In what instances can a woman not physically deliver vaginally? - Mothering Forums

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Old 12-02-2004, 09:14 PM - Thread Starter
 
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My MIL had 5 babies via c-section and was told she would never be able to deliver vaginally. Here's what I know... DH was her first (2nd pregnancy, after a 2nd tri miscarriage). She went into labor spontaneously with him and dilated to a 6. They told her she couldn't physically dilate past that, so they sectioned her. They also told her she has a bicornet (?) uterus so she can't deliver vaginally. An RN one time told her one other reason that she can't deliver vaginally, but she couldn't remember what it was. DH seems to think that MIL doesn't have the cartlidge in her pelvis to allow a baby's head to pass through, but MIL never said anything like that so I don't know if it's a condition he thinks she has or what.

A while ago, she said that she wished her docs would have let her try for a vaginal birth. She feels like she could have done it. I think she was a little disappointed that she had all sections, though, and feels betrayed by her body.

So I'm wondering what conditions she might have had that could have prevented her from having a vaginal birth. How would one not be physically able to dilate past a 6? Or is that another case of an MD not waiting it out long enough?

She deliverd her babes in 1978, 1980, 1982, 1984 (neonate death after 3 days) and 1985. M/C in 1977.

Mama to DD (5) DD (3) and DS (2 months)
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Old 12-03-2004, 12:31 AM
 
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Was the baby head down?? Most of the true bicorniate uterus's that I have seen had a preterm, breech baby by c/s. I am sure that doctorjen can elaborate much more than I can, but a bicorniate uterus is abnormally shaped, and looks like a heart. It cannot contract as effectively as a 'regular' shaped uterus because of the defect. Usually, the baby is forced into a breech position because of the odd shape, and there is a limited amount of space that usually means a smaller, preterm baby. I would imagine that if this was true of her, than it is certainly POSSIBLE that she was a true failure to progress. If they didn't know about her bicorniate uterus before, when they opened her up they sure did! That is when they probably told her she would always have c/s. ( I am also speculating ALOT just based on what you told me, I could be way off the mark too!)

I am trying to think of reasons that I have seen that have caused a necessary c/s. I remember one woman that had a severe auto accident where her entire pelvis was shattered and pinned back together. Her physicians advised against a vaginal delivery because her poor pelvis was practically held together with glue and twine. I have rarely (and I mean rare) seen women with abnormally shaped pelvis, that would be impossible to get a baby out of. I am not talking about the dreaded CPD, I mean a real non-gynecoid pelvis where there is almost no pelvic outlet.

Other than that I really can't think of any off the top of my head. Sorry!
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Old 12-03-2004, 01:19 AM - Thread Starter
 
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Actually that helped a lot. I will have to ask MIL if she remembers if she had breech babies. Thanks for your help!

Mama to DD (5) DD (3) and DS (2 months)
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Old 12-03-2004, 03:17 AM
 
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I have a bicornuate uterus. I think there are a few other moms on here that have this uterine anomaly. Some of the sister hood can have vaginal deliveries if things are "perfect".
Often however the babies find a position and when they get so big can no longer move out of that position. Bicornuate uteri can vary. I think there are nearly a dozen shapes, with and without septums that go all the way down, etc. I have a slight septum, with the right horn being larger than the left.
If you have a deformed uterus you actually have a higher rupture rate with or without surgery. Once the sucker is cut or reconstructed, it goes up. No fun indeed. Miscarriage rate is higher as is preterm delivery, and still birth. Growth restriction can also be a problem and even limb deformity in the baby.
I consider myself "lucky". My uterus aint so bad, but I definitely will not be birthing any babies vaginally unless they are premies. (which I do not want) My daughter was a weird transverse breech, her head was in my rib cage and she was laying with her face towards the ground if I was standing in a kind of side way position with her legs and feet hooked around the septum into the left horn. At the time, I had signs but my green doctor (my choice) didnt no really what to look for. I had an attempted ECV three times which ended in an emergency csection.
I also have had infertility issues, progesterone issues, etc. My mother took DES and I was unaware of this until after my daughter was born.
With my last pregnancy (my middle child we adopted) my baby was posterior in the last trimester. He never moved. His head was lodged into my left hip with his shoulder presenting against the cervix. He was almost a pound heavier than my daughter and he literally stayed that way for over 8 weeks. They had to use a vacuum to pull him out. Even for csections the OBs have trouble getting them out! The bulk of Jack's body though was in the right horn.
I am currently pregnant with my fourth child. I hope its a keeper. I had an US a few weeks ago and the embryo implanted in a really great place and we had heart tones. I will do a repeat csection. I hope this baby goes transverse, because with my last pregnancy I was in a lot of pain due to the position.
I want to note that I never have dilated or had my water breaks. This isnt uncommon from what I have read. Many women with bicornuate uteri carry high and sometimes look lopsided. I never "dropped" with either of my pregnancies.
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Old 12-03-2004, 05:21 AM - Thread Starter
 
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Wow, thanks for all the great info!

One more question-- do you know if a bicornuate uterus is inherited? And if so, how likely would my DD be to inherit this?

Mama to DD (5) DD (3) and DS (2 months)
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Old 12-03-2004, 11:16 AM
 
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Originally Posted by lacysmommy
Wow, thanks for all the great info!

One more question-- do you know if a bicornuate uterus is inherited? And if so, how likely would my DD be to inherit this?
I think the greatest "risk" is to any born children, not grandchildren in your case. And it is slight, very slight. Most women who have deformed uteri have it because of DES taken by their mothers, or other meds to prevent miscarriage. It can happen randomly however. There are great sites on the net about this with pictures.
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Old 12-06-2004, 04:28 PM
 
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My mom has one, and I don't. So if at all, not always!
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Old 12-06-2004, 04:36 PM
 
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My doctor and midwife (s) semmed to think there was something with the way I was shaped that was wonky. My babies never dropped.DD was 44 weeks, breech still after doc turned her once, and ds never dropped when labor started 2 weeks late, water broke, mecomium, labor, etc. Never dropped. Now, the third time around I want to get some chiropractic work done, but who knows if I will actually be able to deliver vaginally? I want to go with the same OB, who is truly awesome(I am usually a doc hater!)and I think , we already talked about it, I want to go a week or so over, see what happens, section if nessecary. It would be my third. There is not alot of acceptance in the natural mothering community for those who truly need sections, but I am thankful to have beautiful healthy children-whereas if I didn't have c-sections that wouldn't have been possible for me. Sure, it's a bummer- but hey, it was nessecary in my case both times.
there are many different types of oddly shaped uteri as well.
I had plenty of room in my pelves so it was always a shock to the doctors.

Due with number 5 in August. We do all that crunchy stuff.
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Old 12-06-2004, 06:51 PM
 
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There is a condition called a Bandl's ring where a ring of muscle in the uterus does not relax after each contractions, but instead gets tighter and stays that way. This could cut off oxygen to the baby. I don't know how this is diagnosed, though.

Abdominal pregnancies must be delivered by c/s, but it's very rare those would go to term anyway.

I don't know about this "can't dilate past 6" though. Since dilation can take several hours, even days, how do they know the mom couldn't do it without waiting that long? As long as the baby is not in distress, there is no reason not to wait. And I doubt there is any way to diagnose this "not enough cartilage" either. Pushing for a long time, or the head not engaging, are not necessarily indicators of CPD.
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Old 12-06-2004, 08:05 PM
 
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Originally Posted by Leilalu
My doctor and midwife (s) semmed to think there was something with the way I was shaped that was wonky. My babies never dropped.DD was 44 weeks, breech still after doc turned her once, and ds never dropped when labor started 2 weeks late, water broke, mecomium, labor, etc. Never dropped. Now, the third time around I want to get some chiropractic work done, but who knows if I will actually be able to deliver vaginally? I want to go with the same OB, who is truly awesome(I am usually a doc hater!)and I think , we already talked about it, I want to go a week or so over, see what happens, section if nessecary. It would be my third. There is not alot of acceptance in the natural mothering community for those who truly need sections, but I am thankful to have beautiful healthy children-whereas if I didn't have c-sections that wouldn't have been possible for me. Sure, it's a bummer- but hey, it was nessecary in my case both times.
there are many different types of oddly shaped uteri as well.
I had plenty of room in my pelves so it was always a shock to the doctors.
Leila come check out the Cesarean Support Thread. I know how it feels to feel unaccepted by the natural parenting community when it comes to csections. I had one woman say I would eventually had my daughter vaginally but the facts are she would have died first. I am going to try to go to my due date with this baby (actually two days before) but I am definitely not going to try a VBA2C. Just too risky. Especially now that my odd shaped uterus has been cut twice. Deformed uteri fall under Mullerian Anomalies. I should have stated that in my previous posts. Before you have your next baby you should ask for your surgery reports.
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Old 12-07-2004, 04:52 AM
 
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I've been a Mothering supporter for several years & reading this forum for months, but I have never posted, so please forgive any goofs!

Going into my first pregnancy, I knew I had spine issues. I was diagnosed in college with spondylolisthesis at L5-S1, presumably from 10 years of competitive gymnastics.

On Mother's Day 2003 (& 2 weeks past due) I delivered my 9 lb. son by c-section. I had planned for natural childbirth. Unfortunately, my midwife had to leave town when I was a week past due, & her back-up was set on inducing me. To prevent that, my hubby & I made the decision for me to hop in the car with my family & head to my hometown so I could deliver at a birth center where my sister, a 10-year NICU nurse assisted deliveries.

After a full day in labor at the birth center, I dilated to 10, my water broke, and I began pushing. We tried numerous positions...in the tub, squatting, etc. I pushed for 5 1/2 hours. Interestingly, my contractions basically stopped when I got to 10 cm., so I was pushing on my own. As I sign of things to come, my son remained stable throughout the entire day. He my amazing, strong, 19-month old today.

Surrounded by 3 very experienced midwives & a supportive sister & husband, we decided that I should be transported to the hospital before we ended up in an emergency situation since the hospital was nearly 30 minutes away.

As I said, I ended up having a c-section (fully knocked out by choice since several anesthesiologists (Sp?) said an epidural would be risky with my spinal condition). I still have moments of saddness that my son's birth ended up like this. I struggled for months with the fact that I believed so strongly in the body's natural ability to give birth, yet I felt like my body failed me. It took a wonderful attachment parenting therapist to give me a new perspective. She said that my body didn't fail me, and instead, worked just perfectly. Since my son couldn't "get out", I stopped having contractions which prevented him from going into distress. True or not, this idea helped me come to terms with his delivery.

Jumping forward to May 2004, I decided to take some proactive steps to find out the actual condition of my spine before having another child. After MRI's & x-rays, we were told that the severity of my spondylolisthesis (Grade 4, right at spondyloptosis), caused by a congenital defect (spina bifida) & exacerbated by gymnastics, made getting a baby through the birth canal impossible for me. My L-5 vertebrae has slipped completely forward (towards my stomach) off the top of my sacrum. I'm a rare case, in that I have very minimal pain for such a severe case. Every Dr. we have seen has said that I will have to have surgery some time in the next 2 - 10 years to correct the slip. Rather surprisingly, they all said we could have another child, but they expected my pregnancy would be much more challenging this time around (since I've already had my stomach muscles stretched out once before, cut through, & have toddler to chase after this time around), & obviously, that c-section is my only option. My husband & I are debating if/when to get pregnant again knowing the risks and considering whether to adopt the rest of our children.

Sorry for so much background detail, but I'm still struggling with whether Dr.'s are just telling me that a VBAC is out of the question b/c that's the safe thing to tell me. Obviously, most of them feel that c-sections are completely safe & normal, & they blindly overlook the negative aspects of such a major operation. I doubt the Dr.'s I saw would understand why I cried after leaving their office trying to come to terms with the fact that I would not be able to give birth the way I felt I should be able to.

I'm in search of an "expert" anywhere in the U.S. who can look at my MRI's & x-rays & give me an accurate assessment of my ability to deliver vaginally. I can accept c-section as my only option for a safe delivery once I feel confident that I've received an opinion from an "unbiased," yet knowledgeable source. I search the internet weekly for other women's childbirth stories who also have spinal deformities, but I keep coming up empty-handed. Any help/direction/referals would be greatly appreciated!

Thank you for letting me share my story. These issues have kept me awake many nights, & it was time I reached out to others for help.
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Old 12-07-2004, 04:53 AM
 
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I've been a Mothering supporter for several years & reading this forum for months, but I have never posted, so please forgive any goofs!

Going into my first pregnancy, I knew I had spine issues. I was diagnosed in college with spondylolisthesis at L5-S1, presumably from 10 years of competitive gymnastics.

On Mother's Day 2003 (& 2 weeks past due) I delivered my 9 lb. son by c-section. I had planned for natural childbirth. Unfortunately, my midwife had to leave town when I was a week past due, & her back-up was set on inducing me. To prevent that, my hubby & I made the decision for me to hop in the car with my family & head to my hometown so I could deliver at a birth center where my sister, a 10-year NICU nurse assisted deliveries.

After a full day in labor at the birth center, I dilated to 10, my water broke, and I began pushing. We tried numerous positions...in the tub, squatting, etc. I pushed for 5 1/2 hours. Interestingly, my contractions basically stopped when I got to 10 cm., so I was pushing on my own. As I sign of things to come, my son remained stable throughout the entire day. He my amazing, strong, 19-month old today.

Surrounded by 3 very experienced midwives & a supportive sister & husband, we decided that I should be transported to the hospital before we ended up in an emergency situation since the hospital was nearly 30 minutes away.

As I said, I ended up having a c-section (fully knocked out by choice since several anesthesiologists (Sp?) said an epidural would be risky with my spinal condition). I still have moments of saddness that my son's birth ended up like this. I struggled for months with the fact that I believed so strongly in the body's natural ability to give birth, yet I felt like my body failed me. It took a wonderful attachment parenting therapist to give me a new perspective. She said that my body didn't fail me, and instead, worked just perfectly. Since my son couldn't "get out", I stopped having contractions which prevented him from going into distress. True or not, this idea helped me come to terms with his delivery.

Jumping forward to May 2004, I decided to take some proactive steps to find out the actual condition of my spine before having another child. After MRI's & x-rays, we were told that the severity of my spondylolisthesis (Grade 4, right at spondyloptosis), caused by a congenital defect (spina bifida) & exacerbated by gymnastics, made getting a baby through the birth canal impossible for me. My L-5 vertebrae has slipped completely forward (towards my stomach) off the top of my sacrum. I'm a rare case, in that I have very minimal pain for such a severe case. Every Dr. we have seen has said that I will have to have surgery some time in the next 2 - 10 years to correct the slip. Rather surprisingly, they all said we could have another child, but they expected my pregnancy would be much more challenging this time around (since I've already had my stomach muscles stretched out once before, cut through, & have toddler to chase after this time around), & obviously, that c-section is my only option. My husband & I are debating if/when to get pregnant again knowing the risks and considering whether to adopt the rest of our children.

Sorry for so much background detail, but I'm still struggling with whether Dr.'s are just telling me that a VBAC is out of the question b/c that's the safe thing to tell me. Obviously, most of them feel that c-sections are completely safe & normal, & they blindly overlook the negative aspects of such a major operation. I doubt the Dr.'s I saw would understand why I cried after leaving their office trying to come to terms with the fact that I would not be able to give birth the way I felt I should be able to.

I'm in search of an "expert" anywhere in the U.S. who can look at my MRI's & x-rays & give me an accurate assessment of my ability to deliver vaginally. I can accept c-section as my only option for a safe delivery once I feel confident that I've received an opinion from an "unbiased," yet knowledgeable source. I search the internet weekly for other women's childbirth stories who also have spinal deformities, but I keep coming up empty-handed. Any help/direction/referals would be greatly appreciated!

Thank you for letting me share my story. These issues have kept me awake many nights, & it was time I reached out to others for help.
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Old 12-10-2004, 02:32 AM
 
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Kim,

I feel a ceasarean birth is just as beautiful as a vaginal birth if the mother walked away feeling good about it.

I have a prob with c-sections when the moms feel cheated or like the Dr. forced her before her time.

Sorry, just wanted to add that not everyone here is c-section unfriendly
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Old 12-10-2004, 03:05 AM
 
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I heard some women can't deliver vaginally because of thin retinas (a part of the eye).. apparently during pushing they could rip and cause blindness!
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Old 12-10-2004, 03:20 AM
 
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I heard some women can't deliver vaginally because of thin retinas (a part of the eye).. apparently during pushing they could rip and cause blindness!
Wouldn't the solution to this be to discourage pushing? I mean, the uterus will get that baby out without you popping your eyeballs, kwim?

Mama, homeschooler, midwife. DD (13yo), DS (11yo), DD (8yo), DD (3yo), somebody new coming in November 2013.

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Old 12-10-2004, 03:33 AM
 
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Leila come check out the Cesarean Support Thread. I know how it feels to feel unaccepted by the natural parenting community when it comes to csections. I had one woman say I would eventually had my daughter vaginally but the facts are she would have died first. I am going to try to go to my due date with this baby (actually two days before) but I am definitely not going to try a VBA2C. Just too risky. Especially now that my odd shaped uterus has been cut twice. Deformed uteri fall under Mullerian Anomalies. I should have stated that in my previous posts. Before you have your next baby you should ask for your surgery reports.


Thanks

I know what you mean- I felt deep inside that there was more to the birth, even the second time around.That it wasn't just goping to be easy. I also felt a strong sense of peace when I had to make the desicion of whether to keep going or be sectioned. I feel I truly chose what was best. I feel very grateful that I had the choice. If I was in that same situation some odd number of years agao, I might not have had that option and probably would've died with dd or birthed her still.I am planning on using the same obnext time around, and preparing for a c-section but I also want to just let my body initiate labor at least. It is so much better that way.And *I recovered faster the second time around when my body actually went into labor.

So to stay on topic, I do beleive there are clear instances where harm is inevitable if someone does not intervene. We don't live in a perfect world. I think it my case it was a bicornaate uterus.

Due with number 5 in August. We do all that crunchy stuff.
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Old 12-20-2004, 06:39 AM - Thread Starter
 
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Thanks to all of you for your great stories and information! I really appreciate it!

I spoke with my MIL yesterday and asked her if her babies were all breech. All five babies were breech at all times. Also, every one of them came early (but I'm not sure if it's because she had big babies or what-- DH was 3 weeks or so before EDD and he was 8.5 pounds). She didn't even know she had a bicornuate uterus until she had a friend who was an RN do a case study on her after her fourth baby died and during the pregnancy/birth of her fifth baby. She was only ever told that she couldn't have the babies vaginally and was thinking it was one of those "once a c-section, always a c-section" things. It was a nice talk. I'm glad we had it.

After I talked to her about what I learned, we both vented about how there are way too many c-sections in this country, and that the rates need to go down, and that having a c-section for no reason other than you don't want to vaginally deliver a baby is terrible. I love my MIL. She's been to both her grandbabies' births, both of which were totally unmedicated, vaginal births. She was a great support to me at my daughter's birth, and is always a great advocate for me, and is such a good supporter of all my parenting styles (because she was a breastfeeding cosleeper, too!). Every woman should be so lucky!

Mama to DD (5) DD (3) and DS (2 months)
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Old 12-20-2004, 07:24 PM
 
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Wouldn't the solution to this be to discourage pushing? I mean, the uterus will get that baby out without you popping your eyeballs, kwim?
I don't know if I could have not pushed if I tried. Actually I did try, I knew I was about 9cm when I had the pushing urge. I was afraid to push yet because of being "just 9" but as much as I thried I could not control myself, I was bearing down really strong. I started crying that "it's making me push!!" My midwife assured me it was fine to push and not to worry but for a few minutes I was trying so hard and nothing could stop me from bearing down. LOL! I always wonder how they manage to get the women on those TV hospital birthing shows to stop pushing while the doctor is getting ready or whatever, I couldn't stop. I guess later on in the 2nd stage I could have probably held back but at first, the first 5 minutes maybe, the urge was overwhelming.

But for sure none of that dumb ass hospital "1-2-3-4-5-push push push push 6-7-8-9-10 deep breath, now push push push 4-5-6 push push push 8-9-10"
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Old 12-20-2004, 10:47 PM
 
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I just wanted to add that, after having #1 in the hospitial, I was told I had a "heart-shaped uterus" and "could not push."

I had #2 at home after pushing only 2 or 3 times, after a three hour labor.

I had #3 at home after a two and a half hour labor, and had to push for about 15 minutes. He was over ten pounds and had his hand by his head.

None of them were breech, allthough #2 was two or three weeks early.

Just saying not to take your doctor's word as gospel.
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Old 12-20-2004, 11:55 PM
 
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Any woman who has had rickets or a pelvic injury in, say, a car accident or perhaps a skiing accident would not be able to push a baby out vaginally.

There are other problems as the Bandi's Ring or incoordinate contractions from poor levels of oxytocin or pacemaker cells that would make a vaginal delivery impossible.

Placenta previa, or placenta abrupto?

Often, when a baby is malpositioned, it is the reason for the malposition, not the position itself that is the problem.

I was reading the torah portion two weeks ago about Tamar who had twins with Judah. The midwife tied a ribbon around the hand of the first twin. Then the hand went back in...the first twin completely out was not the one she tied the ribbon on. The second twin had the ribbon on his hand...what a difficult birth that must have been!

"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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Old 12-21-2004, 12:13 AM
 
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I had cesarean births with all 3 of my children.

I won't go into the whole story. I had a severe pelvic injury as a child....it's not possible for me to deliver vaginally. There are those who have clear physical issues and are not able to deliver vaginally.

I'm definitely one that supports natural births...have attended and assisted in several home births. And I think unnecessary cesareans......well I just don't have words for it - it's so appalling!

But I am thankful that I live in these times and I am able to have the children I have.
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Old 02-05-2005, 02:19 AM
 
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I think I am one who cannot deliver vaginally. I was in a serious car accident as a baby, 5 serious/totaled car accidents in college, one of which resulted in a week-long hospital stay. In several I was hit from behind (sitting at red light, sitting at a stop sign) and even the backs of my seat bent in and broke at the mid-section. Both my boys had beautiful labors but their heads were stuck in the identical places, identical positions. I had the sensation that their heads were *bumping* into something. After birth, both boys had identical scars on their foreheads from what I believe is a bone spur or calcified scar tissue that blocked the birth canal. If you've been in a serious car accident, there can be serious complications to a natural delivery.

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Old 02-05-2005, 03:25 AM
 
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Wow, Loftmama. That is really weird!
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