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.

@pregnantandsuffering

I'm so sorry I took so long to get back to you.

Lying on your back while in the bath is okay - unless you spend hours in the bath.

It is absolutely recommended that you lie on your side in the third trimester.

There's more information in this link.

www.tommys.org/pregnancy-information/im-pregnant/sleep-position-pregnancy-qa

What a fantastic thread. Thank you.
On my second baby I got to 10 cm and was then told my baby was face presentation. So had a c section. My question is can this be spotted with an internal examine. Earlier than when I was fully dilated? Midwifes didn’t check for such a while and I can’t get it out of my head that a c section and stras to my baby could have Been avoided. Thank you

@Highfivemum

Face Presentation

This is another one where without your notes it's a bit difficult to answer you.

Face presentation is rare. It is usually the end result of a baby who has started off posterior (facing upwards) and then, instead of the head descending and flexing, the head deflexes.

A face presentation in itself isn't a reason for a CS. There would have to be concomitant fetal distress and/or doubt over your pelvic measurements.

Yes, of course it's possible to know that a baby is presenting by the face prior to full dilatation - unless it hadn't got as far as being a face presentation when you were examined earlier in your labour. What I mean is this - in earlier labour the baby might not have been a face presentation. It might have taken the whole labour for your baby's head to have deflexed enough to be presenting by the face by the time you were fully dilated.

There is also a much rarer phenomenon, in which the face itself is posterior.

So without your notes it's really difficult to work out what was happening and how it happened.

Was your first baby delivered vaginally or was this second baby a VBAC?

Babies presenting by the face are not usually more stressed than babies presenting by the vertex (crown of the head) but if there was fetal distress that could be why you were delivered by CS.

I have delivered face presentations vaginally without incident - also breeches (and twins.)

Thank you for your detail response.
My first baby was vaginal. A nightmare. . I was induced and it was forceps in the end which resulted in stitches that they said hold the hospital record!! . I honestly think I have a very small pelvis. My care in labour wasn’t the best. It was intermittent visits. The nurse when I got to 10 cm was convinced it was his bottom so called a doctor. Who said it wasn’t and said you need an emergency section. I have always had this guilt as a nurse came in a couple of hours before he was born to do a check and my husband ( daft head on ) walked in with a friend of his so the nurse walked out and said she would come back in a min. She didn’t until much later and I plagued with if only. I may have avoided the emergency. 🤔🤔 daft as it’s quite a few years ago now.

@Highfivemum

Whatever the series of events were, you could not have avoided what happened.

It does sound as though you have a pelvis which just wasn't quite big enough for your second baby. That fact is often not known until you're fully dilated.

If you'd had fetal distress you would have been examined prior to full dilatation.

When a midwife says she's coming back in a few minutes, and doesn't, it means that something else has happened in the labour ward which takes her attention away from you. However it would have been better practice if she'd asked your husband and his friend to wait outside while you were examined. In fact, she should have asked the friend to fuck off leave the labour ward. It is not a clinical area where visitors are appropriate at all.

From what you say there was a mechanical problem (unusual presentation and smallish pelvis) and as soon as that was discovered you had the CS.

Honestly I cannot see that you did anything wrong. Please don't beat yourself up about this. Was the baby okay when delivered? Is that why you're worried that you didn't say anything earlier?

On our first baby we didn't find out the sex, but on my induction so many people said that he'd be here soon etc. So is there a midwife / sonographer code they use to describe the sex? I couldn't see it referenced in my notes or was it just fluke they "guessed correctly"? Not once was baby referred to as she. It was indeed a boy! I did say to the consultant we hadn't found out the sex and she said she was just guessing, as boys are often overdue ?!

@havinganotherbaby

No, there isn't a code which describes the sex on your notes.

Most midwives and doctors say "your baby" though, which covers all bases.

Anyway, scans are occasionally wrong when they tell you the baby's sex.

Sorry if I'm late to the party! Hoping you're still reading :-)

Thanks for doing this I've found it very informative!

I have a beautiful baby boy but did not have an easy time of the birth. I ended up with forceps delivery in theatre and episiotomy. All was going well (induction and epidural) when I started feeling pain at 8cm. They kept referring to it as pressure but I swear it was pain. I was given gas and air. The baby had turned to be back to back and I do not remember anything past this point. My Dh tells me my temperature shot up, I started talking complete nonsense and the room filled with people. They said because I had a high temperature and baby had now turned his head to the side I needed to be taken to theatre to try and turn him with forceps or if not then c section. My baby had low cord gases at birth so we were in for a week and they ran cultures? They said the cultures were fine but I'm very worried as he took a long time (to me anyway-maybe 1-2 mins) to cry etc)

No one really explained all this to me.

Was it my fault I had to go to theatre? I feel like I wasn't pushing enough as I kept being sick when I was trying to push. Also they said my epidural was still working but I remember feeling intense pain? Was I being dramatic? I remember in theatre they gave me something else (said my epidural was working and they were topping me up?) that was amazing!

Sorry for all the questions! I'm so grateful for my little boy as when he came out I really did think we had lost him and was quite a hysterical mess by all accounts but I'd just like to understand more about his birth.

Also! Sorry one more question! I saw upthread someone has bought gift cards for Midwife etc. I like that idea but wondered if individuals in the nhs are allowed to accept them? Wouldn't want to get them in trouble :-) but would 100000% like to thank them (and you!) for doing an amazing job!

@Offforanotherwalk

No, none of this was your fault. None of it. When you have an epidural it takes much longer for you to push out a baby when the baby is facing sideways. Assuming everything else is fine, best practice is to wait until the baby descends and turns before asking you to push. This can take two or three hours.

From what you say there was fetal distress. There was also your rise in temperature. Getting the baby out would have been a priority. There wasn't time to wait for the baby to descend in your case so forceps were applied in theatre - in case the forceps were unsuccessful and a CS was necessary.

Many babies are a bit shocked my a rotational forceps delivery so I wouldn't be too anxious about your baby's not crying for a couple of minutes. It's possible that you over-estimated how long it took for your baby to cry.

I think most women have a tendency to blame themselves when things don't go quite to plan but I cannot see that any of this was your fault. Can I suggest that you ask for a debrief so that everything can be fully explained to you by someone who has your notes to hand. This is so important when you have questions like this.

Gifts to staff are not permitted in the NHS but women do often show appreciation for specific members of staff. I've received plenty of gift vouchers and flowers over the years - and one wonderful man got me a recording of a piece of Bach that he knew I especially liked.

A box of biscuits/chox/cakes is always welcome on wards though.

Thank you so much for taking the time to reply :) it is a relief to know you think it was not my lack of pushing that led to the forceps etc!

I worried because they said the epidural was working and I felt it was not that I was a bit of a wuss 🙈

I have decided to buy the two midwives gift vouchers for the on site coffee shop so they can treat themselves and colleagues one shift :-) hope that's okay!

Thank you again!

I promise you that most patients don't give presents so getting vouchers for the on-site coffee shop will be a real treat.

Hello 👋🏻
I just wanted to ask about my blood loss in my first delivery.
I was induced at 38weeks due to a mature placenta (which I have since been told is a very flimsy reason to induce) Dd wasn’t ready to come, it took two full days and two pessary gels for mild contractions to start, and as that was taking so long the doctor decided on the hormone drip.
That sped things up and Dd was born on the third day of being in hospital.
She was born vaginally with foreceps. I lost 1litre of blood.
From what I have read that’s probably down to being induced. Is this correct?
I am due to give birth to dc2 any day now and for the past 4-5weeks my iron has been low 107 as opposed to 110, so not drastic, but the midwife did prescribe iron tablets and my iron count isn’t improving. Should I be concerned that I may end up losing that amount of blood again?

I had a really stressful time during my last pregnancy (failure to diagnose pre - eclampsia, prolonged failed induction, multiple painful examinations, lack of communication). Upshot is that I am having a planned CS this time. However, throughout this pregnancy I'm not being taken seriously by either my midwife/Obstetrician and they keep asking me if "I'm sure I don't want to VBAC".

Why don't they understand that no means no? They've agreed to CS, but I still have to see the Obstetrician at 28 weeks to "check I haven't changed my mind". What is driving this? In my practice, once the patient is informed and if they have capacity, I wouldn't dream of haranguing them.

OP. Sorry if you have already answered this question, only starting reading this today. Please can you signpost me to the evidence that supports your claim that almost all women prefer to be looked after a Midwife that has given birth herself. I would be very interested to read this. Thankyou

@Highfivemum

Your DH bought his friend in whilst you were in labour?????