A Complete Guide About Shoulder Dystocia

a_complete_guide_about_shoulder_dystocia

What is Shoulder Dystocia?

Shoulder Dystocia is a birth complication that happens during vaginal delivery. When this occurs, one or both of the baby’s shoulders get stuck inside the mother’s pelvis during labor. This causes a stall in the delivery process, which can be life threatening. In most cases, babies born with this complication are delivered safely. However, it can cause problems for both the baby and mother. 

Shoulder dystocia happens in 0.2 to 3 percent of pregnancies, and sadly, is unpredictable and unpreventable. When complications happen during labor, doctors turn to urgent cesarean delivery or surgery to avoid further issues. Although this may work in most cases, urgent cesarean delivery or surgery cannot correct this condition. 

Continue reading below for answers to all questions regarding this topic. 

Frequently Asked Questions:

What Does Shoulder Dystocia Look Like?

When Shoulder Dystocia occurs, the fetal head is delivered but the shoulders are not seen and are not being delivered with normal maneuvers. In other words, this delay in labor causes the baby to be trapped mid delivery. When this is happening, your midwife or provider tries to move your body and baby into better positions to continue natural delivery. 

The shoulder of the baby normally gets stuck behind the mothers pubic bone or sacrum. During this delay, the baby cannot breathe and the umbilical cord may be squeezed or wrapped around the baby’s neck. It is dire that everyone stays calm but acts quickly and efficiently to prevent further complications. The midwife will ask the mother to cease pushing so she can reposition her and the baby as needed.       

Why Does This Happen?

Shoulder Dystocia can occur during any vaginal birth, and without warning. Some of the most common causes for this are that the baby is too big, the baby is in the wrong position or the mother being in a restricting position. Oftentimes, your midwife or provider will change the mothers position to help free the shoulders from the pelvic area. 

It is nearly impossible to predict the risk factors of whether or not your baby will have this complication, but there are some things that can make it more likely. This includes:

  • Shoulder Dystocia occurred during previous pregnancies
  • Fetal Macrosomia (having a larger baby)
  • Having twins or multiple babies
  • Mother is overweight
  • Mother has diabetes
  • Labor induced 

Although these factors may increase the risk of a baby being born with Shoulder Dystocia, it is not clear why some pregnancies experience this complication while others do not. One statistic states that women with a history of having a delivery with Shoulder Dystocia are 10- 20 percent more likely to have a recurrence. 

What are the Complications?

Although most mothers and babies may not experience any further issues regarding this complication, it can bring about further issues. When delivering a baby with Shoulder Dystocia, a midwife or provider may have to break the baby’s collarbone to help with removal of the shoulders. This is a last resort, but may be necessary. This is only one risk that may come from this condition. 

Further risk for the baby may include:

  • Fractured collarbone (clavicle) or arm
  • Fetal brachial plexus injury
  • Lack of oxygen to the body
  • Brain injury due to lack of oxygen (this is rare)
  • Loss of baby (this is rare)

Further risk for the mother may include:

  • Maternal hemorrhage/ postpartum hemorrhage
  • Repairs for episiotomy or tearing during delivery 
  • Uterine rupture

Can You Prevent or Treat Shoulder Dystocia?

Like we touched on above, Shoulder Dystocia is extremely unpredictable and there is very little prevention. Being mindful of potential risk factors like diabetes and watching your weight during pregnancy are all things to help lower your chance of complications during labor. At Midwife360, we recommend our mothers to give birth lying on their side or on all fours to help natural movement of the delivery process. This will help prevent complications like Shoulder Dystocia. 

It is important to inform the expecting mother about the complications and risks of Shoulder Dystocia.  As well as reassure her that, as a midwife, we are trained thoroughly on how to deal with these complications in the safest and most efficient way for the safety of you and your unborn child.  

If You Have Further Questions

If you have any questions unanswered or need more information contact us at Midwife360. At Midwife360 we provide holistic gynecology and pregnancy services, including home and water birth to women throughout South Florida. Our mission and practice is designed to meet the individual needs of each woman and expecting family we care for. We believe women should be informed and educated about their healthcare options for routine care, family planning and birthing.

A Complete Guide to Miscarriage at Home

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Is Miscarriage Normal?

Pregnancy and miscarriage carry a ton of emotions, and one may feel devastated or uneasy when going through a natural miscarriage. Although this is can be an extremely tough time mentally and physically, it may be comforting to know you’re not alone. 

An estimated 10%-20% of women who know they are pregnant will have a miscarriage. Also, most women (87%) who do experience a miscarriage will have a successful pregnancy and birth following that miscarriage. 

Maybe your pregnancy test was positive after missing your period, or some women have that gut feeling without having missed a period yet. Feeling excited, scared, happy, nervous, or just numb are all in the normal range of emotions when you first discover a pregnancy. Or maybe you’ve been trying for months to get pregnant and now you finally are. 

Just when you feel like you are beginning to get comfortable with your pregnancy, you start to have some spotting, maybe a little red bleeding, and then some light cramping. 

Next Steps

Contacting your health care provider and making them aware of what is going on is important. They may offer to have an ultrasound or blood work done. The bleeding becomes heavier and the cramping gets stronger and you no longer have the pregnancy symptoms you were starting to feel prior. Unfortunately, you are most likely experiencing a miscarriage. 

If your body is already starting to bleed and cramp, this is a sign your body is getting ready to expel the products of conception. Sometimes there’s not an actual fetus present. This means it could be a chemical pregnancy with no fetus, just a gestational sac. 

If there are no complications, you can safely miscarry at home. You may want to have some ibuprofen on hand and a hot water bottle. Soaking in a warm bath can also be very soothing. The worst of it can take about 2 hours with some pretty intense cramping and heavy bleeding. 

When to Seek Help

You would need to seek out medical care if you have pain that you cannot tolerate, or if you begin to hemorrhage. The definition of a hemorrhage is, soaking a maxi pad to where you can wring it out, and doing this for 2 hours. Of course, if the bleeding is much heavier than that or you feel unsafe, don’t wait to get medical help. 

Missed Miscarriage

A ‘missed miscarriage’ is where the fetus stops growing but there’s no signs of bleeding or cramping right away. It’s usually during the first ultrasound that this will be diagnosed. Or if you were following the beta HCG hormone, and it isn’t doubling or rising appropriately in the first 10 weeks, a miscarriage can be diagnosed this way, as well. 

If you do have a missed miscarriage, do not wait before seeing your provider for an intervention. It is dangerous for the pregnancy to sit in your womb for months, as it can cause some dangerous bleeding when the natural miscarriage begins. You will most likely be given several options, depending on the preference of the provider. It is always best to be informed ahead of time, in case your provider does not offer all the common or available options. 

Intervention Options for Missed Miscarriage

  • D&C or Dilation and Curettage

A D&C is a fairly common procedure to eliminate uterine lining and pregnancy contents. This procedure is very safe and complications are rare. Light spotting and cramping is common in the first few days after a D&C. 

  • Medications

Medications like Misoprostol are also an option, which cause your uterus to cramp. This process usually takes about 24 hours to complete. This option is also very safe and complications are rare.  

Miscarriage is Common

Miscarriage is very common, you would have to have 3 in a row before it is considered a medical problem. An option is to see a Maternal Fetal Medicine doctor to have a consult regarding any specific blood tests needed to determine if you have a genetic predisposition to miscarriage. These may include: Anticardiolipin, TSH, Lupus anticoagulant, beta 2 glycoprotein, and maternal karyotype. 

Some providers will recommend taking a baby aspirin every day to reduce the risk of miscarriage. And sometimes they may recommend taking progesterone to help you maintain the pregnancy. These all depend on the results of the blood tests and the actual medical diagnosis that is causing the miscarriages.

Next Cycle and/or Pregnancy After Miscarriage 

You can have your beta HCG levels checked, or simply wait for your next cycle. You should have a period by 4-6 weeks after the miscarriage. If you don’t have your cycle within 4-6 weeks, contact your care provider for further testing or ultrasounds. It is recommended to actively prevent pregnancy for 2 cycles following a miscarriage to lower your risk of having another miscarriage right away.

Holistic Gynecology and Pregnancy Services

If you are looking for holistic gynecology and pregnancy services, including home birth and water birth in South Florida, contact Midwife 360 for all of your questions and needs.

Finding The Optimal Fertility Diet

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If you’re considering becoming pregnant or trying to conceive, you’ll want to make sure that you’re staying healthy and fit. That doesn’t simply mean seeing a lower number on the scale or paying closer attention to how much time you’re spending on the treadmill—being your healthiest means taking a good, hard look inside your kitchen cupboards and at what you’re putting into your body. Practicing a well-rounded fertility diet is one of the first steps to successfully conceiving and carrying the healthiest child possible.

What you’re putting into your body each day is even more important than you think. Some foods may even be hurting your chances of becoming pregnant. To get pregnant and maintain a healthy pregnancy, you’ll need a fertility diet that increases your chances of conception and keeps you strong.

Fill Up on Fruits and Vegetables

You’re aiming for a healthy pregnancy for you and your baby. To be at your healthiest, you’ll need nutrients that take you there. That’s why eating enough fruits and vegetables is vital to optimizing your fertility.

Somehow those leafy greens and juicy fruits aren’t as familiar to the American diet as you would think. Unfortunately, many people don’t get enough of these essential foods when ordering on the run from their local restaurant or shopping for weekly groceries at their neighborhood grocery store. Although packaged foods tend to be the go-to items that people choose during a hectic workweek, they’re not the most nourishing foods for the body.

If you want to improve the quality of your reproductive system, start filling up your plate with plenty of fruits and vegetables. Here’s a simple tip to remember the portion sizes you need: At each meal, make sure half of your plate is full of fruits and vegetables. Some raw fruits and vegetables contain a good supply of glutathione. This is highly important for your egg quality.

If it feels difficult to get enough fruits and vegetables in each meal, put your juicer to good use. Juice some fresh fruits and veggies rich in vitamins each morning at breakfast. Or, try making a delicious smoothie with frozen fruits and yogurt.

Switch to Healthier Fats in Your Diet

Remember to stay away from trans fats. It’s a cruel culprit in the food world that’s considered one of the worst forms of fat you can eat. Trans fats can hide in vegetable shortening, fast-food items, non-dairy coffee creamers, and even baked goods. They can clog your arteries, and they can also increase insulin resistance. When the body experiences high insulin levels, it can cause a metabolic disturbance. This can affect your ovulation cycles, as well.

From now on, try to only eat healthy fats. Not only are they better for you, but they can also help women who are having a tough time getting pregnant. That means focus on incorporating plant-based fats that give your body the nutrients it needs as well. For example, try adding more avocados, nuts, olive oil, and grapeseed oil to your diet.

The switch from trans fats to healthier fats may be tough, seeing as these items are popular in many people’s diets. These are common foods that you may want to indulge in when you’re craving something sweet during the day. Unfortunately, these foods aren’t healthy for your body or your baby.

Strengthen Your Diet with Powerful Proteins

It’s not always easy to get enough of the protein you need to stay healthy. Also, not all protein is created equal.

When it comes to creating a balanced diet geared toward peak fertility, you’ll want to reconsider the protein sources you’re eating. First, you’ll want to cut out the fast-food meats that may be lurking in your diet. These convenience foods are never good for you. Keeping away from these foods is crucial to sustaining a healthy pregnancy. If you’re not already eating an organic, whole foods diet, start now.

If you’re getting a large amount of your protein from red meat sources in your diet, you may want to begin cutting back. When you’re creating a meal plan, notice how much red meat you’re eating. Switch to other protein sources that will be better for your fertility. That means more chicken, pork, and turkey. These foods will give you the protein, iron, and zinc you need.

Another source of protein to include? Coldwater fish. If that worries you, you’re not alone. Chances are, you may be worried about the mercury levels that physicians warn about ingesting before or during pregnancy. However, food items like salmon, sardines, and canned light tuna are fine to eat a couple of times a week.

Choose Better Dairy Options

Maybe you’ve heard about people filling their meal plans with low-fat dairy items. Or, perhaps a particular “no-dairy diet” has made enough magazine headlines that it’s made you reconsider your stance on cream and milk products.

The truth? Dairy items aren’t the “bad foods” people have made them out to be in recent years. It just depends on what kinds of dairy items you’re consuming. For example, milk is an excellent source of B-12. It’s essential to have adequate B-12 levels in your diet. Some studies suggest that low levels of this critical vitamin are associated with infertility in some women.

Experts recommended that you get one or two servings a day of a full-fat dairy item. When it comes to milk, make it a glass of whole milk. Full-fat yogurts are always better than low-fat yogurts when it comes to an optimal fertility diet. It’s ok to have a small dish of full-fat ice cream as well.

Complete Your Fertility Diet with Complex Carbs

Carbohydrates that contain the fiber you need are different from the carbohydrates that are in cookies and cakes.

The sugar-filled cookies and frosting-covered cakes that line the shelves behind glass containers in bakeries are the kinds of carbs that aren’t good for you. These foods will digest quickly in your body, and turn into blood sugar.

However, the good carbohydrates your body craves take time to digest. These are the carbs you should be focusing on adding more to your diet. “Slow” carbs are considered to be better carbs for your body. These good carbohydrates come from whole grains, vegetables, and fruits.

The fertility diet that’s best for you will include nutrient-dense foods that give your body the vitamins and minerals it needs to create life. The decision to have a child is one of the most rewarding decisions you’ll ever make. It can be a challenging, and beautiful journey. To create and maintain a healthy pregnancy, you’ll need someone who can give you the guidance, compassion, and support you deserve. Whether you’re deciding on the best fertility diet to implement, or selecting the best midwife to deliver your baby, you deserve someone you trust by your side to make these decisions along with you. Midwife360 is available to guide you through every step of your pregnancy journey. Visit our website today to see our array of services.