Midwifery Today Community

With the birth of my first baby I had "severe" shoulder dystocia, baby weighed around 3kg. The doctor told me I would need a cesarean for following births, as it would be too risky to have a vaginal birth because the risk of having another shoulder dystocia is very likely. What are your thoughts, experiences relating to this. I really want to have another vaginal birth.

I'm not a midwife, just a mother!  But here are my thoughts....

What position did you labour and deliver in?  Were you able to move around a lot?  Did you give birth on all fours or standing or in another upright position or on your back?  Did you use medication during your labour, especially epidural, or not?  What position was the baby in before labour and during labour?  How did the dystocia present from your point of view (what happened)?  How was the dystocia resolved?  Did they flex your legs/do an episiotomy/turn you onto all-fours?

If you gave birth without epidural after an active labour and were on all-fours or upright when the head was born, and the doctor had to try several different position changes and cut a deep episiotomy i would be more worried about another dystocia than if you laboured and delivered flat on your back with an epidural and the flexing of your legs released the baby.  Dystocia is more likely when the pelvic muscles are not working at their best (due to epidural), the weight of the body is on the sacrum, closing the pelvic outlet (if you're on your back) and can often be relieved by turning mum onto her hands and knees (which opens the pelvis and usually involves mum passing through a lunge position which can help shoulders squirm through).  So i would think the risk of a repeat is higher if your labour the first time was despite being active/upright/persistent.

Ditto to all that Bec has said.  Tell us about your birth and if you can, describe your pelvis; any previous injuries to your skeletal structure or has any medical personnel said anything about the shape of your pelvis?