Help me process my delivery? - Mothering Forums

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Old 04-29-2004, 04:31 PM - Thread Starter
 
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So ds is now four weeks old! Yay. I'm still thinking about his delivery and I'd just like thoughts if people have them.

My disclaimer: I had a great delivery. It might not sound like it was, from my description, but I really feel very good about it. If you think I didn't need my C-section, please don't post - I'm very comfortable with the decisions we made, I just want a little insight on ds's movement during the labor. Thanks.

So I had 17 hours of *great* labor - I was on top of the contractions, I was progressing well, things felt good. (This was in contrast to dd's labor three years ago, where I had back labor and threw up for more than 20 hours.) At about 7 cm I got into the tub and labored there through transition. Sometime during transition, or shortly after, I started to feel intense, unbearable pain that did not go away between contractions right in the front of my pelvis.

Nothing helped. Position changes did not help, the tub did not help, shower directed at my pelvis did not help. After about an hour I got an epidural, which was a good decision - I could cope again, and breathe, and go through a contraction without high-pitched screaming.

I pushed for about two hours, and my midwife realized that during/after transition, at about 9cm, ds had turned to be posterior. He was posterior and not moving down at all - he did not move from zero station during all the pushing. (I should add that the epidural was very light, I was able to move a lot and I was doing good, strong pushing.) She and her two ob partners tried to move him for about an hour. He did not change position.

Eventually it became clear that I wasn't going to be able to push him out. We had a C-section. He was nine pounds, nine ounces. My doula and my mw told me, and I believe them, that had he been anterior, I could have pushed him out, and had he been smaller, they could have changed his position.

My doula speculated that my pelvis might have been damaged at some point - possibly during dd's vaccuum extractor delivery - such that ds *had* to move to posterior - that he might not have fit in any other way. I don't have any history of trauma to my pelvis that might explain this (no car accident, for example.)

So I'm just curious - why might a baby change position like that that far into the labor? We're not planning more children, so this is really more about me having a full understanding than for any practical reason. I had such a good labor that the whole experience is mostly good memories - dh and my mw and doula were great, my baby is beautiful, I feel good. I'm just wondering what to make of my experience.

Speculate away!

Can't give up actin' tough, it's all that I'm made of. Can't scrape together quite enough to ride the bus to the outskirts of the fact that I need love. ~ Neko Case

 
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Old 04-29-2004, 04:45 PM
 
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First off, I'm so happy that you had the freedom to try different things each step of the way! It sounds like you were well supported!

I question the thought that your pelvis was damaged during your last birth. Your pelvis is two bones and I don't think that it is possible to damage your pelvis from a vacuum extractor. Damage tissues, yes. Damage your pelvis, no.

I recently had a birth where the first birth for the mom was a horrible posterior labor, with a transport to the hospital and vacuum extractor for a posterior baby.

Her next birth was with me as well and this labor was much quicker. It didn't seem like, at the start of her labor, that baby was posterior. All signs pointed to an anterior baby. Then, when she started pushing, she was complaining alot of intense pelvic pain. I was suspecting maybe a hand up by the head or something. I had not checked her at all during her labor, so I wasn't sure of baby's position. After pushing for about an hour, I asked if I could check her while she was on the birth stool. She agreed and when I went in to feel baby's head, it was clearly posterior. I didn't say that the baby was posterior (she had alot of fear she was voicing about this baby, like the last, not ever coming out).

My assist and her husband moved her into a deep squat and within 12 minutes of pushing, she pushed out a posterior girl, a pound heavier than her last (9lbs10oz).

I think that some pelvic outlets just encourage babies to turn posterior for whatever reason. As the baby is rotating out, the only option (maybe due to the ischial spines or the shape of the outlet) is to rotate posterior.

I don't think your pelvis is damaged or there is anything "wrong" with your body at all. It also could have been that maybe your baby was a tad asynclitic (head off to the side a bit) or there was a hand up by the head. Any slight variance to a posterior position can compound getting baby through.

I don't know if this clears things up for you or not. Perhaps it's just one view of persistent posterior births.
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Old 04-30-2004, 02:26 PM
 
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I am working on trying to avoid a posterior baby with my next, but like Pamamidwife conjectured, it may just be that my pelvic outlet encourages that kind of positioning. I don't really know! In any case, all I can tell you about is my own experience dealing with a posterior positioning in a managed setting. Like you, I was doing the high-pitched screaming (and unfortunately encouraged not to, grr!) Really awful. I was doing a lot of moving around until I was at 9 cm., then I was told to get into bed so the midwife could do perineal massage (another grr!) and catch. I was told to push at 10 cm. (didn't feel the urge, which I now believe was because my body actually wasn't ready yet to push him out, despite the fact that my cervix appeared to be ready.) I pushed for two hours also. He eventually did move down. But I do think it probable that had he been a larger baby, for him to be birthed vaginally would have probably required that I push in a squat, and not until my body instructed me to.
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Old 04-30-2004, 09:50 PM
 
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Hi Penelope,
I don't have any speculations for you, unfortunately. I just had to post and say good job! Your birth sounds very very similar to mine. I also had a smooth begining to my labor, if you want to call 36 hours "beginning" . After a transfer to the hospital from a homebirth, an epidural and 3 1/2 hours of pushing it was discovered that my ds (a 9 lb 15 oz'er) became transverse. I also had a c section, one that I begged for. It was painful in a way that eventhough I'm a first time mom, I didn't believe it should feel like that. I also needed help processing my labor and birth of my son and I got a great boost from the response from the mamas here. You tried everything you could and you used tools that were available to you. You made educated decisions and I feel the same way you do...happy about the way things turned out!
So, no input from me on the why your babe turned posterior. I have wondered the same thing. Anyway, a big congrats on the birth of your son!

Amy

Mama to DS1 (4/04) DS2 (HBAC 11/06) DS3 (HBAC 12/08) DS4 (HBAC 1/11). Wife to one handsome hard working DH.
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Old 05-04-2004, 05:30 PM - Thread Starter
 
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Thanks for all the feedback! Pam - your thought about his hands rung a bell. In the photos of his delivery, his hands are right up next to his head, and he preferred that position for the first week or so. He sucks on his hands constantly in the sling, too. Maybe that was a factor. Thanks for the thought that a pelvis that encourages posterior babies isn't "damaged" - I was starting to feel a little down about my pelvis.

I'm still feeling good about his delivery - it's so nice to hear the experience of other mamas of posterior babies, though! I went in about an hour from having a student nurse ask my doula if I was feeling any pain at all - that's how well it was going - to having the grandmother of the baby in the next delivery room retire to the chapel to pray for me. (Her grandbaby was already born.) That's how loud I was once he turned.

He's doing great, though - just over 13 pounds at his four week checkup, which was fun to hear! Yay breastmilk.

Can't give up actin' tough, it's all that I'm made of. Can't scrape together quite enough to ride the bus to the outskirts of the fact that I need love. ~ Neko Case

 
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