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I was wondering if there truly is a time when a woman's body is too narrow to naturally deliver?
My step-sister-in-law is pregnant again and had a c-section with her first dd, because the docs told her that her hips weren't wide enough to naturally deliver. I just never really understood that. She is a big person-at least 5'9' and solidly built (not tiny). I just heard her saying the other day how she will have to have another c-section because she can't help that she has narrow hips......
 

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Yes, some people just have narrow hips, just like some people just have narrow minds...

Yes, there is such a thing as a malformed pelvis, usually caused by malnutrition (we're talking Ethiopia-type malnutrition) or genetic malformation, like cleft palate or something. Often, however, this "diagnosis" of narrow hips isn't based on clinical evidence, but other factors. But since this mother has never had a trial of labor, we'll never know how her pelvis can work with movement in labor and relaxin to flex and open.

I wouldn't worry too much about it. She sounds happy with this arrangement. And please don't pass along my comment to her...I'm trying to control the flow of bitterness out of my soul.
 

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I have a dear friend who is about 5'1" tall who *really* wanted and tried for a homebirth, and labored for 3 days, then pushed for something like 6 hours before transfering for an emergency c/sec with a 10lb baby. Her SO is over 6' tall, and their babies are built like daddy, I guess.

Knowing this woman, I know she tried everything to get that baby out, but he just wasn't fitting through.

So, I'd say, yes, I believe it happens. Occasionally. But I'm sure that it's much more commonly misdiagnosed, and your step s-i-l would not know until she tried.
 

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I am five feet tall. My DH is/was six feet tall. I was one hundred nine pounds before each pregnancy. My DH was a medium build.

My four children were born at home. You just have to believe that you can do it...that is all there is to it.

The only medical condition I know of in which there is true CPD is rickets, a lifelong deficiency of Vitamin D and malnutrition, -OR- a broken pelvic bone from an automobile accident...

There are four shapes of pelvises:

gynecoid, andropoid, anthropoid, and platypoid...most women have the gynecoid shape, while men have an andropoid shape...variations exist, but I truly believe that nature has designed the birth process to work; it has evolved that way, or G-d made it that way...whatever you believe, you have to know/believe that it is designed to work!
 

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"My step-sister-in-law is pregnant again and had a c-section because the docs told her that her hips weren't wide enough to naturally deliver."

Woah. There is NO way the doctors can tell how much *any* pelvis can flex and open before labor, unless the pelvic bones are fused together. She needs a second opinion, badly!

Plantmommy, your friend's situation could certainly have been true CPD, I don't know the details so I can't say, but I just want to point out that a long labor, long second stage, little mama, and a big baby is not in itself proof of that... I've heard so many stories of little mamas with big babies, and so many stories of big mamas with little babies in which the labor and second stage were long, that I have to wonder, when I hear a situation like your friend's, whether there wasn't something about the management of the labor that was the true problem.
 

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I just want to point out that "narrow hips" have nothing to do with whether a baby can fit. What matters is the pelvic inlet- i.e. what you can't see... that, and the baby.

AND, the CPD thing is bs IMO. I don't believe that a mom would make a baby who doesn't fit-- however, often babies are malpositioned and so they don't come out well because of that. Something as little as having a deflexed head increases the diameter of the baby's head by 1.5 cm.... a lot when it's generally a tight squeeze either way.

I have very narrow hips on the outside but have successfully pushed out 2 babies and will do it again this coming January
 

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I agree with the other ladies.. Just because someone looks big on the outside doesn't mean she has a big inner pelvis, and vice versa.. You can't judge whats on the inside by whats on the outside..... BUT you also don't know how whatever you've got is gonna work until you try it out!!
I respectfully disagree about a moma not making a baby that wouldn't fit. (with respect) I think this is a statement based on faith, not fact. I have seen some very tragic shoulder dystocia's (and other things)that can attest to the fact that a few babies are just not proportioned to fit out very well. (albeit not MANY) IN fact, many of you would be surprised to know, that the manuever that many of the "good 'ole boy doctors' use to get out 'stuck' babies, are actually taken from teachings of old midwives. I work with several OB's that swear by techniques they were taught from midwives from other countries. They in turn were taught by REALLY old midwives. This to me even shows that tricky big babies have been around for a LONG LONG time.
PS I'll even admit that those doc's I work with beam with pride when they talk about those midwives that taught them all the in's and out's of getting out a stuck baby.
PSS I also believe that the CPD that we hear about a lot, is many many more times attributed to babies position rather than size of baby itself.
 

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I work with a woman who had two c/s because she didn't have enough pelvic room. This is a large woman... 5'9" at least, not small boned. She told me, "the baby wouldn't fit out because of how narrow my bones are, and bones don't move." I didn't argue, but said, "ohhhhhhhhkay" to myself. She had one seriously misguided doctor.
 

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If you are referring to Ina May Gaskin, I don't know if I would call her an old midwife.


Most cases of CPD are caused by the management of labor. If your water is artifically broken, it can cause the head to be wedged funny. If the mother is flat on her back, the pelvis can't do its thing. If the mother has an epidural....you get the picture.

I am surprised that you would have seen that many shoulder dystocia's since they are very rare and the hospital that you work in seems so progressive the way that you discribe it.

IMO, birth IS faith. Look where the science of birth has gotten us.

Victorian
 

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I whole-heartedly agree that BIRTH IS FAITH. I have the 2 c-cection stories, The history of Major petiteness and being ever reminded of it thru-out my entire life for as long as I can remember, The comments from people about how would i deliver since im so small, The assumptions from so many that my first c sec was because of my size and the babys----- no matter what I learned about physical aspects and historical misunderstandings of women and childbirth, and no matter that i tried natural and got to almost 10 cm at 36 hrs.------ I caved to the pain in the end and the underlying belief that I just couldnt do it. As I wrote those words; BIRTH IS FAITH I cried just now. My daughters middle name is Faith, I have little Faith, but I have her. I will continue to work on my Faith and Will always want another baby just to see if I can do it. but we're not having anymore.
Laura
 

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It's not just "ethiopia-type" malnutrition that can cause bone deformation drastic enough to make a pelvis too small - anyone eating a highly processed diet is at risk for growing daughters with pelvic openings too narrow to birth properly.
This was substantiated when Dr. W. Price went & studied "primitive" peoples eating their native diets, and then people of the same culture eating "civilized" (white trader) diets. Birth problems, which were virtually nonexistent in the native diet population, cropped up with alarming regularity in the second generation of those eating the food of civilization. They were eating plenty, but it was all empty foods - white flour, white sugar, packaged & canned foods.
Our countries are slowly going back to a whole-foods ideal.....but if you look at the average shopping cart going through the store, you'll see that most people in the US are malnourished. With kids growing up on macaroni & cheese, white bread & margarine, and sugar cereals, is it no wonder that there are so many birth problems around here?
 

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All the specifics are in Nutrition & Physical Degeneration by Dr. Weston A Price. It was all done in the 1930's, so yes, that was before "enrichment" was common. But just looking at the pictures in the book is enough to convince you that whole, real foods are definitely the way to go!
 

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Victorian, I think she was referring to actual old, granny midwives. That's where Ina May got "her" maneuver. She didn't make it up.


I think that sitting or lying on your sacrum will make birthing a baby harder - even epidurals sometimes interfere with the rotation of a baby through the mid-pelvis. I would hesitate to say that all shoulder dystocia has to do with a tight fit - most often is poor positioning by the mom.
 

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I've only heard of a couple cases of shoulder distocia that happened in a mother not in the "lamaze position" - propped up on the tailbone.
I know for me, my first baby got stuck at the shoulders, and that was the position I was in. All the others were born with me on hands & knees, and even though Davey was bigger in build that Ian was, he didn't get stuck.

FWIW, my body was telling me quite frantically to get off that table and on my hands & knees during my first birth, but I "couldn't" because I was in the hospital delivery room with an old-school OB attending. I feel that was why his shoulders got stuck.
 

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There are four major pelvic types and you are either one of those or a combo of them. I can't remember what book it was in either Pelvic Health and childbirth or Special Delivery. Pelvic Health is a very pro-c/s book, but pg 207 spells out all I needed to know to make a VBAC happen for me.

I'm 5'8" and the doc told me that I had a c/s for CPD (essentially my hips wouldn't allow my baby to come through). It was a load of crap! He was sunnyside up and turned sideways, he didn't have a chance after they broke my water. He was 9.9.

Before I had my homebirth after 2 c/s I went to my chiropractor who had taken x-rays of my spine and hips when I first went there and asked to see them. I took pictures of the x-rays and then looked at the pictures of the 4 pelvic types in the book. I do have a combo pelvis one good and one bad for birthing, I worked very hard moving my 9.1 pounder down and out. All worth it and I could have done it with the first two, but I wasn't given the opportunity to do so (strapped in a bed on monitors and IV drips, no getting out of bed even to use the bathroom).

spinningbabies.com is an excellent website. It's more than head down, they also need to be face down to move out of a narrow pelvis.

But no matter how much you try to talk someone into a VBAC, if they don't want it for themselves and truly want it, it won't happen. And when you decide you do want a VBAC after you research hospital routine procedures that prevent movement and strict time lines (hospitals have rule over doctors), you will be smart in choosing an experienced midwife to attend your homebirth.
 

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to me, CPD is more an instance of when the baby's head is overriding the pelvic inlet - mainly the pubic bone. If the baby is anterior, I would assume that it means that it is a true case of a contracted pelvic inlet.

I think this is very, very rare, however.
 

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But I think that it warrents being said that a posterior baby can be born vaginally. I pushed out a "sunny-side-up" baby in 6 minutes. I was on hands and knees. If I had been in the "normal" birthing positon, would it had worked? He was a little sticky, and it hurt when he was wiggling to find the way out. (I even yelled at my midwife to knock it off LOL).

Of course, I am a roomy women
 
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