[nukuspot]

Hi all,

I am 39 weeks pregnant today with my first baby. It is fun and also very confusing sometimes to be on this side of things, after going through 3 years of midwifery school and apprenticeship, licensing, etc, I now am somewhere between hours and weeks away from my own labor and birth.

I soon realized that when it is me that is the client, I certainly do not know all the answers, and find myself asking my own midwife many questions that I have had other mamas ask me!

Anyway, my question for you all is about station/posterior cervix/baby positioning. I had originally planned to decline all vaginal exams in pregnancy, as I was sure that I could self-check, or wouldn't even need to know that information, as really, we all know it doesn't tell anything until labor. However, after days and days of cramps and severe back pain, I felt that I had to know if this was changing my cervix...I could stop it with a warm bath, but if it was helping bring me closer to labor, I didn't want to stop it! Plus I wanted to know how effaced I was to see if I could lay off the EPO, or still keep taking it. I'd been taking it orally since 37 weeks. But I could not for the life of me find my pregnant cervix! I tried in all sorts of positions. All I could tell was that my baby was very, very low. I thought maybe zero station? But the cervix was nowhere to be found, very posterior.

So today at my 39 week PNV I asked my midwwife to see what she could feel. When she checked me she said that my baby was even lower than I had thought, at +1! But she tried and tried to find my cervix and it was just too posterior. She tried to walk the lower uterine segment forward, but it just was too painful for me and after about 5 minutes I asked her to stop.

She said that with a baby that low, and with all the back pain I was having, I had to make sure that the head was not engaged in a posterior position. The baby is not direct OP on palpation, the back is along the left side, easily felt, but she thought that the head could be posterior (the neck turned) and that is why I have been having such intense back pain. It makes sense to me, I guess. She told me to do some knee/chest positions to try to get the baby to come up out of the pelvis and then settle back in with a better head positioning.So my question is, regarding that scenario, do you think that the baby is likely to move in and out of the pelvis and settle back that easily?

Also, my other question was regarding the baby being +1 in pregnancy, and the cervix still being so posterior. I have no doubt with the baby being so low, if the cervix was anterior I would probably be in labor right now with all that pressure on it! But with the cervix being so posterior, the the baby being so low, it just isn't getting much pressure put on it to dilate, and it seems that it might be a disadvantage for the poor cervix to make its way over a low, low baby head. What do you think? I haven't seen this scenario much in primips, normally in multips, but with multips I don't worry as much. I also haven't seen very many babies at +1 prelabor, anyway, normally they are somewhere between -2 to 0 station. +1 seems really low at this point to me!

Just bouncing this all off of the internet world, and hoping for some midwife feedback...I like to read other midwifery opinions, I find it very helpful.

Thanks!

 

[Jane]

When labor happens for reals, the lower segment of the uterus is going to shrink/contract. When that happens, the cervix isn't gonna have any choice but to center itself. The slack will get taken up. It's only that slack that allows it to be offcenter at all.

+1 is awesome. Your baby has tried out the inlet of your pelvis and she fits! That rocks! One less thing to worry about, no? She might even fit OP - a larger diameter...what a lovely sweet baby let you know so soon.
Not being able to reach that posterior cervix tells me that you have a nice roomy diagonal congugate, too. All excellent news, IMO.

I do think it's a little funny that you have a cervix that doesn't want to be checked. Apparently it was listening to you. No danger of asking for a stretch and sweep.

I doubt you'll be able to get that baby up and back, but there's no harm in trying. In my experience, nothing whips them kiddos around like labor. I just haven't seen the posterior baby = long hard labor like some have, so my experiences temper my opinion.
I'd blame the back pain on +1 station, ya know? Your pelvis isn't working "right" because there's a baby in it. The mechanics have got to be screwy.
PS I'm totally there on the pregnant midwife thing. I'm freaking out over spotting. Can you tell me it's okay, please?

 

[mwherbs]

I think I would not do the hands and knees to get the baby to change anything- the baby is fitting well and deeply already - I think that back pain could just be pregnancy- pelvic rocks, sunlight, shoes that don't have heels or that have lower heels, massage, saint john'swort oil to sooth the nerves, how are your bowels? many women are constipated at this point so working on that might help
it could also be that the EPO is too irritant for you so you could try a few days of not taking it and see if it changing anything

 

[nukuspot]

Thanks! I was actually going to Facebook message you to ask you the same questions...But since you were so nice to respond on here, thanks!

Do you have a midwife yet? Soon you can be like me...A typical primip who gets worried about little things and asks silly questions. But actually it is worse for us...Since we have seen some oddball things, it is just too tempting for the brain to think, maybe it will happen to us! But probably we will both have normal regular pregnancies and births and postpartums in actuality. (Well, my hyperemesis wasn't too "normal", but maybe that is my one strange thing I get. Spotting might be yours!) Think about it, how many moms with spotting did you see that went on to have healthy happy babies! A whole bunch, I would guess?! And you always have that option of an early u/s in a few weeks just to reassure yourself that everything is fine. It's not foolish if it makes you feel better.

 

[nukuspot]

mwherbs, thanks for responding also. You must have written at the same time I was responding to Apricot. Yes, actually, I am terribly constipated! It is probably the first time...Well, ever, actually. Very good idea. I also wondered about the EPO causing the back stuff. But I am unsure because I have some days (like today) with no back pain or cramping, or very, very little amounts. And I have been taking the EPO orally for the last 2 weeks every day. Some days are terrible with back and cramp issues and some are fine! I've been pelvic rocking but I could do it more. Sunlight...I wish! Here in the NW I hope for sunlight each day. When its there, I will surely take advantage. I haven't tried St. Johns Wort oil, it's a good idea. I have my husband use it a a massage oil for his sciatica. Would you recommend that I rub it topically over my back when it gets bad?

 

[mwherbs]

when I lived in Vancouver I counted 12 days of full sun in a whole year!!!! anyhow even that indirect sunlight is going to do something for you
so I almost wrote magnesium in the other post but thought I would hold back and not over whelm- taking 500 mg of magnesium may just do the trick for you- it is hydrophyllic (increases water in the colon/bm) and it is a smooth muscle relaxant
and yes to the saint john's wort oil topically for your back-- I put it on any sore muscles and to heal up sunburns

take care

 

[MsBlack]

I would definitely lay off the EPO. You clearly do not need it as you cervix has softened and effaced plenty by now. I have seen an excess of EPO lead to problems in labors--remember that you need a balance of prostaglandins and oxytocics for labor to occur, and right now it sounds like your prostoglandins are very dominant. You really don't want that cervix any thinner, or baby any lower on a closed, posterior cervix, prior to labor.

You are a midwife....so trust birth already

Trust yourself and baby to figure this out, women do figure it out every day. Even primips! Even women whose babies don't seem optimally positioned!

good luck!

 

[jljeppson]

I know how it is with low lying babes and severe back pain. With my last 3 (of 6) I was barely able to walk before they were born and 2 of those were born posterior. With those last 2 (should have been all 3, but ignorant doc, what you gonna do?) my chiro was definitely my best friend. I agree about laying off the EPO and would suggest that you start seeing a chiro for the back pain, if you aren't already. Not because she may be in a bad position, but just to relieve some of your discomfort. If the back pain is fierce when you go into labor, she probably is posterior and/or at a funky angle and climbing up a few steps on your hands and knees does an excellent job of fixing it. Low key and kinda funny sounding (and looking), but it does the job.

 

[riomidwife]

Quote:

Originally Posted by nukuspot But actually it is worse for us...Since we have seen some oddball things, it is just too tempting for the brain to think, maybe it will happen to us!

nuku, I know where you're at. My pregnancy with my son was simply filled with every little random oddball occurrance that of course, I had to ask my midwife about. I tried to check myself toward the end of my preg and in warly labor but could not find my cervix anywhere. I did eventually allow my midwife to check me in active labor, something that I immediately, and still do, regret. I am vastly inclined next time around to UC, so that's where I'm at.

But I can relate to a lot of what you're going through. My babe flipped OP at the start of my labor. Do your best to empty your mind and trust your that your body will know what to do and will do it. As midwives we know so much, and sometimes, as you know, all the information leads to monkey minding.

Here's what I might do: Next time you are in a nice warm bath imagine yourself in labor, what the room looks like, how you feel, your baby moving down, your cervix opening...then see yourself, in your labor, knowing that your body is doing everything it needs to do, and you simply letting go, and letting your mind get out of your body's way. And then see your sweet little one swimming out into your hands....

 

[ians_mommy]

Quote:

Originally Posted by Apricot When labor happens for reals, the lower segment of the uterus is going to shrink/contract. When that happens, the cervix isn't gonna have any choice but to center itself. The slack will get taken up. It's only that slack that allows it to be offcenter at all. +1 is awesome. Your baby has tried out the inlet of your pelvis and she fits! That rocks! One less thing to worry about, no? She might even fit OP - a larger diameter...what a lovely sweet baby let you know so soon. Not being able to reach that posterior cervix tells me that you have a nice roomy diagonal congugate, too. All excellent news, IMO. I do think it's a little funny that you have a cervix that doesn't want to be checked. Apparently it was listening to you. No danger of asking for a stretch and sweep. I doubt you'll be able to get that baby up and back, but there's no harm in trying. In my experience, nothing whips them kiddos around like labor. I just haven't seen the posterior baby = long hard labor like some have, so my experiences temper my opinion. I'd blame the back pain on +1 station, ya know? Your pelvis isn't working "right" because there's a baby in it. The mechanics have got to be screwy. PS I'm totally there on the pregnant midwife thing. I'm freaking out over spotting. Can you tell me it's okay, please?

ITA with Apricot's assesment.
Isn't being a pregnant midwife kind of sureal? It is so hard to be a patient sometimes...