United Brachial Plexus Network, Inc.

Our first daughter was born just over 2.5 years ago with a ROBPI and although I lurk about every day, I don't post very often.

When we got pregnant with our second, we agonized over the decision on whether to have a vaginal delivery or c-section as the majority of doctors were recommending. My husband & I decided together that we believed this is a totally preventable injury & although we were taking a chance of another SD, we would go vaginal, with a midwife in a birth center (last time I was in the hospital induced with pit & flat on my back with an epidural). I know this is definitely not the choice of most people, but we felt it was the right choice for us.

We took precautions of cutting sugar & most starches out of my diet & basically eating really healthy (even though I didn't have GD with my daughter...she was 9lbs 4oz...I also didn't have it this time). I gained 20lbs this time vs. 40lbs last time. We also decided with the midwife to try to get mother nature moving at around 38 weeks with a number of "natural" methods.

I'm very happy to report that after a 2hr 45min labor (in which I walked/stood the entire time) early Saturday morning (1/29) at 1:03am, I delivered another little girl (just over 38 weeks). This time 7lbs 1oz and not one problem! Our whole family is ecstatic (though admittedly, they didn't know we would be delivering in a birth center) and enjoying the new addition.

I just thought I'd post, since not many people make this decision after a BPI delivery.

A new happy Mommy,
-Heather

CONGRATULATIONS, Heather and Family!

What a great story, with such a happy ending. I am so happy for you!

It definitely gives us who want more children something to hope for - a normal birth!

Cherie

I'm really glad that this choice worked out for you. However, I'm very concerned about what the "take home" message people will get your post.

Of course not every high risk pregnancy ends in a tragedy. Most vaginal births don't end in BPI or other injury. Should I think it is safe for me to have a vaginal birth the next time around because I know of someone who did, successfully? Following that logic, I should think that there is never tragedy associated with childbirth... after all, I never knew of anyone who had had a problem until we had a problem.

Yes, women can go on to have non-eventful births. Yes, women with one child who already is injured can go on to have another child who is not injured. I'm truly glad that this was the case for you.

But statistically, such a choice is a very high risk, ESPECIALLY if it was your first baby who suffered a shoulder dystocia. In that case, studies have shown that there is a 25% risk of another shoulder dystocia - one in FOUR. And shoulder dystocia is associated with some injury or death to the fetus as often as 20% of the time. Put together, that means if someone had SD in their first birth, their second child has a 1 in 20 chance of being injured or dying if they choose another vaginal birth.

Those are astronomically bad odds.

Kate

I know you're right in theory Kate-but do the stats say how many of these subsequent vaginal births that result in another SD/BPI involved the women having large weight gain, lying on their backs, being induced artificially and having epidurals-I think it is these things that make the vaginal delivery so much more risky, not the vaginal delivery itself. Accepted, there are cases where a baby just gets stuck, but as over half of bpi babies are not large, there is much more to it than just simply not fitting through the pelvis in my opinion.

I truly believe that until women are properly educated about the risks of back lying, induction, ARM, epidurals and the whole cascade of intervention, then at best women have very negative vaginal birth experiences and at worst injuries or even death of the baby can occur. Did anyone's OHB/GYN warn them about any of these risks with the above procedures, which are well documented? Probably not, because most if not all of them are used for doctor convenience, not patient satisfaction or safety. When things go wrong they focus on the size of the baby or say we have an inadequate pelvis (talk about shift the blame to mommy!) That really doesn't explain over half of bpi's, which happen to babies within normal size ranges. So, maybe it doesn't explain many bpi's at all.

I do hear what you say but I am glad and happy to read this positive story, I find the view that ONLY c section can avoid SD very depressing.

Congratulations on the safe arrival of your second child..you have alot more guts than I. My first daughter is ROBPI ( I only gained 18 lbs with her ) no diabetis but I did all the labour wrong. Epidural, on my back, BP machine on one arm, IV on the other, fetal monitoring device on babies head......never felt like pushing but somehow manged to for 3.5 hours until all heck broke loose and you know the rest ......! My second daughter was born 3 years later via c section BUT I believe that a healthy baby is a baby that goes through the contractions and has their lungs worked on during the process . I talked the obgyn into letting me go into labour naturally and going all the way till I was ready to push, he allowed me to. The experience was so very differen't to my first....I walked around the entire time......contractions started at 15 min's apt went down to 3 min's apart within 5 hours i was feeling like pushing and 35 min's later my second daughter was born. It was amazing and wonderful compared to the first labour and I was thrilled to have experienced it that way.

I guess what I am saying is that each labour is differen't but that I agree with the evidence that says we must not have epidural's, lay down and be induced........or that if we do then we are presented with all the facts and risks prior to the event.

Peace and Blessings,
Lenni

Joshua was my first at 9lbs 14oz, shoulder dystocia and LOBPI. He was born at home, in a birthing tub. I moved all throughout my labor, started the pushing phase side-lying on the bed, switched to the tub when he started moving down. There were no drugs, no inducing, no stress, no lying on my back... We supposedly did everything "right" but still he got stuck. It isn't all about labor positioning or drugs.

Kate

Kate,

A few things quickly come to mind....

I think there are always exceptions and I suspect your experience would lean more towards the exception than the rule. After reading much on the topic, hearing stories from other mothers, and hearing professional opinions (with MUCH, MUCH more still to read and learn), I would be inclined to suspect that your experience may not be the usual case, but then again perhaps it is.

These injuries almost always occur because a doctor or midwife applies excessive traction, NOT because the mother had a VAGINAL birth. There are MANY, MANY, MANY women who experience severe SD with vaginal births and NO injury whatsoever (actually it is the majority), and there are many women who go on to birth vaginally after an SD or BPI and the babies are perfectly fine. Thank goodness some doctors and midwives know what do to and what not to do.

I am sure you are aware...c-sections include many risk factors, which physicians often do not truly inform us of. These risks can have serious impact on the mother, as well as the baby, and can even include death.

FEAR....I think fear is a HUGE factor for all of us. Each and every one of us do not want to see another child injured with this horrific injury. It is truly a travesty that we are all way to familiar with. I sense your fear and it is completely normal.....yet, I feel we need to weigh things out here and we need to understand that although you feel you did everything "right"....I may beg to differ. Many of us felt we did things "right", but upon further analysis, we discovered that perhaps a few important details were overlooked. YOU know your birth....I do not....but I would suspect or question the following....

1) Your doctor/midwife was NOT skilled, nor did she meet the BASIC standard of care required by her position.
2) What particular maneuvers did she utilize once the SD occurred? If any were used were they performed correctly? Did she apply excessive traction to your baby's head?
3) Perhaps your doctor/midwife (like many others) begun to panic, pull, twist, etc., immediately without even waiting for the assistance of the next contraction.
4) Did the person delivering your baby get you out of the water and squatting, or on all-fours like many midwives are trained to do?
5) Did you utilize the benefits of gravity DURING the pushing phase? According to our anatomy and the physiology of birth, not being in such a position can surely put mom and baby at a disadvantage and risk for SD or other complications.
6) Are you familiar with Ina May Gaskin's work and the work of others? They are having NO injuries with SD....even severe shoulder dystocias. It is NOT about us, it is about them.

For me...."IF" I can't trust them to be skilled enough to know NOT to apply excessive traction to my baby's head, than I seriously can't see myself allowing them to perform major abdominal surgery on me either.

PLEASE don't take my post the wrong way Kate. I am just a mother, just like you. I don't have all the answers....shoot, I am lucky just to have a few ideas about this crazy injury....but I do KNOW this.....I am so VERY proud of Heather. I think she is an amazing and a very courageous woman. We have ALL been ROBBED of our birth experiences and we have felt intense feelings of powerlessness and fear. Our confidence to birth vaginally has been stripped away from us and that is a shame.

YES, it is ALL about safety and that precious baby arriving healthy and unharmed, but that can be done vaginally and has been done time and time again.

Heather.....I am overjoyed that you took your birth into your own hands this time. You empowered yourself and you knew in your heart that your body was anatomically capable of delivering this baby safely. You found the RIGHT person to deliver your baby and I suspect you put much thought into all of this and educated yourself profusely. You made the right choice for yourself and your baby. None of this is easy and there are not always right and wrong answers to any of this. Thank you for sharing your amazing experience with us. I am sure you felt reservations about even sharing in the first place, since you went against the c-section norm. I can only hope that other women will someday regain the FAITH in their bodies that a messed up system took away from us. Congrats on the little one!

Kate....again, please know I understand where you are coming from. I too care DEEPLY about the well-being of these precious babies and don't want to see one more needlessly injured. There are just always two sides to any story.

Take Care,
Lisa

Congratulations Heather and to the rest of your family on the birth of your second beautiful baby girl!

So happy everything went well with the delivery

Lisa
Are you a doula or midwife? You use alot of doula "termonology"! Just curious. I am happy to hear that you had a great birth experience. Enjoy those girls!! Terri (A Doula!!)