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Birth debrief - is it helpful?

(20 Posts)
KBLondon Tue 06-Mar-18 13:28:04

I have a birth debrief this Thursday. I was wondering if anyone on here may have had one and if you had any tips? Was it helpful? I don't really know what to expect. Did they tell you what might happen in the event of future pregnancies?

I had a 62 hour very intense labour (continuous contractions for over half of it) with shoulder dystocia and bad tearing resulting in intermittent incontinence (both types).

I'm really worried that I'll go into the debrief and be told that as far as they're concerned, the labour went well (both me and baby are alive and the baby had no long term effects from the traumatic delivery) and they'll wonder what my problem is.

I'm desperately hoping they'll offer me a c-section for future deliveries (really worried about repeat shoulder dystocia and permanent faecal incontinence) but I know there's a policy against offering elective c-sections at the hospital my daughter was born at and most (if not all) of the other ones in London.

OP’s posts: |
WhereIsBlueRabbit Tue 06-Mar-18 23:40:37

I found the staff who did mine were actually really kind, and recognised that it was as much about how you'd been left feeling as about what actually happened.

I found it helpful to take a list of questions with me that I wanted to ask, and also to have someone else with me for support (I knew I was likely to get upset).

I found it really helpful - the answer to a lot of my questions was "we don't know" but I felt better for having asked them, iyswim. It really helped that they acknowledged I had received care which fell below the standard I could have reasonably expected, and they apologised for that. I felt listened to, and as though they were keen to take on board constructive feedback.

My debrief was with the midwife responsible for debriefs plus the supervisor of midwives.

Definitely ask about future births - my situation is different because I had an EMCS first time round but although the hospital is part of a group whose official policy is "no electives by maternal request", in practice they were very quick to emphasise that I could choose ELCS and would be supported in doing so. I would be surprised and disappointed if any hospital was not open to a sensible conversation about that for you in view of your very valid concerns. (Of course, they were keen to recommend VBAC too but it would have been my choice and I was told that if I became pregnant again while living in their area, to contact the specialist midwife and she would make sure I was booked in for whatever option I preferred.)

Good luck, I hope you find it helpful.

Icantstopeatinglol Tue 06-Mar-18 23:53:43

I had a debrief after my dd was born as it was traumatic and I felt quite low afterwards. 8 days overdue, few pains so set off to hospital as they weren’t ‘normal’ contractions and then after midwife tried to monitor her heart rate things picked up dramatically. I was literally put in a wheelchair and they ran through the corridors with me, knocked me out and got dd out as her heart rate was so low. I remember not being able to speak throughout! Anyway, it was actually nice to talk it through as you don’t realise how much you block out or don’t remember correctly until it’s talked about properly.
I think it’s a good thing and you can discuss future births etc and have a discussion about the options. Hope it goes well.

sycamore54321 Tue 06-Mar-18 23:54:33

A 62-hour labour is really very very far from the norm and you might want to ask questions about how this situation was allowed to arise. I know you often see on forums and parenting books advice like "baby will come when it's ready" and "there's no reason to rush labour" but the fact is that very prolonged labours are associated with poorer outcomes and are often an indication that something is wrong. You may wish to ask why they didn't recommend speeding up your delivery with using the drip. You might also want to ask whether there was any distress detected and what was the earliest point at which the potential shoulder dystocia should have been detected. Perhaps ask what could or should have been done differently.

It sounds like a terribly difficult experience - heck, even being awake for 62 hours with nothing else going on would be enough for me. I am sorry to hear you are continuing to suffer problems.

I would be stunned if you don't have a very strong case for an elective section - shoulder dystocia history is a good reason, similarly protecting your injured pelvic floor is another. (In my opinion, "I want it" is a good enough reason but...).

I wouldn't be at all worried though that they will gloss over how you feel - this is the entire point of the service. If someone dares to tell you the labour you described went well, I'd ask to speak to their boss and complain.

Best wishes.

elliejjtiny Wed 07-Mar-18 00:00:06

I had debriefs for my last 2 births and I found them both very helpful. I found they don't automatically bring the baby's notes as well as yours though so if there is anything about your baby's care you want to discuss then you need to ask for your baby's notes to be at the appointment.

Bigpizzalover Wed 07-Mar-18 00:10:20

I chose not to have one from my first birth which was traumatic to me - 68hr labour, was refused pain medication for the first 12 hours or so, when I finally got it I was so drugged up I actually struggle to remember what was real and what was imagined - can only go by what my birthing partners tell me. Midwife finally told me in the last hour I needed an epidural as my body wasn’t coping anymore, but then didn’t call the doctor so by the time he was on his way I was pushing - midwife dropped the equipment tray on my foot and to top it off I tore.

I am happy my DS is safe, I’ve suffered not lasting damage and apart from querying why I was left to labour for so long I don’t see how it would help me, I’ve just chalked it up as not a good birth experience - did go on to have a quick and easy labour with DC2.

But each person is different, I think it depends on what you want to get out of the meeting as to whether it would benefit you, or just make you relive it again.

Catinthebath Wed 07-Mar-18 00:19:02

I had a 30 hour labour but was told by a midwife in a social setting a few years after the birth that there is no such thing. I had emergency c section. I had my baby in a hospital where 2 different maternity units had just merged and there was no cohesion in practice between the sets of midwives. I’d had an epidural and the outgoing midwife who was from one unit asked the incoming from another to keep using the ice spray. The incoming said “we never use that here”. They also openly complained about each other. It was frankly intimidating and I couldn’t get out of there fast enough which after a section wasn’t fast at all. I had zero inclination to go back and examine the experience.

dinosaurkisses Wed 07-Mar-18 00:32:55

I had one and it was by far the best thing I could have done to feel hopeful about any future labours.

DD's birth wasn't traumatic in that I'd experienced lasting damage - it was just long (4 days of irregular contractions, with no sleep in the 48 prior to her being born) and I'd had an ambulance transfer from the lovely MLU to the big national maternity hospital as I hadn't progressed fast enough.

The debrief was an opportunity to ask questions and raise some issues I'd had with some aspects of my care at the hospital. I also wanted to talk about if my experience was normal, and I suppose I felt like I'd "failed" in not having been able to pop the baby out in eight hours like everyone else seemed to. My notes stated that I'd haemorrhaged which was news to me , and it would have prevented me giving birth in the future at the MLU.

The midwife who met with me was fantastic- I actually can't praise her enough. She explained what happened and why, and listened to me and gave feedback to the midwives who'd cared for me. She went through my notes with me and reassured me that I'd actually done very well during a long and tiring labour- I know that sounds daft to need that, but it was actually a great thing to hear from a professional six weeks post partum and still not feeling great about the experience.

Most importantly, she reviewed my notes with the consultant of midwives and the head of the MLU and got agreement that the approximated blood loss on my notes was wrong, meaning I can attend the MLU for future births.

Really, I could only speak positively of de briefs- I'd recommend them to anyone who feels they have any unanswered questions or needs some closure about their birth.

LooksLikeImStuckHere Wed 07-Mar-18 00:39:38

I had a debrief. The MW said she felt awful as most of the time women left feeling happier. I was the only she had ever had who left in more of a state than when I started the debrief.

I didn’t know at the time that I had PTSD as a result of the birth so going through the notes for me triggered a panic attack as it made me relive the trauma and I simply wasn’t ready.

I had questions, I had support but I just couldn’t cope with it right then and there. They basically said that the baby was fine and that it all went well as far as they were concerned.

I’m sorry if it’s not what you want to hear but I think it’s important you have a different view.

There was a reason I chose to have DC2 in a different hospital.

I hope you find the answers you are looking for if you do go for the debrief.

sycamore54321 Wed 07-Mar-18 00:39:44

Most importantly, she reviewed my notes with the consultant of midwives and the head of the MLU and got agreement that the approximated blood loss on my notes was wrong, meaning I can attend the MLU for future births.

I don't mean to alarm but that sounds like something very dodgey is happening somewhere along the way. Either they have rewritten your file to tell you what you want to hear (and to leave you unknowingly at risk), or the original file was genuinely incorrect which is a serious professional error and would need a huge degree of investigation and could put the doctor or midwife who signed it at risk of professional sanctions.

Of course there may be more to it but based on what you've said, it sound like they want to please you and I'd be really cautious about making any treatment decisions for future pregnancies based on this revised history.

Littlemissdaredevil Wed 07-Mar-18 07:32:25

I found my debrief helpful. The senior Midwife didn’t read my notes beforehand as she didnt want to come with preconceived ideas about what my labour was like which was good.

I told my story and came armed with a massive list of questions. The Midwife’s in question will also be spoke to as there was errors my care which were not recorded in my notes.

I asked if it was likely I would labour quickly if I had another child and the SM said she would put a note on my file that a) i labour quickly and b) i am to come in straight away whilst in labour and not wait at home. Therefore, I would ask them to put a note on your file concerning future births

The SM also arranged birth trauma counselling for me

DeltaG Wed 07-Mar-18 08:30:24

Hi OP,

I think you have a very strong case for an elective c-section. My labour was only half as long as yours but the baby ended up getting stuck at the end and I had an assisted delivery which left me with a 3rd degree tear and DS in NICU. Unfortunately I then had uterine atony which caused me to haemorrhage and require a blood transfusion.

This was in Switzerland 2 years ago and my consultant immediately suggested a c-section for any subsequent births. I took her up on this and DS2 was born 7 weeks ago in a much more pleasant way!

If the suggestion is not forthcoming, you should definitely push for it; this is what c-sections are for. Otherwise, what constitutes good grounds for one in their eyes? Imminent death of the baby and/or mother?? Not acceptable if so, it's a capital city hospital in the UK not a fucking third world shack in the middle of a jungle.

Lndnmummy Wed 07-Mar-18 12:15:35

Hi Op, just to offer you some reassurance. I only yesterday got my c section approved due to traumatic first birth (and double incontinence) issues. It was approved on medical grounds and every single person that I came across have been outstanding in their support. This is in London (kings).

MuMuMuuuum Wed 07-Mar-18 18:59:25

My debrief was one of the best things I've ever done. It helped me come to terms with my experience and understand what options were available and why my birth took the route it did.

It also very helpfully got me the referrals I so desperately needed that my GP hadn't been hadn't provided me. As a result my prolapse was diagnosed by a gynaecologist and I'm receiving physio.

I asked outright about future pregnancies and the option of a c section. The debrief midwife is also the birth options midwife and while she didn't say yes she told me we would review the options at the time and choose the best option for me.

The gynaecologist whom is also an obstetrician informed me that a c section is offered and I wouldn't "have" to give birth vaginally.

The whole process has left me finally open to the idea of a second and much happier. This was CW.

DonaldWeasley Wed 07-Mar-18 19:06:33

We had a debrief - I thought it would help my OH who was traumatised by the experience and I was fine. But actually it completely changed the way I felt about the whole experience and I feel much happier with the thought of a second!

dinosaurkisses Wed 07-Mar-18 21:05:12

@sycamore54321 The midwife who estimated the blood loss had guessed I'd lost 600 ml, when the cut off is 500 ml to be considered a haemorrhage. I wasn't given any treatment/transfusions or told I'd lost a lot of blood and there was no mention of a large blood loss in my notes other than the 600 ml squiggled in the corner of one of the pages. They didn't adjust my notes for the reason you stated, but were happy to review the case based on the likelihood the midwife had over estimated how much I'd lost.

Thanks though, I'll definitely consider what you said when it comes to picking where I give birth for the next one!

Bellamuerte Wed 07-Mar-18 21:27:12

I was in labour for 27 hours before they decided I was failing to progress and they were worried about shoulder dystocia and tearing, so they did an emergency c-section. I had been awake for 37 hours by that point and was struggling. 62 hours seems a long time and I'd have expected them to intervene long before that!

They said I could have a consultant-led vaginal birth in any future pregnancy, but tbh labour was very intense and agonisingly painful so I'd prefer not to go through it again and would request an elective c-section for mental health reasons (terrified to go through labour again after having had a bad time).

I do still wonder if my labour was excessively painful, or if everyone's labour is like that and I'm just a wuss who couldn't cope?

KBLondon Fri 09-Mar-18 11:08:02

Thanks all for your responses.

I had the debrief yesterday and I think it was helpful. In the event if any future pregnancy, I think the entire pregnancy would be treated differently. They were surprised that I'd been allowed to go on so long. The consultant cringed when I told her I'd been sent home from the hospital after coming in following 20 hours of intense contractions by a midwife who told me that I was only 2cm and 'most women didn't even feel this stage'. Clearly I'd been feeling it or I wouldn't have turned up at the hospital.

It sounds like I'd have the option of a c-section and they'd do extra growth checks to see if a future baby was as big as my first (I think my baby's 9.5lb size may have been part of the issue).

If for some reason I decided not to have a c-section, the consultant said I'd be able to write a birth plan with the hospital that would include notes about not sending me home if I come in in early labour and speeding things along right away so I wouldn't have another 3 day ordeal and I'd have immediate access to pain relief rather than having to do without for 35+ hours.

Still hoping to never have to go through labour again, but I did feel like I was taken seriously and that I'd have options if I were to have another child.

OP’s posts: |
tootsieglitterballs Fri 09-Mar-18 14:14:15

Immensely helpful for me - I spent 7 months following the birth of DS1 depressed and with severe anxiety, because I felt like a failure and couldn’t understand why my sons birth went the way it did.

The midwife in charge did mine, and she was lovely. She makes a point of not reading through the notes first so that she can almost see it how we did to try and understand things from our point of view. She read through every page with us, and it turns out there were so inconsistencies with my care and the way things were handled. She explained why everything happened when it did (which is more than happened at the time!) and it was so helpful to me. It not only gave me an understanding but also closure.

sycamore54321 Sat 10-Mar-18 00:21:56

@Bellamuerte *"
I do still wonder if my labour was excessively painful, or if everyone's labour is like that and I'm just a wuss who couldn't cope?"*

Labour is known to be an excruciating level of pain for the majority who experience it. It's a very modern notion this idea that if we only breathe right or say the right chants, we won't be in agony. Labour is painful. Think about the Bible. A vengeful, all powerful God wanted to punish Eve for the worst sin she could commit of eating the forbidden fruit, and her punishment as the worst thing taut could happen to anyone was pain in labour. This was written by people who had no antibiotics for infected cuts, no painkillers for migraines or for dislocated shoulders or broken bones, no anasthetic for kidney stones. If they thought labour was the most painful punishment for women, you can be sure that it is normal for labour to be horribly painful for the very large majority of women. You are NOT a wuss v

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