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a SLOW crown and a flat baby

Last post 02-09-2011 12:31 PM by lesleymidwife. 6 replies.
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  • 09-22-2010 9:58 AM

    a SLOW crown and a flat baby

     just thought I'd share my last birth....G2 mama, first baby ended in spontaneous 3hr labour at 42wks and easy push of a 3.1kg baby,so we were expecting no trouble with this one,so this baby:mama has a few days of prodromal labour, mum unable to sleep through them and gets progressively exhausted..then starts active labour gently at 8am...comes into active birthing unit at 930am-fully dilated,SROM on internal, baby sounds good and head is low....contractions pick up in force..mum gets into the pool...30min later we have sporadic "iffy" contractions...now im still a baby in this field so.... is this because mum is so tired,last few days with minimal sleep and none in the last 24hrs or is this just the rest and be thankful phase of pushing?(sadly the rest and be thankful phase of pushing is not recognised here) so they make the decision to put pit (here we call it synto) up...contractions take on a definite pushy edge and mum starts to push spontaneously...baby moves down quickly<still sounding great...head comes quickly to a full crown and then does the awful "one hair at a time sssllllooowwww crown" you know the kind that makes your heartrate climb, no restitution but no turtling either, feel for cord-no cord...next push - no movement, change mums position, next push, still no movement, lateral flexion applied, and anterior shoulder slips out easily, so no sticky shoulders...ah theres our problem, tight loops of cord around babys  neck ,arms and upper chest, baby birthed through the cord and up to the surface...baby white,limp,unresposive and a heartrate of 60...so we start to resus baby, took 45 min before he had decided to stop growing angel wings and placed his feet firmly on the earth...such a shocked baby for such a short space of time!!!  so my Q is: surely the tight cord was the reason labour took so long to get going and why pushing was so gentle and sporadic? wouldnt it have been better to have just left the labour and not put up pit? how do you know that the contractions are soft and sporadic because the baby requires or or if its just due to maternal fatigue? what are your experiences with this ladies? PS baby weighed in at a lovely 4.5kg 

     

  • 09-22-2010 6:00 PM In reply to

    Re: a SLOW crown and a flat baby

    I'm not a midwife, just a doula.  But, I am thinking either way the pit was not necessary.  Either the baby needed to come slowly and gently because of the cord, OR mom needed a "rest and be thankful" period.  Her body and her baby knew what was best...  Again, I am just guessing!  Big Smile

    Vicki - wife to Chris, mom to eleven, doula and midwifery student.
  • 09-24-2010 3:05 AM In reply to

    Re: a SLOW crown and a flat baby

    The labour you describe was somewhat similar to my last.  I had on off slow build up, irregular strength and intervals, and long gaps (i was dilated to about a 7 with only 5 contractions an hour).  I was luckily at home and no synto/pit to go up!  My pushing when it happened was very fast (my body demanded it that way).  She was "head at spines" on my one and only VE, and was born and screaming 6mins later.

    She had a true knot in her cord.  I'm sure the weird labour, cautious descent and then dash for the exit was all due to that.  In the middle of the night i tried nipple stimulation to "improve" my labour, as i was getting tired and worried about it going on for days, and all that would happen is my uterus would go hard for up to 2+ minutes at a time and the baby would stop moving.  I am sure if i'd been somewhere where they'd put pit into the equation she would have died.

    Me 32, DH 41, DD 2006, DD 2010, DS 2013
  • 10-07-2010 1:35 PM In reply to

    • Adrienne
    • Top 50 Contributor
    • Joined on 02-12-2009
    • South Carolina
    • Posts 35

    Re: a SLOW crown and a flat baby

    I attended a waterbirth of a G2 mama last month.  Very slow descent and crowning, so I am thinking cord or shoulders, what is happening?  Babe was turtling his head down & back more like a first birth, then after a ctxn or two it stayed down, then mom let out a "whoa" the same time I felt the head retract several centimeters.  Head then descended and crowned very slowly for second baby, restituted slowly, and we awaited the next contraction.  Shone a flashlight to assess his color and general mood and he was pink and serene.  When his body was born the cord was wrapped 2x, once nuchal and once over a shoulder and down across his chest like a Mr. Congeniality banner.  Aha!  He absolutely knew what he was doing with that slow descent.  Wise baby.

    All that to say yes, I do think that the physiologic process was disrupted at the birth you describe, and the baby's distress/resusc. was at least in part iatrogenic (can't say for sure what would have happened without the synthetic oxytocin).  I'll also add this: 2 contractions after the head is birthed with no further progression would lead me to ask mama to get out of the pool.  I'd love to hear other thoughts though, as I am a relative newbie as well!

  • 10-31-2010 10:58 AM In reply to

    Re: a SLOW crown and a flat baby

     You say :"mama has a few days of prodromal labour, mum unable to sleep through them and gets progressively exhausted..." what does that mean? How coud you tell she was exhausted? was the mother eating, drinking, peeing, resting? were there ketones - lots of them? What were her prodromal labor contractions like?

    Determining whether a mama is truly exhausted is a topic I would like to know more about. I tend to go by a combination of things: is she eating and drinking, resting, discouraged or determined and are the contractions bam! one after the other, strong and been going on a long time....Nature is wise and most mama's sleep in between contractions like that so that they will have the energy to push out thier babies. And sometimes nature gives them nice long breaks in between pushing contractions as well.

    But just from what you wrote, this mama going from active labor to complete in an hour and half tells me she it was not maternal exhaustion.

     

     

    Lesley Nelson, Warrior who prefers to move in open space in search of mysteries.
  • 12-20-2010 7:13 PM In reply to

    Re: a SLOW crown and a flat baby

    I think we need to rethink how we manage labor. I had a situation once where the labor was weird. irregular contractions from 3 - 10 min apart through the whole labor, i think at one time she even had a random break of 20 min. Tried to regulate things with a little Red Rasp and she only threw it up. later  the heart tones were off. low dips of variable decels. I checked her and she was only 8cm so we decided to transport because we were in the middle of nowhere and a hosp was an hr away. I went in the back of the makeshift ambulance (this was in MX) about 10 min down the road her water broke and the baby came down fast. Baby was born just a few min later with a nucal cord.

    I stood in awe of how her body worked to gently bring the baby, keeping the baby high until the last min. It makes me question the use of anything to change the natural course of labor, even herbs.    

  • 02-09-2011 12:31 PM In reply to

    Re: a SLOW crown and a flat baby

     Bumping* Would love to hear others thoughts on what/how they determine maternal exhaustion....
    This is a good thread!

    Lesley Nelson, Warrior who prefers to move in open space in search of mysteries.
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