Guest post: Here’s what happens AFTER the shoulder dystocia

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Natural childbirth advocates often imply that shoulder dystocia is not big deal when successfully resolved. But the consequences of shoulder dystocia don’t end when the baby is born safely. Rachel Acosta and her son have been living with the consequences of his shoulder dsytocia: a brachial plexus nerve injury leading to a partially paralyzed arm known as Erb’s palsy. She is suffering terrible regret and wrote to tell me her story, hoping that she might prevent other babies from being injured and other women from feeling responsible as a result.

No natural childbirth advocate or OB-GYN ever mentioned brachial plexus injuries.

It was not in the 2008 What To Expect it was not in my silly birth plan book I bought. In fact no one ever said (my peers, SAHMs, or doctors or hippy friends for lack of better word) ever said: if the baby gets stuck he could die of brain damage or have a permanently damaged arm.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Natural birth advocates made it seem like doctors are referees trying to foul you out so they can slice you open.[/pullquote]

Natural birth people I met consistently made it seem like doctors are referees trying to foul you out so they can slice you open. The Business of Being Born scared me.

I sat in front of a doctor and asked him how do I avoid a C-section. The doctor asked, “What did your first baby weigh? Did you tear, did he have shoulder dystocia?”

He recommended I have a C-section. No explanation. If only he had said, “Babies get stuck and die; a second labor is not always shorter or easier than the first.”

Maybe I would have understood if only I was thinking straight and was less guarded.

I joined a baby wearing group. I hired a doula for $450. I asked around for a low intervention OB and he was recommended by all the AP and baby wearers and natural birth people.

I attended the natural birthing class and apparently my interest in the subject made the doula say, “Are you sure you don’t want a home birth? You’re a great candidate!” Now I shudder at that thought. The saving grace was that I was in a hospital with trained professionals when the shoulder dystocia happened.

Apparently desire is the only thing you need to be a home birth candidate. I was obese, had a history of large babies and a previous shoulder dystocia. And in Ohio, home birth is illegal. I should have known then that the doula was wonky.

Wonderful people were telling me big babies are born easily and flawlessly. They said there were so many pros for vaginal delivery, but they were all cancelled out by shoulder dystocia:

No major surgery if I go vaginal:

The consequence but now I have a grade 2 cystocele. My bladder bulges out; it’s visible and I can’t barely hold urine in. I have to have procedure to fix the prolapse.

Speaking of surgery my son will have nerve transfer surgery from his Erb’s palsy brachial plexus injury if he doesn’t meet the next few milestones. That’s a major surgery for a little 1 year old. That certainly cancels out a pro of avoiding a C-section.

Better bonding skin to skin:

Bullshit! They were trying to get my child to breathe and I did not hold him for the longest time. It’s hard to bond with a baby who was perfect and that you were supposed to protect but you didn’t research enough. It’s hard to bond with a baby who’s arm is completely limp because of my choice. It’s hard to bond with a baby when you regret being a diva I did not know my demands were stupid; that’s a source of my postpartum depression.

Being able to go home sooner if you have a vaginal birth:

No that was canceled out we had to wait for him to be cleared to leave.

Faster recovery time, my favorite!

The vaginal birth canceled that out because my second was 11.5 lbs (sad I can not even be proud when I say his weight) so I got a third degree tear.

Lastly vaginal birth is not traumatic.

No, that was cancelled out. What’s really traumatic is almost losing your baby from your defiance fueled by ignorance.

I got postpartum depression. I had tons of stitches. I still have to have surgery and my bonus prize for begging and begging for a vaginal is a beautiful baby with arm issues that are slowly resolving, but I am one of the lucky ones.

I really want to raise awareness of Erb’s palsy. Often we look for the positive stories, but had I only heard one negative story of big babies I would have never risked my child’s arm use. Even if someone told me “your child will not have arm use for just one day,” I still would not risk it.

That’s not all:

In my overzealous search for this stupid ideal birth I alienated the women in my husband’s family who had medically necessary C-sections (breech and twins and emergency). But when I turned to the natural birth people who had encouraged me, they kept asking me “well, did you have an epidural??”

“Did you try squatting?”

“You’re overweight; were you eating a lot of sugar?” Somehow the latter become important only they wanted to discredit my story.

Every thing I have shared was turned around and used against me as if everything that saved my sons life and mine was an error and my fault.

My birth plan seems so narcissistic when I read it now. One source of my depression was the stupid affirmation, “your body would not make a baby to big to birth.”

The birth plan said “only intermittent monitoring so I can have free movement.” But I couldn’t move I could only screech and hold my breath and beg for my husband to punch me so I can pass out. I did get a regional epidural only because I lost all energy from just the hours of being alive and in pain. My doula kept blaming me, saying, “When you tense up your pain will be higher.”

I have to clarify I absolutely did try squatting and every position to open me up laying down with the hospital tray table elevated to lay in between my legs to open me up.

Once I had reviewed the epidural I could actually make sentences and I felt so bad about getting it even though I could feel the pain and could move; I felt like a sell out.

My doula told me that I could have done it had I been mentally stronger, even though I had been “strong” enough to push out a 11.5 lb 22.5 inch baby. She implied that the shoulder dystocia and 3rd degree tear happened because I had caved from the pain.

But it’s funny and sad that now I’ve met some very nice women in the Erb’s palsy group. There’s even one from my state and we go to the same brachial plexus center. She had a home birth and a brachial plexus injury more severe than my son’s injury. She really saved my life and my marriage when she told me that no epidural plus free movement does not always equal no shoulder dystocia. Because she had done just that in her home and still encountered a consequence of it a shoulder dystocia and brachial plexus injury. When I heard she had done everything I attempted to do and still got I thought to myself that the epidural and the doctor were my SAVING GRACE.

For months when I put my son onesies over his head and I had trouble I would think back to the terror that childbirth was. How he was stuck and we were coded and they saved him but his arms didn’t work symmetrically. My poor little guy he was trying to be born safely and here I was making deals against his survival

The shocking part I have received more sympathy from the doctor than anyone else even though he had recommended a C-section.

I had worried about the cost of a c-section as if I were refused coverage by insurance and thought of the horror stories of how costly a c-section bill would be. But weekly physical therapy visits for 9 months combined with 3 trips Cincinnati Children’s Hospital brachial plexus clinic is not cheap either.

I feel like the doubt that is spread online is insidious and I treated my doctors like biased referees in a ball game instead of guardians of my child’s life and mine.