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

I am sorry text on hand

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.

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  • rachelmarie Acosta

    Again I want to thank my OB he stuck around he checked on us all before and during and then delivered. He checked on me 2 hours later and then the next morning and then the next.

    I think with my ADHD my thoughts were clustered and i may have just been so distracted that my one worry of avoiding dystocia could have been the solution I was offered that was right before my very eyes.

    But I really think saying csections are in necessary is a contributing factor because as I went I focused more on avoiding csection than I did dystocia I think.

    I don’t know apparently idiots walk among us and I am one of them I really think my doctors thought “oh she must know she can’t be that stupid”

    • attitude devant

      STOP BLAMING YOURSELF! YOU WERE THE VICTIM OF A LOT OF LYING TRUE BELIEVERS WITH UNSTATED AGENDAS. YOU THOUGHT YOU WERE DOING THE RIGHT THING!

      • rachelmarie Acosta

        So far in therapy my therapist and I have thought out a statement.
        When I want to make myself accountable and end up torture myself to be fair to others.binhave to have a balance between the authentic taking accountability for my actions. And limit it to that and not go beyond that me feeling worse does not heal my sons arm. I just feel like when my family members finally caught on that they think I don’t care.
        So to reiterate my therapist said
        “sometimes being too fair to others is unfair to yourself”
        So for the record I take the blame but it’s over now and I want to help others.
        So when I want to be accountable I end up really messing with my own head.
        As in I’m my own worst critic.

        So people might wonder why I would be in therapy but it’s because of my anxiety. And that I was in charge of my Sons well being and didn’t figure things out. But it’s okay now. I think it sucks because I’m so inside of my head that now it appears that I’m a narcacisst.
        Anyways.

        Birth threw me a curve ball and thankfully I was in a hospital.
        Even if chances were on my side I wish I would have gotten a c/S because the consequence though small happened and we just want our son to be normal. My husband says idiots don’t know they are stupid so there is that 🙂 thank you for everyone my Son Orion is just so great and such a trooper we had to do special stretches at diaper changes and maneuvers for baths so thinking of the birth was par for the course. But as he gets better hopefully he will gain supination and external rotation (think snow angels)

        I’m glad I wrote Dr. Amy because I swore I would never tell anyone what happens out of embarrassment for my ignorance but this has been very helpful and maybe this way more people speak up about the brachial plexus consequence.

        Also I wanted a large family as I was an only child but people kept saying csections prevent that but I met a woman who has had 3 or 4 she is an ex home birther and she is the woman that helped me realize no epidural plus free movement does not always equal 0 shoulder dystocia.

        But again I would probably go TO MY OB about that question!

    • CanDoc

      Rachel, it is so difficult: Being in the position of recognizing that you made a decision that, in retrospect, you wish you could change, but at the same time, being gentle with yourself and moving forward. I will repeat because it is important: Be gentle with yourself.
      You have a beautiful child, who is getting lots of therapy. You are spreading the word in a way that helps other understand shoulder dystocia and reconsider their own ideas, including challenging trite fallacies like “My body wouldn’t make a baby that it couldn’t birth”. You are strong. You are loving. Don’t let yourself be defined by a single regretted decision in a lifetime of good, caring, sound decisions.
      I hope that you can get to the point of feeling some regret but with the overwhelming burden of the guilt that is dragging you down now.
      I’m an OB and your piece is also a good reminder for *me* to always check with patients to make sure that they understand clearly why I am offering interventions and the basic risks/benefits/rationale.
      Thank you again for sharing.

      • CanDoc

        (Eek! Typo: I meant to write: “I hope that you can get to the point of feeling some regret but WITHOUT the
        overwhelming burden of the guilt that is dragging you down now.”)

        • rachelmarie Acosta

          Thank you I appreciate that and though it feels like stating the obvious I think it will help the risky patients.
          I was risky and on the fence ultimately I fell for the failsafes and quotes..
          It is hard to swallow being one of the women that have large babies with small pelvis or just plain large baby. So I drew the short straw on shoulder dystocia glad my OB delivered him alive.

          Maybe some kind of print out on those who would benefit most.
          I also like the analogy that we are already alive and here, it’s the baby who is doing the marathon and trying to make it to the finish line.

          That is opposite of the natural birth analogy.
          They say “your running a marathon you need emotional support and environment”

          My decision making now is cautious “is me trying to have a bonding birth going to put my child at such a risk that we can not bond”

          Take care

          Thank you

  • rachelmarie Acosta

    To the other questions about conversations with my actual OB Doctor I should have asked him a question that I asked the midwife.

    I am just replying kind of at random I see some comments and I can not find the exact one but it said maybe I heard what I wanted to hear.
    My feelings are: I’m an idiot brain damage is an obvious complication. Why did I not put two and two together I don’t know.
    I did ask the midwife after telling her the water birth suite at the hospital looked great but how would they see that the head was out all ready?
    I asked “can’t a baby die from being stuck for TOO LONG?”
    Her reply was A Doctor will be there and they will count once the chin is out”
    I saw the actual Doctor during appts 4 times
    1 (since I moved from Tennessee to Ohio mid term)
    From tenn is the one that I asked how do I avoid a csection
    In terms of positions and what can I do to help baby get out.
    His reason se was the one in the above post. He asked 4 questions and told me that because of my risk factors it’s best to get a c-section.
    I take fault in this because how does he know to explain further unless I ask.
    The 2nd time I saw actual Doctor a different one same location
    I said “I was disappointed to be recommended for a c/s
    Before I was even in labor, that I had another child and he came out after being stuck for a minute and 10 seconds and that I have no one to help me no family or friends where I will be moving” talk about ignorant I really think my doctors over estimated my common sense.
    The response was “yes but women have csections every day and you will be fine”
    (most appt were midwives and at this practice mostly midwives deliver)

    The third time I saw a doctor it was the new location where we had moved states. They had all records and I was very open about the shoulder dystocia. Because I wanted advice on how to avoid it.
    I said “I feel like I have twins can we see if one is hidden”
    He did an ultrasound 30 weeks he said “you have a lot of amniotic fluid there is a large section of water right here”
    I asked him if he could attend the birth and he said that they don’t really do that because they all would be sleep deprived
    (But he ended up coming when I was in labor and stayed from 1 pm (labor started at midnight and ended almost to the minute the next morning at midnight) he stayed all that while to deliver me.

    The 4th time I saw a doctor (his business partner also a doctor)
    Said “your a candidate for a c/section it will be covered because of your history what do you think would you like to schedule one?”
    This is where more of my stupidness comes in
    “No I am going to try to avoid the epidural and walk around freely
    That should clear any potential problems up”
    “He said okay I just had to let you know I can give a c-section if you want one because of the dystocia in your chart”

    So it’s most me being stupid and then the advocates speaking about free movement and birthing big babies (there was a website)
    And then a comedy of errors except it wasn’t funny it was miscommunication at its best.

    The conversation I had with the midwife saying that someone will see the head come out and start counting and she told me I wouldn’t push inside the tub (against hospital policy for dystocia) but I could labor in the tub.
    And I swear on everything she looked at me like I had a third head when I said “but don’t they die if they don’t come out in a certain amount of time and how would we know when to start counting or pushing if everything is done u see water”

    But I did not end up doing water birth suites
    1) I was not registered took the class but didn’t pre register with insurance
    2) I could not stand the feeling of water
    3) I couldn’t walk just frozen in pain.

    So it wasn’t that I didn’t want to hear it I would never forget if someone told me “your baby has a risk of death or arm paralysis if he gets stuck and we can not get him out”

    I had to much faith in what natural birthers said
    Not enough faith in my doctors I guess the whole “c-section conspiracy” is terrible. Because hearing your insurance covers the c-section but not “your baby could get brain damage”

    My husband and I initially thought we were not warned of the damage because it would be like a warning of mal practice we thought those terrible cases were when doctors were not around or when they had made a mistake”

    Now that I know how dystocia goes down
    That if they don’t get child out you need to pull them out of you can pull them out you need forceps etc and al the while the time is ticking against you.

    I really question my capabilities as a basic human when I never knew of obvious implications. It was obvious to people with commons sense but the one time I brought up my fear (talking with midwife about water birth)
    She brushed it off like I was being paranoid.
    I really hate to talk crap about her because I think somehow we really got our wires crossed.
    I should have asked the OB I asked the midwife but the conversation was centered around the water topic and I don’t think she understood I was asking in general about brain damage under or over water.

    • attitude devant

      I hope you are not blaming yourself for this! You are a loving mother who got a lot of bad advice. Your son is gorgeous and is lucky to have you as a mother! Please stop torturing yourself. Shoulder dystocia is SO hard to predict. 75% of the time you wouldn’t have had a second dystocia at all, and most don’t have such serious consequences as you experience. You did the best you could based on the advice you got.

      • rachelmarie Acosta

        I think If i had just replaced my name with “idiot” my story would make so much more sense.

        Thank you for the statistics i guess it was hard because a lot of the Erbs palsy parents had dystocia recurring.

        ” my name is idiot, one day i went and googled other idiots that had large babies and had idiotic births with out idiot consequences, i thought that I could have my delivery in a hospital and avoid the idiotic consequence but get the idiotic ideal birth” People are really driving women mad talking about ideal births. it upsets me so because somewhere there is a reader like me that is reading all the “success stories” and none of the “consequences” and somewhere is a little baby born of a stubborn woman…

        Its just not fair and you can’t hardly warn anyone with out sounding like I’m projecting on to them my own problems.

        the first time i saw what happens in shoulder dystocia was when i was you tubing ERBS palsy babies videos. the shoulder dystocia video had that tagged as a word.

        anyways thanks. Im hoping my son meets his next mile stones he started reaching up over his head (at 9 months but still) this is really good news for us.

        • demodocus

          We all screw up royally at some point. One of the emergency department nurses told me about the time she crashed into her kid while trying to stop her bicycle and broke the kid’s arm. My ob’s (3rd!) kid was crawling, they didn’t have a gate up, and she fell down their hardwood stairs. A lot of those NCB crowd push (no pun intended) the gloriousness, but forget or ignore the messy details.
          We understand the guilt and anxiety and even depression from this stuff. Even my MIL still feels guilty 40 years later about catching rubella when she was pregnant with my Demo resulting in his blindness.
          I’m glad you’re in therapy and I hope telling everybody about your son and your experiences both teaches someone else something and helps ease your pain a little. My boy can articulate a bit that he wants his mom to be happier, and I’m sure your boy wants that too. *hugs* and keep working on forgiving yourself.

          • rachelmarie Acosta

            Thank you I am so lucky to have my family especially little O he has really changed my perspective on a lot of things.

          • demodocus

            *hugs* It helped me to hear other people’s stories of major screw ups, so i figured that maybe it’d help you.

  • prudentplanner

    You have a beautiful boy. You are doing your best, and that’s the best you can do.

    I had one big baby and one large baby- no problems pushing out either one… but I still checked both of them for the ‘waiters tip’.

    We wish you all the best.

  • Monkey Professor for a Head

    Rachel, your baby is beautiful. I’m sorry about what happened, and the guilt that you’re feeling. What’s wonderful is that your son has a mother who loves him so much, that’s clear to see.

  • CanDoc

    What a beautiful baby and an honest story.
    My heart breaks that you are still harbouring such guilt over your beautiful child. I’m so sorry that you had this experience, delighted that you have a gorgeous child, and hopeful for your future.
    Thank you so much for sharing.

  • PeggySue

    What a beautiful little boy you have! I’m so sorry you both went through such an awful time, and I hope your procedure works perfectly and he continues to recover. I have a brachial plexus injury, don’t know if there is any birth component because my mother died before it became symptomatic, but I do know she had an abnormal tailbone and had to have it broken (ooowwwwww! poor mom!!!!) for any of us to be born. Thanks for your great post and for bringing awareness to an issue too many people take too lightly. And kiss that little guy for all of us!

  • rachelmarie Acosta

    I have to add that I alienated myself inadvertently from both sides of the spectrum
    So when I was suffering the most I couldn’t really tell anyone about my regrets
    We were very lucky

    • Charybdis

      Slightly OT: What is the tape on his arm for? Is it that kinetic tape athletes use?

      • corblimeybot

        It is kinesiotape, yes. When it was used on our baby, the therapist said it was to encourage her to rotate her arm outward. Supination, I think. That motion is often a big problem with BPI.

  • rachelmarie Acosta

    Thank you for the support.

    If I remember correctly back then I was trying to avoid the cascade of interventions also known as (saving my kids life though I was in denial)

    I had beat into my brain a mantra of avoiding the domino affect

    Because it was just something commonly stated that it was the reason of not progressing.

    So it was a combination of avoiding all these potential situations
    Doing the water birth suite mandatory class (part of the hospital)
    taking the mandatory class for natural childbirth so I could get the suite.

    Going mad trying to print birth cards and save money for a doula by selling my stuff on eBay. Just going crazy researching big babies and birthing positions.

    The glaringly obvious solution was to research the benefits of c-sections and research shoulder dystocia and its complications.

    But I looked for positive stories and distracted myself with everyone’s “advice”
    Of having a doula decreases c-sections and stress and pain.

    Looking back I really was a novice to the whole birth process.

    I should have said “but why is a c-section a good idea what can be avoided”
    Instead I was defiant and thought (I’m not even in labor and like everyone warned me my Doctor is trying to do the c-section talk)

    What a idiot it’s been really hard realizing how stupid and distracted I was.
    Why did I surround myself with people who did not really know about birth complications.

    Anyways the Erbs palsy group has many Moms who didn’t know what happens after shoulder dystocia, women who had one with thier first child and then the second is the unlucky one.

    I’ve learned a lot of lessons in my life this is probably the hardest. My sons arm is getting better little by little but that’s not always the case. And ofcourse there are the grim stories of loss. It destroys my confidence in decision making that I could have caused my son to die.
    I think my doctor did great my only regret is that he probably assumed I knew the consequences of shoulder dystocia
    And I should have known and made myself know but other erbs Moms didn’t know either so there are a lot of us out here hating ourselves trying to forgive ourselves

    • demodocus

      *hugs* Hopefully both your son’s and your surgeries go well.
      I hear you about self-hating. I broke my son’s femur at the park last summer. I was carrying him, tripped over a piece of equipment, and landed on top of his leg.

    • rachelmarie Acosta

      Again I think my Doctor did great and if I had one complaint which I shouldn’t it would be just mention a summary of what happens and what could happen during shoulder dystocia. It should be common knowledge but I guess for some it is not. It seems like a terrible misunderstanding.

      I hate that to other people this may seem like I’m not taking blame and in shifting it to doctors and online natural birth advocates.

      I just think when your with your patient think about the people and the blame culture that surrounds c-sections and epidurals. People in her social group sending little notes and links- If you can remind her that c-sections can prevent this and why it would be great. Apparently Job description will have to include reminding paranoid Moms that babies need a safe way to enter the world.

      Idk it is sad that aside from saving lives you have to save your patients from propaganda aswell.

      • attitude devant

        I don’t think anyone sees this as blame shifting. It is a very evocative description of the “fog of war” that pregnant women can get caught in with such competing messages. We have babies when we are relatively young and we feel invincible. Be gentle with yourself. You were trying to do the right thing. Thanks for speaking up so others can hear a different point of view.

        • rachelmarie Acosta

          Thank you.

    • MaineJen

      Rachel, thank you for sharing your story! Your son is absolutely beautiful. You have helped a lot of women by sharing here.

    • Chant de la Mer

      I fell for the “cascade of interventions” ruse too. I ended up getting an epidural as well and felt guilty about it for years; until I started reading this blog and got my facts straight. Luckily I had an easy birth with that pregnancy but the next one I knew better and had definitely wanted an epidural but complications prevented me from getting one. That baby was 10 lbs and ended up with a severe shoulder dystocia and luckily the OB was able to get her hands and the midwives hands in there and free his arm and deliver him but it was so incredibly painful for me. I’m so grateful they were able to save him and without permanent injury that I don’t really care about the pain, but I still remember it. So I’m grateful that you were able to have an epidural, even if it was a full complete one that wouldn’t prevented all pain. I’m incredibly sorry that your doula made you feel bad for getting pain relief for an event that is very painful. And finally I’m glad you were in the hospital and they were able to save your beautiful son. My son doesn’t have any permanent injury from his shoulder dystocia, we were just lucky I think because it was a close thing considering how blue and stunned he was when born, but I understand that feeling of looking back and wishing you’d done something differently. There really wasn’t anything differently to be done in my case, we had no particular cause for a c-section but oh how I wish that’s what we’d done since then my baby would never have been in danger and I wouldn’t have been in screaming pain.
      Thank you for sharing you story.

  • attitude devant

    Oh my goodness. I am so sorry. I’m an OB, and shoulder dystocia is the one thing that has turned my hair gray. This is what we’re talking about when we talk about not letting people push forever, and why high forceps and vacuum assists are to be approached with caution. When I see midwives blithely saying that shoulder dystocia is no problem, or blaming it on epidurals, I want to smack some sense into them.

    • Jennifer

      Since you’re an OB, I want to say that I hope you allow maternal request c-sections.

      • attitude devant

        Absolutely.

        • Jennifer

          That’s great! The world needs more doctors like you 🙂

    • The Bofa on the Sofa

      Of course shoulder dystocia is no problem. All you have to do is a Gaskin maneuver. Midwives all know it, and it always works. The fact that OBs fear dystocias is because they are ignorant of the Gaskin maneuver. It’s secret midwife knowledge that OBs are too thick to learn about.

    • CanDoc

      Yes, yes, and yes. Well said. Agree.

  • Sarah

    Your doula is a fuckwit.

    • Cody

      I want to know if she was certified and with who.

  • Madtowngirl

    Thank you for sharing your story. You may be saving a life. I wish you and your son a full recovery.

  • devonshire

    glad you shared your story! I’ve had the same thing happen to me. After a previous SD birth the dr recommended a c-section with no explanation. I thought, why would anything happen, just because SD happened before and resolved itself, it can resolve again in the future. The drs didn’t explain, and all other doulas or natural birth advocates were convinced everything could be fine. I had a great doula at my “natural” birth, had no epidural, stayed active during the whole labor and still, my baby ended up with a bad SD when he nearly died and now is a beautiful 5 year old with very noticeable Erb’s Palsy. He’s had surgery already at age 2 and might need another later in life. My next baby was a c-section. I couldn’t go through this again. The C-section was rotten as can be and took a long time to recover from, but when I see my baby using 2 arms to lift up a cup or lift 2 arms up in the air, I see the miracle in the existence of C-sections. My only thought – aside from educating the public about SD and brachial plexus injuries, I think we need Doctors to give less “orders” (or opnions) and offer more explanations…

    • attitude devant

      ‘the dr recommended a c-section with no explanation.”

      Seriously? Did you not ask why he was recommending a c/s? Did you think he just liked to cut people?

      • Gatita

        Some doctors are extremely poor at communication and patients are often intimidated by their degrees and by being in a medical setting. I hope this is getting covered in medical schools now. It’s too much to expect a scared patient to know how to question a physician. Physicians need to do a better job of getting this right and if for some reason they feel their skills aren’t up to par they should either train for it or refer out appropriately to an educator who can work with the patient.

        • MaineJen

          You know, I felt the same way during my husband’s hospitalization…his illness came on very suddenly, I had no idea what was going on or what could happen (because I’m not a doctor!!), so I was confused a lot of the time. People kept telling me “just make sure you’re asking good questions!” And I’d be like “…..?” I felt like any questions I would ask would have been way too basic. Such as: what is in all of these IV bags? LOL I’m a fairly intelligent person, but I’m not a doctor, and I wasn’t sure what questions to ask. I had never heard of his condition before and it was all totally new to me.

        • The Computer Ate My Nym

          It doesn’t help that doctors are supposed to see patients in 10 minutes and therefore have a perverse incentive to not probe to see if the patient really understands or not. If s/he assumes that the patient who says “no” when asked if they have any more questions understands everything, the appointment can be over and they can move on. If they probe a bit and find that the patient doesn’t understand, it can take another 30 minutes to clear things up. Thirty minutes that they will not be paid for and will be penalized for using. Yes, they should do it anyway, but if you really want people to do the right thing, every time, you have to make it easier for them to do the right thing than the wrong thing.

          • EmbraceYourInnerCrone

            Don’t forget having to enter everything in EPIC and usually while you are with the patient because patients are booked all day long.( I appreciate my primary care doc because she can type fast and take a few minutes to talk to me in between putting in orders for my blood work and my prescriptions, and notes about my visit)

      • Dr Kitty

        Sometimes honestly Drs say one thing and patients hear another.

        Sometimes we assume patients know things that they don’t (like how serious shoulder dystocia is, or what “we’re no longer looking at a curative approach, but we’ll do palliative radio and chemo” means).

        I vividly remember as a medical student sitting in while a consultant clearly and concisely told a patient that they had terminal cancer and that treatment had been reoriented to palliation. All the patient heard was that he was getting more chemo and left the consultation upbeat and positive.

        I say this as someone who had to explain MS to a patient as being like rats eating the insulation around the electrical wiring in your house, and so that the lights are on the fritz and your microwave doesn’t work.
        I was getting nowhere trying to explain auto-immune demyelination, but that kind of worked.
        This is a patient who has had MS for years and was just asking me what the Tysabri did… Several infusions in.

        • Nick Sanders

          That kind of thing was a real problem for me in my teens. My mother is a control freak, and refused to stop accompanying me into the exam room until my late teens Because she was the parent and I was the child, many doctors listened to what she said over what I said, even though I was the actual patient and she was getting things wrong in both directions. An incident that stands out in my mind, partly for how exemplary it was and partly for how it finely got some of the problem through to her, was when I was being checked out regarding my then suspected (now confirmed) diabetes. This was a rare doctor that was actually talking to me instead of my mother, even though she kept trying to butt in, and he was asking me about my urination. After yet another wrong answer given by her while I was trying to talk, he kindly and patiently told her that he was not asking about the volume but the frequency. My mom had been confused because he had asked if I went “a lot” and kept trying to tell him how much I went at a time.

          So yeah, miscommunication can definitely be an issue.

        • attitude devant

          I think you’re right. I was sort of probing to get at that very thing. It can be very very hard to break through the cloud of hope, anxiety, misconception, or whatever. I had a long discussion today with a patient who REALLY needs induction (over 40, now 40 weeks,etc) but she has been fed the ‘induction causes c/s’ BS from all sides and it was REALLY hard to make sure she was hearing me. I even printed her out articles from the literature showing that timely induction PREVENTS c/s. She’s 40, healthy, she feels great, and she can’t conceive how this relates to her.

          So yes, I think sometimes we say one thing and people hear something else. Or hear nothing at all.

          • Who?

            It’s difficult too when being pregnant is the first real experience of the possibility of physical fragility/exposure/risk. Someone who has ever been really sick or badly injured, or perhaps had a family member in that state, would perhaps be more inclined to believe something could go wrong. And we don’t hear the bad stories very often.

            When we’ve always felt well, we can feel invincible. Internalising the good luck we’ve experienced to date, perhaps.

            I hope your message got through.

          • Dr Kitty

            Yes.
            And sometimes in order to ensure people have even a vague understanding you have to use weird analogies and oversimplifications.

            I’m not 100% sure if my MS patient understands that Tysabri isn’t REALLY rat poison, because I couldn’t find any other way of explaining it that seemed to make sense to him.

            At least he doesn’t think he’s getting infusions of new nerve cells any more.

          • The Computer Ate My Nym

            I’m not 100% sure if my MS patient understands that Tysabri isn’t REALLY rat poison,

            I suppose telling him that rat poison is what you take for blood clots, not MS, isn’t going to help any. I remember when I was a medical student one of the residents saying that if you felt obliged to offer coumadin to someone but really thought they’d be better off without it, just ask them if they want to take “that rat poison stuff”. He was joking, but it’s a reminder of how presentation can quite strongly influence people’s decisions about their health care.

          • Monkey Professor for a Head

            I was about to do a cardioversion on a patient when the ED doctor who was doing the anaesthetic held up the syringe of propofol to the patient and said “This is the stuff that killed Michael Jackson!” I had to stop myself from face palming.

          • The Computer Ate My Nym

            Oh, dear. Were they trying to get the patient to refuse propofol? It’s pretty safe if you don’t take unsupervised at home every night to try to sleep and cardioversion (I assume not for V fib) is pretty nasty when awake.

          • Monkey Professor for a Head

            I think he just thought it was an interesting fact! Surprisingly the patient was ok with the propofol, and it all went well.

          • Dr Kitty

            Absolutely.
            The Doctor as drug and all that.

            For example Amitriptyline can either be presented as
            “This drug with a long track record of efficacy and safety and no addictive potential” or “this really cheap old drug with no street value”.

            Sometimes I’ll tell my patients how much a drug costs (bear in mind, it is free for them) if it is particularly expensive, as that has been shown in studies to boost perceived efficacy.
            “This new bladder tablet costs £25 a month- ten times the price of your old one, so it must be good!”

          • Margo

            Like the patient who having had stents put in following heart attack asked the doctor “will I be able to play the piano” …”yes” said doc….”oh great” said patient, “I have always wanted to play the piano.”

          • Charybdis

            Infusions. Of new nerve cells.

            Oh dear. *headdesk*

          • rachelmarie Acosta

            I am just replying kind of at random I see some comments and I can not find the exact one but it said maybe I heard what I wanted to hear.
            My feelings are: I’m an idiot brain damage is an obvious complication. Why did I not put two and two together I don’t know.
            I did ask the midwife after telling her the water birth suite at the hospital looked great but how would they see that the head was out all ready?
            I asked “can’t a baby die from being stuck for TOO LONG?”
            Her reply was A Doctor will be there and they will count once the chin is out”
            I saw the actual Doctor during appts 4 times
            1 (since I moved from Tennessee to Ohio mid term)
            From tenn is the one that I asked how do I avoid a csection
            In terms of positions and what can I do to help baby get out.
            His reason se was the one in the above post. He asked 4 questions and told me that because of my risk factors it’s best to get a c-section.
            I take fault in this because how does he know to explain further unless I ask.
            The 2nd time I saw actual Doctor a different one same location
            I said “I was disappointed to be recommended for a c/s
            Before I was even in labor, that I had another child and he came out after being stuck for a minute and 10 seconds and that I have no one to help me no family or friends where I will be moving” talk about ignorant I really think my doctors over estimated my common sense.
            The response was “yes but women have csections every day and you will be fine”
            (most appt were midwives and at this practice mostly midwives deliver)

            The third time I saw a doctor it was the new location where we had moved states. They had all records and I was very open about the shoulder dystocia. Because I wanted advice on how to avoid it.
            I said “I feel like I have twins can we see if one is hidden”
            He did an ultrasound 30 weeks he said “you have a lot of amniotic fluid there is a large section of water right here”
            I asked him if he could attend the birth and he said that they don’t really do that because they all would be sleep deprived
            (But he ended up coming when I was in labor and stayed from 1 pm (labor started at midnight and ended almost to the minute the next morning at midnight) he stayed all that while to deliver me.

            The 4th time I saw a doctor (his business partner also a doctor)
            Said “your a candidate for a c/section it will be covered because of your history what do you think would you like to schedule one?”
            This is where more of my stupidness comes in
            “No I am going to try to avoid the epidural and walk around freely
            That should clear any potential problems up”
            “He said okay I just had to let you know I can give a c-section if you want one because of the dystocia in your chart”

            So it’s most me being stupid and then the advocates speaking about free movement and birthing big babies (there was a website)
            And then a comedy of errors except it wasn’t funny it was miscommunication at its best.

            The conversation I had with the midwife saying that someone will see the head come out and start counting and she told me I wouldn’t push inside the tub (against hospital policy for dystocia) but I could labor in the tub.
            And I swear on everything she looked at me like I had a third head when I said “but don’t they die if they don’t come out in a certain amount of time and how would we know when to start counting or pushing if everything is done u see water”

            But I did not end up doing water birth suites
            1) I was not registered took the class but didn’t pre register with insurance
            2) I could not stand the feeling of water
            3) I couldn’t walk just frozen in pain.

            So it wasn’t that I didn’t want to hear it I would never forget if someone told me “your baby has a risk of death or arm paralysis if he gets stuck and we can not get him out”

            I had to much faith in what natural birthers said
            Not enough faith in my doctors I guess the whole “c-section conspiracy” is terrible. Because hearing your insurance covers the c-section but not “your baby could get brain damage”

            My husband and I initially thought we were not warned of the damage because it would be like a warning of mal practice we thought those terrible cases were when doctors were not around or when they had made a mistake”

            Now that I know how dystocia goes down
            That if they don’t get child out you need to pull them out of you can pull them out you need forceps etc and al the while the time is ticking against you.

            I really question my capabilities as a basic human when I never knew of obvious implications. It was obvious to people with commons sense but the one time I brought up my fear (talking with midwife about water birth)
            She brushed it off like I was being paranoid.
            I really hate to talk crap about her because I think somehow we really got our wires crossed.

        • Monkey Professor for a Head

          I remember consenting a patient for a coronary angiogram as an intern. For any lay people here, this involves inserting a thin tube into either the artery at the wrist or groin, then threading it through the artery up into the arteries of the heart where you can inject dye to show the arteries on an X Ray and insert stents (little mesh tubes which hold open blocked arteries). It’s done under local anaesthetic and the only incision is a small one over the wrist/groin artery. After explaining all this to him, I asked if he had any questions. His first question was “Are you going to cut me open?” I started again right from the start.

          (I’ll never forget that patient – he came back into hospital weeks later with chest pain, then proceeded to have a cardiac arrest on the ward minutes before he was due to be discharged. He was found by the cardiology team on their evening ward round – I arrived to find the cardiology consultant doing chest compressions. It must have been some really good CPR, because in spite of his ventricular fibrillation he was semiconscious when they shocked him – I know this because he screamed “Ah Jaysus!”. They got him back, then he tried to self discharge from hospital straight afterwards.)

          • Dr Kitty

            That sounds like a classic D8 patient.
            Was that James’s?
            It sounds like James’s.

            The home of patients who have “not a thing wrong with me doc!”, despite their median sternotomy and laparotomy scars… But sure, what is a little open heart surgery and having half your bowel removed?

          • Monkey Professor for a Head

            Yeah, it was James’s! Ross Murphy was the consultant doing the CPR 🙂

            Ive had plenty of patients like that. My favourite one was the one who said he had no medical history, but when asked specifically about surgery told me that he’d had a brain tumour removed!

          • Dr Kitty

            I had a feeling it was.

            I can beat that.
            No significant medical history… Actually a history of active TB and spinal reconstructive surgery with lengthy rehab following a motorbike accident.
            But sure that was in the past! They’re fine now!

            My new patients must think I’m a bit mad, because at their first appointment, even if they have written “no medical problems” I don’t trust them.
            “Any operations? Any pins, plates or screws?Anything taken away by a surgeon- tonsils, appendix, gallbladder?Anything added- breast implants, pacemaker, new joints, transplanted organs?Any hospital stays overnight? Ever attended any outpatient clinics? Any regular medications?”

            But yes, there is a method to the madness and I have been caught out before.

          • Monkey Professor for a Head

            I always ask specifically about diabetes – it’s amazing how many people forget about that. And I always follow “Do you smoke?” with “Have you ever smoked?” – I’ve come across do many people who think that since they quit smoking yesterday, they aren’t a smoker.

          • Who?

            The gps here are keen on knowing for sure what supplements ppl are on. My gp knows I would rather have a pencil in my eye than dream up a supplement regime for myself, or go to an ‘alternative practitioner’ but the other docs always ask, very nicely ‘and what supplements are you on?’ then ask again when I say none.

            A lot of my friends and neighbours have supplement regimes they dream up themselves, or in association with their nutritionist (not dietician, mind you), naturopath or whatever.

      • Charybdis

        I wonder if the doctors (in general) know what they are up against when someone comes in prepared for a fight.

        By that I mean: the belligerence and defiance that some women carry with them into the doctor’s office with them. The absolute certainty that the doctor does not know *anything* about natural birth and that the doctor is wanting to force them into compliance with the dreaded “cascade of interventions” so that s/he can make the tee time or family dinner, or other “convenience” reason. The 30 page birth plan that micromanages the color of the sheets, the temperature of the water in the jacuzzi tub, the refusal of continuous monitoring, no cervical checks, etc. The mother (general term) comes in loaded for bear, ready to argue about every last little thing and doesn’t want to hear about any potential CS. The fact that the doctor even mentioned it is PROOF that s/he doesn’t understand natural birth! I’m not even close to delivery and they are already mentioning a CS!! The very NERVE! *flounces out to commune with midwife*

        If the doctor cannot even MENTION a CS without a woman immediately tuning out and writing the OB off and the OB is probably tired of every single thing being a knock-down, drag-out fight with the patient and getting a consent for a GD or GBS test is a challenge, then how can an honest conversation take place?

        No one wants to hear that there might be a complication with their pregnancy or delivery, but things do happen. How can an honest conversation that leads to truly informed consent occur when the two sides are diametrically opposed?

        • KeeperOfTheBooks

          I think you’re onto something.
          I had a good-but-odd conversation with my OB today. I’m 38 weeks along, hoping for a VBAC (it would be nice to be able to lift the toddler and not do wound care), and while baby’s head-down and doing great according to the BPP, he’s also very much not engaged and I’m not at all dilated, so I asked at what point we should just look at scheduling a RCS.
          For much of the conversation, it seemed as though I had to reassure him that I WANTED his honest opinion, that while I would prefer to VBAC, I want a healthy baby and me most of all, and that I simply wasn’t going to freak out about his tentative suggestion that, provided baby continues to look good, we schedule a RCS for 41 weeks and hope I go into labor sooner. No, no, really, doc–it’s okay! I promise! You have 30+ years of experience and schooling in this, and that’s why I hired you, damn it!

        • Puffin

          This exactly. When I was pregnant with my second, I lived somewhere without midwives. At the time, I still didn’t understand the negligence that I had suffered at the hands of the midwives I’d had with my first (it wasn’t until I’d reviewed my antenatal and birth records with someone that the real horror of what they’d done and failed to do became clear.) I was completely brainwashed by the NCB movement, I was convinced that the OB wouldn’t respect any of my choices and I went in to every appointment completely adversarial, absolutely convinced that I knew best and that he was an idiot. I think I may have made him actually throw up his hands at one point as he was leaving the exam room. I ranted about them in blogs and petitions. I refused important screening (GTT and GD) and I started planning an unassisted home birth because I was so resentful of being forced into OB care. Reading this blog actually stopped me from doing that, and saved my life. I’d have bled to death at home.

          But I’m a medical student now, and very likely to go into OB/Gyn myself and I’m horrified at my behaviour when I was younger and I’m impressed how well my OB actually did respond to my outright hostile behaviour. I am now hoping to set up an elective with the group of obstetricians I was a patient of, since I want to return there to practice and they are the only OBs, and I’m tempted to actually give a proper, formal apology for my youthful idiocy when I was their patient.

          • rachelmarie Acosta

            I feel that too.
            I was not really hostil or throwing papers in the doctors face but I was very paranoid because everyone acted like csections were a way to make money and be quick. After this ordeal of being head in the sand I want to be a labor and delivery nurse.

        • rachelmarie Acosta

          I was reading over this I completely agree. The whole movement has made it seem like the Doctors are trying to pay off student loans or go golfing.
          That makes it really heard and it’s my fault for believing them.

          I’m not still thinking of all this but I came to read the story again and the comments.

          I have resolved to pay for my regrets by spreading the word on my personal mistake so someone can save themselves the grief.

          My son is reaching behind his head to scratch and can reach almost behind his back. We were lucky to have the provider and hospital that we did.

    • rachelmarie Acosta

      thank you

  • Allie P

    What a sweet baby. Look at those curls! I’m so sorry for everything that happened to you. Thank you for sharing your story and your son’s story, and help spreading information to counteract the propaganda and ignorance. I wish you and your family the best in the future.

  • Gatita

    Your son is beautiful. Thank you for sharing your story. You could be helping to save a baby’s life

  • Cody

    Your doula is bad at her job. For so many reasons. She was NOT supportive and she gave medical advice. If she is certified, I would suggest filing a complaint with her certifying organization. It sounds like there was some HypnoBirthing stuff being done too; I’m not a fan of that program.

    • MaineJen

      Yes, I was mentally berating that doula the whole time I was reading this.

  • Felicitasz

    OMG, I am so sorry about all this needless suffering. Your son is so cute. I wish healing and strength for both of you – strength that you actually already have, going on and fighting and raising awareness like this. Thank you for sharing your story, it truly has an impact and will make many people think twice.

  • Lurkerette

    Your son is adorable! Look at those eyes! I wish healing for both of you. Thank you for sharing your story.

    Please be kind to yourself. You didn’t cause the dystocia (anyone blaming the epidural should have to explain how it changes pelvic geometry after the head is born), you were smart to choose a hospital, and you’re doing everything you can to help your son now. He is a very lucky little boy to have you as a mom.

  • Anna

    What a sad story! Hoping that it does get a happy ending finally. That poor little guy((( My daughter is one too, I couldn’t even imagine her having to have surgery, that is beyond terrifying. The mother is blaming herself but let me say her first OB who failed to explain why she had to have a c-section has a share of guilt in this too. After all he was the one with medical education there, he should have made the effort and expalined all clearly and honestly. My OB did and though it sounded a bit harsh at that particular moment I am grateful for it now. I was a GREAT 4th degree tear candidate and my pelvic issues after vaginal birth might even involve fractured pelvis. My daughter wouldn’t have been fine either. That is what really caring for patients is about, telling them the TRUTH, ALL the truth. They deserve it.

  • Rationalob

    Your son is adorable. I would like to add a few comments about shoulder dystocia.
    1. Most shoulder dystocias occur in babies of a normal birth weight
    2. I would hope every maternity unit has a protocol in place that is activated immediately upon diagnosing a dystocia. An experienced obstetrician knows how to alleviate the dystocia but needs help.
    3. Our ability to predict a baby’s weight at birth is not very good. Multiple studies have shown that the mom’s estimate is better than an ultrasound or providers estimate
    4. Offering a CS if the OB thinks a baby will be large is routine but again, our estimates are often times off and the moms preference has to be taken into account.
    5. My worst shoulder dystocia was with a mom who had a normal labor, 7 pound baby….looked at her husband after the delivery and he had the broadest shoulders I have ever seen. Some things you can’t predict.

    • Irène Delse

      That’s interesting, about the dad’s shoulders. I come from a family with a history of big babies (especially baby boys) and adults with large heads but not larger than average shoulders. Still had a shoulder dystocia when I was born. (Luckily, didn’t get sequelae.)

      But I wonder how health care providers take family history into account? Weight at birth, difficulties encountered during birth, not just for the patient but for her ascendants?

      • Erin

        I don’t think they do at least not here. No one asked our birth weights or if any issues were encountered ante-natally.

        My son was six pounds nine ounces with a 90 % percentile head and thus couldn’t fit through my pelvis. It turns out that we’re probably the lucky ones. My MiL needed 81 stitches with her first. “Karma” bit said first when her 11 Ib something 95 % percentile headed son arrived in about 3 hours flat tearing her badly. Second sister-in-law was okay with her first as he was premature and didn’t have such a big head, second baby went to 42 weeks and was 10Ib something with a head which was almost off the scale. She had surgery for incontinence and to fix a prolapse. If my son gets married to someone capable of childbearing or we go on to have a girl, I will be mentioning it…a lot.

        When I discussed a second pregnancy with a Consultant OB and raised head size and that of his cousins, father and aunties, I was pretty much patted on the head and told that all babies are different. Pointing out that we were currently 7 for 7 out of the term babies just got me a “look”.

      • MI Dawn

        When I worked as a midwife, we always asked about mom and dad’s birthweights and sizes as a possible SD predictor. Didn’t care how big/small they were as adults. We also asked about their mother’s pregnancies (if there were problems or not – if they knew). The biggest baby I ever saw, 15 lbs, was a c-section. Dad was a normal size baby (IIRC, about 6-7 lbs at birth in the 1970s), but mom had been 11 lbs and her mother’s 5th baby. We guessed early on, even though mom had a proven pelvis for 11 lbs baby (her first), that this one was bigger and we were right!

        • Roadstergal

          A co-worker of mine had an 11lb baby two years ago. It wasn’t post-dates AFAIK and didn’t look it – a bald, chubby, standard baby in the pics. Just ENORMOUS. I’ve never seen anything like it.

      • demodocus

        My ob did ask for weights at birth for my husband and I. Problem being, i was a 7 monther, and i was fuzzy on how big my sibs were. DH was almost 10 pounds at birth and has a big head. I think the junior resident was concerned for a minute that my big headed child was going to get stuck, but fortune was with us. ‘course there’s still his sister-soon-to-be.

      • AnnaPDE

        When I told my OB that large heads run in both my and my husband’s family, she said “ok, you might be lucky though”. On every ultrasound, the head was ahead of gestational age by about 2-3 weeks. By week 35, the idea of trying labour was summarily ditched, and when kid was pulled out at 39+5, the head was 99th percentile (and still almost an inch less than his cousin…).
        It’s not that his head is huge, it’s just pretty square-ish where forehead meets temple. Normal head size babies look positively conical next to him.

      • rachelmarie Acosta

        I was 10 lbs and 2 weeks late as a baby
        My husband was 6 lbs

        He has the widest shoulders I do to

        Don’t know why of all things occurring to me the most obvious did not!

    • attitude devant

      As an ob, I’m surprised that the author of the post and at least one other commenter have both reported that after their first shoulder dystocia the doctor recommended a c/s but didn’t explain why. I find that REALLY odd, even if I believe that. Thoughts?

      • The only thing I can think of (and I am NOT a doctor or in the medical field at all) is that OBs might get twitchy about “playing the dead baby card”. Especially if their patient already seems leaning towards the woo, bringing that sort of thing up might push them away faster*. Then, too, if the doctor says “I’m worried about the baby being too big so I think you should have a C/s”, a lot of people won’t understand that as a serious medical thing. SD is a technical term that OBs might shy away from.
        *See the complaints about OBs who were too pushy, who brought up “unlikely” worst-case scenarios, etc., etc.

        • rachelmarie Acosta

          I think they need to refer some women with history of large babies and shoulder dystocia to the erbs palsy group and maybe idk

      • An Actual Attorney

        As that Jewish sage once wrote, “a [wo]man hears what he wants to hear and disregards the rests.”

        • attitude devant

          LOL. I had a partner once who was a wee bit crazy about full disclosure who would write (this was in the days of paper charts) “I told her she may die. I told her her baby may die. I told her she may hemorrhage and need a blood transfusion and get AIDS.” Or some similar such awful catastrophic stuff that almost never happens. And he would make the patient sign the note….

          Consequently all the patients were terrified of him.

          • EmbraceYourInnerCrone

            I actually would like a Doc like that. But the women in my family have a history of weird issues the “hardly ever” happen, so I appreciate knowing the worst case. Hope for the best, prepare for the worst, don’t forget to duck…

        • Karen in SC

          that sage being Paul Simon?

          • An Actual Attorney

            Yes! Bonus points to all who read that and followed with a mental “lai la lai. Crash!”

          • Box of Salt

            yeah, teach me to read the next comment down before I reply . . . . Sounds of Silence cover getting a lot of airplay in my area.

            Do I still get points if my following thought was the Capitol Steps parody of that song? Lie lie lie . . .

          • An Actual Attorney

            There’s a cover? Damn I’m old.

          • Box of Salt

            Husband says the band is called Disturbed. The cover reminds me of Trans Siberian Orchestra.

            When in high school, I wrote an English paper on the poetry in Sounds of Silence.

            I’m old too: my mother wouldn’t let me join my friends (mostly male; most of the girls’ moms agreed with mine) at Concert at the Park (original one: in the 80s).

          • An Actual Attorney

            Just listened on YouTube. Actually impressed. Then read comments from younguns who never heard of S&G. Now, crying myself to sleep.

          • Roadstergal
          • demodocus

            I think my mom wanted to go to that, but she had the bother of 2 very small children and an even smaller bank account.

          • Roadstergal

            My husband LOOOOVES that cover.

            Also, there’s a bit in the original song when they do “Words… like silent raindrops fell…” and don’t have the a line that, per the structure of the song, really _should_ go there, so my brain always auto-fills “…straight to hell…”

          • The Bofa on the Sofa

            I think of the Mad Magazine Lord of the Rings musical.

            “My lovely Precious is a ring
            Which I lived like anything
            ‘Til a thief came by to rob it
            Twas a double-crossing hob-bit”

            Although in a different forum just the other day. I was thinking of Lirty Dies and Lonica Mewinsky, Trinda Lipp with a bapedeck in her toobs, and a mistinguishing dark.

          • Box of Salt

            but that was a long thyme ago . . . .

      • CanDoc

        Agree. Hate to nitpick, but had the same thought.
        But I think when people get flooded with information, they selectively recall the highlights and assume the rest never happened.

      • Rationalob

        Who knows what other OBs tell their patients. I know I will counsel them about risk of SD with a large baby or hx of SD and the risk of permanent damage to baby. Same with TOLAC counseling. Can’t predict uterine rupture, rare, but if it occurs obviously has devastating consequences. Birth is risky.

        • EoW

          I still can’t believe non-medical idiots were telling my family member to have a homebirth. First baby, total breech, estimated a couple ounces under 11 pounds which was correct. All the boys in the family are huge babies, no GD, except for this one’s father. He was 5.75 pounds and 19.5″ at 6 weeks premature. All of his mother’s babies came out at 19.5″, no matter born premature or overcooked. Heck, the grandfather to the baby was close to 13 pounds in WWII Eastern Europe in close to starvation conditions for his mother.

    • Monkey Professor for a Head

      With regards to number 1, is that because more babies are born at a normal birth weight than are born large for gestational age? A bit like saying that more babies die in hospital than at home birth – technically true, but only because 98% of births happen in hospital.

  • Irène Delse

    Thank you for sharing, Rachel, you’re very brave. Hope your story helps other women do a reality check. I’m sorry you and your family had to go through all this. The doula and childbirth educator are reprehensible.

  • Mishimoo

    Awww! He is such a cutie, I hope he smashes those milestones and if not, that everything goes smoothly with his surgery + recovery.
    My youngest was 8lbs exactly and he barely squeezed his broad shoulders through my pelvis. We were lucky: it was only a mild dystocia and he has had no arm issues. I am questioning whether the brief moments of late decels are why he doesn’t speak very much, or whether it’s the result of having two older sisters who are only too happy to ‘help’.

  • slandy09

    My good friend’s oldest son was nearly nine pounds at birth. He got stuck during pushing and they had to use the forceps to get him out…breaking his collarbone in the process. He broke the same collarbone in the same place a few years later in an accident. He’s fine now thankfully.

    My friend had to have a c-section with her second because her cervix was swollen and he was in distress. He was a smaller baby. Second kid is still young, but my friend is determined to have a VBAC or what she says a “normal” birth next time around. I’m personally afraid she’s setting herself up for disappointment, but another pregnancy is pretty far off because she has some health issues that must be treated.

    • Fleur

      One of the most disturbing things that I recall reading online whilst pregnant was some woman blogging about her home birth shoulder dystocia. She was bragging about what a great choice the home birth had been because, if she’d been in a hospital, the doctors would have cut her. As it was, the “only” consequence was that her baby had a broken collar bone, which she seemed to think was a much better option than having to suffer any pain herself. I also saw a woman on an online discussion thread claiming that it’s better if shoulder dystocia happens at home because, in a hospital, they’ll want to hurry to get the baby out as quickly as possible and you might tear, whereas a home birth midwife will take her time. A sibling of mine died after getting stuck and being starved of oxygen during birth, so I’m not exactly the most receptive audience for those kind of arguments (and I can only imagine what my poor mother would say).

      Rachel – I’m sorry that it’s been such a tough road but I’m so glad you got to take your lovely son home. Best wishes to you both.

      • Nick Sanders

        As it was, the “only” consequence was that her baby had a broken collar bone

        I simply cannot understand this kind of thinking.

        • KeeperOfTheBooks

          Nor can most non-sociopathic individuals.

      • Monkey Professor for a Head

        I just don’t get it. I had an episiotomy because my son was having bad decels due to a nuchal cord and we needed to get him out ASAP. Every time it hurt afterwards I thought that it might have helped save my sons life, and I found I didn’t mind at all. I would have gone through so much more than that for him.

      • demodocus

        It’s been nearly a year and I’m still devastated emotionally from when i broke the kid’s leg. It had been such a lovely day, went swimming, had ice cream, had fun at the park, none of which matters to either parent since 3 seconds after I fell down. It’s ludicrous.

        Fortunately, *he’s* long since over it.

  • SporkParade

    What a cutie! Wishing you both a speedy recovery.

  • Amy

    Your baby is adorable! Sorry you’re having to deal with all the armchair Monday-morning quarterbacking from crunchy mamas who all got their degrees from Mothering Dot Com.

  • guest

    Thank you for sharing. Your son is the cutest! I hope that his therapy works well for him and that he can avoid surgery.

  • Heidi

    Your son is beautiful. I’m sorry to hear that you both have much recovering to do, but I am so glad you and your son are here to share your story.

  • Amazed

    Your little one is gorgeous. I’m sorry for all that the two of you went through, and I thank you for sharing your story.

    Something about this picture reminds me of one I received a few days ago. I only use Facebook for work and all of my friends there are my RL friends. My brother and SIL had my niece (not quite 4 months old) “congratulate” me. She’s smiling toothlessly on her pillow, in her hand a plastic flower (very wise of them since she tried to eat it) and near her head a happy birthday card. All of my friends, the majority of them never having seen SIL, lined in to say how cute it was and what a gorgeous niece/daughter we had. Why on earth do those “natural” women feel the need to brag about their births than their healthy child? (And, as in your case, mom was nowhere in the picture. That’s the kid’s moment. Mom isn’t the star!)

  • corblimeybot

    Hey there, fellow BPI parent. My child was too big for me, and got her injury in a hospital birth. And ever since, assholes have been telling me that none of it would have happened with a damned homebirth midwife. Since my child had to be suctioned for mec and had an abysmal one minute Apgar, I don’t even want to think of how much worse it could have been if we’d been at home. She was lucky to survive at all.

    Our doctors did not expect me to have a dystocia. My baby did not look
    that big on ultrasound, and the margin of error didn’t work in our
    favor. I would not hesitated a single moment to get a c-section if they could have known. Compare that to a woman I know who seems to think that babies “getting stuck” is just a normal part of birth, and who was accepted to a second homebirth after a previous dystocia.

    I had never heard of BPI when my baby was born.. My child avoided nerve transfer and orthopedic surgery, but she was a candidate for it (based on the Toronto Active Movement scale) until she was 9 months old. She had the same arm taping that your little one has. Today my child is a bit over 2 years old. Only people with a trained eye could detect the difference between her arms now. She is probably 95% functional in that arm. It’s possible to recover quite a bit, and I deeply hope for a similar outcome for your son.

    I’m so sorry this happened to you and your baby. It’s not your fault. It is the fault of people who make their money lying to women about the risks of childbirth. Best of luck to both of your recoveries.

  • Ob in OZ

    That last line really hits home. When did doctors start being perceived as anything but a patient advocate? How diid doctors lose that expectation from their patients, and how do we get it back? This story will remind me as well that how we express risk to patients (recurrent shoulder dystocia) is critical in informed consent. Thank you for sharing your story.

    • AA

      I think the Internet has magnified the perception that most people are suspicious of their doctors AND that doctors merit suspicion. It’s not as bad as it seems to be from the Internet. As for how to improve things, I really don’t know. HCPs can’t reduce their patient panels to have more time to spend with patients, there’s too much demand, and seemingly no way to reduce administrative burdens either. I tip my hat to MDs, they are pulled in more directions than any other profession I know.

      • The Computer Ate My Nym

        There are ways, but they involve (dramatic music) spending more money on health care! And we can’t have that, can we?

    • Jennifer

      I live in Boston and many of the doctors here are NOT patient advocates. They’re cheerleaders for vaginal childbirth, exclusive breastfeeding, and forced rooming in.

  • BeatriceC

    My oldest son is 17 and had SD at birth. He has a genetic bone disease, so for years we blamed his difficulty using his left arm (his dominant arm) on that. Not too long ago it became apparent that unless those problems were fixed, he would never be able to drive, so the doctor proceed to order what he called a BFW (big fucking workup) and look at absolutely everything. He has brachial plexus nerve damage, but absolutely no sign that the bone disease has caused it. The doctor dug into his birth history and is hypothesizing that the SD at birth is the true cause. I’m so glad people are speaking out. This is something that shouldn’t be swept under the rug.

  • OBPI Mom

    Hi Rachel, it’s Betsy here. You are so amazing for sharing your birth story and keep being open and vocal… you are helping others even when the naysayers seem the loudest. We are together in this! ((hugs))

    • rachelmarie Acosta

      Thank you for the support it was you who ideas talking about in the post. Thanks for the help.

  • NoLongerCrunching

    Thank you for sharing your story. I’m so sorry you and your son suffered.

  • Deborah

    Shoulder dystocia is one of the most feared complications for a midwife. That is one of the reasons I did not go into homebirth after I graduated as a midwife years ago, even though I had homebirths myself. When I was having my own babies, and was not a midwife, I had no idea of the seriousness of a shoulder dystocia, how frequently it occurs, even without risk factors, and the devastating sequelae that can result.
    My ideological bubble began to burst as I encountered more and more serious outcomes that had nothing to do with how healthy a woman was, whether she had a correct birth plan or whether she had been subjected to the dreaded “cascade of interventions”. Complications occur because that’s just childbirth. Somehow these midwives who encourage women to take spectacular risks with their babies births by downplaying them or ignoring them completely have insulated themselves from reality. Their ideology inoculates them and drives them along even in the face of an increased perinatal mortality rate and serious perinatal and maternal morbidity.
    The suggestion that you were “a great homebirth candidate” by the childbirth educator, simply on the basis of your desire to avoid a c/s demonstrates this perfectly.
    Thankyou to our guest for sharing her story and I wish you all the love in the world as you continue to get the care needed for your son’s recovery.
    He looks absolutely gorgeous 🙂

  • CognitiveDissonaceHurts

    What a beautiful little guy you have! So sorry about how things turned out.
    You are in a powerful place now. You will help others by telling your story. When I was homebirthing I couldn’t find any negative stories. Keep speaking out!

  • Who?

    I’m sorry you’re going through all that, and that your boy is also in need of further care.

    Thanks for sharing your story.

    Hope things go well for both of you.

  • momofone

    Rachel, I”m so sorry you’ve experienced this, and like you, so glad that you were in a hospital when it happened. All the best to you and your son.