[poppet]

Hi, I will try and make this as brief as possible but just hope that someone can help.<br><br>
I am 28 weeks pregnant with my 2nd child and have just been told by my consultant that I have cephalopelvic disproportion and should have a c-section. Obviously I am upset about this.<br><br>
I had my first baby (9lb 1z) vaginally in Oct 2005 after a long labour and 3 1/2 hours of pushing in stirrups (did have an epidural), eventually after an episiotomy he came out. The the morning following the birth I found that I could not lift my legs off the ground, more or less paralysed. I was given an immediate MRI scan and told I had slipped a few discs. I was discharged from hospital (remember we are talking NHS!) about 4 days later and had 6 months of physiotherapy. It took 3 months before I could get in and out of the bath myself without help.<br><br>
Now I am obviously keen to avoid a repeat situation and if this means a c-section then so be it, especially if it puts the baby in any kind of danger. However, I have read that cpd is VERY rare and normally misdiagnosed and most women who end up with an emergency c-section can have a vbac next time. I can't find any info anywhere on the net of someone actually giving birth, being "injured" and then being diagnosed.<br><br>
It has taken 2 years for someone to give me an answer to what happened to cause such problems from my birth 2 years ago.<br><br>
I am unsure what to do next, I have a pelvic and fetal estimate weight and size scan in 7 weeks (at 35 weeks) and then have to see my consultant again. I don't want to push for a normal delivery if it is going to be dangerous, but I also don't want to just opt for a c-section just to appease the NHS who may be worried about the hassle I may cause them.<br><br>
Does anyone have any thought? And thank you if you got this far!!<br><br>
Danielle

 

[MsBlack]

Seems quite plain to me that you do not have a pelvis too small to let out a baby! You may have some sort of issue, but CPD is definitely not it!<br><br>
I can't help but feel that your epidural, together with your birthing position, helped to cause the damage done to your back.<br><br>
It is quite possible that your preparation for natural birth, and your insistence on maintaining full mobility during labor/birth, will help you to avoid further problems. You might even want to seek a homebirth, where you are most likely to receive fullest support, prenatally and during birth, toward preparation and most effectively managing your labor/delivery.<br><br>
good luck! Please don't accept CPD diagnosis....it just ain't true.

 

[poppet]

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<div>Originally Posted by <strong>MsBlack</strong> <a href="/community/forum/post/10297705"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Seems quite plain to me that you do not have a pelvis too small to let out a baby! You may have some sort of issue, but CPD is definitely not it!<br><br>
I can't help but feel that your epidural, together with your birthing position, helped to cause the damage done to your back.<br><br>
It is quite possible that your preparation for natural birth, and your insistence on maintaining full mobility during labor/birth, will help you to avoid further problems. You might even want to seek a homebirth, where you are most likely to receive fullest support, prenatally and during birth, toward preparation and most effectively managing your labor/delivery.<br><br>
good luck! Please don't accept CPD diagnosis....it just ain't true.</div>
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Thank you, yes after research I have been starting to get a bit suspicious about the diagnosis. I had been set for a normal delivery minus the epidural and stirrups this time and have been really looking forward to it. I was thinking water birth would be fabulous.<br><br>
I was just unsure that if the baby was bigger this time that he may not fit - but at the same time questioning the diagnosis as I did manage to give birth to a 9 pounder. I was also worried about doing some long term damage to myself. Also, I am worried about going against the advice, I can't understand why they would want to cut someone open instead of allowing normal deivery - if anything surely an operation and aftercare is more expensive to the NHS.<br><br>
Thanks for your reply - I will definately consider pushing for trying a normal delivery

 

[turtlewomyn]

ETA: I am not a birth professional, I saw your post and had to answer as a woman who was formerly coerced into an unnecessary c-section for "big baby". Then after my passioned response I realized I was in the birth professional forum.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/soapbox.gif" style="border:0px solid;" title="soapbox"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/splat.gif" style="border:0px solid;" title="splat"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/rant.gif" style="border:0px solid;" title="rant">:<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/Cuss.gif" style="border:0px solid;" title="cuss"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/censored.gif" style="border:0px solid;" title="censored"><br>
That is how I feel about your care attendant. Please drop them and get a new one.<br><br>
CPD is when you have an unusually small pelvis (usually due to poor nutrician, a disease or condition) and a babies head cannot fit through. It requires a c-section. You pushed out a 9lb baby, your pelvis is more than adequate. Your care provider isn't even trained enough to use proper terminology, I would dump them.<br><br>
The reason you had so much damage was because you were lying on your back, with your feet up in stirrups.<br><br>
I also had my baby in Oct 2005 and she was 9lb8.5oz. I had a late term U/S that estimated her size and I was coerced into a scheduled c-section for "fetal macrosomia". The Midwife and her doctor were afraid that my big baby would get stuck i.e. have Shoulder Dystocia (which would be likely if they put me on my back to push) and that they would damage the baby trying to get it out (which would be likely with an untrained care provider that doesn't know how to resolve Shoulder Dystocia). I regret that all the time. I have suffered from PPD and PTSD. I will be having a vbac next time, hopefully at home. The American College of Obstetrics and Gynecology DOES NOT recommend automatic c-section for "big baby". It subjects far too many babies and moms to the risks of c-section to even prevent one case of Should Dystocia.<br><br>
My recommendation is to find a new care provider. Preferably a homebirth midwife. Upright positions (i.e. squatting) are much more effective at pushing out a large baby without doing damage. Do some research.<br><br><a href="http://www.ican-online.org" target="_blank">www.ican-online.org</a> - this is the website for ICAN (International Cesarean Awareness Network), they have a yahoo group and you might want to join. Find a local meeting if you have one. The moms there can direct you to a good care provider and can share some of their stories. Edited to add, I just realized you are in London, I don't think they have a chapter there. You might want to try the list serve for information.<br><br>
I also recommend avoiding the U/S to determine baby size. You already know that your body is built to give birth to big babies. There is no sense in allowing them to scare you with their weight estimates. At the same time, make sure you are eating a good healthy diet (which you probably are already).<br><br>
Are you getting chiropractic care? That will help in getting the baby into a good position for birth and with helping your old injuries.<br><br>
Some other good sites:<br><a href="http://www.spinningbabies.com" target="_blank">www.spinningbabies.com</a> - great info on positioning<br><a href="http://www.childbirthconnection.org" target="_blank">www.childbirthconnection.org</a> - great info on risks of c-sections vs. vaginal birth<br><a href="http://www.ubpn.org" target="_blank">www.ubpn.org</a> - the United Brachial Plexus Network - this has a lot of information on injuries caused by SD and care providers who don't know how to deal with it. They have a brochure on how to prevent SD, and talk alot about positioning during labor and staying upright.<br><br>
It would probably also be a good idea to avoid an epidural next time, so that you can stay upright. You might want to look into some birthing classes that will give you some more pain management techniques (hypnobirthing, hypnobabies, etc.)<br><br>
Finally, have you considered a homebirth? In my search for a care provider I have found that most homebirth midwives are very experienced in catching big babies, and have more experience in dealing with SD if it does happen. I think that even if you don't feel comfortable with that idea, you should at least meet a HB midwife in your area and check out that as an option.

 

[Mindi22]

Did they take an X-ray? True CPD can ONLY be diagnosed on film. Period.<br><br>
And it's way too early to call it anyway! I agree, ditch these providers and find ones that have some faith and trust in your body.

 

[mwherbs]

Can you have a home birth ? what I would be thinking is that you injured your back because of the position you gave birth in--<br>
doesn't sound like a pelvis problem since they are saying discs ---<br>
the sacrum and coccyx that are in the pelvis aren't going to have bulging discs so it is above there and injury to that area was probably positional-and possibly injured due to the epidural as well either by blocking your sensations so you were not aware something didn't feel right and stayed in place long enough to cause injury or how it was placed may have caused irritation and injury--<br><br><br>
your pelvis has some flexible points in the middle front is the sympathis pubis and in the back is the sacrum and coccyx in pregnancy these areas soften in response to your hormones ,actually the cartilage all over your body including the tip of your nose,responds to pregnancy/birth hormones - and as you know your baby did fit through so CPD did not occur for a first baby and with an epidural inplace your pushing stage was normal- an episiotomy just cuts soft parts- and does not have to do with bony tissue or CPD--<br>
as you see my suggestion would be quite different than the doc's, at a minimum I would recommend that if you have another epidural that it is a "walking" one and that you do not get into that same position to push --better positions are side lying so there is no pressure on your back or kneeling or hands and knees -- stay off your bottom and back--

 

[MsBlack]

mwherbs--<br><br>
thanks for that concise report on how epidural possibly was at base of poppet's spinal injuries. You said what I was picturing, but I knew I couldn't explain it concisely! And there's only so many 10,000 word posts I feel I should submit yall to, in a given week <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"> (been there a couple times already this week....)

 

[etoilech]

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<div>Originally Posted by <strong>Mindi22</strong> <a href="/community/forum/post/10297844"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Did they take an X-ray? True CPD can ONLY be diagnosed on film. Period.</div>
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This isn't true. A pelvis is not static (i.e. does not move), a pelvis is dynamic (i.e. it moves). The pelvis flexes to let your baby through. A baby's head also molds to fit through a pelvis. These things cannot be diagnosed on film. It is also inappropriate to x-ray a pregnant woman for the sake of measurement (which are inaccurate when the above information is noted).<br><br>
A true measure of a woman's pelvis is a baby's head... so the saying goes. CPD can't be diagnosed until to try to push the baby out. If you've had a vaginal birth with a nine pound baby, I wouldn't worry about it. You are unlikely to have CPD, unless you have other medical problems (uncontrolled diabetes, previously fractured pelvis whihc has not set properly, rickets, etc.)<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>poppet</strong> <a href="/community/forum/post/10297665"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I am unsure what to do next, I have a pelvic and fetal estimate weight and size scan in 7 weeks (at 35 weeks) and then have to see my consultant again. I don't want to push for a normal delivery if it is going to be dangerous, but I also don't want to just opt for a c-section just to appease the NHS who may be worried about the hassle I may cause them.<br><br>
Does anyone have any thought? And thank you if you got this far!!<br><br>
Danielle</div>
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I would refuse the ultrasound. It really isn't going yield any useful information. You are in the UK. I would get in touch with the National Childbirth Trust (NCT) for support and guidance to help you birth *your* way. They can support you and let you know your rights with the NHS. You can refuse everything and you have a right to a home birth on the NHS.<br><br><a href="http://www.nct.org.uk/home" target="_blank">http://www.nct.org.uk/home</a><br><br>
Their help line: 0870 444 8708<br><br>
This is a group for midwives and consumers in the UK, I bet they can help you if you let them know what's up.<br><br><a href="http://health.groups.yahoo.com/group/ukmidwifery/" target="_blank">http://health.groups.yahoo.com/group/ukmidwifery/</a><br><br>
This is also a good source and it's in London, I bet they can let you know your options too.<br><br><a href="http://www.activebirthcentre.com/" target="_blank">http://www.activebirthcentre.com/</a><br><br>
Please don't except this bollocks as you would say in the UK.<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:

 

[turtlewomyn]

<a href="http://www.independentmidwives.org.uk" target="_blank">http://www.independentmidwives.org.uk</a><br><br>
Someone gave me this link as a way to search for an independent midwife in your area.

 

[poppet]

Thank you so much everyone for all your replies, they really have been very useful and reassuring.<br><br>
I obviously definately do not have cephalopelvic disproportion and am shocked that I have been told I have.<br><br>
I think I may go and visit my gp and ask for a 2nd opinion amd argue for a natural delivery.<br><br>
Thanks again x

 

[April422]

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<div>Originally Posted by <strong>Mindi22</strong> <a href="/community/forum/post/10297844"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Did they take an X-ray? True CPD can ONLY be diagnosed on film. Period.<br><br>
And it's way too early to call it anyway! I agree, ditch these providers and find ones that have some faith and trust in your body.</div>
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<br>
While I agree with the second paragraph of your post, the fist part is untrue. Xray doesn't account for the influence of relaxin on the pelvis and the baby's head to mold to pass through the pelvis.<br><br>
The only true way to diagnose CPD is to allow a woman to labor and push. Even then a diagnosis of CPD is more likely failure to wait or more a case of the baby being posterior or asynclitic and if those were resolved there'd be no CPD and baby would pass.

 

[SublimeBirthGirl]

Why stay with a provider you'll have to argue with? Switch, if you want a decent birth. You might investigate homebirth. I think it's unlikely that if you'd had an unmedicated birth and not been in the WORST position possible for pushing (not just lithotomy but stirrups!), that you'd have had such damage to your back.

 

[Ak Mom]

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<div>Originally Posted by <strong>poppet</strong> <a href="/community/forum/post/10297665"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I have a pelvic and fetal estimate weight and size scan in 7 weeks (at 35 weeks) and then have to see my consultant again.</div>
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I wouldn't rely on an ultrasound to estimate the weight and size of the baby. I had an ultrasound done because they were concerned the baby was too small for dates (how funny that in the first ultrasound, I was too big for dates and they were trying to tell me my due date was different than what I knew it was). They estimated him at 6lbs. I went into labor 2 days later and he was 7 1/2 lbs. For a baby, 1 1/2lbs is a big difference, so I would say the estimate was WAY off!<br><br>
Don't fight them-pregnancy is not the time for fighting, if you can help it. Find someone who believes in you.

 

[danotoyou2]

I just scanned the replies, and didn't see this mentioned, but... I have a question.<br><br>
Isn't CPD referring to the PELVIS? If that's so, then the actual bones themselves would not allow the passage of the baby. If that's the case, then how would getting an episiotomy help? Obviously it did, because the baby was born.<br><br>
I'm just sitting here scratching my head.