forced consent to vaginal examinations

[terrifiedmummy]

Hello,

This is my first post and I'm posting as I really need help.

I'm going to have my second baby soon. My first labour was horrific, abusive and traumatising. Before that I had a history of sexual abuse. I've also subsequently had a traumatic botched coil fitting which ended up requiring hospital treatment.

As a result this time I'm refusing:

• all vaginal examinations
  
• any medical staff to touch or look between my legs
  
• assisted third stage of labour (I'm want the physiological option)
  
• post labour examination for tearing.
  

I've been seeing a midwife councellor and I have a consultant because this birth will be a VBAC. All staff at the hospital are adamant that my consent will be sought before any proceduce and that they will make it as comfortable as possible but that I am not permitted to not consent. Does that make sense? In effect I have to do it! Finally today, after much harrasment from me and from the staff they have agreed to my wishes but say I must come in to hospital and sign a document saying all negative outcomes (ranging from maternal and/or fetal death to tearing) are a direct result of my choices. I've also had one midwife tell me that labours without vaginal examinations usually result in dead babies.

I've provided the hospital with NICE, WHO, Lancet and Cochrane Report papers to support the safety of my decision and provide information on how to make things safer but they won't read them.

I'm glad they've finally agreed not to force me (this happened with my first labour) but I stilll need support to help find alteratives to make things actually safer and make me feel safer, calmer and less under seige. My baby will need NICU observations after birth so I'm keen to give birth in the hospital with the NICU. My babies consultant says her complications won't effect the actual birth.

Please help. Does anyone have similar experiences or information.

[bishboschone]

I had a horrendous birth first time , despite not having any issues you have had before hand . It was violating to say the least . I presumed all birth was like that but it took me 7 years to be brave enough to do it again.. I had a elcs second time round .. The pain after was much worse but the experience was much much calmer . I would consider it .

[fuzzpig]

I agree with those who've said you need to find a birth partner. Find a doula ASAP and get to know her well. No matter how you end up giving birth, you shouldn't have to do it alone

[MsAnthropic]

"the women's breathing, behaviour, breathing" was supposed to be "the women's breathing, behaviour, sounds she makes"

[MsAnthropic]

but it makes it very hard for the midwives to do their job, surely
Hmm. There are other things for midwives to observe during a normal labour that is progressing well (the women's breathing, behaviour, breathing and the purple line that appears in most women) and vaginal examinations, aside from all the problems that many women have with them which can have negative impact on labour, are just not very accurate.

There are Pros and Cons to every birth intervention.

This is quite an interesting read.

[RedToothBrush]

Their job is to listen to the woman, understand how they feel and work WITH her to build trust.... Not just getting the baby out.

[Sleepyhoglet]

Trying to think of a metaphor. Having a vb is one thing and I understand your reasons for not consenting but it makes it very hard for the midwives to do their job, surely. Like asking me to teach a child but not talk to them.

[PacificDogwood]

"...but the antenatal care was more of a dialogue and discussion…"

See, I think that is key. I am sorry your determination came from a position of terror. You did something v contructive with it, so kudos for that.

[RedToothBrush]

Starlight, that line:" Those are not the actions of a confident woman but a scared one"

Are such important ones to understand.

I think its really the key to how you tackle it, whatever method of birth you have.

I think that often women are under estimated in their understanding of the subject and how they know their own needs and are written off as demanding or difficult when that's far from the case.

Hcps can best 'protect' themselves simply by listening and accommodating those issues.

[StarlightMcKenzie]

'You come across as v well informed, not backwards in coming forwards grin and prepared to 'fight' your corner: politely and calmly or more stridently is required.'

That sounds wonderful, - thanks.
And perhaps it is true to an extent, - now, though any confidence in this area grew out of terror.

I was a completely different person going into my first birth. I was vulnerable, scared and a part of the psychological trauma suffered was from looking back and blaming myself for the things that happened to me and for not having the strength of character to stop it or assert myself.

My second birth had to be completely on my terms so I found the resources and information to ensure that happened, whilst trying to be realistic about potential scenarios. I researched how to increase the chances of avoiding potential scenarios too, but if they happened, I had a clear plan, - and a doula to support me in ensuring it was followed.

Those are not the actions of a confident woman but a scared one.

I was not scared for my 3rd birth, though the terms were even more 'radical' and I had suspected gestational diabetes (I didn't suspect it myself and found a way to demonstrate this) but the antenatal care was more of a dialogue and discussion than the insistence surrounding my second.

[PacificDogwood]

StarlightMcKenzie, I may remember only bits and bobs of your making/having babies history and what you wrote here, so apologies if I get things wrong.
I think you (and women like you and maybe me and many others) come from a somewhat different direction that what terrifiedmummy sounds like (again, I could be totally off the mark, so apologies there too).
You come across as v well informed, not backwards in coming forwards and prepared to 'fight' your corner: politely and calmly or more stridently is required.
I had heavily medicalised labours and births (induction and emCS) and 2 rather nicer, calmer VBACs (never made it in the water as things moved to quickly). I v frequently remember ALL of these births with fondness and awe as to what the human, female body is capable was. I feel strongly that the fact that I have good memories even from the more traumatic moments is that I at every point knew what was going on and why, had not just signed a consent form but had in my head consented to what was going on AND felt that my wishes would have been heard if I'd had any particular needs at any point.

I realise that this is too often not the case.

MsAnthropic, sorry to read that you had such a bad experience. I hope you have fully recovered; in every repeat.
I have no idea what a CS under GA might be like (particulary if it is a 'crash' CS), but I do know of people who have not had psychological aftermaths from that kind of situation.
As far as terrifiedmummy's situation goes, I think it is important to think about the worst case scenario NOW and then hope it never happens. Plans for the worst, hope for the best - trite I know.

[MsAnthropic]

OP, I haven't read the whole thread but I have a lot of sympathy for you having had a traumatic experience in hospital having my son that I am still traumatised and feel violated by 7 years later (he was absolutely fine, btw, agpars of 9 and 10 and perfect blood gases afterwards so nothing that happened was to 'save' him). I had an internal after saying no, then screaming no, no, no by someone who did not introduce themselves and invited in and stood chatting to a random stranger (presumably another doctor) in the end stages of labour.

One thing I would strongly advise is to get everything you are told documented. That midwife who made the comment about "dead babies" or consent? If something like that happens, insist they write exactly what they said in your notes, and if they refused then YOU write them in your maternity notes, in amongst theirs. I did this throughout and it formed a very interesting record but you must do it at the time so your memory can't be questioned.

As for the person who suggested a c-section under GA? Have you had one? Do you have any idea how traumatic it is to be unconscious when your child is born? Obviously, I am sure that some people might say it's not, but it was horrific for me (c-section with failed epidural, spinal failed during surgery and rapid conversion to GA half way through)

[StarlightMcKenzie]

The thing is though, if you have a good birth (By good I don't mean painfree or straightforward necessarily), and you are in control, and you trust the people attending, and they stay away from you unless asked or offer their advice or recommendations without touching you, if and when they eventually ask politely if they can 'have a quick look, if you don't mind' for the third time, having backed off the first two when you've replied no, well then, there is every possibility you'll not only consent but also not even mind consenting.

[StarlightMcKenzie]

Plenty is doable without looking between a woman's legs. I was in the water for my last two and no-one ever looked between my legs - ever. I had the heart listened to with the first of those a couple of times.

With my second I did my own internal examinations and reported back to the midwives. I also had a problem with the membranes being tangled up inside me and difficult to remove so I asked for help and was guided through the removal, but it was still me that removed them. Being in the pool like, forever and way past the first feed ensures that no-one can get anywhere near your anyway.

[Gruntfuttock]

Sorry, I've only skim-read the later posts but are all these things do-able without a HCP looking between the OP's legs at any point, because the OP insists that never happens as well as any touching and VE?

[StarlightMcKenzie]

But it is no more effective than other less awkward or arm-aching ways of dislodging the baby, and contractions in that position are bloody awful.

[StarlightMcKenzie]

I think there is a motivation to 'DO Something' when things appear to be going wrong, instead of asking the woman gently if their body is telling them to do something.

Of course I understand that drugs can impair a woman's ability to judge that (though some women, including me say that drugs neither impair their mind, reduce their mobilisation or do a thing for the pain (though never tried epidural)), so to be certain I could play an active part in subsequent births confidently I abstained.

In fact even though I'd had it very clearly written in my birthplan that no-one was to touch me, with my second, the midwife couldn't help herself pushing me down as the baby crowned as she thought I was about to stand up in the water. This resulted in me being unable to follow my instinct to change into a position that would allow the superman arm out without shredding my insides.

[Crazeeladee]

<a class="break-all" href="http://www.google.co.uk/imgres?imgurl=intranet.tdmu.edu.ua/data/kafedra/internal/distance/classes_stud/English/2%252520course/Elective%252520course%252520(Reproductive%252520health)/06_Obstetric%252520operations.files/image014.gif&imgrefurl=intranet.tdmu.edu.ua/data/kafedra/internal/distance/classes_stud/English/2%2520course/Elective%2520course%2520(Reproductive%2520health)/06_Obstetric%2520operations.htm&h=677&w=646&tbnid=4rMEonLG5jpz7M:&zoom=1&docid=RevxcEGhrWdZXM&hl=en-gb&ei=ebIEVOniJ8XcaJvDgrAK&tbm=isch&client=safari&ved=0CEIQMygaMBo" rel="nofollow noindex" target="_blank">www.google.co.uk/imgres?imgurl=intranet.tdmu.edu.ua/data/kafedra/internal/distance/classes_stud/English/2%252520course/Elective%252520course%252520(Reproductive%252520health)/06_Obstetric%252520operations.files/image014.gif&imgrefurl=intranet.tdmu.edu.ua/data/kafedra/internal/distance/classes_stud/English/2%2520course/Elective%2520course%2520(Reproductive%2520health)/06_Obstetric%2520operations.htm&h=677&w=646&tbnid=4rMEonLG5jpz7M:&zoom=1&docid=RevxcEGhrWdZXM&hl=en-gb&ei=ebIEVOniJ8XcaJvDgrAK&tbm=isch&client=safari&ved=0CEIQMygaMBo like this (if the link works!)

[Crazeeladee]

That's only if it's still not working. We touch the bed to lie it flat, as you can usually suspect there might be an issue as the head is crowning, and ask you to grab your legs and pull them as far back as you can. I never actually touch the woman, sometimes, they put a foot onto my hip to help them, but that's them choosing to do that.

[StarlightMcKenzie]

I am fairly certain that no midwife would do the McRoberts without touching me, unless I had made it extremely clear beforehand and even then they'd probably forget in the moment.

This is what I understand a usual method to be: www.5minuteconsult.com/ViewImage/7050461

[Crazeeladee]

starlight the only pressure that should be applied wouldn't be to your legs or abdomen, fundal pressure would only impact the shoulder more behind the pelvic bone, making it worse. You would normally hold your own legs, and if that didn't work, which often does, then some pressure over your public bone to release the shoulder, either rocking or straight down is the next step.

[Booboostoo]

Like others on this thread I think you need more control over the decision making process and then it may be easier to find solutions that are less risky and still acceptable to you. Can you afford to hire a souls that will come with you to all appointments to help reinforce your wishes? Or possibly is this a role your partner could play?

[StarlightMcKenzie]

I understood that you'd be 'assisted' with keeping your knees back (I'd have to be anyway as I don't have the stamina for even a couple of seconds of that) and then someone might feel obligated to apply pressure to the abdomen, with no time for specific consent for that particular hands-on action.

[Crazeeladee]

Mcroberts isnt a manoeuvre, it's hands off. You lie on your back, with your knees as wide apart and far back as possible.

[StarlightMcKenzie]

Because my first baby was delivered by non-consensual fundal pressure after being repeatedly held down when my body and instinct was telling me I should stand.

[Iffy2014]

Out of interest, Starlight, why did you not wish to consent to the McRoberts?