Posted by My OB said WHAT?!?.
May
17
Posted by My OB said WHAT?!?.
“…Your Pelvis Is Just Way Too Tiny.”
“You’ll never get a baby bigger than 7 pounds out of there. Your pelvis is just way too tiny.” – OB to mother attempting to have a VBAC.
There are 50 comments to this post.
Soo.. how do you explain dwarfs giving birth to normal sized babies?? And all other petite women throughout history for that matter.
My Grandmother gave birth to 9 babies, most of them bigger than 7 pounders, and she was 4’10″, pretty petite if you ask me. Also, I thought that I had a narrow pelvis (though I had already vaginally birthed 2 minimum 9 pounders) because my hips are very narrow, but with this last baby (10lb 1oz), my Midwife told me that my pelvis was *not* narrow (while stripping my membranes) and I could birth any baby I wanted. She also said that there is no way to to tell if a pelvis is “too narrow” to birth vaginally, the pelvis will stretch. [I guess unless you're that Indian lady a couple of years ago who had a 19lb baby.]
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CCindy Reply:
May 18th, 2010 at 6:17 am (Quote)
When will people get over the height has something to do with width theory? So your grandmother was 4’10″ SO WHAT! Were her hips 36″ or only 28″? We are talking internal diameter here folks. Even outer diameter is meaningless. And no I don’t want an x-ray to measure the internal diameter of my pelvic bones thank you very much. Just let me labor seated in the same position I would pass a bowel movement or get on all fours as nature directs!
Dear Doctor,
You don’t know as much as you think you do.
Signed the tiny little woman with the breeders hips.
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Dear Doctor:
May we borrow your crystal ball? The powerball drawing is up to thirty-five million and several of us could use a few bucks.
Love,
The moms of MOBSW
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Cmat Reply:
May 17th, 2010 at 6:48 pm (Quote)
No kidding, that must be one heck of a crystal ball. It must have magical twinkle lights wrapped around the base. I could use a few bucks if it can predict the winning numbers!
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Sarah Dorrance-Minch Reply:
May 17th, 2010 at 8:51 pm (Quote)
TWINKLE LIGHTS! I want my twinkle lights! Give me my twinkle lights!
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Bah. There’s no way to measure that. so many things change during pregnancy. And birth, provided that women are allowed to do what nature always intended.
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Katie Reply:
May 17th, 2010 at 7:16 pm (Quote)
Does nature have an “intent”?
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Sheva Reply:
May 17th, 2010 at 7:36 pm (Quote)
What I meant was, the I think that the body was created to give birth vaginally, most of the time.
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Sarah Dorrance-Minch Reply:
May 17th, 2010 at 8:49 pm (Quote)
Yeah, it’s a matter of form following function. Vaginas are good for a lot of fun things, including but not limited to sliding out babies. Pelvises are naturally good at expanding if the owner of the pelvis happens to be pregnant. Cervixes are naturally good at stretching, and uteri are naturally good at flexing athletically, which has benefits both sexual and reproductive, and on a more minor scale, is quite useful for getting rid of an unused lining approximately once per month until the eggs are gone.
Abdomens, on the other hand, usually are naturally better for other things. If we were MEANT to give birth abdominally, women would all be born with zippers. It would certainly save a lot of labour. No more cutting, no more stitching. At the very least, we’d come with marsupial pouches. Velcro holding the pouch together would be kind of cool. We could use the pouches to carry Blackberries and house keys when not using them to carry babies.
But we don’t have those.
Biology is not destiny, but it is ergonomically correct.
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Mistie Reply:
May 17th, 2010 at 9:14 pm (Quote)
ooohh Sarah, I love you.
p.s. Aren’t you the one I read that has Asperger’s. I do too.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 5:28 am (Quote)
Yep.
Do you have long puttering prodromal labour for weeks, too, followed by an hour or two of hanging on for dear life while your cervix goes from zero to ten?
A few years ago, I read that autistic people and people with social anxiety disorders release oxytocin oddly – instead of a long, steady trickle, they tend to release it in huge infrequent clumps, which in social situations results in “failure” to connect, anxiety, getting overwhelmed, etc.
I have a hypothesis that in labour it amounts to long periods of early labour, often with pit drips to augment a “failure to progress” if we’re in the hospital, out of our comfort zone, and clammed up, followed by precipitous labour when our oxytocin actually kicks in.
No doubt the medical profession would prefer to address the issue by sectioning us all prophylactically – “just in case we never make any oxytocin” and the baby gets stuck! forever! or something like that.
This is also why I prefer to give birth at home, now. I’m perfectly happy to wait until my oxytocin kicks in; it always does, eventually. Best of all, there’s almost nobody nearby. No cadre of strange nurses, no bombardment of hospital smells, no unfamiliar people wandering in and out at shift changes or to get student experience doing rounds or whatever, nobody prodding me and coming too close to me and making my skin itch. 
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Michelle Potter Reply:
May 18th, 2010 at 4:37 pm (Quote)
OMG! I have social anxiety disorder. I have long thought that this is related to the fact that I generally labor slowly, with lots of stops and starts. I thought it was that my anxiety causes me to tense up and stalls my labor. I had no idea that it actually affected oxytocin! Do you have a link for this, because I would LOVE to read more!
(PS, have you ever come across anything about social anxiety and alcohol? I have an oddly high tolerance for alcohol despite the fact that I have low body fat and almost never drink. To drink enough just to “loosen up” in a social situation, I pretty much have to kill most of a bottle of whiskey. Which, considering how much I hate the taste, explains why I almost never bother trying.)
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 5:20 pm (Quote)
1) Oxytocin release in ASD and SAD – no, I don’t have a link (alas) but one article I read appeared a week or two after Kassandra was born, the article that showed unusual patterns of oxytocin release in autistic people and people with phobias such as agoraphobia and social phobia. So that would have put it in the nationally syndicated press in mid-April of 2007. A couple of years later or so I read another newspaper article about autistic people being given oxytocin “therapy” to help them learn to be more social. Pitocin: it’s not just for force-starting labour any more. Apparently. (I think it’s still in the experimental stages.)
2) Alcoholic tolerance and SAD: Haven’t seen anything, but my husband, who is NOT socially inept or phobic but who is definitely autistic (I have more social handicaps; he has more problems processing data and dealing with sensory overloads, and he had verbal delays as a kid to the point where they thought he was retarded – he has an IQ of 185, for the record) can drink forty or fifty shots of hard alcohol without getting so much as a buzz. I am not that lucky, alas. I just have the ludicrous natural tolerance to opiates.
Have you considered that maybe you are on the milder end of the autistic spectrum?
Alternatively, if you have some of the bizarre chemical tolerances and hypersensitivities we do, and you clearly have SAD rather than an ASD, then maybe the chemical sensitivities and insensitivities are linked somehow to how we process oxytocin.
Hmm.
This is way off topic, but it was very interesting to play with.
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Mistie Reply:
May 19th, 2010 at 1:39 am (Quote)
Sarah, is there someway I can contact you personally, like on FB or something. I would love to talk more with you about this. Not that I’m not willing to share with others, I’d gladly do so, that’s how we learn, I just hate having to find the last place one of us left off and on which post. Thanks.
http://www.facebook.com/?page=1&sk=messages&tid=1328559009826#!/profile.php?id=1289937453&ref=profile
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Mama Mirage Reply:
May 18th, 2010 at 9:31 am (Quote)
Lol! So true. As a side note, I had a dream once that I was pregnant with puppies and when they were “done” I unzipped a zipper and handed them to hubby, zipped myself back up, and commented that that was “the nicest Z-section I ever had!” I woke up laughing at the absurdity!
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Katie Reply:
May 18th, 2010 at 9:01 pm (Quote)
“Vaginas are good for a lot of fun things, including but not limited to sliding out babies. Pelvises are naturally good at expanding if the owner of the pelvis happens to be pregnant. Cervixes are naturally good at stretching, and uteri are naturally good at flexing athletically, which has benefits both sexual and reproductive, and on a more minor scale, is quite useful for getting rid of an unused lining approximately once per month until the eggs are gone.”
Ok, all this is true except when it’s not. For instance, the human pelvis ideally enables one to walk upright, except when it’s mine, which was born with a badly dislocated hip. Left in my “natural state”, if I’d lived past infancy I would probably not have lived much longer, being a crippled kid. But my sister was born with no such problems. She would have been just fine and assuming nothing ate her, could do a fine job passing on my mother’s genes. With evolution, you win some, you lose some. Speaking as a thwarted loss, I’m glad we have things like braces (and c-sections, for those whose wonky bits are reproductive).
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Sarah Dorrance-Minch Reply:
May 19th, 2010 at 9:30 am (Quote)
Assistive technology is a great kludge. I am deeply grateful for it. I am also glad that most of the time I can get by without it – which is, as you point out, an accident of fortune, or an illustration of the hand of Providence, depending on one’s perspective.
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Michelle Potter Reply:
May 19th, 2010 at 3:38 pm (Quote)
As a Christian, I believe that when God originally created the world, everything was perfect. Then sin entered the world, and His perfect creation became deformed, diseased, perverted, and decaying. In a practical sense I think this means that, when our bodies function as intended, the design simply can’t be improved. When they don’t, we should *all* be grateful for the extent to which modern medicine can help; it’s truly a blessing!
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Katie Reply:
May 19th, 2010 at 5:41 pm (Quote)
Let’s see if I have this right: God, omniscient and omnipotent, created the world. We “sinned” and something, like your evil deity, Satan?, came in and made things evil, overpowering your good deity. My hip was born crappy because of original sin, basically. But then, God allowed doctors to CHEAT his will to punish us for our sins by correcting the defect? If he decided we learned our lesson, why doesn’t evil just go away? Or is it not in God’s power to banish evil? Sounds like it’s God’s will for mothers to die in childbirth and for kids to be unable to walk, rather than run cross country in high school, like I did? How do you feel about “barren” women getting fertility treatments?
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Jane Reply:
May 19th, 2010 at 6:52 pm (Quote)
Michelle’s reply came in non-threaded further down the page.
But no, the Christian worldview doesn’t say that God wants moms to die during childbirth. It’s more that sin broke the world, and now God wants us to minister to one another with love and compassion in order to heal those breaks in the world. So that means that when a mom is in need of help during childbirth, it’s compassionate and merciful to offer her help in whatever form she needs: pain relief, change in positioning, and yes, cesarean section.
But when things are working well, as in a healthy birth, why should the medical establishment try to improve it? None of the improvements they try to foist on a well-laboring mom&babe pair really improve anything except the chance that the mom will have a C-section.
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Katie Reply:
May 19th, 2010 at 7:51 pm (Quote)
This logic escapes me, but… ok. I think we share a similar point of view when it comes to birth, that it generally goes very well and you should only mess with it when it seems something is not right. I also think obstetrics mainly offers few ways to assist: pitocin, pain meds, forceps/vacuum, and c/s, and that this is incredibly limited. We just got to these conclusions by different paths
And yeah… I’m a firm believer that there’s one way you can tell a woman’s pelvis can’t birth a baby, and that’s through labor. Pelvimetry is a joke and it’s weird how much people focus on weight as THE limiting factor. There are really 5 P’s, not 3: passage, powers, passenger (including _position_), psyche, and people (the ones at the birth).
(That’s obv not my original idea about 5 powers, but I cannot remember who first coined it.)
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Suzanne Reply:
May 17th, 2010 at 9:03 pm (Quote)
I totally agree. I am certain I felt my pelvis expanding while I was pushing my last one out (2 lbs bigger than my next biggest brother), and while it seemed to take much longer for things to settle back in place, it’s pretty awesome that our bodies come equipped to make those sorts of adjustments at the very last minute!
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Sarah Dorrance-Minch had this to say,
May 17, 2010 @ 8:57 pm (Quote)
What is it about the magic seven pound figure, anyway? “You can’t VBAC any baby that weighs more than seven pounds because (pick one)
1) Your pelvis is too small
2) Your pelvis is unproven
3) Your uterus will rupture
4) Your baby will be macrosomic
5) Your baby will be at risk
6) It’s my policy to never allow VBAC over 7 lbs
7) It’s hospital policy to never allow VBAC over 7 lbs…”
Got any more, add to the laundry list.
Seriously. It’s like seven pounds is some kind of magic lucky number or something. And it’s BS, because most of these OBs have no intention of letting a mother VBAC anyway, regardless of the size of the baby. So why not just cut to the chase?
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Jena Reply:
May 18th, 2010 at 4:34 am (Quote)
Especially when you consider that even ultrasound has a -notoriously- vast margin of error for measuring (estimating) the baby’s weight. And 8 lber could measure as 6 and vice versa. It’s wholly arbitrary, just to give them a place to stand on the foot they don’t have to stand on.
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Jen in ND Reply:
May 21st, 2010 at 7:27 pm (Quote)
What irks me is when they are afraid to let a (VBAC or otherwise) mom go past 38 or 40 weeks because the baby will gain 1/2# per week. Um.. last time I checked it wasn’t 1/2# of head or shoulder circumference, but rather, fat, which squishes.
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“You’ll never get a baby bigger than 7 pounds out of there. Your pelvis is just way too tiny.” – OB to mother attempting to have a VBAC.”
How about this doc.. “Your mouth is just way too tiny for that much b/s to come out of there.” Mother to OB who attempted to discourage her from VBAC
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 5:22 pm (Quote)
Yeah, it’s a miracle he managed to get his foot so far in.
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I think we have to understand the context from which she is coming from.
First, I do think its wrong to say you’ll NEVER get a baby out of there. The human body is an amazing thing and is to not be underestimated.
Secondly… maybe the woman did have an extremely small pelvis (like I do), and delivering a baby VBAC would be potentially dangerous. I have a small pelvis, and delivering my 5lb baby was very hard. I pushed for almost 3 hrs. The nurse definitely needed to use more tact with her statement, but I think her intentions were pure. VBACs are dangerous and I know first hand that L&D nurses first priority are the VBAC patients. A ruptured uterus can be fatal to mother and child. ANY small signs of complications raise red flags, and I guess the small pelvis was a small sign of complication to this particular nurse. Maybe she was erring on the side of caution?
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Sarah Dorrance-Minch Reply:
May 19th, 2010 at 9:42 am (Quote)
Maybe, but it’s statistically highly unlikely. If you’ve had an accident that shattered your pelvis, or if you have serious pelvic abnormalities due to ricketts or some other disease or problem, or if you are a little person (I was told the terms “midget” and “dwarf” are insulting) AND MARRIED TO MICHAEL JORDAN OR ANDRE THE GIANT while being said little person, yes, there might be a problem with cephalopelvic disproportion.
However, simply carrying a Big Baby (TM!) and having a massive fundus are not sufficient reason to “err on the side of caution” and cut just because there may be a slight possibility of uterine rupture or shoulder dystocia.
Because the possibility is so slight as to be ludicrous, especially if one follows the midwifery model of care rather than the disaster scenarios modelled on Discovery Health and feared by obstetricians and LDRP nurses everywhere.
If the mother is petite and/or looks to be carrying a large baby, there are a couple of common sense protocols to follow to avoid complications.
First: don’t get aggressive with the pit drip, and certainly don’t use Cytotec. In fact, induction and augmentation should be avoided. The tetanic labour pains of induced/augmented labour are generally what causes rupture in the first place. It’s very avoidable. Sometimes labour has to be induced due to a true emergency – say, preeclampsia that does not respond to the Brewer diet or other treatment – but most inductions and augmentations are the result of that ridiculous institution known as “active management of labour.”
Second: let the mother birth in a position of her own choosing, which will probably be a supported squat or on all fours. This widens the pelvic outlet considerably. In fact, in cases of shoulder dystocia, midwives move the mother into an all-fours position, a technique called the “Gaskin Manouvre.” Google it.
Another two disaster myths of obstetrics: busted. (Or at least, sometimes plausible, but highly unlikely most of the time.)
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Sarah Dorrance-Minch Reply:
May 19th, 2010 at 10:07 am (Quote)
PS. It’s very unfortunate that you trusted the professionals when they told you that VBACs are dangerous. Statistics show that they are FAR less likely to result in death of mother or baby than c-sections (repeat or otherwise). I strongly recommend the ICAN website (International Caesarean Awareness Network – http://www.ican.org) for more information about the relative safety of VBACs to surgery. Also you might want to read _Open Season_ by Nancy Wainer Cohen, _The Thinking Woman’s Guide To A Better Birth_ by Henci Goer, and _Born In The USA_ by Dr Marsden Wagner, who was once the head obstetrician for the World Health Organization and therefore ought to know a thing or two about when c-sections are necessary and when they are not. He strongly advocates VBACs.
Third myth: busted.
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Kayla Reply:
May 21st, 2010 at 8:34 am (Quote)
Thank you for your comment. I guess the only reason that I think VBACs are dangerous is because my mom died giving birth to me… It was a VBAC. Please don’t get me wrong. I’m NOT against VBACs and advocate them too, for the right person. My mom (who I’ve never met) wasn’t the right person OR just didn’t have the right care (that was over 20 yrs ago) and so I guess that’s why I personally err on the side of caution, and am glad that doctors, nurses and health care professionals weigh the risks/benefits of a vbac delivery. However, I wholeheartedly agree with you that pitocin/augmented labor now increases vback risks AND agree that VBAC would be the way to go vs another unnecessary C-Section (for the right person of course).
I was glad the OP posted. I just simply added my statement because I think VBACs should be considered using caution, as I did lose my mother to one, which maybe could’ve been avoided. You seem very educated on the subject. Thank you for your comment! My next birth I hope to use a different laboring position, maybe that will help with my small pelvis. I never thought of that.
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CCindy Reply:
May 21st, 2010 at 9:12 am (Quote)
Kayla I’m so sorry you lost your mother. My own daughter lost her original father before she was born. I can understand why you might shy away from VBAC. I shy away from a certain brand of car and not wearing seatbelts. Please keep reminding yourself that 3 times as many women die of c-section than of VBAC (based on percentage not occurances per year.) The risks aren’t as high as most people think. You are not erring on the side of caution. You (and many OBs) are letting emotion, fear and paranoia influence you. Facts are facts and VBAC is safer unless a real medical emergency arises. VBAC should always be the first choice. And always wear your seatbelt.
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Jane Reply:
May 21st, 2010 at 9:59 am (Quote)
I’m sorry for your loss.
Here’s a thought: one of the things every one of us on this board wants is for women to have the best possible birth for them, and one of the key ways a woman can have the best possible birth is by being relaxed and trusting.
If the thought of a VBAC leaves a woman unable to relax and untrusting, then a VBAC is not going to be her best possible birth.
There’s no need to explain, no need to defend. The thing every birth advocate wants is for women to have access to the best possible birth for themselves and their babies: hospital or home, vbac, hbac, unassisted, or cesarean.
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Michelle Potter Reply:
May 19th, 2010 at 3:49 pm (Quote)
I’m so sorry that you had such a difficult time birthing your baby. I hope that, if you have another baby, any factors that might have contributed to your difficulty — such as being induced or augmented, pushing on your back or any other position that narrows the pelvic outlet, or the baby being in a difficult position — will not be present so that you might have an easier birth.
I’m also very glad that you had supportive and caring nurses during your VBAC. Many women are not so fortunate.
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Sarah Dorrance-Minch Reply:
May 20th, 2010 at 6:42 am (Quote)
What she said.
I probably came across as a little judgmental – I’ve been told I do, especially when I have a mad-on regarding the obstetric establishment – and such was not my intent.
It sounds like you trusted your care provider deeply, and I’ve noticed on other mothering/parenting type boards that many times, women are often loyal to a fault to care providers, especially if they have had a long-standing, stable, familiar patient/client relationship, and that can be a good thing because a healthy, friendly relationship with a care provider makes routine visits go more smoothly, and when there is a crisis or illness to take care of, it even makes healing easier. Our attitude affects our general health; the mainstream medical profession is finally learning to acknowledge this.
However, I often encounter statements like “I definitely support home birth, I’ve read the statistics, it does sound very safe and seems a lot happier all around and it’s a really tempting idea, BUT I personally feel better seeing a doctor rather than a midwife and would rather give birth in a hospital, because something might go wrong and I feel doctors and hospitals are just safer.” Also, frequently, “I think the rate of c-sections in this country is ludicrously high, most of them probably are unnecessary, birth is a natural process and there’s no reason to interfere with it or manage it unless there’s a life-threatening emergency, and most of the cases of suspected foetal distress sound, in retrospect, to be paranoia from continuous monitoring providing false positives, or the result of botched inductions BUT I know my own c-section was absolutely necessary because my doctor told me so. I’m only five feet nothing, and the baby was eight pounds, and my doctor said there was a drop in the heartbeat showing up on the monitor, anyway, and that one or both of us could have died. Which is why I won’t be trying a VBAC with my next birth, either.”
There seems to be a disconnect between what we read and what we feel.
It worries me that we, as expecting mothers, are all too often exploited for what we feel.
It could be argued that in birth, we all become warriors, discovering our inner strength – and certainly, that suits my temperament. If I were a dog, I’d be a Jack Russell bitch terrier with an attitude problem. But not all of us are like that! Temperament is not one size fits all, any more than birth is, and many women do NOT warm to the amazon-warrior image, in birth or in any other situation.
It isn’t right that to have a safe birth, a birth that is not only safe but is something other than torment and emotional hell, we ALL have to act like warriors. That is unnatural. And isn’t birth supposed to be natural?
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Mama Mirage Reply:
May 20th, 2010 at 8:03 am (Quote)
So so true! I hear these things so often as well.
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CCindy Reply:
May 21st, 2010 at 6:13 am (Quote)
Dear Kayla,
Please scroll down to get the context. Women don’t send these quotes in just for the heck of it. The woman who sent it in knew the context before she spent the time to write it up. She had two more babies vaginally! This doctor was full of it in this case and in most of the cases posted here. Thus that is why the moms it happened to or others in the room at the time who know how it all turned out send this stuff in.
Dear MOBSW people,
Could you give the OPs an opportunity to be the first post somehow? We would love to get the rest of the details up front if at all possible.
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Don’t worry, lovely people – I DID have that VBAC, went on to become a doula, and birth 8# 8oz. and 9# 1oz. babies outta that “tiny” pelvis! You will laugh when you hear what my first words were after VBAC #1 popped out.. “CPD my @$$!”
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Sheva Reply:
May 20th, 2010 at 8:33 pm (Quote)
So were you the Poster?
I love your post VBAC comment! Well said!
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CCindy Reply:
May 21st, 2010 at 6:07 am (Quote)
Yeah! “CPD my a$$!” Can you get that made up into T-Shirts, bumper stickers and buttons?
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Sarah Dorrance-Minch Reply:
May 21st, 2010 at 6:41 am (Quote)
Put it on Cafe Press and I’ll probably buy it when I actually have disposable income. (Which means February; we only have petty cash in this household once per year, and that’s at income tax refund time.)
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Michelle Potter had this to say,
May 19, 2010 @ 6:35 pm (Quote)
Katie, I’m on my phone, so I can’t reply directly to your post (comments aren’t threaded in the mobile view), so I hope you see this.
I never suggested that your hip is some kind of punishment. How could it be? I only said that when our bodies work as intended, there is no need to try to “fix” or “improve” them. No matter how much doctors think they can “fix” a healthy, normal birth, they can’t and don’t need to. Their meddling makes things worse.
But when our bodies don’t work as intended, the fact that medical science can often help is a wonderful blessing. I’m incredibly grateful that doctors can fix so much that might actually be wrong with us! And no, I can’t imagine why that would be somehow “cheating” God, or why He would disapprove?
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lighting wholesalers had this to say,
Nov 24, 2011 @ 5:06 pm (Quote)
hybrid cars would be the best thing because they are less polluting to the environment~
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Imagine if this was directed at anyone else, in any other situation. Discrimination. Sexual harrassment. LAWSUIT.
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