United Brachial Plexus Network, Inc.

Sarah,

If you "chose" a c-section they would make you go 40 weeks?? Don't they consider you are at higher risk because of one severely injured child? I'm extremely surprised they didn't strongly suggest the choice of a c-section as early as is reasonable (like 37 weeks with an amnio to check the lungs).

Without a strong belief that the situation was going to be very different this time around (sort of like what Heather was describing) I personally think a c-section would be a safer bet. Even though you were induced early the first time, the baby was very large, and you say you are measuring even bigger this time. You didn't have an epidural and moved around in your first labor, so there isn't much different that can be done there. Did that baby get really stuck, or was he just slow to deliver and the doctor panicked? Did the doctor incorrectly impact him further with fundal pressure? I would be looking at everything that could have been done differently, and that could be done differently this time. If this time is different enough, then perhaps a vaginal delivery this time makes sense?

If it was mild dystocia that the doc just didn't handle right, then maybe if your current practitioner is more knowledgeable, that makes it different this time around. But if your first was a true "shoulders impacted pull-with-all-your-might" situation, I personally would rather trust a doctor to perform a run-of-the-mill C-section (they do them all the time unfortunately) than properly deal with a serious shoulder dystocia which they may only see every few years.

Wishing I could be more help. I hope you find something helpful in all these replies. I don't envy you having to make this decision.

Kate

WELL HERE IS MY 2 CENTS my first son was 6pd 10oz and was induced 3 weeks early had hard time to del him but he was born fine..2 son came 1wk early was 10pds 1oz and now has robpi I was told if i ever had another i would need to have a c section ( baby # 2 should have been a c section )

I find all of your responses very helpful. I haven't told you that this is my 3rd child. I have a 5 year old daughter who was 2 weeks early because of pre-eclampsia (?) and weighed in at 7.10, with no shoulder dystocia. So I too know I can deliver. I also had no epideral with her, but I labored totally on my back. My son had to be revived after delivery. The really pulled hard with the old foot on the end of the table. I am really struggling with this, and althogh everything you all say is informative, the answer is still unclear. THank you all
Sarah

Sarah,

Just one other thought. Seeing as how your son was 9-7 and was 10 days early, seems to me you have great cause for arguing against this concept of a 40-week C-section. Babies are, for all practical purposes, done at 38 weeks. After that, it's just growth.

Like you, my first child was a daughter (9 lbs), and I delivered her fine. But my LOBPI son was three pounds heavier and got injured. I delivered him, too, but at what cost? It wasn't a matter of whether or not I could give birth. The issue was what happened to him in the process.

I think what might be key for you is going to a HIGH-RISK obstetrician - someone whose antenna is always beeping for potential problems. At least you could go for a second opinion. That's what I did, and that's why I switched providers so late in my 3rd pregnancy. He told me there was no reason to go beyond 37 weeks with my third and that it should absolutely be a C-section. Your current OB sounds - pardon me - like a bit of a moron.

Good luck!
Janet

P.S. Heather ... that NOBPI is CLASSIC! I love it!

Hi Sarah. First off, Congrats on your 3rd baby. I on the other hand am done after 2. My second son was injured.ROBPI I wasn't going to respond to your post because I have no experience with c-sections except for the OB telling me my next should be one, HA!! But I feel that you are really feeling anxious(for lack of a better word) I hinestly could not take the chance to have another child be injured. I would definately go for a c-section. But as I say that, I cringe because it is still a risky operation. Most operations are. I think you should get one before 40 weeks or birth vaginally before 40 weeks. I mean this is only how I feel, I can't go through another pregnancy or child birth. Hell, I can't even watch one on tv or see a pregnant woman on the street without getting a "twinge of upsetness". I just wanted you to know that whatever choice you make it is your choice and it is the right one. So, don't stress and always go with your gut instinct. If you don't like what your OB says, see another one. I wish I would have. GOod luck and Congrats.

Marlyn

Hi )

Firstly congratulations onyour pregnancy!

I had Chris (10 years old, right Erb's Palsy) a few weeks late. My pelvis was too small to cope with a 10lb 5oz baby, hence the shoulder dystocia which caused my pelvis to split, and his Erb's Palsy.

During my 2nd pregnancy it was decided that I would have an early section, as sizing scans had shown another huge baby. I had a section at 36 weeks and 5 days, and my tiny boy was born. He was 6lbs 15oz. All the sizing scans over here are done on leg measurements mainly, and he was a long, skinny baby. He suffered from respiratory distress syndrome, his right lung collapsed and he had heart problems due to his early birth. He now has minor learning difficulties (possibly dyslexia among other things). He also suffered in early childhood from behavioural issues most probably linked to his lack of oxygen at birth.

My 3rd pregnancy was obviously petrifying. We'd had the extremes either way and wanted to avoid either situation at all costs. It was decided to induce me at 39 weeks. Unfortunately I again failed to progress and after 3 days of hormonal induction and full contractions, I had an emergency section. She was fine, I wasn't (but I wasn't bothered about that as long as she was okay). She was 7lbs 8ozs and had no problems related to her birth.

If I were to ever have another (but believe me I've learned my lesson and never will *lol*), I would ask for a planned section at 38-39 weeks. That way the likelihood of going into lbaour beforehand would be reduced, but I wouldn't be risking a premature and sick baby. I would not leave it later though in case I went into labour. I also wouldn't put a huge amount of faith into the sizing scans - they told me to expect an 11lb-er and he was only just over half of that.

Best of luck!

Kathy
xxx

Dear Sarah Mae,
I am the mother of 3, my 3rd born severe LOBPI, all born vaginally @ 7-11, 9-2, 10-8 (pounds-ounces). I have often thought how stressful it would be to have had another pregnancy, after a BPI birth. Having had all 3 within 3 years, I did not have another pregnancy.

Are you scared to death to have SURGERY? Here is another thought for you to consider if you go vaginal birth. I WAS SEVERLY INJURED with the birth of my 2nd child. Now at age 50+ I desperately need surgery. MY INJURY now affects me daily. I have a rectocele. Never ever knew about this but I understand it is that little secret no one likes to talk about. Because of embarassment I posted this as a GUEST
http://ubpn.org/messageboard/thread ... read=11968

Also to GA mom, I had those same feelings after my 3rd was born, after having that 2nd. My second although big, just flew out, although her entire face so purple it looked black, she fine. I ended up getting 2 units of blood, was ripped so badly he didn't know where to start, so he didn't stitch. And I suffered in dire pain for 6 weeks (while running after a 2 year old & a Newborn). The nurses told me I was SO SEVERLLY injured because she came so fast. Now I realize she also could have been injured (her chest & head measured the same as my OBPI child at birth) I understand going through the surgery to make the repair will be like going through the original injury. a long painful recovery. I realize this is graphic.....but I think it needs to be known, as part of the decision process.

Oh I was on time for my first 2 babies, and 2 1/2 weeks late for my 3rd. Like you GA mom, I felt so responsible, but I trusted my doctor. Also I had friends that labored and then a c-section done as needed....at the last minute....so thought that decision would just occur naturaly, as it had for some of my girlfriends. I had never heard or known about OBPI. Also, when I asked my doctor about being SO overdue he said "babies come when they are ready."

Each of my babies got bigger by approx. 1 1/2#. So at that rate my 4th would have been a 12 pounder.

We opted for a c-section for our second baby - born w/out any complications just 4 weeks ago. Our decision to have a c-section was a little easier because I had some complications from our first child's birth (Natalie, almost 3, ROBPI) that required surgical repair to the peritineum area. I was advised by several doctors including the doctor who did the episiotomy repair, Natalie's delivering doctor, the doctor who reviewed our case, and our new OB to NOT attempt another vaginal birth. I'm glad we had a c-section and found the recovery to be easier than my first delivery (a fourth degree episiotomy is the worst!!;-)) Best of luck with you decision and my best wishes for a safe delivery for you and your baby. Becky

I just want you to know at least for me it got better. I absolutely didn't want anymore, and could talk to pregnant with out being negative. My son had c6 and c7 ruptured. Not the worst, but not the best either. He has healed amazingly, and I wouldn't want him any other way. That does NOT mean I want to put another child through that. I guess for me after 3 years have gone by, I still really have a special connection to delivering vaginally. I really enjoy labor and delivery. I hate to miss out on that this time just because the last went terribly wrong. I just have to figure out if this time is going to be the same. Good luck. It gets easier.
Sarah

Sarah,
I am currently 32 weeks and also measuring 4 weeks ahead. I dont know the severity of my DD's SD but she has recovered well from her BPI and has only mild deficit at 2 years. We went ahead and scheduled a csection for 39 weeks for this baby. I hate the idea, I dont want to do it by any means but felt like this was the only way to assure our outcome.

I, too, really wanted to labor again and deliver naturally. Its been a tough road for me to let go of that and realize (for myself) that I'd rather miss out on that experience and have a healthy little one. I also came to the realization that it wasnt just me birthing, its my husband as well too. He could never understand my desire to birth vaginally again but he understands this is a tough decision. He was the one who convinced me because I saw that he was more scared about me delivering vaginally and possibly being injured or our baby being injured. I had never really thought about his perspective as the labor coach watching it all happen.

I KNOW its hard and there is no right decision. Probably if my OB had said to go for a vag birth again I would have but he didnt. I cant say I feel confident in my decision and I know I will miss out. I'm sorry that you have to be in this place too and I really hope that whatever decision you make your little one and you will be 100% healthy. You sound like you've thought about it a lot and Im sure your labor plan will provide for as many things as possible to help prevent SD. Let us know what you end up choosing!