I see this many, many times -- dysfunctional labor with a posterior/asynclitic positioned baby. Labor drags on and on. Sometimes, the provider is relaxed enough to not jump the gun on calling a c-section for FTP, and "allows" the labor to continue.
Eventually, the woman gets to 10cm. Baby is still posterior/asynclitic. Urge to push commences, and the pushing stage begins. She pushes, pushes and pushes, and the baby barely budges.
Will the baby fit?
We change her position frequently to help facilitate rotation and descent.
Pushing continues.
There may or may not be some pitocin infusing. Most women have an epidural long before this point.
The doc comes in, tries a vacuum. It doesn't work. Doc recommends a c-section. The woman and her husband refuse the c-section. They would rather keep pushing and changing positions. (Thank goodness for a good nurse when this situation happens!)
Lo and behold, but what happens?
Most of the time, vaginal birth just isn't in the cards. Proceed to a c-section. Not always so........believe it or not, I've had some births that follow this exact same scenario, and after a failed use of a vacuum, the woman is able to push her baby out spontaneously.
Tearful cries of joy abound!!! The baby is here!! No shoulder dystocia, great apgars!! Baby lies skin to skin with mom, and nurses like a champ.
All in a day's work.
