I’m a midwife AMA

[Doubleyouexwhyandzed]

I’m a midwife, with 15 years experience. AMA

I’m not a midwife but I don’t think there are necessarily more traumatic births now than before - not judging by stories I hear from older relatives.

I do think women are more likely to admit to finding birth traumatic, that there is more openness about it, and that there are also expectations around birth beyond simply surviving it. I also think women expect to be consulted on their care and to be involved in the decision-making process and sometimes that doesn’t happen to the extent it should or they women would like/may have been led to expect.

Sorry, posted too soon! Would be interested to know what you think, OP, as well as others.

Is Cephalopelvic disproportion an actual thing? I was told by the doctors after dc1 that I'd probably never manage to give birth to a term baby because my pelvis is too flat. The community midwives with dc2 told me that "different baby, different labour" etc etc and of course so many people I know have trotted out "your body won't grow a baby it can't birth" etc.

Dc1 started back to back but rotated during labour into what was described as an optimal position. I pushed, I changed position, they tried forceps and he never moved lower than mid pelvis. Was eventually delivered by emcs.

Dc2 went into labour ahead of my elective date. Thought she was back to back due to location of pain. Turns out she was optimally positioned from the start, I was just contracting in my back/pelvis which the consultant said was a further indication of my rubbish pelvis. Delivered by emcs again.

Also do you think the language of birth helps contribute to the way women feel about it? With my first, everything had failure plastered all over it. Failed forceps, failure to descend, failed vaginal birth...I had a bit of breakdown (various factors including losing consciousness on the operating table for a bit, dc1 needing nicu) and couldn't accept what happened as giving birth. Even now, 5 years later and another baby, I don't consider myself to have given birth because it was made so clear to me in those first few days that I'd failed ds.

I remember the birth trauma association saying they get women in their 70s who are still suffering from trauma from giving birth half a century ago. Shows how long-lasting birth trauma is, and also that it’s always happened- we just talk about it more now. Same with postnatal depression.

Yes you don't forget trauma. My mum recalls labour with my sister (her worst) still. And still remembers 30 years later how a registrar gave her a really painful internal examination. Things like that stick with you.

@princesshoneysuckle

I'm definitely teary a lot and have trouble switching off but I'm hoping it's just a bit of bad anxiety.

I have called the doctors this morning though as I need to sort out my contraception anyway and so I will be mentioning it to them then. Not ideal though when the first appointment they could offer me was March 31st.

The NHS is just so underfunded in so many areas and it has a real impact on so many people.

If it weren't for the fact I need the appointment to get contraception sorted I'd probably have told them this morning not to worry about an appointment if it's a 6 week wait....i guess if I can get through the next 6 weeks there's probably not a lot a dr can do that I can't do for myself.

@annie9876, definitely ask regardless of the six week wait - there’s lots that can be done to help. Don’t leave it as long as I did! Especially if you want a second child but don’t think you could ever go through birth again (like I felt - I have just had a second baby 4.5 years after the first and it has been a very healing experience).

@Doubleyouexwhyandzed, I’d be interested to know how common it is to not go into labour by 42 weeks and why you think this might be. I’ve had two babies, failed to go into labour with either of them and failed to respond to induction drugs with the first (straight to section with second). I’m curious as to why I don’t seem to go into labour and what would have happened without medical intervention, whether I just cook ‘em for longer or what.

Thank you for answering my questions.

My first was born by EMCS at 28 weeks (she was a footling breech). My second was born by VBAC at 33 weeks. I'm pregnant and hoping for a VBAC again this time around. Obviously this is something I will discuss with my obstetrician nearer the time, but if I were to go full term this time, is there any way I'd be able to have a water birth, having had one successful VBAC already? Or as I've had one caesarean, is constant monitoring still necessary?

How do you feel about c-section post care?

Personally, I'm amazed by the difference in treatment of c-section patients vs those who underwent another major operation. My local hospital discharges c-section patients after 2 nights. In my ward c-section mum's got very little additional help with the baby after their partners went home - I've had one and really struggled with pain in reaching the baby during the first night and utter exhaustion after a cocktail of drugs.

Hi
I'm hoping to train as a doula but ,as I work full time, its unlklkey I'll be able to be "on call" for a couple for the foreseeable future.

Im already a "general" volunteer
at my local hospital, Maybe I could also be available at the weekend for ant births that could do with a bit of extra support/ very busy times.
I would be able to stay for the duration of a birth as I do not have fixed commitments at home.

Would I be considered a menace/ nuisance or could I be of help e.g. helping a vulnerable mother with simple things like massage / changes of position / emotional support.

What could I do/ what could I offer that would actually help on the labour ward.

And, more importantly, what should I not do?

What could I say to the head of midwifery that might sway opinion towards my idea?

Thanks

My first baby, I went from 2 to 9 cms in a couple of hours. I had to do two 25 mins hospital trips in that time, with the second one only after the midwife on the phone told me not to come in, it would be ages yet. Came in anyway and my baby was
born pretty sharpish. I'm keen on a home birth for the next one - no interventions were needed in my first labour, 2nd degree tear but healed well. My biggest gripe was the dismissive attitude of the midwife and I felt like she was almost annoyed that I was 9cm when I had to persuade her to even examine me, like she was irritated as she'd misjudged it. Hence me wanting a home birth. What do you think of them? My partner isn't keen as I think he worries that something may go wrong. How often do things go wrong with home births and they aren't picked up quickly enough?

Have you read Adam Kays This is going to hurt and if so, what were your thoughts?

Do midwives in different roles receive different levels of training (I found midwives doing pre natal checks lovely, as were the two during my labour, but the ones doing admissions and aftercare to be the complete opposite!)

How do they know the healing times of tears/episiotomy stitches etc, when there's no post natal check ups unless you book one yourself due to issues?

Why do you make women fill out birth plans, when it seems to just build unrealistic expectations? I genuinely can't see the point.

Thanks for all the work you do

4 weeks lost c section. Found nasty massive lump under muffin top above scar. I am very squeamish. What is it and should I be worried?

My question is from a bit of a different perspective to the others. I'm a new student midwife and I'm yet to do a placement. I'm pretty nervous for my first one, any tips on how to try and be prepared and not worried? I'm worried that I won't know what to do as I won't have had much theory by then and it being my first placement, and then I'll end up just getting in everyone's way.
Thanks

My question: is it normal 14 years after giving birth to my lovely DD to remember the horrific trauma that was her birth every single day? I do try not to think about it. She was 17days late, 10lb10oz and had shoulder dystocia which led to a crowded, alarm-ringing, people-shouting birth room with blood seemingly splashing on the floor where the pain (despite an epidural) was horrific. It felt like someone was trying to pull a portable telly out of me!
My continual guilt is that when the midwife asked "did I want to hold her?" I said no and turned away. Because I felt like my world had ended in blood and agony and all I wanted to do was stare at the wall. I ended up with PND.
I had a subsequent C-section for my now aged 12 DS (I demanded this from the start!) which was just beautiful and calm, he was 12 days early and already 9lb11oz! My guilt for his birth was that when he was wrapped and handed to me I said "oh, he smells funny" and I have no idea why I said it!
Do many new mums say strange things?

Are you dual trained?
Are you a community midwife, independent or hospital?
In your experience, how are doulas perceived to medically trained professionals?

Hi
I had my baby almost 7months ago,had to be induced at 36weeks,and it didn't work I was in hospital from Monday and on Thursday night they decided they would give me a csec the next day, couldn't have been happier but on the day they still tried to break my waters instead of going on with the c-sec.
Anyway insisted I wanted it to be done I was in tears by that point and they finally gave in and took me to theater.
All was going okay had my baby then the lady that done the c-sec comes up to me after she finished to congratulate me and then she told me Ohh it was good that you insisted to have the c-sec as it wouldve been a really hard birth and I had to use forceps to take the baby out.
As I was so all over the place didn't even cross my mind to ask her why did she have to use it,she didn't even ask me or my husband if we agree,that was something I always told my husband that I wanted to avoid and it still happened,baby was all bruised from it and all...anyway...that was way to long..my question is do you have any idea what mightve been the cause or reason as to why they had to use forceps..I keep Googling to find out but I can't find anything about it.

And also thank you!

Promise I’ll come answer these soon but half term chaos in progress

Not a question but just want to say thank you for doing such an amazing job. My midwives were great during both my labour's and made me feel so calm and safe.
I'll never forget either, you are all fantastic ❤️

Oxytocin making labour faster- it can do if it’s used quite aggressively, but my experience would say that if you laboured quickly with the oxytocin you would probably labour quickly without it next time anyway. Most likely your body just works like that.

Sorry to hear about your birth in the car, how scary. We know women who have precipitate labours are more likely to bleed heavily after as your uterus can be so exhausted from its labour that it doesn’t contract as well afterwards to stop the bleeding. The third degree tear may have been due to a fast birth without midwife offering support to the area and guidance to you. Home birth is worth considering- depending on how much blood loss there was. If it was lots and lots it would be safer to be in hospital in case it recurs, but it it was a moderate loss then a homebirth with a midwife might be the safer route to avoid another baby born in hospital. Either way a midwife would advise you come in/be seen at the first signs of labour to avoid a repeat unattended birth. If your year has healed well and you are not suffering ongoing problems then a vaginal birth is still a good option, they don’t often reoccur particularly if it’s likely caused by a rapid birth that could be better managed in future.

GBS testing still very debatable. It comes and goes, we can test for it at 36 weeks but it may well not be present at birth. The tests take a couple of days to get a result so testing in labour would be less useful. I’m not sure how I feel about it. We take GBS positive women on our birth unit and they have IV antibiotics but otherwise low risk care. Some places being GBS positive would mean consultant unit care and for me I would have to carefully way up the benefits of the antibiotics versus the negatives of birthing in a delivery suite.

** i meant to avoid another baby born in the car (not hospital)

VBAC I’ve never heard the statistic suggesting a 4% chance of successful VBAC. I’m wondering where they got that from?! You might find more information on the RCOG website. But in my experience you would be much more likely to have a vaginal birth than 4%. Personally I would be keen to give it a go, but of course it’s up to what you feel is right for you.

Big pph is more likely to recur but also it’s worth looking at possible reasons for the bleed. For example,if you had the hormone drip/a low placenta/ a really long labour these could be risk factors for a pph which may not apply next time. Depending on how big a pph it was you may need consultant care next time or may not. We have women in our birthing unit as long as it was less than 1litre last time. We’d recommend active management of the third stage to try to reduce the risk of pph.
Pre eclampsia is more common if you’ve had it before and would be more closely monitored in pregnancy. Locally we offer aspirin in pregnancy, more frequent antenatal checks etc. PET can be linked to the baby’s father also, so different dad can make it more or less likely.

Fave birth stories... I have a few but they’d be a bit outing I think. Lots of exciting stuff happens when babies are born.

Hi! First of all, thanks for all you do.

Secondly, when my youngest was born (in an amazingly perfect homebirth) the midwife said the placenta looked like a smoker's one. I have never smoked. What does that mean, and if my baby hadn't come when she did could that have been bad for her?