Narrow pelvic arch? - Mothering Forums

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#1 of 7 Old 11-22-2009, 01:19 PM - Thread Starter
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Hello! I'm four days overdue with our second little boy.... I was due on the 17th. I had a c-section with my first son after 17 hours of labor that stalled at 5 cm. He was 9 lb 8 oz and was born with a MAJOR conehead.... he definitely looked like he was trying hard to get through.

I had a doctor's appointment yesterday and my doctor informed me that I have a "narrow pubic arch". He said that could have been why my son couldn't be born vaginally. He's still 100% supportive of me trying for a VBAC, but didn't sound as optimistic that I'll be successful.

My concern is after researching this, it looks like I have a much much higher chance of shoulder dystocia and complications, especially because it's looking like this boy might be another 9 pounder.

Does ANYONE have information on this? I'm completely at a loss of what to do.... part of me just wants to schedule a c-section and get my little boy here safe and in my arms. But I have been striving for this VBAC for YEARS.... planned and researched since the birth of my first son. I'm quite frustrated that I wasn't informed about this narrow pelvic arch thing until just now.

I'm just getting so discouraged.... I'm officially losing all faith in my body. I keep having contractions, but they never usually get regular for a couple hours and then completely putter out. I just feel like my body is broken, and now hearing that I have this "narrow arch", I'm starting to feel like.... what's the point?

Thanks so much!

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#2 of 7 Old 11-22-2009, 02:20 PM
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My advice would be to find a doula, or preferebly a midwife, to have with you during labor...someone completely supportive of VBAC.

I had two cesareans after a combined 7 total hours of pushing. IN other words, I had a cesarean the first time because I couldn't get my baby out; so, for my VBAC attempt, I did Bradley classes and hired a good midwife to assist me. I now know that I do have a narrow pelvis...a VERY rare occurance, but it does happen. But I do NOT regret my VBAC attempt one bit! There is just no way to accurately know if a women has a narrow pelvis before labor because your pelvic bones loosen and shift during labor! Plus, if you're trying to push a baby out while flat on your back, your pelvis is going to be more narrow than if you are pushing in the squat position. There are just too many variables for someone to tell you that your pelvis is too narrow at this stage of the game. Please go to the ICAN website and you'll find some great resources...and the book, 'The VBAC Companion," had some great info for me, along with the book by Ina Mae Graskin, "Childbirth....." (I can't remember the title right now) If your labor stalled, by the way, then you didn't get to even test the girth of your pelvis or anything....grr at the misinformation given to you! But, yes, I respect your concern that your baby is nice and safe, but I bet that if you do some careful research, you'll discover that the safest way to birth is surgery=free if at all possible. ANd this is coming from someone who is having a c-section in three weeks....some of us have to, but I'm so tired of the medical world pushing for so many UNnecessary ones! Bless you!

Mama to Samuel (6) Gabriel (4) and Jacee (just born on 12/15/09 7lbs5oz 20.75 in)
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#3 of 7 Old 11-22-2009, 04:30 PM
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I think a conehead can just be a sign of prolonged ruptured membranes with an engaged baby, not anything to do with your pelvic arch. My first was more than an inch longer the first time she was measured compared to her length two days later. She had a massive conehead. My water broke before I went into labor, she was engaged the whole time, and all of that pressure on her head just made her head mold like crazy. My other two didn't have that because my water was broken much much closer to when they were born.

IMO, your biggest risk factor for having a repeat cesarean (and just about every cesarean performed in this country) has nothing to do with your anatomy. Your doctor and his POV regarding your chances is probably the biggest determining factor in the outcome of your labor. It's impossible for him to really know how well your baby will fit through your pelvis, but if he believes you can't birth a baby vaginally his actions during your labor will reflect that.

My advice? Stay active and upright in labor and especially during pushing. Avoid an epidural so that you can get into optimal vertical pushing positions. The shape and the amount of room in your pelvis is positionally determined, and there's a lot less room for baby to fit through when you're on your back compared to when you are upright (and if you're numb, you don't have the same options WRT positioning that you do if you've got full control over your body.

In addition to your position, your baby's positioning also can play a huge role in how a baby fits through your pelvis. The baby's head circumference is actually bigger if his chin is up or if he is posterior. Spending some time in positions that promote optimal fetal positioning (all fours, etc.) right now is a good use of your time and is usually pretty comfortable and soothing for your back at this stage of pregnancy.

Take your time getting to the hospital, trust your body, talk to your baby, and relax. He'll be here so very soon!

Here's a hopeful quote from this link "Studies report two-thirds of women will have a successful VBAC despite a previous diagnosis of CPD. One study showed an 80% VBAC success rate for women who had undergone a cesarean for arrest during the second stage of labor (CPD). In another study of women who had undergone two previous cesareans for CPD/FTP, 56% delivered vaginally"
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#4 of 7 Old 11-22-2009, 04:52 PM
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I have a narrow pubic arch too. I pushed for over 5 hrs with my first. My second only took a couple of pushes and he was out. I would agree that avoiding an epidural is pretty important if you want to be able to change positions frequently. I also think it is VERY important to listen to your body and not have any preconceived notions of what position you want to give birth in. With my first I pushed in every position and finally delivered in McRoberts. It was my favorite because it allowed me to fully relax between ctx. For my second, I really wanted to be upright, squatting or on hands and knees, but when it came time to push, none of those positions felt right. I instinctively wanted to be absolutely flat and to hold my knees to push. As soon as I got in this position I felt him descend and exit very rapidly (ouch!) Trust your body and try to just go with it during labor. Good luck!

Wife to Joe and Mama to Rosie, 6/28/06, Jack, 10/25/08 and JoJo 3/18/10.
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#5 of 7 Old 11-22-2009, 07:18 PM
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I had a doctor tell me that before I had even given birth. She left me with the impression I'd never be able to have a vaginal birth. She was my GP for years.

I felt like calling her and bragging when I gave birth to a baby with a 14.75" head and a nuchal hand. Vaginally with only one hour of pushing. I also took Bradley classes.

Heather Mike Married 8/1/99 Mom to Charlotte Aug 04, Nov 06, and Katherine Oct 07
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#6 of 7 Old 11-22-2009, 08:38 PM
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Get the book "Active Birth" and make plans to birth in any position that you feel you need to do instinctively. Hands and knees or squatting will be helpful. I have read many stories of women who were told their pelvises were malformed or narrow or whatever who went on to birth very normally.

Wife to Doug, mom to Hank and Logan !!!
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#7 of 7 Old 11-23-2009, 12:51 AM
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A narrow pelvic arch can move and stretch during labor. Your doctor is trying to scare you at a very vulnerable time for you. Do not buy into it.
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