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)

Hi, and thank you for answering all these questions
Like Guggenheim, my labour 'did not progress', cervix didn't open despite my waters breaking, 10 hours of labour and back to back contractions at the end. I ended up having an EMCC under GA. I've always wondered why this happened and never had an explanation. I've also been had real trouble having coils fitted and begun to think my cervix is just glued shut!
I'd love to hear your ideas on this if you have time.
Thank you

@mrssunshinexxx I have personally delivered 127, I still keep a count. I don’t count the forceps, ventouse and caesarean deliveries however as while I was the midwife I didn’t deliver them. And I think water births are lovely.

@rotavixsucks there is no such thing as ROT. When you understand where LOA, ROP comes from you can see ROT etc. is impossible. R/L left or right. O occuput the bone on the fetal skull we use to determine position, A anterior, P posterior T transverse, how can the head be transverse (lying horizontally) if the baby is head down?
If a mother is in excruciating pain I would expect them to do something about that pain no matter the reason why she is in that level of pain.

@lostmybaubles that’s impossible to answer without knowing your full history and the likely cause of you PPH sorry. Its usually a failure of the uterus to contract after delivery but there are other causes.

@coddlemoddle you should never have been left in pain and had pain relief withheld from you when they were stitching that is awful and I’m sorry that happened to you. Also you have every right to decline whatever you want it is your body and you can say no at any time to anything. Yes I would recommend writing a birth plan specifying these wishes, we do read them yes and it’s a lot harder to ignore something that is written down.

@lilaciris I am very sorry for your loss, yes the SANDS stickers are commonly used, trusts that don’t use them will have a different way of marking your notes so that people are aware and don’t say hurtful things or make you repeat the story over and over.

@ohyesiam your hips and pelvis do widen yes.

It sounds as if a lot of us could have done with a birth debrief

I requested one but never got one

The same old story I guess - resources! But why advertise the service if you then ignore people asking for it?’

Brilliant thread OP thank you. Currently 34 weeks pregnant and I have told my consultant I will not consent to the use of kiellands forceps (she also referred to them as mid cavity) and I want an intervention with a c section instead. She said totally fair enough, she has no problem with that. And she’s written it in my notes. Just interested in your opinion. Thanks.

This is so interesting. What are your professional opinions on forceps? During my pregnancy my dh found out that most European countries don't use them any more because of the potential damage to the mum. Is that true? Are there awful long term impacts? Would an EMCS in that situation be better?

@flatwhite32 its good to see your name! Hope the scan goes well and baby arrives safely.

Can you refuse to be checked how dialated you are? For me it’s so uncomfortable and one of the worst bits of labour but if I said no what would happen?

“I have personally delivered 127, I still keep a count. I don’t count the forceps, ventouse and caesarean deliveries however as while I was the midwife I didn’t deliver them.”

Personally I don’t like this terminology, the idea that medical professionals deliver babies... the mothers birth the babies, some get more help than others, but saying that the doctor or midwife delivers the baby seems to sort of remove the mother from the equation...

I am sure that is absolutely not your intention OP and it’s just the medical terminology. But it bothers me.

ROT does exist. The baby is in a longitudinal position, not a transverse position. It’s the occiput which is transverse.

If the words "resussitation measures implemented " are on my medical notes what does that mean? Ie what happened? Did they ressucitate me and if so how?

In your opinion obviously!

Do you have many women acting like a spoilt toddler because they're in pain and won't do as they're told?

(I need comfort. Ds got stuck for 5 mins and I screamed at her to leave me alone and I started acting like a spoilt toddler apparently saying "NO" when she needed me to get out the birthing pool immediately. Apparently she got really pissed off with me)

@Bobbiepin thank you! Bit nervous after the high Doppler readings, but just have to try and not stress!

Thank you for answering
I have been told it is due to uterus not contracting but another hcp mentioned could have been because of the 'botched job' (bad hosp ans bad experience)
Is there anything I can do ro reduce risk of pph?

Sorry, another one
I have low lying placenta. Consultant said might need section due to this. With my history does that not increase pph risk?
Normal delivery theyve massaged abdo while workimg on me to help stop the bleeding, how would this happen with a section?

Sorry and once again thank you

@mygreycat I’ve never seen that and I’ve been involved, either delivering, witnessing or assisting in over 500 births. It’s very very rare. I have seen a fetal to fetal haemorrhage in a twin vaginal delivery however as a student. It was a very scary experience and knocked my confidence for a very long time. I often wonder how that baby is as I never found out.

@fruitcider patchy epidurals can be common, a lot depends on your spinal structure and the skill of the anaesthetist.

@eeeeek2 you can request a spinal if you know local doesn’t work for you.

@chasingcars123 it’s horrific isn’t it! Makes me so so angry.

@notasinglefucktogive no I have never said that, it’s not true we encourage and support women to stop smoking in pregnancy. I suspect it was either a long time ago or they were making excuses for continuing.

@crazycatbaby you can go home after your waters have gone, it was probably because your labour was so intense they wanted to make sure you had decent pain relief or they thought you might progress quickly.

@guggenheim I hate the term failure to progress. What we should say is we tried to force your body to do something it wasn’t ready to do and we failed in doing that. It more common than you realise.

@mayaknew midwife led units have been proven to have better outcomes than consultant led units for low risk women. Birth is becoming more and more medicalised. Some people really need that the vast majority don’t and as the medical staff never see normal labour and birth they don’t recognise it and treat everyone as high risk and intervene when it isn’t always needed.

@kitchenfloor it’s common to feel a premature urge to push if your baby is back to back and it’s right to try and hold off as it can cause problems. I think women know instinctively what position they need to be in or what movements to do and they are usually right. The female body is amazing!

@utterleyunimaginativeusername saying baby is a bit shocked is usually a nice way of saying baby needs some resus or assistance but without seeing the notes or being there it’s impososble to say what happened.

Not noticing that they were recording your heart rate is bad practice of course but mistakes sadly do happen. That doesn’t necessarily mean his heart rate had stopped it could have just stopped being recorded. Trying not to be blunt but if his heart had stopped 22 mins before he was born he would he dead they wouldn’t have been able to revive him at that point, 12 minutes of resus to get a heart rate is a very very long time as it is, that must have been very scary for you. I’m very glad that all was ok in the end. It sounds like he had a very close call!

@butidontlikethatlamp no one really knows why these things happen there are so many factors at play that it’s impososble to pin point one reason, these things do happen however and that why we are so lucky to have the medical care we do in this country to intervene when needed.

@namechange30 I often recommend a birth debrief to women as I think it’s so beneficial when things havnt gone to plan as many women don’t know why and this is wrong. I don’t have any involvement in that as it’s a consultant that conducts the debriefs at around 6 weeks after the births but I hope the ladies I’ve referred on have had the debrief they have needed. It’s wrong to not provide this. I bet it’s funding and not being seen as essential which is sad.

Hi Catching, thanks for doing this! My DS1 was in the brow position and like RubyGrace I had an EMCS under GA. My question is how rare is the brow position - how many cases would you expect to see in the average year at your hospital?

Hi op, please can I ask a question based on my second delivery? My son was born with his cord wrapped round his neck and body and needed to be rescutitated.

I found out by reading my notes that he also had shoulder distocia. Was I supposed to be told at the time? When I mentioned what I'd read to the midwife, she was dismissive.

Also after the birth of my eldest, my stitches had to be redone on the ward with only gas and air for pain relief. That was horrendous.

Ohhh lots of questions.

With ds he was back to back, caused complications and feral destress etc and was rushed in for emergency section - managed to get him out with forceps. After the birth I hemorrhaged and lost over 2 litres of blood. At the time I vaguely remember them say they had “left something inside me” causing me to bleed. I am pregnant with dc2 and have had conflicting advice. One midwife has told me I’m less likely to have a bleed again as they will inject me with something to stop it and other midwife says I would have had that previously and my chances of hemorrhaging again increase? What is your opinion?

Thinking of water birth with dc2 but have read about how lots of not so nice things come away (know you can do a number 2) is this more disgusting in a water birth? It’s put me off a bit as I don’t want to be paranoid about it although I know in the moment I won’t care!

Lastly I am currently 37+4 by dating scan (37 going by my dates). Is there any obvious signs days or weeks before labour. Felt this one may come early but the nearer it gets I don’t feel any different.

Thank you for answering @CatchingBabies. My daughter died from it and it seems so difficult to get information (even the hospital couldn’t provide us with much) but, as you say, I suppose it is so rare that there isn’t much out there. I do hope the twin who suffered the fetal to fetal haemorrhage fully recovered - I had no idea twins could do that to each other but, then again, I had no idea it could happen between a baby and mother until it happened to me. In your experience, so you think there would be specific extra precautions in place in a subsequent pregnancy and what would they be?

Thank you for answering Catching
Yes, I've always felt very lucky to have been in the UK and incredibly grateful for our wonderful NHS. I dread to think what would have happened if I had been somewhere where this isn't the case.

@spritegirl totally your choice and I’m pleased the consultant has accepted your choice as they should do.

@bobbiepin as a student I was horrified by them and thought they should be banned and a caesarean performed instead. As a midwife I have seen cases where the delay in going to theatre for a caesarean rather than using forceps would have resulted in a potentially stillborn baby so while I don’t like them they are sometimes a necessary evil, it all depends on the situation however sometimes a caesarean is a valid alternative and other times not. You might find it interesting to know that forceps are sometimes used in a caesarean to get the baby out the pelvis, it would be impossible to ban them completely.

My baby was breech, turned during an ECV, induced due to being very overdue, but stuck during pushing and eventually delivered by forceps.

I've had lasting physical damage from them as well as PTSD. I'm nearly recovered almost 2 years on but thinking ahead if I have another:

1. What are the chances of needing forceps again?
2. Would you recommend an ELCS in this case?
3. Is it possible to find out if it's my pelvis or something that's just too narrow (apparently my mum was told this about hers in the 80s after an EMCS so next had to be ELCS)? I don't know if they still do this.
4. My baby had torticollis - could this have been from being in the breech position for months, or from the forced position of the ECV, or being stuck part way down the birth canal for a couple of hours? Or something else?
5. If I went overdue and wasn't having a section next time, what happens if I refuse to be induced? Do I need to stay in hospital for monitoring anyway?
6. Likewise if I refuse internal examinations? How would they know when I'm in each stage of labour?

Sorry, I have lots. Just not sure I can go through it again but I really do want two children.

I'm currently over due had one sweep did nothing is it worth trying again tomorrow I'm almost 41 weeks few cm dialatedo and 90 percent effaced when I had one dome on Wednesday.

Sorry to ask my midwife didn't really make it clear how effective they are and don't want to do it again if success rate is really low.

Do they work more than not or more effective second time?

Thanks for sharing so much has been great to read this thread

@RubyGrace17 I had my second DC under a GA very suddenly and also feel so sad nobody was there who loved him to see him born. I didn’t meet him for several hours. I think I still suffer PTSD two years later.

With DC2 I had an awful midwife who refused to listed to me. I wish I’d pursued things as she made a mistake which may have resulted in me needing the CS (first birth was vaginal, second birth was going well until she injected me with something I shouldn’t have had, said I couldn’t have, didn’t want and subsequently reacted badly to). The hospital said it would be reviewed and dealt with internally and wrote to me asking if I wanted to follow up. I was just glad I was okay and had a healthy child so ignored it.

What happens when somebody makes a mistake and the patient doesn’t follow up - does it just pass or does an internal investigation mean it would have been dealt with?

Thank you Catching. The doctor who did the episiotomy did give me a local anaesthetic, but it was done so quickly there was no time for it to kick in. I sometimes wish I hadn't spoken to that second doctor and found out I could've had pain relief all along... My MW said this time round I'm less likely to need intervention like that, and I'm just hoping that's true!