Questioni had a emergency c-section 3 years ago for a couple of reasons. my son had been stressing, dilation was not progressing from 4 1/2cms, and someone mentioned my birth canal was to small for my small 5pound 14oz. son to make it through. i am pregnant again is there a chance that it hasnt grown and i may have to go through another c-section?
AnswerFirst, if you only dilated to 4.5 cm, nobody has any idea if your baby would have fit or not. A diagnosis of true CPD (cephalopelvic disproportion, where the baby is too big) can only be made after dilation is complete and pushing has been attempted with no progress. In the absence of physical deformities in the mother, such as scoliosis, rickets, or pelvic fractures, it is vanishingly rare for a woman to grow a baby she cannot birth. However, by following the generally accepted model of birth in hospitals today, even a woman with an ample pelvis can have trouble delivering a very small baby. Positioning is everything. A baby and mother in the proper positions can birth easily even when the mother is small and the baby is big.
If you were laboring on your back in a bed, if you were induced, if you had an epidural, if your son was in the posterior (sunny-side up) position, if your water was artifically broken...ALL of these things can cause problems during birth, and it has nothing to do with your size. Laboring on your back or in a reclining position compresses your pelvis by 15-30%, and also causes your tailbone to curve inward and create a bony obstruction to the baby's descent. Induction of labor has a failure rate of up to 60%, depending on the methods used, because you are trying to force your body to release the baby before it's time; naturally, your body will do its job by trying to keep the baby in. An epidural can cause a variety of problems, including fever, slowing of labor, and stress in the baby; it also forces you to remain in suboptimal positions in bed, where gravity cannot help with dilation and descent. A baby in the posterior position has their forehead or the top of their head pushing against the cervix; since this part of the head cannot mold and shape like the crown of the head, posterior babies can take longer for dilation and much longer for pushing, and are much more likely to get stuck. Breaking your water artificially releases the fluid cushion around the baby and reduces the baby's ability to move around into a better position, effectively locking your baby into whatever position he falls into whether it's good or bad.
All of these things can be corrected, though. Many, many women have gone on to VBAC babies who were much bigger than their c-section babies. You can see a video about this at (cut and paste link):
http://www.youtube.com/watch?v=roFVkDV45MM
You may want to consult with a midwife who will be more familiar with natural birthing techniques and can discuss with you in detail how you can prevent a recurrence of the problems in your first birth.
