# Ischial Spines



## Storm Bride (Mar 2, 2005)

When I went in to have Evan (scheduled c-section), I was in labour. The L&D nurse did a cervical check and I was barely dilated (contractions about 8 mins apart, lasting 25-30 seconds - very strong). I ended up the c-section, anyway.

But, when she did the cervical check, she said something I found interesting. She told me that I have very prominent ischial spines. I'd never even heard the term before, but I'm wondering what that would mean. She thought it may have been why my first two turned breech, and why Evan hadn't dropped.

Any input anybody?


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## darkstar (Sep 8, 2003)

You Ischium is one of three bone that create you coxal bone, also known as you hip. So you Ischial spine is the spine of the ischium, which connects to the pubis bone. I am taking Anatomy right now and have just learned about this.

















darkstar


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## Storm Bride (Mar 2, 2005)

Do you think they could be affecting the way my babies are positioned? This nurse was really great, but she's the only person who's ever examined me who has commented on this (between 3 babies, 3 miscarriages and fertility problems, I've had a _lot_ of checkups in this area).


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## Storm Bride (Mar 2, 2005)

*bump*

Haven't found anything about this elsewhere online yet - just wondering if anybody knows anything about this...


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## Jane (May 15, 2002)

The ischial spines are where "station" is measured from. If you have heard of 0 station or +2 station, it is in reference to these spines. 0 station means the baby is right at the spines. -2 is above the spines. +2 is below the spines (closer to the opening of the vagina).
The baby will pass between the spines on the way out. If the spines are prominent, that would mean they are pointy or stick out a lot. That DOES NOT mean that they are close together, though. There certainly are women who have pelvises that encourage their babies into a particular position - hence some of the women with repeat posterior babies. I have heard of women that have a uterine septum that always have breeches, but not from ischial spines. It's always possible, though.

If you have cesearians without labor before (an asumption based on your breeches, perhaps incorrect), you would probably labor more like a first time mom. Have a uterine scar can lead to slow, moderated labors that can be still be (Very, Very)painful, but have a slower dilation pattern - perhaps the body's safety mechanism or an artifact of the scar line?


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## Storm Bride (Mar 2, 2005)

My first was with labour - 20+ hours, and 10cm dilated when I arrived at the hospital. That's when they discovered he'd turned breech (frank)...definitely within the previous 48 hours, and most likely when I went into labour. Had I been a more experienced mom, I'd have known that it happened...his head definitely moved. They did that section as an emergency.

The second was without labour - I let them bully me into a scheduled section at 39 weeks, 2 days, because they discovered she'd also turned breech (footling).

My third wasn't breech, and I did have labour. It's a long story (and I've told it on these boards a lot), but basically I had the scheduled section, but went into labour the night before. Evan was head down when I went into OR, but I don't think he'd dropped at all.

I think the nurse was suggesting that the spines were getting in the way, but I don't know if that makes sense. I don't think Evan had dropped at all, and it would seem that the spines would only cause him to stop at 0 station, yes?


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## wasabi (Oct 12, 2004)

I think so Lisa. -5 is as high as they can be and be in the pelvis and that's still well above the spines. Not dropping doesn't mean he wouldn't have eventually dropped. Mine always drop during labor towards the pushing stage. It leads to a longer labor but it doesn't mean they won't come out eventually.


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## Storm Bride (Mar 2, 2005)

Uh, huh...I've alreadly concluded that I shouldn't have let them talk me out of waiting another day. I'm sure I would have had a vaginal birth (finally!!) with Evan, if I'd just stuck to my guns a little longer.

I don't think I'm having anymore, but I am scouting out the local midwife about a VBA3C, just in case. I didn't think I'd go that route, but if they're willing to take me as a client, I want to give it one more try...


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## Jane (May 15, 2002)

It's so hard to get that time. Since augmentation is not recommended, and the body sometime putters along on a slower path, it's doubly hard to get the time you need. They don't want to give copious time to women without scars, and they really don't feel comfortable giving it to women with scars.
Scouting out a midwife sounds like a great plan - even if you decide not to have another. Have you been in touch with ICAN in your area?


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## Storm Bride (Mar 2, 2005)

The midwife can't take me - I'm a "high risk" pregnancy. They can only do VBACs with one previous cesarean - not three.

I haven't tracked down ICAN yet. I may do that, or may not. I'm not very good with support in person from groups - I do better one-on-one or online.


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## Jane (May 15, 2002)

I understand the one-on-one thing. It's just that ICAN usually has someone who knows about providers - can separate the true help from the bait-and-switch ones.


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## hubris (Mar 8, 2003)

Quote:


Originally Posted by *Apricot*
There certainly are women who have pelvises that encourage their babies into a particular position - hence some of the women with repeat posterior babies.

That would be me! My first son was posterior and after his birth my MW told me that she had noticed that one spine seemed longer than the other. Nobody else has ever made that observation about me before (but then, how often do people palpate your ischial spines?) Fast forward 2.5 years to the birth of my second son...everything indicated that he was in a good positon for anterior presentation. The OB was sure he was anterior. But he came out posterior! We think he turned in the birth canal. I'm just beveled to give my boys a spin before they enter the world.


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## mwherbs (Oct 24, 2004)

pelvic shape can have to do with how babies position themselves to come out but your ischial spines would probably not have to do with a preference for breech-- a baby would have to be engaged- 0 station or even further +1 in order to figure out it did not want to be in that position-- preference for breech look at uterine shape is there a septum? I have looked in the very old books but have found nothing yet-- when docs did alot of pelvimetry was in the 1800's- early 1900's and that is where you might find someone with a theory of shape = birth position preference.


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