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?

My forceps delivery was horrendous. Absolutely humiliating too to be strapped up in stirrups whilst the room fills up with both male and female staff, all clothed and standing whilst you're lying there bottom half naked and strapped up.
They cut with scissors and I still tore. I was in agony, absolute agony, for weeks afterwards to the point of being in tears on a regular basis. I feel rage when I read about vaginal deliveries being way easier and quicker than c-sections. I'm definitely not alone in this.

One thing I noticed is that when you arrive at maternity units they generally have a big poster with stats for that month or year on them (number of babies born ect) and underneath 'safety' they have their percentage of c-sections against the national average, in a way that indicates the lower the rate the better. This means that women who sustain irreparable damage via forceps actually contribute to a POSITIVE statistic for the hospital. It also means hospitals that refuse to grant maternal request sections have a 'better' rating as well. I think there should be pressure on hospitals to reduce birth injury statistics but they are never mentioned?

@Elaine

Completely agree.

Elaine. Metoo.

Definitely. I think both choices need to be equally presented with all possible risks and positives. Then a woman can decide to have either vaginal or section with no difficulty.

I didn't want to give birth vaginally, so I had two sections. It was my choice and I think it's why I have had no PND, PTSD or just general suffering from injuries.

To be fair, I have had six babies and had none of these injures,I am normal weight and 20 with my first, and I don't know anyone who has either, but I'm shocked that people aren't helped when they happen. I always think that a vaginal delivery is the best option in normal circumstances and its most probably how the deliveries are managed that has led to the complications, and mostly people being induced badly, just my opinion and how I have dealt with the choice.

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

^
Yes.

The mother's health is obviously worth less than the cost of a section.

Does anyone know - if forceps really are the "only option" sometimes, than what happens in the countries that ban them?

@BlueSapp are you sure you don't know anyone with birth injuries? I've not told my friends that I can't orgasm, find sex uncomfortable and leak urine. It's not something you tend to discuss.

Actually, I am sure because the people I know tend to over share, perhaps not about the orgasms but totally if they were incontinent it would've been said. But i think thats OP's point, why don't you talk about it, at least to healthcare professionals

@BlueSapp People do talk about it to HCPs. That's the problem, they talk about it and are brushed off with 'that's what happens after childbirth' or 'do some pelvic floors'.

Shoulder shrug response normally. Yes if you push you'll probably get a physio referral but as some of the PPs have said on here that won't repair some damage. It will strengthen and help, but it won't fix muscle ripped from bone, or scar tissue.

My conclusion after having two DC (one EMCS and one ELCS), and hearing the stories of others, is that you couldn't pay me enough to attempt another VB in this country. Women are being treated appallingly before, during and after delivery and that has to stop.

That's what I was saying, I am shocked that there isn't more help as I assumed like anything else these injuries would be catered for under the NHS

When you say, "Can no longer orgasm", do you mean through masturbation or vaginal sex or both?

Sorry for the sensitive question.

Reading the whole thread as a woman in her late twenties with no children, but considering having one in the next few years. Thread is equal parts extremely informative and very saddening. I knew post-natal care was shocking, anecdotally, from friends who've had babies, but had no idea of the terrible extent of people's birth injuries. I am so sorry to hear about them.

Think I want to ask for an ELCS if I do decide to try for a baby! I'm horrified by the thought of things like inability to orgasm. It might sound ridiculous, but I don't want to have to give up having orgasms for the rest of my life.

@SachaStark both. It's like my clitoras is almost numb. Some sort of nerve damage I suppose.

Just read this article on the Guardian. Warning: very distressing content.
I thought it was quite apt in this thread as an example how HCPs don't listen to mothees with disastrous consequences.

*mothers

Terribly sad story. What on earth was that Doctor thinking? Breech, cord around neck, failure to dilate - carry on regardless?!

Sorry prolapse cord and low heart rate. I'd like to know if she'd delivered many breach babies too.

It's horrendous. And the mother testifying that she tried to crawl off the bed 3 times but the kept pushing her back on horrible

One of the worst things I've read. Medieval.

How awful. That poor woman.

I am interested to hear what happens in other countries that don’t use forceps also? It may surprise you hear that forceps are often used in Caesarean sections to get the baby’s head OUT of the pelvis. Once the baby is in the birth canal it is quicker and safer to deliver with forceps than emergency caesarean (bearing in mind they would be needed to pull baby out the birth canal to deliver abdominally). High rotational forceps are not necessary as at that point the baby is high enough to go for Caesarean section safely. Many countries ban high rotational forceps but I’ve never heard of a country that bans ALL forceps.

I first heard of that story a couple of weeks ago and was just speechless. What possessed that doctor to try to pull a baby out of a woman who was less than 4cm dialated? And why on earth did none of the other HCPs in the room speak up?

That poor woman. I can't begin to imagine how much pain she was in and how terrified she would have been. Inexcusable.

Catching babies if high rotational forceps aren’t needed , if it is a safe option for cs, why are they used in the uk knowing the damage that can be done?
I appreciate some women may prefer high rotational forceps to cs (although I’m guessing these women won’t be fully aware of what living with pelvic floor damage is like if they would opt for this, but each to their own).
If you were to be honest, are women given a choice between high rotational forceps and cs, or are they usually told what they are getting? Or are they given some information, but an amount that doesn’t really allow them to make an informed decision? A sort of rosy picture of forceps?

Not at all trying to downplay the horrible terrible thing that has happened to that poor mother and her baby but I think it is not fair to comment on a case about which you don't potentially know all of the details.

Performing an emergency CS on a 25 week gestational uterus is not the same as in a term woman. There may be implications for the mothers ability to have children in future I think, that the obstetrician is weighing against the infant's chance of survival - which in any circumstances may be very, very poor for a 25 weeker with fetal brady and cord prolapse. The decision about what to do has to be made in minutes before the baby with brady and cord prolapse will die. 4cm dilated in a 25 weeker may mean something different than in a term pregnancy. Labour can progress on a very different timescale.

I am not an obstetrician and don't know the answers to these questions but I think before jumping to a particular conclusion and having a trial by media, it's important to realise there may be many factors that we don't know, and in fact don't know that we don't know. Wait for the results of an inquiry and the opinions of other professionals.