I’m a midwife. AMA.

[Clappyhapper]

I’ve been a midwife for 13 years. AMA.

Obviously not personal medical advice. :)

How risky is it really, to go beyond 42 weeks? Especially if your dates aren't necessarily accurate? I've found a lot of vaguely ominous warnings against it, and one study about increased likelihood of ADHD.

I'm nervous about induction leading to a whole load of medical interventions.

Twirliegig

Amazing thread.

When I had my second my waters went the day before I gave birth. I spent that day in and out of hospital being monitored as there was a bit of meconium in my waters and had to persuade the mw to let me go home and sleep rather than be induced. My contractions finally kicked off early the next morning as I was in bed. When I got to the hospital the midwife examined me and instructed me to lie down and push. She and the midwife really coached and put pressure on me to push and not pause or breathe through the whole thing. Was there a reason for this? Was it because the baby was in danger because of the meconium? I actually zoned out, ignored them and rested when I felt it was too much and baby was born within 10 mins with only a tiny 1st degree tear luckily but I felt angry I was pressured to lie on my back and push. Any idea why this was?

Midwives do an incredible job and I have so much respect for you!
-//////
Thank you
My first thought is what was baby’s heart rate doing. Most common in this scenario would be if the baby was distressed and needed to be born ASAP. In our hospital they don’t send women home if there is meconium in the waters. Very pale, well dissolved meconium is not usually such a concern, if it was loads of thick, fresh meconium I would be concerned about baby’s wellbeing. You could always ask to see your notes/ have a debrief to find out more.

ZogTheOrangeDragon

If you have a precipitate labour, how likely are you to have another one? If subsequent babies are usually born slightly earlier than the last one, is each labour also usually quicker?
——-
If you tend towards quick labours you will most likely continue to do that unless baby is in a more difficult position/significantly bigger etc
What we tend to see, although not always of course, is first babies are longer, second babies are shorter, third babies are unpredictable and often have false starts.

FangTasticBeast

Hi, I had a cord prolapse on the ways. Obviously wasn’t very pleasant but the staff who felt with me were fantastic, quite a few said they’d never seen one before.

I guess it’s less common in a mlu but is it something some mw are likely to never have to deal with
————-
I’ve had two in the last year and zero in the 12 years preceding that. Very unpredictable and possible to have never seen one or to have seen many. Like you say, depends a lot on where you work and how long for.

RangerLady

Do you secretly judge or despair of some women who are just a bit pathetic in labour? Ie telling you they can't do it / crying / not being able to push the baby out? Cam you tell I spent 3 hrs trying to push out a back to back baby with my first?! grin ended in forceps btw and a 3rd degree tear
———-
It really, really hurts. There’s no ‘pathetic’ about it. Sometimes it’s difficult to get women to focus when they’ve lost it and sometimes I inwardly wince when women don’t listen and scream their babies out at speed, but only because of their poor vaginas. But again, this is few and far between. Occasionally I’ve had women point blank refuse to push in a situation where pushing is the only thing moving the baby (often breathing them down is the best way) and that’s difficult.

NickMyLipple

After my C-Section, I was re-admitted 5 days later with sepsis. I had a terrible infection which led to necrotising facitis. I was given the option: 1) be nursed with your baby in HDU on the delivery suite (!) by midwives or 2) go to ITU of the main hospital but baby can't come.

I obviously chose the former, but the care wasn't specialist enough, and the midwives (especially those who had never been nurses) struggled with my dressing changes, 6xdaily antibiotics via a picc line and my magot therapy...!

I've since had to have 5 lots of surgery including a skin graft to help me heal and I've got significant permanent disfigurement - I believe that this was as a result of my care coming from midwives (who predominantly care for 'well' women and babies) rather than surgical nurses.

I haven't ever complained, as I can't prove the above point and my care was good throughout, but I just wonder at what point someone should have said "I know is very difficult but we need to move you somewhere else and you can't bring baby"... I get that they try to keep babies and mum's together but it was so detrimental in my case sad
—————-
Poor you, that’s awful.
It’s a really tricky situation because no one wants to split a mother and baby. I’m wondering if you were on an HDU were the midwifes specifically HDU trained? I’d have assumed you would have been allocated staff with the most experience caring for women with complex needs, but obviously I don’t know the set up at your unit.
It’s difficult to say whether the outcome would have been different if you’d been on ITU, it’s such a nasty condition. You’re probably best to debrief with the hospital and see if they feel it would have had any influence on the outcome.

IVEgottheDECAF

I am expecting my fifth baby this year (august)

Some things i have read online suggest i will automatically be classed as high risk? Is this true? If so how would my care differ?

I have had four natural deliveries, heaviest baby 8lb9. And have gone home from the delivery room with dc2 3 and 4. No stitches, large bleeds or other issues.
——//
Congratulations!
This is a little bug bear of mine. In our unit we would move you to consultant care when you are a para5- and having your SIXTH baby. Some of the doctors seem to think that it is when you are having your fifth baby that the criteria changes but not so, here at least. Women having their fifth babies are welcome to use our midwife led unit, everything totally normal, unless other issues are present. Get this clarified with your hospital, ask for a second opinion if you don’t have any joy!

Hi, thanks for doing this thread.

I had an ELCS for breech in Feb 2016. I’m now pregnant again and thinking about VBAC as I’m scared of the recovery for the C Section with a toddler.

As I’ve never been into natural labour, would this affect the 75/25 success rate you mentioned earlier in the thread?

Assuming the pregnancy progresses normally I assume I would not have the option of ELCS available as it was for a specific issue with my first?

@Moominfan the same happened to me! I was given a sleeping tablet and told to get some sleep as if I was feeling pain now I wouldn't cope when I went in to labour! I felt my body take over and he was born within 23 minutes! It was the middle of the night and they had sent my partner home. He managed to get there after he was born I was and am still upset about it!

Thank you Clappy

When i had dc4 my midwife said i might need to be consultant led for that pregnancy as i am quite petite and dc3 was 8lb6. She was apparently concerned i wouldnt be able to deliver dc4 safely and thought i might need to be induced early. I ended up staying midwife led but had an extra scan for growth. I was also told i wouldnt be able to have a home birth (didnt want one anyway!) due to increased risk of pph.
Baby was born 1 day before due date, 8lb9 after a 5 hour labour, no tears or anything although was back to back so difficult to get out!. Bleeding was fine. Suspect i have same mw again this time so will see what she says i suppose

Where do you feel is the best place to go for advice/information on c-section vs natural birth?

I’m mid risk (old, ivf, endo and previous surgeries so risk of scarring causing issues but generally healthy). I’ve got an appointment at 36 weeks to see if the consultant wants me to go c-section but the assumption seems to be I’ll want a natural birth unless I’m told I medically need a c-section.

I don’t know if I want a natural birth or a c-section (assuming I don’t need a c-section). What I really want is some information on the options, how the stats relate to my personal situation and some none bias advice. But that doesn’t seem available. Natural birth/water births seem very heavily pushed in my area and I’m worried I’m going down a path that isn’t necessarily best for baby and me just so the unit hit a target.

I posted a thread a while ago about my situation. I know you can’t offer medical advice, but I wondered if you might give me your thoughts? A c-section scares me, but am I mad to try for a vaginal birth?

www.mumsnet.com/Talk/childbirth/3422907-ELCS-or-vaginal-birth-after-episiotomy

My midwife suggested perineal massage. In your experience, does this reduce the chances of a tear?

Thanks

Thank you for doing this thread.

I had a 3c tear and hidden haemorrhage which resulted in me having Hb level of either 4.5 or 5. I didn't want a transfusion (someone in my family got hepatitis from one) and probably wasn't compos mentis enough to think logically. The consultant told me my heart could stop at any moment if I didn't have a transfusion, and my baby wouldn't have a mother. I then agreed. My question is - how bad is that Hb level, and was it true I could just drop down dead?

Hello! I had an emergency section after induction because my LO was two weeks late - but I had amazing care and still consider it to be a hugely positive experience- so many thanks to you and all midwives!

My question is, I was told I was suitable for a VBAC - assuming all goes well with the next one, is it likely I'd be suitable for the midwife led birth unit, or are you automatically considered high risk as a VBAC?

@Clappyhapper thanks for replying to my question (about waters breaking at the start of labour). My first baby was back to back so that makes sense.

Thank you for doing this @Clappyhapper really interesting thread and feel I've learned a lot!
I'm currently 14 weeks pregnant and the thought of childbirth has always terrified me (makes me a feel a bit faint - why do people always have to tell you the gory details!). I'm starting to read through the birth choices booklet and always assumed I'd 100% want an epidural but now am considering how I'd like to try hypnobirthing/water birth first as I've read how epidural can obviously have complications/slow down the birth/be more likely for tears/episiotomy (terrifying!) Not really sure what my question is but in your opinion does having a positive attitude to the birth make a difference and is the pain copable without an epidural?

Thank you so much for replying to my question. It has really put my mind at ease. You sound lovely and anyone would be lucky to have you as their midwife.

Sorry, another question! I ended up having a squirt of some pain relief or other put on my tongue after begging for some pain relief during transition (despite discussing the likelihood of this request beforehand with DH, he was useless at coaching me through it without pain meds!). I was told it was related to morphine but I think it began with a d.

Any idea what it was?

Thank you for answering my questions

I had my first baby almost a year ago. At 6 months pp I was diagnosed with an umbilical hernia. It’s very small - about 1cm long. My question is whether to have it repaired before baby number 2, or whether to leave it until after birth. I’m worried about going into pregnancy with a hernia but know little about what could happen if I do so. Just wondering if you could share any experience/knowledge.

Thanks for this thread.

I had hellp syndrome and breech baby in my first pregnancy, delivered by c section, very traumatic as I only knew I was pregnant for 7 weeks before that. Baby born 37weeks.

2nd pregnancy, heavily monitored I had gestational diabetes only diagnosed at 36weeks, c section at 40 weeks due to measuring large and breech.

I am very grateful to have two healthy babies but I would love a third. Do you think this would be madness?

How often do previous episiotomy scars tear in a second Labour?

What are your thoughts on requesting a planned section after a tricky first labour resulting in high rotational forceps and episiotomy?

I had dd2 by emcs last year. Labour was very fast. 8cm when I arrived at hospital about 90 mins after contractions started.

She was back to back. After pushing for 90 mins they discovered she was brow presentation. And I needed a c section.

Midwives and my notes told me that I lost 1500ml of blood.

C section was 2am. I was allowed home at midday. I pushed for this as I wanted home to be with dd1. But very unaware of how much blood I had actually lost.

I had serious bruising under the incision and from hips to both thighs within the first days. I showed this to every midwife that visited me. At least 3-4. I couldn't lie down flat. And took minutes to stand up. Couldn't lift my feet properly when I walked, mostly shuffled.

After 8 days at home I collapsed in pain and was taken by ambulance back to hospital. A CT scan showed that I was bleeding internally. I had to be opened up again but they couldn't find the source. Left with a drain in for several days. Unbelievably painful. They said from the mixture of red and black blood I had been bleeding internally since the c section. I was on morphine, IV paracetamol and more for a week. Couldn't breastfeed. Just pump and dump. On 15 min observations for days. Could barely hold my baby. Lost another 1000ml blood in the second operation and had 3 blood transfusions.

My question is - should someone have been able to tell that something was wrong. I didn't complain about the pain or not being able to move much as everyone kept telling me how painful a c section was. Should the bruising on my stomach and thighs been have investigated?

The consultant said I must have an extremely high pain threshold as the level of internal bleeding should have been incredibly sore.

With my dd I ended up with an Emcs although only emergency in the sense not elective - failure to progress.

I have a Cervix that is off to the right - Am I correct in thinking that would make natural labour harder? Or would it even be impossible? All internal examinations and smears I have to make sure I mention it to make it easier for the hcp to navigate me I always wonder whether it's more difficult to get pregnant to.

Midwives are amazing. I always wanted to be one growing up.

@Clappyhapper come back!