Tuesday, March 29, 2011

Our Bodies are not Defective: A Compilation on CPD

Anatomy of the Pelvis:
Cephalopelvic Disproportion (CPD) is a condition that does exist, although it is quite rare in developed countries. CPD is generally diagnosed in women who were severely malnourished as children, people who experienced trauma to the pelvis such as in a car accident or in women with congenital bone conditions.

It is also loosely connected to *untreated* Gestational Diabetes, although the details of that issue are hotly debated and based on numerous factors. (Meaning, a simple diagnosis of GD does NOT guarantee CPD or macrosomia).

Unless your doctor ordered specific tests to measure your pelvis such as x-rays, he was speaking with opinion and not authority on whether or not your pelvis was appropriately formed to birth a baby.

More common reasons for failure to progress and a false CPD diagnosis include:

1) A time restriction was placed on a normal labor that would have ended normally if left alone. Recent findings suggest that impatient care providers lead to increased numbers of c-sections. http://www.sydneymidwife.com.au/2010/10/impatience-with-labor-low-vbac-rates-tied-to-c-section-increase-study-finds/

2) The baby was positioned differently and required additional time to mold and move down the birth canal. See http://www.spinningbabies.com for ideas on how to determine your baby’s position and encourage optimal positioning for birth.

3) The cervix might have been scarred from previous procedures such as a LEEP, IUD insertion or a D&C. This article breaks the silence on cervical scarring: http://birthfaith.org/midwives/cervical-scar-tissue

4) A very new idea that I heard from a midwife is that babies with certain conditions which might be called "autism" or some other form of ASD or sensory disorder might have difficulty "mapping" the pelvis efficiently. They tend to become asynclitic (tilt their heads), which increases the length of labor. In general, other situations such as a short cord, Down Syndrome and more can also impact the pattern of labor.

5) The mother might have over or under developed muscles and ligaments due to certain exercise routines (particularly if you were a gymnast or runner or did a lot of rowing) resulting in an imbalance to the round ligaments and pelvic bowl. You might also have damage to the ischial spines/sacroiliac joints, which need to move outwards towards the end of birth for the baby to descend. In this case, chiropractic care before and during labor and changing positions can help.

The American Pregnancy Association provides excellent information on choosing a chiropractic provider and the benefits of chiropractic here: http://www.americanpregnancy.org/pregnancyhealth/chiropracticcare.html

6) A previous history of sexual abuse (or any abuse) can impact birth. Feelings of fear, pain and panic can resurface, causing an adrenaline rush, which stalls labor. If you are an abuse survivor or currently experiencing abuse, share this with your care provider and brainstorm ways to avoid triggers. Things such as being restrained and pelvic/cervical exams are NOT required and can be avoided to provide a peaceful, healing environment.

Here is a paper on birth and abuse:

On vaginal/pelvic/cervical exams:

Tons of info on stalled labor:

This list is not exhaustive. Every woman’s body and every woman’s birth will be different. If no red flags are present during labor, than a long labor and/or slow progression might be normal for YOU. But even if a long labor is simply a variation of normal, it does come with specific considerations.

Longer labors can increase your chances of becoming fatigued, dehydrated or overwhelmed by the contractions. Fearful or poorly committed care providers might also lose faith or interest and create a sense of panic or failure, which can spiral downward.

Links that might be of interest for those with longer or slower labors:

Waterbirth and pain:

Pain relief methods:

Renowned midwife Gloria Lemay talks about appreciating the different pelvises of women. We come in all different sizes and shapes and should not experience discrimination in birth anymore than in the rest of our lives: http://www.midwiferytoday.com/articles/pelvis.asp

Gloria also has an excellent video review here:

Being pressured to consent to an ultrasound to monitor baby's size? Doctors find ultrasound inaccurate:

"An ultrasound diagnosis of fetal macrosomia at term is inaccurate in the majority of cases, and this inaccuracy may be contributing to unnecessary cesarean deliveries, new data suggest."

Did someone hastily diagnose you with CPD? Here is the truth about CPD:

Question CPD. A video about women who were wrongly diagnosed with CPD and went on to birth babies normally (even bigger babies in many cases):

Healing from a cesarean surgery? Join ICAN for community and information:

My first birth: here is my 11lb, 4oz daughter born asynclitic/transverse face presentation at home after about 3 days of labor.
My second birth: here is my 10lb, 2oz son born Occiput Posterior at home after about 7 hours of labor.

My third birth: here is my 11lbs, 7oz son born asynclitic, rotating from OP to anterior after about 5 hours of labor and 3 pushes.

My fourth birth: here is my 10lb, 1oz son who turned from posterior to anterior before
basically flying out of me from negative 1 station in a matter of seconds after about 3hrs of labor.

1 comment:

  1. Beautiful children. These pictures are amazing. Congratulations on your commitment and births.