Has anyone else felt upset ('violated' maybe too strong a word) after an internal?

[hollyw]

At the end of my last labour it was decided that things weren't progressing fast enough and a consultant was called in. I can't remember the exact details but it was decided that he would do an internal. I was told he was going to do it but I had no idea how painful it was going to be and it felt like he had his whole hand up there feeling/rummaging around her head. He then said that a c-section was necessary as he thought there was some sort of lump on her head (midwives had said that they thought her hand was by her head and this was indeed the case). Anyway, despite starting to be prepped for a section I managed to get her out naturally.

I was quite teary thinking about the internal for a few days after but then blocked it out. I had a smear test about 2 months after the birth and burst into tears as it brought back all the memories of the internal.

I know that the internal may well have been necessary but I can't help feeling upset by it.

Has anyone else felt like this? I was hoping for a homebirth this time around so that I could avoid being touched/examined so much but that is looking dubious at the moment so I need to try and get a handle on my feelings

[Secondtimelucky]

Not exactly, but I felt similar about the midwife breaking my waters with DD1.

Have you thought about talking your feelings through with someone? Prepping for my homebirth with DD2 with my doula really helped me move on from the first birth. If you've had a traumatic experience, that it totally valid and sometimes you need someone external to just listen, instead of family trying to make you feel better by saying things like "well you have DD1 now, that's the main thing. You're all alright". I wanted to scream at times that I wasn't bloody alright!

The thing I found most difficult was a lack of communication and respect from the staff (not explaining what they were doing or why, not treating me like an adult, not introducing themselves). It was one of the reasons why the forceps, which many people would think of as the worst bit of my first labour were actually ok - the registrar was lovely to me. Was it the procedure itself or the manner that upset you?

Also bear in mind that you can refuse internals in hospital too, or keep them to a specified limit (e.g. one when you arrive, one if you feel ready to push but aren't sure) unless you specifically agree otherwise. Waterbirth is quite good for that I'm told, since they have to get you to agree to get out to do one. Would that be an option?

Also, you don't say why the homebirth is dubious, but there are loads of good people on here to advise on pushing for one if that's what you want.

[Tangle]

I'm sorry the consultant doesn't seem to have been very considerate or sympathetic and that the experience has left you feeling like this. :(

I was lucky and all the internals I had were done by MWs who were very gentle and sensitive, both physically and emotionally. If you still feeling traumatised by what happened it might be worth calling the Birth Trauma Association and talking it through with a listening, supportive and experienced ear. Alternatively, have you had any kind of birth debrief? You should be able to arrange one through the PALS at your hospital.

DD1 was a planned HB with IMs - we knew them, they knew us and there was minimum intervention involved (including no VEs). We'd hoped for the same with DD2, but events over took us and I wound up in hospital being induced. One of my biggest fears was feeling as though I would't be allowed any control of the situation (as in the HCP's deciding what was going to happen and ignoring what I thought) - and DH and I worked quite hard at managing the staff to ensure that didn't happen. We asked a LOT of questions to ensure that we understood exactly why they wanted to do each and every intervention and what information they hoped to gain from it before we would agree to it - and by doing that it kept us feeling very much involved and in control. I found these phrases by Mary Cronk very good for keeping in the back of my mind to remind me that it was my choice what happened, and that I could ask them to stop at any point.

We're now trying to decide where to plan to birth DC3. We've booked IMs again (as much for the continuity of ante- and post-natal care as for the birth) but know that at least one will come into hospital and work as our advocate, if that is what we decide to do.

Have considered an IM or a doula - someone with a little bit more experience and a little less emotionally involved who can talk things through with you before hand and help you get the care that you want/need?

Sorry - I know that's not really answering the question you asked, but I hope it might give you some ideas that might help during your next birth.

[hollyw]

Thanks both. Homebirth has always been dubious as I had a c-section with my 1st, have had 2 vbacs since. Add to that I was diagnosed with high Amniotic fluid levels at 36 weeks. They've since gone down to just above normal but the medics are still seeing it as an issue.

I can't afford an IM and finding a doula here is not that easy (mid wales). My hb is prepared to stand up for me, I'm just worried that he might end up getting angry if they don't listen!

I've got the midwife superviser coming for a chat this afternoon with regard to the homebirth/hospital birth thing.

My main aim is a natural and safe birth. The dream is to have it at home, the priority is to not feel pressurised by medical staff into it being a medical event, for them to communicate with me on a level that doesn't just say 'this is what needs to be done, so accept it' (I want things to be explained)and for me/nature to be in control.

Sometimes I wish I just wanted an elective c-section!! I'm sure it would be easier and less mentally exhausting.

[Tangle]

Please don't be put off talking to an IM because of the cost - most are in the job because they believe passionately in supporting women to have the best birth that they can, and most will be more than happy to negotiate over the cost (or come up with a payment plan, or barter -one of mine got paid in homecooked frozen meals once...). It may not be possible to get something organised, but if you don't ask you'll never know - and you might just be surprised...

Fingers crossed things go well with the Supervisor and that she's interested in discussing things with you rather than dictating Trust policy. Those Mary Cronk phrases might be even more pertinent there than in labour (she does say they're more use antenatally - although the only time I've used any of them was when a MW put her arm across my back in labour and I wanted it off NOW!).

Another tool DH and I found useful for keeping calm and in control with an acronym we learnt with the NCT: "Remember to use your TBRAINS":

Do we have Time to Talk about this?
What are the Benefits?
What are the Risks?
What are the Alternatives?
What does my Intuition or Instinct say?
What happens if we do Nothing for now?
Smile!

We also found that once the staff caring for us realised we were going to ask a lot of questions and not agree until we understood, they worked hard to facilitate getting us the answers to our questions and didn't make assumptions about what care we would accept.

If you want some alternative sources of data on what the risks of your particular conditions might be - or where to look for the information or what questions to ask - you might want to join the homebirthUK and/or the ukmidwifery mailgroups. There are some very experienced MWs who post on both, who won't be able to give you personalised advice (as they don't know you or your case history) but who have had a lot of experience in getting better care for women during pregnancy and birth.

[Cutelittlecatlover]

Yes but only because she didn't ask or even tell me first. I still feel quite about that, it just seemed so unnecessarily rude!

[heather1]

Yes I can relate to you hollyw. I had to have stiches after birth of first ds. I would rather have given birth again. They didnt stich me up untill about 5 hours after the birth because they were busy. And I found it very upsetting and was tearful about it for quie some time after. It can be really upsetting I think.
I hope you get the birth you want this time. I think that homebirth is a great thing. I wanted one with ds1 and 2. However I had high blood pressure which was a contra indication. Also I would have had to go into the hospital after the birth anyway because I had quite bad tears each time (despite only pushing when told, apparently some women are just prone to it). And also I would have had to go into the hospital for the 24hour post birth check for baby. So although i was disappointed on balance it was less disturbance for me.

[cardamomginger]

Yes. Although this relates to after the birth. I have serious birth injuries and have had quite a lot of VEs over the last few months. I find it depends so much on the person who's doing it. With the gynae who is now in charge of my treatment I feel absolutely fine and at no time do I ever feel that my dignity is compromised. He is very compassionate and very respectful. With another consultant who I went to or a second opinion earlier on I felt extremely vulnerable and very unhappy about it afterwards. But I can also relate to what you're saying about this issue during the birth. I had a doula and during the pushing stage she decided to position herself at the business end of things. I was quite horrified and shocked as I hadn't realised that she would do this. To be fair to her we hadn't discussed it so I hadn't told her not to. But as she doesn't need to be at the business end of things in order to do her job, it didn't occur to me to talk to her about it. The whole birth was awful and I felt too traumatised to tell her to move. It still bothers me now TBH.

[hollyw]

Thanks everyone. We've spoken to the midwife supervisor plus a community midwife who we've seen for the previous 2 children. They went through all the problems, explaining things but have stated that they will support whatever decision we make. They've written 2 birth plans and the hospital one makes it as clear as possible that I understand about things like continuous monitoring and cannulars but that I'm not interested in them unless things go pear shaped. We've also mentioned about how I felt about the internal last time and have said that my hb will be questioning everything, not to be troublesome but to make me as comfortable as possible.

The midwife even asked if we knew anyone with a house close to the hospital as a compromise solution. We'd actually been considering finding a holiday let but thought maybe we were being a bit silly. Still fairly tempted to have the baby in the car in the hospital car park too!

Just got to decide where to go now

Cardamom did you mention to her afterwards - might be worth giving her some feedback so that she can at least discuss it with future clients?

[cardamomginger]

Glad you seem to have had a good conversation with them and that they seem to respect your position. Yes, I had thought of saying something. But it's all been so stressful with getting the injuries diagnosed and deciding on the best possible solution that I have had no energy for anything else. Plus I might need to use her for post-natal doula services for childcare when I have my op and after when I am recovering. Dunno. But, yeah might. And, yes, agree that it might benefit future clients.

[TanyaBranning]

Yes.

With my first pregnancy I went along to my 40 week appointment and the midwife insisted on giving me a sweep. When I say 'insisted', I mean she sprang it on me, i said I didn't really want one as I wasn't overdue, she kept on and on about it, called a second midwife into the room to try to persuade me and the next thing you know I am lying on the doctor's couch having a very painful internal which i hadn't wanted to have and wasn't convinced I needed. i felt horrible afterwards (and it didn't bring on labour).

Fast forward a couple of weeks and I was in hospital being induced by pessary. I had so many internals I lost count and ended up with really bad thrush. Shifts kept changing while I was in hospital being induced (4 days), so it ewas always a different doctor doing the internals and I started to feel quite uncomfortable physically and emotionally with the constant rummaging around. The straw that broke the camel's back was a middle-of-the night internal by a doctor who didn't even introduce herself, just walked in and ordered me to open my legs and then was incredibly rough, despite the fact I told her I was sore with thrush (which, btw, the midwives didn't treat as they 'kept forgetting' to give me canesten - my DH eventually had to pop to a 24 hour chemist to get me some). I complained about the middle-of-the-night doctor's treatment and she did come back and apologise (half-heartedly), which I am pretty sure was because she thought I was going to make an official complaint, not because she was genuinely sorry.

I have never felt like such a piece of meat in my life

[BeautifulBirths]

I'm so sorry to hear this. I don't think you are alone though. I'm a midwife and so can appreciate what the circumstances may have been like. You probably were tired, full of hormaones, perhaps under the influence of pain relief or just under the influence of natures endorphins. It sounds like you may not have been prepared for the internal and perhaps the doctor was concerned about getting the information he needed for delivery of your baby that he did not prepare you fully. Of course this is not acceptable either but I believe not intentional. However, I would recommend you contact your head of midwifery. Tell her what you've told us. She will meet with you if you wish and go through your notes. The doctor / midwife can then be educated or supported to ensure this doesn't happen again. I'm sorry to hear this. Good luck

[BeautifulBirths]

Also, you should definately discuss this with the midwife caring for you now. She can support you through this. There are ways of determining how dilated you are without exams too. If absolutely necessary she may be able to do it in a different position to try not trigger memories. If you need to iscuss this further you can message me. But please talk to your midwife who is looking after you. SHe can visit you in your home so you won't feel rushed to talk about it.

[hellymelly]

I had a sweep which left me feeling assaulted.I had agreed to have a prostglandin pessary but no-one expleined to me that a sweep would also be done (I would not have given permission) and so it was a horrible shock when she started rummaging around violently.It hurt like hell and she didn't stop even when I started to cry.She just said "sometimes its tough being a woman" and my Dh had to insist she stopped.I completely understand how you feel.I was so panicked and upset,and it led directly to my c-section. I was angry for ages and it was only the birth of DD2 that helped me somehow focus on a different experience,even though I ended up with another c-section. If I really think about it,like right now writing it down,I feel very angry again,and it was six years ago.Do you have a close friend or sister who would act as a doula for you? Someone calm and supportive? I would have loved one of my friends to be with me but the ones I wanted all lived too far and/or had smallish children.I had a doula instead as we didn't have anyone I could or would have left DD with overnight.

[sprinkles77]

This is a very interesting thread. It rings a lot of bells for me, and reminds me of things that at the time I though were all part of having a baby, but now I realise did not need to have been. Like my consultant doing a sweep when I thought I was just having an IE (so that's why it was so uncomfortable), and why placing the gel to induce me was so painful (because they were doing another sweep without my permission). And I had 3 doses of gel, and each time it hurt and seemed to take ages. There was definitely little empathy or compassion from the staff involved. Any now I know why! And breaking my waters was so fucking awful I needed gas and air! I can't say I really feel violated, but definitely better informed thanks to you all. Ended in an EMCS anyway. If there's a next time I'm putting my foot down and insisting on ELCS.

[hollyw]

Thanks again everyone for your comments and I'm sorry that so many others feel similarly. I guess we should all complain/give feedback (I'm aware that in some cases the staff might be 'doing their job' in their eyes) about our feelings on the way we have been treated in the hope that the staff are educated and learn from it

x
Holly

[FutureNannyOgg]

I originally asked for no VEs, but the MW I discussed it with at 36 weeks made out that was a ridiculous idea. I wish I had stuck to my guns or had a doula to see my side and not make me feel like I was putting my baby at risk by refusing. I had one internal (consultant) under epidural that was still painful, even though my strong syntoed up contractions were mere prickles. I did feel violated, I have a history of sexual abuse (didn't tell the MW because I didn't think it would make a difference if a procedure was necessary, I kind of hoped that they would be as gentle and respectful as possible regardless) and it definitely contributed to my PN PTSD. Next time I intend to be very clear with the MW what I am comfortable with and why.

[Miffster]

I was really clear on my birth plan that I did not want unneccessary VEs and elected to have a HB mainly to avoid interventions and VEs. In the end one MW visited me Sat night and coaxed me into having a VE and I could literally feelmyself tensing and closing up with fear, I cried with the pain and the traumatic memories it brought back ( i have a survivor backstory).

She said I was 2cm dilated at that point yet prior to the exam cx were every minute lasting 50 secs. Am sure I closed up and labour stopped as result of internal. Thank god had the fabulous Hackney Doula with me and after what felt like a violation, managed to get back into the zone. MW teamof 2 arrived for the birth at 5am Sunday and despite their pressure, including highly inappropriate emotional blackmail pressure) to have further VE I stayed in my pool and began pushing without direction or effort, having been left alone while they wrote up self justifying notes. My baby swam into my arms and had a perfect score. I credit my amazing birth experience with having a great DH and Doula who fought my corner. If VEs had been medically needed I'd have had them, but they weren't.

Good uck with your birth and don't be afraid to stand your ground against random protocol.

[thursday]

yes, and i dont think violated is too strong a word tbh. i had an internal from a consultant with my first baby, he gave the usual 'let me know if you've having a contraction and i'll stop' but flatly refused to stop when i did, i was screaming and kicking and swearing (only time in 4 days of agony) and trying to fight him off. then he 'accidentally' broke my waters with his hand. i never believed it was an accident for a second but i didnt know until i was pregnant with number 2 that they need your permission to break your waters. so i'm now even more angry than i was already. i was traumatised after that birth and that incident in particular. when the consultant decided to break my waters during internal in second birth i stopped him and shouted him out of the room just to ensure i could. he thought me insane but he did listen. sort of

[shipsladyg]

Yup - with you on this. I found the internals by far the worst bit. Sweeps were fine - but the mid labour internals were horrific. So painful. Far too numerous. Like other posters, it was the lack of respect, lack of information, not explaining and not listening. I know they're busy, I know they're the knowledgable professionals not me, but respect and curtesy goes both ways.

And on top of the internals, I'm sure three catheterisations in six hours weren't necessary. I knew I didn't need to pee. I hadn't been able to keep any fluids down for 12hrs but they wouldn't listen and I was trying so hard to be a "good" patient.

It took me weeks before I could let DH touch me without getting a flashback & it all ending in tears; and after that I have to admit to gritting my teeth / faking / being drunk just so he didn't feel bad / neglected. Even a year on, it's still a case of "don't mention the war".

We're seeing an IM tomorrow. Hopefully with Someone who's had a chance to get to know me and act as our advocate will help to avoid such un-necessary drama for DC2 due in Feb.