Re: episiotomy and shoulder dystocia
From: Jennifer Hali Enoch (jenoch@indiana.edu)
Wed Apr 30 17:54:34 1997
I expect Margie really has been there. I've seen SDs with fetal injuries
with no episiotomy, no fourth degree tear either. One was seven minutes
from birth of the head to birth of the whole body; the midwife used
several maneuvers; baby was born with a dark purple head, white limp body
and needed resus; baby had a broken arm, client had a first degree tear.
It is possible to resolve SD with the client having an intact sphincter,
even an intact perineum.
Jennifer Enoch
midwife
On Wed, 30 Apr 1997, Ronald Helm wrote:
> Sorry Margie, tight shoulders, no permanent Erb's palsy, no fetal injury,
> no Zavinelli maneuver, does not make a "true" shoulder dystocia. Someone's
> sphincter has got to go in the case of "true" shoulder dystocia, be it the
> provider or the "client", as the midwives so love to say. Until you have
> really been there, your comments will be judged accordingly. Ron
>
> ----------
> From: Margie Dacko[SMTP:dacko@bighorn.accessnv.com]
> Sent: Wednesday, April 30, 1997 11:07 AM
> To: Multiple recipients of list
> Subject: RE: episiotomy and shoulder dystocia
>
> Sorry Ron, but I have had "true" shoulder dystocias and I have also
> never had a third or fourth degree episiotomy or laceration from the
> dystocia or from the maneuvers involved in resolving the dystocia,
> and usually it has been with an intact perineum. It can happen!
>
> Margie Dacko
> Midwife
> Las Vegas, NV
>
> On 30 Apr 97 , Ronald Helm wrote:
>
> > It is obvious to me that you have never had a true shoulder dystocia if
> you
> > have never had a third degree, and have delivered them all over an intact
> > perineum.
> >
> > Ron
> >
> > ----------
> > From: FlynnCNM@aol.com[SMTP:FlynnCNM@aol.com]
> > Sent: Tuesday, April 29, 1997 9:47 PM
> > To: Multiple recipients of list
> > Subject: Re: episiotomy and shoulder dystocia
> >
> > >How many of you feel that episiotomy is actually of any benefit in the
> > >management of shoulder dystocia ?
> >
> > Not me if it's true SD (i.e. bone on bone problem). Might help with
> tight
> > shoulders (soft tissue problems), but I haven't had to do one yet. Never
> > had
> > a third, and usually get them out intact even with classic turtle sign,
> > etc.
> >
> > Cynthia Flynn, CNM, PhD
> > Private Practice, Kennewick WA
> > FlynnCNM@aol.com
> >
>
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> end
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