Birth after injured baby - c-section or vaginal?

[admin]

Hi All,

I know we've posted this topic before but now that I am actually pregnant with my second child (my first was injured ROBPI) - I really need some input.

I had read I am 14 times more likely to have a baby with shoulder dystocia after my first... I found this to be a huge risk and scary as hell (what if my second child was also injured).

I go to a new OB practice and will be seeing an actual OB as oppossed to midwife this time. We discussed this prior to my getting pregnant and decided on a c-section. However, my heart still breaks thinking that I will not get to experience child birth vaginally again. I'm all torn up and sometimes I think - well maybe we could try vaginally with this one? He has stated he has had babies with shoulder dystocia and was able to deliver without injury... but I have such a hard time trusting now.

How many of you decided on a vaginal birth after your injured child? Did you experienc shoulder dystocia again (and any subsequent injuries)? I really need some feedback, because I'm going nuts here!!!

[Angela Butterfly]

I imagine you have already read these posts, but just in case.

http://ubpn.org/messageboard/thread ... msRange=15
C-Section birth plans

http://ubpn.org/messageboard/thread ... msRange=15
C-Section VS. vaginal birth after OBPI

[Josh'smom]

My first was a shoulder dystocia and broken collar bone and the second was a shoulder dystocia, boken collar bone and LBPI (all with a OB--I refused the mid wife) and the third was a DEMANDED c-section. I actually felt Great after the c-section. The recovery for me was better than the vaginals, because both vaginals were very tramatic w/lots of stitches and I had a hard time walking after both two. The c-section was cake in my eyes. You need to do research and feel comfortable with your decision, for me the third one and the decision for a c-section was soo easy...I didnt want another one of my baby's injured. Do lots and research and talk to your dr. Good luck to you.

[admin]

I understand everyone's feelings after have a child with a obpi,
I had a child 12 months after having my son with whom has a ROBPI.
My OB, who was a different OB, monitored my pregnancy with care and was able to bring me in 2 weeks before my due date to induce me and help prevent another OBPI.
My son who has the injury was almost 10lbs at birth, my daughter who was born vaginally and 2 weeks early, 12 months later, was born almost 8lbs and as healthy as can be.
Its a personal call, If you have the right OB who understands what complications may arise during a delivery that can prevent an injury then I would say go for the vaginal birth, knowing that there is always the option, that if things arent going well during the delivery, you can always get the csect,
I also believe that with my daughter, I had an epidural but it had worn off, the anestesiologist was about to come top me off, when I told him it was too late, I have to push,
I think being able to feel what was going on during the delivery with my daughter also helped me to deliver her easier then
with my son---i had so much epidural in me that my legs were like lead and I couldnt even feel them, the nurses had to hold my legs to my chest and another nurse had to apply fondal pressure, because I couldnt feel a thing! I wasnt able to help in the pushing process the way I should have
Good luck and I hope all works out well

[BIGJAVSMOM]

First of all congratulations and good luck. I have a question- I have had 2 babies vaginally. My second was injured ROBPI - severe. Both were shoulder dystocia. I love my kids more than life itself, but I don't have any stand out beautifully, bonding moments from child birth and definatley not labor. What is the big deal about vaginal deliveries. I only wish I would have known about BPI, I would have begged and pleaded for a c-section.

It's an honest question, and I truly hope that I don't offend anyone. I couldn't think of another way to express my thoughts.

Marlyn

[solson]

I can only answer for myself but vaginal birth is a big deal for me as its the most miraculous experience I have ever had as a woman. Being able to carry this little miracle and birth her from my body was an amazing thing. Being a part of the process of starting her life, holding her and putting her to my breast was an absolutely amazing experience BPI or no BPI. I am sure there are many for whom the method of birth isnt important but for myself its being able to participate in creation and to do things the way God intended. I struggle with the c/s because its surgical, sterile and your more of an observer than a participant. I understand I still grew this child but Im not a part of its delivery.

To the OP, I am due in 3 weeks and have a scheduled c/s. There is not a day that goes by that I dont question it. I do know there would be no worse feeling to me to decide to go vaginally and have the same thing happen again. That is the biggest factor in my decision making. I have also needed to put aside some of the above feelings about vag birth and recognize that it is only one part of motherhood and birth (though so important) but I would rather my child being healthy and whole than to "experience" something.

In your case the fact that your doctor has admitted having SD births to you would be a bit of a red flag to me. I know its often unpredictable but I know in my situation there were some huge signs that there was a problem that went ignored. I'd be interested to see what others say about that part of it.

I just want to encourage you though because I know its a tough decision. There are the what-ifs and you want to try it again but we cant see the future. So as mamas we make the best decisions we can with the information that we DO have. I hope that you make the decision that you feel is right and best for your family and I wish you a happy, healthy pregnancy and birth!

[admin]

My first child had a robpi. I was very concerned when I became pregant with my second. I used a different ob that I felt very comfortable with. We went back and forth with the c-section or vaginal. He would have done a c-section if I wanted but he felt very confident that he was going to deliver earlier and carefully watch me. I went for the vaginal the second time around and she was born without a problem. I was lucky that the second time went so smoothly and a much easier recovery than with a c-section. You need to go with your gut and heart. No one at the end of the day can tell you what is best for you, you need to make that choice for yourself. Good Luck!

[TNT1999]

"In your case the fact that your doctor has admitted having SD births to you would be a bit of a red flag to me. I know its often unpredictable but I know in my situation there were some huge signs that there was a problem that went ignored. I'd be interested to see what others say about that part of it."

Sara,

The OB who I ended up choosing to deliver my 2nd baby told me that he'd encountered many SDs during his many years of delivering babies, but that he was always able to successfully deliver them w/o a BPI. To me, that gave me confidence and made me seriously consider the possibility of having a vaginal delivery. As you know, I ended up choosing the c-s, but did consider a vaginal birth. He did strongly recommend a c-s for me, but said that he'd be willing to discuss a vaginal birth if that's what I really wanted. It's funny b/c the other OBs I'd met along the way (b/w leaving my old one and finding him) all automatically said that I should definitely have a c-s.

Here's how I feel about it. The fact that an OB has encountered SDs doesn't mean that he should've necessarily done a c-s. Afterall, most BPIs are avoidable by doing appropriate maneuvers and maybe also by the dr. telling the patient that she shouldn't have an epidural and that she should try to deliver on all fours. Most SDs don't result in BPIs so just b/c there's a SD, it doesn't necessarily mean there should've been a c-s (alhtough I realize that in some cases, a c-s may have been the only way to avoid a BPI, but that shouldn't be the norm). A good OB will know how to manage the SD. That's why for me, I felt really good about the OB I ended up choosing b/c I knew that he had encountered SDs and had the knowledge, skills, and abilities to successfully manage them.

Anyway, I'm not sure if this is the same thinking the original poster has, but that's my opinion. Hope this helps.

~Tina

[TNT1999]

Hi, Amy. I know that this can be a very difficult decision. I decided on the c-s the 2nd time, but I also know of Moms who have successfully delivered vaginally. I think you really need to take a good look at the circumstances surrounding both pregnancies. Review the risk factors and see how many / which ones you had the first time compared to this time (your weight when you got preg., wt. gain during preg., gest. diabetes, etc.). As your OB about the size of your pelvis. I would also suggest going to the courthouse in the district where the new OB practices so that you can request to see any suits that were filed against him/her. Ask lots of questions.

~Tina, bpmom@comcast.net, Mom to Nicole (6 y.o. w/LBPI) & Joshua (1 y.o. w/NOBPI)

[admin]

Thanks to all who responded... Maryln you made me laugh with your comments - thank you! I agree with Solson about birth being miraculous. It hurt like hell, was harder than anything I've ever experienced and so rewarding. The comment "your more of an observer than a participant in a c-section" is probably why I feel so sad about a c-section.

I agree with TNT1999 about the doctor encountering SD's... just because they have seen them does not mean they are not a good doctor. It means they have experience with delivering the baby anyways, and NOT injuring the child (well not in all cases of course, but in his it is true). I even questions him on how he would respond if a shoulder dystocia were encountered and he knew exactly what to do. He was very open, honest and willing to discuss what we would do when I became pregnant (I interviewed him prior to getting pregnant when I moved down the Cape). He is a high risk OB and that makes me more comfortable too.

We are already to schedule the c-section but I can change my mind (particularyly if I go into preterm labor like last time... he said as long as I'm 35 weeks he'll let me deliver any way I want). I like that he is letting it be my choice with his guidance. I wish I didn't feel like I was missing out on something by not being able to deliver vaginally... I guess it's something I just need to come to terms with.

PS - Good luck and congrats to Solson also... hope your c-section goes well!