Shoulder dystocia - Mothering Forums

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#1 of 12 Old 10-18-2010, 12:45 AM - Thread Starter
 
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Just wondering if any moms here had this? My son is now 4 months old and I still think about it daily. We are still experiencing complications from his clavicle fracture but I am terrified to have any more children again. Does previous SD qualify for medical elective C-section? My son almost died and I really can't do that again. I was in labour for 3 days after 2 failed inductions, honestly, the pain of that doesn't bother me, it's the fear of the birth itself. He wasn't a huge baby - 9lb 3oz - big, but not overly large for 41 weeks.
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#2 of 12 Old 10-18-2010, 08:19 AM
 
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I think that the best birth for *any* woman is the one that she can feel confident about, and in control of. I could absolutely see myself feeling like a c-section was the safest course of action after a shoulder dystocia that severe. I don't think you are crazy or wrong, and I think that you should absolutely be able to find a medical provider willing to go the elective c-section route with you after an experience that traumatic and dangerous.



You've been through a lot, mom. Wanting to avoid that experience again is an absolutely normal response.

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#3 of 12 Old 10-18-2010, 09:34 AM
 
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I agree--of course this possibility is now pretty scary to you! Of course it will take some time to recover from the shock/fear, and be able to consider a next birth calmly. Give yourself time to heal emotionally--which I'm guessing will occur as your baby heals physically from his injury, and just more time passing since that birth.

And know that SD is often preventable, with the right birth care. Your birth, with induction and no doubt fatigue and worry prompted by the induction attempts, seems to have been somewhat medically pushed toward various scary outcomes. I'm just so glad that it was 'only SD' (which is very relative, I know--NOT meaning to minimize your experience/feelings--I just know even scarier possibilities, KWIM?). Anyway, various things aspects of birth care can maximize the possibility of SD, and other things can minimize that risk. There are also different ways to manage SD if it does occur--differences in approach really can make all the difference in how it goes. There is time to heal, first...and then in time, to look into SD more deeply as you consider how to best approach future births.

Also--while your mention of future csec is totally understandable--totally!--know that csec carries it's own risks, we just cannot eliminate risk from birth, only substitute certain risks for others. One of the risks of csec is fairly dependent on how many kids you hope to have: if only 1 more, then maybe that is a choice you can make, feeling comfortable that the risks are well worth it. But since the risks of future pregnancies rise after csec, and the risks to moms and babies both rise with each subsequent csec (and w/each new pregnancy following multiple csecs), then this is something to review carefully before deciding.

I'm so sorry your birth was so scary, and that you are still dealing with your baby's injury and your own upset in the wake of his birth...I know that is hard. Just know that you will heal, just as your baby will heal--and that you have time to learn more, and make wise decisions for the future when you are ready for that.
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#4 of 12 Old 10-18-2010, 11:05 AM - Thread Starter
 
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Originally Posted by loveneverfails View Post


I think that the best birth for *any* woman is the one that she can feel confident about, and in control of. I could absolutely see myself feeling like a c-section was the safest course of action after a shoulder dystocia that severe. I don't think you are crazy or wrong, and I think that you should absolutely be able to find a medical provider willing to go the elective c-section route with you after an experience that traumatic and dangerous.



You've been through a lot, mom. Wanting to avoid that experience again is an absolutely normal response.
Thank you loveneverfails, I think the lack of control is the fear. Thanks for your support.
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#5 of 12 Old 10-18-2010, 11:09 AM - Thread Starter
 
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I agree--of course this possibility is now pretty scary to you! Of course it will take some time to recover from the shock/fear, and be able to consider a next birth calmly. Give yourself time to heal emotionally--which I'm guessing will occur as your baby heals physically from his injury, and just more time passing since that birth.

And know that SD is often preventable, with the right birth care. Your birth, with induction and no doubt fatigue and worry prompted by the induction attempts, seems to have been somewhat medically pushed toward various scary outcomes. I'm just so glad that it was 'only SD' (which is very relative, I know--NOT meaning to minimize your experience/feelings--I just know even scarier possibilities, KWIM?). Anyway, various things aspects of birth care can maximize the possibility of SD, and other things can minimize that risk. There are also different ways to manage SD if it does occur--differences in approach really can make all the difference in how it goes. There is time to heal, first...and then in time, to look into SD more deeply as you consider how to best approach future births.

Also--while your mention of future csec is totally understandable--totally!--know that csec carries it's own risks, we just cannot eliminate risk from birth, only substitute certain risks for others. One of the risks of csec is fairly dependent on how many kids you hope to have: if only 1 more, then maybe that is a choice you can make, feeling comfortable that the risks are well worth it. But since the risks of future pregnancies rise after csec, and the risks to moms and babies both rise with each subsequent csec (and w/each new pregnancy following multiple csecs), then this is something to review carefully before deciding.

I'm so sorry your birth was so scary, and that you are still dealing with your baby's injury and your own upset in the wake of his birth...I know that is hard. Just know that you will heal, just as your baby will heal--and that you have time to learn more, and make wise decisions for the future when you are ready for that.
Thank you MsBlack,

I do want to wait longer before considering another birth, my DH does not, so I guess I feel some pressure there. Yes, I think the overmedicalization of the birth greatly contributed to the SD (I had group B strep and my waters leaked for several days at 41 weeks so they said I needed an induction, something I certainly didn't want).

And yes, "only SD" is something I am grateful for, because when it is severe enough to require intentional fractures, it's only a few minutes from cerebral palsy or death. For that, I am grateful that I came home with him. He still has complications from the injury (he still fears the breast after being pushed onto it with his fractures multiple times, even lactation consultants have not been able to get him back on it), but he is alive.

I think I will have to give it a long time. It's a far cry from the natural med-free labour that I had desperately wanted.
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#6 of 12 Old 10-18-2010, 11:32 AM
 
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Oh mama...yes, there can be so much hurting around a birth like that--more than just the pain of the labor, or a broken bone, or the loss of the original plan...so much more. Do give yourself time. Dh will just have to understand how important it is to you, to your present baby and all your future babies--important to the whole family, including him!--that you have plenty of time to heal and make plans that you truly feel are best for the next birth.
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#7 of 12 Old 10-26-2010, 05:46 PM
 
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I am so sorry that you and your son had such a scary birth, I am so glad he is OK!

I am not trying to scare you, just wanted to share my experience. I lost my second son to shoulder dystocia & everything was done right,I was at home, normal length labor, never on my back, not tired, etc etc. In water even. We transferred in enough time that they may have been abe to save him, but the OB's coudnt get hm in time either, it took them 15 min. & they assured me being athome had nothng to do with his death, it was very severe & rare. There really are no predictors for s.d. & no guarantees. I have gone on to have 3 kids since, all C sections. My first was a hb, all fine, my second was a totally unexpected tragedy. I had dreams of a peaceful section during my 3rd pregnancy & I was very comfortable planning for that. All of my C sections have been wonderful, went according to plan & I healed well. The milk was in at 24 hrs pp each time. I am planning a 4th C this January. Yes, there are definitely risks with multiple C's ,but a lot of it is luck. If there is at least a year btwn surgeries & you scar well, the risks are pretty minimal. Good luck with whatever you decide, you will know what option brings you the most peace. ((hugs))

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#8 of 12 Old 11-03-2010, 09:03 AM
 
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liseux--

Respectfully, the risks of repeat csec (RCS) are NOT 'minimal'--and those risks become higher in every way, with more cesareans. Cesarean mamas are already more than 2x more likely to die due to birth (surgery complications, during and after) than those who birth vaginally. The more cesareans, the higher the maternal mortality rate due to surgery/post surgery issues. The rate of hysterectomy, needed to save mother's life, also rises significantly with each cesarean (well above mortality rate). The rate of MANY other health and pregnancy issues for women rises with even one cesarean, and risks compound with each successive surgery.

You can go to ican-online.org, to the 'white papers page', to see this spelled out. VBACfacts.com is another well-researched source. It is true that some mothers have survived multiple cesareans, even more of them than you. It is also true that a planned csec can be a beautiful experience for all. Yet no one should feel that the real risks of repeat csec are just a 'matter of luck'. Your loss was a matter of 'luck' or 'random chance', most likely--at least, it seems all was done that could have been done for your baby, and I do think random chance plays its part in birth as in all things...but it's not really 'luck' to blame if a mama suffers loss of life, uterus, and/or normal health from repeat cesareans.

I fully respect your choice, made following your tragic loss of a baby! And yet I hope you will be more cautious about recommending your choice to any mama. We cannot eliminate risk from birth...we can only take a hard look at the choices and statistics, and make our own best choice. I don't mean to dramatize risk--and clearly, you demonstrate that a woman *can* remain healthy in the face of repeat csecs. It's important too, though, that we don't minimize risks either.
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#9 of 12 Old 11-03-2010, 04:38 PM
 
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I agree & the facts are clear that maternal risks do rise with each C/s. I also feel comfortable having multiple c/s b/c the risks that scare me personally most are placenta issues, esp. accreta/percreta. That's what I meant by luck, if your placenta is nowhere near the scar, its not a big risk at all. I definitely never recommend C/s to "any mama" & I didn't recommend my choice to the OP either, I merely shared my experience. I felt very comfortable planning a c/s after my loss, I had dreams that made me feel I was in the right place. Not to mention, no provider, from DEM to OB would feel comfortable letting me deliver naturally. SO my only option would be a UC, which in my situation would be far from prudent & if it went wrong I could have even more people blaming me than last time & a 17 page thread of condolences here. I will take my chances with a surgery that is done often & well (unfortunately all too often IMO).

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#10 of 12 Old 11-03-2010, 07:35 PM
 
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thanks for clarifying that, Liseux. I misspoke to say that you were 'recommending' RCS, sorry about that.

You are right that placental location makes all the difference with placenta accreta, increta, percreta. However, cesarean is associated with a higher incidence of placenta previa as well.

I understand why you made your choice--and I imagine it can't have been easy to do. It does sound like your SD was really very severe--well beyond most.
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#11 of 12 Old 11-05-2010, 03:15 PM
 
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Thank you for your kind response MsBlack. You are someone I respect on MDC a lot, you know your stuff for sure!I definitely consider my situation very rare & I hope that all mothers who face this kind of dilemma weigh all of ther options & pay attention to their intuition as well.

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#12 of 12 Old 11-07-2010, 08:12 AM
 
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Thank you for your kind response MsBlack. You are someone I respect on MDC a lot, you know your stuff for sure!I definitely consider my situation very rare & I hope that all mothers who face this kind of dilemma weigh all of ther options & pay attention to their intuition as well.
Yes, this is so important! I really believe that in the end, the 'best' choices are made with respect for available info AND intuition....our birth choices (in any circumstances) cannot, IMO, be made from logic alone.

And Liseux--I'm so glad to hear your multiple-C success stories I've been doing a renewed study of csec/RCS and vbac lately--my head is full of dismaying statistics right now. Good to have the balancing effect of stories like yours
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