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Shoulder dystocia & smaller babies?

643 views 6 replies 7 participants last post by  blissful_maia 
#1 ·
So is there any concern with shoulder dystocia & smaller babies or is it more of a big baby worry? We're planning a homebirth & going through the list of possible complications. Midwife & everyone else keeps telling me this baby is not a big baby so I'm wondering if I can write that off my list of worries. I've had 2 big headed but smallish weight babies but no problems with shoulder dystocia.

Thanks!
 
#2 ·
I am not sure, but I thought it was a "big baby" issue mostly. However, I also have heard that fetal positioning could play a part.

My third baby was born at home and we did deal with shoulder dystocia. She was fine, no transfer needed, but she was big 9 pounds 10 ounces. Her measurements were big too (head and shoulder circumferences) but I don't remember what they were. Her length was 24 inches (also big). MW measured SEVERAL times because she kept thinking that she mis-measured. I did not have gest. diabetes. My dh was an 11 pounder at birth though so I chalk it up to genetics.

Amy
 
#3 ·
Shoulder dystocia is not a matter of size, it's a matter of position. A baby of any size can get stuck if they're having difficulty rotating through the pelvis like they need to.
 
#6 ·
Having had a severe dystocia in dd2's birth (and being a reference librarian
) I ended up doing a lot of research on shoulder dystocia. It's not a "big baby thing". It's also not a "small baby thing", a "slow labor thing", a "fast labor thing", a "big/fluffy mama thing", etc. There really isn't any single "thing" that can be used to predict a shoulder dystocia. It's one reason it's so scary... it's not something that can be planned for.

That said, maternal position changes like the Gaskin Maneuver, McRoberts, "running lunge", "flip flop", etc can help free the trapped arm. Soft tissue changes like an episiotomy aren't helpful unless the care provider needs more more to "reach in" and free the shoulder manually. There's a nice look at the literature here, though it comes with a specific bias (it's posted by a company that is working on creating a SD risk assessment tool).

Anyway, unless you've already had a SD your risk is pretty low. However, it's worth asking your care provider how they'd handle the situation... I wasn't medicated, was pushing without coaching and pushing instinctively in a squatting position, dd2 was smaller than my first babe and presenting well, and still... she had a SD that wasn't resolved by either the Gaskin or McRoberts maneuver. It's something that does happen, but again... not something that should top a worry list!
 
#7 ·
Quote:

Originally Posted by cristeen View Post
Shoulder dystocia is not a matter of size, it's a matter of position. A baby of any size can get stuck if they're having difficulty rotating through the pelvis like they need to.
:
 
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