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The Third & Fourth Stage of Labour Labour doesn't end with the birth of the baby - it ends with the third stage - the birth of the placenta! So if you have any questions about anything third stage, for example cord blood, cord clamping, vitamin K injections or the 'fourth stage' of post-birth bonding, post here!


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Old October 28th, 2008, 10:12 AM
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Angry WHAT???? Shoulder Dyslocia???!!

I rarely talk of my third birth, it was completly horendeous.

He is now 8, and it still upsets me no end.....

I had a 2.5 hr labour that was sheer torture. When I got to hossy they broke my waters, and they were black and green. So they put me up on the bed, and said to get him out NOW. The pushing was excrutiating, and after 2 drug free births, I was screaming for an epidural, and was literally pulling out chunks of hair with each contraction.... I was terrified and in unbearable pain. The Ob rolled me onto my side, my mum and partner held my leg up, and he went in and PULLED out my sons head. I was SCREAMING. Mason was blue and black and not breathing. The Ob held the back of his neck, and under his chin, and pulled the rest of him out, and with him came my small shruken black placenta. The Ob ran from the room with my son, and a middie came back in about 5 min and said "its alright, we have your son back with us". It took 3 attepts, and finally a full resusitation to get him back. My placenta had obviously already pulled away long before birth.

But we left the next day, with all being perfect. I was simply told he had been posterior. My 2nd was too, and her birth was dream compared to Mason though!!


Skip to 2 days ago, and the middie was filling out my yellow card for Baby Girl. I got home and looked it over, and next to 3rd birth, it says "Shoulder Dyslocia'.

WTF???!!!

Why was I not told, what is it, and did it contribute to the worst experience I have EVER had in my life???
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Old October 28th, 2008, 10:25 AM
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Shoulder Dystocia is where the shoulder gets stuck in the pelvis on the way out. It can sometimes cause the shoulder/collar bone to break and have nerve damage in that arm. Most times baby is fine. It can happen because of the position of the baby or they way the baby comes out Ie, you said your baby was literally pulled out, and this is probably what caused it. My DD also had this and it was caused by the same thing as you described. She was fine but also born not breathing due to shock i think they said. They probably did not mention this because it was probably very minor but it's still be in your medical notes.
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Old October 28th, 2008, 10:30 AM
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Thanks hon.

I just googled it, and oh my god!!! It can be sooo dangerous!!!
I'm glad I didn't know at the time, I'd of been scared ####less!!!

Less than 1% of babies have true Dystocia, and some are brain damaged or even die.....

I cant believe how lucky I am the Ob got him back....
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Old October 28th, 2008, 10:33 AM
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I know, it is very scary. Especially when your baby comes out blue and silent. I know it was the worst moment of my life.
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Old October 28th, 2008, 10:39 AM
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"Mild, to moderate, shoulder dystocia is the most common type of dystocia, and probably does not truly reflect 'real' shoulder dystocia. This is because it generally poses no problems for the baby, only causing a brief delay in the birth of the shoulders, and a little extra manipulation by the caregiver.

Most cases of mild to moderate shoulder dystocia result from the baby's shoulders not rotating quickly enough, before the next contraction, or the woman pushing before the shoulders have had a chance to rotate. Another common reason for this type of shoulder dystocia is that the woman is pushing her baby out in a semi-reclining position, on her back. This causes her coccyx bone to be pushed inwards, preventing it from being moving back out of the way, to make room for the baby.

In these circumstances, if the baby's shoulders are not coming readily, the caregiver will use some careful manipulations and / or ask the woman to change her position, to help the baby's shoulders be released, and allow the baby to be born more easily.



Severe shoulder dystocia


True shoulder dystocia is regarded as 'severe', and can occur in about 0.2% of vaginal births. It happens when the baby's shoulders are too large to fit easily through the woman's pelvis, even when they are lying vertically in the woman's pelvis. The anterior shoulder becomes 'wedged' in a sense, behind the woman's symphysis pubis. Severe shoulder dystocia is more likely to happen with a baby that is 'macrosomic', or unusually large (over 4,500grams or 10lb). "

Mason was 3999g born. I just called mum and she said even though he was not breathing, after his head came out, he turned it to the left, and thats when the Ob grabbed him and got the rest out. I think the Ob knew what was happening, and done what he could to get him out.....

This is freaking me out....
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Old October 28th, 2008, 10:46 AM
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The thing with previous shoulder dystocia too is that when its on your record all doctors seem to automatically think it was severe. I keep getting asked if she suffered any damage, how long was she stuck for etc. I had to nearly fight off a c/s for DS. After DD was born they told me i would need a c/s everytime now because she was obviously too big for me. Which wasn;t the case at all because DS was the 9lb also and he came out fine.

I try not to think too much about it. I know it was only mild and it wouldnt have been severe because she was not too big for me as most severe cases are. And DS came out fine. So i just have in my head, i know more now, i know what position to get into to prevent this and i have done it before without problems. If i dwelled on it too much i wouldnt be able to birth properly without that fear in the back of my head.
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Old October 28th, 2008, 10:50 AM
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So true!!!

The next two bubbas after Mason were both bigger then Mason, so I think it was just his position, not size.......

I also birthed them upright, and will be again this time !!!

I cant believe it has only just come up, and noone checked my last two bubbas before delivery!!! Mason almost died!!!
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Old October 28th, 2008, 11:03 AM
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But it is really nothing to go ringing alarm bells about. Yes its damn scary when it happens (I've had 2 out of 4 - both were OP babes) and it's action stations to get you in a different position or to help manouver bubs out, but by making sure that your baby is in the optimal position for birth helps a great deal because it's a POSITIONAL problem, not a baby size problem. The worst thing is you being told about it I think because you went into your previous two births not knowing and therefore focused only on getting them out YOUR way, now you are going to head into this birth with the baggage that is the knowledge of what happened with your third birth.

So you need to de-brief properly from his birth now you have your notes and give yourself time to digest it all so you can put it behind you and move on to this birth - which will be FINE! You've had 4 uncomplicated births and one which had problems which were beyond your control by the sound of it, so don't let that hinder you this time. If you are *thinking* too much about it in labour, then it will only hinder you. Know what you want done IF it happens so that your birth can still flow smoothly.
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Old October 28th, 2008, 11:19 AM
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Google the Gaskin manouvre... midwives have great skills in avoiding and preventing this without having to break collar bones etc. The medical profession contribute to the prob when they put you on beds and provide birth environments that don't encourage or support active birth.
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Old October 28th, 2008, 05:32 PM
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I had it too and wasn't told. I only knew because as I was lying there recovering and waiting for stitches & the OB whispered to the trainee OB "that was shoulder dystocia". I was really shocked. It sure explained why they suddenly said "OK we are getting this baby out", gave me syntocin, put me in stirrups & vacced Brock out. It all happened so quickly after a long & painful labour. I looked through my notes on discharge incase I had misheard & sure enough there it was in black and white. I think mine would've been classed as mild. I have no idea why they don't discuss it with you afterwards, I think they should.
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Old October 30th, 2008, 02:57 AM
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Gosh, that's an awful lot to digest! I didn't have this problem with DD but I can actually understand now why my labour went the way it did, to an extent; they knew (or the Ob suspected at least) that DD was going to be a big baby, and my labour went on for ages. I ended up squatting on the bed, pushing for almost 2 hours with no action, then the midwives made me go into the semi-recline (when I say made me, they practically pushed me over into it because I was paralysed with pain), and DD was born within minutes. So thanks for posting, everyone, this is a very informative topic.
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Old October 30th, 2008, 07:21 AM
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Big babies have very little to do with how a birth will turn out. Naturally sometimes a bigger baby can take longer to be born as they can need more time to be pushed through the birth canal - but the biggest factor in birth is how big a role your mind plays in it. If you are told beforehand that you are going to have a big baby then no way known will you be able to push that to the back of your mind and forget about it. If you have no idea of the estimated size of your baby, you just go about giving birth - you don't focus on their size and if that will make birth harder/longer/ more difficult. All these women who appear in the paper from time to time having given birth vaginally to really large babies (like the 5.8kg bub the other day and there was one in the UK who was nearly 6.5kg) had no idea as to the size of their bub they just birthed them, simple as that. And sometimes all a birth needs to progress is simple as a change of position for a mum.

The same applies here for Jodi who has birthed beautifully two times since her third birth, unhindered by the knowledge of what happened in that birth, so now her job is to work through the feelings she has about it so she can have another beautiful birth this time.
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