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Discussion Starter · #1 ·
I had an appointment with my Dr. yesterday for my 28 weeks. I had a list of questions namely in regard to a comment he made last time about having a cesearean for a baby 9 lbs and over. Again this time he commented that "we wouldn't want to see a baby any bigger than the 7lb8oz" my Ds was.<br><br>
So here is my question - WHY?? My last birth resulted in deep transverse arrest - I was induced 36 hrs after my water had broken for start stop surges, given an epidural and lay on my back or side for the remaining 10 hours of my 58hr ordeal. No one told me that baby was in a bad position during my 1 1/2 hours of pushing (which wass on my back of course<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry"> ).<br><br>
I believe the arrest had to do with being on my back for so long and pushing in that position - so my pelvis didn't open enough. Plus i was told to push to remove a lip - I am curios if this had anything to do with it. The epi was gone at this stage so I could tell when a contraction was happening. Th medwives commented that my pushing was very effective.<br><br>
I confronted the Dr, "Are you saying my pelvis is too small to birth an average sized baby?" He quickly stated no and that the reason for my c was largely circumstantial. So then why had he made the comment about "big babies". He really changed his tune by the end - being very supportive and encouraging and agreeing to many of my requirements that other drs may not have. He knows how committed to this VBAC I am. But he never really answered my question. What does a past CPD / deep transverse arrest have to do with this birth?<br><br>
My DH thinks maybe Dr. was withholding info so I wouldn't get discouraged. "Would you really want to hear if your pelvis is too small?" I think this is horrible and I honestly don't believe it b/c i know that any woman can birth the baby inside her except in extreme circumstances.<br><br>
Sorry this is so long. I am obviously feeling lost and alone and confused. Can anyone give me info on CPD - if that is how you spell it - any why there would be any concern over the size of this babe. BTW I have bee consistently measuring 2 weeks ahead at each fundal height check and that is why the conversation even came up.<br><br><br>
Thank you so much
 

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Your instincts are right - you can birth a baby vaginally.<br><br><br>
Deep transverse arrest and CPD are totally different things. Deep transverse arrest is a positioning issue (baby gets hung up sideways on the pelvic ischial spines) - not that the head is too big for your pelvis.<br><br>
I wonder about the support you will continue to receive from this doctor in regards to your desire to VBAC. Within the medical model, macrosomic (or "large babies") are those that are 8lb 13oz and over. If this was the case, nearly all of my clients would be induced for "big babies". It sounds like this doctor has an extreme version of what he considers "too big" for a VBAC.<br><br>
How do you feel about this doctor and his support for your VBAC? Do you think he may be looking for a reason for a secondary elective cesarean? Do you feel supported and that this provider is genuinely interested in your ideals?<br><br>
Here's more information on cephalopelvic disproportion (very, very rare!):<br><br><a href="http://www.midwiferytoday.com/articles/truecdp.asp" target="_blank">http://www.midwiferytoday.com/articles/truecdp.asp</a><br><br><a href="http://www.naturalchildbirth.org/natural/resources/vbac/vbac04.htm" target="_blank">http://www.naturalchildbirth.org/nat...bac/vbac04.htm</a><br><br><a href="http://www.familyinternet.com/fisites/pregcom/05040170.htm" target="_blank">http://www.familyinternet.com/fisite...m/05040170.htm</a><br><br><a href="http://transitiontoparenthood.com/ttp/foreducators/shortwomen.htm" target="_blank">http://transitiontoparenthood.com/tt...shortwomen.htm</a><br><br><br>
Here is information on deep transverse arrest:<br><br><a href="http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_61zPzhtm" target="_blank">http://www.mercksource.com/pp/us/cns...dmd_a_61zPzhtm</a>
 

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IMO? Yr doc is full of crap. My first baby, c-sec, supposed CPD, 36 hour labor, (no food no drink for me all that time, finally a morphine drip for some rest, then pitocin) started pushing at 9 cms to get lip out of the way, pushed for one hour, so similar to yours. Well, baby was 10 lbs 2 oz.<br><br>
2nd baby, 8 lbs, pushed her out in 45 mins. 3rd baby, 9 lbs, pushed him out in 45 mins. I do believe I have a shallow pelvis as I carry high (like you) and babies do not "drop" until labor. And obviously I do have to put some effort into pushing.<br><br>
I do not remember if all the babies' head sizes were similar, but I imagine so. #1 was just a little fattie!<br><br>
The 2nd two births were home VBACs, BTW! I used pushing on the toilet, and finally, standing to deliver for the first VBAC. Next baby, I used hands and knees position, then finally sat to push, with back upright against pillows. Had tiny labial tear with 1st VBAC, no tearing with delighfully controlled birthing pushing with last baby!<br><br>
Remember, upright pushing opens the pelvis a critical few more cms as ligaments stretch!
 

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Your instincts are right. CPD is really very rare. Doctors use this "diagnosis" because their medical management of birth tends to fail quite frequently and they don't have a "real" diagnosis. Just like "Failure To Progress" (FTP).<br>
Your baby was probably in a "bad position" because you weren't up and about until transition/pushing. Laying down in early labor, unless it's bedtime, is a really bad idea. Your pelvis isn't moving as you walk around, squat, etc., so it doesn't give your baby much to work with in terms of positioning himself. So of course, by the time you started pushing on your back, he may not have been in an optimal position, anyway.<br>
Just for future reference: research consistently shows that the bag of water can be broken for extended periods of time without problems as long as A.) nothing is inserted into the vagina; B.) you don't immerse yourself in water; and C.) you check your temperature frequently to make sure you are not developing a fever. You should know this in case it happens again.<br>
Good luck!
 

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I have a friend who had her first (and possibly second?) born by Cesarean for CPD...she just had her 4th vaginally, at home--he weighed in at close to 13 lbs.<br><br>
My mother was given a C-section for me, born at 7 lbs 13 oz for CPD...she went on to VBAC 3 more, one was 8 lbs and another was 9 lbs (the third was 6 lbs)...and she's a pretty little 5 ft. 2" thing.<br><br>
Our bodies can do it!<br>
Keep the faith!
 

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Discussion Starter · #6 ·
Thank you for your thoughtful responses. I am feeling a bit more grounded. I am glad my care provider is more on board w/ me after i talked w/ him. But i do still have concerns. The thing is - I live in a small town - I feel very uncomfortable with the only midwives here (for many reasons from last birth and followup). I always have felt comfortable w/ this Dr. - who was at the last birth and was very positive. Besides in this area he is the most hands off (I think more than the medwives). So what I need to do is get a doula, stay home, know my Self, and let Dr. know when it is time to push.<br><br>
He has agreed w/ me that I will not be induced - "even if my water has been broken for 3 days"- no vag exams, Dh will catch the baby etc. So I am feeling more confident. But in reality - he is a Dr. and so is always on the look out for potential problems. He always says unless something happens. That is concerning to me. I am so glad I have found women like you that are my true inspiration and really help me ground and believe in what I know.<br><br><br>
Pamamidwife - I know from reading other posts how respected you are. If only we could transport you around - Oregon isn't that far from BC -HMMMM maybe I could move there for the birth<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> Wishfull thinking. Thanks for the links<br><br>
Thank you again
 

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Freedom, my hubby and I dream of moving to BC...but I'm not sure if I can be the type of midwife that is legal there. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> It would take much more training, and some huge accomodations in what I believe about birth. Still, I dream of moving there!<br><br>
I think your plans sound fine. You may have to revisit your belief system a couple more times before the birth, but that's a good thing. I think it reinforces who you are, what you believe, and what you deserve from this next birth!
 
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