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Debriefing of labour anyone?

(3 Posts)
Keptquietfortoolong Sat 04-Jan-14 17:48:45

I am going to have a debriefing of labour after I told the therapist I do not want to have a VBAC after my EMCS. I also told her I have been sexually abused when I was a child and I really do not want to go through more vaginal examinations (had a failed IOL). Two people who were in theatre told my DH my son couldn't have been born vaginally (I never dilated but had awful contractions).

I am not pregnant, but if I have another baby I would not want to pressured into having a VBAC, which seems what the therapist wants me to do. What can I do when I go to the debriefing>? My post natal 'care' was awful.

My Postnatal care included:
1. My bedsheets were bloodstained (plus some tea I dropped) and they only changed them once my DMIL demanded it.

2. When I used the buzzer and kept using it because I could feel I had blood everywhere (the lochia) once the midwives arrived they asked me for how long was I calling them> I said I don't know maybe 1 hour (I had my mobile phone with me but because of the drugs I wasn't sure) and they laughed at me.

3. When I used the buzzer to ask for someone to help me change my baby's nappy I was asked: do you have cotton wool? I said yes, so I was given a bowl and told to go to the toilet to get hot water and change my baby on my own (I had a catheter and I couldn't move my legs yet).

There were more things, but I do not want to bore you all.
This is another thread I started with more information

RedToothBrush Sat 04-Jan-14 18:57:55

I just read your other thread.

I'm appalled at the counsellor you have seen and even the fact that she has referred you to someone who is pro-anything you feel uncomfortable with. To say she was incompetent is being kind. She has done even more damage with what she has said and done imho.

I saw on your other thread that you posted this comment:
I can't afford private counselling and I am scared of telling someone because I do want this on my medical notes.
Can I ask the question why? They can resist access to medical notes that are sensitive like this. This is actually important information to them, and might well aid you if you feel pressured about a VBAC.

I have also had reasons why I an anxious about having a VB and managed to get an ELCS agreed in principle prior to getting pregnant because it was causing me that much distress. It is unusual still to go down this route and it can be difficult, but it is possible. The discussion was on my terms and didn't ask any distressing questions at all; I'd put my worries into writing to avoid having to have conversations I didn't want. I made it clear that I did not want to have counselling as part of this for various reasons, and they said this was ok.

I am aware that having been abused in childhood, is actually one of the most common reasons for maternal request ELCS and this has shown up clearly on the small amount of research that has been done. Whilst not as widely recognised as it should be, there is more and more awareness of this. You definitely are no alone in your thinking - it is more common than you think and quite understandable.

Whilst you might not have a physical reason for an ELCS you most certainly do have one on the grounds of your mental health; which is why it is worth discussing with someone even if it does mean it ends up on your medical records. YOU have nothing to be ashamed of. You are behaving in a rational, and relatively normal way given your experiences, and actually NICE's guidelines on CS are on your side in this respect.

NICE do recommend offering counselling to women who want an ELCS, but they also say in their documentation, there is absolutely no evidence of what type of counselling works. Which is very unhelpful to be however, but highlights the problem of ignorance on the subject. Unfortunately, there is a huge gap in our knowledge and the fear is that what is currently on offer varies hugely in quality and effectiveness. There are real concerns that there is a lack of trained counsellor who have any idea how to deal with certain problems. This means there is next to no quality control in who you might be referred to. It really is pot luck in many cases. It is very possible that some bad counsellors, may be so bad that they make women more distressed and more fearful. Tbh, in your case, it sounds very much like this is the case. Counsellors should listen, not pressure you down a particular route especially if your issue is about having a lack of control for whatever reason.

The whole approach of the hospital I have been to, is completely in line with the NICE guidance and they take the attitude never to refuse a request for an ELCS because of the importance of allowing the woman to be in control. Instead they work with a woman, listen to her, and try to build up a relationship of trust so they achieve this. During this process a lot of women do change their minds because THEY want to and feel able to have a VB but they also support women who do not change their minds.

This is really why I think your therapist needs shooting. Whilst they have recognised that having a vbac might be empowering to you and genuinely help, they are missing the fundamental point that any birth you have has to be on your terms and you have to feel like you are the one making the decisions not them. Pressuring you is the one thing they shouldn't be doing. You clearly do not trust them, and thats your main issue tbh. Referring you to someone who has a biased point of view is unlikely to help matters, as you aren't going to engage with them well, as you are again going to feel like your views are irrelevant. Ideally you need someone who acts impartially and advises you based on YOUR feelings and YOUR needs, not because they have a particular set of beliefs that want to convert you to.

So, my advice is to write as much as you possibly can down prior to the appointment and to explain how pressured you are feeling and that you think no one is listening to you. I definitely would still go to the meeting, and see what she has to say with as much of an open mind as you can but if the midwife still fails to listen, please don't think that this is the route you have to go down if you are still uncomfortable. It absolutely is not. I don't want you to end up in a position where you don't know where to go after this. There are options.

I think you should also go back to your GP and tell them. There should be alternative therapies that you can be referred to.

Honestly, this is a failing of the system and lack of education and research in healthcare and absolutely not your fault. You just end up being caught in the minefield of it all.

The other thing is, if your care was bad previously, have you considered the possibility of another hospital as a way of trying to avoid similar problems? You can choose to go to any hospital you wish, not just the ones that are recommended to you. This is actually the position I am in - I am planning on going to one outside my local Trust.

Keptquietfortoolong Sat 04-Jan-14 23:42:23

Thank you Red for replying. When I wrote this: I can't afford private counselling and I am scared of telling someone because I do want this on my medical notes. was before I told the therapist about the abuse, so now it's on my medical notes. When I went to the gynecologist she asked me how was I feeling and then she had to leave the room and I saw on the screen the disclosure about child sexual abuse was there.

The gynecologist was very gentle and nice when she did the examination and used LOTS of lubricant as I requested. Before that I was made feel like a nuisance when I asked them to be very gentle and requested lots of lubricant for the examination, when I was pregnant I even bled after the Fetal Fibronectin test, I wish I had been told I was going to bleed, it really didn't help.

As for medical reasons to request an ELCS, the doctors said I couldn't have given birth naturally, they might have referred to that pregnancy or maybe to any futures pregnancies, I will find out (I hope) during the debriefing. If it makes a difference, I had a back to back labour and my baby's head was big, he was a long and big baby (I was a size 6/8 pre pregnancy and I am short). I think he might have been stuck, I clearly remember feeling something like a headbutt inside me and pelvis before we went to the hospital. Even with all the contractions, my cervix never dilated. They tried to do an artificial rupture of membranes, but they couldn't even get the 'needle' in.

I discharged myself from the therapist, so I won't see her again and I am not sure if I want to see another one.

Thank you so much again for your reply.

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