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This Sister Wives home birth sounds painful... for the baby

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Birth can be scary and downright difficult in even the very best-case scenarios. Even when labor is progressing normally and the baby makes its appearance on cue, it's normal to feel freaked out before and during the process and exhausted afterward.

When something happens to complicate delivery, the situation can become pretty frightening. Add in a home birth — a growing but not quite mainstream practice — and a broken bone, and you've got the gist of what happened on Sister Wives last night when Robyn gave birth to her daughter, Ariella.

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Ariella, who was born in January of this year, had something of a bumpy entrance into the world, largely due to the fact that she became stuck in the birth canal, a complication called shoulder dystocia. In labors with shoulder dystocia, the baby's shoulders don't deliver right away when one becomes caught on the pubic bone. It's considered an emergency, since the umbilical cord can become compressed in the birth canal and cut off the oxygen supply to the baby. To free little Ariella, Robyn's midwife, April, snapped the baby's clavicle, a move that has a lot of fans cringing.

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Shoulder dystocia can turn a run-of-the-mill birth into a pretty high-stakes one, which can be scary if you're far from a hospital at the time. If you're planning a home birth like Robyn, you should know how a complication like this can affect you and your baby.

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There really isn't a way to predict whether your labor will be obstructed ahead of time. There are a few common risk factors, like obesity, previous labors with shoulder dystocia or a big baby, but ultimately there's no way to know until it happens, which is rare — about 0.7 percent of vaginal births.

If your baby becomes stuck, the first thing you'll be asked to do is stop pushing. Then, with assistance from other health care professionals, a slew of maneuvers may be attempted to free your baby and get things moving again. Externally, pressure can be applied above the pubic bone, or a position that widens the birth canal could be enough to jump-start the process. Failing that, you may be asked to get onto all fours, or your midwife may attempt to manually free the shoulder. At this point, if the baby has not been delivered, it's usually recommended that you call an ambulance and get to the hospital as soon as possible. Breaking the clavicle is considered a move of last resort.

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As frightening as a broken clavicle sounds, the complications that can result from a labor obstructed by shoulder dystocia if the baby isn't freed in time can definitely be worse. That includes injury to the brachial plexus nerves that run from neck to shoulder, hypoxia and death. If you're worried about or have an increased risk of shoulder dystocia, you'll want to talk to whoever is assisting your birth, whether it's an OB-GYN or a midwife. But if you know you're giving birth at home, it can be well worth the peace of mind to have a plan in place or to know precisely what your midwife's plan is should complications arise.


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