To not understand the assault/internals threads?

[GingerJulep]

I've never had one so am really struggling to understand how so many women on here (NOT aimed specifically at the other poster on this page, there are lots in different sections!) manage to have internal examinations before/during/after birth that they say they didn't consent to/asked to be stopped?

I mean that physically, don't they have the option to just shut legs/take feet out of stirrups/kick HCP in face?

Nearest I've ever come (so far, lucky me!) was someone trying to take blood suddenly... I made an automatic physical reaction (big flinch/jump) and they simply couldn't do it until we'd had a quick cat.

So, how much more difficult is it to avoid/stop internal exams if you really want to IYSWIM?

littlesporks that sounds like a speculum.
I'm so sorry you were assaulted. That sounds awful.
Sorry to all of you who have been treated badly when so vulnerable.

I agree that OP was badly worded.

I had two lovely midwifes but v soon after a painful birth, v large baby and v large afterbirth Some random midwife came in and gave me a very painful internal to see if I needed stitches and I kept saying ouch and stop but she didn't and it did feel like an assault in the respect that my feelings did not count at all

Perhaps my post will be helpful to OP.

When I was pg with DC1, as part of having my history taken at booking it was noted that I had previously suffered a sexual assault and had ongoing PTSD as a result. Unfortunately my hospital deals with a lot of asylum seekers from a particular region who have been raped, so all their staff are very sensitive to related issues. A note was placed on my file that internals should be kept to a minimum.

Fast forward to 33w when I am getting strong contractions and they need to assess if I am going into premature labour. They very sensitively and calmly explain that a VE is needed to assess if my waters have gone etc. I consent, and they proceed very carefully - lots of information, confirming consent frequently, I'm holding DH's hand, and so on.

Suddenly I'm terrified. I don't kick, because I can't move. Like a rabbit in the headlights, I can't do anything. Eventually I manage to squeeze DH's hand hard and say very quietly "I don't like it, please stop".

They stopped immediately and left the room ASAP. I then screamed and cried for a long time, clinging to DH like the world was ending.

They did absolutely everything right, and I still had that very visceral reaction. If I'd had less sensitive staff, or if DH hadn't been there, I don't know how traumatic that experience would have been. Internals are a very intimate and disempowering experience at the best of times.

The trauma comes from your experience of the situation, not necessarily the bare facts of the experience itself. So if you've never been scared enough to have that extreme instinctive "fight, flight or freeze" adrenaline rush, you couldn't know how paralysing it can be. And if you haven't been in that vulnerable physical position compounded by fear for the life/health/safety of your baby, you won't understand how irrational and nebulous your thoughts and feelings can be at that time.

I'm not permanently traumatised by that experience, or by two subsequent vaginal births, but I can easily see how I could have been. That bad experience did teach me that if I said "stop" they would do, and that gave me the confidence to relax in later VEs, which in turn made them less scary, and as a result less uncomfortable and quicker.

Must be a personal thing I've had them without pain worry trauma etc they're a necessary evil to be endured IMO

Oh goodness, the fisting! After DS3, the midwife (who had been horrible throughout and I still hate 3.5 years later) said that she just needed to check whether there was any retained placenta because it had been ragged. What she didn't tell me was that this involved shoving her entire hand into my uterus and feeling around. It was horrific, painful but I didn't feel I could do anything about it and so just had to lie there until she was finished and hope it was over quickly. I had never had an entire arm up my vagina before, and hope never to again . I gave consent for the procedure, but it wasn't informed consent.

Bogeyface I love Sheila Kitzinger's work and have read "Birth Crisis", sorry that you had such an experience as to be included in her book but thank you for allowing your story to be written about to help others.

I was induced with my first baby. I had a number of increasingly painful internals which I consented to, when labour started it went from nothing to defcon 3 in about 10 minutes.

I was being cared for by a lovely, kind, gentle but unfortunately newly qualified midwife who had to defer to a very cold, rough, brutal senior midwife who was supervising her.

My junior midwife did a painful internal but could not reach my cervix so asked the senior one to check for her. What followed traumatised me for a very long time, she just shoved her hand into me with no warning it was excruciating, she then without any form of consent or explanation ruptured my membranes. Threw her used gloves on the bed and walked out having never actually looked at my face or spoken to me.

About an hour later during the pushing bit she was called in again because of late deceleration's. This time she just snapped at the junior midwife pass me the scissors. I screamed dont cut me you bitch no I dont want an episiotomy. At this point my lovely midwife stood up for me and said I am sure she will deliver on the next push. I was determined to prove her right, older midwife just shrugged and said it will be her fault if anything happens to the baby. I put every ounce of myself into that next contraction and delivered without even a tear.

I said to my husband afterwards that I felt like I had been assaulted. I had been.

I don't want to go into too much detail as it's still pretty traumatic for me, I had a very fast unplanned home birth and ended up having to travel 25 minutes to the nearest labor ward post birth.

The doctor and nurses who looked after me were nice but seemed to be really busy and in a hurry.

I had to have stitches to close two tears in my labia, I had pre-warned them that I have a severe needle phobia and that I have issues with internal examinations for personal reasons. When it came to sewing me up they lied about how many needles I would get, didn't let me know what they were doing and started stitching me up whilst I could feel it.

I obviously got very upset and thrashed about almost kicked the nurse holding my leg in the chest, moved away from the doctor on the bed and begged them to stop, they spoke to me like I was a little girl who was just being silly, despite me telling them I could feel it, that I didn't understand what they were doing and they were going too fast for me.

Eventually my DM stopped them because I was howling I was that upset, they agreed to stop and give me pethidine and give me some time to calm down.

So I thrashed and I closed my legs and tried to move away and I still feel as if I was assaulted -if my DM hadn't have intervened I have no doubt it would have been worse too - but I shouldn't have to. Doctors are there to help support women who need medical attention, not run rough-shod over their feelings, traumatize them and assault them.

I wish I had realised I didn't have to have a sweep. I at the time trusted his view (not consultant, house officer? Unsure...) in some freaky "your in a white coat so must be next to god" blind way. I hated it and him but didn't feel I could say no because he said it should be done.

It was the start of an awful first birth it took me best part of 18mths to get over.

Assumption, fear, intimidation, they must know better than me, all came with it. It was only on here I found out I didn't have to and could have avoided it. I felt so ill when I knew I should have trusted MY instinct.

If u haven't been there, lucky you. Some of us just aren't that lucky.

If the thought of internals scare you it might be wise to have a chat with the supervising mw and also look in to relaxation techniques for during labour.

Generally if they need to do an internal it is because they need to do so - possible to keep it to a minimum but they can monitor your progress by doing so. And some cases will require more internals than others. So be prepared and have ways of dealing with it - relaxation techniques can help as the whole fear response makes you tighten up so would make it more painful - I definitely found it beneficial during the internals.

Look in to all the options at your labour ward too - if they have rooms with birthing pools it'd worth considering - those rooms are often quite relaxing as is the birthing pool.

Reading these stories makes me so and at the same time.

I'm a midwife and I always say to a woman prior to any examination, if you'd like me to stop say or raise your hand. I always stop. Always. Even if I could have just been 2 more seconds and accurately assessed dilatation. It means sometimes having to do the exam again, which actually most women don't mind but at the point of wanting to stop it always always should. We may never know if these women have been victims of abuse in the past, and I've met a few where unfortunately they've buried those experiences and in labour it seems to come out.

I hate that there are midwives who give the rest of us a bad name.

I'm really shocked at the experiences of people here. I've been very lucky in that the vast majority of medical personnel I have encountered have been lovely and the ones that weren't didn't have much to do with me in a physical way. I can't imagine how this must leave people feeling or the long term impact.

OP it's hard to imagine how you will feel and act when the time comes. Although I have not had to deal with the traumatic situations others have, there have still been times when I should have said something or demanded something. I didn't because I was in labour and a bit preoccupied. If non-pregnant/in labour me had been standing right next to me at the time, she would have acted differently.

I feel the OP asked an honest question. We can't learn if we don't ask. We can't know how asking can upset and offend if we know nothing about it.

No, I think I understand what the OP is saying. I don't see how it is victim blaming to not know the mechanics of how something like this could happen. And it was a question, not a statement. And she's not just idly wondering; she's giving birth herself soon and probably concerned that something of a similar nature could happen to her. I know I worried and wondered the same thing. The wording is irrelevant. She has never been in that situation or mental state, ergo she has no experience of what it feels like.

From my own experience, my midwife behaved perfectly, but I would not have been able to stop her from doing something if she had chosen to. Physically, I could have fought her, and I could certainly scream, but mentally I couldn't. I was in such an intensely helpless and frightened mental state that she could have ordered me to do anything and I would have done it because I was so desperate for help.

It's only later that I would have realised she'd fucked me over big time, like a lot of the other posters on here have been. It's awful to hear and I'm so sorry. I completely understand and don't blame any of you at all. But I do feel more of an understanding for the vulnerability of the labouring woman now that I've been one.

OP, I appreciate that you haven't been through childbirth, and I think most posters would be willing to cut you a bit of slack about your initial post if you hadn't followed it up with a whole load of arsines and oh-poor-me nonsense.

You have been told quite clearly that you have upset posters who have had bad experiences in this area. The appropriate response would be an apology and a better worded request for any information you want. The poster who really deserves an apology is the OP of the other thread who you quite clearly referenced in your insensitive opening post, despite the wishy-washy "oh I'm not talking about the person who I'm quite clearly talking about."

I haven't had this experience. I had two rapid deliveries, including one homebirth, and my midwives were lovely. But it's surely not that hard to understand that childbirth is an intense, sometimes frightening time, when a woman can be at her most vulnerable. I find it hard to understand why you would think that a labouring woman could simply kick a health professional in the face, thus overcoming not only whatever physical difficulties she was in at the time, but also some pretty basic social conventions that require us to not go round kicking health professionals in the face.

As I said, it is just about understandable that, as someone who hasn't been through childbirth, you wouldn't understand the intensity of the experience, but surely you can understand the basic fact that a woman in the middle of an experience that everyone knows isn't a walk in the park isn't going to be karate-kicking HCPs?

And if this is something you genuinely didn't appreciate, surely the responses on this thread have clarified matters to the extent where the posters deserve some acknowledgement that you were wrong and that you are sorry?

Many years ago I was at a houseparty and woke up early in the morning to find someone's hand in my knickers having a fidget with my clitoris. I knew him, but wouldn't have classed him as a friend. It took a moment to process the situtation and then I reacted by kicking him in the face. Hard. I hope it hurt his neck after.

Going through labour is very, very different. Physically your bump makes it hard to see what's happening and change position. I've had PGP which makes movement of my legs hard, and couldn't make a quick reaction. Your mental state is affected by drugs- G&A makes you hazy (pleasantly so for me), pethadine more so (for me, it's as though 8 hours of my life were cut out, I was locked up into a parallel universe- DH consented to the second round of pethadine for me as I had no clue it was being offered. I only know from reading my notes) Pain has an effect- my first labour was long and wearing, the second short and intense- neither situtation is conducive to quick thought and reaction. The biggest thing is trust. You place yourself in a position of trust with the HCP. You're particularly concerned about the welfare of the baby so trust that they are doing the right thing for them as you've been carrying and caring about that baby for 9ish months and just want everything to be over and that baby to be safe and well in your arms.

I've not felt assaulted over treatment in hospital (and fortunately the party experience hasn't affected how I feel over medical care in that department) but having had two intervention heavy births I can see how it happens. My negative experiences in my first birth originates from a poorly explained intervention, "Things are progressing too slowly, I'd like to break your waters to speed them up" I wish I'd been prepared for the surge of contractions and discussed pain relief. As I mentally failed to cope, I nodded agreement to "I know you said you didn't want pethadine but..." As the pethadine went in, that was the loss of connection with the labour that haunted me after. I would have consented to anything at that point, but then lost the ability to do anything other than passively flow with the situation.
(There were positives in that labour, thank God the pethadine wore off when pushing so I can remember going to theatre and the ventouse/ CS where there were some nice staff which helped a lot. My second birth was much better, I had a very gentle MW who explained things a lot, and despite is being a rough forceps birth in theatre, I could repeat it with the same staff- the key thing being that they treated me well)

OP, I hope you have a good birth and that none of these problems and issues become yours.

Flat what a great post - any chance you're free to hang around a South London hospital over New Year when DC2 is due?

My first internal when giving birth to DD was the worst physical experience of my life - half way through which the MW told me 'not to be so pathetic'

On another note, given all these stories, what is the really advantage of internals? When are they absolutely needed? Is it safe to refuse?

The best part about giving birth at home unexpectedly was that I at least avoided having an internal examination, if I ever have another baby I think I'd opt for a homebirth just so I didn't have to have one.

The other thread and this thread are both making me feel light headed and nauseous bringing back memories of my first birth.

OP I'm going to take your question at face value and assume you are naive enough to not appreciate how offensive it will seem to someone who has been assaulted (akin to why doesn't a woman fight off a rapist)

Dynamics of healthcare mean that many women politely wish to cooperate. Fear, ignorance and sheer vulnerability of being with someone who you need to help you during a medical procedure, means you 'keep them on side' so you don't argue, shout or scream...let alone 'kick them in the face'. An assault is not necessarily violent or aggressively performed. It is an unwelcome intrusion into or onto your body without your consent or agreement or understanding of why.

A Dr asked my husband to hold me down. Legs in stirrups, husband holding me down, midwife urging me to be quiet and hold still whilst my shredded vaginal walls were inexpertly stitched together because I was writhing in pain so much

I am obviously forever indebted to this care because I had a healthy baby... . (Which is the other bollocky rude implication of shut up and put up)

What a crass, insensitive and ignorant thread.

I really hope you have a good birth experience, OP. You sound as though you have no idea, unfortunately.

I was always asked very nicely, and had the consultant very specifically say a number of times that she could not touch me without my consent. When I had my first internal I asked the midwife to stop because it hurt, so she did and got me some gas and then we both agreed to try again.

And as for kicking someone. Would love to see a massively pregnant woman flip herself out of stirrups and close get legs. I tried to climb out of the stirrups and it was impossible even without someone elbow deep in my vagina.

Adding that I had a painful forceps delivery but i am very happy with it because the staff were kind and patient and made me feel like I was an active participant rather than just doing it to me iyswim? I was involved and informed all the way through and even though I got a bit hysterical at the thought, they kept me calm and were patient and professional all the way through. When you're up in stirrups it's a very vulnerable place physically and emotionally, and good staff can mean the difference between a traumatic experience that can scar you and an experience that want your ideal, but was actually OK.

It's not an excuse that the OP hasn't been through childbirth yet so can't understand the trauma of internal examinations that you haven't consented to.

I am pregnant with my first child and when I read the other thread (which this thread is clearly and unashamedly based on) I was horrified to read the OP's experience.

This is goady, distasteful and victim blaming.