Thank you so much to Jes C. for sharing her beautiful birth story with us! If your plan is a natural birth, a c section is probably not on your radar. In the video above, Jes describes how she planned to have her second natural birth in a hospital. After pushing for over 2 hours without her baby descending into the birth canal, Jes delivered her little one via a cesarean birth. It’s helpful to realize that birth can be unpredictable, even when you’re well prepared and well informed. I love this birth story because Jes helps us see that an unplanned c section can be another path to a positive, empowering birth experience.
After watching the video, you might have questions about some of the more technical aspects of Jes’s birth story and c section experience. Let’s discuss a few of those points now:
Do I have to go to the hospital right away if my water breaks at home?
When to go to the hospital is an answer best left to your healthcare provider. Some women have medical conditions that may lead to an increased risk for baby after the amniotic sac ruptures. This might include if mom is Group B Strep positive or the presence of meconium in the amniotic fluid. Discuss this question with your doctor or midwife at your next prenatal visit.
What happens if my water breaks and I’m not having any contractions?
As you will learn in your Kopa Birth® childbirth class, labor doesn’t officially begin until you are having regular contractions that bring about effacement and dilation of the cervix. Thus, just having your water break alone does not mean that you’re in labor. Jes was one of those lucky 10% of women whose amniotic sac ruptures before the onset of true labor(1). When women are at least 37 weeks pregnant, this is known as “term premature rupture of membranes,” or term PROM.
Providers vary in the way they care for women with term PROM. If all appears to be well, some providers will have mom call back in 24 hours if contractions haven’t started on their own. Others may ask for a call back in 12 hours, and still others might ask mom to come in to the hospital right away to be assessed.
The membrane of the amniotic sac serves as a barrier to infection while it’s still intact. For a woman whose water has broken, there is evidence to suggest that inducing labor can result in a lower risk of maternal infection than simply waiting for contractions to begin on their own(2). Thus, some providers may encourage labor induction.
On the other hand, around 75% of low risk women will start having regular contractions, without any intervention, within 24 hours of their water breaking at term. There’s also some evidence to suggest that waiting for labor to labor to start on its own is associated with a lower rate of cesarean birth (3). Thus, some providers may encourage mom to wait for a period of time before starting a labor induction.
What does it mean that the baby was getting stuck on the pelvic bone?
After pushing for 2 hours with little progress, Jes’s doctor told her that the baby was likely getting stuck on the pelvic bone. This may have been a true case of cephalic pelvic disorder (CPD) – a scenario where the baby’s head is too large to fit through the pelvis. Or, the difficulty could have been due to the angle of baby’s head in the pelvis (4).
As Jes described, she tried a wide variety of recommended positions for pushing. She went on all 4’s to widen her pelvis and she squatted to open up her pelvis. She swayed on a birth ball to encourage the baby to descend, and she also used a birth bar to attempt additional squatting. Although her mobility was somewhat impeded by the IV poles and fetal monitors, Jes was unmedicated and able to attempt many upright positions through the strong labor contractions. Whatever the reason the baby wasn’t descending, it’s obvious that Jes did what she could to help support the natural physiology of birth and to encourage the baby through the pelvis.
Why was Jes offered a c section instead of an assisted delivery?
As we learn in this blog post, an assisted delivery (vacuum extraction or forceps) is a possibility if baby is in the birth canal. In Jes’s scenario, the baby had not descended past the pelvis and into the birth canal yet. Thus, a c section was the option for medical intervention.
What causes the pins & needles feeling on the c section incision that Jes described?
The temporary pins & needles sensation that Jes felt at her incision were likely due to some minor nerve injury following the cesarean surgery. The abdominal wall is rich with nerve innervation. Studies suggest that nerve injury or entrapment is the main cause responsible for chronic pain following a c section (5). Women describe sensations around the cesarean incision ranging from numbness to tingling to burning. Fortunately, Jes’s uncomfortable sensation went away after just a few days.
Birth can be unpredictable, and a c section may just be the way your baby decides to make an entrance into this world. Be sure to prepare yourself with a high-quality natural childbirth class, labor coping tools, and form a good relationship with your doctor or midwife. When you’ve done all you can, it’s time to sit back and enjoy the wild, exciting, joyful ride of childbirth! Thanks again to Jes C. for sharing her amazing birth story with us!
Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!
(1) Gunn, G.C., Mischell, D.R., Morton, D.G. (1970). Premature rupture of the fetal membranes. A review. American Jorunal of Obstetrics and Gynecology, 106(3): 469-83.
(2) Hannah, M.E., Ohlsson, A., Farine, D., Hewson, S.A., Hodnett, E., Myhr, T.L., Wang, E.L., Weston, J.A., B.Sc.N., Willan, A.R. (1996). Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term. The New England Journal of Medicine, 334: 1005-1010.
(3) Pintucci, A., Meregalli, V., Colombo, P., Fiorilli, A. (2014). Premature rupture of membranes at tern in low risk women: how long should we wait in the “latent phase”? Journal of Perinatal Medicine, 42(2): 189-96.
(4) Retrieved from http://spinningbabies.com/learn-more/baby-positions/cpd-will-baby-fit/
(5) Sippo, W.C., Burghardt, A., Gomez, A.C. (1987) Nerve entrapment after Pfannenstiel incision. Am J Obstet Gynecol 157:420–1