was resounding "no" from 2 dr's and my mw's. why is that? he was at -2 station. He would move down during pushing just a bit (I could feel it and it kept me wanting to keep pushing!) but then he would pop right back up. I squatted, H&K's, lithotomy EVERYTHING!

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#15 of 22 Old 02-18-2008, 10:17 PM
 
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Yes, the OP is correct...deep transverse is a toughie...as is oblique. BUT it is not CPD...it is a deep transverse arrest. And funny enough all of the cesareans that I can recall for either one (of the births I have attended)occured after an early rupture of membranes.

I'd say to just do what you can to make sure that your baby is positioned well to begin with, and also pay close attention to your diet! I'd make sure you got LOTS of vitamin C rich foods, and that you got great healthy sources of omega fats, and that you got enough protein... Vit C in particular can help to make a strong amniotic sac...one that is less likely to rupture before labor starts or early in labor. Also, find birth support who is knowledgable in baby's position and in changing mamas position to help amend that.

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#16 of 22 Old 02-18-2008, 10:34 PM
 
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My DS's head was transverse and acynlitic during labor - a very very long labor since he also didn't descend much to help me dilate. It came very close to a csection but i was able to have a vaginal birth. I think part of the reason I was able to push DS out was that he was small (under 7 lbs) and his head wasn't large either - but man was the pushing phase difficult.

I hope that I do not have similar issues with my next baby - one 52 hour labor is enough for me thank you very much.

(And the frustrating thing is that I was very concientious about positioning my entire last trimester, spent labor mobile walking, hands-and-knees, standing and swaying, hip squats, etc... - every possible chance to encourage DS to turn! However he never fully engaged in my pelvis and spun around on his head like a top every day. I hope the next baby is different.)

In the hands of an intervention-happy Ob or MW I would have had a csection, but my midwife was very pro-NCB and didn't even mention interventions until a few complications happened, and made us partners in deciding what to do which I so appreciate - i am ok with the interventions we needed b/c i was part of choosing them and based on my own research and birth knowledge felt they were necessary. Heck, I was in the hospital laboring for two days without pitocin or an epidural and i was fully supported - that's rare!
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#17 of 22 Old 02-18-2008, 11:24 PM - Thread Starter
 
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I can't thank all of you enough for sharing with me, I truly appreciate you taking the time to share stories of experience as well as knowledge you have.

It's a relief for me to find out that all in all it wasn't my fault, I used to keep thinking if I had just gone on a while longer, if I had squatted/walked/etc more maybe it wouldn't have happened. I'm coming to terms with my c-section and I now feel much better equipped to prepare for my hbac. I can't wait!

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#18 of 22 Old 02-19-2008, 02:34 AM
 
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My first was ROT (although it's not noted in my records as anything but CPD, it was obvious from the molding on his forehead!). He never really descended past 0 station. My water was broken as part of an induction at 2cm (bad, bad, BAD idea!). I had an epi at 4cm. I was confined to the bed for then entire duration of the labor. Dilation stalled at 7cm and swelling developed because of the poor positioning. c/s was done after that (38 hours post-start of induction).

My second was also malpositioned for the majority of my labor, but having my waters intact allowed him that extra measure of bouancy to make the move right before I started pushing. My labor was long (35 hours), but was well worth it and so much more peaceful and less traumatizing (it was in a fsbc with a hombirth midwife).
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#19 of 22 Old 02-24-2008, 07:54 AM
 
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Originally Posted by lyterae View Post
It's a relief for me to find out that all in all it wasn't my fault, I used to keep thinking if I had just gone on a while longer, if I had squatted/walked/etc more maybe it wouldn't have happened. I'm coming to terms with my c-section and I now feel much better equipped to prepare for my hbac. I can't wait!
Hi - I just came across this post and wanted to tell you that my first son's birth sounded almost exactly like yours, and I feel the same way you do after reading these replies (esp. Tema's explanation). I'm going to be trying for a VBAC in about five or six weeks, and I certainly hope baby won't be in the same position.

The one hitch in my situation is that I'm dealing with some pretty painful sacroiliac joint dysfunction pain this time around, and many fetal positioning exercises aggravate it even more. So I'm torn between whether to keep at it or to back off from movements that interfere with stabilizing my hip area - such as squatting, rolling around on a birth ball, etc. At this point, I'm trying to find a happy medium.

Anyway, good luck to you!
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#20 of 22 Old 02-24-2008, 01:24 PM
 
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I know it's not the comfiest at 9mo pg but hands and knees is VERY useful and it may take pressure off your sacrum. scrubbing the floor or even just crawling around for 5-10 min several times a day can help! (positioning wise) also sitting on a birth ball instead of chairs helped me too.

oh and walking is the best thing at all you can so for sacral illiac joint pain. (About the only thing you can do IMHO) I know how painful that is though! ouch!

just throwing it all out there in case one of you mamas finds it useful! good luck with your VBAC! you can do it!!!!!

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Originally Posted by junomama View Post
Hi - I just came across this post and wanted to tell you that my first son's birth sounded almost exactly like yours, and I feel the same way you do after reading these replies (esp. Tema's explanation). I'm going to be trying for a VBAC in about five or six weeks, and I certainly hope baby won't be in the same position.

The one hitch in my situation is that I'm dealing with some pretty painful sacroiliac joint dysfunction pain this time around, and many fetal positioning exercises aggravate it even more. So I'm torn between whether to keep at it or to back off from movements that interfere with stabilizing my hip area - such as squatting, rolling around on a birth ball, etc. At this point, I'm trying to find a happy medium.

Anyway, good luck to you!

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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#21 of 22 Old 02-24-2008, 04:47 PM
 
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Originally Posted by junomama View Post
Hi - I just came across this post and wanted to tell you that my first son's birth sounded almost exactly like yours, and I feel the same way you do after reading these replies (esp. Tema's explanation). I'm going to be trying for a VBAC in about five or six weeks, and I certainly hope baby won't be in the same position.

The one hitch in my situation is that I'm dealing with some pretty painful sacroiliac joint dysfunction pain this time around, and many fetal positioning exercises aggravate it even more. So I'm torn between whether to keep at it or to back off from movements that interfere with stabilizing my hip area - such as squatting, rolling around on a birth ball, etc. At this point, I'm trying to find a happy medium.

Anyway, good luck to you!
Junomama, have you seen a chiropractor? It may be JUST what you need to get rid of that pain!! I spent almost every other day in my chiro's office at the end of my first pregnancy that went to term...but he kept me pain free, and able to birth my girl in 4 hours of active labor (and she was full on posterior until about three minutes before I started pushing!). Just a thought! Too, seeing a chiro who is skilled in Webster could help your baby to stay in an optimal position in general!

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#22 of 22 Old 02-24-2008, 08:16 PM
 
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Junomama, have you seen a chiropractor? It may be JUST what you need to get rid of that pain!! I spent almost every other day in my chiro's office at the end of my first pregnancy that went to term...but he kept me pain free, and able to birth my girl in 4 hours of active labor (and she was full on posterior until about three minutes before I started pushing!). Just a thought! Too, seeing a chiro who is skilled in Webster could help your baby to stay in an optimal position in general!
I do see a chiropractor (who specializes in Webster) and a physical therapist weekly; maybe I'll have to starting visiting the chiro more often!

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Originally Posted by rainbowmoon View Post
I know it's not the comfiest at 9mo pg but hands and knees is VERY useful and it may take pressure off your sacrum. scrubbing the floor or even just crawling around for 5-10 min several times a day can help! (positioning wise) also sitting on a birth ball instead of chairs helped me too.

oh and walking is the best thing at all you can so for sacral illiac joint pain. (About the only thing you can do IMHO) I know how painful that is though! ouch!

just throwing it all out there in case one of you mamas finds it useful! good luck with your VBAC! you can do it!!!!!
This is very helpful! Thanks.
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