Childbirth injury risks

[BackInTime]

A discussion among friends about our childbirth experiences has made me think that not enough information is given to women about the possibility of injuries and long term problems as a result of a vaginal delivery. Almost all of us have ongoing incontinence, some had bad tears and one has had a prolapse needing surgery. These things are impacting women’s lives years after giving birth. It seems to be a hidden problem with many women suffering in silence.

AIBU to think that women need to be more informed about risks of a vaginal delivery especially in situations where there’s a high risk of injury like with a big baby?

@IReallyHateCycling

Im so sorry for your loss

Has the age of mothes increased dramatically? I know it’s gone up for first time mothers, but I have a friend who does a lot of family tree research and just from the few things she’s told me there’s loads of women having children late on - they’d just had babies earlier too.

irealyhate

I’m so sorry

Bustopher spot on. My family tree shows the same. All four of my great-grandmothers had babies in the forties (this gave me great hope when I was trying for my first at 40). The oldest was 46, and the next oldest 45. Giving birth in your forties is not new.

I think the age of a first-time mother has increased by a fair bit, but as mentioned in previous generations many women had subsequent babies well into their 40s

It's not women's fault. They are speaking up about it. And the NHS doesn't like it that we are.

@MNHQ - This thread might be interesting in light of your recent campaign regarding post-natal care. It's very relevant.

The think that drives me crazy is that women are developing issues with continence, urgency and/or prolapses after birth.

No one is checking if their muscles are damaged and to what extent.

No one is warning them that further vaginal births might lead to permanent incontinence or more serious prolapses that might require surgery which will bring risks if it’s own.

Women that have developed issues after a first birth should be assessed properly and given information about the risks of further vaginal births. They should be able to opt for an elective c-section if they want to as in fact I believe should any woman after being properly informed of the risks of both.

The consultant I saw privately after DC3 said that I must never give birth vaginally again or I would risk severe fecal incontinance (nice). He said he was happy to write letters to this effect though frankly I haven’t been remotely tempted by any more DC. I just wish I had seen him after DC1 or DC2 before the damage got so bad.

As for this not happening in the past. I bet it did. The number of women who died in child birth in this country was massive and I don’t see why there wouldn’t be lots of childbirth injuries as well.

You're right @TheUnmentionable. I wasn't aware that I had a prolapse until I was pregnant with dc2. I'd had a terrible first birth (induction/high forceps etc) and even though I'd done my pelvic floors religiously I always wet myself badly when I sneezed unexpectedly after birth. I'm only 33. At my six week check the Dr examined me, checked my stitches we all dissolved and gave me an internal (I had a lot of internal damage). So I was looked at really quite closely. She said all was fine and that pelvic floor exercises were all I could do to help.

Wasn't until another Dr examined me when pregnant with dc2 (now) that she told me I had a prolapse. I thought things weren't quite right. I wish I'd have pushed for more help after dc1. Now, I'm having to be referred for specialist physio after dc2 is born by ELCS.

Blacklister at least you have found out in time and are having DC2 by ELCS. That way there won’t be any more damage to your pelvic muscles and ligaments and you can get more help after the birth.

Judging from this thread there are still doctors out there that are telling women another vaginal birth won’t make their prolapse / incontinance any worse.

Can I ask the people on here that seem to know what they're talking about...What do you think about ELCS vs VB for a second (and most likely last) in my situation?

I'll be 31 this year and going to try for another baby soonish.
I have a small pelvis and my first baby was 8lbs12oz (DH was 9lbs10oz so think it's genetic on his side as I was about 7lbs).
First labour 24 hours b2b ending in surgery tear, episiotomy & high rotational forceps. They thought it would be emc but they wanted to try forceps first.
It's still uncomfortable having sex and I mentioned up thread i can no longer orgasm. I leak urine occasionally but concede that can be caused by pregnancy too. (Ds is almost 2)
I've heard about episiotomy scar tissue not stretching well in a second birth and tearing badly. It's making me lean towards elcs.
Does anyone have any info on VB after episiotomy and big babies vs small pelvis? Ds wasn't only b2b he was also basically stuck in my pelvis and his forehead was hitting against it every time I pushed, or that's how they explained it anyway.

Yes @TheUnmentionable that's true. They didn't agree to let me have the ELCS because of that though, only because of my awful first birth and the risks of another VB to dc2. Its not to save me from more damage in the slightest.

But I am lucky, because I know now and hopefully once dc2 comes I'll be able to sort it out, or at least improve it. So many women are in a much worse position than me.

Boils my blood. Men would never be treated like birthing or post-natal women are. In no other medical scenario would you just be left to put up and shut up when throngs weren't right.

@kaytee87 Your birth founds similar to mine. I'm having an ELCS with DC2 soon. Dc1 was badly stuck (shoulder dystocia) and I had all sorts of horrid complications. She was nearly 9lbs, and I'm only 5'2 with size 4 feet (and a small/narrow pelvis it seems) and she was properly wedged in. I sustained a lot of damage from getting her out, lost lots of blood and we're exceptionally lucky that dd wasn't deprived of oxygen and has no lasting effects. Other babies are not so lucky.

I wouldn't even consider another VB. If I couldn't have an ELCS I wouldn't have got pregnant again. Luckily, the Ob who delivered my daughter wrote a report for me afterwards which said future births should be by ELCS and I've been allowed one with not too much fuss (just waste of time appointment pointing out the risks and discussing 'options' when I really don't have any!). In my view, in our circumstances it's much safer. I'm also not planning any more children so this should be my only CS.

Undoubtedly an uncomplicated, straightforward VB is preferable to surgery. However, if you're unlikely to get that - like
me - than a planned CS is IMO the next best thing. I'll take planned surgery anyway over an unplanned, complicated potentially dangerous VB. Yes, you're going to have a longer recovery than a straightforward VB but it took me weeks and weeks to recover from my complicated one too! So it can't be worse than that anyway.

Katee87 can you ask your gp if you can be referred to a urogynaecologist? Someone who could examine you and possibly do some tests and give you an informed opinion?

Or if there is a long wait then get a consultation privately?

@blacklister thanks for your reply, congrats on your impending new addition 

@TheUnmentionable that sounds like a good idea, I would maybe go privately anyway? Feel like I'd get a more unbiased view possibly.

It worries me that midwives are so vocal on why natural birth is best, even pushing dodgy research on epigenetics to further their argument, but have so little to say about the postnatal care that they are also responsible for, which has a huge impact on mothers.

Things like the Top Tips for Natural Births from the RCM which compare women to animals doesn't help either.

I don't get it. I've lived in the UK for over 10 years. I'm from a Western European country, where my best friend is a midwife. They don't use forceps anymore. At all. Under any circumstances. Due to the risk of injury to the mother.

So why do they have to be used here? I simply don't understand it. I had on my birth plan in big letters underlined that I would not consent to forceps, and if necessary I wanted a Csection. Thankfully, I needed neither, but I still tore badly and couldn't have sex for a year. I've still got scarring tissue. No-one ever checked me after I gave birth; only when I went back to my GP a year later as it was all still painful.

Where I'm from, all women register with a gynaecologist, who also gets called in for the birth. Is it because they get to know you better they can support you better? Perhaps they are more likely to intervene quicker? Maternal death rates are also slightly lower there than here. Neonatal morality is also better. (I've actually looked up the figures on official websites, I'm not making this up)

@ISeeTheLight I've no idea why forceps are still used here. It's actually barbaric, my sons face was so bruised and swollen when he was born. He jaw was so swollen he couldn't open his mouth wide enough to feed and required paracetamol at less than 24 hours old I had to express for him for almost 3 months and he never did get the hang of breastfeeding.
I'd never let forceps near me again. The frustrating thing is they discovered he was in a bad position when he was still high up so could have easily taken me for a section. They had me push him down as far as possible (bruising his forehead on my pelvis in the process) knowing I'd never be able to get him out without assistance.

@ISeeTheLight I don't know. But I agree with you. I wish I'd have done some more research and refused consent for forceps. They used three attempts on me, two high rotational and one normal. It was awful, though luckily I had already had an epidural.

I'm sure the recovery from a CS would have been easier and resulted in far less damage to me and baby.

@isee

Apparently if the baby is already in the birth canal or something, its better to use forceps than ECS - i'd be interested to know the reasoning behind that if thats true.

The fact that forceps have barely changed in their design since they were invented hundreds of years ago says a lot. I swear if men gave birth, they would never have been invented. They are barbaric.

@freegazelle I think that's true for normal forceps but not high rotational ones that are used when the baby is still quite high. I believe these are the forceps that are banned in a lot of places.
I might be wrong though.

It's disgusting the way they treat women in this country. A friend of mine had a still birth at 34 weeks, I'm pretty sure that could have been avoided if she had been followed up more closely. It seems they like to "let nature take its course" when it suits them.

My DM can't watch OBEM (which they broadcast in my home country) - she says the forceps usage just makes it unbearable to watch. It's considered barbaric and positively medieval.

I def think the high rotational ones should be banned in the uk!

Another point, but I think the arguments I hear about the cost of C sections are really rubbish.

In some developing countries there are far higher C section rates, because its less risky and they don't have the resources and midwives to deal well with even common complications in vaginal births. And its easier to deal with hospital bookings. I don't think these are good reasons to have C sections, but I think goes some way to show natural birth is probably only more cost effective with zero complications.