Anxious about second labour

[ZebraZeebra]

Like so many women, I had a really traumatic first labour with my son, 21 months ago. A lot of it was down to feeling let down by my care providers and the subsequent unnecessary path of intervention - it ended in a full episiotomy and forceps. I was left alone (with just DH) to labour for 24 hours with contractions 2 minutes apart from the get go after being pressured into an induction. We saw a MW three times in those 24 hours. I had hoped for a calm labour at home but ended up hysterical and terrified in hospital. When it came to the pushing part, I was shouted at and told if I didn't try hard enough, I'd have to have an EMCS. I was frightened, completely head fucked by the lack of care and traumatised.

I went through the whole debriefing and complaints procedure, and the local health authority accepted complete fault and apologised. I have the option of transferring to another authority - and therefore a new set of community MWs.

I'm now 12 weeks pregnant with DC2. I've hired a doula to help me and act as my advocate for my choices and options, for support, and to assist the MWs if I can (I hope, all being well) give birth at home this time. I've been listening to the hypno birthing CD I used last time, which kept me pretty calm for several hours last time. But I just...it doesn't feel enough. I feel so frightened. I know labour is painful but just the complete lack of compassion I faced last time has left me so lacking in trust in any MW. I'm going to check out the other LHA but to be honest, it's completely tainted my ability to see past what happened - and to rationally think, not all MWs are the same. I don't know what to do :(

[2beautgirls]

Hi, god your first labour experience sounds terrible :(.

i had great care in both of mine but still when i was pregnant with my second i was so scared because i knew what was coming!! but honestly it was so much better than the first, sounds crazy but i found it calm and when i look back at it it was almost enjoyable, because you know what to expect and its normally shorter and i knew it was the last time i would be doing it i treasure the memories!! :)

your doula will look after you and make sure you get the care you deserve im sure!!

[aprilj11]

wow, that sounds really difficult. Getting a doula was definitely an excellent move, having a women and an advocate can make all the difference. I'd also recommend looking into hypo-birthing methods. It completely changed my perspective and experience of childbirth.

There is also a whole area of therapy for traumatic birth experience. I don't have anyone personally to recommend, but I've heard it can be very helpful.

[ZebraZeebra]

Thanks both. I feel so scared...not of the pain but just how I was treated, with such little care. It's such a vulnerable time and you need a caring face and voice, not people being bullying and controlling and just lacking in any kind of bedside manner. I did do hypnobirthing last time and it got me through 12 hours of labour but I kind of just lost the plot when they examined me and I was only 4cm.

I just don't know how to make it better for myself. I'm hoping for new midwives - different midwives - and to speak to them and say, "Look I don't want to tar your entire profession with the same brush but I have absolutely no trust and faith in you based on my experience last time and it makes me feel like absolute shit because I need to be able to trust you." I feel utterly miserable about it all, like no matter how it goes/what birth plan, there's just no trust there to begin with and I feel a bit bereft.

[RedToothBrush]

I suffer from severe anxiety around HCPs to the point that its an issue. I'm different in that I am expecting my first, but I was aware that my lack of trust would prove problematic, so I've tried to be proactive about it, and be blunt about how I feel.

I have chosen a hospital in a different authority, but am being supported by local community midwives (I was given options to choose to a certain extent).

I explained in full my issues, and they have been taken on board and respected. They have given me extra time and support through their mental health services, which has allowed me, despite my expectations that it wouldn't, to trust them. I've had a lot more appointments than is usual as a result, to both discuss how I feel and to explore things that they/I feel might help.

They have helped by tailoring my birth plan to my needs and my needs alone. Certainly things that I didn't think were possible have been done to help me cope - throughout the pregnancy. Its very much been about the focus being on me and trying to make me feel in control of the situation.

I can't comment on the 'end result' as it were; I'm two weeks off. All I can say, is that I didn't think that I would feel like this at this stage. Thats not to say, I'm not extremely anxious, more that I feel they couldn't have done anymore than they have done.

Obviously, I can't offer you any more reassurance than that, as it does depend on where you are and it may all go tits up yet. All I can say, is it is possible to gain trust when you didn't think you would be able to.

[ZebraZeebra]

Redtoothbrush all that was really helpful, thank you.

I have my booking in appointment tomorrow. My GP was very sympathetic and said I could change health authorities to another borough if it just got too much going back to the same healthcare people. So we agreed I'd be booked in with the same community MW's but I could change my mind and go elsewhere if I wanted. Should I mention that tomorrow? I feel bad saying to them that I can't stand the thought of seeing them, even though they might not be the same people - it's the same buildings, the same attitudes...I can't bear it. I had to go back to the same hospital I gave birth in for an early scan a few weeks ago...going back to the place brought me out in a cold sweat, it was horrible :(

[RedToothBrush]

Anything that makes you anxious is worth them knowing. If they are worth their salt then they will understand that certain things will be triggers and they will want to help you avoid them. If they aren't worth their salt, then you don't want them to be treating you, so why should you feel bad about what you are saying?

The thing to get into your head is that anxiety is a health condition, so getting the right care is important so don't feel obliged to worry about their part in this. Your priority AND their priority is your health. Being honest with them, has helped them as much as its helping me in my experience.

It is fine to be 'difficult' if thats going to make a difference. Ask for what you think will help. They can only say no - and they might surprise you and say yes too.

[NiceCupOfTeaAndASitDown]

You poor thing, that all sounds rotten, no wonder you felt frightened and out of control!

my first labour had many similarities to yours - I wasn't induced or left alone but DS was back to back which was much more painful than I'd imagined, the sweep I had really hurt and destroyed my confidence before I was even in labour (if I couldn't cope with that how could I manage the real thing?!) I was disappointed and disheartened after a VE revealed I'd not progressed very far and I too ended up with an episiotomy (stitches got infected - worst pain of my life) and forceps and I feel it had a lasting effect on my DC. I think the worst thing for me was not knowing what was happening so just agreeing to things and doing as I was told even though it felt wrong

anyway the upside to my story is that I went on to have a completely textbook, calm and even wonderful 2nd labour and am now pregnant with number 3. I listened to a CD (Maggie Howell) which really helped but other things that helped me achieve this were

• a really laid back and supportive midwife throughout my pregnancy (can you change yours do you think?)
• reading as much as I could about labour and accepting that anything can happen but at least I'd know what it was
• learning that even if you were in a coma your body would give birth, so most of the time when you see midwives saying "chin on your chest it's time to push" on birth programmes I'm shouting at the telly "screw that, let her body tell her when it's time!"
• I declined all internal examinations (except when one horrible midwife refused me gas and air until I'd had one) because I felt that 1) how many cms you are dilated is only an indication of where you are right now not how things will go, 2) learning how many cms I was first time round just made me feel worse and 3) actually if you do a bit of research there are many other ways to tell how far a woman is progressing
• I did a bit of reading on the fear/panic/pain theory...The idea that the more you worry the worse it gets because your body tenses up
• I actually asked to be left to my own devices so I could get 'in the zone'
• I tried to focus on just 'breathing' my baby out remembering that it was a natural process, I was an amazing strong woman and there was nothing I couldn't conquer if I put my mind to it

who knows if any of it will help you but I'm sharing just in case

have you had any kind of counselling with regard to your first labour? it would be such a shame to not enjoy any of your pregnancy through fear, obviously there are many things you can't control when it comes to labour but your mind and your voice are yours..you don't have to agree to an induction or internal examinations or many other things. .I think doing some research on these will build your confidence so you feel strong enough to know what you want and be assertive in asking for support with it. Best of luck

[ZebraZeebra]

Thank you both so, so, so much for your posts! nicecup DS was also back to back and you put it very well when you describe the sweep as "destroying your confidence" - that's exactly why I completely lost it mentally despite having hypnobirthed for 12 hours prior to that.

The irony is that I am usually a very assertive person, very able to speak my mind. I'd also done my research on inductions and it was that that was my downfall, so to speak. At 41 weeks I had a sweep and was completely closed up - the MW automatically began booking a 42 week induction, no asking, no talking through choices, just - you will do this.

All I said was...can we just wait and see what happens. I'm comfortable with that. Suddenly I needed emergency scanning and monitoring that I hadn't needed five minutes prior. The next day at this "emergency" scan they said my waters had gone. I said they hadn't. An internal examination showed no evidence they had. The registrar said - your baby will die if you don't agree to an induction right now.

That was at 9am. Of course my husband and I agreed! We went to the hospital being told it was an emergency. 15 hours later, they still hadn't done anything and I was hysterical begging them to either do something or let me go home. I believed my baby was dying. 24 hours after they started the induction, my waters broke.

And then followed the awful labour. So my trust was already destroyed as well as my confidence.

Redtoothbrush your post has many insights into anxiety and has helped me feel less like I'm being difficult. I feel like I need to speak their language!

nicecup your points on perspective during birth are really good to read. I believed all of that about fear and pain, being left alone to get in the zone, I just lost all confidence because of the emotional toll of how it started. I had actually wanted a home birth!

[RedToothBrush]

ZebraZeebra, I'm also usually very assertive/know my own mind and that completely goes to pieces when I deal with HCPs - which is where a lot of my fear comes from. I don't feel I can do this, and I feel like choice is something that I no longer have. I get frustrated and feel out of my depth. Knowing what my rights are, being very clear in what I need and conveying that in a situation where I feel more confident has been very helpful. Especially when it has been met with direct acknowledgement and/or action.

I find having confidence in yourself and your decisions aware from HCPs is really helpful - if you are at peace with things, then it makes it easier to deal with them. Knowing that anxiety is something that is 'legitimate' for example, is a huge part of that for me. I don't feel I have to speak their language as such. Its really up to them to understand me, not the other way round. I think its a difference between feeling like you have to 'justify' how you feel rather than simply accepting it and saying 'this is how I feel - its for this reason which is/was beyond my control' and using that as a starting point in many ways.

[RedToothBrush]

*your decisions away not aware.

[NiceCupOfTeaAndASitDown]

Zebra I wanted a home birth too...Both times! The first it was my decision to go in because I felt I couldn't handle the pain at home (turned out it didn't get any worse and gas and air helped a lot, I wish I'd had the confidence to stay at home) the second time I was talked out of it by a registrar (I think) with a similar lack of bedside manner..In answer to my question of what happens if my baby's shoulder gets stuck (something they thought* might happen in my first labour so used a special manoeuvre - it transpired it hadn't happened at all) - she replied "9 minutes and your baby's dead" - I burst into tears (she'd kept me waiting 6 hours at an appointment to discuss baby's size at 36 weeks) and needless to say I lost all confidence to continue with a home birth. looking back I suppose I'm glad, I'm not sure I could have 'relaxed' with a toddler running around!

but really and truly having a midwife who was on my side and knew her stuff helped so much. I had time to accept I wasn't having a home birth and planned for a birthing centre one instead (which I also didn't get but that's a whole other story) and my midwife's support and confidence in me helped me stay strong and assertive on the day which is something I'm not very good at usually as I struggle with anxiety too

if you have a doula I think this will help greatly, it's someone rooting for only you and remembering your preferences when things get tough, but I think you would also benefit from a decent midwife, someone who knows their stuff from a medical side

my midwife helped a great deal with the thing the doctor had said (she was livid and I had to stop her reporting her) - she told me they only see the emergency side of labour so they can't be diplomatic about it when talking to you..so I was able to remind myself that what I was going through was natural and I was able to do it...you are too! The thing to remember is you've done it before so you know you can do it again.

another thing I must state again - you have a choice in how things go. You can say no to a sweep, an induction, vaginal examinations...These things are not out of your control in every case. It might be worth looking into facts to build your confidence - for example I discovered that the risk to the baby at 41 weeks is the same as at 39, at 42 it's the same as 38 and at 43 it's the same risk as 37 weeks which is considered full term. This helped me feel confident in refusing any intervention (which usually leads to more intervention) - you have lots of time to build your confidence and knowledge and have the calm birth you deserve

[NiceCupOfTeaAndASitDown]

oops bold fail!

[ZebraZeebra]

Thank you both so much...again...for such insightful posts. I'm so sorry you've both had such awful experiences that have led you to have these perspectives.

I think that's the thing really...deep down, I'm so scared of not dealing with the pain but insisting on a home birth because I really REALLY do not want to go into a hospital...but secretly just wishing I could have an epidural to take it all away. But then, the epidural ran out last time and no one told me that could happen!

And not-so-deep-down, I don't really believe my body can go into labour. It wasn't given a chance, he wasn't ready to come out...even when my waters finally did break, it still took another two days to get to 10cm. I feel like they forced so much for the sake of covering themselves. I don't know. Feels like a big fat mess.

redtoothbrush your stance is exactly where I should be, i can totally see that when I read your post. These are my feelings, they need to be dealt with by you, the professional. "It's up to them to understand me." That shall be my mantra tomorrow.

nicecup you have such a positive perspective on birth. It's where i was all through my pregnancy with DS and it's where I desperately want to be again. It's not going to happen by itself, is it? I need to be active in this, stop being paralysed by fear. I think I should definitely do some reading up on the medical aspects to arm myself with knowledge...what you say about no more risk at 38 weeks than at 42 weeks...I remember that somewhere in the recesses of my brain from last time but I feel like they completely disarmed me by insisting on emergency scans, and then saying I had no waters.

What you say about having a MW on your side is so true but I don't know how to get that. It's such pot luck. I'm in London, I didn't see the same MW every time, I could go to Lewisham (the other borough) and it just be the same. I am really pleased about the doula though, and will talk through all of this with her.

This thread has been so helpful, thank you. Your posts have really made me see I can't be a passive participant in this, not when I feel like I'm hurtling towards a situation completely out of my control.

[lovemakespeace]

Hi OP, I was planning a homebirth with my first baby and I got diagnosed with gestational diabetes right at the end. I fought to not be induced early as I believed the reasoning was not supported by evidence. In the end I went to 42 weeks (although I was not confident they had my dates right) and was pressurised hard into an induction. It ended as I feared - forceps, 3rd degree tear, PPH and subsequent PND. I had good and bad experiences of the health professionals during my labour. I wasn't left super-traumatised by the birth itself, partly because I knew I had done all I reasonably could to avoid induction. I couldn't hear one more person tell me that my baby would be stillborn (based on knowing nothing apart from I had a label of diabetes, and had got to the "perilous 42 weeks").

I had my second baby in the water at home seven weeks ago! I actually had her without any medical assistance because I was in denial I was in labour until her head popped out! It was pretty unbelievably painful, but it was one of the most wonderful experiences of my life all the same.

I didn't realise until near the end of my second pregnancy how much confidence the first had taken from me. I particularly didn't believe I would go into labour. But I did have a wonderful midwife, and also support from the ladies on the homebirth email group (it's a yahoo group if you want to google it) who reassured me that yes, my body would most likely do exactly what it was designed to.

Because of my diabetes I was going against hospital policy to have my baby at home, and this meant I had to go to the supervisor of midwives to get it agreed. As it turns out the one who heads up homebirths in my trust took me under her wing and I only saw her from the point I made contact (28 weeks), so that was an enormous blessing. I would really recommend contacting the Supervisors of Midwives at your trust though, as in both pregnancies I have found them so supportive and useful. Do it early to give yourself maximum time to get all the support you need.

I don't know if any of this is helpful. I have both of my babies birth stories written out, and I would be very happy to private message you them if you wanted to have a read. No worries if not though!

[ZebraZeebra]

lovemakespeace that was hugely helpful, thank you! I'm coming to realise that I'm very frightened of a natural birth now..even though that's what I want because I can't bear the same medicalised intervention-birth! I'm worried I'm a fake, that I won't be able to handle it and then end up miserable in the same place again. How did you do it without medical assistance...was the MW there but you just got on with it? Massive congratulations on your baby :)

This thread - and talking to my husband - has made me realise I am finding it impossible to believe that you can have a lovely second birth. Not at all saying you're liars - just, I can't believe it :( I need to get so proactive with the approach I want, don't I?

Had the booking in appointment yesterday and they were very nice and compassionate and made a care plan to regain my trust...but still sorta talking in the parameters of all the medicalisation. I don't know. They were positive about a home birth so I think I'm just going to have the appointments but focus more on my relationship with the doula and get reading up again on natural births. I just can't wrap my head around it being a positive experience. Maybe watching videos of women birthing at home peacefully will help. I don't know.

[RedToothBrush]

Zebra, I think you are being a little hard on yourself here. You are trying to wrap your head around something, which in all honesty, at this stage, I don't think anyone would expect you to be able to. It takes time. It takes them time to get to know you too. Its often a natural assumption that anxious women need the reassurance of medicalisation rather than a more hands off approach, especially with the way policies have been framed in recent years. I really don't think in reality thats the case, as anxiety covers such a wide spectrum and you have to fumble your way through it blindly at first.

As for worrying about being a 'fake', I certainly had/do still have feelings along those lines. I think its about feeling guilty about how you feel and being scared at how others will perceive you. I can't really say how to deal with it, but I do think its part of the process of coming to terms with things.

Don't pressurise yourself to 'do it all at once'. Eat the elephant one bite at a time rather than being daunted at the magnitude of the whole thing. You don't have to believe it now; you just have to get through each chapter and appointment as it comes.

It sounds like your booking in was positive, so thats a good start. Especially if they were positive about a home birth. Don't forget they would also be negligent if they didn't express some possibilities in terms of medicalisation too as they are ultimately responsible if things go wrong or your pregnancy was to unfortunately become more complex. You will need to think of plans b and c and d etc to a certain extent to help you cope otherwise you run the risk of becoming totally fixated on a home birth or total failure. Definitely go for it, and check out the risks etc yourself but set yourself some limits where you would compromise too.

[lovemakespeace]

Zebra I am going to message you my daughter's birth story and I hope some of it may resonate with you.

I'm glad your booking in went well :) I think I viewed my second birth slightly differently to how you do - in that I felt, for want of a better word, like a real victim of "the system" with regards to my first. I strongly believe that for most women birth is an event that can take place without medical intervention. I resisted induction because I knew this would lead to a cascade of interventions. And it did. So in a way I felt failed by a risk averse, litigation fearful, NHS culture, rather than my own body. Don't get me wrong, I have spent a lot of time in Tanzania and I am extremely grateful for the medical care we can receive in this country when it is really necessary. Which undoubtedly sometimes it is. But I look around my friends who have all had babies within the past couple years and there is 1 maybe 2 who had natural intervention free births. The rest of us all went through many cuts and scars and drugs and bleeds to have our babies. I can't help but believe this cannot have been necessary in all our cases.

However as my birth story will show you I did not acknowledge nearly enough how much my first experience dented my confidence in myself, as well as "the system". And so it is good you acknowledge this, I think it will help you work through all you need to before your labour comes around.

I really recommend this book: www.amazon.co.uk/Natural-Childbirth-McCutchen/dp/0452276594/ref=dp_ob_title_bk?tag=mumsnet&ascsubtag=mnforum-21 for some excellent and clear explanations of what happens in labour and how our bodies are working. It is a bit over the top anti medical input, and also a bit dogmatic about what labour will look like (mine did not look like they so confidently describe!), but nonetheless it really helped me to believe in my body.

I also totally agree with the above post - you can have a plan A - but as you know there may be things that come up that mean that you have to deviate from this. For me it has always been about knowing the risks, and the evidence, and not just being pushed along by a policy. If you do decide to go for a homebirth I would really encourage you to join the Yahoo group. If anything comes up you don't know about now, then those ladies will help you think it through. They certainly don't say "home birth at all costs". I began to cross that bridge at the end of my second pregnancy as I approached hospital induction dates. I was scared, and they really helped.

I think it's really positive that you are thinking about all this now so early on. Keep talking about it all :)

[PenguinsIsSleepDeprived]

Sorry, don't have much time, but I wanted to say that your doula could be great here. I used one who has since specialised in helping women overcome birth trauma and she had some wonderful techniques. We did all sorts of stuff that sounds a bit hippy and odd but was actually really helpful, like stream-of-consciousness writing and art and stuff. I'd have rolled my eyes, but it did help me process. Do PM me if you want any details. x

[redexpat]

This thread has been a comfort to me too. Not such a traumatic birth, but mistrust of hcps. DD due in nov. Ive been reading up on birth in more detail, last time everything was just done to me, i never knew i could refuse anything. At the 20 week scan we told the sonographer that 3 years previously the guy had just mumbled into his screen and we didnt understand what had happened, and she was then crystal clear in her explanation. Hoping the same will be true of mws.

[lovemakespeace]

Questioning and feeling more in control were very important to me too Redexpat. Keep going, and this board is great if things crop up that you need to think through. But I hope it will all be straightforward and a good experience :)

[blushingmare]

Hi sorry I haven't had time to read all the replies, but just wanted to say that your second labour and delivery could be completely different, both in terms of the care and also what your body/the baby does. I had a long and traumatic first labour with some issues with my treatment and care and medical complications, so was anxious about DC2. But I was in a different hospital and labour was 3 hours from zero to baby appearing! There was simply no time for discussion and decisions - my body simply got on and did it. I did have medical complications afterwards again, but my care was so much better. Overall birth of DC2 was a really positive experience, even though not entirely straightforward! Just wanted to highlight how very different a second labour can be. Good luck - I hope it all goes well.