Curious

One of my good friends just had a baby boy today! She was induced at 39
weeks due to preeclampsia and ended up having an emergency c-section because
the baby's heart rate dropped significantly. It turns out the baby was
trying to come out face first. Her mother (a nurse) was talking with the OB
and the OB told her that my friend would never be able to deliver a baby
vaginally. First of all the OB should never have been discussing this with
my friend's mother before my friend (she heard it from her mother!). If that
were me I would have a few words with the OB. But my question is, how can
they tell that she will never be able to have a vaginal delivery? Is it
possible to determine that while they are doing a c-section? Just curious.

--
Nadene

"Plissken" wrote in message
news:OFkWb.457279$JQ1.406337@pd7tw1no...
One of my good friends just had a baby boy today! She was induced at 39
weeks due to preeclampsia and ended up having an emergency c-section
because
the baby's heart rate dropped significantly. It turns out the baby was
trying to come out face first. Her mother (a nurse) was talking with the
OB
and the OB told her that my friend would never be able to deliver a baby
vaginally. First of all the OB should never have been discussing this with
my friend's mother before my friend (she heard it from her mother!). If
that
were me I would have a few words with the OB. But my question is, how can
they tell that she will never be able to have a vaginal delivery? Is it
possible to determine that while they are doing a c-section? Just curious.

A face-first presentation is a fluke. It happens. Sometimes babies are born
that way. I can't think of any reason it would recur, or be any more a
factor in future deliveries than any other fluke presentation.

I think the doctor was blowing smoke out his @ss, personally.

--angela

I don't know much about preeclampsia, but I know that a good doctor can
determine if the patient can or can not have vaginal birth, eventhough,
physically she supposedly can.

My sister has something called Placenta insufficiency (theoretically,
she can have vaginal birth), but in real life, she can't. Even after
they tried to enduce labor, she still couldn't. She had a c-section.

Her first doctor said that this should not be a problem & that her
second delivery will be vaginal. Well, the baby died.

In her second child (third pregnancy), she had changed the doctor & the
new doctor was surprised that they even attempted vaginal birth. He said
that eventhough she physically can have vaginal births, but the danger
is about 95%. She had a c-section.


Plissken wrote:

One of my good friends just had a baby boy today! She was induced at 39
weeks due to preeclampsia and ended up having an emergency c-section because
the baby's heart rate dropped significantly. It turns out the baby was
trying to come out face first. Her mother (a nurse) was talking with the OB
and the OB told her that my friend would never be able to deliver a baby
vaginally. First of all the OB should never have been discussing this with
my friend's mother before my friend (she heard it from her mother!). If that
were me I would have a few words with the OB. But my question is, how can
they tell that she will never be able to have a vaginal delivery? Is it
possible to determine that while they are doing a c-section? Just curious.

--
Nadene

But my question is, how can
they tell that she will never be able to have a vaginal delivery? Is it
possible to determine that while they are doing a c-section? Just curious.

Under normal circumstances, there is nothing about a C-section that leads
inevitably to an inability to have a future normal delivery. But since your
friend's C-section was done as an emergency, it's possible the doctor had to
use a vertical incision (rather than the more common and safer "bikini" or
horizontal incision). If that's the case, then it's basically true that any
future births she has will be planned C-sections, because there is a greatly
increased risk of uterine rupture in labor with a previous vertical incision.
Almost any medical practitioner would strongly advise her not to take that
risk.

It may also be that the OB was referring to restrictive hospital policies that
make it near-impossible for anyone who has access only to that hospital to
attempt a VBAC; some hospitals have very strict interpretations of AMA (?)
guidelines that call for the hospital to be prepared to perform an emergency
C-section on any TOLAC patient, and so, because the doctors aren't able to
comply with that interpretation of the guidelines, they will refuse to take
someone who wants a VBAC as a patient.

(TOLAC = trial of labor after C-section)

If that's the case, then your friend should be perfectly able to attempt a
normal delivery in the future, as a face presentation isn't something that
would necessarily recur, but she may have to move to an area with a wider
selection of hospitals and doctors. :-)

Holly
Mom to Camden, 3yo
EDD #2 6/8/04

Preeclampsia is not a recurring condition so that should not necessarily be
an issue with the next child. She was induced and the induction failed so
we cannot say that her body does not work, only that this induction did not
work (or it worked too well as to put the baby in distress). There is no
way to assume that her pelvis is too small because she did not get to try to
push the baby out and the baby was malpositioned, although many doctor's do
this because they would rather section her next time anyway. Even if the
doctor feels her bones and believes she has a small outlet or inlet, there
is no way to tell because these bones move during delivery. If she had an
incision that was vertical or even on the fundus, she can still have a VBAC,
but there are greater risks and finding a doctor to attend would be
difficult because of liability issues. I have known women who have had
VBACs after a classical incision and some who have VBACed after 4 and five
sections and even one who VBACed after a Uterine Rupture and did so at home
at that. Any doctor who flat our says a woman cannot VBAC without very
concrete evidence of recurring problems is an idiot and there are a lot of
idiots working in Obstetrics these days. If she needs support for her
c-section or would like to know for sure whether a VBAC is a safe choice for
her, I suggest she visit ICAN. (http://www.ican-online.org) Their website
is full of facts that can help her figure it out. Also the email group
(http://health.groups.yahoo.com/group/ICAN-online/) is most helpful and the
women there are both very understanding and knowledgeable and can answer any
questions that she may have and they will also help her heal emotionally
from her traumatic birth experience. HTH.

-Melissa Ann

Plissken wrote:

One of my good friends just had a baby boy today! She was induced at 39
weeks due to preeclampsia and ended up having an emergency c-section because
the baby's heart rate dropped significantly. It turns out the baby was
trying to come out face first. Her mother (a nurse) was talking with the OB
and the OB told her that my friend would never be able to deliver a baby
vaginally. First of all the OB should never have been discussing this with
my friend's mother before my friend (she heard it from her mother!). If that
were me I would have a few words with the OB. But my question is, how can
they tell that she will never be able to have a vaginal delivery? Is it
possible to determine that while they are doing a c-section? Just curious.


The odds that this is true for real medical reasons
are very, very slim. Bad positioning in one birth does not
guarantee bad positioning in the next. The odds that this is
true for spurious reasons (i.e., doctors refusing to allow a VBAC
for future births) are significant.

Best wishes,
Ericka

Thanks for all the insight!

--
Nadene

Chotii wrote:
A face-first presentation is a fluke. It happens. Sometimes babies
are born that way. I can't think of any reason it would recur, or
be any more a factor in future deliveries than any other fluke
presentation.

Actually, the midwife who saw me when I was pregnant with Vernon said she
thought there *was* some correlation between an individual woman's pelvic
geometry and the likelihood of posterior presentation. She said that if a
woman had had a previous posterior baby, she seemed more likely to have a
posterior baby in a subsequent labor. But it was hardly a one-to-one
correlation, in her opinion--just a tendency she'd noted.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [23 mos.] mom)

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"Circe" wrote in message
news:AysWb.39180$QJ3.383@fed1read04...
Chotii wrote:
A face-first presentation is a fluke. It happens. Sometimes babies
are born that way. I can't think of any reason it would recur, or
be any more a factor in future deliveries than any other fluke
presentation.

Actually, the midwife who saw me when I was pregnant with Vernon said she
thought there *was* some correlation between an individual woman's pelvic
geometry and the likelihood of posterior presentation. She said that if a
woman had had a previous posterior baby, she seemed more likely to have a
posterior baby in a subsequent labor. But it was hardly a one-to-one
correlation, in her opinion--just a tendency she'd noted.

But, I would not call a face-first presentation something likely to recur.
Posterior, yes.

--angela

Chotii wrote:
But, I would not call a face-first presentation something likely to
recur. Posterior, yes.

Whoops, misread the original post. I thought she meant "face-up". Yes,
face-first is a whole different kettle of fish!
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [23 mos.] mom)

This week's special at the English Language Butcher Shop:
Financing for "5" years -- car dealership sign

Mommy: I call you "baby" because I love you.
Julian (age 4): Oh! All right, Mommy baby.

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman