Shoulder Dystocia

Little did I know, but about 10 minutes before this was taken, the doctor almost sent Avery to the NICU.  

When Avery was born, all I was told afterwards was that her shoulders got stuck and they had to tear me to get her out.  Seemed pretty straightforward and I didn't know that it was actually a bigger deal than they made it out to be.  She had something called "shoulder dystocia".  Even reading the description of it is scary,

"Shoulder dystocia is a birth injury that can have terrible consequences for a child’s life. It occurs in birth when, following delivery of the baby’s head, the baby’s shoulders are unable to pass through the birth canal. The partial compression in the birth canal can cause lasting damage to a child’s nervous system, and is a major cause of Erg’s palsy, cerebral palsy, as well as large number of brain, heart, and lung defects."

Needless to say, when the doctor filling in for my OB at my last appointment 2 weeks ago started asking me questions about Avery's birth and how recovery went for both of us, I got a bit concerned.  Then she said the likelihood of dystocia happening with subsequent births was higher, I got very freaked out.  Then I went home and read about what dystocia actually is and almost had a panic attack.  Not good.

I decided to wait until my next appointment (this morning) to ask for more details before allowing myself to really be scared about this birth.  Turns out, Avery was stuck for less than a minute (anything more than 5 minutes can cause fetal death), and it wasn't very complicated.  She wasn't breathing when she was born (she had the cord around her neck and her heartrate had already been dropping so the cord was likely compressed while I was pushing) and so I didn't get to see her right away.  There was no cry, and her entire body was as white as her hand was in that picture above.  If she had taken about a minute longer to breathe she would have been sent right to the NICU without me having seen her at all.

There are a number of risk factors that can cause dystocia to happen, a lot of which were present for Avery's birth (she was transverse, I had an epidural, needed pitocin to speed up labour, long second stage of labour, she was over 8lbs) but the biggest ones are the size of the mother's pelvis and the size of the baby.  This time around, since we're having a boy, he's likely to be bigger than Avery was so I'm still worried that this will happen again.

We booked an ultrasound for 2 weeks from now to get a sense of how big baby is and whether we will need to induce early in order to try and prevent the dystocia from happening again.  She reassured me that the likelihood of c-section is still fairly low and that because I had a successful vaginal birth it should go easier this time around.  She also said that the fact they are aware of previous dystocia will help them prepare for it this time and that they are very experienced with dealing with it at this hospital so they know what to do.

I'm worried and I hate the fact that I feel that I may have to induce before I want to but if it means the difference between having a healthy baby and one with brain or nerve damage, I'll opt for the former.  If baby is measuring more than 4lbs at 34 weeks at our ultrasound, then we will likely have to induce at 37-38 weeks.

I'm pretty scared, but I know we will make the right decision when the time comes.  Just needing a bit of support.