I feel like I have been forced to have 2 unnecessary c/sections due to possibility of shoulder dystocia.
My first child, a son, was born naturally within 5 hours without any drugs and only 2nd degree tears. He was 7lb4oz.
My second son was 9lb5oz and I was told he had severe shoulder dystocia, which I no longer believe.
Due to the notes about my 2nd birth, it was recommended that I have a c/s as the ultrasound indicated my third child would be bigger than the 2nd. She wasn't, only 7lb10oz.
After one unnecessary c/section I pulled out all stops to have a natural birth next time around. Unfortunately, nobody directed me to birthrites and NO-ONE would listen to me. I tried to tell them the ultrasound was wrong last time and they just said, "she was smaller because she was a girl, boys in subsequent births are statistically bigger". Because I am 1000 k's north of Perth, I did not have access to a second opinion and the Dr's had no choice but to follow the Specialist's advice. He told me that Shoulder Dystocia is an Obstetrician's worst nightmare as you only have 5 mins to get them out. Can you direct me to information on shoulder dystocia in case I get pregnant again and wish to have a VBAC?
P.s. I have also been told that they won't let you have a normal birth after 2 c/s in Australia!
==========================
Dr David
Moderator posted 02 February 2001 10:43 PM
Debby Miller has written an excellent article on the issue of shoulder dystocia &endash; see the magazine section of the Birthrites website. I'll put below an on-line copy from PubMed of the summaries of the 2 main journal articles she quotes. I would suggest writing to your local library for a copy of the full Rouse and Owen article if you want further information.
Rouse, D.J. & Owen, J. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10454678&dopt=Abstract
Sandmire and DeMott http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9065129&dopt=Abstract
Macrosomia (big baby) is not a reason to avoid VBAC.
See SGOC guidelines on VBAC &endash; "Published information does not suggest that a diagnosis of suspected macrosomia is a contra-indication to labour after previous low segment Caesarean section" . http://www.sogc.medical.org/SOGCnet/sogc_docs/common/guide/pdfs/ps68.pdf
Flamm reported their experience with VBAC in women with large babies. They found lower VBAC rates, but no significant difference in perinatal or maternal morbidity (injury or sickness) when compared to VBAC with babies under 4000g, or when compared with women with macrosomic babies but with no uterine scar. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2638575&dopt=Abstract
Evidence from the medical literature (documented in other postings at this site) suggests that labour after 2 caesars may have a higher chance of scar rupture (not in all studies) and a somewhat lower chance of vaginal birth. Women with a previous vaginal birth, however, have the highest rates of VBAC. Vaginal birth after 2 caesars is certainly an option in well-informed and counselled, motivated women. As such, there are Australian obstetricians who support a woman's right to choose such a course of action.
Dr.David
DISCLAIMER:
This advice is of a general nature to help in decision-making. It
does not constitute recommended treatment for an individual. You must
consult your health care provider for individual
advice.