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I came into the hospital at 8 cm, 80% effaced, zero station after laboring at home with my doula for approx 10 hrs. 12 hrs later I was given a c/s for "arrest of descent and dilation". I was told there was a "lip" and that my cervix was swollen--I never got past 9 cm, was 80% effaced, and baby never dropped past zero station.<br>
I was not allowed to move during labor b/c of monitor problems and the labor tub was broken. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br>
I just got my surgery records and they say that my "subpubic arch" is narrow, that my "diagonal conjugate" cannot be reached. my spines are avg, my sacrum is concave, and nothing is checked off in the "gynecoid pelvic type--yes/no".<br>
I was about 180lbs at delivery and avg.activity (prenatal yoga, walking)--no other complications.<br><br>
Is my pelvis too narrow?<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> I want to TTC and VBAC and want to be armed with enough knowledge to battle the people here in NJ who are going to tell me I HAVE to have a repeat C/S<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry"><br><br>
Any help deciphering the info in para 2 would be much appreciated.
 

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I'd like to offer you this (and its only one person's experience) but I labored for 20+ hours and pushed for more than 4.<br><br>
I pushed a baby with a 14" head right by my "narrow pubic arch"<br><br>
I am 5/2, normally a size 6 and wear a shoe size of 6 or 7, depending.<br><br>
What I have come to believe stongly is that the position of the baby plays a very important role in how long it will take them to move from our womb to outside of our bodies.<br><br>
Many ICAN women who are labeled as having pelvi that are not "ideally" shaped for childbirth go on to have even larger babies next time.<br><br>
Do you believe you can birth? I do <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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<div>Originally Posted by <strong>2bpeaceful</strong> <a href="/community/forum/post/10265030"><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 was not allowed to move during labor b/c of monitor problems and the labor tub was broken. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br><b>I just got my surgery records and they say that my "subpubic arch" is narrow, that my "diagonal conjugate" cannot be reached. my spines are avg, my sacrum is concave, and nothing is checked off in the "gynecoid pelvic type--yes/no".</b><br>
I was about 180lbs at delivery and avg.activity (prenatal yoga, walking)--no other complications.<br><br>
Is my pelvis too narrow?<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> I want to TTC and VBAC and want to be armed with enough knowledge to battle the people here in NJ who are going to tell me I HAVE to have a repeat C/S<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry"><br></div>
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I am not a trained expert, but i am very well-read about these things and i would guess that your c-section was more about your care provider's impatience and your inablility to be mobile than about your pelvis.<br><br>
The thing about pelvimetry is that it is an art, not a science. When they did that exam that told them all the information that i bolded, you were most likely laying on your back. This speaks nothing of your ability to birth a baby in an upright or squatting position, which open your pelvis considerably. In the absence of a physical deformity, the odds are highly in your favor that you will not grow a baby that your pelvis cannot birth.<br><br><a href="http://www.youtube.com/watch?v=roFVkDV45MM&eurl=http://www.onebirthatatime.blogspot.com/" target="_blank">Watch this video</a><br><br>
Your chance of being able to vbac is extremely good, provided you find a good, patient care provider that is open to you laboring and birthing in any position you choose and believes in your body's ability to birth.<br><br>
Peace,<br>
Erin
 

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<span style="font-family:'Comic Sans MS';"><span style="color:#800080;">I agree with everything Erin said! Sounds like everything was going great until you got to the hospital <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: Also read "Pelvi I have known and loved" by Gloria LeMay.</span></span>
 

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Discussion Starter #5
Thank you for the ICAN video, Erin. I felt so damn empowered!<br><br>
One more question--my baby never dropped--Im assuming b/c of bad positioning and my narrow subpubic arch and her gigantic head <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/redface.gif" style="border:0px solid;" title="Embarrassment"> what can I do next time?<br><br>
oh--and having the lip--was that anything to do w/my "narrow pelvis"?<br><br>
I hate that I have to be prepared to defend even asking for a VBAC in NJ.
 

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OK, imagine I'm holding a globe in my hands. You're looking over my shoulder. We're both looking at Iowa. That globe, rather than being round, is sorta old shaped. It is a mold of the interior of your pelvis.<br><br>
So, when they say that your "diagonal congugate" cannot be reach, that means that the other side is really far away - That's the "through the earth" distance to Australia. Not being able to reach it is normal. The abnormal result is to be able to reach it.<br>
If the spines are average, that means that the area on each side of the US - the atlantic and pacific - they are not too close together. If you poked a finger into each ocean and tried to make them touch in the middle of the globe, that would simulate prominent spines. The spines mark off Zero station - if the baby passes them, it's at a plus station. Above them is negative.<br>
Your sacrum is concave, also a normal result - that means that australia is located on the round earth, instead of in a hole or depression.<br>
The pubic arch is kinda Canada. Is there room for Newfoundland and Alaska in your pelvis? That measurement is the only abnormal one. However, it usually causes problems during pushing, not dilation. If you made the boy scout plege with both hands, and put those two fingers of each hand down on your vulva, you could feel the bones that make the arch. A picture<br><a href="http://lpig.doereport.com/generateexhibit.php?ID=3563&A=65077" target="_blank">http://lpig.doereport.com/generateex...D=3563&A=65077</a>
 

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<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lurk.gif" style="border:0px solid;" title="lurk"><br><br>
Have I got my fontanelles mixed up or is the baby in that diagram posterior?
 

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Discussion Starter #8
Apricot, thanks for the great globe metaphor. I've also been looking for medical illustrations exactly like what you sent to me. From what I've been told about my birth (intentional passivity), Winnie didnt drop until I was in active labor--I had to take castor oil at 41 weeks to get labor going to stave off an induction. I think if I'd had a midwife or an OB who was willing to manipulate the cervical lip , or let me get off the faulty EFM to squat or move....I felt pressured and I felt like a failure and I was panicing--when they told me that my contrax were slowing after 20 hrs of labor, that she was stuck and starting to show distress (and they werent going to do anything to help me get her moved--and I was paralyzed at that point with an epidural bc of the pit to get the contrax speeded up..)<br>
well--we know what happened next.<br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad">
 

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Pelvises I Have Known and Loved by Gloria Lemay (pasted with permission of author)<br><br>
(c) 2003 Midwifery Today, Inc. <br><br>
[ note: This article first appeared in Midwifery Today Issue<br>
Summer 1999 and is also available online in<br>
Spanish<<a href="http://www.cafemom.com/articles/pelvissp.asp" target="_blank">http://www.cafemom.com/articles/pelvissp.asp</a>><br>
.]<br><br>
What if there were no pelvis? What if it were as insignificant to how a<br>
child is born as how big the nose is on the mother's face? After twenty<br>
years of watching birth, this is what I have come to. Pelvises open at three<br>
stretch points—the symphisis pubis and the two sacroiliac joints. These<br>
points are full of relaxin hormones—the pelvis literally begins falling<br>
apart at about thirty-four weeks of pregnancy. In addition to this mobile,<br>
loose, stretchy pelvis, nature has given human beings the added bonus of<br>
having a moldable, pliable, shrinkable baby head. Like a steamer tray for a<br>
cooking pot has folding plates that adjust it to any size pot, so do these<br>
four overlapping plates that form the infant's skull adjust to fit the<br>
mother's body.<br><br>
Every woman who is alive today is the result of millions of years of natural<br>
selection. Today's women are the end result of evolution. We are the ones<br>
with the bones that made it all the way here. With the exception of those<br>
born in the last thirty years, we almost all go back through our maternal<br>
lineage generation after generation having smooth, normal vaginal births.<br>
Prior to thirty years ago, major problems in large groups were always<br>
attributable to maternal malnutrition (starvation) or sepsis in hospitals.<br><br>
Twenty years ago, physicians were known to tell women that the reason they<br>
had a cesarean was that the child's head was just too big for the size of<br>
the pelvis. The trouble began when these same women would stay at home for<br>
their next child's birth and give birth to a bigger baby through that same<br>
pelvis. This became very embarrassing, and it curtailed this reason being<br>
put forward for doing cesareans. What replaced this reason was the<br>
post-cesarean statement: "Well, it's a good thing we did the cesarean<br>
because the cord was twice around the baby's neck." This is what I've heard<br>
a lot of in the past ten years. Doctors must come up with a very good reason<br>
for every operation because the family will have such a dreadful time with<br>
the new baby and mother when they get home that, without a convincing<br>
reason, the fathers would be on the warpath. Just imagine if the doctor said<br>
honestly, "Well, Joe, this was one of those times when we jumped the<br>
gun—there was actually not a thing wrong with either your baby or your wife.<br>
I'm sorry she'll have a six week recovery to go through for nothing." We do<br>
know that at least 15 percent of cesareans are unnecessary but the parents<br>
are never told. There is a conspiracy among hospital staff to keep this<br>
information from families for obvious reasons.<br><br>
In a similar vein, I find it interesting that in 1999, doctors now advocate<br>
discontinuing the use of the electronic fetal monitor. This is something<br>
natural birth advocates have campaigned hard for and have not been able to<br>
accomplish in the past twenty years. The natural-types were concerned about<br>
possible harm to the baby from the Doppler ultrasound radiation as well as<br>
discomfort for the mother from the two tight belts around her belly. Now in<br>
l999, the doctors have joined the campaign to rid maternity wards of these<br>
expensive pieces of technology. Why, you ask. Because it has just dawned on<br>
the doctors that the very strip of paper recording fetal heart tones that<br>
they thought proved how careful and conscientious they were, and which they<br>
thought was their protection, has actually been their worst enemy in a court<br>
of law. A good lawyer can take any piece of "evidence" and find an expert to<br>
interpret it to his own ends. After a baby dies or is damaged, the hindsight<br>
people come in and go over these strips, and the doctors are left with huge<br>
legal settlements to make. What the literature indicates now is that when a<br>
nurse with a stethoscope listens to the "real" heartbeat through a fetoscope<br>
(not the bounced back and recorded beat shown on a monitor read-out) the<br>
cesarean rate goes down by 50 percent with no adverse effects on fetal<br>
mortality rates.<br><br>
Of course, I am in favour of the abolition of electronic fetal monitoring<br>
but it would be far more uplifting if this was being done for some sort of<br>
health improvement and not just more ways to cover butt in court.<br><br>
Now let's get back to pelvises I have known and loved. When I was a keen<br>
beginner midwife, I took many workshops in which I measured pelvises of my<br>
classmates. Bi-spinous diameters, sacral promontories, narrow arches—all<br>
very important and serious. Gynecoid, android, anthropoid and the dreaded<br>
platypelloid all had to be measured, assessed and agonized over. I worried<br>
that babies would get "hung up" on spikes and bone spurs that could,<br>
according to the folklore, appear out of nowhere. Then one day I heard the<br>
head of obstetrics at our local hospital say, "The best pelvimeter is the<br>
baby's head." In other words, a head passing through the pelvis would tell<br>
you more about the size of it than all the calipers and X-rays in the world.<br>
He did not advocate taking pelvic measurements at all. Of course, doing<br>
pelvimetry in early pregnancy before the hormones have started relaxing the<br>
pelvis is ridiculous.<br><br>
One of the midwife "tricks" that we were taught was to ask the mother's shoe<br>
size. If the mother wore size five or more shoes, the theory went that her<br>
pelvis would be ample. Well, 98 percent of women take over size five shoes<br>
so this was a good theory that gave me confidence in women's bodies for a<br>
number of years. Then I had a client who came to me at eight months pregnant<br>
seeking a home waterbirth. She had, up till that time, been under the care<br>
of a hospital nurse-midwifery practise. She was Greek and loved doing<br>
gymnastics. Her eighteen-year-old body glowed with good health, and I felt<br>
lucky to have her in my practise until I asked the shoe size question. She<br>
took size two shoes. She had to buy her shoes in Chinatown to get them small<br>
enough—oh dear. I thought briefly of refreshing my rusting pelvimetry<br>
skills, but then I reconsidered. I would not lay this small pelvis trip on<br>
her. I would be vigilant at her birth and act if the birth seemed obstructed<br>
in an unusual way, but I would not make it a self-fulfilling prophecy. She<br>
gave birth to a seven-pound girl and only pushed about twelve times. She<br>
gave birth in a water tub sitting on the lap of her young lover and the<br>
scene reminded me of "Blue Lagoon" with Brooke Shields—it was so sexy. So<br>
that pelvis ended the shoe size theory forever.<br><br>
Another pelvis that came my way a few years ago stands out in my mind. This<br>
young woman had had a cesarean for her first childbirth experience. She had<br>
been induced, and it sounded like the usual cascade of interventions. When<br>
she was being stitched up after the surgery her husband said to her, "Never<br>
mind, Carol, next baby you can have vaginally." The surgeon made the comment<br>
back to him, "Not unless she has a two pound baby." When I met her she was<br>
having mild, early birth sensations. Her doula had called me to consult on<br>
her birth. She really had a strangely shaped body. She was only about five<br>
feet, one inch tall, and most of that was legs. Her pregnant belly looked<br>
huge because it just went forward—she had very little space between the<br>
crest of her hip and her rib cage. Luckily her own mother was present in the<br>
house when I first arrived there. I took her into the kitchen and asked her<br>
about her own birth experiences. She had had her first baby vaginally. With<br>
her second, there had been a malpresentation and she had undergone a<br>
cesarean. Since the grandmother had the same body-type as her daughter, I<br>
was heartened by the fact that at least she had had one baby vaginally.<br>
Again, this woman dilated in the water tub. It was a planned hospital birth,<br>
so at advanced dilation they moved to the hospital. She was pushing when she<br>
got there and proceeded to birth a seven-pound girl. She used a squatting<br>
bar and was thrilled with her completely spontaneous birth experience. I<br>
asked her to write to the surgeon who had made the remark that she couldn't<br>
birth a baby over two pounds and let him know that this unscientific, unkind<br>
remark had caused her much unneeded worry.<br><br>
Another group of pelvises that inspire me are those of the pygmy women of<br>
Africa. I have an article in my files by an anthropologist who reports that<br>
these women have a height of four feet, on average. The average weight of<br>
their infants is eight pounds! In relative terms, this is like a woman five<br>
feet six giving birth to a fourteen-pound baby. The custom in their villages<br>
is that the woman stays alone in her hut for birth until her membranes<br>
rupture. At that time, she strolls through the village and finds her<br>
midwives. The midwives and the woman hold hands and sing as they walk down<br>
to the river. At the edge of the river is a flat, well-worn rock on which<br>
all the babies are born. The two midwives squat at the mother's side while<br>
she pushes her baby out. One midwife scoops up river water to splash on the<br>
newborn to stimulate the first breath. After the placenta is birthed the<br>
other midwife finds a narrow place in the cord and chews it to separate the<br>
infant. Then, the three walk back to join the people. This article has been<br>
a teaching and inspiration for me.<br><br>
That's the bottom line on pelvises—they don't exist in real midwifery. Any<br>
baby can slide through any pelvis with a powerful uterus pistoning down on<br>
him/her.<br><br>
Gloria Lemay <<a href="http://www.consciouswoman.org" target="_blank">http://www.consciouswoman.org</a>> is a private birth<br>
attendant in Vancouver, B.C., Canada.
 

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If you want to avoid the lack of descent next time, try looking into homebirth. Your labor was restricted because of a machine that has been proven over and over again to increase the risk of cesarean without any improvement in outcomes. I think that stinks.
 

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<div>Originally Posted by <strong>2bpeaceful</strong> <a href="/community/forum/post/10276848"><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 felt pressured and I felt like a failure and I was panicing--when they told me that my contrax were slowing after 20 hrs of labor, that she was stuck and starting to show distress (and they werent going to do anything to help me get her moved--and I was paralyzed at that point with an epidural bc of the pit to get the contrax speeded up..)<br>
well--we know what happened next.<br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"></div>
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So now, to have a more normal birth, let's reverse this. I would get a homebirth mw, who knows how to move a cervical lip(not an uncommon procedure) and would be upright and mobile for all the labor. your pelvis is a movable object, not a stone carving,(and the baby's head is flexible too, and molds to fit you) and you will move and squat and walk and wiggle so your baby will move down just fine. I think the immobility that hospitals so dearly love(better control over the mothers) was a huge contributor to the section. You might want to read Silent Knife, by Nancy Wainer Cohen, and the sequel, Open Season. And please join your local ICAN group. You are not alone. Please seriously consider a homebirth, it really is your best bet at avoiding more surgery...
 

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No one can diagnose your pelvis without a significant trial of pushing with freedom of movement. You didn't get that. You dilated great with great progress at home. Arrested when restricted and immobilized. Not hard to see why. If a lip gets too swollen I have had a mama take and epidural and we just wait and let her sleep while it goes down (I usually am giving her arnica secretly too ;-)! ). Their monitor problems were not your concern, they needed to bring in another or do intermittent with a doppler as backup. I would say you are a great candidate for vbac and for home birth. I caught a babe on a woman who was told she was too small for birth after her first. Baby was two lbs heavier the next time and came so fast the midwife didn't make it (it was a planned home birth) and I was the one who had to catch. Ten lbs with 3 hours of labor and a 20 minute pushout. I don't think her pelvis actually grew in the three years between babies. Sounds like another case of active management of labor in hospital leading to cesarean. Some women like the Pink Kit for reassuring themselves of their ability to vbac.
 

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You have a normal gynecoid pelvis. The arch doesn't come into the equation until the baby is at +2 station.. It sounds like you had a malpresentation, OP or asynclitic, and thats why the swollen anterior lip, usually can be corrected by TAKING OFF THE MONITOR AND GETTING OUT OF BED! I am a midwife and do both hosp/BC births, but I have to constantly take off the monitors ang help patients out of bed when the nurses leave the room. You are a VBAC candidate, so don't worry. How big was the baby because sometimes thats the issue too.
 
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