CPD???? Could I be one of the unlucky ones?

[Trillian]

Kylie, there could have been other reasons why your labour was so long - malposition of the baby for a start. If a woman is left alone to let her body do what it is supposed to do then even a baby with a large head can be birthed vaginally - that is why babies have skulls that mould to the vagina - mother nature knew what she was doing. Often Obs don't like to let a woman go past a certain stage of pushing either, which is ridiculous because if they could just wait, stop telling her to push and just let her be, then it will happen. There is a post that Hoobley made recently that said often women can go past the magical 10cms if they let their body take all the time it needs to stretch slowly to accomodate the baby and this makes a lot of sense.

Tamara, I really doubt that you have it - bubs not being engaged at 38wks is no indicator at all considering that a pg can be up to 42wks long. Out of my 4pgs I have only had one baby engaged before labour started and that was my second. As for public hospital birth and VBAC, you will be better off in a public hospital than a private one and better off again if you have a homebirth with an independant midwife. Private hospitals seems to be the natural enemy of VBAC from what I have read of other women's experiences.

[BellyBelly]

Was your bub posterior? Were you induced? Were you flat on your back/in the bed?

[kyliealysha]

Was your bub posterior? Were you induced? Were you flat on your back/in the bed?

I don't think she was poterior but not sure. I was not induced although I did have syntocin at the end (after I was already fully dilated) in the hopes it would push her down a bit. I was sitting up, not laying down.

Trillian, thanks for that info. I didn't get to push at all as she was too high up

[shorty]

My first baby, Logan never engaged till birth.

[paradise lost]

Hi,

Ok, let's be clear that CPD is a REAL condition, it is just very very rare. I know that seems like an obvious statement but it does mean that for SOME women, the diagnosis of CPD will have been correct.

Kyliealysha it's hard to know if you had true CPD. The head %ile, believe it or not, isn't hugely relevant - in general c-section babies with 41cm heads would have been vaginal birth babies with 38cm heads - the skull moulds to such an extent, you can never REALLY know how it would have gone down if the birth had been vaginal (or a section, if it WAS vaginal). I know my vaginally birthed DD had a 35cm head the day she was born and a 37cm head on day 6...

What WOULD be an indicator is a baby that remains high for all the attempted 2nd stage with no descent. -1 is in fact descended to some extent, but since her head was entirely unmoulded it is possible she simply didn't fit into the pelvic inlet. There is a homebirth midwife's account here of a true CPD labour. Her lady was fully dilated for many hours too and they tried all kinds before they decided to section - the baby never came down past -3 and the head was unmoulded at birth.

The good news is that CPD is not a permanent diagnosis - it ONLY applies to that baby and that labour. Studies show that around 65% of women with section due to CPD do NOT have it in the next pregnancy and go on to birth vaginally.

I would urge you to surround yourself with positive people, use positioning techniques to gets bubs in the best position, learn good birthing positions for bigger babies (supported squats, deep squats, hands and knees) and THINK POSITIVE for your future VBAC.

CPD is very rare and though you're slightly more likely than most to experience it, having had it once, that doesn't mean you will - even having had it once you're still more likely to birth vaginally successfully than have CPD again.

Best of luck.

Bx

[~mamaspice~]

Hoobley, I think that was very well said.
Kyliealysha, I am going to take my second pregnancy and birth as a whole different experience. I am hoping for a VBAC and I will be doing everything in my power to try and achieve this. At the end of the day though none of us can be certain that our birth WILL go as we want it to. I wish you all the very best for your next birth

[suse]

I was given a diagnosis of CPD; after a long labour, full dilation and three hours of pushing (posterior bub), heartrate was starting to drop and he was showing signs of distress. The ob suggested that it would not be safe to try an instrumental birth at that stage, as bubs had not descended enough and was already starting to distress. He had not engaged prior to labour, which was started naturally 11 days postdates.

The ob said that she would check my pelvis during the surgery and see if there was any reason due to pelvis shape / width that would prevent me having a VBAC. She said that true CPD is very rare and that hopefully it was just a case in this instance of bubs getting stuck in an unfavourable position, but later debriefed me that I do have a pelvis that is unusually narrow and that even a smaller, anterior baby could not be birthed through my pelvis. In my case I am apparently one of the genetically unlucky ones. I too have questioned whether my own diagnosis has been a genuine one, and intend to have it confirmed, even though I trust my ob and know that she is very supportive of VBAC.

Euan had fairly significant moulding though (and a relatively narrow HC of 33.5cm), so it is interesting to hear that other CPD babies have not had any moulding. Does anybody know if lack of moulding is a trait common to all CPD babies?

Kel, I do agree with you that we are the result of natural selection, and that diagnoses of CPD are bandied about quite unnecessarily at times. It is unfortunate that the term is not more accurately used (aside from the implication to the birthing mother), as any studies on the incidence of CPD would undoubtedly be skewed.

Having said that, it is quite feasible that the occurrence of CPD as a genetic trait (which may be either due to mutation or a combination of multiple slightly unfavourable genes that were not sufficient to cause true CPD on their own) will rise in this and future generations due to the incidence of c/s surgery - before this, women with genetic CPD would have died in childbirth. It would be interesting to see some accurate studies done on this.