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?

Lucifer and Edna Totally agree. My injuries were devastating at the time and are now disabling

Can't help thinking there's some institutionalised misogyny underlying this.

YY to this.

And having had two elective sections after 3 horrible natural births my recovery after the sections was a walk in the park whereas I will never be fully recovered from the natural birth due to being left with bowel incontinence.

Same for me lilifer (hug)

I’d really like to see research and stats on the risk of being overdue and subsequent induction. I felt very much pressured into an induction with my first birth, and I’ve since read about the cascade (is it cascade??) of intervention. My induction, which I resisted for a few days, was a proper shit show and resulted in an emergency section.

And my own anecdata is that my recovery from both my sections was really straightforward. I have friends who are still injured from their vaginal births almost 10 years ago. Vaginal births can be absolutely brutal, it seems.

Caesareans can also be brutal, too though. I have heard some stories of anesthesic failing mid-operation and really horrible issues with wound. They are not a panacea. On a population level, which I know no one really cares about when it comes to their own case understandably, there is increasing evidence that being born vaginally has benefits long term in terms of seeding the microbiome.

5 years on and I'm still in huge amounts of pain from a star like tear due to forceps. 30 and fit when I gave birth. I've had 4 repair surgery and still it's hugely impacting on day to day life.

My spinal failed during my c section.

It was dealt with quickly, efficiently (pumped full of morphine rather than put under) and although it was unpleasant it’s not left me traumatised at all. no lasting effects and I’d still prefer a repeat c section over a vbac.

@EvilEdna1 I did all those recommendations tried every trick and position possible. 3.5 hours of pushing and she didn't budge. I was however lied to and told my daughter was in distress and they had to use foreceps. I wish every day that they'd given me a c-section and if not at least an epidural which would have helped with the horrendous pain as my daughter was literally ripped out of me with zero pain relief

Thanks @Shrimpi

Rationally I believe that the majority of medical professionals are exactly that and I try to forget this ever happened. Unfortunately it has left a mark and so I was very relieved that DC2 was eventually delivered by ELCS. By sheer luck it was the same surgeon who delivered DC1 during the EMCS, which allowed me to relax because I knew I could trust her.

I feel sorry for all those medial professionals who practice correctly and appropriately though - it isn't right that the inappropriate actions of a few others can lead to patients feeling insecure with you when you're doing it right

I see we've discussed consent. Consent? What the fuck is that?!

I was unlucky with DD1 to go into labour over a bank holiday, and to go into labour coming up to a shift change. Denied pain relief and shouted at by staff constantly I was becoming more and more terrified, and then my MIL rocked up and not one person asked if I wanted her in the room - just invited her in. I was terrified of being left in the pain I'd been in from SPD all pregnancy (virtually housebound from 20 weeks, unable to walk properly and in absolute bloody agony) and I'd heard the stuff about being careful with epidurals etc that you noted your pain free gap you could open your legs to make sure that you didn't end up with long term damage.

So they needed/wanted to use forceps (I still remain convinced if they hadn't of been bodily forcing me down onto the bed DD1 would have come out of her own accord as she definitely started to move when they got me vertical to put a spinal block in) and all I wanted was for them to make a note of how far I could move my legs apart... and they wouldn't do it - shouted and screamed at me right in my face until I had no answer but to agree... took me down into surgery and DD1 basically started crowning the second they moved me vertically - assured me that they were not allowed legally to cut me without my consent and they would ask me before doing so as well. I started reacting to the spinal, couldn't stop shaking, something was beeping like mad - no one would explain why I couldn't stop shaking or what the fuck was beeping (I think if you're attached to a machine and it starts beeping the fuckery that you're bloody well entitled to know if it's a good beep or a bad beep). DD1 was born and they took her away, didn't even do me the courtesy of saying if it was a boy or a girl - stitched me up and dumped me literally in the corridor outside and I could hear them muttering how they'd let me calm down and leave me there a few minutes.

Then someone had to sheepishly admit they'd cut me quite massively, and they chucked me on a postnatal ward where I had a breastfeeding leaflet literally thrown at me - and I had to listen to the nurses slagging me off as a "troublemaker" and "need to keep an eye on that one" all night. In the morning they hauled me in for an interview and said they'd referred me to social services as a "resistant patient" and did a full on interview of everything that had happened... getting more and more sheepish as the interview progressed and they realised just how fucking disgracefully I'd been treated - and then went white when I very politely told them that I wasn't the complaining type and I didn't want to get anyone into trouble but that the perspex panelling between the desk and the patients really wasn't very soundproof and I'd heard every word so they might want to keep the voices a bit lower in future just so they knew. Still had to go through the full social services looking into it process - even though it was thrown out as quickly as it could be. Wasn't until my community midwife heard what had happened and then the midwives at DD2's birth heard the abridged version as an explanation and advance apology for me being a very very terrified patient - and their reactions of total horror - that I realised just how badly I'd been treated and I was being urged to consider really pushing the breech of consent thing... but who was I to challenge things - we had the social services referral in our past and that always scared the shit out of me.

My relationship with DD1 has never been the greatest - there's a massive clash of two similar personalities there - but there's also an element of me struggling to bond with a baby I got fucking terrified I was going to lose. Every bump, scrape, bruise I was terrified would need a trip to A+E and the social services referral would be there - even now it's still always there in my mind that we are a family known to them.

Oh yeah and the second they got that spinal block in they had my legs in positions they've never gone into before or again - and that's what completely fucked over my SPD - I struggle to walk any distance, constant kicked in the crotch type pain, struggle to sleep at night, my pelvis makes some impressive cracking and creaking noises and it's a fucking miracle DD2 was conceived as my sex life is pretty much nil. Mentally though was a bigger birth injury than anything at all - still makes my eyes feel slightly like the tears will come typing it up now and DD1's 6 for fuck's sake.

EvilEdna1 to check if the plug is still there and if cervix is not opening prematurely. What financial benefit exactly for the doctor employed by local nhs?
Why the sweep is so popular here? i was trying to find some info from poland and had really a problem with it. I really find it surprising that you have no VE at all and don't even see obgyn on regular basis and toward the end pregnancy you have sweep which for most women here will be a shock.
Plus the doctors here have a 'god's syndrome', they no better and how dare you contradict them. I suspect that's why so little info is given to female patient during pregnancy because they want them to do as they told.

@Kolo I was shocked at the induction stats for my hospital.. something like 45% of first-time mums having an induction end up with an emergency c-section. Then obviously out of the 55% who have a VB a percentage of those are assisted/forceps etc. Basically if you're having your first baby there via induction you're more likely to have an emergency c-section than an uncomplicated VB.

@4yearsnosleep. Following the recommendations increases chances of a straightforward birth but if the baby is in a difficult position sometimes nothing works.

There should have been time to give you anesthesic of some type, pupendal block or spinal. The only instrumental births I have heard about with no anesthesic personally are ventouse with the baby almost there , just needing a little encouraging.

Emergency caesarean is often riskier if the baby is low in the birth canal as forceps are used during the operation to get the back back up. Have known a woman negotiate a ceasarean against drs advice in those circumstances and vice versa , negotiate a forceps birth when the Dr wanted to do a cesarean.

bing that is truly horrific. I am so so sorry that happened to you. It’s disgraceful.

And a stark example of why consent is needed and why consent is an ongoing process.

Sreberko. Those checks aren't evidence based. NHS drs don't do them, there is no financial benefit . In other countries drs get paid for each visit and each check and test and do shedloads of unnecessary stuff.

I agree with you OP. I was diagnosed with gestational diabetes within weeks of my due date. That was my plan for a calm water birth out of the window. Instead i was restricted to a bed and hooked up to a drip. I sustained a 2nd degree tear and painful hemerhoid although the birth was quick and relatively easy. Although I can't fault the care I received in labour, i was surprised that no one checked on the tear or my bum after leaving hospital, neither was my gd followed up. I had just assumed local midwives would do this as part of their visits.Like many others i now suffer some incontinence and still have trouble with my bum nearly a year and a half on . It seems that women are just expected to put up with these after effects of giving birth and it's rarely talked about.

YANBU I was very much sold 'natural' labour as the safest easiest option... its not that is it. It certainly can be for some people but I really wish that accurate info had been shared with me about how traumatic it can be. I wasnt prepared for the fallout from it at all. I knew I would bleed for some time afterward.. I did not know about the tearing and bruising and infection and constipation and pain. I was unable to sit properly for months and months, had to wee and poo underwater because of the pain.. could barely walk for the first couple of months.
Luckily im completely healed now but I know other women who have not been so lucky. And I wouldnt have realised that I would completely heal which is another issue... when I would look at the tears there seemed no way such a massive wound would ever heal and it made me extremely depressed.... again I just wasnt aware of how common tearing is and how many women do completely recover in the end despite serious seeming injuries.

Vaginal delivery is sold as being so much less damaging than a section which is always labelled as 'major surgery which will have a large impact on your body and your mobility in the first weeks'
I honestly think that many womens experience of vaginal delivery is exactly the same if not worse sometimes.

Factor in stuff like forceps and I think if I were actually given a choice id go for a section next time.

(as it is im going for a home birth to try and avoid assisted delivery and/or induction)

A recent Cochrane review has found no evidence that any type of yoga/floor scrubbing/positioning pre start of labour can change the position of a baby to a more favourable one. They found a small decrease in back pain in pregnancy with some excercises, but zero effect on the presentation of the baby.

It is a myth, and another one that places the blame for a poorly positioned baby squarely on the woman. Scrub those floors, bitch, or you deserve the pain.

We’ve not really moved on from the biblical exhortation to bring forth in suffering have we? Men would NEVER be treated like this.

'Tis fine babelfish - I make a point of telling the story because I sobbed with the first time I found accounts of women being basically threatened with social services over childbirth choices as I'd thought it only happened to me and I must have deserved it or something... so if I tell what I went through - if any other poor woman's out there who has had similar go on they might come across it and realise they're not alone at least.

DD2's birth was superb incidentally (different hospital, same NHS trust which may or may not have been on the BBC Hospital recently) they double checked and triple checked I was OK with absolutely everything, handled my knackered pelvis like it was fragile glass when they needed to spinal me to go on a small placenta retrieval mission and were generally superb (although having someone up to their elbow in you James Herriot style while they're discussing how crap the surgical scenes in Holby City are was an incredibly surreal experience).

People are always going to have a birth story. Some are amazing, some are horrific. I have had a planned c-section (breech) and a Vbac. Currently pregnant with my 3rd. I know the risks of both. I know people have suffered either way. I also know giving birth isn’t an exact science. If there is no faith and trust among the people helping you at that most vulnerable time then how will that help?

I have the opinion (probably very unpopular) that women (and partners) who are pregnant have a responsibility to research the pros and cons of childbirth themselves. There are 9 months to do it (give or take!). There are so many women getting pregnant out there. How does the nhs keep up with them all? It’s horrific.

It's not that long since women frequently died in childbirth! You have to weigh the risks. A vaginal delivery is still the best option but obviously the fitter you are and the younger you are (generally) the easier the delivery. You cannot completely remove the risks but they are vastly reduced but as PP said many more women are becoming mothers for the first time much later in life and when they are not physically fit and healthy. You have to take some personal responsibility for this. If you try to get pregnant you should try and be in the best physical fitness that you can possibly be to try and minimise the risks. Also, your body will not cope as well with a fist time pregnancy at 36 as it would at 26 or 16! These are facts that you cannot get away from!

I had an epidural failure during my EMCS that I was bullied in to by a doctor who told me I was a ‘negligent mother’ for not consenting to one as baby was not in distress and there didn’t seem any reason to.
I felt the knife slicing in to me and screamed as they hadn’t checked if I was properly numb. GA quickly administered when they realised. Not one person came to see me to explain what had happened after.
I finally plucked up the courage to go for a birth reflection after years of PTSD to find that the anaesthetist had written ‘mother distressed at the idea of impending motherhood’ in the noteworthy comments, not a single thing about how they had cut me open without any pain relief.

Being physically fit helps with recovery and stamina. Of course being fit is a positive thing generally

It does nothing for any structural issue (small pelvic outlet) or malpresentation issue or issue like placenta previa etc. There’s a slight increased risk of shoulder dystocia if you’re obese I think. But overall It’s wrong to imply that fitness is the key to a good birth, again it’s blaming women for factors they have no control over.

Bing, your experience (from the physical side) is pretty much exactly what I feared when I pushed for an ELCS with my DD - my SPD sounds very similar to yours, i was immobile, inflexible and in agony and they were so damn determined that as long as I had an epidural and couldn't feel the pain at the time then it would be fine.

The way SPD is ignored treated in a lot of hospitals is horrific.