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Birth plan said no ventouse or forceps

(30 Posts)
LouM10 Wed 29-Jun-11 15:12:03

I gave birth in September and in my birthing plan I said I would rather have a CS than forceps or ventouse. I had an awful experience. Was meant to be having a homebirth but could not get in touch with mw. Ended up getting to hosp when I was 8cms with no pain relief. After a while on gas and air at the hosp. I eventually had an epidural. My husband couldn't even keep his eyes open so he didn't realise what was happpening. Had major bp issues so they said if I hadn't delivered within an hr they would take me in for a cs. I was in no fit state to tell them I didn't want a ventouse but it was in my birthing plan.

I ended up with an episiotomy and ventouse and am quite upset that they did this. Are they allowed to do what they want regarding your birth plan?

friendcat Wed 29-Jun-11 15:14:45

birthplans are like wishlists. You can plan for what you'd like to happen but you should always be aware that the professionals are there to do what is required medically for the safety of both of you.

belgo Wed 29-Jun-11 15:16:47

If you said you would rather have a CS then a ventouse, then that is not the same as saying NO VENTOUSE IN ANY CIRCUMSTANCES.

And ultimately the doctors and midwives did what was necessary in the circumstances.

HAve you spoken to anyone about how you feel?

mousymouse Wed 29-Jun-11 15:16:54

afaik they are allowed provided you give your consent.
consent unfortunately sometimes means "not protesting too loudly".
are you sure you didn't give consent? nodding at the mw/consultant to proceed?

Lovethesea Wed 29-Jun-11 15:21:06

When my birth went pear shaped I was given a form to sign that basically said I agreed to any medical intervention necessary to get DD out. I was so out of it with pain I thought I was signing an ok for a c-section but I reread my notes later and realised it was a general consent (I had high rotational forceps in the end).

Was something like that presented?

LouM10 Wed 29-Jun-11 15:21:11

In my birth plan I had 'no forceps or ventouse' The only thing I consented to was my epidural. I was spending most the time trying to wake the other half up. I was quite panicky due to bp. I know i didn't verbally say yes you can do it. I have unfortunately no idea whether I nodded. When women are in that state though, they are hardly at their most rational which is why birth plans are there. i thought anyway. I haven't spoken to anyone about it. Not sure who I could spk to. Thank you for your replies so far

LouM10 Wed 29-Jun-11 15:21:50

i'm sure the only thing I signed was the consent for the epidural

Primafacie Wed 29-Jun-11 15:23:22

It sounds like you had a hard time. I'm shocked that you couldn't get a midwife for your planned homebirth.

When you say you were in no fit state to decline the ventouse, did they ask you the question? Did you tell them as they were approaching with the ventouse that you did not want it? Were you told about the pros and cons of the ventouse vs CS? For what it is worth, I think a birth plan is just the abstract expression of the mother's wishes, and quite often the hospital cannot abide by it. This being said, I also the misfortune of having my birth plan completely ignored and I am sorry for you. Have you had a post birth meeting to discuss what happened? I had one with the head of midwifery and I found it helped me to get closure.

Good luck, I hope you find the answers you are looking for. <unmumsnetty hug>

Primafacie Wed 29-Jun-11 15:25:37

Sorry, x-posted with everyone!

mrsravelstein Wed 29-Jun-11 15:27:38

unfortunately i think birth plans are often pretty redundant, and especially so once there is any sort of emergency or something going wrong.

and even if you/your husband had reminded them you didn't want ventouse, they may still have wanted to do it if if was the quickest safest way to deliver in their opinion.

with ds2 the doc was very keen to use ventouse after 42 hour labour, and both myself and dh had to pretty much have a stand up row with her to insist that i wanted a section instead.

mousymouse Wed 29-Jun-11 15:27:57

I had a ventouse delivery with ds, but I don't remember signing anything. just the consultant coming in and explaining what they would like to do. and asking if I am OK with this. I was, btw and dc was out quickly, in my case the ventouse was only needed to stop dc slipping back in iyswim.

Blackduck Wed 29-Jun-11 15:30:45

I was the other way - they were already to do CS when consultant said 'nope 10 cms, coming out this way' Tried vontuse, no go, so forceps....
Frankly my view was you do what is necessary (ds in major distress)

BikeRunSki Wed 29-Jun-11 15:31:22

A birthplan is a wishlist. The medical team's priority will be to get the baby out in the safest possible way for mum and baby. This is rarely a CS, as there are risks associated with this - it is likely that at the time a ventouse was safer for you than a CS.

Is your DC fit and well? Are you well - physically and mentally (how upset is "a bit upset") ? Are there any lasting issues? Are you acheiving anything by dwelling on it?

(Put in context, friends' baby died at 2 days old. Investigation found fault with mw practices during labour and infection introduced. Couple were asked if they wanted to sue the hospital. They decided not to, as, in the end, it would not acheive anything. Their child is still dead and the NHS would just be worse off).

Blu Wed 29-Jun-11 15:35:23

Poor you, you sound very traumatised by the whole thing. Maybe start with your hospitals PALS (patient liaison) department - sometimes there are de-briefing appointments with midwives in which you can talk through what happened, and why. If after that you feel there are grounds for a complaint you can proceed - there will be a leaflet telling you how, and PALS should advise you.

As regards Birth Plans - they should be about preferred strategy..."my preference is to try natural low intervention methods first...if this happens I would like to try that.. if possible i would like to give birth upright....if intervention is indicated i would like to be told what, why, and what are the likely outcomes of doing nothing..." A birth plan should also include contingencies, because obviously birth often does NOT go to an idealised plan.

Ripeberry Wed 29-Jun-11 15:40:07

Why were you against Ventuse or forcepts in the first place? When I had DD1 they wanted to try a 'new' suction cup and were trying to get me to sign.
I just told them to use normal stuff so DD1 came out with a ventuse.

I was angry that they were trying to get me to consent to something untried when I was vulnerable angry

LouM10 Wed 29-Jun-11 15:58:12

They did not ask me if they could do it. My son was in no distress, the only problem at the time was my bp and the rim of my cervix wouldn't move out of the way even after being induced. I understood a cs was a major operation but after reading a lot of material I decided ventouse was not what i wanted. I would have preferred a natural birth and I did put I would only want a cs if they needed to get him out quickly.
Tbh, I always wanted 2 or 3 children but I don't think I want anymore now. A mixture of the problems with getting the mw out at home (I'll add the mw was from a different hosp. to the one i gave birth in) and also the dis-regard to the birthing plan. The thought of having to give birth again terrifies me. They gave me an hr to get him out, he wasn't stressed so it wasn't for his benefit that they needed him out. if he was getting stressed and ventouse was quicker than cs then I could understand it.

Thank you for sharing your stories too

coccyx Wed 29-Jun-11 16:04:07

Why would they offer you a C section if he wasn't stressed and just needed a hand to get out? Bizarre. move on

LouM10 Wed 29-Jun-11 16:09:57

because I was having major bp issues and didn't want a ventouse?

motherinferior Wed 29-Jun-11 16:15:37

I am sorry you didn't get the birth you wanted - but this way does at mean you can have a home birth for any subsequent babies if you change your mind; it is very hard to find midwives ready to support a home birth after a C-section (both the Royal College of Midwives and the RCOGP recommend against) because of the (small) risk of scar rupture.

I'm very glad, for that reason, that I did have the episiotomy/ventouse route for my first baby.

vj32 Wed 29-Jun-11 16:53:01

Have you had a look at your notes? I am going to arrange soon to look through my notes with a midwife. I think everyone did the best for me and baby, just want to check what it says. Is this service offered at your hospital?

I'm surprised your midwife didn't explain about birth plans though - mine said it was just what I wanted to happen if everything went smoothly. In the end it didn't- I had an emergency c-section. I would assume that if you had problems with your bp they would not want to take you for major surgery if there was a safer way for you and baby. I'm surprised they don't seem to have asked for your consent though - my Drs and midwives were very careful to explain everything at every stage.

VivaLeBeaver Wed 29-Jun-11 17:04:13

Its normal to not sign a consent for a ventouse or forceps. If they said to you we need to do a ventouse they wouldn't necessarily expoect you to say "yes, that's fine, go ahead". Most people are not that talkative by then. So as long as you didn't scream at them to stop, etc then its implied consent which is a valid form of consent.

But I'm sorry you didn't have the birth you wanted and agree that talking to someone about it may help.

Tangle Wed 29-Jun-11 17:19:09

I'm sorry things didn't go as you hoped - and that your wishes were seemingly ignored.

From what you write it does seem as though the HCP's didn't communicate with you very well as to why they felt ventouse was the best course of action, and that you have a lot of unanswered questions as to why various things happened.

We can offer all manner of possibilities as to why they did what they did in the way that they did - but ultimately I'd suggest you get hold of a copy of your notes (PALS should be able to explain how, and help you organise it) and that you make an appointment to go through them with a MW or Obstetrician (again, PALS should be able to help - or your GP. If there is no service of this nature in your area, or if you come away with as many questions, then you could arrange an appointment with an Independent MW who would probably charge you about £50 for an appointment to go through your memories and your notes to try and help you understand what happened and why).

One other thing that struck me is that it sounds like, for whatever reason, when it came to it your DH wasn't in a position to be able to support you as fully as would have been helpful. If you do decide to have another child could I suggest you consider hiring a doula, so that there would be another person there who could act as your advocate and share the load with your DH? I did read that atm you have no intention of having more children, but emotions can change. Sorry if that's presumptuous - it just struck me that it might help if you do change your mind.

gasman Wed 29-Jun-11 17:23:07

Sorry things didn't go the way you wanted.

I think you sound like you would really benefit from a birth reflection type service.

You may also find it useful to know the way in which health care professionals regard birth plans. As others have said they are 'wishlists' and in a dynamic situation where woman may end up in a situation they could or would never have imagined we cannot rely on them absolutely.

For example I have sited epidurals in several women who had "I do not want a epidural" in their birth plan but who for a variety of reasons have changed their mind. I believe that it would be wrong of me to deny someone analgesia because they had written down prior to ever experiencing labour that they didn't want an epidural. There is a converse argument which says that they were in a better position (ie not in pain, possibly suffering from effects of gas and air/ pethidine) to make a decision pre-labour but essentially we act on what people wish in labour.

With respect to your ventouse it would be usual for at least verbal assent to be given by you to medical staff(assuming that there was no crashing fetal emergency at the time). I don't know how clear your recollections of the discussions at the time are. Certainly, medical staff would be looking for you to verbalise your disagreement with their plan.

It may help you to know that at 10cm dilated there are quite different risk profiles with respect to ventouse vs. c-section (ie I believe that at that point in labour a c-section may be more risky, but someone who has access to YOUR medical notes would be in a much better position to comment.).

BikeRunSki Wed 29-Jun-11 19:03:29

If you were having blood pressure problems, then I can't see an aneathatist (sp!!!) being happy about giving you an anaesetic for a CS anyway.

For what it's worth my "waterbirth" became and emcs.

Poppet45 Wed 29-Jun-11 20:43:13

OP you poor thing, you've really been through the wringer, am shocked that your HB midwife was a no show - that's terrible. Unfortunately birth plans are not legally binding, and are indeed just a sort of wish list for if everything is going okay. You can get more detailed and specify what you want to happen in all sorts of less than perfect scenarios too but then you run the risk of the document being so long and unwieldy it won't be read - particularly when things are going wrong and people are running around in a hurry. You need your DH or a doula to verbally argue your case when you can't (I say this but my DH didn't do it either). FWIW I remember when the doc came in and said I needed to go to theatre for either a trial of forceps or a section, and after 19 hours and a failed waterbirth and two hours of pointless pushing I said over and over 'no forceps just a c section' because I didn't want the damage and was so tired I didn't have the strength for any more pushing. As it turned out what I signed (in a spidery Guy Hawkes post torture hand, and despite my clear verbal opinion) was consent to either procedure, and they were going to try for rotational forceps first but DS was just out of reach. The weird thing is that even though you are totally out of it, it's illegal for your DH to consent or not on your behalf. Stupid I know.

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