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Discussion Starter · #1 ·
My SiL had a c/s last September. She was 41 weeks, was induced (she put off her doctor at 39 weeks and 40 weeks and caved at 41).

Anyway, she had maybe 5 or 6 hours of pitocin and they said she was only 5 cm (she was 1 when they started) so she was Failure to Progress (don't get me started).

So they wheeled her off and did a c/s. I was in the hall in tears, because I kept trying to butt in and say "You don't have to do this. You do NOT have FTP! Your body is doing AWESOME"....

ANYWAY... the doctor told my SIL after the c/s that she has a bone that goes the wrong direction and it covers her birth canal so she will never be able to deliver vaginally.

SIL is 26 weeks pregnant now (due in September again, this was her "Oops, doesn't EBF prevent fertility??" baby) and has a scheduled c/s, because of what her ob said.

I guess I've never heard of this, and wanted to know if it is legit, or an excuse on behalf of the ob. I'd hate for her to have a c/s if it is unecessary, kwim?

Kimberly
 

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Sounds to me as if he could not wait to get her into the OR.

Yes, as far as I know, the coccyx, i.e., the tailbone can be in the way or the ishial spines can narrow the passage, but really, if they let her get up and walk around during her induction she might have been able to engage the little one better and open her pelvis and push the little one out...and really, my personal opinion is that five hours is rather short for a first labor even if it is induced... was there some fetal distress??...or was it just "obstetrician" distress?

JMHO.

I hope everything goes well for her this time however she goes...

Thank you for standing by her.

She was lucky to have you even if she allowed the C/S in the end ...
 

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Discussion Starter · #3 ·
OKay.... that makes sense.

Yes, I was RAGING because of the "FTP" diagnosis the slapped on her. She had NO fetal distress, but they wouldn't let her out of bed AT ALL because... oh wait, there was NO REASON. Except they didn't want her off the monitor with a "post term" baby????

I felt quite hypocritical saying they didn't need to give her a c/s, since I had a c/s... but HAVING a c/s has made me REALLY want to prevent it when it is NOT necessary, kwim? It is painful!!

Kimberly
 

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At the very least I would want a second opinion if I were her. I would also take a hard look at an OB who did not see ANY indication of a physiologocal abnormality that makes it impossible for me to birth until after he has induced me.
 

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I know of a woman who has an issue with her pelvic bone. It protrudes somehow, and makes sex very painful. She doesn't have children, so I don't know about whether she would be able to give birth or not.
 

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"the doctor told my SIL after the c/s that she has a bone that goes the wrong direction and it covers her birth canal so she will never be able to deliver vaginally."

Shouldn't they have been able to tell from doing vaginal exams? The fact that this diagnosis was made only *after* the c/s makes me very suspicious. Absolutely get a second opinion.
 

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Elizabeth Davis' Heart and Hands has in-depth how-tos on pelvimetry. None of it makes a bit of difference, though, if she is not open to changing her plans to make a diffrerent experience.

The residents I used to teach didn't know the first thing about pelvimetry.

Oh, yeah, one's pelvis is not fixed bone. I have seen pelvises that look very constricted open up like flowers. Stuck at 5-6 cms. sounds like an issue of the baby's presentation, though there may be other confounding factors
 

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Definately get a second opinion. Unfortunately, not everyone has a gynecoid shaped pelvis. this is the nice open oval shaped inside of your pelvic bones. there are several other shapes that some women have that are not very conducive to childbirth, but that does not mean that all of them CANNOT have a vaginal delivery! I have felt some pubic bones that instead of arching up like a rainbow, arch down or point down like a letter V. This makes the internal diameter of the pelvis very small, and VERY difficult to pass a baby through. This CAN be felt during any pelvic exam I would imagine.
It would be comforting for her to hear this from someone other than the doctor wanting to take her to the operating room.
I feel badly for anyone that was taken to the operating room at 5 cm after only 5-6 hours on pitocin. IMO, that is GREAT progress. Sometimes it takes 5-6 hours for a moma to even start feeling her contractions on that stuff! Never mind dialate 5cm. That is too bad. However, I was not there and cannot tell you what her pelvis feels like.
I wish her luck, and hope she gets some answers. It would seem like a more reasonable c/s if she got to fully dialated, pushed well for hours and couldn't get the baby passed this apparent bony obstruction. At least it would seem as if they gave her more of a chance...
 

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I have met a few women who say that their doc told them they cannot give birth vaginally based on feeling their pelvic bones during a cesarean. Having assisted at a lot of cesareans, I don't really see how this is possible. I suppose a doc could theoretically have some method of feeling around the pelvic cavity (although during surgery, before the baby is out there is no room, and after, you generally are trying to control blood loss) but I don't see how, even if this was done, that the measurements of someone's pelvis while they are lying flat on their backs with their legs stretched out would have anthing to do with whether they can birth a baby. Honestly, though, I don't think docs do any sort of measuring. I do think they believe this stuff, though, and think they are somehow "saving" women from another awful vaginal birth.
Yes, I have seen babies not fit, but the mom's bones are certainly not the only factor. The only "couldn't fit" baby I've had in my practice in the last 75 births was a 4'10" mom and baby was 9 lbs. However, I think her baby would have fit just fine if he wasn't posterior with a deflexed head. This mom's water broke on it's own just prior to the start of labor, and the baby wedged posterior. Hours of hands and knees, walking, etc. wouldn't turn him. The diagnosis for her cesarean was malposition, not CPD.
I also recently had a mom who pushed for 2 hours with her first child before having a cesarean for failure to descend/CPD. She was 7 lbs 2 oz. I attended her VBAC recently, and the new baby was 8 lbs 14 oz! Almost 2 lbs heavier, head circumference 2 cms bigger, but baby came out just fine.
You just don't know until you try.
And anyway, a first time mom at 5 cms is just entering active labor, slow progress prior to that is absolutely normal. There was a recent study that found that waiting 4 hours for someone with no cervical change instead of the standard 2 hours reduced the cesarean rate significantly without jeopardizing mom or baby (although maybe some doc's pampered chef plans.)
 

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Discussion Starter · #11 ·
Wow.

I honestly don't think approaching the subject with her would help though... she's very convinced that her body is faulty.

My question was.... she has had at least a dozen surgeries for endometriosis... and she had 5 years of infertility treatments prior to conceiving her son. In allllll those procedures.... including IUI and IVF, wouldn't they have noticed a funky bone?

Oh well, not my life. Just makes me sad that's all.
 

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Any faith she had in her body being healthy and able to do what it is supposed to was underminded beginning with the infertility treatments.

But that would be another thread, so sorry,
T
 

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Discussion Starter · #13 ·
Oh, I agree Applejuice.

That is something I totally understand.... it's why, after 5 losses, my first words to my ob about this pregnancy were "So, am I miscarrying yet?"

I do agree that her confidence in her body is shot from failed IUI's and failed IVF's...
 

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My midwives told me my coccyx curves inward and that the baby was getting caught on it. They asked me if I had ever broken it. I haven't, but I had a lump removed from it. Things were more difficult, but we eventually got the baby out. They reached in and held the bone back while I pushed. But no doctor is going to invest that much time and energy, I'll bet.

I'm sure I would have been sectioned if I'd had a hospital birth. They would not let a 2nd-time mom push for 5 hours, especially when for the first 2 hours the head was not even engaged and the cervix was not fully effaced. It just goes to show that waiting is often the best course of action. I'm always hearing about FTP due to the mom being at 6 cm for 10 hours or something like that. How does anyone know that in another hour or two, the baby wouldn't come barreling out?
 
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