I’m a midwife, ask me anything

[CatchingBabies]

Seeing as this has become a theme recently I’m jumping on the bandwagon because I need a distraction from my new house that is slowly becoming the worst decision I ever made.

Soooo I’m a midwife ask me anything! (Dons hard hat)

slinkier. Yes, where i work there’s definitely an option on the drop down box computer programme for ROT and one for LOT in the labour summary. So if a woman ends up with a section for a deep transverse arrest this could well be documented in her notes.

I’m so glad to hear that other consultant picked it up and your son survived @Signoritawhocansway. I hope he made a full recovery. My daughter’s HB was 2.1, so very similar. She lost over 100ml of blood and the post mortem said it was acute rather than chronic. Nobody has any idea why it happened or has been able to give me many definitive answers, which makes it hard at times to try to process. I suppose the truth is nobody really knows and they are just giving their best guesses.

I know this has been touched upon already, but what are the reasons for using forceps rather than a ventouse? DSis recently had her first in, in continental Europe, and apparently forceps are rarely used. I looked it up on the NICE website and it just said it depends on the situation. The RCOG advice leaflet says the chance of tearing is much higher with forceps than with a ventouse (8-12% rather than 4%). Are forceps more common than ventouse, or does it just look like that on MN? I really wonder why they're still used here when they're virtually obsolete in other European countries. They just seem barbaric I am genuinely worried about my vagina being ripped to shreds, I struggle with sex as it is already and adding pain/ altered sensations into the mix would be the final nail in the coffin for our sex lives. Do you get many women opting for a CS instead of forceps? Is it possible to request a ventouse instead of forceps? Sorry for the multitude of questions, I seem to spend too many Saturday evenings thinking about this...

@slinkier

I am aware of how it is spelt and pronounced. I am answering hundreds of questions here as quickly as I can while doing actual real life stuff and my phone autocorrects words to whatever it thinks it should be, I’m sure my spelling has been horrendous on this thread!

What I say isn’t meant to confuse or invalidate women at all, a deep transverse arrest is an emergency situation no matter what you call it. The point I’m trying to make is that while some language is used and accepted it’s wrong, not the women that are wrong but the medical profession wrong, a) because it’s quite literally incorrect or b) because it’s negative language. Like the point I made earlier about failure to progress when in fact it’s us who have failed to induce. I just think language is important.

In my last pregnancy, baby 4, I had OC and had had a retained placenta with baby 3 and slow placenta requiring cord traction with baby 1 , plus pyrexia in labour and so all babies given antibiotics after birth. I also had slow labours that became fast after cervix exam in established labour - 7cm to delivered in 1 he with baby 2, 5 cm to delivered in 45 mins with baby 3. With baby 4 I was told my baby would have to be in consultant led unit but my hospital had just implemented a 'go home from delivery room' plan which meant couples blocked delivery rooms for several hours after delivery. My water broke but as a high risk mum I was made to stay on antenatal Ward and was told would go to consultant led delivery suite when labour was established. However it got to about 9 or 10 pm and I was repeatedly told the delivery suite was full. There seemed no plan - couldn't go to alternate midwifery led unit, couldn't deliver on antenatal Ward. They wanted to examine me and I said I'd deliver if they did, so refused for a while but we were at stalemate with them saying I couldn't even look at delivery suites until they examined me. I eventually consented, was told I was 3cm and not in established labour. My DD was born 18 mins later on the antenatal Ward; no privacy or dignity. Thankfully no retained placenta. This was 8 years ago and I still feel aggrieved that no one listened to me. Is there a time limit to pals and debrief?

I was strongly advised to put in a formal complaint after I was readmitted to hospital after DS3's birth - about how the birth itself was handled, how I was spoken to (and about when they thought we couldn't hear) and the immediate post-natal care. The hospital took information that I had to call to confirm all was correct. I couldn't get through to the right person and life just got in the way. This was over 5 years ago and I had another child since, but things that happened still really bother me. as an example I couldn't face going to have my third degree tear checked up in the clinic they run and the thought of a smear test fills me with horror. (I had a c-section with DS4)

To get to the point(!) is there any value in my contacting them all these years later? I was told with DS4 that my notes for DS3 were missing.

I should add it was the staff on the labour ward where I was readmitted to (needed a blood transfusion and as I'd been discharged the infection risk meant I had to be on the labour ward - I think anyway!) that advised I should formally complain.

Thankyou for your reply, ROT is what was written in my notes. The midwife doing the debrief said that baby was never in the correct position hence the extremely long and intense early labour (contractions continuing at 5mins apart never getting any closer but getting more intense over 3 days without let up).

She also said that baby may of got into the correct position if my waters hasn't been artificially ruptured. Apparently baby had become wedged in my pelvis with a shoulder towards my back.

I had my first child 13 years ago (v young) and now expecting number 2. Very easy straightforward labour with DC1 and quick (4hrs from first pain to baby). Does it make a difference how long ago the first was? In your experience does the body "remember what to do" regardless or it's like a first labour again?

Thank you for this thread op x

Do you believe in hypnobirthing?

Both my sisters have had 2 pregnancies, both of their first ones ended with extremely severe pre eclampsia and HELLP syndrome resulting in terrifying emergency c section

They both contracted pre eclampsia in second pregnancies but this was managed much better as they were consultant led and had elective caesareans one was okay the other still had a hard time and lost a lot of blood as it wouldn't clot the way it should.

My question is do you believe it's genetic?
Would I immediately be consultant led?
Is there ANY chance of me being able to have a natural birth?

Would really appreciate an answer this plays on my mind a lot x

Do you tell mothers everything is ok even when it's not or you're not sure? With DS I was told everything was good by "we are going to stick some electrodes on baby's head as labour is progressing quickly". Why did they say this?

Thank you @catchingbabies really appreciate the time you’re taking.

Hi catchingbabies
I have a question. What test do you use for checking if waters have broke? And how accurate is it?

My 4th baby my waters were leaking from about 37 weeks. Each time I went to the hospital they tested and said it wasn’t my waters. 4 times in all. At 39.6 weeks I went into labour but baby wasn’t doing well. I had an emergency c section and my baby had a stroke due to infection in me. It is recognised now that it was due to my waters breaking and the midwives not believing me.

My waters went first with 3 of my 4 babies.

*@rotavix *What you are describing is called a deep transverse arrest, when the baby does not turn into the correct position. Babies usually rotate into a good position as they progress down, like a screw, but if there is a lot of pressure (or sometimes other reasons) it is like hammering a screw - sometimes there is no time for the head to turn into place and the baby gets stuck.
I'm sorry you had to go through this - it is difficult and painful!

I hope you and baby are well now and doing ok.

Fascinating thread!

I have two children and both times when baby was on the way out the midwife would ask if it was pressure or pain I was feeling, I've tried to explain both times that it's both. When baby is on the way out I just get this one constant painful pressure and baby literally just pops out by themselves in seconds, I don't have to actively put any effort in. Is that common or am I unusual

Hi OP, sorry if you've answered this before and I've missed it.

Do you and your colleagues have any 'old wives' tales' that you hold to be true (but that have never been scientifically studied)? Things like labour being more difficult for red-haired women, or subtle impending signs that a woman will go into labour? I seem to remember reading once that the small of the back turns a bluish colour when delivery is imminent. Is that true?

I'm just fascinated to hear stories like this, I feel there must be many subtle signs to do with pregnancy and childbirth that have never been officially recorded in a study, because they wouldn't make men any money.

Maybe I'm totally wrong on this but would love to know.

Thanks for all your hard work also. Have had 3 good experiences with midwives for my births

Thankyou Slinkier
I'm now pregnant with number 2, still suffering with some issues from my 1st labour which I think are going to make this pregnancy very uncomfortable.

I thought deep transverse arrest normally end in c-section? My baby was turned with ventouse and delivered with forceps.

Catchingbabies, thank you very much for answering my question.

Thankyou @CatchingBabies. I think babies who have clefts are gorgeous too but I'm a bit biased . Love his slightly wonky post surgery smile too.

Really interesting thread.

May I ask what your opinion is about episiotomies? Do you think tears are better? And how many women tear in labour or need an episiotomy?

Is risk lower for subsequent labours?

Thanks

If you're overdue with the first, will you be with the second as well? I had to be induced 40+12 and the baby didn't appear until 40+16 after lots of induction drugs. I want to refuse induction next time but what if my body just doesn't know how to go into labour? My placenta still looked healthy apparently.

If an epidural didn't work on you the first time, does that make it more likely it wouldn't work a second time?

I didn't have any breaks in the pain though I did feel contractions come and go on top of a constant agony. But according to the machine I never in my labour had the right kind of regular contractions to progress. I think this might be why I wasn't offered more pain drugs, or can you not have them if you've had an epidural? I was progressing because they checked when I started trying to push and I was 8-9cm. I had a debrief but they didn't seem able to explain why my labour was so weird. At the time the non-contraction pain was kind of dismissed even though I was begging them to kill me it was so bad! Is it common to be in constant pain like that and why might it happen?

With DS1 I desperately wanted a water birth, but couldn’t have one due to having a high BMI of 33.
We’re talking about TtC DC2 soon, and I LOVE a water birth - I really think it will help me, but BMI currentl around 32, I am losing weight though.

What is the actual risk of this for me/baby?

@rotavix DTA does indeed usually end in CS, as the baby will not budge. Perhaps then it was not a true deep transverse arrest but your baby was starting to move after a difficult start. Babies (and mums!) can only cope with so much though. Well done you for getting through it and all the best for this pregnancy!

@rotavix Please do mention any problems you are having from the first time to your midwife - don't be embarrassed to talk about things - there is lots of help available for gynae problems that people just don't access out of embarrassment. All the best!!