NEED advice PLEASE

Hey I really need some advice here cause even the doctors are fighting bout this one!!!!

I went in hospital with contraction last sunday...they said it could just be prelabour I lost my plug whilst in hospital and had a 2 day stay I had to have an CT to measure my pelvis as Im really a tiny person they said my pelvis is too small for the baby to go through so at this point im booked in for a C/S next tuesday... my cervix is very soft and around, just in ALOT of pain the babies head is SO far down and Im still getting tightenings and some contractions but they are bearable... while I was in the hospital the midwives were sure id go into labour but nothing really ammounted to anything....

We went to the OB yesturday (thursday) i waited 2 hours! he saw ALL his patients before me even if they were booked in after me! so we went in and he gave me and mum this huge lecture about the fact I shouldnt of had a CT scan done and that measuring my pelvis has NO scientific proof that I cant push the baby out! he was SO rude to us and said that I shouldnt have a C/S done on tuesday as there is too much risk to the baby as I will only be 37 and a half wks that the baby could have severe breathing problems and more! he was SO damn rude that I really didnt say much he said that the other doctor who booked me in for a C/S will be getting and earful cause apparently we found out later my OB is head of the maternity in canberra hospital! He said if I wanted to I can go ahead with the C/S i can but he doesnt see why! Im having SO much pain like I have my period and if I walk or anything i have heaps of lightening pain which he said was just ligament pain and that it would be 10 times worse in the next pregnancy!

Later in the arvo DH called the lady who booked me in for a C/S(the doctor we saw while i was in hospital) and discussed what was said, she talked to my OB and apparently my OB only wanted me to think of all the options as he felt all my options had been taken away from me which was really a load of cr@p cause he sat there and bad mouthed this other doctor! the lady said I can book in later next friday if i still want to have a C/S but im not a doctor how do i know whats best for me and the baby??? Im just SO confused and tired of all this.... PLEASE I hope u wise women have SOME advice for me im going insane!!!!! :crying:

Oh leah...I cant believe its almost time for your baby to arrive! Im sorry I dont have any advice for you apart from relax. Your baby will be here soon :hugs:

This is a tough one Leah.... I hear in your words that you are desperate for this to end & I understand why. I dont for a moment imply that you would take the decision lightly but I am a firm believer that no-one can tell a woman what will happen in her labour until she actually gets into labour. Your body is an amazing thing & this process was carefully designed long before your existence. C/S is a very serious thing..... All I can say is what I would do, & if it were me I would ask for options on induction, but try to proceed as naturally through the labour process as possible. There is a VERY good chance you can push this baby out so go ahead & give your body a chance. I had a watermelon on my belly, I was HUGE, & I am a fairly small girl too. I was scared but I just trusted my instict. Dop what you feel is right for you & bub.

Good luch Leah, whatever you choose to do.

I really don't know if I can say anything to help you make your decision. I guess you have to take what the Dr's say as gospel, as we don't know any different... we aren't qualified!

I am sure that Kelly will have something to help you through this decision, she is the one to ask... I am not sure if she looks in here much though... maybe post in Labour&Birth too...

I hope it all works out... I really haven't helpped at all... Thinking of you though.

Leah,
Of course, it is your baby and YOUR body. How do you feel about the birth? Are you scared that the baby is too big for you? Did you ever question your ability to give birth before that hospital admission?

You have to do what is right for you and your baby. Don't let the doctors dictate to you what will or won't happen.Their advice is important to HELP you make choices.

I won't give you my opinion, but I will tell you a story... I was working in the birthing suite a couple of years ago and a tiny lady came in. She was TINY. Maybe a size 6 and short too. It was her first baby and she didn't look overly large. She was admitted with a history much like yours, niggles and tightenings, low 'period' like pain, radiating into her legs. She was in early active labour when she arrived and laboured throughout the day.
She gave birth to a ten pound baby girl, with no tears! She was amazing! No one knew that her daughter would be so large so no one questioned her ability to birth her baby vaginally. She went into the labour with the expectation that she could/would birth vaginally and she did. Women are AMAZING!

Anyway, hun. I would do some reading and thinking before you make any decisions.

Leah - HUgs to you, you don`t need to deal with this at this stage into your pregnancy.

As Tiff has mentioned do what YOU feel is right, if you feel in your heart you really want a vaginal birth go that way, if your unsure and think a c/s might be best at this point go that way. Only YOU can make that final decision.

I`m a size 8 and 168cms tall, I was diagnosed as having CPD (small pelvis) via a CT scan when I was pregnant with Matthew, I was 40 weeks along OB recommended my pelvis was too small to push a big baby out so I went along with him and had a c/s. It wasn`t until I was pregnant this time round that I have read up so much on CPD and CT scans to diagnose it and how it can be inaccurate and the only way they can tell if you have true CPD is if you go into labour. After all my researching I have decided to have a VBAC for this baby and I have a great support team. So that`s just info on myself.

Read up on CPD and make your own decision, also read up on c/s so you know what goes on.

Good Luck Leah.

Take Care

Dee

The Cochrane Database of Systematic Reviews 2006 Issue 2
Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Pelvimetry for fetal cephalic presentations at or near term
Pattinson RC, Farrell E

Plain language summary
Too little evidence to show whether measuring the size of the woman's pelvis (pelvimetry) is beneficial when the baby is in a cephalic position
Sometimes, a pregnant woman or her caregiver might be worried that the pelvic bones might be too small for the baby to pass through during birth. Pelvimetry measures pelvic size using x-ray, computerised tomography scanning or magnetic resonance imaging. For women whose baby is in a head down (cephalic) position, the review of trials found too little evidence to show whether pelvimetry is beneficial. There is some evidence that women having pelvimetry are more likely have a caesarean section, but there are no trials that show whether this is beneficial for the baby.

Abstract
Background
Pelvimetry assesses the size of a woman's pelvis aiming to predict whether she will be able to deliver or not. This can be done by clinical examination, or by conventional x-rays, computerised tomography scanning, or magnetic resonance imaging.

Objectives
The objective of this review was to assess the effects of pelvimetry (performed antenatally, intrapartum or postpartum) on the method of delivery, and on perinatal mortality and morbidity, and on maternal morbidity.

Search strategy
We searched The Cochrane Pregnancy and Childbirth Group trials register (30 June 2004).

Selection criteria
Acceptably randomised comparisons of the use of pelvimetry in cephalic presentations.

Data collection and analysis
One author assessed trial quality and extracted the data.

Main results
Four trials of over 1000 women were included. All used x-ray pelvimetry to assess the pelvis. The trials were generally not of good quality. Women undergoing x-ray pelvimetry were more likely to be delivered by caesarean section (odds ratio 2.17, 95% confidence interval 1.63 to 2.88). No significant impact was detected on perinatal outcome.

Authors' conclusions
There is not enough evidence to support the use of x-ray pelvimetry in women whose fetuses have a cephalic presentation.

*hugs* Leah, this is such a hard descion. I have quite a small pelvis and towards the end of my first pregnancy i had the most severe pelvis pain because she was fully engaged, i couldn't even walk properly and i was doubled over in constant pain, plus i had regular braxton hicks, it was a night mare. She turned out to be 9lb7oz, but i got her out, i admit with a little trouble but my midwife thinks it's because of how i was positioned. I have a lot of info here about birthing big babies, so if you want any, you know my email.

It is very common to be diagnosed with CPD and the result is malpositioning of the baby, especially posterior babies. Your Ob is right in what he said, but just could have used better people skills. I too get very frustrated with the whole thing, but I bite my tongue and often have to bite my fingers when typing in here too! I just wish I could give everyone the knowledge and insight I have, but the fact is, it's harder to take when someone else is telling you (sounds like a lecture) and it only works when women find it out for themselves. So I don't lecture. Get a bit passionate sometimes, yes, but there is really some bad stuff going on.

Have a read: here.

Have confidence in your body, some labour is better than none, it gets oxytocin flowing and as Michel Odent says, take advantage of the peak levels of oxytocin you will ever have, the hormone of love and bonding. Yes you will love your baby regardless, but you will never have the opportunity to get such a high level of oxytocin going in your body. It prepares the baby for birth, even if you do have an emergency caesar, but you definitely deserve the benefit of doubt. I bet your Ob also feels upset as he feels that he was taking care of you (and well it seems!) then some doctor had to come along and scare the crap out of you and insist you need a caesar. I would be ****ed too! Stick with your Ob, he sounds like he wants to give you a fair chance, but still let him know you didn't appreciate the way he spoke to you.

You may be close to birthing anyway, try and rest and check out our articles on early labour suggestions and natural induction methods.

I agree with Kelly. I think your OBS had a valid point, and was probably a bit upset that some other Doctor jumped in. I agree with your OBS he probably has seen this too many times and all turned out to be fine. IMO i think it best for your body to go into labour, this way it does prepare the baby for the birth, then take it from there, if you then need a cesar it will be done but atleast you have given yourself the chance the to have a natural birth (if thats what you want).
I am not that tall (166cm) and am a size 8 and had no problem pushing out my 2 boys, also another girlfirend diagnosed with CPD gave birth with no problems, so they can get it wrong.

Goodluck but it looks like your going to give birth very soon.:)

WOW you girls totally rock when a girls in need!

I think the thing is from tuesday (when i got out of hospital) to thursday (when I had the OBs appointment) I totally accepted the fact I was not going to do it naturally I shouldnt have cause I was really unsure of it and scared HEAPS about a c/s the first thought and discussion I had with DH was I felt like i wasnt going to be the ideal mother cause I wasnt going to push our baby into the world IYKWIM.... My mum obviosly is very small like me had all the scans done but they said she could do it and broke her tail bone... I suppose a broken tail bone would be nicer than a c/s... I totally agree with u all I do thank you ALL SO much I think I will ask about induction... I actually have to be induced cause of the pulomanry embolism I got and have to b monitored in labour cause im on a blood thinning agent....


I definatly will be checking out the articles on early labour suggestions and natural induction methods so I can get this baby out... otherwise I will b booked in for induction at 38 half wks... I really dont feel easy bout this c/s....

THANKS YOU ALL SO SO SO MUCH i really appreciate it!!!!!!

Leah, nearly everything i have researched up on says that having a pelvis too small, is a rare event these days, as nutrition etc is so much better than it once was, and birthing techniques are so much better than the old "you must lay on your back and stay on the bed,legs in stirrups, that our mothers had".
Trust your own instinct hun, because when it is all said and done, it is a decision that you have to live with and come to terms with later on. You can always try naturally, and if needed, know that a c-section will always be done if you cant deliver yourself.
I was not given the choice with my first c-section, and now, I have just found out that after 2 (I have had 3), none of the hospitals in a 200km (at least, havent gotten any further than that yet) will let me try for a vbac, as they arent allowed. I know that I will hav to have another one, but really wish i had not been coersed into the first by my obgyn.

G'day Shinee,

I really can't add much more to what Kelly has said other than to note that CPD is extremely rare and that pelviometry is highly inaccurate. Those who have CPD are often women who have had rickets as a child or have had their pelvis damaged (such as in a car accident). Your ligaments loosen as you get closer to the birth and allow the pelvis to expand to accommodate the baby and thus it is highly unlikely that you would be unable birth your baby.

Hang in there and go for the birth you want. I think your ob is absolutely correct to help you avoid a CS. It is major abdominal surgery.

Do read the references Kelly has provided.

All the very best and I look forward to hearing of a marvellous birth.

Cheers

David

How true David, My scar last c-section got infected with staph on day 2 after surgery last time,,,,i was sent home and had to have nurses visit me every day for 2 weeks to dress it as the wound got really bad, and had to go on some nasty antibiotics. I would not wish that on anyone who truley didnt need it. I think sometimes labour is very scary, but I have had both natural and surgery, and healing time is many many times faster with the natural.