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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

forced consent to vaginal examinations

258 replies

terrifiedmummy · 29/08/2014 12:53

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.

OP posts:
BitchPeas · 29/08/2014 13:21

From my understanding a ELCS is a calm and controlled environment with no need for any vaginal examinations.

Tbh a VBAC with no examinations etc it seems far too risky.

Is there any reason why you don't want a ELCS?

oif · 29/08/2014 13:23

i refused all VEs for second birth because of traumatic first birth and had no objections from medical staff. My birth was luckily very smooth and easy. No one needed to look or check between my legs except at the very end, but as I was kneeling I caught baby and mw was actually standing quite far back.

I did have first degree tears but the treatment was v different to first birth.

With first birth I was stitched immediately, in stirrups position, bright lights on, 7 people in room and the mw refused to tell me how many stitches she was doing. I was given no choice of whether to have stitches or not.

With second they waited until I had established bf, had eaten and was calm and alone. Then the mw checked with a small light in a dark room and discussed the extent of tearing with me and what stitching she would recommend. She then left me to think it over and came back later when I consented to stitching.

Wishing you the best of luck with whatever you decide.

magoria · 29/08/2014 13:27

You need some help to come to terms with what has happened to you and how you feel.

Yes it is your right and best will in the world everything goes lovely and baby comes out easily with no damage to you.

What if it doesn't?

Are you really going to lay there maybe bleeding massively and risk leaving your precious new born and older DC motherless?

Are you really prepared for no one to even look between your legs and check your baby is safe and well?

FuckYouChrisAndThatHorse · 29/08/2014 13:28
Thanks

The comment about dead babies is appalling.

There was no time in dd's birth for any checks and she was born normally and with no issues at all.

How dare they suggest that consent is just a formality?! Well done you for fighting them :) you must be incredibly strong to have stood your ground.

I'm not going to recommend a type of birth, but by monitoring baby's heartbeat, and simply looking at you you can see so much more than an internal can tell you.

I hope it all goes as planned for you. If it weren't for needing to give birth in a hospital I would very much be recommending a home birth.

oif · 29/08/2014 13:29

Forgot to say - I also had an amazing doula. We discussed my fears before the birth and that was really helpful. Also just having that protective presence there made a huge amount of difference to me.

Castlemilk · 29/08/2014 13:30

One of the things I would also be looking into is a formal complaint against the midwife who uttered that blackmailing, uninformed, and UNTRUE 'fact' about examinations. She needs hauling right over the coals.

You have every right not to consent to anything at all, and if they ignore that, IT'S ASSAULT.

treaclesoda · 29/08/2014 13:32

I don't want to be the voice of doom, but when I had my c sections, there was the catheter and also vaginal swabs, lots of them,as I was bleeding heavily from there and there was concern about 'cleaning up' correctly for the purpose of preventing infection. I couldn't feel it though, and actually I wouldn't have known at all if they hadn't been talking me through what they were doing.

That's not meant to be a scare story, just a caution that cs doesn't necessarily mean there will be no intimate treatments required.

OP I hope you are able to give birth in the way that is least traumatic for you.

DeWee · 29/08/2014 13:40

I'm not sure.

I had a 2nd and 3rd birth where I told the midwife at the start I didn't want any internals. They were quite happy with that, assuming nothing untoward started happening, or I wanted an epidural. They didn't even ask me after I'd told them that.

However. I had had a normal (if very long and trying) birth for my first. They said they were quite happy as they knew there was nothing wrong as a baby had already come out.

A c/s does take longer to recover, and if baby is going to NICU then I would understand that you probably want to be mobile so you can visit them, so I understand why you don't want that.

I can however totally see their point of making you sign a disclaimer. Because there is an element of risk, and yes, it's your baby, but it's also potentially their job/reputation, which is small compared to a life (or even two lives-baby and you) but if they can't do examinations if they feel they need to they are potentially making uninformed decisions.

Fairylea · 29/08/2014 13:43

What about a c section under general anaesthetic? Then you wouldn't be aware of them looking at you to put the catheter in or anything like that. You may even be able to pull the tube afterwards to remove the catheter yourself - I did. I just asked the nurse to deflate the balloon which she did without having to look at me and then I pulled the tube out. It was fine.

slithytove · 29/08/2014 13:44

I am having a home vbac any day now with a private midwife and she has told me there is no need for internals.

A good HCP recognises other signs of dilation, and doesn't feel the need to intervene or risk infection through arbitrary internals.

You have the right to not consent. If you do not give consent and they proceed, it is assault.

Where are you based? I would think a private midwife or a doula would be extremely helpful in your circumstances.

SantasLittleMonkeyButler · 29/08/2014 13:48

I am very sorry for everything you have been through in the past.

I would also suggest a C-section in your circumstances. I have had three vaginal deliveries and I honestly don't think any of them would have been possible without some element of examination or assistance.

Yes, of course, there is every possibility that your VBAC will go exactly as you wish - but it may also become the very situation you are trying to avoid (e.g. if baby gets stuck & forceps etc. are required). For this reason, I would think that a planned C-section may be better for you.

Good luck with whatever you decide Flowers.

RedToothBrush · 29/08/2014 13:50

Sorry but Anyfucker is wrong, and not for the reasons that people might think.

I am having an ELCS for psychological reasons. One of these reasons is due to issues regarding consent.

I have an enormously supportive midwives who have said that they will do everything to try and help me, and to minimise issues over examinations. However they have stressed that there may be certain situations where it might be dangerous not to have an examination and that a catheter is unavoidable.

I have had a fairly easy time getting an ELCS approved; one of their main arguments at my hospital, is that they would rather work with women and try and built up trust rather than have situations where women like the OP, might be so scared they avoid all medical assistance and contact and freebirth.

However, an ELCS does not mean you avoid any medical staff between legs.... its just a different situation. You need a catheter and you may need to be cleaned (though you can refuse anal pain killers). It depends on how you feel about being in control and whether being immobile might actually fuel the anxiety rather than help it. Its a very personal choice.

If I go into labour early, it has been made clear that I may need an examination, depending on the circumstances. If there is a suspicion of a prolapsed cord for example. This is for the safety of mother and baby. This terrifies me and I am hoping and praying that I don't end up in this situation. They have said they will respect my wishes and avoid it, unless absolutely necessary though. Whilst I don't like it, I do think they have to be honest about this, and make the point that totally refusing could be irresponsible and life threatening. If put into a position like this, I would need to know exactly why it was necessary and why there is no alternative available before consenting - my DH is aware of this and its all over my notes.

The issue here is NOT the examinations themselves. Its the sensitivity with which the OP is being dealt with in my honest opinion. There is clearly a lack of trust here, that somehow needs to be addressed.

When I look at this paragraph:
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 do wonder what conversation has actually been had and how the OP has interpreted it. Has there been a breakdown in communication somewhere along the line or has the OP genuinely been treated with contempt for her wishes and a general lack of empathy. In all honesty its very difficult to tell, and on one of my bad days, I know that I could draw similar conclusions from things that have been said to me, if they haven't been quite so sensitive about my anxieties.

I genuinely feel that the OP would benefit from the support of ante-natal mental health services if they are available at the hospital she is at, and would also benefit from somehow building up a trust with a particular midwife or midwives who would be at the birth. Whether this is realistic or not, I don't know as I don't know what the time frame here is - but I think this is the only real option open to the OP given how strongly she feels and how it seems that she is unable to consider any exceptions at all to her rules.

I also think drawing up compromises, under certain situations needs to be the step forward, but I do think this needs to be done with the assistance of a specialist team who understand anxieties of this nature. Being so generalised and vague adds to the anxiety.

unweavedrainbow · 29/08/2014 13:56

People are right. You have the right to not consent, even if refusing treatment leads to the death of yourself or your unborn child. The issue is around competency and informed consent. They are assuming that if you come into hospital before the birth and sign the form removing liability from the hospital then they have prior informed refusal of consent. If they do not do this and you or the baby die due to refusal of treatment during labour, then the GMC may argue that you were not competent or informed enough to make that decision (due to the emergency nature of the situation) and the doctors may end up in trouble. This is a very complicated area of biomedical law and the hospital have to make sure that they are complying with it.

mildmaygrovenorth · 29/08/2014 13:57

Please contact BirthRights (as suggested above). An excellent organisation started by a lawyer and doula - I am sure they will be able to provide some guidance.

www.birthrights.org.uk/about-us/contact-us/

OneLittleToddleTerror · 29/08/2014 13:58

So sad to hear about your problems.

But from my own experience, I don't think it will be possible to not end up with a dead baby (or dead mum) without anyone looking between my legs. I had a assisted delivery after failing to push. It was after a very long labour of three days. I have also an episiotomy. I'm not sure what the tearing would be like if they didn't perform the episiotomy. That part is probably avoidable. But many women have assisted births.

I would suggest ELCS too. But redtoothbrush posts make me think maybe you still get examined with CS? I havne't been through one so I wouldn't know.

OneLittleToddleTerror · 29/08/2014 13:59

And I can understand totally why they want you to sign the waiver. If anything happened to you and/or your baby during the birth that is the result of your refusal, they'll need the paper work to show they havne't done anything wrong. You have every right to refuse, but they have also the duty to inform you how dangerous the refusal could be.

maggiethemagpie · 29/08/2014 14:01

Sorry I know the OP has a history of abuse, but can't understand anyone who'd prioritise their own needs over the baby's this way.

treaclesoda · 29/08/2014 14:02

perhaps because the abuse has traumatised her so much?

Downamongtherednecks · 29/08/2014 14:06

You poor thing, no wonder you are so upset. I tried for vbac with my second dc, after an emergency c-section with first -- and the monitoring and messing about was endless, stressful, and in my case ultimately futile. I tried to get the midwife to let me get up and walk around (would have had to take monitors off), she also said "Then your baby will die". I ended up with a c-section anyway. I would have an elective section if I were in this situation again. Good Luck, and stuff anyone who tells you vaginal birth is "better"!

sanfairyanne · 29/08/2014 14:06

the paperwork is just to cover them. i signed similar for hbac. its a shame you cant hbac as you would have less problems with your request imo.

can you take someone eg doula or friend to advocate for you, as well as your birth partner?

wishing you well

rainbowinmyroom · 29/08/2014 14:07

You can't understand because you haven't been abused like that.

PourquoiTuGachesTaVie · 29/08/2014 14:08

Really Maggie? Hmm

minifingers · 29/08/2014 14:15

Personally, having had gynae surgery with a spinal, I didn't find the experience of lying immobile and flat on a table naked from the waist down and catheterised, while people did fairly vigorous things to the lower half of my body, less disempowering or frightening than pushing a baby out of my foof.

I think the OP needs an advocate - a doula/private midwife/a strong friend or relative to support her. She should be having case loading care at the very least, and in my area she would be allocated this.

passmethewineplease · 29/08/2014 14:16

Maggie, really?

It is obvious OP has suffered some major traumas which has led to obviously feeling scared, take a look at her username for starters!

Your comments are in no way helpful to her.

SoonToBeSix · 29/08/2014 14:17

A vaginal birth without exam action is very very dangerous for your baby. I know I am being blunt but the trauma of loosing a child will far surpass the trauma you have previously suffered.
For the sake of your baby and yourself have a C section.