Immediately after my first baby finally came into the world, he and his cone head were placed on my bare chest. Hubs and I took a breath and looked at each other with wide eyes. We didn’t know much about babies, but this kid looked big. “That’s a big baby, isn’t it?” I asked my midwife. “That’s a big baby!” she replied. He was 4.2kg and 57cm, so not as massive as you read about in the newspaper, but clearly big enough to make his entrance into the world spectacular and scary.
I didn’t feel the “urge to push”
After a very normal, and relatively speedy, first stage of labour, my first baby’s pushing phase was a little less straight-forward. Although I was pretty exhausted, I felt something wasn’t right as soon as my midwife said I’d reached the much-laboured-for (pun intended!) 10cm dilation and encouraged me to push. For two hours I was pushing my heart out but had no urge to do so.
Now that I have had two more kids, and have felt “the urge to push” everyone talks about, I realise why my midwife raised the alarm after having me push for so long with still no baby in sight. Somehow my son, and his 37cm head, were stuck in the birth canal. My midwife told me later that his head was probably not tucked down into his chest, streamlining him, so my pushing probably hyperextended his head backwards during each contraction – scary!
My midwife knew something wasn’t right
Luckily, my wonderful midwife called for back-up (I wasn’t kidding when I said she raised an alarm) and I was transferred from the birthing centre to the delivery suite.
After three failed ventouse (suction cup) attempts, the amazing obstetrician managed to deliver our baby’s head with forceps. It was scary, it hurt like crazy but we were relieved because we made it. Now his body would easily plop out with me pushing during the next contraction, right?
Then came the second hurdle
Wrong! His shoulders were stuck.
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In medical speak this is called Shoulder Dystocia. It’s an obstetrical emergency and apparently your caregiver’s worst nightmare. Because the head is now out but the rest of the body isn’t (the baby’s shoulders are usually stuck behind the mother’s pubic bone) it can lead to complications for mother and baby, including the baby dying.
I know it sounds scary, but please don’t freak out. While shoulder dystocia is largely unpredictable and unavoidable, it is really rare. Only about 1% of vaginal deliveries have reported shoulder dystocia.
It’s called shoulder dystocia
Shoulder dystocia is usually defined as taking longer than 60 seconds between delivery of the head and the body and as a delivery that requires additional obstetric manoeuvres to release the shoulders after gentle downward traction has failed.
Apparently following shoulder dystocia about 20% of babies will suffer some sort of injury, usually temporary. These can include nerve injury, fractures of the collar bone or humerus (upper arm), bruising and loss of oxygen to the baby which in the worst-case scenario can result in brain damage or death. But please remember this is extremely rare – only 0.4% of cases have been reported.
My son didn’t experience any of these complications and, thankfully, he was healthy and happy as soon as he was out.
The impact on mum
Unfortunately, the mums can suffer some complications too. I had quite extensive tearing following my son’s birth, which required a trip to theatre to be stitched new again. Thanks to the fantastic surgical team my nether regions are literally new again, and by that, I mean can run, jump and do other fun things.
Vaginal and vulva tearing are known complications with shoulder dystocia, as are uterine tearing, haemorrhaging and loss of uterus strength. Thankfully most of the mother’s complications are temporary or remediable.
We need to talk about it
I know this might seem quite confronting, but even the scary things that can happen when you have a baby need to be spoken about, because they do happen. My son and I are both still doing great (he’s turning seven in two weeks). I had two more vaginal births with nothing more than minor grazing.
My son’s shoulder dystocia was an anomaly but that doesn’t make it any less important to talk about. So, share, talk and divulge; the good, the bad and the scary.