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Flat pelvic arch - teen

Last post 01-20-2010 3:43 PM by marlenecpm. 6 replies.
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  • 11-24-2009 8:21 AM

    Flat pelvic arch - teen

    I am a doula for teens here.  I had a mom yesterday who turned 16 a month ago.  She labored well and pushed for 4 hours.  She pushed great - we were all very proud of her.  However, as she pushed, the baby formed a caput and the caput would lower a tiny bit, but the actual head was stuck.  They had an OB come in who has much experience and she determined that the mom has a flat pelvic arch and the baby's head just couldn't make it.  She said she could probably work it out with a vacuum extractor but then she would risk having the shoulder stuck.  The poor girl was crushed to have worked that hard all day and end up with a c-section.

    Anyway, I am wondering if part of the reason for the bad fit is because she is so young.  I guess what I am really wondering is will she always need c-sections due to that, or will she grow more before she has more children?

     

     

    Vicki - wife to Chris, mom to eleven, doula and midwifery student.
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  • 11-24-2009 12:14 PM In reply to

    Re: Flat pelvic arch - teen

    What position was she in during pushing? Do you think that was "aggravating" the circumstances any?

    Susan
    Moderator

    I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. --E.B. White
  • 11-25-2009 7:22 AM In reply to

    Re: Flat pelvic arch - teen

    They had her on her back most of the four hours of pushing (poor girl!)  I was able to get them to let her turn to hands and knees for a few contractions and it did move baby down some, but then it seemed to be "stuck" there.  Mom was pushing beautifully and baby was advancing fine until a certain point where it just stopped.  Do you think hands and knees for a longer period of time would have helped?  Or another position?

    Vicki - wife to Chris, mom to eleven, doula and midwifery student.
  • 11-25-2009 12:17 PM In reply to

    Re: Flat pelvic arch - teen

    Even with a "normal" pelvis (for lack of a better descriptive word), being on one's back during pushing is just not a very good way to get the pelvis to open at all.  I wonder what would have happened if she would've tried some lunging or even some asymetric positions which would have given her more room.  Or trying a hip squeeze since most of the time a double hip squeeze requires mom to be on all fours which would then be doubly helpful.

    Susan
    Moderator

    I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. --E.B. White
  • 11-25-2009 2:54 PM In reply to

    Re: Flat pelvic arch - teen

     I was under the impression that a "flat" pubic arch (more than 90degrees) was a good thing and made having babies easier - i have a very wide arch and was told this would help, and since i didn't have much of a second stage (spent 90 minutes roaring to prevent myself pushing and then DD was spontaneously born) i assumed it did.  I thought a narrow arch (90 degrees or less) was the more problematic shape?

    Me 32, DH 41, DD 2006, DD 2010, DS 2013
  • 01-20-2010 3:42 PM In reply to

    Re: Flat pelvic arch - teen

     Being on arms & knees lets the tailbone swing out instead of pinch in, like when she is on her back, or semi-sitting, but squatting, or standing with one foot up on a chair  opens up the pelvis best. I had one birth where the baby reached a point, just as you described, where caput was increasing, but no progress on the head descending. Finally I reached in and held the pubic bones apart as she pushed. She  pushed for 6 hours altogether, baby had quite a cone head, but was born naturally at home. The Next time around, we were ready to help her as I had before, but she only pushed 15 minutes and baby came flying out! Quite a difference in time and effort, only a few ounces of difference in weight.  

      It sounds like none of these techniques were used, so I would think if she were to hire a competent HCP next time, she'll do just fine.

  • 01-20-2010 3:43 PM In reply to

    Re: Flat pelvic arch - teen

     You are right, worstfriend!

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