In labour - need urgent advice!

[Ineedadvicee]

Well.. kinda in labour, kinda not!

Waters broke 27 hours ago, arrived at the hospital shortly after they broke but contractions failed to start. The hospital said that if nothing happens in 24 hours (24 hours after works breaking), they will start the oxytocin drip to get things moving. Apparently they can only allow 24 hours as you are more prone to infection once waters have gone.

Problem is… the 24 hours are up but there are no beds on labour ward so they want to take me in for a c section. I’m gutted because I haven’t even been given the chance to try for a vaginal birth… of course I need to follow their advice but it seems so unfair that the reason for the c section is purely down to lack of beds, not because of anything medical?

I don’t know what to do…

Congratulations! You know, with that weight it was probably always going to be a c-section. You're both well and that is the most important thing.

Congratulations OP! It can feel lonely on the maternity ward. Just remember you and bubba have each other. He doesn’t need anything except you to hold him. But I understand it must feel scary and frustrating not being able to move. I hope you get some rest.

Oh - one tip - I was exhausted from the long induction + pre-induction process and found it hard to not fall asleep. One very helpful midwife helped me get positioned into side-lying C curl rather than having baby on my chest and slipping - perhaps chat with someone about what's best in your situation?

Congratulations op. Enjoy your baby and rest up. At least you are both well.

No. I'd nicely tell them that I am not having major surgery because of their issues. Get me a room and a midwife. Idon't care if it's in orthopaedics

Congratulations on the arrival of your beautiful little boy!

what a horrible and frustrating experience for you. But just to put your mind at rest I had a the drip as I was very overdue and ended up having a section anyway. The drip was horrendous and as they were so busy they couldn’t get an anaesthetist in so they gave it to me without pain relief which was torture and apparently they should never have done that. My husband actually rang his mum crying (I didn’t know this til after ) as he thought me and the baby were going to die. It was so traumatic. I then ended up in theatre as the baby was in so much distress, heart rate dropping scarily low then going really high. I was also very disappointed with my birth experience. I had done hypnobirthing and wanted a water birth etc (don’t we all!),

We ended up having a meeting with a senior midwife about two weeks later. I also put a formal complaint into PALS. There were a lot of issues not just those mentioned above. Talking it out and feeling heard did actually really help.

my baby was beautiful and healthy, my recovery was very straightforward even after the trauma, and I was lucky to have no issues with breastfeeding. I also had an amazing pregnancy. So in my full pregnancy - birth - recovery- parenting journey the birth itself was such a small part of it that I’ve totally made peace with it now and am just grateful that I was so lucky with all other aspects.

I did have a VBAC two years later with my son and it really was no walk in the park and actually I probably had more post birth issues from that than the section.

it is quite bleak in hospital overnight, that’s the worst part, but you will be home in a day or two. Get your husband to bring you fresh fruit and nice things from M&S!

wishing you all the best for a quick recovery.

They have to do paperwork for a C-section. Elective or emergency. Your situation is neither. Wonder how they'd explain that as there are only two forms.

Congratulations!! I love Theo!
I had the drip and believe me you...it was so intense! Ended up in a C-section as the dilation didn't progress and I didn't want to have a baby in distress. You did really well and you have a healthy boy in your arms.
Please be proud of yourself that you managed to give birth to a healthy boy, you will recover and soon enough the birth will be a distant menory. X

Congratulations! 💐
Theo, Noah and Isaac are all lovely names (Theo is my fave). But after all you've been through, I'd say you deserve to have the name you want.

When did this become the norm, I wonder? All these mid/late 20th century TV programmes about birth suggest that women were welcomed in, and that they were never overwhelmed. Only TV? Older women I've known also say that was the case in real-life, but every one of my friends got told how busy the hospitals are when they went in to give birth in the last couple of decades-and that's in a lot of different hospitals! I'm not happy when today's women get the blame for being older/not as fit/more demanding than women in the past. Services need to improve, and I'm sorry for everyone turned away when in labour/not able to have the birth they wanted for reasons like OP.

Congratulations and it now sounds as though a csection was serendipitous.

If you need help @Ineedadvicee you have every right to expect it and I'd venture you should be quite firm. Any hint of delay or tutting, a very soft but hard "I agreed to a caesarean because you didn't have a bed and to suit the maternity unit, I now expect the care I need to recover and support my baby." Any hint of an eyeroll, ask to speak to whoever has oversight of the Trust overnight.

You had been there 24 hours and they admitted mothers to the labour ward knowing the urgency of your situation?

Why didn't they transfer the other mothers, so that a place would be ready for you to give birth in the labour ward?

It isn't as though you turned up too late. They knew you were there.

Theodore or Theophilus?

See how it rolls off the tongue when you say the names together, or better still, perhaps wait another week and see if he looks like your idea of a Theo?

I think a lot of the posts on here have focussed on the 'bed on labour ward not available' aspect, but in reality, it's not the bed is it? It's the availability of the care team that is spread out across the beds. So when the beds are all full, there's not going to be a spare midwife floating around twiddling her thumbs to take a mother off to some other random ward to deliver!

I'm sure OP will be doing plenty of reflecting on the last 48 hours, and I hope she's able to make full use of whatever debrief service her trust offers.

But honestly, it sounds like you've had a bit of a get-out-of-jail-free card from the perspective now available of 20-20 hindsight...

No-one would want to be in a position of not being given a chance to labour & to have a section instead if they could help it. BUT no contractions had started at all spontaneously, even with many more hours waiting for the delivery (a caesarean, as it happened in the end). It's not just about beds because inductions require close monitoring by the team to check baby isn't suddenly descending into distress, heartrate problems etc & dose is being managed and adjusted effectively so contractions not too insane.

Midwives are typically juggling several early stage labours in different beds. One-to-one care throughout is not typical. It was decent of the hospital to be up front about the increased risks it would present to care if OP had continued to await contractions & then had a lower ratio of care than they would like to provide. No-one would want declining baby vitals to be missed because of longer gaps between check ins. No-one would want a developing infection to be left longer without being picked up.

As it was, I hope the pause to wait for theatres has allowed you to reconcile a little OP, that baby was unlikely to just drop of his own accord. And 36 hours of painful labouring on an induction drip, followed by an episiotomy and forceps delivery wouldn't have been a great outcome for either of you (and it does look like this would have been a significantly likely outcome).

As it is, you've got a neat surgical scar you need to respect in these first couple of weeks & ask for all the help you can get with lifting baby, EVERY time! But the recovery and long-term impact on SO, SO many more muscles is likely to far worse delivering a 9+ pound baby after a slow/long labour.

So if you can focus on aaaall the positives of having your baby boy here safe with you now @Ineedadvicee, I would absolutely recommend that over beating yourself up over what you thought could or should have been, you'll be in such a good place for moving forward & letting a busy day on the ward being just one tiny part of the story, not the overriding element your focus keeps swinging back to.

Wishing you all the very best with your happy, healthy boy, Mama!

As a lady of a certain age, the name Theophilus makes me think of Lenny Henry head to toe in leather as Theophilus T Wildebeast!

I agree broadly with what you are saying. I'm a former NHS nurse. They should have been doing their utmost to get her a "bed" in another unit. We don't know if they did try, From what the OP is saying that is not the case. . To attempt to impose a major surgery on someone astounds me. Consent send to be overlooked here . If they have done everything possible to locate a place for her in another unit and they are also full, then that is a different matter
I think many people forget that a Caesarean section is MAJOR surgery. It still astounds me that women undergo this and 24 glad player are sent home. To look after baby. Whilst they are supposed to be resting and recovering from this surgery. "Don't lift anything heavy" ( ? Over 10 lbs). Be careful how you bend and lift things - wriggling baby in and out of cot, pram etc. make sure to rest, eat - I and drink a lot if you are breastfeeding. And remember. Rest to heal and recover and whatever you do, don't do anything which will cause damage to your healing abdominal tissues . And men get diazepam and cat amounts of sympathy for a vasectomy - very minor allergy t, but I digress.
There are also significant risks to further pregnancy and childbirth at a Caesarean. And something I only learnt any recent so I the don't know much about it - the incision in the uterus means there can be invasion of the uterus by the uterine lining tissues.
( If something can weigh in here and describe the actual process in gaining to describe i would be most grateful!).
So .. There are many things to be considered. I had a Caesarean myself. My son was in a flexed breech position and we would have both died, so I am behind grateful that this is available. But never to be entered into lightly, or because the NHS can't get it act together

There is a whole lot about him in Wikipedia. My late husband was a renouned theologian who wrote a commentary on St. Luke. He had several Masters degrees and prizes from Queens Oxford. I just could not resist putting the name in the post. To save time I have copied this from Ai:

• Theophilus is addressed in the opening verses of the Gospel of Luke and the Acts of the Apostles, suggesting he was someone of importance to whom the author wanted to provide a detailed account of Jesus and the early church.
• The identity of this Theophilus is not definitively known, but he may have been a Roman official or a potential convert who commissioned the work.

If she had been in the hospital 24 hours and they knew she was there, waiting for delivery room availability, why did they admit new patients, rather than sending them elsewhere while they were still ambulant or at least not urgent?

I think the OP should register a complaint, because her life and that of her baby was at risk through careless management.

I think because they’re in different wards/areas?
I was induced in the prenatal ward and then was in the postnatal ward after birth. So if she’s being induced she’d need a bed in prenatal, though sometimes triage can accommodate - all depends on the hospital though!!

Congratulations, having a baby whatever the route of delivery is so so hard x
As a midwife, please please complain about this in writing. This is horrendously serious and shouldn't happen.

This isn't on level of someone not having a birth pool available, or no breastfeeding support

Usually when delivery suites don't have enough beds, it doesn't mean like, literal beds/rooms - it often means delivery room + midwife. In labour, you need a midwife to be able to give 1:1 care, ie, allocated only to that woman.

They can leave to get something, or fill up a water jug or check a medication with a colleague, but they can't be allocated another patient. It's not a silly bureaucratic thing, it's a serious safety thing; if one lady starts delivering, and the other

Inducing you could take 12h+. Doing a c/s means you're on delivery suite only 2, maybe 3 hours, and once they've done the actual delivery bit they don't need to allocate just that one midwife to you.

It's so wrong it makes my blood boil. A band 6 midwife gets roughly £200-£250 for a 12 hour shift, which you could reasonably give induction a decent try in, and they do major abdominal surgery on someone for want of this.

As a midwife, one thing I would like to clarify in response to several comments on here is that when you are told a delivery suite is short of beds, that doesn't often mean a literal bed/room isn't available.

It usually means a delivery suite room and a midwife together are not available - I've been on 3 different delivery suites and usually the latter is the factor rather than the former. You can get a physical room available very quickly if you need to usually, the midwife not so much.

If you are intentionally inducing someone then:

There has to be a midwife to give 1:1 care to the woman.

The room has to be a delivery suite equipped room, ie with delivery bed, resuscitaire ect ect.

It's different than if someone labour really quickly in a triage room (like 5-10 mins) and delivered there.

I saw some posts saying why not send her to another ward - you can't do an oxytocin infusion to induce labour somewhere that isn't delivery suite.

I'm not trying to justify the trusts position, I also think this state of affairs is appalling, and I don't understand why they did not discuss with her transfering her out. Just to explain how these procedural factors lead to this.

I had my baby 7 months ago - if this happened, I would literally get in my car and rock up at another hospital. Or call another triage and say I want a second opinion. But I completely understand if you don't really understand how the system works it's very difficult to make these sort of decisions.

You don't go from theatre straight to postnatal ward. You go to recovery first, next to the theatre - and if you have a complication like a haemorrhage, you need to go to delivery suite. Which has no beds, so where would she go were there a complication?

They won’t have wanted to transfer her out as they can’t do that without declaring themselves “closed”. Once they do that there are not only financial penalties but it has to be officially reported and everyone takes a dim view of this. Any senior midwife who makes that decision to close will have that decision scrutinised.

Congratulations! I think you deserve Theo.

Are you allowed partners in overnight? If you end up being in a second night please consider asking a family member or close friend to stay overnight with you to support you. I appreciate DH has a leg issue but you really do need support post c-section if hospitals allow partners in overnight.