shoulder dystocia & 5th degree tear

[hiphophooray]

Hello ladies! I just found out we are expecting #2 and I couldn't be happier! DS was born at 34 & 5, due to PROM. He was 7 lbs 1 oz due to type 1 diabetes and slightly uncontrolled blood glucose levels. When he was born he got stuck, they called it shoulder dystocia. My OB at the time said next time would be a c section because my son and I could have died. Today I had my first OB appointment with my new OB, who is my old OBs partner, my old one just retired last year. I explained what happened and he said "if this baby is smaller, you can try for a vaginal birth again rather than c section" I had always assumed that I would just be getting a c section but now I would love to have a normal vaginal delivery, without the awful complications of a "5th degree tear" my blood glucose levels are much easier to control with new technology I have so I hope that helps with the size of the baby. Has anyone had shoulder dystocia/5th degree tear and gone on to have "normal" subsequent vaginal deliveries?

 

[hiphophooray]

Any similar experiences?

 

[Eleanor ace]

What is a 5th degree tear? I'm in the UK and we only go up to 4th, so I'm not sure what your tear entailed or if my experience has any relevance! But with my 1st I had a 3c tear (although it is recorded as a 4th degree on my surgical notes as the tear went into my anal cavity- tmi sorry - so I'm not sure if it was a 3c or a 4th; my consultant counts it as a 4th, I count it as a 3c because it sounds less scary ) and I went on to have a vaginal delivery with minimal tearing with my 2nd . I ha mild shoulder dystocia with her which was resolved and she delivered hand and elbow up but shoulder back. Obviously that was a lot different to your experience, and LO and I were both fine, but when I asked my consultant whether there was a potential issue for having another shoulder dystocia this time and it being worse he told me that there are certain risk factors (such as LO being big, LO's position as they come down) it isn't a given that it will happen again and there is every reason to believe that I will have a straightforward delivery . Hopefully the same is true for you! Oh also my 2nd, the one who tried to come out shoulder first was my smaller baby; DS was 9lbs 15oz (which was quite big for my frame) and I had no shoulder dystocia with him, so even though it is an increase risk, a bigger baby doesn't necessarily= shoulder dystocia

 

[hiphophooray]

Thank you! I actually had to double check with my OB and apparently I suffered a 4+ degree tear, he said the equivalent to a 5th degree if there was such a thing! My nurse kept saying 5th degree afterwards thats why I was confused. I was also cut in a different spot then the normal v to a I guess I can't imagine having a much smaller baby than 7 lbs though this time, so the fact that size may not have only been the factor makes me feel better. Do you happen to know anything that can help prevent SD? I would love to prepare for both way just in case I get a choice

 

[catty]

I had a 2nd and that was a large tear which involved muscle so I cant even imagine what a 5th degree tear is but it makes my lady bits feel squeamish just thinking about it (sorry) I think if you want it and you have had the ok from your doctor then you should go for it, I had a 2nd the first time and judt a small graze the 2nd so your not garunteed the same kind of tear each time

 

[Eleanor ace]

Thank you! I actually had to double check with my OB and apparently I suffered a 4+ degree tear, he said the equivalent to a 5th degree if there was such a thing! My nurse kept saying 5th degree afterwards thats why I was confused. I was also cut in a different spot then the normal v to a I guess I can't imagine having a much smaller baby than 7 lbs though this time, so the fact that size may not have only been the factor makes me feel better. Do you happen to know anything that can help prevent SD? I would love to prepare for both way just in case I get a choice

I'm glad we only go up to 4th degree, 5th degree makes me clench up in sympathy even though I don't know what it is . My consultant mentioned labouring in water again (I had a water birth with my 2nd) as it makes it easier to change positions which can help to get LO into a good position for delivery and making sure not to labour on my back (not that I want to; I had to with my 1st and it wasn't the best!) and he said that the MW delivering will check LO's position more often to make sure s/he's coming down in a good position. I'm not sure what else can be done but I bet your consultant will be able to talk you through it, I bet they have steps in place for women who've been through what you did.

 

[hiphophooray]

Thank you! I would love to labor in water, its not always an option at my hospital but I am hoping for that. I will definitely talk to my doctors and find out what the steps are!

 

[goddess25]

My first birth involved shoulder dystocia and 4th degree tear. C section was never discussed with me as an option at all and it was assumed i would have a vaginal delivery. 2nd birth in labour my daughter was in a similar position and my MW made me do lots of odd movements, she moved and she pretty much fell out. 3rd delivery of a 10lb er was also sitting funny but he moved and came out after a couple of pushes.
I was pushing for 4 hours with my first son and was totally bruised and swollen, eventually he was manipulated and pulled out with forceps in the OR.

 

[NDH]

Oh gosh that sounds traumatic!

I don't personally have experience with shoulder dystocia or bad tears (I had a 2nd with my first and a graze with my second) but I know many women who have birthed vaginally without complications after SD.

Having it once doesn't mean it will happen again and it doesn't even have anything tondo with size either.

Simply changing positions in labour is often enough to relieve shoulder dystocia (though that's easier said than done with q head hanging out of you!)

Here is an article you may find usefulh ttp://midwifethinking.com/2010/12/03/shoulder-dystocia-the-real-story/

 

[hiphophooray]

I just wanted to update that my OB and my MFM docotor both agree that a vaginal birth is definitely not unreasonable unless this baby is obviously big in the wrong spots again. They said with the amazing improvement of my blood sugars prior to pregnancy I have a slim chance of having a 90+ percentile baby again, and if thats the case we get to go with a vaginal delivery again! So we will see what the groeth scans say down the line but I am just so happy it's not a guaranteed section already

 

[sweetcheeks78]

Hi! My story is a bit different, but I too had a very difficult first delivery and a severe (nearly 4th degree) tear. My DS1 was 8lb 12oz, 5 days overdue. In the end he was a forceps delivery, and it was all very traumatic for all of us. I was petrified when I went into labour with DS2, so scared it would happen again. However, just 3 hours of labour and a natural delivery, no pain relief and no tear. He was just 7lb 7oz. Your second delivery is pretty much always easier than your first. Your body just knows what to do as you've done it before, and it's all been stretched already IYKWIM, lol. Good luck hon, I'm sure you'll be fine x