AIBU to consider suing the NHS?

[BrokenVag]

Today is the 5th anniversary of my child's due date. In reality she was delivered by forceps after a traumatic labour 2 weeks later. During delivery I was given an episiotomy. For various reasons DH and I didn't attempt sex until 6 months later, and it was clear that something wasn't right. I spoke to my HV who told me to see the GP. The GP didn't examine me, and just said that it was probably just the new scar tissue causing problems, and that it would settle down.

Another year passed, we still didn't manage to have sex, and I went to the doctor's again. Saw a female locum who examined me, said all looked fine and that I should just "get over it" (I was crying in pain at being examined). A year later (so DD is 2.5 at this point) I insisted on a referral to see a specialist. The appointment took a year to come through, and as soon as the consultant examined me she said it was highly irregular for a birth in the UK. Turns out I was given a midline episiotomy rather than a median one (the cut went straight down between the muscles rather than diagonally across one). The result is that the muscles went into permanent spasm and pulled against each other, meaning the scar didn't heal (the consultant split it open just examining me - this is 3.5 years after having DD). She suggested botox to stop the muscles pulling apart, and i had the first done last summer (2014). I was recommended to have it checked and a second dose after 6 months.

I had the second dose today, 15 months after the first. Part of the cut has healed, but not all, and again it split when I was examined. Consultant said that it should help, but she's not sure it will ever fix it completely, and the NHS only allows 3 treatments. Given the NHS caused this problem, which has caused significant issues between DH and I as sex is pretty much impossible (I can't even use tampons), WIBU to sue them in the hope that I'll be given whatever treatment is needed to fix the issue?

Do it! There is so much of the NHS to be thankful for but that doesn't negate fuck ups like this.

Maybe she meant it was too tight/poorly done - as the link above shows just because it was midline isn't going to be an effective argument as there isn't clear evidence that this is any worse and these incisions may actually heal better

If a body of medical opinion states that a midline episiotomy was an acceptable practice at that time, your claim will fail

Really even though this has left her with such major damage physical and emotional and so on?

Forceps are acceptable but surely if they are mis used or leave damage then there has to be a come back?

Op good luck I feel out raged for you.

You can under Eng NHS choose your own consultant and do research and get best one in your field, you can do that here although may have to travel.

Its awful the things women are supposed to accept after birth, this is why second time I decided it was not a risk I was prepared to take and got an ELC.

Maybe she meant it was too tight/poorly done - as the link above shows just because it was midline isn't going to be an effective argument as there isn't clear evidence that this is any worse and these incisions may actually heal better

Or they may cause years of pain, potential divorce and ptsd.

You poor thing. 5 years and still not healed - somebody has been negligent somewhere I'd say possibly not the hospital but a failing in aftercare. Get legal advice asap and see if you have a case.

FWIW I had a surgery that went wrong and when the hospital admitted full liability they advised me to sue. Said that unless there were consequences mistakes weren't always taken seriously, which I can totally believe.

I feel so bad for you it sounds like you have been through hell and if you can save another person going through this then I say push forward to get the repair you deserve.

I'm not saying that you haven't received poor care just that the midline vs lateral incision may not lead to a successful claim.

Clearly you should have been properly examined when you first went to your GP and promptly referred. It was completely unacceptable to wait a year for your appointment too.

Some very strong statements about midline episiotomies in the UK on this site.

(Not sure its kosher, but it came top in a google search)

www.thirddegreetears.co.uk/midline-episiotomies-practised-uk/

it's correct that if a practice was supported at the time by a responsible body of medical opinion, however small, it would not be negligent. However that opinion would have to withstand logical analysis . I think you would have a claim PERHAPS but not at all guaranteed. I think your limitation is probably fine. I'd suggest that if guidelines at the time said no midline episiotomies then it would stand you in better stead for them to explain why the guidelines were not followed. I would also say that you may have a case in terms of the length of time w/forceps during delivery, or the follow-up care that you received.

That site is talking about third degree tears which by definition means a tear that involves the anal sphincter. This is the reason that midline incisions are not recommended in the UK. I don't think this is what you have suffered?

I think your first step should be writing a complaint letter about your care to both the hospital and your GP practice and if you're not happy with their response than you can take further action.

I also think you should seek a second opinion on surgical repair (perineoplasty/perineal repair) to someone like the surgeon at St George's in London that was recommended above. I think Botox is mainly used for chronic perineal pain and may help you but if your incision is still breaking down you may need a repair.

I'm sorry you've had such a bad time under the NHS. You're obviously still suffering a lot and it is the NHS' duty to exhaust all options to get you back to a pain free state and able to have intercourse again.

It might also be worth having some counselling to help you deal with such a traumatic experience. And maybe think about getting a new GP to start afresh as I'm guessing you must have (understandably) lost faith in your current practice.

Request your medical records before informing the hospital of your intentions.

Make sure you get the hospital records and do it before you mention any possibility of complaints.

There was serious cause to complain about treatment of DN - another hospital was shocked at the treatment when her mother contacted PALS to complain at first suddenly the medical records had been lost.

We had serious cause to complain mid pg about MW - different area of NHS so did my Dsis. Dsis complained to GP practise and they past complaint directly onto MW who then acted very unprofessionally putting her at risk. We took advise and complained via correct people but the complaint was managed away even though they put me and my DC at serious risk. We left it as frankly other crap was happening in our lives and we were luckily fine.

We are not the only people we know in RL who have found medical notes altered obviously later, inaccurate or go missing. I don't know anyone who was even thinking of suing just going through complaints procedures to try and make sure stuff like that didn't happen to others or find out why things had happened to them.

That not to say most of my treatments or interactions with NHS and haven't been good or professional. Just there does in some areas of NHS seem to be a culture of serious arse covering.

YANBU.

OP, I recommend you see a solicitor that specialises in obstetric clinical negligence. That's very important. They will usually give free advice in the early stages and some operate on a no-win, no-fee basis.

Irwin Mitchell is one good one but there are many others.

Generally, even if you do win, you are unlikely to get more than a few thousand pounds sadly. The really big payouts are for when a baby is damaged at birth and care has to be paid for.

But I agree with others that you need to get started immediately.

Horrible, horrible thing to happen - lots of sympathy.

Just to clarify about medical notes - your GP will not have a complete set of your hospital notes (they should of course have a full history of everything that has taken place at their practice, appointments, medication prescribed etc.)

As a general rule (and it certainly isn't always the case), your GP should have been sent copies of anything that has been typed, including discharge summaries (which I'm guessing is the paperwork you were told to hand to them), consultant letters, test results etc. But they will not have copies of anything that was handwritten (such as ward notes). I'm guessing that the medical team will have documented what took place during the birth by hand (all dated, timed and signed as it happened) and this is what you need.

So to access this you will need to contact the medical records team at your hospital. Make sure you state that it is the maternity notes you want as some departments keep separate notes.

Your GP should have explained all of this to you before they took your money for a copy of their notes. I can only speak for my own Trust but this should give you any idea of where to start. Do this ASAP as requests can take a while then contact PALS/PILS afterwards (as they will then request your notes for themselves.)

I also think that the priority should now be on getting you well. This can't go on, with appointments years apart. I'd consider going private, and find the best surgeon for these sort of repairs in the country. Honestly, I'd throw cash at it, even though you might not see a penny of compensation.

Get your body healed first, then tackle the psychological damage they have done.

A court case might take another couple of years, that's another couple of years of your life lived in pain with no sex life - in your 30s!

A little research has helped me enormously in finding 2 specialists for 2 surgical different procedures - one for me, one for my teenage DD. Both consultants/surgeons are a "last resort" normally, people go to them after numerous failed operations/recurrences. My DD's operation - properly done - will hopefully save her any more procedures, and she has no visible scar (unlike me, I had 3 operations and look butchered in that area).

My procedure was a nerve root block for slipped discs. The NHS doesn't do it under GA, this consultant says it's pointless otherwise and he has a high success rate. It worked.

Do your research, there are people out there who have experience of this and can sort you out. I wouldn't trust the medical people you've been dealing with anymore. Everyone has let you down.

Sorry, that was confusing. I had the same operation as my DD, as a teen, and two more in my 20s which have left me with seriously ugly scars. It's hereditary, so I knew what could happen to her if I didn't find someone who is an expert.

I'm sorry this happened to you - how awful. I always remember at NCT anti natal classes I attended, the instructor telling us that there are loads of women walking around with botched episiotomy stitches.

I had an episiotomy which did not heal well and I couldn't have sex comfortably for a really long time - my situation was nowhere near as bad as yours though :(

My sympathies op. I've just had an episiotimy.. They are barabaric when they aren't botched.. It has put me off ever attempting vaginal birth again.
It seems like something definitely was not done correctly. I wonder if the suturing was wrong as well as I've heard loads of horror stories about incorrect epi stitching.
Would a Fenton's procedure not work better than botox?

So I've received a copy of my maternity notes today. I'm pretty sure everything is there (the discharge note is illegible though so may ask for them to re-do that one). Gone through all the notes and there's nothing about my episiotomy being midline anywhere - just "routine - interrupted suture of vaginal laceration".

Not sure what to do next.

Wasn't at Bolton hospital was it? I know someone who had a similar issue - she ended up having reconstructive surgery. You should definitely seek legal advice.

No. Nowhere near Bolton!

Sorry to hear this has happened to you. It is dreadful.
I am in the process of suing the NHS over an serious omission in diagnosis throughout my pregnancy. Belief me, and I am not saying it is not worth doing, it is a lengthy process. Someone else said that staff will close ranks, and I was (naively) horrified when this happened. I belief people are generally honest and was really shocked to find myself in a situation where basically I was lied too repeatedly by senior medical staff. I began the process 5 years ago with an excellent law firm. I was. and still am after justice. Be aware that in a case of medical negligence you and your legal team need to prove that your medical status or prognosis is worse now than it would have been had you not received the treatment you did. They will probably argue that the treatment you received was warranted for all sorts of reasons you may never have considered. I am in no way condoning what has happened to you. It sounds appalling.

I just want it fixing. The pressure this is putting on my mental health and relationship is growing ever more difficult to manage. I feel like I've been butchered.

i have read most of the thread now. Some people say that taking legal action will cause you unnecessary stress and it is true, it is stressful. I can only speak for myself and really don't know if the medical experts will argue that this was the best cause of treatment, given your situation, But what I will say is, stressful or not I am personally less stress taking legal action simply because, I was treated injusticely and I wanted to do all I could to ensure justice was done. Maybe it will, maybe it won't but I know I've done all I can. I realise you say your priority is to get the problem fixed and I hope you can achieve this.
By the way taking legal action over something like this has nothing whatsoever to do with supporting the NHS.

Or not supporting it.

Op I'm so sorry you're dealing with these consequences. And I really hope you get the solution you're looking for.

However I do agree what what others have said - you're going to have a very hard, if not impossible, time proving you have a case. You consented - and again, I know that's crap, because you were in crazy amounts of pain and exahusted, but you signed something and verbally agreed. Your best way of getting results and treatment might be to aim at finding out why that type of incision was used, whilst mentioning the results it has had. Be prepared for a lot of resistance, the possibility of no results, and being reminded frequently that a lot of women suffer after child birth.

Good luck.