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  #1  
October 23rd, 2006, 03:07 PM
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Join Date: Jul 2005
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This is kinda long so please bare with me. I have some unanswered questions that are really bothering me these days.

I had my baby girl over 3 months ago and ended up with a c-section. I do not want this to turn into a debate. I just have a few questions for those experienced with labor issues. I was so overwhelmed by the surgery & the birth of my daughter that I never did ask the doctor to fully explain. It all happened so fast.

I had false labor for a few weeks leading up to my daughter being born at 38 weeks. At 37 weeks, 6 days I met my husband for dinner around 7pm and immediately started to feel funny. I was having contractions stronger & different than the false labor I'd grown accustomed to. Earlier that day I'd had an ultrasound to check the weight of the baby & fluid level. They estimated the baby to be 10lbs and said my pelvis was very small and the doctor feared harm to both me & the baby if I attempted a vaginal delivery. We decided to schedule a c-section for the next week.

Around 10pm that night, after soaking in a bath & lying down and nothing making the pain any better, I called my OB. Luckily he was on-call. He gave me the option of going into L&D to be checked stating he didn't think I was in true labor. I was crying because I was hurting so bad and decided to go ahead and get checked out. At 10:45pm I was 2cm dialated and 80% effaced. I'd been this way for the previous two weeks. They hooked me up to the monitor and sure enough I was having contractions every 5-6 minutes. They checked me 30 minutes later and still no change in my cervix. They called my OB who instructed them to give me stadol w/ phenergan and inform me they were keeping me the entire night for observation. I tried to settle into the hospital bed and go to sleep, but the pain kept increasing.

By 1am I was hurting so bad and my contractions were STRONG and 1 1/2 minutes apart already!! They checked my cervix and I was still only 2cm dilated and 80% effaced. The contractions (1 1/2 minutes apart and strong) were doing nothing to my cervix. The nurses checked the printout and immediately left my room to call my OB. It wasn't a matter of minutes until the nurses and nurse anesthetist were rushing into my room telling me I was about to have my baby by c-section. Ally was born via c-section at 2:12 AM!

So, here are my questions....
1. Why wasn't my cervix changing if my true contractions were 1 1/2 minutes apart already? Is it possible it could have changed if we'd waited longer?

2. I was having tons of pelvic pain in addition to the contractions. They said the baby's head was pushing on my pelvis trying to come down but couldn't move. Does this sound right?

3. Based on the information I provided & the two questions above, does it sound possible that I could have given birth vaginally?

Thanks so much in advance, ladies! These thoughts are staying with me and I need answers.
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  #2  
October 25th, 2006, 11:23 AM
ShawnaCAN's Avatar Platinum Supermommy
Join Date: Aug 2006
Location: Alberta, Canada
Posts: 11,397
Post partum nurse checking in...

1. Why wasn't my cervix changing if my true contractions were 1 1/2 minutes apart already? Is it possible it could have changed if we'd waited longer?

It's possible that your baby was in a posterior position (do you happen to remember if that was mentioned). Labour with posterior babies tends to produce contractions that are painful, but not as effective for dilation and effacement - so things just take longer. Yes, it's very possible that things could have changed if you'd waited longer (or had the baby turned).

It's also possible that your pelvis really and truly is too small. Part of what helps dilation is the pressure of the babie's head against the cervix with each contraction...but if your pelvis is truly too small, the baby's head may have been unable to engage far enough to create that pressure.

2. I was having tons of pelvic pain in addition to the contractions. They said the baby's head was pushing on my pelvis trying to come down but couldn't move. Does this sound right?

Possibly. That also sounds like a posterior baby (lots of back pain, lots of pelvic pain).

3. Based on the information I provided & the two questions above, does it sound possible that I could have given birth vaginally?

The ONLY way to know is to try. There is no ultrasound or measurement that can say FOR SURE that your pelvis is too small. I've known far too many women who were told they had small pelvises, had c/s with their first babies - and then went on to have completely normal vaginal deliveries with consecutive babies.

Now if size wasn't really the issue, and it was the SHAPE of your pelvis - that's different. Certain abnormal pelvic shapes make vaginal delivery impossible, but these are quite rare. Did your doctor say anything about the shape of your pelvis?
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  #3  
October 25th, 2006, 12:16 PM
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Thank you for the information. Here's the catch - they never told me ANYTHING! The nurse checking me was the one that said "I don't see any way a large baby is fitting through this pelvis" while she was checking me. They drugged me up with Stadol & Phenergen when my contractions got too painful (which didn't help at all) and then whisked me away to the operating room about an hour later. I was too drugged up to ask questions plus I hadn't had any sleep. I heard the nurses telling my OB in the operating room that my contractions were strong and 1 1/2 minutes apart.

I had already agreed, with my OB earlier that day, that I'd have a c-section. However, I'd like to know what was really going on with my body that night. They never told me the baby was posterior. Like I said, they never told me anything and I didn't know what questions to ask being that this was my first time.

My OB came into the operating room at 2am and started my surgery. I never even had a chance to speak with him. He went off call shortly after my c-section and was out of town the remainder of my hospital stay. Then, when my postpartum appointment rolled around I was so overwhelmed from lack of sleep and having a colicky baby that I forgot to ask. I suppose I'll never know.

Would this info be in my file from the hospital? Would they have documented exactly what was going on or only that I had a c-section?
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  #4  
October 25th, 2006, 02:12 PM
LaLa's Avatar Platinum Supermommy
Join Date: Jun 2005
Posts: 11,576
Gosh, so many things to address here. Id start off by getting a copy of all your records- read through them. Grab a few books & start reading - one of the first being "The thinking womans guide to a better birth" and eventually the vbac companion.

Ok - couple of things - how big was your baby? First and foremost - ultrasounds are highly inaccurate for weight & gestation measurements in the 3rd trimester - off by 3 lbs in many studies, 2 lbs in the best of studies.

AND - absent majro pelvic trauma, there is no way to tell wether or not a woman will be able or unable to deliver vaginally - and even then... you have a chance. I know moms who have had fractured pelvic bones, been told theyd never deliver vaginally & go on to have not only successful VBACs but also homebirths. My MW is one of them!

But - all that aside - weight of the baby alone means nothing when it comes to wether or not you can deliver vaginally. Position & presentation & the position you push in mean a whole lot more. Given the right opportunities, most women can vaginally deliver any size baby they grow. There are some exceptions but again, these are rare, and there is no way to foresee it. Sure, some of these end up in cesareans b/c of brow presentation, transverse lie, etc... but this doesnt mean the baby is in danger necessarily. Its just that the baby isnt goign to come out that way - and then on the other hand, these things dont automatically mean a cesarean. As for pelvic size - it means nothing. your pelvis changes throughout labor. Even at the beginnin gof labor you cant tell, you cant even tell 5 minutes before birth. Hormones are constantly being produced. With my last labor - my baby didnt drop until about 15 minutes before she was born. My pelvis opened rather quickly, and trust me - I FELT IT lol.

Now - another issue is - yes, your baby could have been in a funky position, and its true that you could be having some major contractions, regular contractions even, even for a long period of time, that may or may not have resulted in a baby by the end of the night. I had mine 2 weeks ago for example. All along she was posterior - right up until labor. I had several nights of GOOD hard contractions, 5 mins apart, some got really close, they were really regular. Never resulted in labor. The one night that my contractions were 40 mins apart - thats the night I had her! Those early contractions DO something - even if its not cervical changes... so much more takes place to have a baby. Your hormones have to gear up - yoru breastmilk gets ready, contractions encourage a baby to get into a good position, etc. Its TOTALLY common & normal in natural childbirth for a woman to go into what seems like full fledged labor, only for it to stop totally hours or even days later. Would yours have? Who knows. What I do know is that you ARE capable of having a baby, and of going into labor on your own.

BUT - the problem is in hosptials, many drs are very heavy into managed labor. Woman walks in , shes having contractions. Ok, she gets put on a clock. No cervical changes after x amount of time? give her pitocin. Her contractions arent following a strict pattern? give her pitocin. Her conttractions arent sending her climbing the walls in pain? Oh they must not be strong enough to produce a baby - give her pitocin. And - if they are, well, we cant have all that ruckus, give her something to quieten her down. What happens? Contractions get irregular - farther apart, closer together, depending on where your body is & wether the adrenaline chooses a fight or flight path. Pitocin, drugs, all ccan cause fetal distress. Im going to guess from your description of things that lal the interference created an environment that the baby didnt tolerate well - and his heartrate went down or something similar. Hence - the hurried cesarean birth.

The only way to know for sure is to get a copy of your records. Request a copy. sit down & read through them.

Dunno if the hospital will have it, but your OB definitely will.

Does it sound possible that you could have given birth vaginally? I say yes. Would you have definitely? No way to tell. But with fewer interventions & more support, chances are more than likely that you would have. And chances are good that you will deliver vaginally next time too given the right support

Hope that helps. Keep looking into it, how does it make you feel? How do you see it all? Thats what matters. Keep asking questions if you feel you need to

Lala...
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  #5  
October 27th, 2006, 08:06 PM
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Could you have given birth vaginally?

Maybe. You would have had to have a completely different set of circumstances, though. Everyone (including you) had already decided that you would have a c-section. Many of the moms I know who schedule c-sections are terrified that they will go into labor "early" before their surgery is scheduled. The brain is a very powerful organ and a mother who is afraid releases tons of adreneline, which produces the fight or flight instinct. In a hospital labor where flight isn't an option, this instinct presents as stalled or unproductive labor.

You say you felt like your baby was stuck, but did you feel that way because she was stuck or did you feel that way because everyone around you expected her to get stuck? You may never know that.

I will say I've seen "stuck" babies...three of them. Each labor pattern was different but they all produced cervical change. On the other hand, in my first labor I labored 12 hours with long, intense, close together pitocin contractions and produced little to no change then went on to have a 9+ pound baby vaginally. My point here is that lack of cervical change does not always = CPD.
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  #6  
October 29th, 2006, 03:50 AM
Lotsakids's Avatar Platinum Supermommy
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Location: Australia
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Firstly I am NOT a Dr or in the medical field. Just a Mother that has had 4 children of her own & been present at a few births & these views are JMHO.

Firstly just wondering how big Ally actually was?

Everybodies bodies are different.

U/S estimations for babies weight can be out by 2lb either way. With 2 of my babies I was told were going to be 'tiny' & both came out in the high 8lb range. That said, of course they can go the other way & come out tiny when they were supposed to be huge.
I was a week over 18 when I had my first child & was a tiny little thing with a tiny little belly. Everyone believed I was having a 5lb'der & out popped an almost 9lb'der who was short & FAT! Noone could believe that my tiny belly had produced something so large, but she was actually my heaviest & easiest baby to deliver

Dilation - Me personally, I can be stuck/stalled/whatever you want to call it at 5-7cms for literally hours, & then suddenly go to 10cms & have a baby in my arms within minutes, actually scrap that, within seconds with one of them. As I said before, everyone is different, that's just the way my body works

There are alot of things that could contribute to not dilating.

1. Not being in labour very long. You could have very well still been in early labour, even with the close contractions. Mine start at anywhere from 2 1/2 to 5 mins apart & are very intense from the word go.

2. I am pressuming that you weren't up & about & that you were in a hospital bed, which is often not conducive to either labour or dilation. Positional change (even on the bed,) can do wonders to get you dilating.

3. Also with the above, baby might have been in a not so great position to 'come down', which moving around & leaning over forwards often helps.

5. Stress (all round.)

6. Naturally slow labour, (my last was my longest.)

7. There could truly be a size issue going on.

(The list could go on & on....)

As I said, I'm honestly not a Dr or medical in any aspect. Maybe sit down & have a really good chat with your Dr about it. Ask him/her all the questions that you feel are still unanswered for you.
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  #7  
October 29th, 2006, 04:33 PM
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Thanks everyone for all of the thoughts, opinions, and advice. I'm a little bummed that I didn't even attempt a vaginal delivery. But, being 38 weeks pregnant and hearing your OB tell you that he feels a vaginal delivery is too risky isn't something you take lightly. He explained the different types of trauma Ally could face and mentioned that an emergency c-section would have to be performed if she literally got stuck and said that both of us could be high risk at that point. Needless to say, I was SCARED!! So, yes, maybe I decided to take the easy way out. But at the time it seemed like the safest from what I was told.

That being said...it was my first pregnancy and at the risk of sounding cliche "I wish I'd know then what I know now." I didn't know what questions to ask. I didn't know how to handle the situation other than to go along with his suggestion. And frankly, I didn't know all of my options. My OB is a very well respected kind man so my first instinct was that he wouldn't do me wrong. And I still don't think he did me wrong. However, I do feel he led me down the easiest route, for both of us as far as delivery goes. Now recovery - ha that's a different story! Ouch!

Yep, they had me flat on my back in bed and wouldn't allow me to move due to the contraction monitor. I needed to sit up due to the pain but they wouldn't allow it. It was horrible. And I don't understand why they allowed me to have contractions that painful and that close together for 4 hours before deciding on the c-section, since I was already a planned c-section. My contractions were already strong enough to cause me to cry walking in the hospital (and I'm not a wimp when it comes to pain) and 4 1/2 to 5 minutes apart when I first got there. Needless to say I'm still upset about that!

Ally ended up weighing 8lbs 15oz at birth. And she was exactly two weeks early.

Question...If I was attempting a vaginal delivery, what could they have done for me as far as pain management with contractions as strong and close as the ones I was having, but only being 2 centimeters dilated? They gave me Stadol and Phenergan and the only thing it did was make it so I couldn't concentrate well. It didn't take the edge off the pain.
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  #8  
October 29th, 2006, 06:47 PM
Lotsakids's Avatar Platinum Supermommy
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Location: Australia
Posts: 5,393
Quote:
So, yes, maybe I decided to take the easy way out.[/b]
I don't think that anyone here would even imply that by having a C-section that you took the easy way out. You listened to your OB, you did what you thought was right for you & your baby. That's all that any of us can ever do.

Quote:
Question...If I was attempting a vaginal delivery, what could they have done for me as far as pain management with contractions as strong and close as the ones I was having, but only being 2 centimeters dilated?[/b]
I would look more at what you could do for you, than what they could do for you. We all need to be pro-active for ourselves.
Movement/positional change (if constant monitoring is necessary request it to be external,) warm water ie: bath or shower, both are AWESOME for pain relief, heat packs, squatting holding onto someone or the bed, vocalising, feet stamping, bouncing on a birth ball, gas & oxygen mix (doesn't cross the placenta,) TENS unit, hypnotherapy, other relaxation techniques.. The list goes on
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  #9  
October 29th, 2006, 06:58 PM
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You've given me a lot to consider with my next pregnancy. I will definitely be a lot more involved in what's going on.

Thanks again!
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