A few more details, please, @Seek_Kolinahr – do you know how many minutes passed between the baby’s head and delivery of the shoulders? If you don’t, request a copy of your hospital records so you can review the delivering doc’s dictation. After shoulder dystocia, the note will usually estimate the number of minutes along with a subjective assessment as to whether the dystocia was mild, moderate or severe. They’ll describe in sequence what they did to resolve the dystocia.
It’s useful to know is what manuevers and how many it took to get the baby out. If all they had to do was McRobert’s bringing your knees as close to your ears as possible to open up the pelvic bones a bit more and it took 1–2 minutes, that’s a mild dystocia. If they tried that first, then flipped you onto your hands and knees or had to reach inside to deliver the bottom shoulder first or had to do what’s called a Wood’s screw or tried to break the baby’s clavicle, it was a more severe dystocia. If the baby needed a lot of help to get started breathing after delivery, it was probably a more severe dystocia.
It’s really unfortunate that you didn’t have your midwife with you. It sounds like you were planning a home birth with a DEM direct entry midwife? I can tell you that in my community, most DEMs accompany their clients to the hospital as a doula/labor support person in the kind of situation you describe. Depending on the previous encounters between individual DEMs and the local docs, interactions can be tense or collaborative.
If you were coming into the CNM certified nurse midwife practice here in my community, they’d be getting records from your first birth. You would probably have at least one consultation appointment with one of the obstetricians to talk about your last birth and about pros and cons of different birth plans including scheduled C/S, or induction at term to try to keep the baby at a more reasonable size. You’d have an ultrasound about a month before the due date to get an estimated fetal weight and they’d be particularly interested in the ratio between the baby’s head and shoulders big shoulders increase risk of dystocia. If you decided to try for a vaginal birth, you’d have the CNM with you for labor and the OB on call would most likely come in for the delivery and be ready to step in and help if there was another dystocia. They would not want to do a vacuum or forceps to avoid a repeat of your last birth.
I hope this helps. I have seen women with a history of a shoulder dystocia have a normal vaginal birth next time around.