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To not understand the assault/internals threads?

(464 Posts)
GingerJulep Sun 21-Jul-13 00:04:18

I've never had one so am really struggling to understand how so many women on here (NOT aimed specifically at the other poster on this page, there are lots in different sections!) manage to have internal examinations before/during/after birth that they say they didn't consent to/asked to be stopped?

I mean that physically, don't they have the option to just shut legs/take feet out of stirrups/--kick HCP in face--?

Nearest I've ever come (so far, lucky me!) was someone trying to take blood suddenly... I made an automatic physical reaction (big flinch/jump) and they simply couldn't do it until we'd had a quick cat.

So, how much more difficult is it to avoid/stop internal exams if you really want to IYSWIM?

Carolra Sun 21-Jul-13 00:09:47

Lady I know consented to an internal. She did not consent to having her waters broken and her cervix pushed over the baby's head. Which is exactly what the midwife did during the "internal" without even telling the couple what she was doing.

Cherriesarelovely Sun 21-Jul-13 00:11:37

Well I've never refused one point blank but I did beg a Dr not to during labour. I agreed in the end but it was the 4 th in a few hours and bloody painful. When you are 9 mths pregnant, perhaps strapped to various monitors, in alot of pain it would be very hard to physically resist. Plus you can feel very vulnerable and as if you have no choice even if you do.

iamadoozermum Sun 21-Jul-13 00:12:49

Sometimes the way the HCP phrases it means that you don't realise that you can say no. E.g. "I'll just check to see how far gone you are", rather then "I think it would be good if I could check how many cm you are dilated because of X reason, will you allow me to do that?" I specifically put in my last birth plan that they midwife needed to specifically and clearly ask permission because the birth before that, the midwife didn't.

In the throes of labour, I found that the pain made moving difficult and so couldn't physically have stopped them. I had one internal that was very painful and I asked the midwife to stop and she goes "I'll be finished in a sec but I need to do this right now" and I wasn't in a position to get her out. It is easy to underestimate how vulnerable you feel whilst in labour and just after going against someone who has more power in the situation.

OldLadyKnowsNothing Sun 21-Jul-13 00:13:00

I've never wamted to stop an internal for whatever reason, but I gave birth to ds1 in stirrups; it's not so easy to take your feet out ir close your legs. (That's why they were invented, after all.)

Fakebook Sun 21-Jul-13 00:14:24

hmm.

You don't realise what's happening and it stuns you so you freeze up. I didn't particularly feel I could shut my legs or run away when there was a hook up my vagina scraping against the walls. hmm.

I had too many internals with my first baby and was told each time it was necessary. It wasn't necessary and I made sure I didn't have any with ds.

Eilidhbelle Sun 21-Jul-13 00:14:53

I'm no expert but I would imagine that during, or after, labour, a person is not physically able to push someone away, or 'kick (them) in the face'.

Not giving consent should be enough. What you're doing here, OP, is victim blaming. And that's horrible.

littlemissshittingit Sun 21-Jul-13 00:16:17

Can be. I had an internal in hospital as part of emergency treatment. The doctor forced my legs apart, over the bed's cot sides and forced a very sore intimate examination and treatment. I was crying, biting a paper towel for pain relief. I ended up bruised and bleeding because she was so rough. I had no choice because I was ill - but I did want her to stop. Difficulty is when you're frightened and in pain it's hard to be assertive, I just wailed that I was sore and wanted it over! .. Plus kicking her would never have worked given the fact that my legs were blimmin wrenched apart. I dont know if that was assault but it hasn't made future examinations/treatments easier to cope with.

In most cases though when I get internals - I've had over 50 - I flinch initally, spasm and pull myself backwards, most doctors instantly stop even if I dont ask them to. At least one refused to go any further. Most doctors are lovely if you explain your worries/fears - either not going ahead or if they must, going very gently and explaining everything, stopping for breaks etc which helps a lot.

Shiraztastic Sun 21-Jul-13 00:17:02

I have had my vagina swabbed by a gp without consent. I consented for a visual external examination. I was looking at ceiling and relaxing, when I felt a cotton bud inside me. I physically jumped.

I was not pregnant at the time btw.

Sometimes things happen so fast, or someone says they're doing one thing and does another. In my case I think it was just the next thing on the gp's checklist, only she forgot I didn't know, nor necessarily agree to her automatic next step.

GingerJulep Sun 21-Jul-13 00:19:50

Eilidhbelle that is absolutely NOT what I'm doing! And I'm slightly offended that you jumped to that conclusion.

What I was doing was asking a genuine (and as I'm now just a little past my due date and have specified no/minimal internals during labour potentially very personally relevant) question about something I know little about and was having trouble visualising.

To the other replies - thank you, that does indeed help me to understand a little!

INeedToKnow Sun 21-Jul-13 00:20:42

So it's my own fault.

A thread about a thread and a fucking vile and insensitive one at that.

Bogeyface Netherlands Sun 21-Jul-13 00:23:23

I have 6 children. With my eldest (DS1 in 1990) it was done to me, I was told "I am just checking your cervix" and then she was up to her elbow in me, no discussion. I didnt care at the time, but thinking back makes me shudder.

With DD1 (1997) I was "asked" but in a way that made it clear that "no" was not an option.

With DD2 (2001), DD3 (2004) and DS2 (2005) if an internal was needed they would say why, get everything ready and then say "are you happy for me to proceed?" they also asked throughout it I was ok and to to just say if I wanted them to stop. I remember it because with DD2 I was really surprised that they asked. With DD4 (2011) I was at home and only had one internal after me begging the MW to check, as it was my longest labour by many many hours! I think she knew I was happy to proceed!

My point is that that is obviously protocol now at my local hospital, and should be throughout all gynae type exams in all hospitals or GP surgeries. Funnily enough, that same hospital is on the list for investigation for having a high death rate, but that at least, they seem to have got right.

MamaChubbyLegs Sun 21-Jul-13 00:23:34

It's very difficult to close your legs or kick anything when you have an overly determined midwife wrist deep in your fanny with her fingers hooked inside your cervix, actually.

<traumatised> angry

Twirlyhot Sun 21-Jul-13 00:24:55

You are victim blaming.

'Don't they have the option to just shut legs'

Listen to yourself FFS

GingerJulep Sun 21-Jul-13 00:26:34

INeedToKnow please read my second post on this thread before jumping to that conclusion.

Fakebook Sun 21-Jul-13 00:27:24

Ginger, unfortunately it does sound like you're blaming the victim for not jumping up and away. It's a very naive statement you've made. It's good to know that you know you can refuse internals and have had a think about it with your first pregnancy. I knew nothing with my first. I kept taking the midwives advice which left me scarred for life. Not everyone is clued up or in the right physical and mental state to stop the internals from happening.

Bogeyface Netherlands Sun 21-Jul-13 00:29:15

I dont think the OP is victim blaming at all, she has never been that woman, as I and many of us were that had it "done" to us.

Its like someone saying "If my husband hit me even once I would leave" or "I wouldnt just lie there and let someone rape me". They say that because they genuinely dont understand what it is like to be in that situation and how they would react. They dont understand that if the man you have loved and been happy with for 20 years suddenly belts you one, you want to work out why, make sure it doesnt happen again etc. Or that when you are in real fear for your life, you will let someone rape you if it may mean that they wont kill you.

GingerJulep Sun 21-Jul-13 00:29:51

Twirlyhot likewise.

It was a genuine question about something relevant to my personal situation.

But on the plus side at the moment overly forceful HCPs are beginning to seem rather less scary than some of the MN posters so you have d0one something to alleviate my concern without any of the helpfulness of other posters!

Bogeyface Netherlands Sun 21-Jul-13 00:31:16

Sorry, submitted too soon.....

So the OP also doesnt understand that when you are in the most vulnerable situation that any woman would ever expect to be in through choice, that it isnt that easy to just "close your legs".
She doesnt know and I pray that she never ever finds out.

Twirlyhot Sun 21-Jul-13 00:31:51

I accept that you asked a question about something relevant to you without meaning to upset or offend. You have phrased it very badly and it is upsetting and offensive.

INeedToKnow Sun 21-Jul-13 00:32:20

INeedToKnow please read my second post on this thread before jumping to that conclusion.

I did and I still think it's vile, insensitive and blaming me however you like to dress it up.

maja00 Sun 21-Jul-13 00:33:35

It's really not that easy to just kick a midwife in the face if they are doing something you haven't consented to. Most people would say no or ask someone to stop first, and expect to be listened to. When you are emotionally and physically vulnerable kicking someone in the face isn't your first thought.

NotYoMomma Sun 21-Jul-13 00:36:27

the OP is in tgeform of a question and she made it clear she had never been in that predicament herself.

if she is pregnant with her first surely after reading some threads on here you would think 'hmm oh my god. how can it happen so often, could it happen to me? I could just shut my legs?'

so asking people with experience when you are worried is not tge same as victim blaming IN THIS INSTANCE imo.

when I had dd I knew absolutley sweet bugger all - I didnt realise you would bleed, I had never heard of anti D (thanks biology you mofo) and I CERTAINLY didnt know about internal examinations or your rights to refuse them etc, found out online!

as many of us do!

wigglesrock Germany Sun 21-Jul-13 00:37:16

Why didn't you just start a thread saying that you were a bit worried, confused re internals? In the title of a thread you specifically referenced a seperate thread where someone was asking for advice and support.

At the very least your opening post was thoughtless and insensitive.

GingerJulep Sun 21-Jul-13 00:39:00

Bogeyface is exactly right. I don't know. Which is why I asked.

If I knew/thought I did I wouldn't have posted the question.

I'd just be quietly and happily "blaming victims" by myself without giving my angry respondents the pleasure of venting. Go on girls (feel free, get angry about the gender assumption/diminutive terminology) enjoy yourselves! Just about cool enough to sleep here now so I shall look forward to your irate replies in the morning.

And to the genuinely helpful replies on here. Again, thank you. It is really helpful to hear other's experiences before contemplating facing something yourself for the first time.

BeaWheesht Sun 21-Jul-13 00:41:56

When I was in labour with ds the doctor told me she needed to do an examination, I said ok but not in the middle of a contraction - she literally then forced her hand up inside me whilst I was contracting, it hurt like hell and the midwife had to tell her to stop. I didn't complain (but did refuse her care from then on) and didn't push her off etx because my priority was having my baby safely and I wasn't thinking straight.

Twirlyhot Sun 21-Jul-13 00:43:06

There are people who don't have any more children after experiences like this because they can't face it and you post 'how much more difficult is it to avoid/stop internal exams if you really want to IYSWIM?'

You are at best thoughtless.

Bogeyface Netherlands Sun 21-Jul-13 00:44:13

Go on girls (feel free, get angry about the gender assumption/diminutive terminology) enjoy yourselves!

OP, I understand where you are coming from, I did and will defend but that ^ ^ ^ ^ really wont help your case. Just a word to the wise.

Bogeyface Netherlands Sun 21-Jul-13 00:44:49

Twirly no, she is ignorant. Long may she remain so.

notanyanymore Sun 21-Jul-13 00:45:58

Has anyone else not really cared though? I wasn't always entirely sure what they were doing down there but I thought it was something to do with the baby so was happy for them to crack on. Mind you my birth plan consisted of 'a baby at the end of it' for the first 2 and for the third I just added I'd like a midwife present for the actual delivery as she was off having a sarnie with dd2. Would have prefered her up to her pits in my cluf at that point tbh. (Not trying to be little other peoples experiences AT ALL btw, just wondering if I was a bit blasé?)

notanyanymore Sun 21-Jul-13 00:48:57

Actually I think I've answered my own question there, I wasn't bothered so it wasn't against my will.

When I was 16 weeks pregnant with my first, I went to hospital after vomitting pretty much for 7 hours straight and feeling horrid and a very vulnerable 18 years old. I was asked about doing a "swab". All the swabs I had in my life until then were external and they never said anything about it being internal. They asked my (built like a wall) partner to leave the room.

When it became obviously internal, I withdrew consent. I wanted to know why they were doing this (I'd already at this visit had my consent ignored about a blood draw). I said no very clearly and tried to sit back up and move away. I was then actually held down by two health care staff (I have no idea what they were, professionally, they weren't midwives or doctors, it was a gyno ward), and had a hard plastic cone shoved into me and...it was horrible. I normally have no issue with internals, this was awful. I was left surrounded by a lot of blood, hearing them talk about how they taught me a lesson. I can still hear it in my ears.

I was so ashamed I lied to my partner when he returned and didn't tell him the truth for over 6 years. I felt so violated. It effected all the later care I've had with medical professionals across my four pregnancies, I still can't go in without my partner at least in shouting distance.

And I was never given the results or the reasons for those tests. I almost miscarried.

Women have suffered horrible abuse at the hands of people who were suppose to care and you're response is to ask us why we didn't do something? You can be as offended as you like, how your attitude hurts women who have suffered medical violations hurt far more.

BeaWheesht Sun 21-Jul-13 00:50:04

Not blasé. I didn't care how many internals I had during my labours etc because presumably they were all needed. I fucking hated that doctor for forcing her arm up during a contraction though and I also imagine if you've had previous issues / abuse etc it could well be very very traumatic.

notanyanymore Sun 21-Jul-13 00:53:20

littlesporks thats a truly horrific story

Bogeyface Netherlands Sun 21-Jul-13 01:11:30

To be fair to the OP, did any of us get it until it happened to us? I think mine is the least traumatic story, and yet it still makes me shudder because I know it was wrong.

If someone had asked me before I had DC1 what I thought I would do if I was internally examined against my will, I am sure that my answer would be very similar to what the OP said, and would bear no resemblance to what actually happened.

Wouldnt you who have been through it have said the same?

I think the issue here is the wording of the OP, not the Q she has asked.

GettingStrong Sun 21-Jul-13 01:20:36

Message withdrawn at poster's request.

StuntGirl Sun 21-Jul-13 01:23:28

Your assumption that it wouldn't have happened had the women 'just done x' or 'just said y' puts the onus for the assault on the victim, and so yes, its victim blaming. Please choose your words more carefully in future if you wish to get advice and help from others who have experienced what you are fortunate to not have.

Eilidhbelle Sun 21-Jul-13 01:26:57

Bogeyface I'm eight weeks away from having my first (which I think explains the insomnia!) and I honestly don't know what I'd do if anything like that happened to me. I so hope I never have to find out.

I do agree though, the wording of the OP was horrendous. I don't think she meant to come across as unsympathetically as she did, and having read her updates, I think her question was a genuine one. But she's also not done herself any favours by not apologising when she clearly offended someone.

LittleSporks That's a horrendous thing to go through, I honestly have no words. Really, really vile.

Bogeyface Netherlands Sun 21-Jul-13 01:33:26

Stunt I think that had the OP said "Well, when that happened to me, I kicked them in the face/closed my legs/ screamed blue bloody murder, so you should have done the same" then yes, it would be victim blaming. But she didnt. She said that she didnt understand why people didnt do that. That isnt victim blaming, it is naivety and she has been reeducated. But I agree that an apology for her wording wouldnt go amiss.

The wording is a major problem, the refusal to apologize (and joking about it and playing the wounded party) even more so. Asking victims of violence "why didn't they just..." is pretty nasty and has commonly been used to beat and silence victims.

If I were asked, I probably would have said I'd cry loudly and my partner would stop it. Got the first part right at least, damn thick closed doors. I was silent during other mistreatment if he wasn't there, I'd panic so badly, I ended up putting please be nice to me and don't send my partner away on my birth plans I was so scared. But I had very little faith in people I didn't know not trying to dominate me and far less faith in my abilities at 18, so I'm probably not the person to ask.

If women can have sex and be raped with their legs together, I don't see how it could prevent an internal from a medical profession that has power over a vulnerable patient. Stirrups were designed to keep women were medical professionals wanted them - they were used on enslaved women to get the roots of most of modern ob/gyn knowledge. And very large pregnant women aren't exactly known for being athletic or fast, particularly during or after labour. In a medical professional / patient relationship, it's pretty much always the medical professional in control and has more power, more so in a vulnerable situation like labour. I just don't get how anyone can ask a victim why didn't they do something, even more so with so much stacked against them. Asking how to prevent, sure; asking if we'd do something differently, okay; asking if it's something particularly to worry, fine (No, it isn't Eilidhbelle, most professionals are fine - just people and most are nice but a few aren't, but keeping a person with you, getting professional's names, and making any fears clear to them has seemed to help and in the rare situations that it does happen it makes complaining a lot easier particularly from an emotional standpoint. I felt unable to complain as I didn't know anyone's name and I didn't have any witnesses). But to ask victims of medical violations why we didn't kick people in the face and run for it, and mocking people's pained responses, is just nasty. You're far nicer than me Bogey, I just can't get past the responses to being called out on the harm she's obviously done by being more hurtful.

I hope a nice medical person comes on this thread or if anyone else could tell me, I'd like to know what that white cone was. It was a thick plastic, it looked like a cone with the tip cut off, when they did the internal they obviously scraped well above the hole in the top. I've never seen anything like it before or since - even with three other pregnancies and pap smears, and I've always been too scared to ask cause just thinking about it has brought tears, and I can't remember if it was smooth or bumpy just a wide white cone missing the tip and after they pulled it out there was so much blood. I only went in with acute vomiting, no bleeding, I was told I just needed IV hydration, and I ended up losing so much blood and the pain, they ended up doing a scan to ensure I wasn't miscarrying. It was risky for a while, he's now thankfully almost 9. It was on an obgyn ward, because I was only 16 weeks, they called it a swab and I've had many internals since (and some before) without any problems, paps are a doddle for me, if someone could tell me what it was and what most likely they did - as I was never told, never got any kind of results from it and it wasn't included in my notes - I got all my notes from his pregnancy and there wasn't anything other than tests were done to ensure I was pregnant (blood were taken for it) - I would be very appreciative. At the time, I really thought they were trying to abort him they were so rough and so much blood and they said such horrible thing, it would be very nice to be able to put it to rest, if something like that every can be.

Oh, I've worked myself in such a state, triggers are such a nasty thing.

Mumoftwoyoungkids Sun 21-Jul-13 02:41:32

Go on girls (feel free, get angry about the gender assumption/diminutive terminology) enjoy yourselves!

Wow - you ask people to basically justify their behaviour during the most traumatic event of their lives and then post that?!? Seriously!?!?

I have never been examined against my consent but I can still understand how the situation can arise.

Firstly have you ever been in a life threatening situation? I have - you don't react the way you think you will. I look back on those occasions and think "What!?!?". The "fight or flight reflex does funny things to you. Evolutionarily it probably works best if you are being chased by a lion. It's not so great in a clothing fire.

Secondly it is very hard to overcome lifelong programming. We are all taught as children not to assault healthcare professionals, not to kick people in the face generally, that "no means no" and people will respect that. My mum once told me about a fire in a department store. On the top floor was a cafe. The sort of cafe where you pay the bill at the end. A large proportion of people in that cafe died in the fire - more than you would expect. It was felt that people wasted vital escape seconds once the alarm went off worrying about paying their bill.

If what you are really saying is "I'm about to have a baby and worried this will happen to me - how can I prevent it" then you need to apologise and explain this.

Bogeyface Netherlands Sun 21-Jul-13 02:46:52

Sounds like a speculum little I have had metal ones, clear plastic disposable ones and white plastic ones too in my career as a uterus owner. Although disposables are used now for smears etc, I found that the metal ones were less painful.

My heart goes out to you, I can see why you feel that you have no proof in order to complain but there are other ways of making sure no one else suffers as you did. When I suffered severe birth trauma (nothing to do with internals) I ended up talking to Sheila Kitzinger for hours at a time. She used what I told her in one of her books (Birth Crisis). She was very helpful and understanding, I am sure she would talk to you too. I can PM you the number if you would like.

courgetteDOTcom Sun 21-Jul-13 03:29:28

I didn't have to be raped to understand that when you're raped fighting them off is not that easy, neither did I have to be assaulted during a birth to know it either. Being in either situation didn't change that.

I was put in stirrups despite having long term pelvic issues. My doula threw herself across me and the midwife tried to argue with them. I tried to pull myself out but my legs don't work in that position. I was barely able to walk for weeks later.

My mum had her legs hoisted onto midwife's hips who then said "push" so she kicked her over. She wasn't in a difficult position to move in though and I doubt there's many who can do that.

I can understand what the OP is trying to ask, but it was an offensive way to ask and I really felt for INeed when I saw it.

When you are a first timer, you do trust the midwives to do their best because you have no experience to tell you otherwise. When I arrived at the maternity ward in labour, the midwife refused to give me pain relief until she did an internal. As soon as her hand went in it was extremely sore. I shouted at her to get out and she didn't. "Nearly done". I told my husband to pull her hand out but he deferred to the midwife's authority. Second time round, he knew that my request trumped any midwives' demands. But then I had the baby half an hour after the midwives showed up and they struggled to get my BP let alone in my vagina!

My top tip would be brief your birth partner on what is acceptable for you and make sure they will support you. Shouting at the HCP to stop does not mean they will unfortunately.

filee777 Sun 21-Jul-13 04:41:39

I had a doctor shove her thumb up my arsehole with no pre warning what so ever after I gave birth to my son. Fortunately I am not adverse to such things but some women may be sensitive in that area and doctors really should check!

BeyonceCastle Sun 21-Jul-13 04:48:13

OP

It is quite a simple explanation

I didn't want to die
I didn't want my baby to die

I was alone. I was terrified. I was vulnerable.
Childbirth/gynaecological smears etc are situations where you trust the professionals to know what they are doing and to have your best interests at heart.

It is also the strangest of situations where you are smiling at your aggressor because you feel utterly powerless and don't want them to let you suffer/get on their bad side when lives are at stake.

I have had smears - not pleasant. I have had internals - not pleasant.
I have had good midwives - trying to be gentle, reassuring, explaining
I have had bad midwives - ignoring my cries/pleas, brutal, 'practical' who treated me like a piece of meat.

With DC2 I had a midwife practically fist me.
With DC3 I was alone and a midwife basically said 'I am breaking your waters now' and it took her three times and was excruciating.
Same midwife said very dismissively 'yes,yes,yes' as I begged her not to let me die - was in labour with no pain relief, nothing and panicking.
Same midwife forced me into stirrup position to give birth in, gave me my son to hold whilst I was practically falling off the bed/waiting to have stitches done/still crying and then pressed down on my stomach so hard
I shrieked and scared my baby who then cried with me sad

Please tell me what I should have done in that situation?
No you cannot do an internal to see how many cm I am
No you cannot break my waters even though I am 5cm dilated
No you cannot push me into whatever positions suit you
No you cannot press down on my abdomen for the afterbirth

Then what?
I am sent home?
I end up with a synctocin drip?
I cause my baby to be starved of oxygen?
I develop complications?

I say no to all four and I give birth in an empty room if the midwife buggers off as I am not cooperating?

I reiterate:
I didn't want to die
I didn't want my baby to die

BeyonceCastle Sun 21-Jul-13 04:59:03

Littlesporks

Don't care whether it is unmumsnetty I am sending you hugs and brew
I hope someone medical is here in a minute to confirm whether it was a speculum but not sure whether that would bring closure or not.
Sounds brutal and vicious and am very sad and angry for both 18 year old you and you now.

xxx

garlicagain Sun 21-Jul-13 04:59:52

You poor woman, Sporks, how dreadful shock

I'm shocked & upset by many of the replies here already. I am also shocked, offended and angry at you, GingerJulep. Your wording in the OP is exactly what people say about rape victims, when victim-blaming. The reasons why women can't "just" prevent unwanted, forceful penetration during gynae processes are exactly the same, too. Your physical position is vulnerable because it prevents counter-attack. Once somebody or something is inside you, you can't do much because the risk of injury is so great.

I've never given live birth, by the way. I have been raped and I have submitted to a grossly invasive cap fitting - the woman was nearly in to her elbow, and just dismissed my protests.

You didn't even THINK about "why" - despite, evidently, having read some of the threads - and then chose to follow up with patronising put-downs. What effect d'you think you've had on women here? Have you enjoyed it? angry

BeyonceCastle Sun 21-Jul-13 05:07:09

OP

I am due my 6 weeks check next week. Last time around I refused to go for 6 months. I have to go next week as I had bright red bleeding lasting for four weeks and as I had tearing of vagina and rectum I need both checking.
My gynae is a nice enough guy - perfunctory but capable, tries to get everything over and done with as quickly as possible including dildocam and often has to get me to aid and abett the internal by having me put my fists under my buttocks so I am at the right angle.

All of which I am going to frigging hate.
According to you I can Just Say No.

Really?

Putting my health at risk puts my kids at risk.

I know you didn't mean any harm by your original post and you might think I am exaggerating or being a dramallama or have a low pain threshold or am not as assertive or as empowered as you to be able to refuse examinations.

But often it is not as clear-cut as that. I wish you the best if you ever find yourself in a similar situation. But I really really hope you don't.

courgetteDOTcom Sun 21-Jul-13 05:11:17

There's a good article that you might find useful for your partner to read, it's called Difficult Birth a Dad's Perspective, should be easy to find on a Google search. It'll help arm you against this kind of thing.

I totally agree with garlicagain.

Emilythornesbff Sun 21-Jul-13 07:57:31

littlesporks that sounds like a speculum.
I'm so sorry you were assaulted. That sounds awful.
Sorry to all of you who have been treated badly when so vulnerable.

I agree that OP was badly worded.

ThePowerof3 Sun 21-Jul-13 08:04:49

I had two lovely midwifes but v soon after a painful birth, v large baby and v large afterbirth Some random midwife came in and gave me a very painful internal to see if I needed stitches and I kept saying ouch and stop but she didn't and it did feel like an assault in the respect that my feelings did not count at all

Perhaps my post will be helpful to OP.

When I was pg with DC1, as part of having my history taken at booking it was noted that I had previously suffered a sexual assault and had ongoing PTSD as a result. Unfortunately my hospital deals with a lot of asylum seekers from a particular region who have been raped, so all their staff are very sensitive to related issues. A note was placed on my file that internals should be kept to a minimum.

Fast forward to 33w when I am getting strong contractions and they need to assess if I am going into premature labour. They very sensitively and calmly explain that a VE is needed to assess if my waters have gone etc. I consent, and they proceed very carefully - lots of information, confirming consent frequently, I'm holding DH's hand, and so on.

Suddenly I'm terrified. I don't kick, because I can't move. Like a rabbit in the headlights, I can't do anything. Eventually I manage to squeeze DH's hand hard and say very quietly "I don't like it, please stop".

They stopped immediately and left the room ASAP. I then screamed and cried for a long time, clinging to DH like the world was ending.

They did absolutely everything right, and I still had that very visceral reaction. If I'd had less sensitive staff, or if DH hadn't been there, I don't know how traumatic that experience would have been. Internals are a very intimate and disempowering experience at the best of times.

The trauma comes from your experience of the situation, not necessarily the bare facts of the experience itself. So if you've never been scared enough to have that extreme instinctive "fight, flight *or freeze*" adrenaline rush, you couldn't know how paralysing it can be. And if you haven't been in that vulnerable physical position compounded by fear for the life/health/safety of your baby, you won't understand how irrational and nebulous your thoughts and feelings can be at that time.

I'm not permanently traumatised by that experience, or by two subsequent vaginal births, but I can easily see how I could have been. That bad experience did teach me that if I said "stop" they would do, and that gave me the confidence to relax in later VEs, which in turn made them less scary, and as a result less uncomfortable and quicker.

Figgygal Sun 21-Jul-13 08:19:14

Must be a personal thing I've had them without pain worry trauma etc they're a necessary evil to be endured IMO

GettingStrong Sun 21-Jul-13 08:23:00

Message withdrawn at poster's request.

iamadoozermum Sun 21-Jul-13 08:25:02

Oh goodness, the fisting! After DS3, the midwife (who had been horrible throughout and I still hate 3.5 years later) said that she just needed to check whether there was any retained placenta because it had been ragged. What she didn't tell me was that this involved shoving her entire hand into my uterus and feeling around. It was horrific, painful but I didn't feel I could do anything about it and so just had to lie there until she was finished and hope it was over quickly. I had never had an entire arm up my vagina before, and hope never to again angry. I gave consent for the procedure, but it wasn't informed consent.

Bogeyface I love Sheila Kitzinger's work and have read "Birth Crisis", sorry that you had such an experience as to be included in her book but thank you for allowing your story to be written about to help others.

TweenageAngst Sun 21-Jul-13 08:26:35

I was induced with my first baby. I had a number of increasingly painful internals which I consented to, when labour started it went from nothing to defcon 3 in about 10 minutes.

I was being cared for by a lovely, kind, gentle but unfortunately newly qualified midwife who had to defer to a very cold, rough, brutal senior midwife who was supervising her.

My junior midwife did a painful internal but could not reach my cervix so asked the senior one to check for her. What followed traumatised me for a very long time, she just shoved her hand into me with no warning it was excruciating, she then without any form of consent or explanation ruptured my membranes. Threw her used gloves on the bed and walked out having never actually looked at my face or spoken to me.

About an hour later during the pushing bit she was called in again because of late deceleration's. This time she just snapped at the junior midwife pass me the scissors. I screamed dont cut me you bitch no I dont want an episiotomy. At this point my lovely midwife stood up for me and said I am sure she will deliver on the next push. I was determined to prove her right, older midwife just shrugged and said it will be her fault if anything happens to the baby. I put every ounce of myself into that next contraction and delivered without even a tear.

I said to my husband afterwards that I felt like I had been assaulted. I had been.

ANormalOne Sun 21-Jul-13 08:30:37

I don't want to go into too much detail as it's still pretty traumatic for me, I had a very fast unplanned home birth and ended up having to travel 25 minutes to the nearest labor ward post birth.

The doctor and nurses who looked after me were nice but seemed to be really busy and in a hurry.

I had to have stitches to close two tears in my labia, I had pre-warned them that I have a severe needle phobia and that I have issues with internal examinations for personal reasons. When it came to sewing me up they lied about how many needles I would get, didn't let me know what they were doing and started stitching me up whilst I could feel it.

I obviously got very upset and thrashed about almost kicked the nurse holding my leg in the chest, moved away from the doctor on the bed and begged them to stop, they spoke to me like I was a little girl who was just being silly, despite me telling them I could feel it, that I didn't understand what they were doing and they were going too fast for me.

Eventually my DM stopped them because I was howling I was that upset, they agreed to stop and give me pethidine and give me some time to calm down.

So I thrashed and I closed my legs and tried to move away and I still feel as if I was assaulted -if my DM hadn't have intervened I have no doubt it would have been worse too - but I shouldn't have to. Doctors are there to help support women who need medical attention, not run rough-shod over their feelings, traumatize them and assault them.

Dackyduddles Sun 21-Jul-13 08:31:41

I wish I had realised I didn't have to have a sweep. I at the time trusted his view (not consultant, house officer? Unsure...) in some freaky "your in a white coat so must be next to god" blind way. I hated it and him but didn't feel I could say no because he said it should be done.

It was the start of an awful first birth it took me best part of 18mths to get over.

Assumption, fear, intimidation, they must know better than me, all came with it. It was only on here I found out I didn't have to and could have avoided it. I felt so ill when I knew I should have trusted MY instinct.

If u haven't been there, lucky you. Some of us just aren't that lucky.

maddening Sun 21-Jul-13 08:34:09

If the thought of internals scare you it might be wise to have a chat with the supervising mw and also look in to relaxation techniques for during labour.

Generally if they need to do an internal it is because they need to do so - possible to keep it to a minimum but they can monitor your progress by doing so. And some cases will require more internals than others. So be prepared and have ways of dealing with it - relaxation techniques can help as the whole fear response makes you tighten up so would make it more painful - I definitely found it beneficial during the internals.

Look in to all the options at your labour ward too - if they have rooms with birthing pools it'd worth considering - those rooms are often quite relaxing as is the birthing pool.

Flatasawitchestit Sun 21-Jul-13 08:38:59

Reading these stories makes me so sad and angry at the same time.

I'm a midwife and I always say to a woman prior to any examination, if you'd like me to stop say or raise your hand. I always stop. Always. Even if I could have just been 2 more seconds and accurately assessed dilatation. It means sometimes having to do the exam again, which actually most women don't mind but at the point of wanting to stop it always always should. We may never know if these women have been victims of abuse in the past, and I've met a few where unfortunately they've buried those experiences and in labour it seems to come out.

I hate that there are midwives who give the rest of us a bad name.

soapboxqueen Sun 21-Jul-13 08:47:18

I'm really shocked at the experiences of people here. I've been very lucky in that the vast majority of medical personnel I have encountered have been lovely and the ones that weren't didn't have much to do with me in a physical way. I can't imagine how this must leave people feeling or the long term impact.

OP it's hard to imagine how you will feel and act when the time comes. Although I have not had to deal with the traumatic situations others have, there have still been times when I should have said something or demanded something. I didn't because I was in labour and a bit preoccupied. If non-pregnant/in labour me had been standing right next to me at the time, she would have acted differently.

I feel the OP asked an honest question. We can't learn if we don't ask. We can't know how asking can upset and offend if we know nothing about it.

BinksToEnlightenment Sun 21-Jul-13 08:54:33

No, I think I understand what the OP is saying. I don't see how it is victim blaming to not know the mechanics of how something like this could happen. And it was a question, not a statement. And she's not just idly wondering; she's giving birth herself soon and probably concerned that something of a similar nature could happen to her. I know I worried and wondered the same thing. The wording is irrelevant. She has never been in that situation or mental state, ergo she has no experience of what it feels like.

From my own experience, my midwife behaved perfectly, but I would not have been able to stop her from doing something if she had chosen to. Physically, I could have fought her, and I could certainly scream, but mentally I couldn't. I was in such an intensely helpless and frightened mental state that she could have ordered me to do anything and I would have done it because I was so desperate for help.

It's only later that I would have realised she'd fucked me over big time, like a lot of the other posters on here have been. It's awful to hear and I'm so sorry. I completely understand and don't blame any of you at all. But I do feel more of an understanding for the vulnerability of the labouring woman now that I've been one.

kungfupannda Sun 21-Jul-13 08:56:00

OP, I appreciate that you haven't been through childbirth, and I think most posters would be willing to cut you a bit of slack about your initial post if you hadn't followed it up with a whole load of arsines and oh-poor-me nonsense.

You have been told quite clearly that you have upset posters who have had bad experiences in this area. The appropriate response would be an apology and a better worded request for any information you want. The poster who really deserves an apology is the OP of the other thread who you quite clearly referenced in your insensitive opening post, despite the wishy-washy "oh I'm not talking about the person who I'm quite clearly talking about."

I haven't had this experience. I had two rapid deliveries, including one homebirth, and my midwives were lovely. But it's surely not that hard to understand that childbirth is an intense, sometimes frightening time, when a woman can be at her most vulnerable. I find it hard to understand why you would think that a labouring woman could simply kick a health professional in the face, thus overcoming not only whatever physical difficulties she was in at the time, but also some pretty basic social conventions that require us to not go round kicking health professionals in the face.

As I said, it is just about understandable that, as someone who hasn't been through childbirth, you wouldn't understand the intensity of the experience, but surely you can understand the basic fact that a woman in the middle of an experience that everyone knows isn't a walk in the park isn't going to be karate-kicking HCPs?

And if this is something you genuinely didn't appreciate, surely the responses on this thread have clarified matters to the extent where the posters deserve some acknowledgement that you were wrong and that you are sorry?

GettingStrong Sun 21-Jul-13 08:58:03

Message withdrawn at poster's request.

MrsMook Sun 21-Jul-13 09:17:48

Many years ago I was at a houseparty and woke up early in the morning to find someone's hand in my knickers having a fidget with my clitoris. I knew him, but wouldn't have classed him as a friend. It took a moment to process the situtation and then I reacted by kicking him in the face. Hard. I hope it hurt his neck after.

Going through labour is very, very different. Physically your bump makes it hard to see what's happening and change position. I've had PGP which makes movement of my legs hard, and couldn't make a quick reaction. Your mental state is affected by drugs- G&A makes you hazy (pleasantly so for me), pethadine more so (for me, it's as though 8 hours of my life were cut out, I was locked up into a parallel universe- DH consented to the second round of pethadine for me as I had no clue it was being offered. I only know from reading my notes) Pain has an effect- my first labour was long and wearing, the second short and intense- neither situtation is conducive to quick thought and reaction. The biggest thing is trust. You place yourself in a position of trust with the HCP. You're particularly concerned about the welfare of the baby so trust that they are doing the right thing for them as you've been carrying and caring about that baby for 9ish months and just want everything to be over and that baby to be safe and well in your arms.

I've not felt assaulted over treatment in hospital (and fortunately the party experience hasn't affected how I feel over medical care in that department) but having had two intervention heavy births I can see how it happens. My negative experiences in my first birth originates from a poorly explained intervention, "Things are progressing too slowly, I'd like to break your waters to speed them up" I wish I'd been prepared for the surge of contractions and discussed pain relief. As I mentally failed to cope, I nodded agreement to "I know you said you didn't want pethadine but..." As the pethadine went in, that was the loss of connection with the labour that haunted me after. I would have consented to anything at that point, but then lost the ability to do anything other than passively flow with the situation.
(There were positives in that labour, thank God the pethadine wore off when pushing so I can remember going to theatre and the ventouse/ CS where there were some nice staff which helped a lot. My second birth was much better, I had a very gentle MW who explained things a lot, and despite is being a rough forceps birth in theatre, I could repeat it with the same staff- the key thing being that they treated me well)

OP, I hope you have a good birth and that none of these problems and issues become yours.

GettingStrong Sun 21-Jul-13 09:19:10

Message withdrawn at poster's request.

Yonionekanobe Sun 21-Jul-13 09:28:37

Flat what a great post - any chance you're free to hang around a South London hospital over New Year when DC2 is due?

My first internal when giving birth to DD was the worst physical experience of my life - half way through which the MW told me 'not to be so pathetic' hmm

Yonionekanobe Sun 21-Jul-13 09:29:49

On another note, given all these stories, what is the really advantage of internals? When are they absolutely needed? Is it safe to refuse?

ANormalOne Sun 21-Jul-13 09:35:47

The best part about giving birth at home unexpectedly was that I at least avoided having an internal examination, if I ever have another baby I think I'd opt for a homebirth just so I didn't have to have one.

HenWithAttitude Sun 21-Jul-13 09:48:05

The other thread and this thread are both making me feel light headed and nauseous bringing back memories of my first birth.

OP I'm going to take your question at face value and assume you are naive enough to not appreciate how offensive it will seem to someone who has been assaulted (akin to why doesn't a woman fight off a rapist)

Dynamics of healthcare mean that many women politely wish to cooperate. Fear, ignorance and sheer vulnerability of being with someone who you need to help you during a medical procedure, means you 'keep them on side' so you don't argue, shout or scream...let alone 'kick them in the face'. An assault is not necessarily violent or aggressively performed. It is an unwelcome intrusion into or onto your body without your consent or agreement or understanding of why.

A Dr asked my husband to hold me down. Legs in stirrups, husband holding me down, midwife urging me to be quiet and hold still whilst my shredded vaginal walls were inexpertly stitched together because I was writhing in pain so much

I am obviously forever indebted to this care because I had a healthy baby... hmm. (Which is the other bollocky rude implication of shut up and put up)

DespicableYou Sun 21-Jul-13 09:56:56

What a crass, insensitive and ignorant thread.

I really hope you have a good birth experience, OP. You sound as though you have no idea, unfortunately.

HopALongOn Sun 21-Jul-13 10:05:27

I was always asked very nicely, and had the consultant very specifically say a number of times that she could not touch me without my consent. When I had my first internal I asked the midwife to stop because it hurt, so she did and got me some gas and then we both agreed to try again.

And as for kicking someone. Would love to see a massively pregnant woman flip herself out of stirrups and close get legs. I tried to climb out of the stirrups and it was impossible even without someone elbow deep in my vagina.

HopALongOn Sun 21-Jul-13 10:12:53

Adding that I had a painful forceps delivery but i am very happy with it because the staff were kind and patient and made me feel like I was an active participant rather than just doing it to me iyswim? I was involved and informed all the way through and even though I got a bit hysterical at the thought, they kept me calm and were patient and professional all the way through. When you're up in stirrups it's a very vulnerable place physically and emotionally, and good staff can mean the difference between a traumatic experience that can scar you and an experience that want your ideal, but was actually OK.

HotCrossPun Sun 21-Jul-13 10:12:57

It's not an excuse that the OP hasn't been through childbirth yet so can't understand the trauma of internal examinations that you haven't consented to.

I am pregnant with my first child and when I read the other thread (which this thread is clearly and unashamedly based on) I was horrified to read the OP's experience.

This is goady, distasteful and victim blaming.

Yonionekanobe Sun 21-Jul-13 10:18:43

HopALong, that's an excellent point about being active in the process, not having it done to you. There is the element of having control that way, which I imagine eases the process a little.

I've just remembered having 'just relax!!' barked at me too.

HotCrossPun Sun 21-Jul-13 10:19:26

(NOT aimed specifically at the other poster on this page, there are lots in different sections!)

Funny how you should feel the need to point out that this isn't about any other poster in AIBU. It's not actually common place for these types of threads to be posted here.

Unless you have started a thread about another posters assault that she started an AIBU about yesterday... hmm

soapboxqueen Sun 21-Jul-13 10:19:50

She didn't say she didn't understand the trauma. she said she didn't understand why you wouldn't just get up and stop them. People have shared their experiences so that the OP now understands that it is not as easy as it sounds.

If we only ever asked questions to which we already knew the answers to, the sum of human knowledge would be very small indeed.

flippinada Sun 21-Jul-13 10:31:02

What a nasty thread.

I've never been traumatised by an internal examination but I can immediately see how this post would be upsetting and triggering for someone who has.

No-one on here (well no-one worth talking or paying attention to) would start a thread asking a victim of assault why they didn't do x,y and z, so why is this ok?

Shameful.

Fakebook Sun 21-Jul-13 10:43:51

Yonionekanobi, that's a really good question. Through my experience, the only time an internal was needed the second time was when I was dilated enough (about 5cm) but not progressing, and the midwife (with permission) broke my waters without any pain or discomfort. The first time my waters were broken when I wasn't even dilated!

After birth I consented to an internal to check how bad my tear was, again she did it quickly and with minimal pain. Final time was after I'd been stitched up, she told me she was putting lube on her finger and putting it up my anus to check she hadn't stitched too far up. I was anaesthetised so didn't feel much, but she still asked and took steps to minimise pain.

I believe stretch and sweeps and insertion of gels at the cervix are a complete waste of time and cause needless pain as they are conducted when the woman is not even a tiny bit dilated. It's painful and every woman should know that they can refuse them.

With my first labour, I still get horrible flashbacks of my ordeal from before induction to post birth. The worse part was when they stuck their hands up my vagina to put a hook like clip on Dd's head to measure her heart rate because the pathetic belt they'd tied around my belly kept moving out of place. Not only was I hurt by that, but so was my baby.

I'm sure there are other more important reasons for an internal, when labour isn't progressing or trying to ascertain if baby is breech during labour. Things like episiotomies for ventouse need internals too.

HotCrossPun Sun 21-Jul-13 10:59:19

Soapbox The very fact that she made a flippant comment asking when the woman 'didn't just close their legs' shows that she doesn't understand the trauma behind an assault during pregnancy.

She hasn't asked a question, she has given her own offensive and upsetting opinion. She has argued with posters who have tried to explain to her what has happened to them.

Go on girls (feel free, get angry about the gender assumption/diminutive terminology) enjoy yourselves!

I've not seen such an inflammatory thread in a long time.

soapboxqueen Sun 21-Jul-13 11:06:33

But that's the point she didn't understand. She asked and now she knows. If she hasn't experienced something and genuinely doesn't understand, she can't know that some people are going to be very upset by the wording of the question or the question by itself until she asks it.

Yes some of the OPs responses where a bit defensive but many people would act that way if they felt they had asked a genuine question to be met with a lot of anger and in some cases name calling.

I agree with others that after it became apparent that this question had caused some distress, an apology was in order.

Tweasels Sun 21-Jul-13 11:19:29

I think this is a nasty thread. Not having gone through childbirth is absolutely no excuse for ignorance on this scale.

She is talking about a specific thread and no one with an ounce of intelligence would read that thread and think why didn't she "kick the HCP" hmm

Orianne Sun 21-Jul-13 11:25:59

I've not read the whole thread so apologies if I'm making no sense but its talking about situations like this that take away some of the guilt I still feel about the birth of my daughter. Without making it all about me I was in the middle of a difficult labour in a foreign country with a 'not very understanding' midwife and a husband who was being an unsupportive twat because he didn't really know what was going on. And at one point I screamed at the midwife ' get off me, if you want to examine me, ask me I'm not a fucking animal'. And that's how she made me feel. DH was very embarrassed and told ME to behave and I've always had a 'I was being a big baby and should have just got on with it'. I wasn't being a baby my DD was stuck and the midwife had given me no pain relief because she 'chose' not too. Consultant was horrified and I was rushed for an emergency csection. Thanks to Mumsnet I realize I'm allowed to be upset about it and moreover I was right and the midwife was wrong and you too DH. So I can move on and hold no guilt. Sorry for length of post

Orianne Sun 21-Jul-13 11:29:56

So OP my point really is I would have refused so many things if I'd known. I didn't but its not always as easy as saying no to these things when you're dealing with experts in the field.

Cheeseatmidnight Sun 21-Jul-13 11:37:33

I consented to one then started to scream and begged them to stop as I was having a contraction on my back which I couldn't cope with. They carried on and left me on my back and I begged them to do them while I was standing.

If I have another baby I am insisting on standing internals

enormouse Sun 21-Jul-13 11:52:46

Before having DS, I hadn't even had a smear (I was 22) so I didn't really understand how internals would work, how far they would go in or whether I would be able to say no. I would have trusted medical professionals to do whatever they thought was best.

At a week after my due date I was examined (not internally) and was told by the consultant that a sweep wouldn't be favourable.
I ended up going 11 days over and was offered a sweep. It felt so painful that I said ' no, stop!' Loudly and burst into tears after. The lovely registrar stopped immediately and informed me that if I was unhappy at any stage I had the right to say no, that no one would examine me and put it clearly on my notes.

That experience gave me confidence to only consent to 2 internals to check dilation and to get an episiotomy when I felt ready. My DP had to give consent for me though, I was too scared and in pain to make sense or feel like I'd be acknowledged. So op, does that answer your question? It is hard to get your wishes accross during labour and I was very very lucky to have a determined DP and wonderful, sensitive obstetric hcps looking after me. I feel so sad and angry for the ladies that had such traumatizing experiences.

for my next birth I will make sure I have no non essential internals and get stronger pain relief should I need an episiotomy

Bunnygotwhacked Sun 21-Jul-13 12:06:33

See even after three births I didn't realise you could completely refuse internals until recently. Luckily I havent had it too bad noone likes them but some experiences are much worse than others.
With my first I knew nothing I didn't even know that there were going to be internals which came as a bit of a shock but noone really goes into what happens in labour and afterwards and certainly in my position I just had the vaguest idea I knew it would hurt i knew there would be drugs available i knew i would have to push and i knew there was a jab i could have to get the afterbirth out quicker. That was about the limit of my labour knowledge. So when i was told that I needed to be examined I didn't know there was ever an option and when i was stitched up after the birth I didn't know that anesthetic was an option it was presented as Oh we just need to pop a stitch in there maybe another one oh and just one more. I felt everything even though i was on gas and air but there was noone to tell me any different.
So why would i of kicked the midwife who was just doing what she was supposed to as far as i knew? All through the pregnancy you are asked if you have any questions but if you don't know what to ask it doesn't help any.
I am due my fourth now the labour will be in a hospital with a mw team i have no experience am currently cacking it hoping i will have the strength to say no when they tell me they need to "take a little look"

LaLaLeni Sun 21-Jul-13 12:11:53

If you don't ask, you don't get - this applies to information above all else.

Maybe if op hadn't referenced the other threads, people with experience of assault etc wouldn't have read the thread and she wouldn't have got any answers. It would've sounded purely like she was asking what medically happens during an internal, and people would've probably just told her to say no to anything she felt unhappy with - which as this thread proves - isn't always enough.

When you've been through that experience, any mention of it, or hint that someone maybe doesn't understand how it can happen, can be triggering. That doesn't mean we should all stop asking - it's better that more women know about it surely?

What we're able to do as victims is enlighten others, educate, and remember we were once unaware of how these things happen too. We learned the worst way, but by telling op our stories we can help prevent her going through the same. The more we see questions (however worded) as a threat, the more we allow assaults to carry on under the radar.

courgetteDOTcom Sun 21-Jul-13 12:39:52

I'm coming back later when I have a laptop to respond properly.

I just wanted to answer the question about the point of internals. They show a lack of skill. There are many hands-off ways to tell how dilated a woman is, regular VEs aren't necessary. I had two in the week I was in last time because of my gestation (29) one at arrival to make sure I was dilating and one 5 days later when I had started to bleed to make sure this was it and nothing sinister, as they didn't want to risk bringing him out quicker. I was impressed at the skill they showed in managing a week without VEs.

flippinada Sun 21-Jul-13 12:40:47

Well there's nothing wrong with talking about it at all but fling do in a shaming, victim blaming way is entirely inappropriate.

Replace the words "unwanted internal exam" with "sexual assault" and you can understand why people have had a strong reaction to the post.

Plus the spiteful comment referenced below...

flippinada Sun 21-Jul-13 12:41:24

"doing so"

edam Sun 21-Jul-13 12:45:44

OP, there are polite respectful ways to ask for information. And then there's what you have done. Extremely rude, dismissive and upsetting for people who are distressed.

If you don't know something, it's OK to ask, but think about how you phrase your question, for heaven's sake.

lougle Sun 21-Jul-13 12:48:35

There is a massive power imbalance in the relationship between the Professionals and the woman. Huge. It can't be underestimated. The Professionals are gatekeepers to information, medication and resources.

If a Professional recommends a course of action and the patient declines, the consequences will stay with them forever. It's impossible to make a rational decision about that unless you are informed of the risks and benefits. However, the person who wants you to take the decision they consider to be essential is presenting that information, so it's inherently loaded.

As an off-topic example, I had a routine growth scan at 33 weeks, baby was 4lb 9oz. Two weeks later I had a follow-up growth scan. The baby was 4lb 9oz. I said 'no, that's what he/she was a fortnight ago...'. They realised she hadn't grown at all in that two weeks.

When the Registrar met me, she was quite keen for me to be monitored and for the pregnancy to continue. She couldn't tell me why baby had stopped growing, whether she would grow from then on in, etc. I said 'I want her out.' For me, the risk of the unknown was far greater than the risk of giving birth at 35+3 weeks. The Reg didn't agree, so she went and got her Consultant, who said that either option was 'valid'. So I asked to be induced.

I had the luxury of calm discussion, no pain, etc., - the power balance was, relatively, in my favour. Had that been an emergency/acute situation, I would have had to just go with the flow.

gordyslovesheep Germany Sun 21-Jul-13 12:53:34

wow OP really??? Wow - I guess women who are raped have the same option - just close your legs silly women

what a vile thread biscuit

Funghoul Sun 21-Jul-13 12:54:23

I gave birth in stirrups that I couldn't get my legs into or out of by myself. After I gave birth I felt so wobbly and shaky that it took a good hour until I could stand with support.
My consent was given for everything and I was happy with my midwives and care, but no way could I have physically stopped anything.

yamsareyammy Sun 21-Jul-13 12:58:47

Wow at this thread.
Never knew there was such a big problem with this.

Did the posters on here, report either the medical person, or the hospital?

Maybe there are certain hospitals that this is happening in, rountinely?

Not sure of the motives of the op. May be fine, maybe not.
But I think this is talking about a subject that needs talking about imo.

Ginderella Sun 21-Jul-13 13:13:25

A labouring women cannot benefit from an internal exam. There are used as a diagnostic tool for incompetent and poorly trained doctors and midwives. A woman does not need an internal exam from the start of a pregnancy until the end. A well trained midwife worth her salt will know exactly how a birth is progressing just by observation.

Checking to see how far a woman is dilated before offering pain relief is cruel and inhuman. Stitches without pain relief is barbaric. Not waiting for the placenta to come way naturally - rushing a woman to theatre to manually evacuate the placenta - is all done to save the midwife time.

As for saying no to internal exams - how many times have we seen on TV shows such as OBEM the midwife saying to the woman "I'm just going to give you a little check" and she has her arm shoved up as far as it can go before there is any chance of informed consent.

Once you are in hospital you are at their mercy unless you have a strong advocate with you. It's never about your birth experience. It's all about getting that baby out of you as quickly as possible so that they can move onto the next victim.

I was induced with a pessary, 3 x gel, then the works. While I contented to umpteen "I'll just see if you are dilated" VEs, they regularly were really painful and the MW would say "I've just done a sweep while I was in there". I never consented to sweeps and quite frankly if a sweep was going to do something then it would have done by then. I think that there is a significant issue of "full" consent rather than brief, minimising consent.

I had my legs in stirrups + SPD, could not move at all. It was awful.

In my case it was useful, because they found DS was stuck and I needed to go to theatre, but it was terrifying and painful. Worst moment in a frankly terrifying pregnancy and birth.

It haunts me now, but this is the first time I've ever mentioned it to anyone.

OK, I actually feel quite ill reading this thread. Is it possible that the doctor didn't actually need to do an internal to realise I needed theatre? I'd been in pushing almost 2 hours at the time.. could I have done without the internal?

Lalaleni - Have you read all of the OP's posts? If the OP was sincere, or had any decency, she would have apologized, she didn't, she played the offended party after she hurt women and then mocked women's pained responses.

It is vicious to ask a victim to defend why they didn't prevent their attack. And how bloody dare you blame victims of medical assaults for the assaults of other. LACK OF EDUCATION IN PATIENTS DOES NOT CAUSE THESE ASSAULTS, BAD MEDICAL PROFESSIONALS WHO ASSAULT PEOPLE CAUSE THESE ASSAULTS. It is not a victim's job to educate others, we should NOT just take it on the chin and smiley sweetly when someone reopens the wound to ask us to play the part of the teacher - there are plenty of other resources and ways of doing that. Already we've discussed prevention issues on this thread with someone who said they were concerned about it - because that's how to decently ask. Words do matter, that's the whole point of words, to convey a specific meaning. We should let people know when they hurt us, whether they do with actions or with words, and I have every right to be angry and to express that anger. Stop telling victims they no right to express their anger when people disrespect and devalues and blames them for what happened to them. Being nice doesn't stop assaults, it doesn't stop disrespect, and I will not be shamed into hiding my anger and I will not be blamed for others pain when I do so.

And don't talk to me or others about this 'not being aware' stuff, many of us suffered abuse as children as well, in the streets as well, and have always known about being dominated. People not knowing and the cries of education will never excuse victim blaming. It is NOT a victim's job to educate and we should never take the devaluing of our pain (and being blamed for the pain of others) nicely.

Bogey, Emily: It was possibly a speculum, I've searched it before and have yet to find one that matched, it was one solid plastic object rather than a device that could open and close which throws me off and the cylinder ones I've seen so far haven't matched. It did seem a rather crude device, maybe they aren't used much anymore and that's why I can't one.

Thank you those of you who game me your kind comments and beverages.

Particularly Castle I had a similar experience with my third, particularly the pushing hard on the stomach bit - she was so concerned about getting the placenta out that she pushed so hard and yanked while I screamed (her colleague took the baby out of my sight to get me to cooperate better - I didn't even know she was DD2 for a good 15 minutes), ended up pulling the cord out with a chunk of placenta (and a lot of blood, I went into shock and thought I was dying), ended up rushed into theatre for a manual extraction. Theatre staff were brilliant and caring, the midwives who prepped me (who blamed me for this) not so much. Sadly had to deal with one afterwards.

valiumredhead Sun 21-Jul-13 14:30:33

Jesus, what twirlyhot said!!shock

Ginderella Sun 21-Jul-13 14:54:35

I am shocked to read on this thread about the unecessary manual pulling on the cord to remove the placenta. There is no reason whatsoever to perform this crude procedure on a woman other than to speed up the birth process for the midwife. This is a further example of incompetence, poor training and lack of patience.

soapboxqueen Sun 21-Jul-13 16:32:47

Ginderella my midwife pulled on the cord to try to get my placenta out. It made a weird popping noise. So I said, "oh is it supposed to do that?"
oh said,"that doesn't sound right" So midwife left to get a catheter and a more senior midwife. Senior midwife asked me to push it out and out it came.

Dackyduddles Sun 21-Jul-13 16:44:31

Op are you prepared to apologise yet for your offensively phrased original post?

I hope you have listened, learned and that it doesn't happen to you. But god forbid were it too, come back because at the end of the day you will then need support and understanding and I'd still listen.

courgetteDOTcom Sun 21-Jul-13 17:24:28

I have seen placentas coughed out and weed out! Both my VBACs I coughed, trick I've picked up from clients, my last one she was gently encouraging me to push, I looked down and said "am I weeing?" she said "yes, don't worry, it's working, keep doing it!"

Things go wrong when you mess with something don't need messing with!

There is a place for intervention but normal birth isn't it.

::files away information about coughing out the placenta for planned HWB::

LaLaLeni Mon 22-Jul-13 21:48:43

LittleSporks - yes. And I stand by all I said. I couldn't see mocking I never saw blame. I read genuine questions.

I can see of course how the thread could be interpreted as all of the above by those who are living with this. But that shouldn't be projected on to the OP. I still maintain that these questions need asking.

RevoltingPeasant Mon 22-Jul-13 22:09:54

Courgette and ginderella, can I do a brief hijack??

Interventions without consent are one of my big fears about childbirth. If there are ways to tell ow dilated one is, etc, without doing an internal, what are these, please?

It'd be amazing to know, as then you could say, "can you try x instead of an internal?"

I have very bad flashbacks to ds birth after reading this thread. Ds was my first baby and when I went into labour I was absolutely terrified and I was only young too, high on pethidine, shit scared and not in control at all. I was held down and forced to have several internals because I had been induced and I was strapped to a monitor. I remember the midwife groaning and saying jesus my fingers as my internal bits had contracted and crushed her fingers. I was in agony and screaming, it was awful.

I think I was assualted as I didn't actually consent to these internals and I was in no position to say no.

Ive had four children now and I've had internals since which have been better for me but nothing prepared me for what I went through 14 years ago.

Its not always a case of 'just close your legs'is it

courgetteDOTcom Tue 23-Jul-13 01:53:35

revolting, they should be able to use their powers of observation, experience and trust in the birth process. Watching mums behaviour, listening to her talk or vocalise should tell her a lot. If she is up to date, she should know she can watch the linea nigra because it spreads the other way during labour or she can feel mums calves as the blood drains from them in labour, half way up the calf is about 5cm and so on.

If you want your birth plan to say no VEs, you are with in your right to do so. I delivered without them because of my gestation they didn't want to create any complications. You could say no VEs without discussing with you why first and if they can't discuss it you're obviously too far along to need it. Arm your birth partner/s with the knowledge you do not wish one unless in an emergency and tell them to say "she said no, she does not consent to that!" loudly should anyone try to go against your wishes.

courgetteDOTcom Tue 23-Jul-13 01:55:01

in case it's not obvious blush the calves get colder as labour progresses.

lozster Tue 23-Jul-13 05:39:14

So (and be kind as I am being induced tomorrow with number 1)...
1) how does a VE during birth compare to say a smear or a procedure such as hsg or embryo transfer? I mean in terms of what you feel
2) as I understand it, might there not be a genuine need to know how far along you are (eg is the induction working, is it the most appropriate time to site an epidural/give a dose of pethidine)

Obviously no one should shove a hand of instrument in you without consent, but i am confused about how necessary the VE genuinely is and, by association, how often it should be done.

lozster During labour I didn't mind VEs much at all - and because it was "for baby's benefit" rather than for mine iyswim it was just another part of the weirdness of the whole experience.

By contrast I've never managed a smear except under general.

Catsize Tue 23-Jul-13 08:07:08

I did close my legs during a particularly painful internal, but as her hand was inside me, it just clamped her hand. Even when I said 'stop' so I could relax and she could continue, she didn't. She just kept going. I said I thought I was gong to be sick. And was. Tried to avoid being sick on her. Wish I hadn't! Think there is still something that says we shouldn't kick midwives!

Catsize Tue 23-Jul-13 08:08:44

Homebirths, by the way, they rarely do internals. Think the only reason hospitals get excited about these things is to check you are progressing according to their charts and to predict bed availability.

hiddenhome Tue 23-Jul-13 08:40:34

A registrar assaulted me when I was pregnant with ds1.

I consented to an internal examination, but then he started to cause immense pain and I had to beg him to stop. The hca next to him told me that he was doing a membrane sweep (the doctor didn't speak much English).

This procedure wasn't explained to me and I certainly didn't consent to it! I was crying and shaking with pain, but he just carried on anyway.

My membranes broke prematurely (due to the membrane sweep) and I ended up with an emergency c section and ds1 had strep b and had to go to special care.

Yes, I was fucking assaulted angry

RevoltingPeasant Tue 23-Jul-13 09:07:21

Jesus, hiddenhome. That's fucking appalling. Did you complain? I hope so!

courgette thanks. That's really interesting! I want a homebirth myself--ttc at the moment, still. I am mostly worried about forced episiotomy.

I have only ever had one gynae procedure done against my will; I was having a smear test and she decided to swab for chlamydia/ gonorrhea/ something as she had decided I was in a high risk group. It was clean, of course. I asked her to stop but she did the whole 'nearly done' thing.

It does just make you feel so degraded, even if in that case it didn't hurt. And it definitely means I will never, ever, ever access gynae services at my local hospital again for fear of running into that awful woman.

RevoltingPeasant Tue 23-Jul-13 09:10:36

I can't imagine 'just closing my legs' but I have decided, following the swab experience, that if someone does something to me against consent, I will say rudely firmly 'No, stop that. I want you to stop that now' and then if they don't listen, 'I said stop. It is assault if you touch me without my consent.'

Fuck knows if I actually would though. Easy to all assertive behind a keyboard.

Has anyone done anything like, and did it work?

Mostly, I'm just still queasy at the idea that when going into labour, we even have to think about this. I'd love to be able to sit back and presume the professionals were just doing their best, but sadly, after this thread and many others, and my own experiences, I think I will go into labour feeling armed against people trying to push me around and hurt me sad

GettingStrong Tue 23-Jul-13 09:27:06

Message withdrawn at poster's request.

hiddenhome Tue 23-Jul-13 09:55:29

Yes, I spoke to a midwife at the hospital when ds1 was a few weeks old. She indicated that they'd had problems with that particular registrar before and did I want to make an official complaint. I said "no", but said that he urgently needed some re-education. I didn't have the energy to make an official complaint.

I felt as though I was just a piece of meat. I was only 1cm dilated at my 40 week pre-natal check, so he just went ahead and fucked up my sac with his rough handling. I felt like a farmyard cow. I only consented to a quick dilation check.

You can't treat pregnant women like that sad

Appalled to hear the other experiences on this thread. I don't know who they think they are doing this to people angry

Itchywoolyjumper Tue 23-Jul-13 12:33:03

This thread is horrifying. Why do some HCPs think its ok to treat women like this? Near the start of my labour a midwife gave me an internal with no lubricant on her gloves, it was so sore I was crawling up the bed on my elbows to get away and she just kept her hand up my vagina. I didn't say no but it was obvious I didn't want it done.
If no one minds I think I might let someone at the NMC (the governing body for nurses and midwives) know about this tread, there's clearly a need for improvement in the attitude some health care professionals towards what are a very vulnerable group of patients.

lozster Tue 23-Jul-13 14:48:37

thanks horry and getting strong. Good to know.

courgetteDOTcom Tue 23-Jul-13 14:50:44

Because they're the HCP and we're the silly girl who got pregnant. You see this attitude from the first visit to your GP to being discharged from hospital when you get the contraception talk.

lozster

1) how does a VE during birth compare to say a smear or a procedure such as hsg or embryo transfer? I mean in terms of what you feel
I can only comment on a smear, but it's a lot more relaxed, there's no time constraints, you're not in pain, you're not dealing with them disrupting the natural hormonal effects of labour.

2) as I understand it, might there not be a genuine need to know how far along you are (eg is the induction working, is it the most appropriate time to site an epidural/give a dose of pethidine)
As I've said before there is a place for any intervention, but it shouldn't be the norm. If you're happily(ish - as much as you can be in labour) labouring away then there's no need. If you're begging for more pain relief and they need to know if there's still time, then that's one of the factors you consider when asking them for a higher pain relief and one of the things that adds to the spiral of intervention. If you've consented to an induction then VEs are a part of that, but when you're into labour you can still say no to them.

thebody Tue 23-Jul-13 15:03:14

after 4 kids I honestly see the problem as a communication one and basic care and good practise.

I don't think most HCP are creepy sickos who give internals at the drop of a hat because THEY want to but even.or especially ,when someone is in pain and frightened clear concise and genuinely warm communications are vital.

Having read this thread, alternating between open-mouthed shock and tears in my eyes at the accounts on here, I cannot understand why GingerJulep has not come back to apologise grovellingly for her insensitivity and frankly nasty comments.

Ladies on this thread - my heart breaks for you, and I wish I could offer you all a hug right now. You are brave, amazing women!

HopALongOn Tue 23-Jul-13 15:10:37

I'm shocked at some of the recent posts on here too. It is so sad. BUT, lobzster not everyone has a bad experience; as I said upthread I had lovely midwives who were gentle and got my express consent. There are great midwives out there, I hope you have a good birth. I only had one VE, which was to check where we were when we 'check in' and it was painful, but the midwife gave me some gas and stopped when I asked. I didn't actually have another one as I just felt 'ready' to push and the midwife said she could tell with a quick visual check and a gentle probe that we were good to go. When it all went a bit wrong at the end, it was still fine. So, what I'm saying is that there are great HCPs out there, with good practice and women are having good births, but sadly not everyone. I would brief your partner (let them read this thread) so that they can advocate for you when you're in labour.

Itchywoolyjumper Tue 23-Jul-13 15:13:38

I don't think most HCP are creepy sickos who give internals at the drop of a hat because THEY want to but even.or especially ,when someone is in pain and frightened clear concise and genuinely warm communications are vital.

Exactly this.

JohnnyUtah Tue 23-Jul-13 15:23:09

Op I haven't read the other thread. And your intentions may have been ok. But your posts are thoughtless, honestly.

StuntGirl Tue 23-Jul-13 15:31:44

This thread is horrifying.

Absolutely agree woolyjumper So sad for these women sad

catsmother Tue 23-Jul-13 16:19:23

This is a horrid thread - recounting so many stories where women have been assaulted, and NO, there are all sorts of reasons why you don't do what you imagine you might have done when it's actually happening to you!

In my case it was more than 23 years ago but I still find it very upsetting and I'm still full of fury - at myself - for not reporting the arrogant male registrar who decided, without my consent to perform a sweep on me. I was a week overdue and, word for word, what was said to me was that he was "just going to have a little look to see how things were progressing". I didn't find it at all unusual to be accompanied into the examination room by a female nurse as a chaperone but I remember feeling rather confused when she put her arm very firmly around my shoulders - whether this was to comfort me or restrain me I don't know. In that instant I felt the most gut wrenching sickening pain and screamed out - and was told "almost there". I didn't know what the fuck was happening - remember I'd been told that they were looking - as I'd been looked at on a number of previous occasions and was in pain, scared and bewildered because at that time I had no idea what the hell was going on.

The arrogant bastard didn't even have the courtesy to explain after what he'd done or what he'd hoped to achieve. And I was far too shocked to confront him - which is my everlasting regret because I should have had his guts for garters for what he did. I was simply told that "things should start moving soon now" and off he went. It was only after getting home, reading my notes, and further research after I had my son that I put it all together and realised what had happened.

At no stage did I give my permission for that. It had no effect in any case as my son was born 10 days later - not that it would ever have been acceptable even if my labour had started soon after. I think I was in such literal SHOCK that all my usual self confidence vanished and it was only later than I realised what I "should" have done. The anger I still feel is indescribable .... not least because the nurse obviously also knew what was about to happen and even she didn't have the decency to ask my permission, let alone explain any of it. Maybe she was scared of Mr Bigshot arrogant consultant too ?

And then - to my eternal regret - even after I had my son I did nothing. I obviously had the whole new baby thing, lack of sleep, I moved 6 weeks after birth, it was his word against mine etc etc but I so so wish I'd complained for all I was worth - and not just complained at "poor treatment" or "bad service" or some wishy washy whingeing - but had put forward a complaint of assault against him. I don't give a flying fuck whether it was technically a medical procedure or not - he hurt me, he hurt me really badly, and he made me feel violated and stupid - like I was a slab of meat without feelings or intelligence ..... far too lowly for him to waste his arrogant breath on. And the nurse colluded with that - which makes me feel even worse - a woman allowing another woman to be assaulted like that.

I "could" have said "stop" but I didn't get the bloody chance to - and because I wasn't expecting any sort of procedure, my head was in an entirely different place and if you know what I mean, it kind of took me a while to realise that something was happening I didn't want, didn't like, didn't understand. And after .... well, he was big Mr Important consultant wasn't he - and while I was still there, although I knew something had happened, I still didn't know (at that stage) what it was .... I was just stunned. I guess I more or less froze before coming to my senses a while later.

I'm not a stupid woman - far far from it - not that intelligence should have any bearing on how acceptable it is to assault a woman of course but somehow the fact he couldn't even be bothered to speak to me like a normal adult human made the whole thing even worse. He was so abrupt - and dishonest about his intentions. Oh ..... and to add insult to fucking injury, do you know what the only other thing the ignorant pig said to me that day was ? It was "did you have trouble conceiving ? " in what I am still convinced was a sneery tone of distate - I just murmured "no" - when I should have asked why he was asking me that ...... but I sussed his probable reason while I was still in the antenatal clinic that day, because I have rather a lot of hair down there, and I assume the sexist pig was suggesting I might have PCOS.

I just left there in pain like I'd been kicked in the stomach, feeling utterly used, and insulted by his unnecessary personal remark about something I'm very sensitive to, and feeling like the lowest of the low. I was knocked for six and couldn't quite believe what had happened. And THAT is why I didn't stand up for myself I'm sorry to say.

catsmother Tue 23-Jul-13 16:19:53

Sorry .... didn't mean to go off on one quite as much as I just did.

JamieandtheMagicTorch Tue 23-Jul-13 16:34:57

I hope that those of you who have contributed to this thread and dredged up painful memories for somone else's gratification, have not done so needlessly ( i was on the other thread).

I think the fact this OP has not come back speaks volumes.

courgetteDOTcom Tue 23-Jul-13 16:39:59

I think the difference is that this is an unusual area of healthcare in that we're not sick, but these are doctors and nurses (I know there's a difference) their job is to treat the sick and I think they can forget that there is a difference, sometimes they are there to save lives but most often they're not. I think you see it more in the US with their health system than here but it's a similar thing.

maja00 Tue 23-Jul-13 17:02:40

Actually I think it's more that some HCPs can forget they are dealing with people, and start to see women as obstacles to doing their jobs as quickly/efficiently as possible. Not taking time to explain things, doing extra procedures at the same time without consent, not stopping when a woman asks because they are "almost done" - they need to get the baby out quickly, the bed cleared, the case signed off and the women just get in the way.

PoppettyPing Tue 23-Jul-13 17:07:50

Holy mother of fuck. This thread is making me feel sick.

Why there is not international outrage at what can only be described as widespread state-sanctioned assault of women, is fucking beyond me.

PoppettyPing Tue 23-Jul-13 17:10:46

Not that it makes a difference but just wanted to add I am so fucking sorry to read all of your traumatic stories and my heart seriously hurts on your behalves. Jesus Christ. And a triggering thread to kick it all off again. sad

RevoltingPeasant Tue 23-Jul-13 17:17:27

Poppetty yes indeed. And no, the thread hasn't been a waste, because it has let a lot of people see what exactly women are going through.

I have to say I feel honestly a bit nauseous after reading some of this though.

catsmother that was a really eloquent post. I think you have described exactly what it feels like to be assaulted. Somehow, you just feel.... stupid or ugly or unwanted. flowers to you

MiaowTheCat Tue 23-Jul-13 19:05:56

Shall I tell you what can happen if you try to resist them doing anything they want to do to you during labour?


I'll leave a few lines in case anyone who is pregnant and wobbly wants to scroll past this bit.



First pregnancy - I had severe and very early onsetting SPD, to the extent I'd been unable to walk to the end of our street for a good 4-5 months prior to the birth. I was frightened of being left in permanent pain from this and had read all the stuff about trying your best to make sure you didn't get your legs opened past the pain-free gap, avoiding stirrups, being careful in the event of spinals and epidurals etc... mentioned whenever they wanted to swab me and do internals that I had SPD could they please be careful and was generally ignored but put up with that.

However I went into premature labour - had to deal with a snowballing night of terror as I realised this baby was going to come and was going to be heading straight into an incubator, wondering if she was going to make it, and also being denied any pain relief as they couldn't find anyone to sign it off apparently... waters broke and they found I'd got to 8cm with no pain relief at all and then they started pulling my legs apart with one midwife leaning half her bodyweight on my legs despite me begging her not to do that... things snowballed and they started talking about forceps and a spinal - and I was there terrified, trying to get them to note how far I could open my legs and promise not to damage my pelvis permanently... they just shouted at me again and again and ignored me. They explicitly stated they wouldn't do an episiotomy without my consent and wheeled me off to the theatre shaking with fear.

Wouldn't tell me what they were doing, wouldn't explain why someone was up to their armpits in my uterus (I later found out they were fishing chunks of placenta out) and later I found out they'd done a bloody mahoosive episiotomy without asking me or even telling me they'd done one - they left that to the physio the following morning to spread that bit of joy.

Because I'd got scared and tried to get them to note my pain-free gap for my SPD - the next day I not only got the joy of the physio telling me about their snippy snippy antics - because I hadn't immediately jumped to allow them to do everything and was trying to get them to stop them causing permanent issues with SPD... the fucking bastards rang social services on me for being "resistant". Also got left with some long-term issues with my SPD because of how they'd yanked my legs apart and locked them down around my ears in stirrups.

Fastforward to a second birth - again, un-straightforward circumstances - prematurity, retained placenta, stop-start labour - and I couldn't have been treated with more respect... no "we WILL be doing this" but consent and comfort levels confirmed all the time - and even going to theatre needing a spinal anasthetic to have my placenta manually removed again (again with SPD) was done with such care and my legs and pelvis handled with such respect I felt like I was some kind of fragile glass ornament. I would have consented to anything going into it all - from the previous experience I felt I didn't have the right NOT to (and I believe that was their aim - to make patients as disempowered and willing to conform as possible for an easier life for them) - and it was only the staff on this different maternity unit, looking horrified when told how I'd been treated and telling me again and again that I had been assaulted in what they'd done in terms of ignoring consent - that made me find my voice and start to stand up for myself again... probably making their lives less convenient in the process (I don't mean standing up in being a pain in the arse - I mean things like saying "yeah you can do an internal fine, but they're painful at present so if it gets too much and I ask will you please promise to stop straight away.")

TO the OP - if you don't understand how some of this treatment can feel like, or actually be deemed to be, assault... I'd be counting myself as very very lucky - I wish I didn't know how it felt to be treated like that either, I wish none of the women on this thread knew.

I'm going to step out and hide the thread now as there'll be people who claim what happened to me can't possibly have happened and I know I'l find that distressing. It did, I know of other people who, when I've told my own story have very very quietly spoken up and said it happened to them - but because of the stigma of it all, lots of people hide it away and don't discuss it. Someone previously on another thread also linked a newspaper article where SS being used in this way was discussed - I cried when I read it - because I had thought for a long while that it was just me and I'd somehow "deserved it." That's the reason I do speak out and tell the story because I hope that if someone else gets treated like I did, they google and come across it, and realise they're not alone and no one deserves that kind of treatment.

Icedink Tue 23-Jul-13 20:28:25

Horrible thread - op I really hope you don't ever find out how it feels to be treated in such a way. I notice you said you were overdue so maybe you are busy atm but I hope you come back and read the responses and apologise for the flippant victim blaming in your posts.

I find it so shocking that so many other women have gone through this. I thought there must be something wrong with me to make the mws and doctor think I didn't deserve the 2 minutes it would take them to explain what they wanted to do and ask me if I was happy for them to go ahead. I had never heard of this happening to anyone else before I joined mn, it really damaged my confidence and self esteem to think that all other women deserve to be treated with respect and I deserved to be violated and sneered at.

flowers to all the women on this thread, I believe you and it wasn't your fault.

SwedishHouseMat Tue 23-Jul-13 20:36:49

I had a stretch and sweep without consent. I was told by the registrar that he wanted "a little look". I too was held down by the stoney faced midwife who said nothing to me throughout my screaming at him to stop - apart from "you might need this" as she threw a sanitary towel at me and left.

courgetteDOTcom Tue 23-Jul-13 21:07:07

I have heard of other doulas throwing themselves over the mother, shouting "She does not consent!" at staff. One even admitted that the mum was far too gone to talk but she could see and knew from before that she didn't want what was happening so she leaned in as if to talk to her and said to them that she didn't want what they were doing and didn't consent, I don't get the impression this is something new or rare.

courgette Thank god for wonderful people like that.

I spoke to DH about it the other day and he said he wishes he'd said something at the time but thought the doctor knew better than him. Wish I'd had a doula there to help me.

courgetteDOTcom Tue 23-Jul-13 21:19:31

I said further up to look for an article about difficult birth a dads perspective. I think it should be mandatory reading for all dads.

That sounds good, DH is normally really good at disagreeing with authority (often too good) but I think because he was worried about me it changed it for him. Think it's often forgotten that it's damn scary for the dads too.

McNewPants2013 Tue 23-Jul-13 21:31:47

This thread hasn't been a waste, as i didn't even know i could have refused an VE in labour with my DC. I trusted the MW looking after me and thought it was just stardard.

However thankfully i don't have a horror story to add to some of the treatment some women has been through. flowers

edam Tue 23-Jul-13 21:44:15

miaow, that's horrifying. It is shocking that health workers can call social services to bully someone for daring to say, hang on, I have SPD! An attempt to terrify you into not complaining and not going to a lawyer, I bet.

Icedink Tue 23-Jul-13 22:46:36

If you haven't seen it already I highly recommend the freedom for birth film - it is such an eye opener!

I had hoped that GingerJulep would have come back and apologised for the insensitivity and offensiveness of this thread, and the hurt it has caused. I am saddened to see that she hasn't.

MsJupiterJones Tue 23-Jul-13 23:23:43

I had an induction 2wks before my edd (due to GD) and spent a week having things inserted, removed and constant internals. It wasn't offered as a choice, I didn't think I could say no.

For the most part, the mws were nice about it. The consultants were not. The last consultant who tried told me off for (instinctively) moving away from her, then said do you want me to stop? I thought she meant pause ie stop shoving her hand further in for a sec so I said yes. She whipped it out and then said I was refusing to cooperate. Warned that she would write this on my notes and that my eventual Caesarian was 'by maternal request' (at this point I'd been having mildish contractions for 4 days but no progression beyond 1cm - DS just wasn't ready).

My vagina burned for months afterwards, despite not actually giving birth through it. I am not sure how I will ever conceive dc2 as I still have flashbacks every time I try to have sex (9 months on).

My experience wasn't as bad as some for sure but I don't think it was right.

courgetteDOTcom Tue 23-Jul-13 23:29:20

MsJJ it sounds like you're suffering BT and that you may have some damage. sad Do speak to your GP, as I said earlier, it's no way to enjoy your baby.

edam Tue 23-Jul-13 23:29:44

MsJupiter, your experience was indeed bad. Don't feel obliged to downplay it - it's wrong, and appalling, that you were treated so badly. That consultant should be shot.

You may find it helpful to talk to the Birth Trauma Association I think that might be a good idea - you are still suffering from the way you were treated now.

MsJupiterJones Tue 23-Jul-13 23:41:34

Thanks, that's appreciated.

BoozyBear Wed 24-Jul-13 00:09:58

i had two slightly dodgy experiences, but nothing on a par with what some of you ladys have suffered. sad

The first was them being insistant on sticking a needle in my hand when i was in hard labour, i dont recall much of it, but i had horrendous bruising and my mom told me that after the 5th attempt from the midwife she stepped in and told them to stop it.. apparently i kept pulling my hand away from them and tried to slap them the last time.. my mom decided i had had enough and made them wait until i was calmer.

The second one was post birth, my emergency epi stitches split and they had to check the wound for infection by swabbing, it HURT, and the midwife who was checking me told me to stop being such a baby and ignored my pleas for her to just STOP because it was hurting... then told me it was my own fault for being too tense and just to be quiet and let her get on with it so it would be over quicker angry

RubyThePirate Wed 24-Jul-13 00:40:38

Another here who consented to an internal exam and got a membrane sweep to which I hadn't consented.

I am still angry about it three years on; about the experience of the sweep itself, the way the breach of trust adversely affected my birth experience and because I should've complained and didn't - she assaulted me yet I felt guilty at the thought of getting her into trouble.

This thread had brought up some unresolved feelings.

garlicagain Wed 24-Jul-13 01:11:21

Such horrible attacks on so many women ... sad Thank you for sharing your stories, and I hope it's some comfort to be able to share & know you're understood flowers

There was a big, very persistent movement against 'factory birth' in the 1970s. Labouring women were being slammed down in rows; induced to hospitals' timetables; scraped, sliced and stitched without consultation and often, allegedly, without need. Aged 20, I wasn't aware of the full horror being inflicted on people, but the fury of campaigners was evident.

The violence & cruelty you're describing is the outcome of improved, woman-centric obstetric care shock shock angry

From here, it looks like time for Phase Two of that protest!

garlicagain Wed 24-Jul-13 01:14:00

Why the hell are they wasting Social Services' time like that?? I'm very sure that a woman screaming on the labour ward is nowhere at all on their list of priorities.

Namechanger012345 Wed 24-Jul-13 03:54:12

Sorry to all the posters who have had such bad experiences. I can identify with a lot of these.

A couple of months ago I had internal examinations done that were really traumatic. Mine wasn't a birth situation, I was having examinations to check for retained productions of conception and possible infection. The doctor said she was going to do a "swab" which I assumed would be like a small cotton swab, as that is what I have had before, and I agreed to that, but then she started to ram in some kind of large plastic cone (sounds like what little sporks was describing!) That was really painful and shocked me because I felt I had no warning since she didn't explain it at all.

I burst into tears and started really really panicking, I was trying to resist it just out of reflex and they just kept saying "relax". When I actually managed to speak I told the nurse that I was finding it really hard because I was raped when I was younger. She didn't really acknowledge what I had said, just kept telling me relax, breathe etc... The doctor did not offer to stop or show any sympathy that I was clearly distressed, just said like it won't take much longer... They held my knees down onto the table to keep my legs open and carry on for about 5 more minutes while I was sobbing sad Afterwards I found that some of the tests they did were not even necessary, e.g. one of the "swabs" with the cone was for chlamidyia which I knew I definitely did not have as I had recently been tested already. If they had asked and explained before doing, they could have saved me some of the unnecessary ones.

The doctor made a comment about why am I reacting like that, how do I deal with smear tests, which made me feel really stupid. I am in my mid 20s, I've only had one smear test before and the smear I had was not traumatic like this as that nurse then was nice, reassuring and told me what was going to happen. These recent internals were much more painful as whatever they used seemed bigger than a normal speculum and it was the shock of having a large foreign object shoved in my vagina without me being informed or consenting angry

This experience has been affecting me a lot. As well as having flashbacks to my previous rape while the examinations were happening I have started having them occasionally during sex and I keep feeling really panicky just before penetration even though I know my partner doesn't want to hurt me and would always stop if he was hurting me or I was upset at all.

I'm really angry about how they handled it all because I think anyone would have felt upset and humiliated by that and they need to treat people with more sensitivity, and it is definitely that experience which has triggered my rape flashbacks and putting me back in a much worse place about that again.

I haven't complained about it but I just got a letter telling me to book in for a smear so I think I will have to talk to my GP about all this beforehand to try to ensure I get someone sensitive and understanding for that.

courgetteDOTcom Wed 24-Jul-13 09:33:31

I wonder if MNHQ have read this thread?

I've always been aware of this happening but reading a thread like this is still shocking, it's not so isolated, this is happening to too many women. what scares me is how many posters don't seem to know they're suffering Birth Trauma! PTSD. I thought I had PND, I was diagnosed with it, it took me well over a year, possibly pushing two to realise when someone posted on a forum asking mums to answer a questionnaire for her university research, I sobbed through it and at the end there was a statement that if you'd been affected by the questionnaire to click the link. I read the whole BTA website in one sitting crying many eyes out realising this was me.

There has got to be something we can do!

aldiwhore Wed 24-Jul-13 09:45:06

I am glad this is being talked about. I am sad that so many people go through it.

It happened to me, I was told was going to happen and led to believe it was in my and my baby's best interests, I wasn't told details, I was high on diamorphine and my DH, like me, didn't realise what this stupid, rough, thoughtless arse of a Dr was going to do.

My youngest is 5 years old and I can still feel that moment. It wasn't so much the pain either, but the feeling of being violated.

And, there was no need to put a 'cap' on my baby's head (heart monitor?) as we were getting strong healthy readings from the standard(no idea what it's called sorry) heart rate monitor.

The Dr also laughed and said "Well, I should have known I couldn't get it on but it was worth a try right?" (Erm no, I was 1cm dilated, he needed 3 fingers to attach the cap, the sums didn't add up even in my drug induced haze).

I was extremely vulnerable during labour. It sounds stupid but I never considered I was ALLOWED to say no. I asked questions all through both my labours and that seemed to irritate people! My care with my first child was excellent, but there's a reason I'm stopping at two. There were a catalogue of events that happened for no other reason that maternity staff not giving a shit... I'm still shocked by the attitudes that night, I work with midwives and academics and KNOW how dedicated they are, how in general they do give a shit!!

I find it very difficult to have smears/coil changes, anything involved with internals now, though before my awful experience I was pretty strong and matter of fact about these things. Actually just writing about it is making me tearful and ashamed.

Icedink Wed 24-Jul-13 10:25:54

Courgette DOTcom this had to be worth a mn campaign! Can we report this thread and ask mnhq?

I complained about certain things that happened during my dc's birth including the vaginal examinations that were given with no warning or consent and received a fairly rubbish reply that didn't address what had happened at all and an apology for me being upset. This thread had inspired me to take it further and I will write another letter because I don't feel that this issue is being taken seriously and it is obviously happening a lot angry sad

GingerJulep stated in one of her posts that she was past her due date so I'm assuming that shes having/had her baby and thats why she hasn't been back to this thread. I found her posts really offensive and upsetting but I think/hope it was down to ignorance rather than a genuine wish to cause offence. Hopefully we have managed to educate her and anyone else who thinks you can just shut your legs or kick hcps in the face! I truly hope that she doesn't find out the same way a lot of us have that its not as easy as that.

aldiwhore Wed 24-Jul-13 12:27:35

GingerJulep in response to your op I DID tell them to stop, I couldn't kick, I couldn't speak, I hand 3 fingers in my virtually closed cervix you see? I was pretty immobile with horror.

DH stepped in, when he realised I was frozen with terror... he asked calmly THREE times to stop, but the Dr only stopped when DH threatened to make him (DH is non-violent, not a thug, well spoken, calm, practical, but everyone has a moment when please just won't do!).

Had the procedure been explained to me properly I would have refused, as it was not necessary, but it wasn't, and then it was too late.

RowanMumsnet (MNHQ) Wed 24-Jul-13 12:56:06

Hello

Thanks for the reports about this thread. We're going to have a proper read and a think. Just to warn you, we're a bit chocker at the moment in terms of campaigns and awareness-raising so this might not be something we can take up in the near future, but just from scanning the thread we can see that this is an issue that many of you feel very strongly about - unsurprisingly given some of the shocking experiences you've had.

Thanks,
MNHQ

bloodybutunbowed Wed 24-Jul-13 13:29:29

I have had 3 years of CBT due to being gang raped aged 17. My psychologist cried with me and said it was one of the most traumatic accounts she had ever had to listen to. I have PTSD and all over my maternity notes it has been written in red ink - "PTSD, no internals, no male staff".

I have had several children (sheer bloody mindedness - I always wanted a big family and the rapists will not win). During hospital births DESPITE my birth plan drawn up in conjunction with my psychologist, DESPITE red inked notes, DESPITE meetings with supervisors of midwives in the weeks before the birth, I have been forcibly held down, forcibly examined, had domestic staff wandering into the delivery room to get cleaning equipment mid examination, had a consultant examine me in front of a team of medical students, been told off for being "silly", asked how I managed to conceive, been humiliated and so on. I have been pushing out a baby while a midwife cheerily asked me "So, were you raped by someone you knew?" Midwives have treated me like a tiresome, neurotic fool. Not all midwives - I will never forget one midwife who held me through labour and kept repeating "No one is going to hurt you, I'm here." But she was an exception. After one birth I needed psychiatric help. The mental health nurses were of the opinion that I had been raped all over again.

My last few children have been born unattended at home, on my own. They have been cathartic and empowering births that have helped me to heal, but the pain, trauma and terror will never completely go away. OP you are living in some kind of beautiful dreamland if you think it's as simple as kicking someone in the face. I hope you don't have to wake up.

bloody that's appalling. Thank goodness for that one wonderful midwife.

ICBINEG Wed 24-Jul-13 14:19:53

I have always had extreme pain during smear tests and so was all over anyone trying to examine me during pregnancy. I practically had them sign a rules of engagement document before they could touch me.

However I did not want to do stirrups. At all. But a midwife convinced me to 'just try it' so I did. I found that the pressure of my enormous bump on my diaphragm/lungs meant that having expended all the oxygen in my body pushing I could not catch my breath and became panicky. I tried to lift my legs down myself and couldn't, I said I needed out to the midwife and she said 'no, your fine' I screamed at her to get me out and she didn't. Thankfully my husband just reached across her and rescued me, and calmed me down. I cannot imagine what it would have been like if my husband hadn't been there.

My heart goes out to everyone who ever found themselves powerless or overwhelmed during labour.
thanks

catsmother Wed 24-Jul-13 15:04:09

What the hell is the matter with these so-called professionals who utterly ignore what has been made very very clear to them in triplicate ?!!? Are they thick ? Are they sadists ? Are they on a power trip ? They certainly shouldn't be in what's supposed to be a caring profession.

Bloody - words fail me, I'm glad that at least some of your birth experiences haven't been the utter nightmares you were subjected to. And Icbineg, thank god your husband was there to intervene. Some of these people clearly think they are above the law when they assault vulnerable women in the name of medicine.

courgetteDOTcom Wed 24-Jul-13 15:15:04

bloody, you should have got a doula, I'd love to have been there and fought for you!

aldi, if this was your youngest, why were they putting a clip at 1cm? Most women in subsequent pregnancies spend most of their pregnancy at least at 1cm!

I think the right to say no is something that everyone should know, as well as the right to decide what happens to your body during your birth. I think men need to know that they can stand up for their partner.

courgetteDOTcom Wed 24-Jul-13 15:16:33

Thank you for responding, Rowan smile

garlicagain Wed 24-Jul-13 18:42:42

Thank you, Rowan.

Oh
My
God
shock
Bloody, I'm so sorry they did that to you. Thank you for telling your story.

JamieandtheMagicTorch Wed 24-Jul-13 19:01:00

This makes me want to cry.

I did not mean to imply earlier that this is a wasted thread. Allowing us to share our experiences may be therapeutic. I hope so.

I just doubted the OPs intention. Not coming back and apologising suggests she might not be what she seemed. Or maybe she is just gutless.

courgetteDOTcom Wed 24-Jul-13 19:12:21

Jamie, she did say she was overdue so she could be having her baby.

SwedishHouseMat Wed 24-Jul-13 20:13:43

ICBINEG - I am sorry about your experience with stirrups. I'm sorry you were tricked by the midwife into using them - no doubt for her benefit and not yours. Seriously, how can anyone think that lying on your back with your legs apart and pushing uphill is the best way to give birth. No wonder women can't protect themselves from unecessary internals if you are so exposed.

All the negative experiences that I suffered when giving birth to my DS are coming back reading this thread. The lies and coercion by HCPs to get me to do what they wanted. I had people touching me without my permission. I had students in my room gawking at my nudity. No one introduced themselves to me. My DH and I were frozen in a state of horror as the events unfolded. It was never about me or my baby, but all about the midwife and working to her timetable, constant monitoring, ticking of boxes after every non-consensual exams, an episiotomy after I begged her not to. My DH said the she was hiding the scissors behind her back and she cut me before he had a chance to stop her. She waved the forceps and beat them against the bed. She threatened me with them if I didn't put more effort into pushing.

I only have my DS. I avoid healthcare and doctors. I can't bear to be touched.

I hope there is a campaign to stop the abuse of women in childbirth. They need protecting.

bloodybutunbowed Wed 24-Jul-13 20:18:23

Thank you. There is so much more I could say on this but daren't because the flashbacks and body memories will begin - I just hope as Jamie says that sharing here opens someone's eyes just a little. I was asked to write my experiences down for AIMS but wasn't strong enough. Maybe collectively we could do something?

RiffyWammal Wed 24-Jul-13 21:25:26

These stories are horrifying. I am so angry for those of you who have told of your experiences.

It's brought back a very unpleasant experience of my own, which I hope no-one minds me recounting as it is nowhere near as terrible as the others on this thread...when I was 16 my mom took me to the doctors as my period was late and I thought I could be pregnant. The doctor had a really unpleasant, arrogant manner which was well known (Christ knows why my mother hadn't changed us to another surgery already), and he said I had to have an internal examination to determine whether I was pregnant - no offer of a urine test, which I don't think were as freely available in shops as they are now, and therefore I hadn't done one already. I asked him if this was necessary and he snapped 'I am not a painter and decorator, <my name>'. I felt so, so small and as though I had no choice. My mother waited outside and it was just me and the vile doctor who proceeded to give me an internal. I think he looked at my breasts too to check if I was pregnant.

When I left the surgery I burst into tears, I felt so incredibly degraded, dirty and ashamed. And I wasn't pregnant at all, as a simple urine test would have confirmed.

This was 24 years ago so hopefully things have changed a lot since then. I hope vulnerable 16 year old girls are not treated in such a rough, uncaring manner nowadays. I dearly wish I had refused the exam, but I didn't feel confident enough, and the person who should have been there for me (my mother) seemed too in awe of the doctor's status to question him. I still feel so angry and sad about it, so I can only imagine how terrible some of you must feel.

GettingStrong Wed 24-Jul-13 21:53:17

Message withdrawn at poster's request.

aldiwhore Wed 24-Jul-13 21:56:14

courgette That is what the Dr said, I didn't measure. He tried to get a cap on my babies head when I wasn't dilated (or was at 1cm) I was induced, had been having contractions for 10 hours and wasn't dilating. There was a health heartbeat on the monitor, no signs of distress in my baby (lots in me, I was so so ignorant about being induced).

Whatever the exact measurement of my cervix was is a moot point, or rather, only added to my distress as I wasn't dilated enough and there was no need to fiddle around, nor was their cause to use so much force, or to continue after being asked to stop.

Had my baby been in distress, I would have accepted the procedure as horrible and necessary, but without the necessity, it felt like abuse.

maja00 Wed 24-Jul-13 22:05:39

GettingStrong - you always have a choice. Unless there is a court order they cannot perform any procedure on you without gaining your informed consent first. There are very few situations where it is so life and death that there isn't a few seconds to explain what is happening and what they want to do.

I had a similar situation to you in that I pushed for 2 hours, and then they wanted to use forceps or possibly go to c-section. I was asked if I wanted a spinal block and signed a consent form. It took moments. I could have still refused though - doctors can't forcibly do something to you even with the intention of saving your life eg. blood transfusions for Jehovah's Witnesses.

garlicagain Wed 24-Jul-13 22:14:29

GS, when you have surgery you're asked for written consent to each procedure the surgical team think might be needed under any circumstances. For instance, I consented to a keyhole operation and refused consent to go for a cut if the keyhole failed. As it turned out, the surgeon plugged away at a difficult keyhole purely because of this; we were both pleased with his results.

Clearly, a baby isn't going to wait six weeks for the rejected procedure, as I'd have done if my keyhole failed! But I think that far better information, ahead of delivery, would allow women and their HCPs to arrive at benchmarked birth plans. I can only see this as undesirable from the pov of an HCP who wants total control of another person's body, tbh.

GettingStrong Wed 24-Jul-13 22:43:20

Message withdrawn at poster's request.

courgetteDOTcom Wed 24-Jul-13 22:48:29

I'm on my phone so will read later. Just watching Meaning of Life.

mum: What do i need to do?
Dr: Do? Why, nothing! You're not qualified to do anything.

courgetteDOTcom Thu 25-Jul-13 00:15:11

aldi, I didn't think that it had come from you, I was just shocked he did that sad at 1cm you not only wasn't dilated enough, you probably weren't even dilating. I've had 4 premature babies and each time they left me alone until I was past 2cm and effaced.

gettingstrong, it is always the mother's choice. They will assume consent unless you withdraw it, but should be explaining what they are doing as they go along so that you have chance to say no. They can also explain to your birth partner/s so that they have chance to speak up on your behalf. Quite often they'll try to make it a done deal, so that you don't withdraw consent and I think as this thread has shown this is where the problems are coming from.

I had a crash section, but they still took time to explain three consent forms they needed signed and do other things to get me ready for theatre. It's not like, even with forceps that everyone is ready straight away, it needs to be set up so they should be making use of that time and I've seen them do that really well.

I think one of the biggest problems with birth plans is they're often a time table/ list of requirements etc. I have a template I made for my due date club that tries to state preferences and important information. I think the problem they have is they think they've seen it all and "ah bless, she wants candles, rose petals and whale song" without even looking. If you have something that says "I can not be put in stirrups" "I'm not suitable for an epidural, please go straight to GA in the event of a caesarean" (that's me) "I want to start off with minimum pain relief and will ask for more if necessary" etc and you make sure your BP knows what you're preferences are and can wave it at them if necessary then it's either going to help or strengthen your case if they try to go against it.

GettingStrong Thu 25-Jul-13 01:36:55

Message withdrawn at poster's request.

garlicagain Thu 25-Jul-13 01:51:53

Possibly ignorance on my part, but why would they be pinning people down anyway? I thought that whole physical restraint business had been abolished after the scandals in the 70s.

They appear to be treating women in labour like violent criminals confused

Bogeyface Netherlands Thu 25-Jul-13 02:07:06

Possibly ignorance on my part, but why would they be pinning people down anyway? I thought that whole physical restraint business had been abolished after the scandals in the 70s.

They do it because they know better. You are just another PITA mother2B who has probably been to those gobby woo NCT classes and you think that you know better than they do despite their training and experience. The fact that you know your own body is irrelevant because they have been taught how the average woman reacts and therefore how you should react. The fact that you are different is YOUR fault and not theirs.

Apparently.

courgetteDOTcom Thu 25-Jul-13 03:13:16

Getting Stronger, if you want a sex parallel, think of marriage and a woman thinking "not tonight" but going on because her husband wants. I don't mean where he's pushed her, I don't want to sound like I'm putting any ok on rape, I'm sure everyone had days when their partner is more willing than them but they go along anyway. That's the grey area, doctor hasn't been told mum isn't happy but she's not saying it's an issue because she doesn't think she can. She might be totally happy out of it or she might be really upset.

Hope that makes sense, just seen how last it isshock

courgetteDOTcom Thu 25-Jul-13 03:14:20

garlic, read my monty python quote! As funny as it is, it's true.

bordellosboheme Thu 25-Jul-13 05:20:45

Wish I hadn't started reading this. Feeling sick now. I also had a procedure I didn't expect. It did fuck all to induce labour and my baby ended up in special care. Did they save my baby from worse or cause massive stress to me and ds ill never now. Massively triggering thread. Something needs to change in the NHS

Leverette Thu 25-Jul-13 05:51:39

Bogeyface I have met a lot of midwives in the course of my job with that exact "philosophy". Patronising, condescending, frankly contemptuous, I'd go so far as to say sadistic - rolling eyes and sniggering at someone's emotional or physical pain or distress.

I've always reported it but frankly they need to leave - if they ever had basic human compassion in the first place, it's certainly a long time gone now.

HenWithAttitude Thu 25-Jul-13 06:35:31

I had 3 lovely midwives. We need to weed out the ones who have forgotten how to care, become disillusioned and can no longer put women first.

I think good midwives would welcome a campaign for change. It would help them give good care when colleagues are unsupportive.

Regarding forceps: I have heard of far more birth trauma both mental and physical following forceps. I was very clear on my birth plan that I did not consent to them and would not consent to them Be clear in early communication otherwise you reach a point when you are unable to have a section and your baby is at risk...so you have no choice. You do have a choice. Plan ahead to avoid forceps. (Give me a section any day over a brutal mechanical delivery damaging my internal organs)

I think forceps are a last resort. I think HCP think forceps are a cheap alternative to sections. That just shifts financial burden to the gynae dept for repair of pelvic floor

GettingStrong Thu 25-Jul-13 08:55:47

Message withdrawn at poster's request.

MiaowTheCat Thu 25-Jul-13 09:14:27

As for being pinned down - in addition to the midwife swinging bodily on my SPD riddled leg on one side - they couldn't keep the heartrate trace on well (DD1 was engaged in full evasive "fuck off you ain't monitoring me" manouvers) so they had another woman brought in holding that trace down so hard it was forcing my body into the bed. That woman also had, well, the world's largest knockers so her mega-norks were pushing my other bloody leg SHUT as one was being yanked open!

I believe at one point mega-norks was annoying me and hurting me so much I actually said, "look give it here, I'LL hold it on cos it's not as if I'm doing anything productive here at all is it?"

The SECOND they got me vertical to put the spinal in to do the forceps they'd coerced me into doing (I refuse to call it consent because agreeing that "we're GOING to do forceps - do you want the pain blocked or not" is NOT consent - and the fucking social services thing was just an act of revenge because I'd dared query it) - DD1 began to move after all the faffing about - I believe firmly that if they hadn't had me bodily forced down onto the bed she would have come out of her own accord and none of the intervention would have been necessary.

Oh they also didn't ask if I was OK with my MIL coming into the room mid-labour either (I chucked her back out) - but that one's another story.

I can laugh about bits of it now like this woman and her bloody huge knockers but at the time it was totally horrific.

Second time around I think my birth plan went along the lines of "I am VERY scared and probably won't trust you because of previous trauma - please accept my apologies for being like that now... if it's looking at all like forceps will be required, please discuss this with me as early as possible as I'm likely to panic if you mention them and would like to be able to consider alternatives... oh and please please please don't wreck my SPD any more"... hardly requesting whale noises and candles. They stuck to my wishes rigidly - and my second labour wasn't the most straightforward, I DID catch the midwife out with the speed of it - but she was kind, yes she was firm but kind and friendly with it and she was wonderful afterwards when she admitted with a wry smile that in her entire career - I was the one who'd totally caught her out with the sheer speed of the delivery (I very nearly replicated the Neighbours one where Daphne didn't take her trousers off to have the baby - I do remember an "oh fuck I'd better get my jeans off before the head comes out" moment)

I actually didn't realise just how badly I'd been treated - until I saw how WELL I was treated the second time round (OK so the post-natal ward was like something out an episode of Carry On Midwife but still!) and I realised that what had gone on at the other hospital was in a whole realm beyond fucked up.

Also jumped at the chance to have a student the second time around as more than anything else - I figured doctors etc would be on their best behaviour trying to impress new (fit) students.

I think there is a difference between medical assault, and traumatic experience of a fully consented procedure.

Greater awareness of birth trauma would be a very valuable thing, but that's separate from the issue of continuous consent and inappropriate contact.

courgetteDOTcom Thu 25-Jul-13 10:45:56

gs - that's not grey, you said no and fought them off.

miaow - I knew mine hadn't been good, this wasn't the birth that left me with ptsd and I wasn't as outraged as my doula but I put it part down to the frustration of missing it as I had my baby whilst she was on her way to holiday, I was 34 weeks though. Then I had a lovely birth about 6 months later where the mum was quite poorly and after giving her good chance they went to forceps. She got distressed so they stopped and waited for her to be ready. I saw my doula a few days later and was telling her I totally got the difference, I really understood what they'd done to me.

horry - the two are interlinked though.

GettingStrong Thu 25-Jul-13 10:48:43

Message withdrawn at poster's request.

GettingStrong Thu 25-Jul-13 10:51:18

Message withdrawn at poster's request.

Yes they're interlinked. But on this thread there are examples of assault by HCPs and also perfect procedures that happened to be traumatic despite being fully consented and sensitively performed and halted as soon as (or indeed before) consent was withdrawn.

I think there are two campaigns here: one supporting women who have been assaulted as part of a medical procedure (actually, any patient who has had any procedure without consent); and one supporting women with birth trauma and other associated gynaecological trauma (eg bad reactions to smears). Both involve making HCPs aware of the limits of their "power" and the primacy of consent, with increased attention paid to potentially sensitive procedures. I can see that they are linked but campaigns tend to have more success when they are more focused.

Assault is completely avoidable and already illegal*; trauma is unpredictable and therefore not eradicable. Making it clear to patients and HCPs that procedures without consent are assault is a hugely important message. Saying to patients that you have the right to refuse consent *at any point is hugely important. In the UK we have rights over our own bodies that only very senior courts can overrule.

Arse. Bold fail.

alohahaha Thu 25-Jul-13 12:23:25

This thread has brought back a lot of memories for me of my son's birth almost four years ago. I feel really strongly that I want to write down some thoughts after reading others' experiences (by the way, thank you for sharing).

I was very clueless about labour and birth, despite preparing as best I could. I had no birth plan. I ended up with an emergency C-section and was left traumatised - I wept every night for six months afterwards.

My story feels pitiful in comparison to the others shared here. after a night of agonising cramps a midwife examined me internally and told me i wasn't dilated at all. a doctor examined me internally a few moments later and told me i was 4cm but after a sleepless night i had been crushed by the midwife's exasperated tone - seems silly now, writing it down, but it was my first time and i was easily crushed. after moving to the delivery room a doctor started to attach a clip to my son's head without introducing himself, or explaining what he was doing. I was flat on my back when he started to insert the required machinery into my vagina, and I wriggled away and shouted at him to stop. The midwife (who "attended" during my labour with her back to me the entire time typing notes on her computer) grabbed me forcibly and tried to pin me to the bed, shouting that I should let the doctor do his job. thankfully he stopped and explained what he was doing before continuing. also, when I refused to be catheterized early on in the proceedings I came under immense pressure from a room full of HCPs and I ended up shouting and crying - it was the only way to make them listen. they ganged up on me and told me i was putting my baby's life at risk because i wanted to go to the toilet by myself. no explanation as to why or how, but just bullying because it suited them better.

I ended up screaming and yelling at one midwife near the end. I feel bad about that because she genuinely didn't deserve it, but the treatment I received during my labour had me in such a state that I felt like a wild animal. i can't begin to explain the powerlessness I felt, or how uncaring HCPs were with my body. i felt like the useless meat surrounding my baby. the whole process affected me deeply, i can't watch any kind of violence on TV or in films now. i don't have flashbacks anymore thankfully, and my second child's birth helped me to make peace with what had happened.

for my second pregnancy i had a planned section. no internals. no risk of maltreatment. i would never again put myself in my most vulnerable state at the mercy of such cruel, contemptuous, savage people. i dread to think what they would have done to me if i had delivered any other way.

garlicagain Thu 25-Jul-13 12:33:15

I disagree with your splitting of the issues, Horry, though not with your overall point, which is after all the point of this tread.

Women are being coolly, deliberately, assaulted by HCPs especially during birth.

'Dehumanisation' is too emotive a word for a campaign, but it adequately describes what posters have suffered in their experiences told here. It's also behind the victim-blaming that attends rape & sexual assault. Another striking parallel is the silencing of victims. This allows perpetrators to carry on abusing, and lying, with confidence that victims would not be believed if they spoke up.

Mumsnet powerfully addressed the silence of rape victims with "We Believe You". How about something like "End The Silence" for victims of gynaecological assault? (Eeuw, the parallels here are terrifying.)

Several posters have already said they hadn't told anybody how they were harmed. Would women feel empowered to make a fuss - supporting both future mothers and good practitioners - by hearing others' pain & anger about these assaults?

garlicagain Thu 25-Jul-13 12:36:36

Savage is a good word, aloha. What they did to you was horrible. Thank you for sharing. I'm very sorry it still affects you in some ways. These are deep traumas, aren't they? sad

RevoltingPeasant Thu 25-Jul-13 12:46:05

Reading this thread, I have two questions which I hope are not offensive. They're not meant to be.

1 how far do we think this is an obstetrics problem?
The other day my colleague told me a horrible story. Her sister had a problem with her knee and went in for exploratory surgery to see whether she was a suitable candidate for a bigger op to cure the problem. She came out of the anaesthetic to find that big op had been done - they'd seen it was feasible, so just done it whilst she was under. No consent, no discussion of alternative treatment. She now cannot walk for 8 weeks and has had to take leave from work and move back to her parents' to be cared for. Is this not a version of what's happening on this thread?

2 how far is this cultural issue within the NHS?
I have been in my local hospital - which is struggling and a bit of a byword locally - for several overnight stays recently. The nurses are always lovely but I notice this sort of "keep calm and carry on" attitude, a kind of blitz spirit - like, yes we are under resourced, but lets just crack on! I wonder if the darker side of this attitude is a kind of grim pragmatism, like "well, it's not ideal to use forceps, but we need to get that labour ward bed free, I'm sure the mum will soldier on".

In every NHS hospital I've been in there is this sense of not grumbling, carrying on no matter what.... Which is really admirable.... But I wonder if it has an unfortunate side too.

garlicagain Thu 25-Jul-13 12:57:16

Whaaaat?! Utterly shocked at your friend's knee story, RP!! How can they get away with that? Dis they trick her into consenting to the bigger op? Surely she has grounds for a complaint ...

I wonder about your NHS questions, too.

garlicagain Thu 25-Jul-13 13:04:48

... Thought twice about adding this, for fear of politicising the thread, but as the NHS is being broken down and replaced by private services, the pressures for healthcare to be just-good-enough, at minimum cost, will only intensify. I've had nothing but wonderful treatment in private hospitals courtesy of BUPA, but that's not the same thing at all.

I think I'm trying to say I can believe this could be a mainly NHS-related problem, but let's not demonise the brand (as it now is), because the issue's not in the name but in the ethics of public health provision.

RevoltingPeasant Thu 25-Jul-13 13:05:01

Garlic again really not trying to be offensive, but....!!

It does seem to me cultural to some extent. I am British but didn't grow up here so NHS environments feel often quite alien. Don't get me wrong, I'm grateful for it, but often find the assumptions made quite odd.

My colleague did not tell that to me as a horrible story. She told it as a story of "fantastic service" as her sis would not have to go on a waiting list now. When I told DH he shrugged and said "yeah but it fixed the problem, right." DH also British btw.

I just see a continuity there between that attitude and a midwife saying "just let the dr do his job" or saying forcing a woman into position was unavoidable. End result, healthy baby? So what are you complaining about?

I do not want to have a baby in hospital after reading this.

RevoltingPeasant Thu 25-Jul-13 13:07:01

But I should say I don't want to derail the thread and also I fully support better funding of the NHS and not damaging it further through privatisation.

Revolting that's sort of my point really: that many of the experiences fall under both "unconsented and/or brutal treatment" and "unpleasant gynae experience" at the same time. Lifting the lid on the extent to which some HCPs consider that their clinical experience outweighs the needs, feelings or wishes of the patient is long overdue.

I wonder if Panorama or similar would be interested?

RevoltingPeasant Thu 25-Jul-13 13:36:27

Horry that is a very interesting idea....

MiaowTheCat Thu 25-Jul-13 13:46:51

I'll try to answer Revolting's two-pointer - but I'm not as articulate on this as I'd like to be (emotion does still get in the way a lot). If I overgeneralise - or am taken to have - apologies, I DO acknowledge the service varies greatly - like I've said before - I had a fantastic experience with my second birth at a different hospital, but I think that "don't give a shit-itis" is bloody dangerously contagious if it starts to get a foothold within one establishment or another.

1 how far do we think this is an obstetrics problem?
I don't know - I do think that within maternity services in general there's still this tendency to see women as somehow silly little girlies who got themselves knocked up and wouldn't know one end of a uterus or baby from another (don't get me started on post natal wards - I was heard to mutter on a couple of occasions that I'd had a baby and not a lobotomy)... I think that a fair few do seem to view it that you've "asked" to be pregnant and therefore chosen to have to be dealt with by the NHS and so you should just shut up and be grateful. Add in time pressures and the fact that maternity services are swamped (our local trust had both units closed to new admissions earlier this week) and it doesn't take much for the "silly little girl making a fuss" mentality to override.

Add in the fact that, by and large, you're likely to leave with a baby and people seem to think that the gratitude for that should override any sense of ill-treatment or trauma. It doesn't work like that (and it's not something I think you can get the understanding of unless you've been there) - the two feelings - of gratitude for the delivery of your baby, and of utter trauma at how you've been mistreated can actually exist in tandem - and the conflicts arising from having to deal with both of them are really really hard to deal with (and even bloody harder to explain). The way I try to do it is to explain how DD1's birth was the worst day of my life... and the day we drove away from that hospital with her in the car seat in the back was the best day of my life - I can remember the exact bloody roundabout where the feelings of "I'm a mummy" euphoria kicked in. While to the rest of the world I celebrate her birthday - privately I also mark her "we got the fuck out of there" day too. I doubt that makes much sense but it's the way I've had to cope with divorcing the two feelings.

2 how far is this cultural issue within the NHS?
I mentioned "couldn't give a shit-itis" being contagious. We have two hospitals in our local NHS trust, both have maternity units - big hospital and smaller hospital. DD1 (the traumatic birth) was born in big hospital - I didn't know any different then, I assumed I'd be treated the same at both of them so I may as well go for the one that was easier to get to in what I assumed would be the frantic "shit in labour" rush.

The entire ante-natal, labour and post-natal ward setup in that place seems to have fallen into the mindset of patients being inconveniences, something getting in the way of the staff and a problem to be shunted off onto someone else at the earliest possible opportunity. It really does seem endemic - it goes right down to start at the ante-natal scans where you're just utterly ignored and not acknowledged as a person - right the way through to the post-natal ward where, twice, I was told, "We don't care about the mothers here, our only interest is in the babies." No seeing them as a unit, as a family... the women are just inconvenient lumps in the way of a more interesting baby.

It's not just me that's said that - a friend has a relative who's just taken up a post at the OTHER hospital... had to go on a training day to the big hospital and was horrified at the attitudes toward the patients going on there. I also became quite close to one of the transitional support workers while on the post-natal ward (I was kept in for the duration of DD1's stay on NICU and afterwards) and she privately told me it's disgusting and the way they talk about the patients in briefing handovers and whatever is disgraceful and she'd complained about it a fair few times... I also had to listen to them slagging off patients all night since my bed was near the staff desk - I actually told staff, not in a "I'm going to make a complaint" tone, but in a "look, someone is bound to come along who is arsier than me and I don't want you to get into bother - so just so you know - if you're in these beds you can hear it all so you probably need to moderate it a bit" way about this... they just don't care.

The other hospital, same trust, same policies... they were amazing - just actually giving a damn about their work. Operating within the same constraints, same frustrations and same things going wrong - but at least they saw the women they treated as humans, and indeed the partners as well - and DD1 was utterly spoilt by all of them when she came in to visit her new sister. I can't quite explain just how massive the difference in attitudes was - going right the way through from the ante-natal clinics up... the "don't give a shit" brigade hadn't got a foothold there yet.

They're really trying to make the maternity service utterly consistent across both sites... I've voiced quite heavily my view of "please for the love of god copy site B and not site A".

In every NHS hospital I've been in there is this sense of not grumbling, carrying on no matter what.... Which is really admirable.... But I wonder if it has an unfortunate side too.

Like I say - both hospitals had the same degree of shit thrown at them - both had delays, lacks of resources, shit food, long waits for stuff - it was just the attitude that made the difference... even between a snarled "you're just going to 'ave to wait - got lots of other people to see ain't we?" and a "yeah sorry we're running a bit behind, I've made sure you're in the queue and they know you're waiting."

MiaowTheCat Thu 25-Jul-13 13:49:35

And sadly I don't think people will be interested - Daily Mail ran an article on birth trauma recently - and there was the usual flood of "silly women, got a baby out of it didn't they - why are they whining" and the "oh their baby died, guess they're suing just to make some money cos it won't sort the baby out" type comments.

Even rarer someone speaks out with the situation I was in regarding social services because I dared query what the doctors wanted to do to me - I think there was a feature in the Guardian about it... but of course that can of worms is a massive stigma and that would deter people - it's only since I really started digging that people have let me know it's happened to them, or women they know. Hell, I only told the grandparents about it last week - I felt ashamed and as if it was something to hide for that long.

garlicagain Thu 25-Jul-13 13:50:17

I agree that there seems to be a strong assumption, on the part of too many HCPs, that their opinion concerning the patient's body & feelings is the only one that counts. I'm also certain that many patients feel overawed (or cowed) by them. I once walked out of a consultation with a patronising bully - as I marched down the corridor, he bawled at me from his doorway. Pretty sure he's had his malicious way with plenty of sick, shy or frightened women angry

Bullying doctors and timid patients are NOT particularly related to public health provision, though, nor to Britain. You find them in any medical setting. I think the difference is that a private hospital wouldn't perform unauthorised surgery, because they wouldn't get paid for it. The fact that a patient's not paying per procedure doesn't entitle practitioners to make decisions without their authorisation - but the disincentive of lost fees/jobs isn't there.

Sorry, there have been some cross-posts I've not read yet. I don't want to get into why this happens or how to stop it, anyway ... sufficient to let the light in. for now, I feel.

courgetteDOTcom Thu 25-Jul-13 13:58:55

Revolting, I think the reason it's more of an obstetric issue is that we're talking about women's genitals. The most private and intimate area, maybe only her husband has seen them as an adult and she's got a ton of people staring and a wielding metal instruments at it. Even if more than her husband has seen, it's still a very vulnerable moment. I think to keep the outside world comparisons up it's the difference between being mugged and a sexual assault. Also being in labour is a very vulnerable time, the neocortex switches off and you go into primal mode, it can be a very confusing and scary time.

I don't think this is an NHS problem. I hear far worse stories from US mothers. I also don't think it's a financial issue either, we're talking basic manners, that's free. We teach our boys growing up that they don't rape women, why should that change if they put on a white coat?

I think your friend's sister is the same. You will see some people who say they had a sweep they weren't expecting but sucked it up and can't see why people are complaining then there's the others who are complaining. If she is happy that it was done and doesn't mind, then there's no problem. They usually do have consent in case they find something different though I thought?

I think the Blitz attitude is probably an issue but more from mums coming out thinking "That was horrendous, but mustn't grumble!"

garlicagain Thu 25-Jul-13 14:03:52

Thanks for putting things clearly, DOT smile

RevoltingPeasant Thu 25-Jul-13 14:11:41

Yes, thanks for some really interesting responses to my points. I wasn't sure if I should post them as I'm aware they might be contentious so thanks for not taking them the wrong way.

Miaow that's why I wonder if it would be more successful as part of a "unconsented treatment is assault" angle, talking to all ages, sexes, colours, classes etc, with gynae experiences as a "now imagine if all this disempowering and terrifying stuff was going on in your stuff " peak. Then it isn't just "silly hormonal women who should be grateful".

courgetteDOTcom Thu 25-Jul-13 14:20:14

Revolting, unlike the OP you asked an honest question without accusation and I didn't see anything wrong with your question.

ICBINEG Thu 25-Jul-13 14:52:08

I'm not going to be very good at putting this into words...but:

I feel like the vast majority of my pregnancy and labour related interactions with HCPs had the net effect of knocking my self confidence to pieces.

I went into pregnancy as an independent reasonably self-confident intelligent woman. Now I am some sort of hollow shell of myself.

Some of this I lay at the door of the actual physical and emotional impact of the pregnancy and birth itself.

But the rest I blame on the NHS.

The whole attitude of midwives and HPCs to new mums to be is one of patronising condescension. A "yes you might think that but we know better". You are undermined at every turn. Told you are wrong and your instincts don't matter. Told what to eat, what to drink. Blamed for everything under the sun, (hyperemisis - well you are a bit over weight - yeah well actually that helps you idiots). You are treated like an idiot if you even question the standard tests, screens or processes during labour. If you ask what something is for, the answer is often along the lines of don't worry your pretty little head about it.

Then there is that whole, 'well of course you are feeling shit, have terrible pain, cannot walk, cannot sleep, cannot catch your breath after walking up 3 steps - your pregnant!' bullshit.

As if it somehow doesn't matter that your life is being ruined, or that this somehow mitigates the symptoms.

It is NOT okay to be throwing up dozens of times a day and not have the energy to get out of bed. It is NOT okay to not be able to walk more than a few steps for fear of SPD keeping you bed bound for the following week. It is NOT okay to be in crippling agony for so long that you can no longer speak or communicate in anyway except screaming.

No of these things magically become okay just because you are pregnant/in labour. They might not be exceptional...but that does NOT make them okay.

It is like a 9 month training program in 'shut up and do what we say' coupled with 'noone cares about how you feel or what pain you are in'.

People probably have no idea how many women have experienced shit care during pregnancy/labour and have never reported it...people are certainly mystified why noone actually complains about the Bounty women...the answer is that we have had every sense of self-possession and every sense of entitlement to respectful treatment thoroughly beaten out of us.

By the time the NHS are done with us WE are glad just to have gotten out alive with our babies...let alone anyone else thinking we should just be grateful.

They really do a total number on us from the word go.

Sorry this got epic...I wrote the below and hence don't want to delete it but don't read it unless you are very VERY bored.
---------------------------------------------

Some examples from my experience:

1. Midwife basically tutting at me for being in hospital for hyperemesis and telling me that everyone gets sick and you just have to get on with it...

I asked if I was fit to discharge then and could she take out the drip, of course she said that wasn't up to her - too fucking right.

2. I felt dizzy and faint after a shower at about 38 weeks and used a heart monitor to discover that the babies heart rate had hit 195. I phoned the maternity ward and they told me to come in so I did. They monitored me for a few hours while it returned to normal. The doctor that saw me basically said, 'yes well this is why we don't recommend people use these heart monitors at home'. I asked what she meant by that (which flustered her somewhat) and she said 'oh well some people get their own heart beat muddled up', I pointed out that I would have been even faster into the hospital if I had thought for one second that MY heart rate was 195 and kinda laughed in her face. I also pointed out that my PhD in experimental physics probably meant I was pretty competent to use a handheld ultra sound machine and I asked what I should do if I measured such a rate again. She said I should definitely come straight back in. But that I should just not measure it so I wouldn't have to come in....

3. I had horrible horrible back pains at about 39 weeks to the point I was getting panicked and sick, and went in to hospital and basically got morphined up. This was great for me, but the baby went unresponsive for about 6 hours. They were on the verge of prepping for a C-section when she finally perked up and gave a bit of a kick. Because of this I wrote 'no opiates' on my birth plan. I got no end of shit about this during labour...why have you written this, what do you know about it, blah blah, blah. At one point a doctor asked in a very aggressive tone 'are you a medical doctor?' My husband jumped in with 'no, both of our PhD's are in physics' having chosen to interpret the question as interest in our titles (which it can't have been because they weren't on our notes) but it did finally shut him up.

4. The thing with the stirrups I said earlier plus an interlude in which after a 4th round of break through pain and with pushing approaching I said I was going to need more power to the epidural if I was going to be able to push and the midwife basically refused to ask for the anaesthetist because everyone knows you can't push if you top up the epidural because you can't feel your legs....I point out that I have been at all times able to feel both legs and stomach muscles all the way through several top ups and the whole fucking problem is that the epidural is barely taking the edge off....this impasse was solved by the anaesthetist randomly showing up to check in on me and then telling the midwife to do one...

5. being told that the best way forward was spinal block plus forceps....then the spinal block not working....and just screaming and screaming in pain. I remember the doctor saying 'oh for gods sake, just knock her out' and then telling me he would have to hold my throat to stop me being sick...and very little else. Did I consent to a GA? I have no clue. Was I in a state to give informed consent to anything? Would I have done if of sound mind - probably. When I woke up I was astonished that both I and the baby had survived. ASTONISHED. I was just so very glad it was over, it would never occur to me to either complain, or ever go back to the hospital again if I could possibly avoid it.

ICBINEG Thu 25-Jul-13 14:53:24

shit sorry, that really is a massive pile of crap....I was just trying to address the cross over from birth trauma to bad care...

courgetteDOTcom Thu 25-Jul-13 15:23:02

ICBINEG , no that was perfect smile

I love your 2 and 3, especially after the Monty Python quote last night!

"When I woke up I was astonished that both I and the baby had survived."

This is what causes PTSD of any variety.

"people are certainly mystified why noone actually complains about the Bounty women...the answer is that we have had every sense of self-possession and every sense of entitlement to respectful treatment thoroughly beaten out of us."

This reminds me of "there are four lights" it's a quote from Star Trek which is taken from 1984. You break a person to the point where they don't complain about anything else and comply with even the most unlike them orders.

garlicagain Thu 25-Jul-13 16:11:51

Not crap at all, IC. I really felt for you and appreciate the time you put into your post smile

I'm not sure about posting on here as the thread has changed quite a bit since I started reading, but I feel like it would be quite cathartic to add my experience to it. Also I am appalled at how many other women out there who have had similar experiences. I thought I was in a massive minority. Some of my prenatal group did mention horrible experiences but we were all so battered and bruised and didn't really want to swap stories. I've heard a few horrors since though so maybe this is the norm and something should be done about it.

Also I want to say a big thank you to the midwives who have come on here and said how much they care about the mums they look after. You sound like lovely people.

My ds was born 5 years ago. I was on a syntocin drip (meconium in the waters... had to speed things up. Birth plan went out the window). Up till that point I'd been quite calm and didn't mind the couple of internals I'd had. I just felt they were necessary. At no point however did anyone say that I could have said no. Not even the prenatal class said that I could have refused if I'd wanted to.

After a few hours on the drip I was in quite a bad way and the contractions were very strong. I had an internal and was horrified to find I was still only 3cm. I had refused any pain relief apart from gas and air because of horror stories from NCT (that's another whole story) and midwives kept coming in to the room and saying 'Are you the woman that's not having pain relief?' and shaking their heads and smirking in disbelief. It wasn't very helpful. If I ever had to go through it again I'd have anything anyone offered! Anyway, after a while a consultant came in and asked me whether I wanted some help. I said yes... I would have done ANYTHING for some help. He said he was going to stretch my cervix. It was agony. I don't think I have known pain like it. I was so out of it that all I could do was writhe and shake. No way could I have formed the words 'STOP'. My husband looked on in disbelief as this butcher tried to stretch my cervix further open. The consultant kept saying 'Focus... look me in the eyes. Breathe'. It was all I could do to stay conscious let alone look the bastard in the eye.

Eventually he said, with a smug gleam in his eye, 'There, 7cm', wiped his hands, and walked out.

An hour later a midwife came and did another internal to see how far I was. 4cm. I made some sort of choking gasping noise and burst into tears. She said, 'Well, no consultant can stretch you dear, no matter how much like God he thinks he is'.

So basically this butcher had lied to me, had done a horribly painful and invasive internal for absolutely no good whatsoever.

Later he catheterised me. He was very violent and I thought he was going to leave me incontinent as he repeatedly shoved the tube inside me. I do remember him asking a midwife 'Is there something wrong with this woman? There is no urine.' He'd obviously decided at this point that I wasn't worth talking to. There was no urine because... well... there was no urine. I didn't need catheterising and wasn't asked. I don't know to this day why he did it.

Later, DS's heart rate dipped and the consultant came back to do ventouse. My husband has said he will never get over the sight of his man with his bloody great scissors cutting me to force the ventouse in. At the end of it all I had a beautiful baby son and didn't really think about the butcher much. One of the midwives did ask me very quietly if I would like to go to counselling. I think it was her way of saying that the consultant was a bloody great bastard who needed a sharp shock. Once I had my son in my arms I just couldn't be bothered to live thought it all again really.

I hope something can be done to stop this treatment of other vulnerable women who are totally powerless to do anything about it. When you're in labour you often can't string together a sentence... you're so out of it you don't know where you are, let alone have the strength of mind and character to stop someone violating you.

ICBINEG Thu 25-Jul-13 16:52:41

So sorry to hear your experience farewell. That is just terrible, terrible treatment.

How can it be okay to cause people pain and suffering just because they are pregnant or in labour? HOW?

Thanks ICBINEG. I'd be very interested to know if anyone else had been offered to have their cervix stretched. Is that normal or do you think it was one isolated consultant's God complex?

ICBINEG Thu 25-Jul-13 17:06:33

I have never heard of it....I think you were spectacularly unlucky to cross paths with this monster.

courgetteDOTcom Thu 25-Jul-13 17:12:14

Yes, the proper name is stretch and sweep. They can sometimes push you a little further, but it's also possible to close, especially if you've been upset.

OrmirianResurgam Thu 25-Jul-13 17:15:15

"Like I say - both hospitals had the same degree of shit thrown at them - both had delays, lacks of resources, shit food, long waits for stuff - it was just the attitude that made the difference... even between a snarled "you're just going to 'ave to wait - got lots of other people to see ain't we?" and a "yeah sorry we're running a bit behind, I've made sure you're in the queue and they know you're waiting."

Quite agree. Attitude makes all the difference. I can put up with poor food, messy wards, minor delays, if the people I deal with are competent, friendly and helpful.

RevoltingPeasant Thu 25-Jul-13 17:15:28

Farewell. Jesus. I really can't say how much I sympathise and wish that had never happened to you. Why does someone like that go into medicine?

As for the cervix thing, I also hang out on the childbirth board sometimes and there was a thread there about a year or 18 mos ago on that. It was by a woman who had had it done years before but couldn't stop thinking about it and wanted to know if it was normal practice. Afair she hadn't wanted to have another baby after thy experience sad

Anyhow the upshot was, this is a practice called manual dilation of the cervix which used to be practised a few decades back in this country and still is in some Eastern European countries. Someone on the thread linked to a Lancet paper from the late seventies or early eighties, and my God, it was awful.

It advised drs to not tell a woman what was going to happen to increas "compliance". It also referred to women who complied as docile and those who objected as highly hysterical.
I am seriously not making that up, this was peer reviewed stuff.

The OP there had later been told she had severe trauma to the cervix from what had been done to her. If you search childbirth threads for manual dilation I bet you could still find it, if you wanted, but it was quite upsetting reading.

OrmirianResurgam Thu 25-Jul-13 17:17:08

farewell - that is horrendous shock

Mum has many eye-watering tales to tell of her times in hospital but that was back in the 50s and early 60s and I assumed that by and large that sort of attitude was in the past. Maybe not.

RevoltingPeasant Thu 25-Jul-13 17:17:35

Courgette I might be wrong but that other thread implied it was ore than a normal sweep as it is designed to get the mum up to 8-9 cm, not just start things off, iyswim. The paper referred to women being able to proceed to pushing within 20 min to 90 min of it.

Thank you for the info about manual dilation. It's interesting that it's an Eastern European 'thing' as at the time my DH and I thought the consultant might have been Russian or from one of the Baltic states (from his accent). It's all a bit blurry looking back now.

At least now I have a name for what was done to me. In a way it's sort of comforting that he wasn't just being a bastard and liked hurting people. Does that make sense? I still don't understand why the midwives allowed it to happen though.

I complied because of a total inability to do anything else. I guess that makes me docile but at the time I remember feeling highly hysterical.

God, it just makes me shudder to think of women who are going to be giving birth in our hospitals. I remember talking to a woman after giving birth about how horrendous it was. She was older... maybe 60. She said 'It's amazing how women don't tell other women before they give birth how dreadful it can be... but then no-one would ever have a baby'. My lovely niece is 25 and one day she will marry her lovely boyfriend and will have a baby. And I guess I will join the ranks of women out there who don't tell their female relations how bloody appalling giving birth can be because I wouldn't want to scare her sad

I've just read another thread about Manual Dilation from 2012... at least 3 other women who had exactly the same procedure without having had it fully explained to them and not one of them was told how agonisingly painful it was. One of them said their consultant was Eastern European. I'm angry now... really really angry. How can a midwife sit back and let that happen? How can anyone think it OK to do a procedure like that when it doesn't bloody work anyway? I can't believe after 5 years I am so upset about it.

RevoltingPeasant Thu 25-Jul-13 17:37:56

Agh just found the thread but can't get sodding iPad to paste link. If you are interested it's a thread by Beckamaw from Feb 2012 called Manual dilation?

Afraid I made up the bit about her not haing more dc, that was someone else!!

RevoltingPeasant Thu 25-Jul-13 17:38:50

Farewell think that was the thread I meant smile it is the most chilling thing, what happened to that OP

courgetteDOTcom Thu 25-Jul-13 18:00:12

I haven't heard of it being done so aggressively like that before. I've heard it done by kind midwives trying to get doctors off your back by telling them you're further along.

garlicagain Thu 25-Jul-13 18:00:28

I understand why, when it looked as if I might manage to have a baby and asked my friends about it, they wouldn't answer questions except to say "It's worthwhile for the baby," and "Take all the pain relief you're offered, never mind the NCT!"

My mother said mine was the most difficult birth. I have faint forceps marks on my cheek. I'll ask her if she wants to talk about it - I almost feel guilty!

I've just seen threads on other forums about this manual dilation, saying it's routine in Australia and America (dated 2012.) They also say it doesn't work and the doctors don't warn them.

It's funny isn't it that we go to prenatal classes, NCT whatever when actually it's our mothers and aunties and friends-with-babies who could be telling us stuff... warning us about stuff. Is it because we live in a more spread-out society now that we just don't automatically ask our female relations and friends about childbirth ie we don't tend to live so close to our parents and sisters? Or is because they'll just clam up and not want us to know the truth of how appalling it can be?

Emilythornesbff Thu 25-Jul-13 18:20:17

It's because they / we don't want ppl to know how awful it can be I think farewell

MiaowTheCat Thu 25-Jul-13 18:27:30

Midwife who handled both my pregnancies (and was fucking livid when she'd heard what had gone on) had to go through the whole "do you want me booking you in on ante-natal classes" spiel at the booking in for my second pregnancy.

I just replied, "With what they did to us - do you REALLY want to let me loose in a room with starry eyed first time mums-to-be?"

She giggled, and said, "Nope, but you know how it is - I HAVE to ask but I didn't think you'd want to somehow."

(She was an utter star both times btw)

Tonight I go to a monthly NCT "mums to be" night where we talk about the "warts and all" of pregnancy and share previous pregnancy/birth details and advice, tips, etc.

I'm the one who always tells women that they are allowed to refuse induction and that they should certainly ask at every stage what the risks and benefits of each option are.

I also tell them to put the baby's first outfit in a labelled freezer bag so the new father doesn't hand the midwife a muslin cloth, a maternity pad, and your cardigan grin

Horry My NCT teacher told us we could refuse, wish she'd been there with me at the time!

BramshawHill Thu 25-Jul-13 19:03:03

I don't think I'll be having another baby, my experiences weren't a fraction as bad as some I've read on here but thinking back about it makes me never want to do it again.

I've also realised how they presented me with options, I was developing pre-ec and the midwife came into the room and said 'Basically, you're being induced today. You're not going home.' When I asked if I absolutely had to be induced (because I was shit-scared!) She said I can be induced today, or have a sweep and be induced tomorrow.

I had no idea I could turn down the sweep, it was absolutely awful and I feel it was utterly useless since I was booked in for an induction the next day anyway.

It makes me angry that so many women are going through this. But yeah, I don't think I'm going to put myself in that situation again. My daughter will be an only child.

My DS is an only child. I'm not sure I could hand on heart say it was totally because of what happened when he was born, but it probably played a part. I sometimes thought I would want another to know what a nice normal birth would be like... but you can't choose 'nice' as an option can you?

bordellosboheme Thu 25-Jul-13 19:27:43

Haven't read the last half of these threads, but it does strike me that we are still living in medieval times as far as childbirth is concerned. Can we not show this thread to a government minister or something? Collectively mumsnet might have the power to reform things? They can put a man on the moon. There's got to be a better way than this?

courgetteDOTcom Thu 25-Jul-13 19:29:53

I think it's because things have changed so much. If it was just a case of natural childbirth then the elder women would be the perfect people to talk to, but all the stuff in this thread, no one can account for that.

I've done NCT classes twice. I'm only allowed G&A because of my back and being a high risk VBAC, so the drugs side of things is irrelevant to me. I've not heard drugs or sections presented as a bad thing though. I've learnt about the spiral of intervention, stair casing drugs etc to help you to have the most natural birth you can and hopefully avoid all this of this thread but the alternatives weren't presented as a bad thing.

MiaowTheCat Thu 25-Jul-13 20:03:14

Only reason I have two kids is that I got pregnant somewhat accidentally (we weren't actively trying but weren't trying not to and I assumed that since it had taken 6 years for number 1, we were unlikely to have number 2... one bonk later and I have an 11 month age gap).

In hindsight I think it was the best possible thing I could have done - I presented myself with a fait accompli so to speak and didn't have any real choice but to go through it again (and clear a lot of the baggage from the first birth somewhat - although I still get flashbacks and nightmares), if I'd thought about it and had to act conciously - DD1 would have been an only child.

Although after the 15 minute labour of the second one - DH is on the waiting list for a vasectomy!

ICBINEG Thu 25-Jul-13 20:51:20

My notes also had 'NO SWEEPS' written on them in bold. I have read the literature and they are no longer recommended to use as routine because of the combination of extreme discomfort some women experience and the lack of evidence of efficacy.

Every labour thread I go on I end up yelling that SWEEPS DONT WORK.

ICBINEG Thu 25-Jul-13 20:53:02

Actually this is one bloody good reason for not getting antenatal info from your mother/aunts etc.

If your mother had a sweep and it didn't hurt her and she then went into labour you are likely to get a completely incorrect recommendation...

Our NCT leader showed us the actual evidence for and against along with common side effects for EVERYTHING.

RedToothBrush Bosnia-Herzegovina Thu 25-Jul-13 21:00:35

courgetteDOTcom Wed 24-Jul-13 09:33:31
I wonder if MNHQ have read this thread?

I've always been aware of this happening but reading a thread like this is still shocking, it's not so isolated, this is happening to too many women. what scares me is how many posters don't seem to know they're suffering Birth Trauma! PTSD.

Courgette, I see that MNHQ have this on their radar. Its on mine and has been for a while. I've lost count of the number of women who say things about internals and consent. The number of threads on MN is quite frightening. There is an overriding issue of what women think they are 'allowed' to do or say and a theme of coercion.

I think I could answer the OP in a couple of ways; the first would be to get my post deleted, the second would be to say, you simply assume that HCP will always have your best interest at heart and will put them first when the reality is startingly different.

Women are made to feel guilty or selfish for refusing to consent. Ironically this tactic is actually being actively used by the NHS to persuade women to have cervical screenings, rather than presenting the facts about the risks and benefits (and there ARE risks). I'm guessing you are familiar with Margaret McCartney from her comments on Bounty. Her position on cervical screening is controversial but based on evidence based medicine and an opposition to this type of propaganda linky to her defence of her position. She is a doctor and openly says that she won't be screened (she defines diagnostic tests as something completely different).

I certainly am not against screening, for anyone who wants it and has made an informed decision to participate. What I am against is the bullying that goes on to make women go for it - and there are plenty of threads on MN that are sadly examples of this attitude - and the lack of ability to opt out that is written in to procedures and GP targeting (there is a lot more about this in Margaret's book which I highly recommend everyone to read to understand what is happening to healthcare and the NHS in this country even if you disagree with a lot of her opinions, particularly this most controversial one).

For me, the start of this, has been Bounty with good reason. Its about getting women (and men), hcp and people in power to properly understand what womens rights are, what they can and don't have to consent to. It creates the groundwork for being able to tackle more complex and serious problems like this.

Language is extremely important as other on this thread have stressed. Its about how you communicate as a HCP to your patient. So is understanding the idea of being vulnerable though not necessarily in a state where you can not make a decision due to limited capacity for whatever reason. The two are too often thought of as being mutually exclusive and that just wrong. Its about properly understanding that consent and informed consent covers a wide range of issues within maternity.

To me the OP is ignorant and naive beyond belief and still in a state where she believes this myth that HCP are infallible and beyond reproach or being guilty of abuse. She is complicit in allowing it to happen by suggesting that women are able to stop it from happening within our current culture. It is that attitude that stop people from speaking out and saying what happened to them for fear of being judged as weak.

Women who are assaulted are not weak. They aren't people who didn't do enough to prevent something from happening to them. They are simply victims of a situation that is not properly recognised nor seen as a problem.

The people who have said 'victim blaming' are bang on for that reason.

I hope in time that MN do follow this up with a campaign, but right now I do think they need to see through some of their other campaigns first, as if success they should make it easier to really make an impact with this. I'm in when they do decide to go for it though.

And I hope anyone reading this thread takes onboard a really important point here. The Bounty campaign fails down most with hospitals because women aren't making complaints. There are a lot of reasons why women don't make complaints about their maternity care; they are understandable. The trouble is that without them, hospitals are actively refusing to acknowledge the various problems that are happening on their wards.

We need to do everything in our power to encourage women to step forward and report each any everything that causes them distress even if it may seem someone trivial, unjustified or it may put pressure on staff. We need to create a culture where is it acceptable to complain about maternity care and it is taken seriously. Women should not worry about it being their word against a HCP. If the same HCP has done it to them, they will have done it to someone else - that means it is not your word against one person. Its several women word. Whilst I appreciate this might put extra pressure on staff, if it focuses them on saying "may I?" rather than "I'm just going to" its worth it.

My heart goes out to the women on this thread who have shared their awful stories. I hope the OP hasn't come back because she is ashamed, though I wish she had the guts and the grace to apologise for her insensitivity.

Orianne Thu 25-Jul-13 21:03:46

It makes me want to be in the delivery room when my DD's deliver. obviously it's their choice . I won't let the same thing happen to them as happened to me.

Itchywoolyjumper Thu 25-Jul-13 21:09:15

I've had a chat with the NMC and have an email address to send the link to this thread to. Would it be ok with all of you if I did that?

RedToothBrush Bosnia-Herzegovina Thu 25-Jul-13 21:12:33

Itchy, its a public forum.

Its obviously an issue that women feel compelled enough to speak publicly though anonymously about.

What harm does it do to get them to read the thread?

Awareness is the key.

Just as a side issue - if NCT classes are presenting analgesia as a bad thing, this is not what I think they are supposed to do, and I would advise people to complain.

When I went to NCT classes when pregnant with ds1, and when I was a NCT class supporter and chair of my local branch, the classes our teachers taught gave information about the pros and cons of all the different forms of pain relief, with no sense of judgement about whether a particular form of analgesia was good or bad. The aim was to give the class members good quality, unbiased information, so that they could make informed decisions when making out a birth plan and in labour.

If NCT classes are no longer doing this, they should change.

Itchywoolyjumper Thu 25-Jul-13 21:28:13

I just wanted to check. This whole thread has been about women finding themselves in situations where they are being disempowered and I didn't want to add to that.
As far as the NMC goes they've told me they can't investigate any case presented on an anonymous internet forum. However I can send this to their education department who might be able to do something in terms of helping to change attitudes.

blueballoon79 Thu 25-Jul-13 21:33:37

When I went into hospital with my second child to be induced (I was 43 weeks pregnant) I'd written in my notes about being sexually abused previously and that I had great difficulty with vaginal examinations.

I can't go into great detail because just reading this thread has made me feel sick, distressed and angry but basically I was held down by the legs and stomach whilst they forced their hands inside me and broke my waters without my consent. I actually did scream and kick out at them but I was held down.

Later on I'd had an epidural and by that point was in absolute shock and was terrorised at the repeated forced examinations and brutal treatment.
My baby was not being delivered no matter how hard I pushed. They put my legs into stirrups against my wishes but I couldn't do a thing as I was paralyzed from the waist down after the epidural, then a doctor stuck her entire hand inside me and I was screaming and crying and begging them to stop.

People were walking in and out of the room and I didn't know who they were or why they were there and she kept her hand inside me the entire time.

That birth was far, far more scary and frightening and I felt far more out of control than I did with the sexual abuse I received as a child.

I agree I found the op insensitive, patronising and very much victim blaming. I'm horrified by this thread. I'm also so, so sorry for all the other women who have come on and said they experienced similar traumatic situations.

I actually wanted to kill myself for the first year after my daughters birth because I couldn't cope with the persistent flashbacks and nightmares and the terrible way I felt about myself. I felt dirty and disgusting and pathetic.

No op, I couldn't fight them off.

courgetteDOTcom Thu 25-Jul-13 21:38:26

I have two thoughts here, firstly that if they want stories to put their email here. Secondly that as with Bounty I don't think anecdotes are the right way forward, it's a colossal change in mindset that they need to get involved in.

Leverette Thu 25-Jul-13 21:46:36

Perhaps the Royal College of Midwives would care to comment on the commonplace infantilisation and brutalisation of so many women giving birth.

Complaints can be made regarding specific practitioners to the NMC directly via the form on their website.

Complaints can also be made via a form on the CQC website if you search for the hospital/Trust where the incident took place.

If you aren't stony broke there is also the option of talking through what took place with a clinical negligence solicitor. Current safety and quality improvement work is still very reactionary and successful litigation is the major driver for significant change. Any financial award can be donated to a good cause if you feel uncomfortable accepting it as some do.

HopALongOn Thu 25-Jul-13 21:49:55

I don't want to minimise what has happened to some of the women on this thread, because their experiences are truly terrifying and awful. But there are good HCPs out there, and I don't like the way all of them are being tarred with the same brush. Maybe they are in a minority, I don't know, but they are there and there is good practice happening that I think we should be promoting alongside exposing the bad side.

RedToothBrush Bosnia-Herzegovina Thu 25-Jul-13 21:51:32

The other thing is, from the first Bounty thread I saw that started to be taken seriously by MNHQ it took about a year to get a campaign going. The second Bounty thread appeared some time after that.

In that time, it took a lot of women to speak up, to provide the groundswell of anecdotes to then go on to the net steps. So I do think that anecdotes have a purpose here. Its essentially part of a process of women starting to step up and say "This is not acceptable".

I think a similar thing needs to happen here. And it will be harder given the nature of the issue being so intimate and so distressing, in a way that is far worse in the vast majority of (though not necessarily all) cases.

Every person that shares their experience is a real person who probably is representative of hundreds more. So speak up! Be heard!

Itchywoolyjumper Thu 25-Jul-13 22:06:52

I am a nurse. I always encourage patients to make complaints if they have grievance with the way they've been treated. With my professional hat on I can see complaints are an amazing way of improving practice, both individual and organisational. They support the staff who do care and mean that no one else should go through what you did.
I know this but I can't bring myself to make a formal complaint about my treatment in labour. I felt so inhuman, I felt like cow in the hands of the vet and I don't think I could relive it by making a complaint.

SwedishHouseMat Thu 25-Jul-13 22:21:35

I like to think of myself as a feminist and that women are all "sisters" under the skin.

What I still can't get over, is how cruel and heartless the female HCPs - midwives and doctors were. I'm not saying that the male registrar wasn't cruel - he was - but somehow I expected the women to have some sort of empathy and help me during a frightening and vulnerable time.

I still remember the cold stare and the look of utter contempt that one midwife gave me. No smiles, no comforting words. I was afraid to speak to her and draw attention to myself. She cursed me for moaning. Told me to shut up and get on with pushing.

Why are women so cruel to other women?

garlicagain Thu 25-Jul-13 23:20:15

I think some people are cruel, Swedish. Malice is equal-opportunity sad

bloodybutunbowed Thu 25-Jul-13 23:23:01

HopALongOn you're right that there are some good HCPs out there, but the sad fact is that most midwives don't seem to be "with woman" at all, but seem to be complicit in the machinery of hospital practice and the conveyor belt of birth and maternity services. It must be very difficult for sensitive caring HCPs to fight an individual's corner in the face of protocols and procedures, I sympathise with that - but the mentality that a great deal of HCPs - in my experience - adopt is terrifying.

I have a lot of children. I have looked countless midwives/supervisors of midwives/consultants etc in the eye and told them I am a gang rape survivor who has PTSD - words that are very very hard for me to voice. I have even taken the trouble to write down why I cannot accept internals under any circumstances, why forceps and speculum take me back to being violently assaulted with a vodka bottle, why staring at me takes me back to being watched while being raped. This has not stopped HCPs from holding me down and forcibly examining me, or abusing me in any number of ways. I have had flashbacks in front of these people, my dh has physically had to protect me on occasion. I am up front, I write very basic and easily read birth plans that clearly state my position, so why do HCPs, despite often being generally sympathetic and reasonable people, consider themselves the exception - the person who can talk "sense" into me and persuade me that I'm just overreacting to a normal procedure that women accept every day. HCPs do not understand. They have no concept of the enormity of the trauma some of us have been through. If you work in maternity services, surely you should be prepared for the fact that you will come into contact with women who have been raped and abused, and that birth will be particularly challenging for these individuals. But for some reason the huge machinery of the hospital process is paramount, sympathy and empathy go out of the window and the prevailing culture is to bully the pregnant woman into submission regardless of what it might do to her mental health. Even the gentlest of HCPs is one small cog in a vast and uncaring machine. Even the best HCPs still don't fully understand and are too hidebound by procedure to truly make a difference.

RubyThePirate Thu 25-Jul-13 23:33:02

Does anybody know what happens when it's your word against theirs?

If I'd complained about the midwife performing a sweep when I'd only consented to a VE, how could I prove it? Surely she could just say I wasn't telling the truth, or was confused. This is one reason I didn't make a complaint; there were others but I couldn't face making an issue out of it, knowing how easily it could be dismissed. And that made me feel disempowered all over again.

I've read the whole thread and am horrified at how appallingly women have been treated.

I don't understand why so many HCPs seem contemptuous of the patients in their care.

Ruby a lot of "normal" sexual assault cases come down to one person's word against another's, too sad angry

RubyThePirate Thu 25-Jul-13 23:37:45

bloody, all I can say is that I truly wish you all the peace and happiness in the world with your many beautiful children flowers

RubyThePirate Thu 25-Jul-13 23:42:21

Horry, yes, the nature of the crime is that that will be so, but I have to confess to ignorance of how such cases are brought, or proved.

courgetteDOTcom Fri 26-Jul-13 00:00:37

I didn't mean that they don't have a place. Look at what's happening with the response to Bounty, people are saying "but what about my Bounty lady? She was lovely" and it's not really about how nice they are or not, it's about the fact they're there - it's a red herring from both sides. Anecdotes are useful to backup that things aren't right, but they can't be the whole picture. I hope that makes sense.

Mumsnet weren't the only ones getting involved in Bounty, there was the BMJ article and other people getting on board, lots of things happening at the same time that kicked it off. I think that's what this needs, others getting involved, maybe someone writing for the BMJ, I don't know!

Ruby they denied everything I said, didn't remember anything and referred to their notes. I have photographic evidence of things they deny but that was as far as the SoM could get. Another sexual assault parallel.

courgetteDOTcom Fri 26-Jul-13 02:50:01

just found this in my inbox.

Thomas K Birth trauma: a guide for you, your friends and family to coping with post-traumatic stress disorder following birth. Lancashire: Nell James; 2013.

Birth ought to be a joyful experience: for some women, however, it is anything but. Women who have experienced a medical emergency during birth often find that the memory of it doesn't go away just because a healthy baby has been delivered. They experience the symptoms of post-traumatic stress disorder: flashbacks, sleeplessness, nightmares or extreme anxiety. Some go out of their way to avoid being reminded of the birth, and they may find it difficult to bond with their baby. Post-traumatic stress disorder after birth, known more simply as 'birth trauma', affects at least 10,000 women every year in England and Wales. Yet the condition is poorly misunderstood and women suffering from birth trauma often do not receive the treatment or support they need. They may be misdiagnosed as suffering from postnatal depression, and many find that friends and family, instead of being supportive, simply tell them to pull themselves together. This valuable and fascinating book explains everything you and your family and friends need to know about birth trauma: what causes it, how it affects your personal relationships, how to treat it and where to find support. Using the powerful personal stories of women who have suffered birth trauma and overcome it, this book shows that it is possible to go through this difficult experience and come out the other side.

bordellosboheme Fri 26-Jul-13 04:01:30

Could a mnhq person comment on this thread please? What options do we have for taking this forward as a collective. I believe the time has come where women should no longer be treated like this is a 'civilised' society.

courgetteDOTcom Fri 26-Jul-13 04:07:16

Rowan commented not long ago.

bordellosboheme Fri 26-Jul-13 04:57:29

Ok, just read Rowans thread. Just saying 'we're a bit choca' doesn't wash I don't think. Saying we're 'busy' just maintains the societal silence that perpetrates this violence against women, and this outdated medical practice. God, this thread is making me angry angry thinking of how human beings have been treated.

mathanxiety Fri 26-Jul-13 05:17:46

Some women in hospital uniforms think that giving birth is a sort of initiation rite that has to be as brutal as possible. The infliction of cruelties both small and large is their role in the process of making a mother out of you.

For 'mother' read 'woman who has been taken down a peg'. I think it comes from a belief that women should not feel great about what they have just accomplished, or expect any allowances or 'special treatment' from anyone because that would take centre stage away from those to whom they think centre stage belongs. For 'special treatment' read kindness and respect.

I found in my own medical experience that nurses in post op (gallbladder surgery) were far kinder to me than nurses in maternity. Kinder and more respectful.

RedToothBrush Bosnia-Herzegovina Fri 26-Jul-13 06:36:29

bordellosboheme, read what I said about a campaign too. If you want one, then there needs to be process to go through to get to a point where it would have benefit.

It is no good just saying 'we want a campaign'. Start thinking about how you go about it, and what you need to focus on and who you need to target for it to be successful.

MN as a organisation have the power to get things into the public eye and the media in two ways; first by direct contact with us and secondly by going to those with power. Direct contact with us, can initially just mean providing a platform for discussion just by having threads like this. They don't need to get fully involved just yet imho.

Campaigns are only successful if you work out a way of getting the message across to both in a clear, concise way. It has to really get under the skin of these organisations to make any impact what so ever. You need to find a way to MAKE them listen, as this is so institutionalised and ingrained into thinking that a) this doesn't happen b) we can easily ignore this and its just a few isolated cases and they should have reported it to their hospital. This is institutionalised, which is the very thing which makes it just so hard to fight. It can be done but it is difficult.

The campaign really starts by people on this forum working now; so that MNHQ can later pick up the baton and really look at it and make a difference. They DON'T have to do the ground work. Its people like you and me who can do that. Anyone on this forum can do this.

Like I said before, its about creating a groundswell that goes beyond MN too. Whilst MN have influence that still is regarded as being representative of a certain section of the public (which isn't true but perception is everything). If you can get wider involvement it will work. I'm sure that organisations like the Birth Trauma Association would be interested. Then you need to think about how you can play up to the media and talk about how tackling this issue is financially beneficial (because unfortunately you can not avoid that topic when it comes to the NHS and frankly lack of resources is the usual red herring totally unacceptable excuse).

Right now, I think getting women to simply talk about this issue in an open way, is the point we are at and where we need to go from. Recognise the fact that this is far more widespread than we would like to believe, recognise the fact that women whilst competent are vulnerable and need to be both respected and protected, challenge the idea that HCP always have your best interests at heart. Get people to ask questions and give them the confidence to challenge certain phrases (before the examinations even start) or to start making complaints if they have the misfortune to be abused in this way. Basically define the problem, define its extent, define what your rights are, support each other.

Like I say, much of this is about language and communication; or lack of it. We need to change a culture that says "I'm just going to" to "Do you mind if I". Thats bloody hard.

I haven't had time to read all of the thread yet, I will do, but I'm off to work in a bit. I just wanted to add my voice to the masses. During labour with my first DD, breaking my waters had been discussed early on, and I said I would consider it if asked. I should also point out, I had rather painful SPD and had limited mobilty because of it (well known to all my HCPs). I was NOT asked about breaking my waters, just asked to consent to another internal, which I did. The doctor who my broke my waters didn't warn me what she was doing, or ask if it was ok. I said it hurt, asked her to stop, and was told to just use more gas and air. When I flinched she caught the damn hook in my cervix, and my midwife physically restrained me so they could get it back out as I was thrashing about in pain. I wasn't alone, my DH was there too, but as first time parents we had no experience of what was normal and were both too shocked to do anything decisive at the time.

I'm pregnant again and I've added to my birth plan that if anyone comes near me with one of those hooks again, I will probably kick them in the face. I have made it very clear that I do NOT give permission to break my waters. I find it very saddening that at our most vulnerable, some of us are going to be worrying about things like this as well.

Itchywoolyjumper Fri 26-Jul-13 09:36:58

While reading this thread has been harrowing, I'd like to thank you all. After 3 years of knowing I should make a complaint and not being able to knowing that many others have felt the same and worse has empowered me to finally make the complaint, which I sent off this morning.

If I had a friend or acquaintance who asked me not to put my arm round them because it reminded them of being attacked, I would bloody well not put my arm around them!! And as a nurse, I find it absolutely appalling that there are nurses and other HCPs who can read in someone's notes, or hear directly from them, 'I was raped/assaulted/I have PTSD/I have SPD, so internals/stirrups/etc are physical/mental/emotional agony' - and can then go right ahead and assault the woman again.

This does not just deserve professional censure, it deserves criminal action.

I am very lucky that this has not happened to me, but I would be keen to be part of a campaign in any way that I can help.

cubbie Fri 26-Jul-13 12:30:31

Such dreadful experiences. I'm on my phone so apologies for any mistakes or lack of paragraphs etc, I've never posted using my phone and am usually just a lurker.

With both my DC, all my MWs and other HCPs were truly wonderful, really kind and caring. However, with DS1, I wasn't making much progress and to cut a long story short (due to being on my phone and finding it a bit tricky), the consultant said he would break my waters.

Can't remember if he asked, or told me. But I was ok with it. However, I can only describe the procedure as being like having a drain unclogged at great speed. It was awful and I had flashbacks for a few days after where I would wake up bolt upright, feeling it all over again.

My DH even said it seemed very very rough and he was taken aback. It happened so fast and I was so shocked, I couldn't speak. He attached clips to my baby's head and did 3 blood tests. That was fine, bit traumatic but I wasn't expecting it to be a picnic in the park!

I ended up with an em c/s. the consultant came in to me after to say that ds had been back to back, that's why my labour had been so painful and I hadn't really got anywhere. He was very pleasant and I have no reason to believe he was deliberately being rough.

I had ds2 by elective c/s due to severe SPD. I had originally said I would try normally, but as things progressed, it just wasn't an option for me. I can honestly say ds2's birth was a wonderful experience (lovely drugs haha) in all respects.

Everyone involved from the mw's to the ward cleaners and those who brought the food, were absolutely fantastic. I don't in any way want to sound as if I'm gloating or anything. I had a horrible experience myself but now I feel like writing to my maternity ward/ HCPs concerned , to thank them for such great care, having read the dreadful experiences here.

My heart goes out to each one of you, I totally believe all the stories but they are so unbelievable IYKWIM. If any of those HCPs involved are reading this thread, then I hope they are hanging their heads in shame.

I still remember the "drain unblocking". Un-mumsnetty- hugs to all of you. (I hope I haven't offended or upset anyone by posting about my mostly positive experiences , perfect in fact apart from that. I just wanted to add my experience whilst also saying I have been so lucky to have had 2 births helped by lovely people. Ds1 is 6 now and I still remember it very clearly. And like a lot you, I'm annoyed with myself that I never said anything at the time or after.)

courgetteDOTcom Fri 26-Jul-13 12:52:15

I have some ideas I want to add later but I need to go and get my friend from the train. In the meantime, anyone want to pass this link to AIMS?

garlicagain Fri 26-Jul-13 14:12:21

I find it absolutely appalling that there are nurses and other HCPs who can read in someone's notes, or hear directly from them, 'I was raped/assaulted/I have PTSD/I have SPD, so internals/stirrups/etc are physical/mental/emotional agony' - and can then go right ahead and assault the woman again. This does not just deserve professional censure, it deserves criminal action.

Yes, it does. It's not negligence or incompetence; it's cruelty. I wonder whether individuals are legally accountable for their actions while at work in a clinical setting? Are they immune, as state-sanctioned torturers have been in various other environments, or are they suffering a delusion that should be challenged?

Cubbie, I'm pleased for your good experiences in labour but thought it a bit odd that you felt a need to stress the point. I was raped by one taxi driver, and helped by hundreds of others. The good guys don't make the bad one any less bad (rather the opposite, really.)

Itchywoolyjumper Fri 26-Jul-13 14:38:01

Garlic, we are legally accountable for our actions and nurses and other HCP can and have been jailed for their actions at work.
Judging from this thread there are a lot more who should be.

garlicagain Fri 26-Jul-13 14:39:19

Thank you, Itchy. I don't know you, but am terribly proud of you for making your complaint.

Itchywoolyjumper Fri 26-Jul-13 16:13:18

Garlic, I'm welling up a bit. I wasn't prepared for how emotional I felt while writing out the report of what happened and I've been feeling a bit wrung out since, your comment has made me feel quite a bit better.

RedToothBrush Bosnia-Herzegovina Fri 26-Jul-13 18:11:58

You should be proud of yourself Itchy. I don't know how it will turn out or whether it will be dealt with the sensitivity and respect you deserve.

However, you are now recorded - the hospital have to log the complaint. And whether or not you end up with the result you deserve, that hospital can not now say they've never had anyone complain about it.

Its an assault of a sexual nature; and the reporting of other crimes of a similar nature like rape or abuse as a child are highly unreported and thats one of the things that makes them most difficult to tackle. It takes people like you to change that.

I hope that you give others the courage to follow suit.

Itchywoolyjumper Fri 26-Jul-13 18:41:45

To be honest I was much more angry about their whole attitude to me and that was what I concentrated on in my complaint, I didn't really want to dwell on the internal. I'm not any kind of role model. I looked at my c-scars this morning and it put me in a rage and the rage pushed me the last bit to complain. The first cut they put in was too high and so they had to go in again a bit lower, leaving me with a 2cm cut above my c-section which has scarred. No one told me that they had made this mistake and I only found out when I changed my dressing when I went home. They had so little respect for me that they treated scarring me as an incidental, like drawing the wrong line on a piece of paper.

GettingStrong Fri 26-Jul-13 19:09:52

Message withdrawn at poster's request.

GettingStrong Fri 26-Jul-13 19:11:16

Message withdrawn at poster's request.

rainrainandmorerain Fri 26-Jul-13 21:47:13

There are some truly awful experiences on this thread. It is heartbreaking and makes me very angry.

A couple of things, in no particular order -

A recurring theme seems to be that women are givng consent, or at least not objecting, to procedures and examinations when they don't actually know what they are consenting to. I don't mean just the issue of sweeps being performed without the mother's knowledge, although that is awful. I mean how much of an arm/what instruments go up a vagina. Something like 'putting a clip on a baby's head' don't really convey much about what is going to be done and it seems to come as a real shock to some women going through that procedure. Likewise manual removal of placenta. Do HCP's assume all women arrive at hospital pre-briefed? or do they not care?

While this thread (after the OP, at any rate...) has been almost all very understanding and receptive to traumatised posters... there have been MANY threads on Childbirth where women are repeatedly told by other women to 'leave their dignity at the door', and 'you won't care what happens to you in the end' etc etc. 'You won't care if an army of students and the next door neighbour walk in at the end ha ha ha' is another theme.

That always makes me furious. And it is obviously not true. Look at this thread. Women care deeply what happens to them during labour and birth. The attitude that says you shouldn't care seems to be very close to the misogynist stance that says of course it hurts, of course it's gory and painful, and if you don't want to go through all that, keep your legs closed (that's before birth, OP). How do you combat those attitudes?

I also think there is a huge and chronic lack of understanding about how a history of sexual abuse or assault affects women. A LOT of women experience this at some point in their lives. It can have a huge impact on how any examination or treatment affects them. I think unless there is much more acknowledgement of how widespread sexual assault and unwanted contact is against women, sensitive treatment from hcps won't be made a priority.

And I'm afraid the other battle is BIRTH CHOICE. I never wanted a vaginal birth, partly because I was terrified of getting treated like some of the mothers on this women have been. I had 2 planned cs's - only one internal throughout both of them, and that was because I went into pre-term labour with my 2nd. Guess what - it was a horrible experience. A series of mws refused to believe I could be in labour, until eventually the nastiest one told me she would 'prove I wasn't’ with an internal, which was deliberately rough. Turns out I was dilated, I was in labour, and I had a cs a few hours later. If I had been believed earlier, perhaps there would have been time for the 2nd steroid injection, and my ds would have been spared several weeks in a scbu as his lungs might have been stronger.

My point is that if we want to deny women the right to choose csections or homebirths, or whatever - then we are saying they have a very limited set of rights when it comes to birth. From saying 'no, you will be forced to have a vaginal birth', it really isn't much of a step to carrying on with an internal when a woman is begging for it to stop, or forcing her legs apart for a forceps birth because - well, they aren't in charge, are they? Midwife/consultant knows best, and can ignore her.

It's also the case that for a lot of mothers, once they are out of hospital and away from it all, they just don't want to relive awful experiences by complaining about it. A lot of trauma seems to resurface and have to be tackled, or not, when women have their 2nd babies, or subsequent babies.
I think without ACTIVE follow up from hospitals for women about birth experiences, not enough voices will be heard.

(not follow up like my community mw. She asked if I had any concerns about the birth - as it was premature, I said yes, voiced a couple... and was interrupted to be told briskly that 'we can all have our idea of how we want a birth to go, but sometimes we have to accept that it doesn't....' I told her if that was all she had to offer, she could go. She was shocked. I was brave in my own house - on a ward, with several mws, I just felt bullied and intimidated...)

courgetteDOTcom Fri 26-Jul-13 23:13:09

I was thinking, maybe this is something we should do on our own as MNHQ aren't able to. If we set up a website with a forum or a guest book even people can add their experiences. We can do that as a bare minimum start them decide through the forum what we want to do. I've got experience with webs, anyone else got any ideas?

Icedink Fri 26-Jul-13 23:35:24

Itchy well done for making a complaint! I hope you get a good apology and feel better for having spoken up flowers

Courgette brilliant idea, I would love to be involved and help in any way I can.

Its exciting how this thread has gathered momentum, it really feels like something huge is happening, although some of the stories on here are horrific.

topknob Fri 26-Jul-13 23:40:44

I have had 5 babies, all early, some more so than others. All had the waters broken by the midwife delivering. At no point did I feel uncomfortable. They always explained what they needed to do and seeing as they were health care medics, I went with what they thought best. If they needed to examine me then I agreed, I was having a baby, I wanted him/her safely delivered. Maybe my circumstances were different, earliest was 32 weeks, latest 37.. but I never felt assaulted in any way, these people were just doing their job. When my last baby was born, by ventouse, I was bleeding all over the place, she would have died, turns out the cord was wrapped around her neck twice, the medics did what they thought best and it hurt, it hurt alot..she is now 8.

RubyThePirate Sat 27-Jul-13 00:33:42

Thanks, topknob for that post that neither addresses the OP nor adds much of use to the ensuing discussion confused

Here's the thing: If you agreed after being informed, as you say you did, it's not assault, is it?

bloodybutunbowed Sat 27-Jul-13 00:44:25

Well jolly good for you topknob.

courgette count me in.

Bogeyface Netherlands Sat 27-Jul-13 02:12:31

I think Topknob's post is actually quite helpful. It shows that it can be done without trauma to the labouring woman. I have had experiences like that, which proved that the horrible experience I had need never have happened.

If Topknob can have 5 babies without feeling violated or abused, then why cant every woman?

garlicagain Sat 27-Jul-13 02:27:34

YY, agreed, Bogey. Particularly as one was a violent and painful birth - with full information and involved consent, Topknob came through bloody but unbowed. It doesn't seem that much to ask.

Itchywoolyjumper Sat 27-Jul-13 08:03:57

I sort of agree, I had a really lovely midwife in the middle of my labour and it actually made my over all impression of the whole thing worse. If I'd felt that it was inevitable that I was going to be treated like a piece of meat it might have been easier to deal with rather than knowing that they could have treated me like a human but chose not to.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 08:14:45

Courgette, isn't that essentially what the birth trauma association website does though?

If you've not seen it/read it, its Here

I have a lot of time for the work they seem to be doing. They support women's choice in childbirth and support women who have both VBs and CSs and how that has an impact on them. They are neither pro vb or pro cs.

They stress the point that a lot of CS requests are made because of previously traumatic births and they stress the point of how much money that poor attitudes and not listening to women is actually costing the NHS.

To date, I'm not sure I've seen them do anything that I had been critical of, and when it comes to this subject I'm pretty militant about the bad use of language or agendas.

They really do seem to be putting women first.

IfIonlyhadsomesleep Sat 27-Jul-13 08:24:09

I have only a trivial experience to add, but was it really necessary to have an internal as a condition of entry to delivery suite when I couldn't make it up the corridor without three contractions? I feel the internal was a condition of entry, I needed a room and she wouldn't give me has and air until she "knew" I was in established labour. I consented-I was in pain and I labour calmly with gas and air and panic without. Dd2 was born hakf an hour later.I know it's not necessary to examine-with baby number two the midwife arrived at home took one look at me and said "I'll not be going anywhere, don't worry". You shouldn't need a home birth to be in a situation where midwives can use professional judgement rather than dogged adherence to procedure.

MiaowTheCat Sat 27-Jul-13 08:44:44

Courgette, isn't that essentially what the birth trauma association website does though?

If you want horrifying - some of the tales the ladies on their facebook group have to tell are beyond horrific.

But I see the post earlier on about having 5 kids and it sums up what you're up against - this idea that by being traumatised at mistreatment - you're in some way selfish and a lesser mother and if you were a proper caring mother you'd just willingly let them do whatever they want without question in the interests of saving your children and that by finding it distressing and traumatic after the event you're in some way bringing the suffering upon yourself by dwelling on it (I've been told this by my mother - that I need to just shut up and get on with things). Competitive mummy sanctimommydom taken to its vilest levels. You can be distressed and traumatised and feel utterly violated - and still be an excellent mother.

I felt immense guilt for a good long while after DD1's birth - I assumed I'd deserved what happened to me, that it was some kind of karma or a hurdle I had to jump to "prove" I was woman enough to be a parent and that I'd failed with it. I assumed that how I was treated was pretty standard and normal and it was just an issue of perception or me being "sensitive" or "hysterical" or "overreacting" - it took a lot of baby steps for me to begin to realise that it wasn't any of that - from the utterly outraged reaction of my community midwife doing the post-natal home visit stuff, to people's faces when I told the story (and I never did the ghoulish thing of jumping on pregnant women with horror stories - these were women who'd had their kids - and it was always told in a kind of humorous, farce-type way - to bring it down a notch or two), to people time and time again telling me "that is utterly horrifying and I'm appalled"... and it was only after months of that that I finally began to realise what had gone on was wrong and it wasn't just poor oversensitive Miaow taking it all to heart again.

I'd love to see something done to address this all - however I don't think I'd be one to speak out and tell my story with a name to it for various privacy related concerns (I have a somewhat unpleasant ex I try to stay well-hidden from), plus people are going to fall back on what is already creeping in on this thread and I discussed earlier... and that would be very hurtful to women sharing their stories.

I do find it disgraceful that MNHQ are more concerned about fighting pink crop tops and bikinis than the institutionalised violation of women's rights in childbirth though.

Shiraztastic Sat 27-Jul-13 08:46:27

I had a midwife when I was induced with one child who made it a condition of me phoning my husband to come in during the night that I sat with my feet up being monitored and then had an internal. I was not 'allowed' to have him come in until I proved I was in established labour, because I was on an antenatal ward (men weren't allowed overnight and she was literally the gatekeeper to my emotional support, as he would have had to get through a locked door with a buzzer!). The rules said mobile phones weren't allowed, so mine was turned off. I felt captive, and like I had to behave and follow her rules.

Once I acquiesed I passed the tests and was allowed to call him. Sadly by then I was completely out of control with panic, and didn't manage to pull it back together again, leading to horrid interventionist labour.

Normally I am assertive, but when put in those circumstances, I behaved like a vulnerable patient. For years I wondered why I didn't stand up to her or insist or just turn my bloody phone on and ring home, and then I realised that we behave in certain ways in specific circumstances because of the position we are in. I was in pain, scared and panicking. She was the authority figure, in charge, expert responsible for 'caring' for me.

I will never forgive her patronisingly saying "your mother did it for you, and hers for her" as I writhed in pain being monitored, just wanting my husband's arms.

I know I am not talking about assault, and I am sorry for all the dreadful experiences here that are far worse.

I never complained, and it is too long ago now to bother (8 years) I didn't feel emotionally strong enough to rake over the awful labour, especially not when I felt what I would likely get back would be a defence and justification of their actions (there was more than I've put here that I was unhappy about). I also got my notes, and there were things written down that were factually incorrect that I felt no-one would believe me about.

I don't think the NHS has any idea how many women feel badly treated. For everyone who's able to complain there will be multiples more who don't or can't.

For me, it led to a mistrust of the midwifery profession and obstetricians. The only time I had to revisit the antenatal clinic at that hospital I ended up in floods of tears. I once went to visit someone on the ward and just walking in was very hard, as I felt a real physical reaction to run away, including nausea. I have had 3 babies since, all born at home with nhs 'care'. In only one case was the midwifery care during labour genuinely good from my perspective, although I had an excellent midwife in a different child's pregnancy.

Listening to women's views and wishes, genuinely respecting them, and following their own professional guidelines to properly seek informed consent. Why is it so hard??

Shiraztastic Sat 27-Jul-13 08:47:00

Shit, now I am crying. Though I was over this sad.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 08:48:53

IfIonlyhadsomesleep, is it trivial that you felt under that level of pressure to 'consent' to a internal?

If you are put under pressure to consent in order to receive treatment then that my not be consent. HCP essentially are therefore not allowed legally to withhold treatment or admit you to hospital until you comply with what they say; eg "we can not admit you if you do not have an internal to establish whether you are in labour or not" is technically illegal.

The fact that you regard this as trivial, even in the context of this thread, shows the extent of the problem in my mind.

It.Should.Not.Be.Happening.

I'll do some hunting down of laws on consent and post up the most relevant points here.

I'm actually thinking that perhaps if MN can't do a campaign atm, maybe they would be willing to show some support to the BTA, or maybe get a representative from the BTA to do a Q&A for MN to do some awareness or publicity.

garlicagain Sat 27-Jul-13 08:57:57

I will never forgive her patronisingly saying "your mother did it for you, and hers for her" as I writhed in pain being monitored, just wanting my husband's arms.

Shiraz, I was shaken up just reading this! I'm so sorry it still hurts you that much, though not surprised sad

It's a total confirmation of what few have even dared to think - women are being deliberately subjected to pain, humiliation and despair, as some sort of rite, by those we have appointed to take care of us.

It's outrageous.

I hope you're feeling very safe just now, so the tears can come out and help you heal.

JamieandtheMagicTorch Sat 27-Jul-13 09:01:11

Shiraz

When i was induced and the pains really started to come hard and fast, i asked them to call my DH and the midwife said to let him sleep a bit longer (it was 7 am). I am an intelligent, normally reasonably assertive person, who had worked in hospitals, interracted professionally with nurses, but becasme a scared, aquiescent person at that point.
I so regretted letting them persuade me, that I didn't let DH leave my side for the whole of my second labour. And it helped.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 09:02:31

Ok, stuff on consent and what is/what isn't consent. These posts are going to be lengthy so I apologise in advance, but I'll try and stick to the most relevant and important bits here.

Source: DoH document dated 2009 entitled Reference Guide to Consent for Examination or Treatment

I'll start with the Introduction as it gives the best context for what we are talking about and then go into a bit more detail.

First two paragraphs from the Introduction:
1. It is a general legal and ethical principle that valid consent must be obtained before starting treatment or physical investigation, or providing personal care, for a person. This principle reflects the right of patients to determine what happens to their own bodies, and is a fundamental part of good practice. A healthcare professional (or other healthcare staff) who does not respect this principle may be liable both to legal action by the patient and to action by their professional body. Employing bodies may also be liable for the actions of their staff.

2.While there is no English statute setting out the general principles of consent, case law (‘common law’) has established that touching a patient without valid consent may constitute the civil or criminal offence of battery. Further, if healthcare professionals (or other healthcare staff) fail to obtain proper consent and the patient subsequently suffers harm as a result of treatment, this may be a factor in a claim of negligence against the healthcare professional involved. Poor handling of the consent process may also result in complaints from patients through the NHS complaints procedure or to professional bodies.

Reference to the Human Rights Act 1998 in the Introduction
5.The Human Rights Act 1998 came into force in October 2000, giving further effect in the UK to the rights enshrined in the European Convention on Human Rights. All public authorities are required to act in accordance with the rights set out in the Human Rights Act, and all other statutes have to be interpreted by the courts so far as possible in accordance with those rights. The main articles that are likely to be relevant in medical case law are Article 2 (protection of the right to life), Article 3 (prohibition of torture and inhuman or degrading treatment or punishment), Article 5 (the right to liberty and security), Article 8 (the right to respect for private and family life), Article 9 (freedom of thought, conscience and religion), Article 12 (the right to marry and found a family) and Article 14 (prohibition of discrimination in the enjoyment of Convention rights).

Reference to the capacity to consent in the Introduction
8.The Mental Capacity Act 2005,5 which came fully into force on 1 October 2007, sets out a statutory framework for making treatment decisions for people who lack the capacity to make such decisions themselves (see chapter 2). The Act establishes overarching statutory principles governing these decisions, setting out who can make them and when. It sets out the legal requirements for assessing whether or not a person lacks the capacity to make a decision.

9.Where a person lacks the capacity to make a decision for themselves, any decision must be made in that person’s best interests. The Mental Capacity Act introduced a duty on NHS bodies to instruct an independent mental capacity advocate (IMCA) in serious medical treatment decisions when a person who lacks the capacity to make a decision has no one who can speak for them, other than paid staff. The Act allows people to plan ahead for a time when they may not have the capacity to make their own decisions: it allows them to appoint a personal welfare attorney to make health and social care decisions, including medical treatment, on their behalf or to make an advance decision to refuse medical treatment.

Shiraztastic Sat 27-Jul-13 09:16:14

Thank you for your kind words. That midwife also (helpfully) indicated that this was only the start, it was only early labour and things were going to get FAR worse. So that did a great job of helping me calm down!

You see it in nurses on tv shows sometimes. I was watching 24hrs in A&E and one of the talking head nurses to camera made some comment about the patient's experience of pain always being right, but it was said in a sort of eye-rolling, jokey, winkey way. The whole theme of the show was about pain, and there were lots of 'comic' moments, like the wife being dismissive of her husband's broken wrist pain, when it turned out he had nerve damage. I think you see the same sorts of attitudes on programmes about birth too. Midwives at the station discussing ladies who are in what they consider too much pain for their stage of labour, or making too much fuss. There was one shocking episode of OBEM where an older Bolshevik midwife was refusing to admit a woman and she stood contracting by the reception desk for ages and walking up and down. The impression given of the midwife was slight exasperation that she and her partner wouldn't go away. Eventually they admitted her (it was a subsequent baby), and the baby was born v rapidly after that. I guess some nurses and midwives become institutionalised sad, and also if they are being asked to be the gatekeepers to delivery unit because of bed pressures then the incentives on their behaviour will not be totally about the patient.

JamieandtheMagicTorch Sat 27-Jul-13 09:28:24

You are right about institutionalisation.

I have seen it in Care of the Elderly.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 09:40:56

Looking through the intro as a starting for ten.

First point: Consent is a legal matter. End of debate. Not only can staff be prosecuted, but so can hospitals if this is institutionalised and they are not doing enough to prevent it (that theorectically could be knowing that certain practices were going on or providing inadequate training).

Second point: Human Rights Act 1998 Article 3 (prohibition of torture and inhuman or degrading treatment or punishment), looks highly relevant here. Even phrases like "Leave your dignity at the door" could be in direct conflict with this as its suggests that dignity or degrading treatment is acceptable. It is not.

Third point: Mental capacity. There are strict rules about this, which need to be looked into in depth in this context tbh. I think looking at this the key point in those two paragraphs is "The Act allows people to plan ahead for a time when they may not have the capacity to make their own decisions: it allows them to appoint a personal welfare attorney to make health and social care decisions, including medical treatment, on their behalf or to make an advance decision to refuse medical treatment."

In short birth plans should definitely be respected and not ignored. The way I'm reading this is, that if you think there is a danger that you may not be able to give consent for whatever reason, you can select someone to do this for you. Given the nature of childbirth you certainly can plan for this possibility. So if HCP sdeem that for whatever reason during the course of your labour, you become no longer able to consent yourself, then they should then immediately refer to your support rather than just doing something; particularly if its in your birth plan not to.

Also from how I'm reading it, I have to say I think its a very, very short leap to say they should not be be being banning birth partners from labour wards under any circumstances because this would technically mean they were forcibly removing someone's advocate. I could be wrong on this though. It is something I need to look more into though to properly understand what the legalities really are and how they could be applied to this situation.

Unless someone here can enlightened me in the meantime...

GettingStrong Sat 27-Jul-13 10:00:23

Message withdrawn at poster's request.

courgetteDOTcom Sat 27-Jul-13 10:07:30

I'm not suggesting doing what BTA do, MNHQ are saying they can't take it on at the moment so why don't we?

Sorry I can't remember who posted being on my pad, but I just wanted to say a. responding to emotional blackmail isn't consent, as I've said a lot in this thread, put it into a sexual context and would it be consent? b. no one has to apologise or justify BT, it doesn't matter how "bad" it was, it happened, which it shouldn't have, and made you feel your feelings.

garlicagain Sat 27-Jul-13 10:08:09

Very enlightening, RedToothbrush, thank you!

Yes, I read the Mental Capacity part to include birth plans - particularly regarding prohibited treatment. The plan would have to be co-signed by your HCP, I think (am not a lawyer.) Also there must be issues with first-timers, in particular, prohibiting things like pain relief before knowing how much they might hurt. I get the impression birth plans are not formally & professionally set out? They probably should be.

I really don't know whether a formal appointment is needed for someone to become your Personal Welfare Attorney for just a short time. No such legal position exists in England; I suspect it's enough to make clear that your partner/mother/doula is empowered to make decisions on your behalf during the labour - maybe written in the birth plan.

courgetteDOTcom Sat 27-Jul-13 10:11:23

rtb, that could make an interesting point for birth plans, them them into a legal document and appointing someone as your advocate in it.

GettingStrong Sat 27-Jul-13 10:14:02

Message withdrawn at poster's request.

garlicagain Sat 27-Jul-13 10:16:41

Shiraz, that incident on OBEM is the reason I've never watched it! First episode I saw, the woman was practically giving birth in reception and they wouldn't let her through. Didn't want to see any more institutional obstructiveness causing distress.

garlicagain Sat 27-Jul-13 10:26:13

Oh, this is interesting - particularly the part about coercion.
www.birthrights.org.uk/library/factsheets/ -> Consenting To Treatment (pdf)

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 10:27:10

OK, another really long post but I hope that some of you will read, even if you consider what happened to you trivial. Some of the stuff you have posted that is 'trivial' is very clearly covered below. I've only pulled out the paragraphs in chapter 1 that most relevant. I'll put up stuff about mental capacity in a bit.

Like I say, I really hope people spend the time to read this properly, because these are your rights and what you should expect as a BASIC level of care.

Valid consent
1.For consent to be valid, it must be given voluntarily by an appropriately informed person who has the capacity to consent to the intervention in question (this will be the patient or someone with parental responsibility for a patient under the age of 18, someone authorised to do so under a Lasting Power of Attorney (LPA) or someone who has the authority to make treatment decisions as a court appointed deputy). Acquiescence where the person does not know what the intervention entails is not ‘consent’.

Does the person have capacity?
2.The Mental Capacity Act 2005 defines a person who lacks capacity as a person who is unable to make a decision for themselves because of an impairment or disturbance in the functioning of their mind or brain. It does not matter if the impairment or disturbance is permanent or temporary. A person lacks capacity if:
•they have an impairment or disturbance (for example a disability, condition or trauma or the effect of drugs or alcohol) that affects the way their mind or brain works, and
•that impairment or disturbance means that they are unable to make a specific decision at the time it needs to be made.

3.An assessment of a person’s capacity must be based on their ability to make a specific decision at the time it needs to be made, and not their ability to make decisions in general. A person is unable to make a decision if they cannot do one or more of the following things:
•understand the information given to them that is relevant to the decision
•retain that information long enough to be able to make the decision
•use or weigh up the information as part of the decision-making process
•communicate their decision – this could be by talking or using sign language and includes simple muscle movements such as blinking an eye or squeezing a hand.

5.A person’s capacity to consent may be temporarily affected by factors such as confusion, panic, shock, fatigue, pain or medication. However, the existence of such factors should not lead to an automatic assumption that the person does not have the capacity to consent.

6.Capacity should not be confused with a healthcare professional’s assessment of the reasonableness of the person’s decision. Under the Mental Capacity Act and the common law, a person is not to be treated as unable to make a decision merely because they make an unwise decision. A person is entitled to make a decision which may be perceived by others to be unwise or irrational, as long as they have the capacity to do so.

7.However, if the decision that appears irrational is based on a misperception of reality, as opposed to a different value system to that of the health practitioner – for example a patient who, despite the obvious evidence, denies that his foot is gangrenous, or a patient with anorexia nervosa who is unable to comprehend their failing physical condition – then the patient may not be able to comprehend, weigh or make use of the relevant information and hence may lack the capacity to make the decision in question.

8.The Mental Capacity Act also requires that all practical and appropriate steps are taken to enable a person to make the decision themselves. These steps include the following:
•Providing relevant information. For example, if there is a choice, has information been given on the alternatives?
•Communicating in an appropriate way. For example, could the information be explained or presented in a way that is easier for the person to understand?
•Making the person feel at ease. For example, are there particular times of the day when a person’s understanding is better?
•Supporting the person. For example, can anyone else help or support the person to understand information and to make a choice?

Is the consent given voluntarily?
10.To be valid, consent must be given voluntarily and freely, without pressure or undue influence being exerted on the person either to accept or refuse treatment. Such pressure can come from partners or family members, as well as health or care practitioners. Practitioners should be alert to this possibility and where appropriate should arrange to see the person on their own in order to establish that the decision is truly their own.

Has the person received sufficient information?
13.To give valid consent, the person needs to understand the nature and purpose of the procedure. Any misrepresentation of these elements will invalidate consent. Where relevant, information about anaesthesia should be given alongside information about the procedure itself.

15.Although informing people of the nature and purpose of procedures enables valid consent to be given as far as any claim of battery is concerned, this is not sufficient to fulfil the legal duty of care to the person. Failure to provide other relevant information may render the practitioner liable to an action for negligence if a person subsequently suffers harm as a result of the treatment received.

18.In considering what information to provide, the health practitioner should try to ensure that the person is able to make an informed judgement on whether to give or withhold consent. Case law on this issue is evolving. It is therefore advisable to inform the person of any ‘material’ or ‘significant’ risks or unavoidable risks, even if small, in the proposed treatment; any alternatives to it; and the risks incurred by doing nothing. A Court of Appeal judgment stated that it will normally be the responsibility of the doctor to inform a patient of ‘a significant risk which would affect the judgment of a reasonable patient’. Following Chester v Afshar, it is advisable that healthcare professionals give information about all significant possible adverse outcomes and make a record of the information given.

19.The GMC provides guidance on the type of information that patients may need to know before making a decision, and recommends that doctors should do their best to find out about patients’ individual needs and priorities when providing information about treatment options. It advises that discussions should focus on the patient’s ‘individual situation and risk to them’ and sets out the importance of providing the information about the procedure and associated risks in a balanced way and checking that patients have understood the information given.

Additional Procedures
22.During an operation it may become evident that the person could benefit from an additional procedure that was not within the scope of the original consent. If it would be unreasonable to delay the procedure until the person regains consciousness (for example because there is a threat to the person’s life) it may be justified to perform the procedure on the grounds that it is in the person’s best interests. However, the procedure should not be performed merely because it is convenient. For example, a hysterectomy should never be performed during an operation without explicit consent, unless it is necessary to do so to save life.

When should consent be sought?
31.The seeking and giving of consent is usually a process, rather than a one-off event. For major interventions, it is good practice where possible to seek the person’s consent to the proposed procedure well in advance, when there is time to respond to the person’s questions and provide adequate information. Clinicians should then check, before the procedure starts, that the person still consents. If a person is not asked to signify their consent until just before the procedure is due to start, at a time when they may be feeling particularly vulnerable, there may be real doubt as to its validity. In no circumstances should a person be given routine pre-operative medication before being asked for their consent to proceed with the treatment.

Form of consent
32.The validity of consent does not depend on the form in which it is given. Written consent merely serves as evidence of consent: if the elements of voluntariness, appropriate information and capacity have not been satisfied, a signature on a form will not make the consent valid.

34.If the person has capacity, but is unable to read or write, they may be able to make their mark on the form to indicate consent. It would be good practice for the mark to be witnessed by a person other than the clinician seeking consent, and for the fact that the person has chosen to make their mark in this way to be recorded in the case notes. Similarly, if the person has capacity, and wishes to give consent, but is physically unable to mark the form, this fact should be recorded in the notes. Or, the person can direct someone to sign the form on their behalf, but there is no legal requirement for them to do so. If consent has been given validly, the lack of a completed form is no bar to treatment, but a form can be important evidence of such consent.

35.Consent may be expressed verbally or non-verbally: an example of non-verbal consent would be where a person, after receiving appropriate information, holds out an arm for their blood pressure to be taken. However, the person must have understood what examination or treatment is intended, and why, for such consent to be valid. It is good practice to obtain written consent for any significant procedure, such as a surgical operation or when the person participates in a research project or a video recording (even if only minor procedures are involved).

Duration of consent
42.When a person gives valid consent to an intervention, in general that consent remains valid for an indefinite duration, unless it is withdrawn by the person. However, if new information becomes available regarding the proposed intervention (for example new evidence of risks or new treatment options) between the time when consent was sought and when the intervention is undertaken, the GMC guidance states that a doctor or member of the healthcare team should inform the patient and reconfirm their consent. In the light of paragraph 19 above, the clinician should consider whether the new information should be drawn to the attention of the patient and the process of seeking consent repeated on the basis of this information. Similarly, if the patient’s condition has changed significantly in the intervening time it may be necessary to seek consent again, on the basis that the likely benefits and/or risks of the intervention may also have changed.

43.If consent has been obtained a significant time before undertaking the intervention, it is good practice to confirm that the person who has given consent (assuming that they retain capacity) still wishes the intervention to proceed, even if no new information needs to be provided or further questions answered.

When consent is refused
44.If an adult with capacity makes a voluntary and appropriately informed decision to refuse treatment (whether contemporaneously or in advance), this decision must be respected, except in certain circumstances as defined by the Mental Health Act 1983. This is the case even where this may result in the death of the person (and/or the death of an unborn child, whatever the stage of the pregnancy).

Withdrawal of consent
45.A person with capacity is entitled to withdraw consent at any time, including during the performance of a procedure. Where a person does object during treatment, it is good practice for the practitioner, if at all possible, to stop the procedure, establish the person’s concerns and explain the consequences of not completing the procedure. At times, an apparent objection may in fact be a cry of pain rather than withdrawal of consent, and appropriate reassurance may enable the practitioner to continue with the person’s consent. If stopping the procedure at that point would genuinely put the life of the person at risk, the practitioner may be entitled to continue until that risk no longer applies.

46.Assessing capacity during a procedure may be difficult and, as noted above, factors such as pain, panic and shock may diminish capacity to consent. The practitioner should try to establish whether at that time the person has capacity to withdraw a previously given consent. If capacity is lacking, it may sometimes be justified to continue in the person’s best interests, but this should not be used as an excuse to ignore distress.

Advance decisions to refuse treatment
47.A person may have made an advance decision to refuse particular treatment in anticipation of future incapacity (sometimes previously referred to as a ‘living will’ or ‘advance directive’). A valid and applicable advance decision to refuse treatment has the same force as a contemporaneous decision to refuse treatment. This is a well-established rule of common law, and the Mental Capacity Act 2005 now puts advance decisions on a statutory basis. The Act sets out the requirements that such a decision must meet to be valid and applicable. Further details are available in chapter 9 of the Mental Capacity Act (2005) Code of Practice, but in summary these are:
^•the person must be 18 or over
^•the person must have the capacity to make such a decision •the person must make clear which treatments they are refusing
•if the advance decision refuses life-sustaining treatment, it must be in writing (it can be written by someone else or recorded in healthcare notes), it must be signed and witnessed and it must state clearly that the decision applies even if life is at risk
•a person with capacity can withdraw their advance decision at any time.

48.Healthcare professionals must follow an advance decision if it is valid and applicable, even if it may result in the person’s death. If they do not, they could face criminal prosecution or civil liability. The Mental Capacity Act 2005 protects a health professional from liability for treating or continuing to treat a person in the person’s best interests if they are not satisfied that an advance decision exists which is valid and applicable. The Act also protects healthcare professionals from liability for the consequences of withholding or withdrawing a treatment if at the time they reasonably believe that there is a valid and applicable advance decision. If there is genuine doubt or disagreement about an advance decision’s existence, validity or applicability, the case should be referred to the Court of Protection. The court does not have the power to overturn a valid and applicable advance decision. While a decision is awaited from the courts, healthcare professionals can provide life-sustaining treatment or treatment to stop a serious deterioration in the patient’s condition.

49.If an advance decision is not valid or applicable to current circumstances, healthcare professionals must consider the advance decision as part of their assessment of the person’s best interests. Advance decisions made before the Mental Capacity Act came into force may still be valid if they meet the provisions of the Act.

garlicagain Sat 27-Jul-13 10:41:37

Haven't read all of your post yet, RTB. Amazing work smile
Now I've discovered Birth Rights, I've made a donation.

soapboxqueen Sat 27-Jul-13 10:48:50

Maybe if birth plans are made into a more formal and legally recognisable document, they would have more clout. Maybe there should be a facility either within the nhs or by a separate charity, where you can meet with a hcp and draw one up with someone who can walk you through possibilities. The pros and cons etc. It would be in a uniform format that all other hcp would be familiar with. They could advise your birth partner of what are acceptable practises and rights, like when to say; no hands off. I think even with a birth plan, many partners would still be in awe of the medical professionals and would just go with it.

After they could run a reflections service to review what happened. Then if a woman needs support to make a complaint or make a criminal complaint, they will have the facilities to support this. Even if they choose not to make a complaint, the information is recorded, hospitals could be warned of unacceptable practises by the charity in an anonymous way.

That being said, a birth plan isn't going to stop the God awful people who have seriously assaulted and violated people. I really just can't fathom why anyone would think it was acceptable to treat anyone in this way.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 10:49:59

Chapter 2 adults without capacity

General principles
1.The Mental Capacity Act 2005 came fully into force in October 2007 and applies in England and Wales to everyone who works in health and social care and is involved in the care, treatment or support of people over 16 years of age who may lack capacity to make decisions for themselves. It is largely based on previous common law and creates a single, coherent framework for decision-making, including decisions about treatment. This chapter summarises the main provisions of the Mental Capacity Act. Detailed guidance is provided in the Code of Practice, which has statutory force. The Act imposes a duty on health professionals (and other healthcare staff) to have regard to the Code of Practice.

2.Under English law, no one is able to give consent to the examination or treatment of an adult who lacks the capacity to give consent for themself, unless they have been authorised to do so under a Lasting Power of Attorney or they have the authority to make treatment decisions as a court appointed deputy. Therefore, in most cases, parents, relatives or members of the healthcare team cannot consent on behalf of such an adult. However, the Mental Capacity Act sets out the circumstances in which it will be lawful to carry out such examinations or treatment.

3.In general, the refusal to an intervention made by a person when they had capacity cannot be overridden if the advance decision is valid and applicable to the situation. There are certain statutory exceptions to this principle, including treatment for mental disorder under the Mental Health Act 1983, which are set out briefly in chapter 5.

4.The legal requirements in the Mental Capacity Act are underpinned by five statutory principles. One of these key principles is that any act done for, or any decision made on behalf of, a person who lacks capacity must be done, or made, in that person’s best interests. This principle applies to health professionals as it does to anyone working with and caring for a person who lacks capacity. The Act also creates a new offence of ill treatment or wilful neglect of someone who lacks capacity by someone with responsibility for their care or with decision-making powers.

6.The Mental Capacity Act provides healthcare professionals with protection from civil and criminal legal liability for acts or decisions made in the best interests of the person who lacks capacity. The Act makes it clear that when determining what is in a person’s best interests a healthcare professional must not make assumptions about someone’s best interests merely on the basis of the person’s age or appearance, condition or any aspect of their behaviour.

7.The Act requires that a healthcare professional must consider all the relevant circumstances relating to the decision in question. These are described as factors that the healthcare professional is aware of and which are reasonable to take into account.

8.In considering the relevant circumstances, the Act rules that the healthcare professionals must take the following steps:
•Consider whether the person is likely to regain capacity and if so whether the decision can wait.
•Involve the person as fully as possible in the decision that is being made on their behalf.
•As far as possible, consider:
–the person’s past and present wishes and feelings (in particular if they have been written down)
–any beliefs and values (eg religious, cultural or moral) that would be likely to influence the decision in question, and any other relevant factors, and
–the other factors that the person would be likely to consider if they were able to do so.
•As far as possible, consult other people if it is appropriate to do so and take into account their views as to what would be in the best interests of the person lacking capacity, especially:
–anyone previously named by the person lacking capacity as someone to be consulted
–anyone engaging in caring for or interested in the person’s welfare
–any attorney appointed under a Lasting Power of Attorney
–any deputy appointed by the Court of Protection to make decisions for the person

Duration of lack of capacity
12.The provisions of the Mental Capacity Act apply to acts or decisions made on behalf of an adult who lacks capacity – whether the lack of capacity is likely to be temporary or permanent. It is possible for capacity to fluctuate. In such cases, it is good practice to establish, while the person has capacity, their views about any clinical intervention that may be necessary during a period of anticipated incapacity, and to record these views. The person may wish to make an advance decision to refuse treatment or a statement of their preferences and wishes. If the person does not make a relevant advance decision, decisions about that person’s treatment if they lack capacity must be made in accordance with the Mental Capacity Act. This would include considering whether the person is likely to regain capacity and, if so, whether the decision can wait, as well as the statutory principle that all practical steps must be taken to enable the person to make their own decision.

Statements of preferences and wishes
13.A healthcare professional must take all statements of a person’s preferences and wishes into consideration as part of a best interests assessment. Written statements which request specific treatments made by a person before losing capacity should be given the same consideration as those made by people who currently have capacity to make treatment decisions. However, a healthcare professional would not have to follow a written request if they thought that the specific treatment would be clinically unnecessary or not appropriate for the person’s condition, and therefore not in the person’s best interests. If the decision is different to a written statement, a healthcare professional should keep a record of this and be prepared to justify the decision if challenged. There is an important legal distinction between a written statement expressing treatment preferences, which a healthcare professional must take into account when making a best interests decision, and a valid and applicable advance decision to refuse treatment, which healthcare professionals must follow. Healthcare professionals cannot ignore a written statement that is a valid and applicable advance decision to refuse treatment.

Lasting Power of attorney
14.The Mental Capacity Act enables a person aged 18 or over to appoint an attorney to look after their health and welfare decisions if they should lack the capacity to make such decisions in the future. Under a personal welfare LPA, the attorney – if they have the authority to do so – can make decisions that are as valid as those made by the person themselves. The LPA must be made in the form, and meet the criteria, set out in the regulations, and it must be registered with the Office of the Public Guardian before it can be used.

15.The LPA may specify limits to the attorney’s authority, and the LPA must specify whether or not the attorney has the authority to make decisions about life-sustaining treatment. Healthcare practitioners directly involved in the care or treatment of a person who lacks capacity should not agree to act as that person’s attorney other than in exceptional circumstances (for example if they are the only close relative of the person). If the person lacks capacity and has created a personal welfare LPA, the attorney will have the authority to make decisions and consent to or refuse treatment as set out in the LPA. Healthcare practitioners should read the LPA if it is available, in order to understand the extent of the attorney’s power.

16.The attorney must follow the statutory principles under the Mental Capacity Act and make decisions in the best interests of the person lacking capacity. If the decision is about life-sustaining treatment, the attorney must not be motivated by a desire to bring about the person’s death. Attorneys also have a legal duty to have regard to the guidance in the Mental Capacity Act (2005) Code of Practice. If there is a dispute that cannot be resolved, eg between the attorney and a doctor, it may have to be referred to the Court of Protection. More information about LPAs is given in chapter 7 of the Code of Practice.

Consent forms
24.Where treatment is provided to a person who lacks capacity following a best interests decision, any consent form should not be signed by someone else unless they have a personal welfare LPA that authorises them to make the decision in question, or they are a court appointed deputy with similar authority. It is good practice to note either in the records or on a ‘patient unable to consent’ form why the treatment was decided to be in the patient’s best interests.

I think the above covers my earlier point about who can make decisions on your behalf legally and who they should make every effort to involve if there is any suggestion over issues of your capacity to consent. I really do think they are dodgy ground if they refuse to allow you to have support whilst in labour for any reason.

If you want to read more about a Lasting Power of Attorney then you can do so here. I'm not sure it will be helpful to the vast majority of people, but I think this could be useful and of interest to a very small number of people. There is a cost involved of £130 though, and just how this would be respected in this situation I have no real practical knowledge and might be one for a solicitor. If nothing else though its an idea and maybe will provide reassurance to a few people.

I've also just pulled out the following paragraph directly from the Mental Health Act as its pretty relevant and important to birth plans:

64J Factors to be considered in determining whether patient objects to treatment
(1)In assessing for the purposes of this Part whether he has reason to believe that a patient objects to treatment, a person shall consider all the circumstances so far as they are reasonably ascertainable, including the patient's behaviour, wishes, feelings, views, beliefs and values.

(2)But circumstances from the past shall be considered only so far as it is still appropriate to consider them.

From that, I do have to conclude that ignoring birthplans is extremely worrying legally. Even if midwives are rushed off their feet and 'don't have time' they need to be aware of the risks of doing so. They are exposing themselves to the risk of not properly obtaining or respecting consent.

Tbh reading all that has given me much food for thought.

garlicagain Sat 27-Jul-13 11:12:06

Very good points, soapbox.

That being said, a birth plan isn't going to stop the God awful people who have seriously assaulted and violated people. I really just can't fathom why anyone would think it was acceptable to treat anyone in this way.

You have to get bullies sanctioned, and hard, because they honestly believe they have power and are 'right'.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 11:12:25

To clarify the point about birthplans.

If you wrote:
I do not consent to the use of forceps

or:
I do not consent to the use of forceps unless necessary

or:
I do not consent to the use of forceps unless the baby's life is in danger

or:
I do not consent to forceps under any circumstances and understand this potentially my endanger my life

The way it can and should be interpreted would be different.

For the second of third, it would be down to when they decided that intervention is necessary.
For the fourth, they shouldn't use them under any circumstances.
For the first, I do think there is potential the HCP could decide that the circumstances have changed and it is in your best interest to use them or that you don't fully understand the implications because you haven't specifically stated X, Y or Z. I think that technically they shouldn't use them, but there is room for them to argue a case for why they did.

Remembering of course, that at any point you retain the right to change your mind. Which highlights why it is necessary for HCP to constantly review your decision and keep you fully informed and involved in what happens to you.

its really difficult, but this is where birthplans should be taken more seriously as something leading up to birth, because sitting down and discussing is a discussion over consent and fully understanding what could happen. You have to always bare in mind what is 'likely' or 'common' in this context. If you had treatment where a complication leading to intervention was a 10% risk, you would be having these type of consultations ahead of the matter to make sure you fully understood things.

timetomoveon Sat 27-Jul-13 11:22:09

This thread has been like poking an open wound but I've been compelled to keep reading sad

I ended up with ptsd after the birth of my ds; one of the trigger points was to do with things being done to me that I had no control over. It's so sad to see that there are many people who have had the same hideous experiences.

bordellosboheme Sat 27-Jul-13 14:48:50

Red toothbrush....... The focus of the campaign would be, 'women are being raped during childbirth'. If we take away all the fancy wording this is what it amounts to. It needs to be targeted towards the media, the politicians and NHS regulating bodies.

I was overdue and the mw who said she was going to check if I needed an induction pessary, gave me a sweep without my consent. She said, 'you're overdue so I'm not going to mess around'. She left me bleeding, sore and f****ing annoyed. My baby went into severe foetal distress straight after this and I was left for 12 hours overnight. By the morning they slapped a monitor on and there was barely a heartbeat so I was rushed off for an emergency cs. He spent 10 days in the nicu. where I was told her would have lifelong disabilities.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 15:02:54

I think you'd have problems using that as a focus. I get your point, and it would be hard hitting, but I also think it would be counterproductive too.

Its criminal assault, but not rape. If you are accusing medical professional of a different crime under law you are going to run into problems.

bordellosboheme Sat 27-Jul-13 15:14:47

As an aside, there are some real twats out there in healthcare. Ds had a febrile convulsion when he was 6 months. We were rushed to a and e. when he came around he was thankfully happy and bouncing around. I overheard one nurse saying to another, you wait, he won't be smiling anymore once we take the bloods.... Or something like that as she scoffed a plate full of flapjacks (whilst leaving me without food a whole day) - dh had to come in with a bag full of supplies. Why talk about a baby like that?

soapboxqueen Sat 27-Jul-13 15:17:05

Yes, that would get people's attention but I think they would be assuming the problem was something different than it is. It would confuse the message.

garlicagain Sat 27-Jul-13 15:20:57

"Assaulted at Birth"?

Fair enough, I would think, since none of these escapades can be particularly pleasant for the baby, either.

bordellosboheme Sat 27-Jul-13 15:33:13

What is the difference between rape and assault? If someone is entering my genitals without my proper consent, I consider hat rape...

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 15:37:25

Its not the same in law for starters.

I know its controversial and does upset some people who have been raped to call it the same thing or to use the term 'birth rape'.

Its best to use a term that unites rather than is divisive between different groups of women, especially those who have been abused.

garlicagain Sat 27-Jul-13 15:41:00

Bordellos, in English law rape is specifically carried out with a penis (and includes anal & oral.) You would alienate more women than you attracted, not to mention laying yourself open to a massive libel charge.

garlicagain Sat 27-Jul-13 15:43:37

Actually, an extract quoted above used the word "battery" which is technically correct. Again, though, its common-usage connotations give the wrong impression. Assault is a perfectly good word.

Assault covers forcible restraint, unlike words associated with sex crimes.

courgetteDOTcom Sat 27-Jul-13 15:46:21

I've avoided using the term so far because I didn't want to further derail. The phrase often used is birth rape. i think it legally applies more in the US where rape is anything entered into an orifice, rather than here I believe is piv/a. I think it's a good term to describe it, I think we need to keep the emphasis on the fact it is a sexual assault because that's how violated it makes women feel.

soapboxqueen Sat 27-Jul-13 15:47:19

I agree with redtoothbrush, I think it will detract from the issues in both camps.

At the end of the day campaigns for any purpose have to get their message across clearly. If I was watching the tv and the presenter said our next guest is here to talk about birth rape, I would assume it was women who had been forced to have sex just before or after birth. Once a message has to be qualified or explained, it loses some of it's power.

More importantly, many women who had been assaulted or received degrading treatment may not identify with it and assume it was something else.

I think birth assault is much more distinct yet can cover a range of situations or even medical assault during birth.

courgetteDOTcom Sat 27-Jul-13 15:52:11

Mega cross post, I'm slow on my phone.

Having been through both I agree with the word. I think worrying about offending people is half the problem, these women on this thread who've over again almost apologised for sharing their experiences.

garlicagain Sat 27-Jul-13 15:59:59

Just going back to the restraint thing for a minute, I read a bunch of accounts last night from women whose babies were spine-to-spine. Most knew how to position themselves for more effective pushing (side or leaning forwards), but were pinned down on their backs, with most yanked into stirrups as well. Horrible. And unreasonable!

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 16:01:08

I think the associations of the term 'birth rape' are correct in many respects, but I have seen too many people object to it online to want to use it as the way to front any campaign. You want to get attention, but it has to be right attention and also not offend people you might be wanting to help. It might be right to 'offend' those who are in power and are committing these crimes, but I think you can do it in other ways by being hard hitting.

There are a number of articles about the subject about, so it is a useful term to know, and perhaps use as part of any campaign to explain how it is viewed by some, but not as the headline phrase.

This is an interesting Blog from a few years back about how we should try and recognise the crime. It does use the phrase (which I why I say it perhaps has its place) but if you are going after institutions in a more formal way, which is what you really want rather than being sensationalist, you need to use the correct terms.

Being sensationalist won't effect change. It will be dismissed by hospitals as being tabloid rather than serious in its intentions. It also doesn't get the message across well about the more 'trivial' breeches that are occurring (and as I say, equally wrong and equally illegal). Its such a strong term, that it would be easy for these women to not think they have also been wronged.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 16:12:21
RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 16:19:51

Venezuela has the specific crime of Obstetric violence

sarah-stewart.blogspot.co.nz/2010/11/obstetic-violence-new-legal-term-in.html

Obstetric violence may include:
1. Untimely and ineffective attention of obstetric emergencies;
2. Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available;
3. Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breast-feeding immediately after birth;
4. Altering the natural process of low-risk delivery by using acceleration techniques, without obtaining voluntary, expressed and informed consent of the woman;
5. Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman

I find that interesting...

bordellosboheme Sat 27-Jul-13 16:38:07

Wow Venezuela is ahead of us! This should be the campaign I think. Venezuela has this piece of legislation, we now need it in the uk. Think i will be going to Venezuela to give birth next time......

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 16:44:49

I think its not a bad idea. It definitely defines a range of different things then and is very clear in objectives.

The big devils advocate question would then be:
Why do we need this law? Why isn't it covered by existing laws?

garlicagain Sat 27-Jul-13 17:19:12

Oooh, Obstetric Violence says it right!

Goes to show what can happen when you have a female PM wink (er, not the one we had, perhaps)

garlicagain Sat 27-Jul-13 17:42:14

It could be created as a specified sub-set of assault, I think, RTB. Offences against the person can only be proven if there is intent to cause injury (intent has specific legal meanings, but they're pretty much as you'd expect.) Medical practitioners would have a ready defence to this so, in a lot of cases, malpractice would provide a stronger basis. Some posters, though, have said their HCPs used expressions like "that'll teach her", which would imply intent.

If I were a lawyer, I'd also look at using the practitioner's knowledge & experience to show they knew their actions would cause injury, therefore intent was present. I'm not a lawyer, though, you need a grown-up to comment!

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 17:45:15

Reason I ask is simply because it would be the first thing that someone would ask, and you need to be really clear about all the whys, how, and wherefores of this for it to really be taken seriously.

garlicagain Sat 27-Jul-13 18:16:56

Points 2, 3 & 4 of your Venezuelan summary can't exist outside the labour setting. Since 1 & 5 specify obstetric procedures, they are also different from common assault or ABH.

garlicagain Sat 27-Jul-13 18:18:17

Or other forms of malpractice, sorry.

Itchywoolyjumper Sat 27-Jul-13 20:51:34

Red thanks for all your research. I think the obstetric violence angle would be a good one to go for.
We could begin by writing to our MPs/MSPs/MAs/MLAs asking them to help get the Venezuelan model made law here and linking to this thread as proof as to why this should be looked into.

CaptChaos United States Sat 27-Jul-13 22:12:35

My DS1 was at spines. No-one told me, no-one told me anything really. When I went into labour I stayed at home for as long as I could bear the pain, and then went into hospital. I was told to lie on a trolley in a corridor of the maternity ward and was told off when I walked about during contractions, I 'had' to lie down, or they couldn't admit me. After a while, I was allowed into the delivery room where I was strapped up to a monitor. I now know that this is the worst position for a woman who's baby is at spines to be in during labour. I was dilating far too slowly, I know this because of the half hourly VE's I was subjected to. During one of these, the MW broke my waters for me, without telling me she was going to do it. She took the gas and air away from me, because I was using too much. The pain was unbelievable, I had been lying in one position for hours, every time I moved I was told off because it would 'upset' the monitors, I was in what was fairly useless labour and I was panicky and felt out of control. I begged for an epidural and was sighed at, eventually she went and found someone who gave me pethedine!!!! Long story short, constant VE's eventual epidural still nothing much happening, until a doctor came in and told me I was having forceps if I didn't 'hurry up', needless to say, a little while later, my DS was born with forceps, I lost a lot of blood and passed out. I came round to find about 20 people in the room, my legs were in stirrups, they were all staring at my vagina, while the consultant (?) talked about me as if I wasn't there. He sewed me up (no one told me that they were going to cut me) and then left, he never spoke directly to me, I don't remember him even looking at my face. I was meat.

This was in the days where they wouldn't let you go home unless you had defecated, so I was chugging fybogel just to get out of there! Eventually I went and was allowed to leave.

My experience is in no way as bad as others, however, I was sexually abused as a child and the feelings of loss of control, the pain and someone forcing their fingers inside me without my consent made me wary of repeating the experience. The mere thought of a doctor inserting anything into me now makes me panic, I can't face having a pap smear, I have made so many appointments and then chickened out, even thinking about it now is bringing those feelings up. I have had to sign a letter which states that I have refused to have a smear even though I know that I am risking having undetected cervical cancer if I do.

What upsets me is that this is still happening, judging by other poster's experiences, there are still HCP's who treat women as if they are meat. We should be angry about this, we should be doing something about this, we are not meat, giving birth is not something someone does to us.

Sorry, terribly rambling, but I started and couldn't stop.

RedToothBrush Bosnia-Herzegovina Sat 27-Jul-13 22:17:01

Ok, we've got the problem, it seems to be pretty widespread and unacknowledged unfortunatley, we've got a loose idea for a focus and how you term it, we've got a vague reason why its needed and not currently covered. Still needs work but I think its fairly easily achievable.

Your next problem is how how do you get hospitals and officials to acknowledge there is a problem within their institution? And how do you persuade them to actually change their institutionalised procedures and change the practices of their staff. On no budget. What line will the unions take on this issue too? Its worth thinking about. Preempt whats they'll throw back and have all the answers ready. Make it water tight.

The 'getting them to listen' bit is actually the hardest. The experience with Bounty was that the hospitals were really dismissive of questionnaires, being biased or unrepresentative and usually they had a counter one to pull out of their backsides.

The obvious way would be with legal test cases, but given the nature of this, and sheer scale of it, there are a few problems with that too. Having enough people to come forward publicly to do that is perhaps unlikely and would be traumatic for those involved. Even if you proved it in one hospital, they could still then say, it was an isolated thing and one hospital and not endemic throughout the entire system.

The other way would be with whistleblowers who work in maternity. Again difficult.

You need to do something to effectively force every Trust to sit up and take note. So you need to play hardball about what they are liable for and catch them out with their own information or policies, by pretty much showing they are flawed in someway.

Its no good just to say this is wrong because the issue concerned has been going for so many years in this way and despite however far women's rights have come, no ones really managed to tackle attitudes in maternity AND within the public. Its all covered up in the whole 'you should just be grateful you and your baby are alive' thing.

How do you show, that these attitudes are allowing maternity in the UK to be massively under achieving and failing women and how do you show that what you are proposing is affordable within the financial contraints of the time?

This one is actually the million dollar question. All the letter writing in the world actually won't do a lot, if you don't have the jugular vein to go for in the first place.

I think I have a few ideas up my sleeve for this one, but this is where its tough and where people really need to think and I'd really like other people to come up with a few too. Especially from people within the profession, as I think they'll have some cracking thoughts on this.

Think evidence. Think proving something. Think where are their policies clearly non-compliant with existing law, but no one has really thought about it or challenged it. Its there because the problem clearly exists; you've just got to pin it down in a way thats undeniable and makes it very difficult for them to make excuses for or just ignore.

bordellosboheme Sat 27-Jul-13 22:42:00

I may have to stop checking this thread as its too triggering for me (and I expect for lots of posters). I need to protect my mental health. However, I really hope that there is enough testimonials here for:

1) mnhq to take this on as a campaign for legislation against obstetric violence,

2) evidence of mistreatment of a large uk cross section of women. These posts themselves constitute narrative evidence.

I may check back In a couple of days when I'm feeling stronger, but red toothbrush and others you are doing well....

Good luck xx

bordellosboheme Sat 27-Jul-13 22:42:34

Are enough..... I should say

bordellosboheme Sat 27-Jul-13 22:43:27

Ps, I'm on pretty good terms with my local mp. I could certainly raise it with him

RevoltingPeasant Sat 27-Jul-13 23:35:53

Red IMO the biggest problem is actually educating women themselves.

About a year ago I started a thread specifically about the importance f being respected in birth, and it not just being about "a healthy baby". Loads of women wrote in to tell me I was princessy or naive, or into whale music. Then MNHQ moved the thread from AIBU to Childbirth, essentially a specialist area which gets much less traffic.

Basically, I think it may be women themselves, including and especially midwives (generally female) who need awareness building.

RevoltingPeasant Sat 27-Jul-13 23:39:01

Also I find this thread bizarrely fascinating even though it makes me remember constantly the one non-consensual gynae I have had. I cannot imagine how triggering this must be for people with birth trauma, and I am in awe of your grace and courage in sharing with and educating others.

I am so damn glad I had a home birth with my only child.
And I would like to say: thank you past posters on MN because it was only after reading other women's stories on here that I realised, whilst still pregnant, that as a rape survivor with PTSD with a specific fear of hospital and internal exams following the rape, that I was allowed to stay at home. Allowed to say no. Allowed to give consent. Allowed to have power, and choices, and protect myself and my body and mind even though I was pregnant and labouring.
I didn't know before MN and I would have been another further- traumatised woman flash backing my baby's birth if I hadn't been guided and informed by your collective wisdom and experience.

So thank you. And flowers to you all, especially those who were hurt and harassed and assaulted and ignored but have told your stories nonetheless.

bordellosboheme Sun 28-Jul-13 02:41:13

Revolting I'm not sure I agree that it's about educating women. Women are pretty well educated on the whole. But during the state of birth you enter a primal state where your 'thinking brain' or neocortex switches off. It is this state, combined with the physical changes your body is making that make even the most educated woman vulnerable to any twattish hcps.

Right, must stop checking for a while wink

RonaldMcDonald Sun 28-Jul-13 02:45:34

I lost track of time and speech.

This seems like a thread to ask a question I have after my 3rd labour.

Can a midwife accurately perform an internal to check progress while a woman is on her hands and knees?

I ask as with DS3 I was on the ward as in inpatient and as with my second baby I went from nothing, no contractions no tightenings to waters breaking and needing to push in about 2 minutes flat, I was on my hands and knees(baring in mind I was an inpatient due to a completely separated pelvis and excruciating pain needing controlled pain relief) this was the only way I could stay conscious and calm at this point.

I buzzed for help and explained my previous birth and that I needed to push as the baby was here.

Cue much eye rolling and her saying she needs to check and if I wasn't prepared to get onto my back then she couldn't help me and she fucking left the cubical!!!

DP finally helped me move onto my back whilst I screamed and she came back and DS was born seconds later as I flipped back over onto my knees.

She claimed afterwards that its impossible to judge progression unless a patient is laying in their back in a standard ankles together knees,apart position.

My theory was, that after already having 2 children I knew DS was here and ready, I needed to be in the labour ward having support to push him out not talked to like a petulant child that was bring disobedient.

GettingStrong Sun 28-Jul-13 09:35:33

Message withdrawn at poster's request.

RedToothBrush Bosnia-Herzegovina Sun 28-Jul-13 09:55:23

i DO think in part its about educating women. How many women on this thread have referred to what was happening to them as 'trivial'?

How many women on this thread have had questions or assumed them had given consent when that consent was dubious at best.

I definitely think a little guide to consent would be worth while. Either as some sort of leaflet or maybe as a QandA type thing that MN could put on the site. That certainly wouldn't dilute any of the campaigns they are currently doing. If further down the line they wanted to promote it more they would have it ready to push. In fairness to MN they have pinned something about birthrights on the child birth section, but I don't think it goes far enough or explains a great number of things - it does link to places that talk about consent, but again, I'm not sure they cover enough either.

It needs to be easy to read and easy to understand but comprehensive. If women are aware that they have been abused, then perhaps that would help them make formal complaints rather than think they are somehow to blame.