Hi sorry, busy day. I’m going to try to keep it quick to try to answer all. Please come back to me if I miss anything.
Some midwives have become desensitised to what a massive, vulnerable experience childbirth is. I think the reasons behind it are complex. Some it’s because they are jaded, exhausted and demoralised from working in the current climate. Some I think it’s self preservation- they have high standards but are continually broken hearted over not being able to provide the care they want and so they emotionally distance themselves so they don’t finish every day feeling like they have failed, sometimes it’s other things going on in their lives. Endless rounds of IVF, failed relationships, etc.
And for a handful- they are just bitches. And should fuck off somewhere else. I’m massively aware of it, drum it into anyone who will listen, especially students. Compassion is everything.
Entonox and B12- interesting. My knowledge is limited, my understanding was that prolonged >24 hrs use or the heavy duty use in anaesthetics could be an issue for vulnerable people , but I’ve never seen cautions for labour analgesia. The BNF is our go to guide.
Home dopplers are a worry. Much of what you can hear is blood flow, maternal circulation etc. Worrying Changes can be brief, dips in heart rate than come and go. Listening to a tap tap tap with little background knowledge doesn’t tell anything about baby’s wellbeing, and so can provide false reassurance. Best avoided. Learn your baby’s ‘normal’ call if you feel it has changed.
Mixed sex postnatal wards? Do you mean partners staying? I feel a bit uncomfortable with it but it seems to have been successful in our hospital. Women seem to like it, postnatal care can be patchy and it’s understandable they want quality, constant support from a loved one. Men have been pretty respectful and the midwives very strict about their conduct. I do see why it’s a worry though. You’d have to see if the private options where you are would meet your needs better. Private care here wouldn’t offer a private room as there’s not enough available, they are allocated on need.
VBAC v ELCS is a difficult call. For me, I’d want to explore the first labour and why it ended as it did. This gives some insight into whether it’s likely to be a repeat issue. For example, If it was a long labour due to a malposition, like a back to back baby, and you got to 8cm it’s most likely you’ll have a much easier, faster journey this time.
Have a good debrief if you can.
Traumatic births are seemingly so commonplace these days, and yet so under supported. Postnatal services have been so under valued and resources that once you’ve both made it there in one piece you are so quickly expectiled to be gaining independence and moving on. It’s a really sad state of affairs, a reflection of the current nhs funding crisis. I’m so sorry :( I’d recommend seeing if your hospital has a birth reflections service, have a good debrief. Look into the birth trauma association online too, they are excellent.
TROOPERS I’m so so sorry for your loss. I’m pleased you were shown the compassion you deserved. Your Midwife will always remember you and your baby. She will have been so so pleased with that card.
BREECH birth vaginally dropped way off the radar for many years after a slightly crappy research saying it was dangerous. Women were rail roared into CS and not counselled well. Recently this has started to improve and it might be the knock in effect is that people wereso keen to ensure you knew you had choices that everyone mentioned l. Also, when women progress really quickly that’s usually a positive sign for the success of a vagina breech birth, and so they probably were trying to say that the felt you had a really good chance of having a vaginal birth and avoiding the complications of section. It can also complicate the CS if the labour has progressed quickly and the baby decended, almost a pushing the baby back in scenario. I’m sorry you felt they overstepped. Each person probably thought they were offering you a new perspective but didn’t realise that lots of people had also done it and you were understandably feeling harassed.
I don’t feel women have too much choice, I’m not sure there’s such a thing. But I do feel expectations v reality causes a lot of trauma for women. I work in a midwife led birth unit and in my practice I often see women who are really really well educated in what to expect but also develop a rigidity of their birth plan. Those women really struggle if the birth doesn’t go to plan as they are almost conditioned to think that if they do everything ‘right’ it’ll be a breeze. So many factors are at play, we can’t control birth, and that’s a huge weight to feel you’ve failed in giving birth. Really sad. Better postnatal support would be the ideal, but also access to really good quality Midwife led antenatal education. Some of the antenatal classes lack balance and experience of the realities of birth.