Birth trauma - poor maternity tolerated as normal report says

[Justkeepswiimming]

Is this the experience of the majority?

www.bbc.co.uk/news/articles/c4n1jv7xxpwo?trk=public_post_comment-text

I think we all have pretty grim tales to tell of Birth experiences. From both our own experiences and those of our friends. Are the resources just not there to care? I had a wonderful Midwife who delivered my baby, but prior to that had to beg for someone to check me once I'd been induced because I was in agony. Was written off as being a wimp. They wouldn't check me. I was in tears in a shared ward, on my own trying to make no noise. When they finally checked me they realised I was far along and sent me to the labour ward.

The next day I was desperate to leave, after finding myself with a male midwife who didn't even introduce themselves before starting to express me. A horrid experience. All round.

I've read lots of awful stories, and wonder how we've got here.

I work in maternity as a mostly non-clinical midwife so I am aware of the terrible service many people receive. It isnt all about funding and cuts either.

However, some of the reported stories are either incorrectly interpeted by the journalists or the parents have left the birth with an inaccurate understanding of what occurred. What i can say is that the doubters within the system (the HCPs who dont think things are that bad) feel that this is proof of it being a media witchhunt and parents literally making it up.

You see many of the doubters say that birth trauma largely occurs in people who had unrealistic expectations about labour and birth. They dont explain why so many maternity staff experience birth trauma and/or PND, though.

@Mackmacking but if it isn't down to lack of resources what is it?

It's frightening that it has got to a full report like this! Some of the stories are horrific and I know they are the worst cases, my birth trauma has changed my life and I will be forever living with it. Things have definitely got to change as it can't just be the 'norm'.

As a first-time mum-to-be (I’m currently 13+6, so a way away from birth yet), the report is terrifying.

I’d already been considering asking for an ELCS after reading so much about posters’ experiences on here and from talking to friends about their births, but would be willing to give a vaginal birth a go on the understanding I’d be listened to, cared for, and if anything were to start going awry, I’d be able to ask for a CS at that point.

It doesn’t sound like that’s a realistic plan, from everything I’ve seen today, and so I’m back to considering ELCS as Plan A.

I’m so sorry to all those of you who went through traumatic births.

Over two pregnancies I was subject to lies ('you can't have that'), procedures without consent ('I've just broken your waters,' 'I always give my ladies the injection') as well as shoddy treatment ('I suppose I could send you for monitoring, it is viable' as well as the whole post-partum shit.) I felt both times that it was a fluke me and the babies survived in one piece.

I then had a independent midwife, who cost me less than my "care" in the NHS had financially cost the NHS, and who actually cared about the outcome. One mother, one midwife.

This doesn't surprise me. Maternity care is horrific in this country. My experience was traumatic, and I had no particular high hopes or unrealistic expectations.

That is really terrifying to read. I had my baby girl 3 weeks ago and I have to say my experience during induction, labour and on the postnatal ward afterwards was absolutely amazing I genuinely could not have asked for better, the care we received was brilliant despite my birth not going the way I hoped it would (ended up in forceps delivery and a few complications) I always felt completely supported. I didn’t realise that was actually not the norm and how incredibly lucky I have been!

The report is quite shocking. If you look at the map of maternity units and their CQC rating it seems very clear that over half of units are inadequate or requiring improvement, and that good/outstanding units are disproportionately distributed to London hospitals.

Sadly I'm not at all surprised. My first born was a super experience with an old school midwife who knew her stuff - was like having my mother by my side. The second time round in the same hospital was horrific and something I'll never forget. The icing on the cake was I was unable to actually leave the delivery room for 24 hrs after - with no explanation, wired up to a drip and had no clue what was happening. My husband had the baby in his arms for over 6 hours as there was no cot available! Weeks later I asked to see the recorded notes of that night (Halloween I kid you not).. many requests were made, the notes vanished. 🤨 that was my last child.

This report is shocking, I can also understand how some of the HCP feel it is very critical of them as well perhaps, given their constraints of money and staffing, but I do think it's also about good leadership around communication and basic standards of caring for and speaking with patients. I've experienced good and bad on this front, and it isn't all about resources.

I was made to feel like an idiot on the maternity ward because my baby wasn't latching. Turns out he had severe anterior and posterior tongue tie.

I havent had children (by choice) but have been on this site for nearly thirteen years and have been horrified by what ive read on here This one really stuck and its from two years ago.

https://www.mumsnet.com/talk/am_i_being_unreasonable/4549623-post-birth-trauma-severe-damage-to-rectal-area

@Hubblebubble both mine had tongue ties. For the second, I asked them to snip it in the hospital knowing how difficult it would be at home, the NICE guidance stating this had just come out, and they said no-one had the expertise to do it, so I just had to go home with a baby with a tongue tie- the latch was agony. Had it done privately about 6 weeks later.

I strongly encourage all pregnant women to look up Samantha Doula Gadsden on Facebook. She is a women's activist, birth activist and all round super heroine.

Its not just births either, There is a thread running at the moment about hysteroscopies and how painful they are and yet general anasthetic is seen as optional

I had two uneventful births with great care. My last was only last year. Try not to worry too much( I know it’s easier said than done) people tend to complain more about negative experiences than report positives!

I had two very uncomplicated births, but some of the staff were really unpleasant to me during my first birth. Happily, the midwife I had for my second birth was really lovely and absolutely brilliant at her job. The notable difference is probably that for my second birth I was never admitted to the postnatal ward, just went straight home. But the staff in triage were quite rude, especially for my first birth.

They were adamant that there was no way I was in established labour. Lots of condescending head tilts and "oh dear if you think this is bad wait until it actually starts".

It was a very satisfying moment when, after being left in the waiting room for ages, a midwife came to examine me in triage, saying "I can tell just by looking at you that you're not in labour yet, you're not in enough pain". I kept saying "I assure you, I'm in a lot of pain!" but she just kept chuckling. She popped down below to examine me, and she didn't even make eye contact when she had to tell me that that I was actually 7cm dilated and would be admitted immediately

I don't know why they get so judging of pain - years ago the midwives we had for antenatal classes said that it was not how painful it was, but how close the contractions were that gave you a clue as to when you were closer to delivery.

Surely if it is painful and a long way from delivery, that is what pain relief is for?

"A male midwife who didn't even introduce himself before starting to express me"

Are you saying this man touched your breasts? That's absolutely horrific and sexual assault if so.

The main issue I have had is midwives not believing I was about to have a baby because I wasn't screaming my head off. Yes it hurt, but I'm very laid back in general and had done hypnobirthing so felt totally in control. Meant that my second baby's head came out with no midwife in the room - my partner had to run out shouting for help. I had told the midwife about five mins before that I was ready to push...but she clearly didn't believe me.

For the poster considering a c section - the worst horror stories I've heard are from people who have had them, been in pain after and haven't had help to pick their babies up so they have just screamed. I didn't actually put my baby in a cot while I was in hospital, but if you do need to I'd definitely aim for a vaginal birth as at least you can bend in the middle. But the main thing is that people tell bad stories much more readily than the good - it's how they process them. For my first I had an episiotomy, a large pph, a crash team and I'd still count it as a good birth as I'm not traumatised by it and the medical team responded appropriately.

Can I ask how you found them and how much it cost? Were they allowed to attend your birth or did they count as a birthing partner etc?

Lack of resources is a huge issue. Dont get me wrong.

Aside from that, I think there is an issue with how student nurses, midwives and junior doctors are trained. They are very good at passing exams (thanks to extensive tutoring from year 4 in passing assessments). They arent as good at applying information to real time patients.

They very quickly start taking short cuts. Maybe because they are overworked. I think perhaps they try and learn the instincts a senior midwife has developed over 40 plus years.

For instance, at my former unit, over 20 years, the number of unplanned births outside the Unit (BBAs) had risen substantially. A quick audit of recent BBAs showed that nearly 3/4 had called or presented to the unit for assessment and been told to not come in yet/go home. I remember seeing more than one set of recent notes where the midwife had recorded information that would point towards a rapidly progressing labour, but theyd sent them home because they werent 4cm and having "strong, regular" contractions.

And you know the labour admission "rules" do say that people should meet that criteria before being admitted. Why? Because otherwise someone who is about to give birth or who needs very close monitoring may not have a room.

But labour is so hard to predict. Progress is not always linear. And you will have to justify why you said someone can have a labour room at 2cm dilated. If they dont progress, you may have to move them out of the room and onto a ward.

What else? Fear of escalating to doctors. Some are arseholes and have a go at midwives if they think it is unnecessary. Also, as a midwife, sometimes you want back obstetric back up and suggestions but you dont want to just move to a section or forceps because it isnt necessary. There are some doctors that create a dynamic where you know that the minute you get them involved, they will just "get baby out". And im stressing this part: even when it is not necessary.

There have definitely been times where physical and mental trauma has occurred just because a doctor is an arsehole at work.

Some young doctors are intimidated by an assertive, experienced nursing/midwifery team. Particularly new registrars. They will go as far as to ignore them pointing out something pertinent just so as not to admit defeat. One of my favourite paediatricians tells all doctors and students that midwives see the most babies and thousands of healthy babies so their instinct is worth more than his consultancy. And it is true. You only have to say "this baby needs to be in the NNU or needs antibiotics" and he will be on it immediately.

Lastly, and I tell all midwives this: documentation. Sometimes bad things happen despite all seeming well. We can only know that in hindsight if you document it. Many HCPs do not document efficiently. Not understanding the technology is a problem here. The other thing is that a lot of informal consultations between staff about patients happens during a shift. You might tell a doctor that something is amiss and they say it is ok. Later, that thing is related to a tragedy. You didnt document that Dr Shitt said it was ok and nobody is backing you up now so it looks like you dropped the ball.

Remember this in relation to the fact that doctors are male, and most midwives and nurses are female.

I had two births in New Zealand and two here. I don't think there was a lot of difference between them although this was 20+ years ago.

I submitted my story (not one of the ones featured in the report) and I feel oddly comforted to read other peoples experiences. Obviously it's awful but I feel less alone to read such similar themes.

On paper mine wasn't as traumatic as a lot of the ones here. Everything worked out in the end. But my experience of pregnancy, birth and postnatal care has made me terrified of having another.

I genuinely thought we were both going to die and being repeatedly dismissed, ignored and even mocked when I felt so desperate... I still struggle thinking about it.

Combined with being repeatedly dismissed about my sons CMPA as a newborn, and the awful hours of him screaming in pain, and it's made me want to just stick to one and done. I feel sad as I wanted more but I don't ever want to feel so out of control and alone again.

I sorted out a load of all newborn clothes the other day and I had no emotion at all. I barely even remember those first few months.

Luckily I love having my toddler and if I could just click my fingers and have a few more of those I happily would.

Could anyone please explain now to see the map referenced in a PP?

I had my first child in another European country, younger children born in the UK. I must say the standards of care are rather low here, with women having low expectations, not questioning and accepting things- understandably as it’s the only service they know. During my second pregnancy in the UK I overheard two midwives saying that European, particularly Eastern European women have unrealistic expectations and are too demanding, expecting consultant-led care, monthly ultrasound, 24hr support line for emergencies, admissions to hospital for “normal” pregnancy issues, 2-3 days recovery in hospital after delivery. I had access to all these things in my country of origin as standard. Fair enough, things are done differently here -I accept it, but I personally think it’s less safe. It’s all ok when you have an easy, uncomplicated pregnancy but when things go wrong it’s not great.