To make a complaint about my son's birth

[Soph88]

Waters went at about 11.00pm, called midwife who said to go in to be checked. Went in and got hooked up and monitored. I was have irregular contractions, baby's heartbeat was fine. The midwife checked my cervix with a speculum and a light, literally 1 second and said cervix isn't doing anything and to go home. I left the birthing unit at 1.30am. Had some more irregular contractions until they got very strong and I got up to go to the hospital and couldn't walk as baby was coming, paramedics called. Baby was born at 3.27am.
My complaint is that this was my second birth, my first resulted in a 3b tear and so I was technically high risk. I've now had a 3a tear with this birth and think this could have possibly been avoided if I had been checked properly when I went in and admitted to the labour ward rather than being sent home. That way a midwife would have been present and aware of my history. I could possibly have longer term medical problems due to this tear.
I'm honestly not sure if I should complain. They can't do anything about it now and my son is healthy. I might be being completely unreasonable even thinking about complaining. Views?

Honestly I think you have every right to complain if you believe your care was inadequate.
I complained about the care at my son's birth. Nothing much came of the complaint but it felt better to put it in writing and enabled me to 'move on' from the experience.
I would look for information on the PALS service at the hospital.

That's what I think I'm hoping, that it will help me move on and maybe the feedback will stop someone else ending up with the home birth they don't want.

I am sorry you are feeling like this but I am really struggling to see how your 3rd degree year could have been prevented. There is no robust evidence that I am aware of linking care in the first stage or latent phase of labour to perineal trauma. (Midwife of 22 yrs). How do you think being admitted would have prevented a tear?

So you gave birth at home?

I had an excellent midwife whilst in labour with DS2 and I firmly believe her advice and help in labour meant I only had a 1st degree tear, much better than with DS1. So YANBU to complain, I would.

How were you not checked properly? You said yourself that the contractions were not regular. Were you forced to go home or did you opt to?

The tear was her fault. She clearly didn’t check your cervix properly if you gave birth within 2 hours!

Labour is just so unpredictable. You weren’t in labour when you were checked. It was a relatively short time before you laboured very quickly indeed but the midwife couldn’t have predicted that.

I hope you heal well and enjoy your baby.

Book in for a debrief with a senior midwife, matron if possible. I had one prior to second DDs birth and it really helped put to rest some anxiety from previous delivery. If you are still not happy then complain formally.

Either way it will be fed back to department and hopefully used for improvement.

@Duchyduke that’s simply not true.

I went from nothing (had a sweep) to baby in just over 40 mins so she could well have checked the cervix properly!

@duchyduke - that's bull. The cervix was checked with a speculum.

Rather than go straight to a complaint, in your shoes I would ask for a debrief with the head midwife first and go from there.

with 2nd babies you can be 1 or 2cm for weeks before then dilate to a 10 in less than an hour, you were not in labour when you were checked. birth is unpredictable and a midwife can not prevent a tear.

As pp has said I would ask to speak to the Supervisor of Midwives first to discuss your care.

With my second baby I went from 2cm to delivery in less than an hour. I had a third degree tear, as I did with my first baby. He was born in hospital, delivered by a very experienced midwife.

That’s not to trivialise what you’re feeling but just to reassure that the outcome may well have been the same (in a physical sense), if you had been in hospital.

I don't think YABU at all to want some answers here. I never complained about certain aspects of my hospital treatment and I really regret it, as it may have helped me deal with things better and also might help someone else in the future.

Have you asked for a debrief and for someone to go through events in detail with you? You could ask some questions and ask for the relevant decision making and evidence, which might help you decide if there are grounds for complaint. And if you then feel there aren't you could still give your feedback on aspects of care/communication etc which could possibly lead to improvements for someone else.

Mrspatrickdempsey, for me it's not so much whether the outcome would have been different, more going through that experience of a difficult birth and not feeling supported or listened to or believing that everything was being done that was possible to support you in getting through it. For example, staff being dismissive of pain, being left alone at certain times, not having the option of my dh with me at times (not for medical reasons), not given option to consent to interventions, failure to refer for appropriate aftercare.Most of this had no impact on the physical outcomes but it all had a big impact on my mental health for years afterwards. When I discuss births with friends, it isn't those who've had the textbook easiest births who feel the most positively but the ones who feel they were supported to have the best birth possible under the circumstances.

@MrsPatrickDempsey from what I understood from my midwife if the head is birthed slowly then there is a lesser chance of a tear? Due to being at home, I feel like I didn't get the right coaching through the delivery to help prevent it and so tore. Of course I could have still torn on a labour ward.
I was sent home, I was due to give birth in a hospital but went to a birthing centre to be checked as it was closer to where I live.

I was very worried about tearing again and do feel like that wasn't addressed through my pregnancy. My first birth was very traumatic. I have the email for the birth reflections team and will email them to ask for a meeting. Maybe she can help me understand if I just progressed really quickly or if I should complain about the care.

Hi OP, I understand your upset as a woman using the service, but speaking as a midwife, the clinical care provided to you was appropriate. Although I wasn't there I likely would have done the same. You were not in active labour when you went in l, and when not in active labour the best place to be is at home- even with a previous 3b tear. Second babies sometimes do some very fast and there is little we can do to predict it, but equally likely was that it could have been hours and hours and hours until you had your baby. If you want to make a complaint then you should feel entitled to do so, but a debrief might be more helpful- where a specialist midwife will go through your records with you and explain why things happened the way they did. I'm sorry you didn't have the birth you hoped for and I hope you heal quickly and well.

@Bue is it common to check the cervix with a speculum and light? I was fully expecting her to check with her hand? It was literally 1 second and I was told my cervix wasn't doing anything.

The cervix can definitely have been checked properly. People can go from closed cervix to baby in a matter of minutes. Please don't make accusatory comments about someone doing their job when your facts are incorrect.

And yes, speculum is common practice when waters have gone but you don't appear to be in established labour! all to do with helping to prevent infection from repeat examinations. Congratulations on your baby

I left the birthing unit at 1.30am. Had some more irregular contractions until they got very strong and I got up to go to the hospital and couldn't walk as baby was coming, paramedics called. Baby was born at 3.27am.

Midwife here. It's entirely possible, just not typical, for a cervix to go from "not doing anything" to having a baby in

OP your cervix was checked in the recommended way. She wouldn't do a digital vaginal examination if your waters had gone because it increases the risk of ascending infection and therefore speculum is the recommended method. It's easy to see a closed cervix on speculum but not so easy to see a labouring one so if she could quickly and definitively say it was closed it probably was. Nobody has a crystal ball and can tell how quickly someone will labour and there was nothing that sounds like a good indication to keep you in and then it sounds like active labour started once you were back home and progressed rapidly. I don't think it sounds like there was any negligence on her part or deviation from local guidelines so it's unlikely your complaint would be upheld but it would at least get you more information and answer any other specific concerns you have and give you some closure so may still be worth it. In terms of giving birth in hospital rather than home there is now evidence that having a warm compress on the perineum and a coached slow controlled delivery of the head can help prevent anal sphincter injury in some cases so it may be that you would have avoided this in hospital but that doesn't necessarily mean your care was negligent. I hope you find the information and help you're after and hope your after care is thorough and appropriate with a physio therapy referral and a postnatal review with a consultant. Take care.

Can the dismissive posters just fuck off please.

The poor woman has just given birth and is feeling upset. She is allowed to ask a question and yes she is allowed to complain.

It's smug mums and dismissive midwives who made my birth trauma so much worse. Booked a c-section for the 2nd child primarily to bypass midwives.

Thank you for the responses, especially to the midwives. This is why I wasn't sure whether I should complain. I felt like potentially I wasn't checked properly but obviously I was and in the correct way. I don't think I'll be having any more children after the two births I've had.

Purely anecdotal, but with my 3rd I was in hospital as I was being induced. Was examined and was told I was 3cm and nothing much happening. My DS was born 22 minutes later. It was just one of those fast and furious things. Even being in hospital might not have made any difference at all