Questioning Birth Outcomes

cultivated from community
for MotherSpirit

• I'm sorry you went through such a rotten experience...I've BTDT too with long painful labour and then a c/s. It really is the worst of both worlds...however some things you mentioned concern me and I hope you don't take offence to this...I just have a habit of analyzing birth stories...

First of all...it's highly unlikely that there's anything wrong with either your pelvis or your baby's size. AS long as you have never had rickets or polio and have never broken your pelvis, chances are OVERWHELMING that your pelvis is fine. You mentioned you are on the small size...you have to remember, with birth, it's what's on the inside that counts. Someone can be petite, have 'narrow hips' or whatever, but as long as the *inside* of their pelvis is okay, they will not have problems. My grandmother is 4'11" and weighed 90 lbs on her wedding day. She is extremely petite! She gave birth to 8 children vaginally, ranging in weight from 8.5 to 12 (yes 12, she had 2 of those) lbs!! Now-a-days, I'm sure they'd have scheduled her a c/s, but as you can see, it would've been completely unnecessary.

Second, if your baby had bruises on his face (I'm assuming it wasn't from the c-section itself) then he was in a bad position period. Think of your pelvis as a keyhole. Then think of your baby as the key. If the key (baby) is lined up right, it will slide right in (through) the keyhole (pelvis). If the key (baby) is turned ever so slightly to either side, then it's just not going to fit into the keyhole (pelvis) no matter how hard you try to hammer it in there, unless the keyhole (pelvis) is abnormally massive. Essentially, what pitocin does is hammer your baby's head into the pelvis, and if it's in a bad position, it's going to get wedged. What baby needs is less force and more movement, not stronger more forceful contractions. Just about the worst thing to do in the case of a badly positioned head is giving more pitocin to strengthen the contractions! Not to mention, because the baby's head is being forced into and against the pelvis unnaturally, with extra force, baby is far more likely to have heartrate variations due to head compression, and can eventually go into distress. Remember, this is usually a problem with the management of labour, NOT you, your pelvis or the baby. If you don't already know, I'd get my records to find out what position your baby was in prenatally, during labour and during the c-section. Also, when babies heads are in bad positions, your labour IS going to be more painful than the norm. Not only is there the pain of contractions, but there is often a lot of bone-on-bone pain, either in your back (in the case of a posterior baby), or in one hip (if baby is asynclitic - that's crooked). So you were not imagining the excessive pain...but it's not because your pelvis is too smalll...believe that!

I also noticed they broke your water quite early on. This is just asking for a bad head position. See, the water is usually the cushion for the head. If baby is in a funny position, then the water will usually allow baby enough room and cushion to rotate or straighten out on. Remove that cushion early on, when baby's head is still relatively high and perhaps not in the greatest position and baby's head usually descends too rapidly and ends up wedged in that bad position. Breaking the water is probably the stupidest thing doctors and hospitals ever came up with. MHO of course. You also mentioned how you dilated 'backwards' so to speak. That's actually common in baby's whose head's aren't well applied to the cervix...the cervix usually needs uniform pressure against it to dilate properly. Without that pressure, dilation usually stalls at 4-7 cm. Sounds to me like you were having the typical labour of a malpositioned baby. OH, and a side note: fevers like you had are usually related to the epidural. It's called an 'epidural fever' and is quite common. It doesn't indicate an infection usually. It usually goes away after the birth.

I'm sorry, I don't mean to be rude, but I admit I LOL'ed when I heard about the doctor saying your baby's head was molding. LOL!! That's what baby's heads are SUPPOSED to do. That's why babies are born with fontanelles (soft spots)! To allow for overlapping of the bones and molding during labour! Molding is a pretty universal thing in birth! THAT's how they all fit through the pelvis. Some degree of molding is pretty much necessary for babies to come out. It never ceases to amaze me the ridiculous scare tactics doctors come up with in order to justify c-sections...I"m just sorry that they used that with you. Of course you would do anything to save your baby, and you put your faith in the doctor, and he betrayed that trust. *sigh*

I'm sorry right now you think you should've had a scheduled c-section. You seem to be under the impression that c-section are safer for mother and baby. That isn't quite so. For the mother there is a 4-10 times greater risk of dying (from infection, hemorrhage, anesthesia accidents) and for the baby there are numerous risks...usually having to do with respiratory problems. Not to mention the as-yet-not-completely-known role of hormones on baby's brain in those last minutes/second in the birth canal. When planning your next birth, remember that the risks of Elective Repeat C-section are almost always greater than those of a VBAC.

I would also have a different opinion of your OB than you would...I would probably consider him highly irresponsible if he would've have given you that scheduled c-section. There is NO way to know how things were going to go, just as there is NO way to predict a baby's size before it is out. Even ultrasounds can be off by as much as 20%!! Every woman deserves a chance to deliver vaginally, and I'm convinced had your baby been in a better position and had they not meddled so much, you would've delivered vaginally as well. Unfortunately it's easier to see these things in retrospect *sigh*.

Now, I'm going to tell you a bit about my story...I had a 30 hour labour with dd. She was posterior, so I had back labour, which was excruciating. They did the usual at the hospital, gave me some pitocin to augment things when my dilation stopped. Then after a few more hours of (imo) torture, I had a c-section. Dd's head was really mashed and molded, and you could see she wasn't just posterior, but asynclitic (crooked) too. Anyhow, I was really traumatized from the whole thing, mostly the labour not the c-section...and was convinced my next one there was NO way in hell I'd be going through another labour, that I was now scheduling c-sections from now on! My thinking changed drastically when I joined an email list called ICAN (International Cesarean Awareness Network) in order to just talk to someone, anyone about my experience. No one I knew IRL had had a c-section and I had NO ONE to talk to. ICAN totally turned my life around. I realized WHY I had a c-section, HOW I could avoid, not only a c-section, but an awful labour next time and I also learned scheduled c-section are not all they are cracked up to be. I went and did a TON of research in which I realized it was the 'management' of labour that usually caused c-sections and by the time dd was 6 months old, I was planning my future homebirth. And here I am, Due in about 5 wks, all ready to have my homebirth! I know there's still a chance that I could end up with another c-section after a long labour, but there's more of a chance I'll have a wonderful vaginal birth and me and my baby will be healthier for it!

Okay, now I'm babbling, but I really think you should check out ICAN...I'm no longer on the list, (I'm on HBAC...home birth after cesarean)but there are a LOT of wonderful supportive women there who will really know what you are talking about and will understand you like no one else can. It really helped me through my trauma (I'm convinced I had post traumatic stress syndrome after the c-section) and gave me a place to air my feelings. Let me know if you are interested and I can find you the URL. Good luck and I hope this post didn't offend or upset you.

• Your size means nothing when it comes to delivering vaginally - even a large baby. Let me give you some examples, J's wife, half your size, just delivered a near 8lb baby vaginally, at home. Old boss, remember her? She's half your size as well - her first delivery sounds exactly like yours, she didn't buy it, second baby, 10 lbs vaginally. My neighbor is about 4'2" and weighs like 80 lbs (really, she's Chinese)...had two 9 pounders both vaginally.

When I was pregnant with DD, they INSISTED that he was going to be this huge baby and that I was going to have problems because I'm tall and small boned and thin. They did a second u/s at 36 weeks and told me that he was HUGE and was going to be probably like 10-11 pounds at birth. When I got to the hospital, they scared the living shit out of me telling me that he was so big (after "feeling" him) that I would be there for at least another 24 hours later...watch my birth video..you actually hear the doctor say "Wow, he's so tiny" - 6 pounds 14 ounces!!! They really don't KNOW how big babies are going to be EVEN if they do diagnostic tests at the very end. They don't KNOW anything about how you can or can't deliver a baby even with a previous birth.

I hear your voice and I know you and what I hear is what I had for so long...refusal to see that I was mistreated, I was lied to, I was raped of my dignity and I was raped of a natural spiritual empowering birth by the medical establishment who's primary role of birth is one of illness. I encourage you to get your medical records - sometimes you'll be amazed at what is in there. I just saw mine on Thursday at the OB... after being told that DD was in distress in labor and that his heartrate was dropping every contraction and after ASKING to talk about the internal fetal monitor FIRST and having the doctor do it without my permission, I found out that his heartrate was dropping but not enough to justify it that most likely the EFM (external monitor) was not picking up the heart rate since he was sideways (and came out sideways) and so he did it for that reason.

• I know, I know! I agree. We MUST educate ourselves much more prior to birth, I agree, and I thought I had, especially with all your help. But when I got to the hospital, they all just took over you know. I EVEN gave the nurses instructions in the nursery, and they didn't even care to listen to me, the mother, they did everything by protocol. I know, I used to work in a hospital, and they tend to be like robots following protocols and not actually listening to the patients. Too sad.

• I was thinking all of what T said as I read your post, though she said it better than I ever could. I know how hard it is to believe certain things about your birth and then be told something different. I suspect your doctors knew EXACTLY why your sweet babies head looked the way it did, but doctors will ALWAYS tell you it was you body that was not working, because they will NEVER admit that there acts to try and "progress" your labour actually CAUSED the C/s. Like T said, AROM, is a disaster as far as malpositioning babies heads, then those 3 bags of pictocin were simply jamming your babies head down so he didn't even have a chance to reposition it himself. As far as your cervix closing, this happens when mama is stressed. We are programmed to be able to stop delivery if we are in danger. You body is way smarter than that OB gave it credit for. You WERE in danger because what was being done to you was hurting your baby, your body knew this and tried to stop labour so you could move away from danger.

My babies were born with heads in the hundredth percentile, they didn't mold at all for some reason. I am a small womyn and had EXTREMELY narrow hips when DD was born. DD came vaginally and I didn't tear....I was lucky. Lucky that the hospital didn't interfere to the extent that your hospital did, they have done you a disservice by convincing you that your body failed you and your baby. This is not true, you body is as capable of birthing as mine is unfortunately you were deceived into thinking otherwise.

I know all this will take time to digest. I know that it took me about a year to realize that I had been taken advantage of in the hospital, and that I COULD have the natural birth I originally wanted. {{{HUGS}}} What they did to you was horrible and you deserve better.

I re read your post and it sounds as thought two different nurses checked you when you supposedly shrank back to 6? If this is so I wanted to add that one nurse’s 6 is another nurses 8. CM of dilation are measured in finger breadths. They teach nurses that a finger tip is 1cm a full finger is two (I am not sure of the exact measurement theory but it continues like this), and so on. Now take a look at your fingers and take a look at a few other women's fingers...are they even close to the same size? Add to that that some nurses will only test during a contraction for "accuracy sake" and others kindly check when it is convenient for you not HER! So you may have slipped back to 6 for the reasons I mentioned before or you may have stayed exactly the same. How fast, and smoothly someone dilates has ABSOLUTELY NOTHING to do with how the labour is progressing. Womyn A may go from 1 to 10 in exactly 10 hours dilating 1cm an hour. Womyn B may dilate from 1-4 in the first 3 hour, from 4-4.5 in the next six hours then from 4.5-10 in the next 20 minutes. Womyn B will actually be at 10cms 40 minutes faster that womyn A but she will probably never find out since she would have been poked, proded, and most likely cut half way threw those six hours that she didn't dilate more than .5 cm. Do you see what I am saying here? Checking women's progress serves no purpose except to deflate them.

• In the end however, I had actually 5 bags of pictocin, if you can believe that!

• 5 BAGS of pitocin?! OMG! I worked in medical review and that would be grounds for malpractice, hon. There's nothing you can do now. I have actually known people who had even more pitocin than that. I'm just letting you know that it was an excessive amount and they should've never used that much. There are guidelines that are supposed to be followed about correct drug dosages, and it sounds like 5 bags of pit greatly exceeds those guidelines (but hospitals ignore the guidelines all the time...technically cytotec is *never* supposed to be used because of the risk of fetal death, and we know how often that gets used for inductions!). In case you ever wonder about what parts of your birth were necessary and which parts were not, or you start to question whether or not they really did anything wrong, you can at least be sure that 5 bags of pitocin *is* a sign that they did something wrong and in itself was probably a large contributing factor to the c/s.

I have been down a similar road with the nightmare birth experience (and my dh did not ever want more kids after that!), so if you need anyone to talk to about it, I'm here. If working through your birth feelings turns out to be at all like my experience has been, you might have some surprising emotions come up the next few months (fear, sadness, doubt, rage) and need a listening ear from someone's who's BTDT.  {{HUGS}}

• How informative your post was! Wow! You did enlighten me and I never took offense to any of what you said. It was very educating to read. It does make more sense that my son's head was not positioned correctly, and the breaking of the water prematurely could have been the cause as you say. I am very disappointed that I never gave birth "naturally" the way God intended for me to. I feel like I was raped of my womynly ability to take advantage of what my body was made to do. And yes, I also agree that hospital management played a part in the whole intervention game that lead to my C/S. So, molding is natural, hmm, damn doctor. I was so scared when he said that. The whole birth was a nightmare until I saw my son's eyes. To top it all off, my DH accidentally erased the part of video where I see my son for the first time. And, he doesn't want anymore children. That's a whole different post.

Thanks for your very well informed thoughts. I will be requesting my records. It's all very interesting to find out the details of your birth afterwards. Most womyn just trust the doctors and the nurses. But I truly believe that if enough of us educate ourselves through groups like Motherspirit and ICAN, by sharing our stories and being aggressive enough to analyze our hospital records, we can educate soon to be mothers and protect them from having bad birth experiences like some of us have had.