I carried all of my children high until I was well into labour. My first was an emergency csec after 15hrs of labour. I was examined at 6am in the morning when the fetal distress was (supposedly) detected and was told the baby was still high at 7cm that I needed the csec done immediately. It then took another hour and 45mins before my son was delivered (so much for emergency - just as well it wasn't true distress). My dh took photos of our son at the birth and he had very distinctive head moulding and a head circumference of only 33cm. My OB told me that I probably had too small a pelvis, a diagnosis supposedly confirmed by the pelvimetry he gave me at 6 wks post partum. I showed the photo to a friend of mine who is a midwife and she told me that the sort of head moulding my son had was indicative of a baby pulled back out of the birth canal. Chances are that at the time they finally got around to cutting me I was actually fully d! ilated with the baby moving down to be born.
With my 2nd and 3rd children I also carried very high and my children did not descend until 2nd stage. I made the mistake of asking for ARM with my 1st VBAC at 7cm and this caused my dilation to regress back to 4-5cm where I sat for the next 8hrs. Fortuneately I had a very hands off OB and eventually after 27hrs of labour my son was born with no assistance what so ever and a head measurement of 38cm (that should not have fit according to my 1st OB).
With my 2nd VBAC I went totally intervention free, and specifically stated my waters were not to be ruptured. Again this baby was high and did not descend until 2nd stage. As I was birthing her the waters preceeded her head during 2nd stage and only ruptured as she crowned. Labour ws 4.5hrs, she was 9lbs (biggest of the lot) with a 36cm head.
In my case I do not know why I carry my babies high but I do know I can birth them. I could have birthed my first one too (and was probably half way to doing so) if my OB had not been so quick to diagnose fetal distress (probably transitory given bubs high apgars after despite the delay it took from diagnosis to surgery). However what I did learn from my 2nd birth is that I need to keep my waters intact. It is these that lead the way for my high babies, and that dilate my cervix, rather than the pressure of bubs head on the cervix.
I agree with Caroline, the OB your friend has sounds like a high interventionalist one. If she really wants a natural birth I would ditch this guy and go public. Get herself a good doula or midwife support person and labour at home for as long as is possible. It may seem difficult to ditch the doctor at this late stage but she needs to think what her needs are and if he is not meeting them then he is not the right practitioner for her, and he will get over being dumped (I know I dumped one of my OBs during my 2nd pregnancy).
In my experience and from what I have heard is that once an OB starts talking about a csec it usually becomes a self fulfilling prophecy - not necessarily because the mother cannot birth, but because the OB orchestrates (possibly subconsciously) interventions, time limits etc that set the mother up for failure to meet his strict birthing criteria and then pressure on her while vulnerable in labour to have that csec that he told her she should have had before labour started.
I hope it goes well for her
Debby
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