I'm a midwife, ask me anything

[MidwifeAMA]

Midwife of 20 years, currently specialising in home birth.
Ask me anything :)

If it was from the epis its really unlikely to happen again, it's a massive fluke, hit a vessel.

If you've had a haemorrhage before from your uterus, that's more likely to reoccur although still much more likely that it won't.

What do you think about induction for bring overdue? I tried really hard to resist induction but eventually had one at 42 weeks. Baby was born about 24 hours after it started (they gave me a pessary) - I'm not sure if the induction even worked or if he would have been born that night anyway.

being*

Have you ever delivered twins at a home birth? I had DCDA twins (not first baby) and my home birth option quickly changed after 12 week scan to fairly non-negotiable hospital birth so I’m intrigued if it happens!

After two uncomplicated vaginal births, my third was an EMCS. I naturally labour very quickly and with my third I ended up opting for an induction due to reduced movements and 24+ hours since waters went.
After the pessary went in labour came on incredibly quickly, but midwives didn't listen when I told them and asked for the pessary to be removed. After 3 hours I knew baby's head was there and was pushing etc but nothing happened (with my second I pushed him out in 1!) Midwives stood by and watched this for 40 minutes, until one examined me and realised baby was stuck face first. They put monitors on me and his heart rate was v low, EMCS quickly took place less than 5 minutes later with the incision beginning before I was under.

My question is - I suspect the positioning of my DC was caused by the intensity of labour because of the pessary. I'm not sure if he would have been in the same position had the midwives listened to me, and had the pessary been removed and my final stages of labour been more controlled and natural. Is this me making up a fantasy or is there science behind it? The birth was incredibly traumatic and I have thought about it more than I probably should.

There is a slight increase risk of the placenta starting to work less effectively later in pregnancy hence the offer for iol. There is also some thought that iol can reduced CS rate but I'm Not sure I'm convinced on that one.
These are small risks though, and have to be balanced with the risks of iol, birthing on a consultant unit, etc so you have to gather lots of info and go with what feels the best fit for you. Risk is very individual.

www.aims.org.uk/journal/item/induction-at-term

Does morphine slow down labour?

My waters broke 31st Dec and I was sent home to wait for ward for induction, this was stretched out quite the wait and it was about 36 hours before I got taken through. I did take morphine as the contraction pain was sore but as I wasn't 4cm I was left in triage

(They were super busy)
Epidural also failed, I got to 10cm but it was decided as it had been so long and there was still a bit of cervix in the way that I needed an emergency section which is what happened

I always wonder if things were able to be handled differently on the day could it have had a different outcome

Not me personally but it does happen although rarely because there are some definite additional risks with a twin birth and being near doctors, neonatal teams etc provide a good safety net in situations where they are more likely to be needed.

Sounds awful.
If I'm honest, I think if he was a face presentation he probably entered the pelvis like this, it's less likely for them to get into this position in labour as it's such a big extension of the neck. Most likely he came down in the funny position but the intensity of an artificially ramped up labour put some additional pressure on him so his heart rate responded.

Just wanted to know what you know about bandls ring and if you've ever seen in?

It was discovered when I ultimately ended up having a CS. I was just told in recovery that's why my labour was obstructed but no other information given and I'm struggling to find more information about it online!🙃

I've not read all the thread yet, in case this has already been asked... are you ever surprised or taken aback by any unsightly vaginas ? You did say ama.

I don't think there's any evidence to suggest morphine slows down labour.

There could be some bits to unpick-
Early breaking of waters before labour is more common when baby isn't in a great position, so where they are back to back if a bit on the wonk. This in itself can mean labour progress is a bit trickier, particularly when you have an epidural on board which means it's harder to stay active and jiggle the baby in to a good position. It's s guess of course but quite s common scenario.
I'd recommend everyone trying to get a birth debrief as it helps so much to process and gain clarity.

Saw one once, baby just couldn't get down in the pelvis. She had a Cs. Second baby straight forward vaginal birth, very interesting. Very uncommon, we hardly see it.

Can you talk me through the training and then what a week in the life looks like?

I've just had my second baby and once I've (hopefully) had a third in a few years time I'm considering training as a midwife - I'll be early thirties with hopefully 3 in primary school. Is it doable? I love being there for my children so not sure it's the right career for that but I really love the idea of helping pregnant women.

Honestly it's just body bits. It's like ears, they are all a bit different but essentially the same. We don't pay a lot of attention to them, unless maybe you've vajazzled or something.

Thank you so much! I had no idea what to expect and it's next week. I'm hoping the induction goes smoothly and not too long.

You do get some that are interesting though- I've had ladies with vaginas where they have two openings or a bit of flesh across. Little bit trickier to navigate for baby .
Sometimes two separate vaginas, with two cervices, interesting!

I won't lie, it's really really intense and will give you all the mum guilt. But it's three years, you show your kids great work ethic and aspiration. And you deserve to chase your dreams.

40 hours of practical placement plus going home and writing essays. It's intense

"Thank you so much! I had no idea what to expect and it's next week. I'm hoping the induction goes smoothly and not too long."

Make sure someone has explained the whole process to you, you can't fully consent unless you know what you are signing up for. Hope it all goes well for you x

Can you tell me if you are positive for strep B during pregnancy should your baby be given antibiotics once born even if by c section or is it only if vaginal birth?

We'd recommend that you have Iv antibiotics in labour which offers protection to baby. Baby wouldn't need them as a preventative if they are well. CS you don't need them

That was a lot of questions, but thanks for engaging it's great

Yeah seems to be super rare - my community midwife of 30+ years hadn't even heard of it!

Does it come about because labour is failing to progress or does labour fail to progress because there is a bandls ring?

Thank you so much for answering something I've had in my head for 2 years!! How common is face presentation and is it possible to deliver vaginally?

I think it's a bit chicken or egg, is it the cause of a long labour or caused by the long labour. There's not a ton of info I think. Bevause it's so rare.