I'm a midwife AMA

[Jemima232]

Community Midwife with four children of my own.

Also worked as an Independent Midwife.

Breastfeeding Counsellor and Sleep Consultant.

@TwittleBee

Cause of Sepsis

Once the waters have broken, any examination vaginally can introduce infection, although midwives always use sterile gloves when they perform VEs. Some women have bacteria inside the uterus, which they do not know about. (Group B Strep, for example)

Was it a long time between your waters breaking and the baby being born?

Yes it was 2 days Jemima , actually there was another time a student midwife came in and attempted to break my already broken waters and ended up cutting me (she was very forceful and it was rather painful! Thankfully I had my mum with me then who intervened as I just assumed the MW would know what she was doing). I suppose it could have even been that too? Lots of causes i guess? Thanks again btw.

Thanks. Very useful.

Yes I'd love to know but notes are all in Spanish and they don't give descriptive notes there like they do the U.K.! Definitely head down at 37 weeks as I had a scan (private health care as abroad)

Ds was 3.7kg (about 8lb 3?) and 52cm.

When consultant lifted him up they were all amazed (at this pale long thin bald baby) at how he held his head up. Arms and legs were all outstretched. (Hes now being tested for HSP having had clear MRI after years of ignoring my concerns - another thread!)

I also wish I knew what happened. Why I didn't dilate. And what they were doing to my stomach.

But on a lighter note I had a hot Male Mexican midwife who was lovely - sonit wasn't all bad

Oh and I'm 5"7. And a lot slimmer back then than I am now! I was a size10-12 in clothes (2004)

Would you expect the midwife to have known my daughter was in ROT position when she told me to push? I was induced, got to 10 cm and never managed to push her out. All the pain was in my back so I wasn't surprised to read this in my notes from the doctor.

She was delivered via EMCS with the cord round her neck and in OP position.

I sort of feel that I was set up to fail in a way as my induction was epic (failed propess, max dose of drip for hours and hours, barely any contractions even with the drip - 2-3 in 10 mins, baby in wrong position)

Thank you for doing your job so sensitively.
I had to have a termination for medical reasons at 20 weeks and essentially had to give birth because of how far along I was. I’m pregnant again and the idea of labour fills me with utter dread - probably because of the negative associations - can I ask for an c-section due to this? My midwife doesn’t seem keen and keeps being quite vague when I bring it up and saying we will discuss it nearer the time but it’s making me increasingly anxious.

Thankyou so much Jemima. I would love to read your memoirs if you get round to writing them.

Does having a section under GA affect babies ability to latch?

Do you know much about placenta previa and its chance or reoccurring in subsequent pregnancies?

I've had a first trimester mmc, a stillbirth, a second trimester and thankfully now have a beautiful dd but had placenta previa in that pregnancy so bad had to be delivered by csection under general and apparently it was very difficult to remove the placenta as it was very embedded into my womb. Their advice is I can have another pregnancy but it could end up much worse next time. I'm happy with what I have and don't want anymore but I wondered just how likely it is to happen and be worse.

Hi Jemima

Thanks so much for your detailed and sensitive response to my posts. Tbh some of what you suggest would have been okay, some not. Anyway it is all in the past.

However your reply prompted me to ask another question if that is okay - what positions do most women give birth in? And is it normally on a bed?

I ask bc your post seemed to assume I would be birthing on a bed - and I have seen several hcp assume this, talking about "the bed" - I have 3 dc and only Twin 2 was born on a bed and I was on my side not my back. I sort of assumed modern midwifery encouraged women to move around, find comfortable positions etc, so was a bit surprised to find hcp assuming I was going to be static rather than walking around. I always find labour to be an incredibly restless time and couldn't lie on a bed if my life depended on it!

So what do most women do?

Hi,
Just wondering if a lot of stress and upset during pregnancy can harm the baby, or delay labour? I had my 4th baby in 2017, and while I was pregnant with her, both my parents died.
She was born 9 days late by induction after 4 failed sweeps.
My other 3 babies were gas and air waterbirths, no stitches. Number 4 was the opposite. Did the stress from my parents deaths possibly cause this?
Is it true that you can get to 10cm and then the midwife still gets you to hold on so baby comes lower before pushing?
Thank you

Thanks @Jemima232

I've thought of another if you don't mind!

If baby is back to back during labour would you tell the mum to be? Also, if they're still back to back when labour was progressing and the woman was nearly fully dilated but in a midwifery led unit, 10mins blue light from the hospital, would you be considering moving them over before delivery?

Hello I am new on here so please bare with me, I am currently 5 months 1 week pregnant I was on queitapine but my midwife told me to come off them (3 months)due to the effects it may or may not have on the baby after the birth recently I have been seen by mimns and been told I have to be on them due to my mental health I am very confused and don’t know what to do for the best for me or my baby

I've skim read the thread but apologies if this has been asked before. I see you had multiple miscarriages and four children.

Did you take any supplements/ do anything differently for your pregnancies that stuck? I have had two chemicals and a mmc. Nothing found on tests for cause.

Ha ha @Jemima232 this thread could almost be your book!

Enjoy the read, I loved it x

VeryStressedOut

Quetiapine in Pregnancy

The consensus viewpoint is that if a woman's mental health is at risk of deteriorating without her taking quetiapine then it should be continued.

There's a lot of information on this website

medicinesinpregnancy.org/bumps/monographs/use-of-quetiapine-in-pregnancy/

@jemima232. Early scan went great. Baby has a strong heartbeat. Measuring in at 5 weeks + 6 days. Thank you for listening to my concerns and for asking how I'm doing.

@crazyforpiggies

Yaaaaaaaaaaaay!

@Wowzel

Baby OP

When you're fully dilated the baby's head may still have some rotating to do, and some descending.

I'd be surprised if your midwife didn't know what position your baby was in at that point, although it can be difficult, after a long labour, to determine the position.

I think what you mean is - should you have had a CS as soon as you were fully dilated, given your baby's position when born?

The answer is no - unless there was fetal distress. Babies who are OP at the beginning of labour usually turn. Some do not, and are born facing upwards. It is reasonable (and of course I'm answering without your notes) to hope that your baby's head would descend and rotate while you were pushing.

The fact that it did not do so and that you had a CS suggests that the doctor felt that it would be safer to deliver you by CS, assuming that the head had not descended despite your being fully dilated and pushing for a while.

One in three babies are born with the cord around their necks, and this cannot be predicted. Almost always they are loose and can be pulled over the baby's head just before the shoulders are delivered. Some need to be cut before the shoulders can come out.

@Aberforthsgoat

Requesting CS - bad memories

How awful for you to have gone through that. I'm not at all surprised that you're ambivalent about going through labour.

Have you discussed this with your consultant? It sounds like a reasonable request to me.

@JohnnyMcGrathSaysFuckOff

Positions in labour

When I go to assess women at home, which is the norm for all births in my unit, they are never in bed. They are in various positions, depending on the stage of labour but I have never seen one in bed.

If I'm called to an accidental home birth, the woman is invariably on all fours, outside the bathroom.

Labour ward beds are made so that they split into two. When they're in the shortened, stirrups position they take up a lot less room, so I always put them like that and cover them (without attaching the stirrups, of course) so that the woman doesn't see the bed as soon as she comes into the room.

I put a beanbag and loads of pillows on the floor, positioned so that the woman can kneel and lean forward into an armchair. If she prefers to stand she can lean on the end of the shortened bed.

Of course, if I need to examine her (abdomen, VE) or she needs to stay in bed for any reason (haemorrhage, pre-eclampsia, epidural) it takes seconds to reassemble the bed.

Over the years midwives have become more adaptable although some prefer the delivery to take place on the bed. (Just waiting for a volley of you to tell me that your midwife made you stay in bed.)

I prefer to let the woman choose the position which makes her comfortable and suggest alternatives if she's struggling.

My personal favourite for delivery is the woman on all fours with me at the side. (It has ruined my knees as many women like to stay on the beanbag.)

Old age and arthritis await me.

@Rarfy

Placenta Praevia

This occurs in 1:200 pregnancies. You're slightly more likely to have one if you've had a CS (and are an older mother and various other reasons - see link) which you have.

www.nct.org.uk/pregnancy/worries-and-discomforts/common-discomforts/placenta-praevia-low-lying-placenta

Does having a CS affect babies' ability to latch

Not in itself, no. But women who have had a CS are almost always more uncomfortable due to their stitches so may find the early days of breastfeeding difficult as a result of that.

Prematurity, abnormalities of various kinds, tongue-tie, incorrect positioning and maternal anxiety all affect the baby's ability to latch.

I'm sensing that you had trouble with this?

Thanks @Jemima232. I had two erpcs for my missed mcs and wonder if that's why I got placenta previa. In which case I'm guessing it would happen again plus the fact it got so stuck.

Dd was born at 37wks due to placenta previa so I guess that's why she couldn't latch. I tried to hand express but got tiny droplets at best. After two days I gave in and switched to formula. At the time it didn't bother me much as I wasn't dead set on bf but it makes me a bit sad now and at baby groups I often feel a bit judged due to ff.

Hi Jemima, I've never gone into labour (3 dc) and have had to be induced every time.

Does this mean I am missing whatever it is that makes people go into labour? If I had another baby, is it likely I'd need an induction again?

If I was missing whatever hormone it is, would this affect other areas of my life?

Thank you!

Thanks OP! Ha ha, my first was a v fast home birth (45 min labour) and I was just as you say, all fours outside the bathroom! Twin 1 as I was pacing the toilet, so fully upright, Twin 2 on my side on a bed as I was so determined never to be on my back!!

Hi,
Just wondering if a lot of stress and upset during pregnancy can harm the baby, or delay labour? I had my 4th baby in 2017, and while I was pregnant with her, both my parents died.
She was born 9 days late by induction after 4 failed sweeps.
My other 3 babies were gas and air waterbirths, no stitches. Number 4 was the opposite. Did the stress from my parents deaths possibly cause this?
Is it true that you can get to 10cm and then the midwife still gets you to hold on so baby comes lower before pushing?
Thank you