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?

Just to put my opinion across, many women don’t get access to obstetrician so don’t even get to discuss the different risks and possibility of a section.
I had a post natal problem after ds. My community midwife wanted me to be seen by a consultant obstetrician back in hospital. She called the hospital and said this. The first thing the receptionist said “who is her consultant”.
The midwifes reply “she’s midwife led doesn’t have a consultant”.
Therefore no consultant for me, despite a very experienced community midwife requesting the consultant saw me, I had to wait for four hours to see a registrar, who didn’t know what he was doing, and I ended up needing to see a consultant two months later anyway because my tear wasn’t healing.

So am I slightly bitter that just because I was a healthy weight relatively young and fit, I was denied care my midwife thought I needed (expert professional opinion). When it id been overweight/older I would have had access to a consultant. Shocking in my opinion.
Yes I understand overweight people and mothers having children later on life have more risks, but in a case like mine I needed care too, and I don’t think I should have been denied that on the basis of having a healthy bmi.

I agree. A lot of it is cost saving though, understandable when most births are covered by the NHS. C sections are more expensive and require a longer stay on the ward.

I had a natural birth, luckily no lasting damage but the lacerations and abrasions took a long time to heal. Baby was a difficult presentation and got stuck.

Next labour I'll use our private health insurance. I'd like an epidural early on and if things don't progress opt for a c section rather than labour for 24 hours because all the theatres are busy!

I think if you've had one traumatic labour and/or birth injury a c-section should be an option for the next one, as the risk of permenant injury is much higher.

I know lots of women with permenant damage to their pelvic floor and continence issues, and a few are still waiting for surgery over a year later.

Last few posts are a case in point, you've got one poster being shot down for c sections shouldn't be a routine choice and ten either implying or openly stating that c sections are better/safer.

I just don't agree that vaginal birth is promoted to the exclusion of all else. It wasn't my experience and it's not what is happening on this thread.

for you tickyticks and you are exactly right it really is a sales pitch when they should give you a balanced view and let you decide.

I do not feel that more info about the risks would have helped me in any way going into my first labour. In fact it would have had a definite negative effect on my emotional and mental health.

What women need is more support around active birth to reduce interventions and then if interventions are necessary more recovery support (eg specialist physio right away, proper follow up checks - 6 week check is a joke!)

@silverpenguin I think experiences differ. It was only when I joined mumsnet in desperation, after my Trust tried to force me down a VB route, that I found other women who had been in my position and were able to help me get what I needed.

It's great that you didn't have my experience but far too many other women did and still do. My friend was recently asked if she was 'too posh to push'; why should she have to explain to strangers that her first birth left her with incontinence and a tear from front to back? Women are judged negatively for CS choices from medical professionals and the general public alike. That's not good enough in 2018.

Dugeehugs I note what you said about your trust trying to force you down a vb route.
I’m worried this is going to Happen to me.
Can you tell me what happened, did you manage to get your cs and how did you get them to agree?
Sorry to derail the thread a little.

I did lots of reading and decided the best thing for me to do to avoid injuries was not to have an epidural and to stay active during the birth. And do yoga before birth, that helped a lot. Worked ok for me. I only had 2nd degree tears that healed easily and that was with two nine pound babies. I am sure that’s partly genetic though. I don’t know who you expect to ‘tell’ you this stuff? There’s loads of information out there. Surely it’s up to adult women to do the research.

I had 3 ok vaginal deliveries. Although my first was really painful.

However, I’m really convinced that forceps should never be used - straight to c section. And also where a woman has laboured for 12 hours - they really should get a c section. It’s horrific to leave a woman in pain and labouring for longer than that and some women are.

Totally agree OP. I also can’t help but think something is going on in the U.K. (as a PP said, far less complication in France, a very similar and nearby country, can’t think of any demographic there that isn’t present here)

What did shock me was the episiotomy

Agony ! And no pain relief advice nothing

Had I been of sound mind I would have researched some decent BF friendly painkillers

@duggeehugs I do understand what you're saying and some of the experiences shared on this thread are awful and totally unacceptable.

However the other side of the "too posh to push" comments (which are rude and ignorant) are the "brainwashed by the natural birth movement" comments about women who want a vaginal birth (equally rude and ignorant!)

It sometimes feels like "women should be informed of all the risks before birth" is just code for "sensible, intelligent women choose c sections".

I do agree with a PP about better postnatal care though, on everything from birth injuries to mental health to breastfeeding it's really poor in my opinion.

Also, I frequently hear about what appear to be silly mistakes - I have 3 close friends who were left to push for more than 2 hours.

-One had a live threatening condition which made her more likely to bleed out (which she did, from 2 hours pushing in a poor position and nearly died)
-Ones baby was stuck (not uncommon but no idea why she was left so long)

• One was taken for forceps where they discovered she was only 7cms

I also have 2 friends who were put under enormous pressure to come in for Inductions after their waters broke, and were promptly forgotten about and left on the ward for between 3-5 days before their babies were born.

And Op I’d love to know the answer because we’re trying for another at the moment and I’m terrified. We had a crash section and it was very traumatic. I’m starting to think my chances of a normal birth are slim to none

gwnnfluff I'd only ever want a c section of there was a risk to me or the baby. I wouldn't want to go straight to c section after 12hours of labour - that's not even that long?

Really interesting thread. I have always wondered when people say c sections cost the nhs more money, is that just the birth itself or does it include follow up treatment afterwards? I had an emergency c section almost 4 years ago due to fetal distress, it was scary at the time but recovery absolutely fine whereas my friend who had a baby just after me had a very complicated vaginal delivery and is still having physio and treatment nearly 4 years later.

It sometimes feels like "women should be informed of all the risks before birth" is just code for "sensible, intelligent women choose c sections".

That’s definitey not what I’m saying. I have someone I know right now who wants a Home birth - no complications, almost next door to hospital, she’s facing HUGE pressure to not do it. We both want different things - I want a section, she wants a HB. There’s no medical reason for either of us to be forced down a route we don’t want. Yet we both are. That’s what I am annoyed about.

What I want is ALL women’s bodily autonomy to be respected. Whether they really want a vbac, or really want a cs.

Obviously there are situations where you’d be very unwise indeed to ignore medical advice - but in the main, far too many women are channelled down routes they don’t want to go down simply because of caregiver bias.

I would say intelligent women, ALL women deserve an unbiased, accurate briefing before birth on the modes of delivery available, the risks and benefits of each, the common ‘things that go wrong and howvthey are dealt with’.

And better postnatal care, because in the UK it might as well not exist.

@Gwynfluff 12 hours isn't really that long. My first labour was 20 hours and progressing nicely. Straight to c/section after 12 hours is madness! Also not all labours are painful

I agree. I thought giving birth naturally would mean I was up and about quickly, a speedy recovery etc. Instead, I delivered naturally, tore severely, ended up under GA being patched up for 7 hours, lost 4litres of blood, woke up catheterised and hooked up to a million machines on HDU with sepsis. It was honestly shit and it took months to recover. Next time I am having a c-section and if anyone dares tell me it's easier to recover from a "natural" birth, I will be fuming!

sprinkles request a section when you book in with the midwife. Be firm. You will probably have to see a consultant but if you had a previous crash section you should get one.

@silverpenguin you're right about the polarised positions on this - neither is helpful and each leaves women feeling undermined and angry.

My position is that women are not offered informed consent and that the information and support for women in delivery and all the areas you mention is woefully lacking. This has to change and I'd love to see the RCOG push harder to see all women given the risk-benefit analysis for all their delivery options.

@ithinkididmagic I've PM'd you to avoid derailing the thread

Surely part of it is that babies are bigger these days.

My 85 year old Mum considers a 6 and a half pound baby to be big. When my DNiece was born 25 years ago at 8lb my Mum was aghast at anyone having a baby so huge! 8lb is nothing these days!

C-section's should not be a matter of routine choice, the female body is designed to give birth vaginally for good reason. Not to mention if everyone started demanding sections the NHS could not cope

That attitude is shit.

Bodies designed to push out babies? Yes they are but a fuck of a lot of women all of the world die pushing out babies.

Women shouldn’t be able to choose a c section because it’s more costly?

You want to take a little look at the overall costs following up complications from birth injuries after a V birth verses a planed C section. Emergence C section costs should be classed as part of the planned V birth costs.

Babdoc, this just isn’t the full picture and is misleading. Women are having bigger babies. I was a slim, active, under 30 mum. Like many others I had an over 4.5kg baby.

Being told it’s probably because you are fatter, less healthy, older mums is offensive actually.