AIBU to think labour was longer than 6 hours??

[Megadesk63]

Any similar experiences or professional opinions very gratefully received!

I've found my notes after I was discharged from hospital following the birth of DS 3 months ago and looked through them properly for the first time (sleep deprivation and recovery haze after birth) - they say I was in labour for 6 hours..

I want to go to the Birth Afterthoughts service at the hospital so feel like I need to have some idea as to whether I'm being unreasonable to think that my labour should really have been classed as longer than 6 hours!

Essentially, I was told that I needed to be induced due to preeclampsia so the process was started with one of the gels on Sunday morning. They didn't give me the second one because I was progressing well but they couldn't get me on the hormone drip until Monday morning. Waters broke early Monday morning, I was on the drip just after that and continuing contractions - midwife checked Monday evening c.11pm (as I was desperate for an epidural at this point) and I was 4/5cm dilated.

Continued on drip and epidural until c.11pm on Tuesday evening when consultant checked and I was 9/10cm but DS had essentially turned into a position where he wasn't coming out naturally so they whisked me in for a C-section at 1am Wednesday morning.

Where does the 6 hours on my notes relate to?! Have I missed something obvious? The hormone drip was switched off for an hour whilst I waited for the epidural to be put in but apart from that it certainly didn't feel like contractions stopped during those days!

They measure when you are in active Labour so : more than 4cm dilated, regular painful contractions, usually when your waters have gone. So they will measure it from the start of then. But it really doesn't matter it's only used for stats so don't worry about It, no reflection on you in a good or bad way at all.

They only count established labour as Labour. I had contractions for approx 24 hours but my labour was only something like 4.5 hours.

I know what you are saying. They measure active labour but it feels quite dismissive of your extreme pain for so many hours.

I agree with caroline though, I wouldn't worry about it as it's no reflection on you and the info is really just for you and stats.

For what reason do you want your labour classed as being longer? Maybe that will help us understand?

I get where you're coming from OP. I felt rather insulted when, after 23 hours of painful contractions, I got told by a midwife 'no woman is in labour for longer than 9 hours... its not possible... anyone who says longer is a liar'

I think its the lack of acknowledgement for what you've been through really. And I know its just for the stats, but I really get what you mean OP.

thenightsky wtf?! I hope you complained

It really winds me up though when people say they were in labour for hours and hours and hours - and I say this as someone who was induced and had contractions for several days. There is a serious difference between active labour and not, and it might feel frustrating but as a PP’s midwife said, no one is in “real labour” for THAT long and the way people say it always sounds like attention seeking or ignorant.

And yes this is contrary to say and I’ll get eaten alive for it I’m sure but it’s one of my pet peeves!

Yup. They only count from active labour.

The reason is that latent labour (1-3 cm) can actually go on for DAYS. It's not uncommon for some women to be walking around for days to weeks 1-2 cm dilated, especially if they have had babies before.

The reason we don't count latent labour is because it can last so long and there's no sort of "established" guideline for how long it is supposed to last. This is why they don't generally admit women to hospital when they are less than 4 cm unless they're having constant contractions (in which case they're normally admitted for pain management) or they're being induced or there is an issue. They really don't want to end up sectioning a woman for "failure to progress" when she's really only in latent labour and it is not possible to diagnose "failure to progress".

My notes say I had a normal, standard vaginal delivery with no induction or instruments. I actually had an induction on a drip with failed forceps and a c section.... So I understand the feeling of a lack of acknowledgement for the work put in!

I think the problem is some medically trained staff don't take the time to explain why things are the way they are and can be quite blunt. To them, they're trained to only call established labour labour but to the ordinary person their labour feels longer so there's a difference of opinion between the two.

I don't think they only record 'active labour' as a diss, it's just the more medically relevant information.

Rowena your notes are just plain wrong though, did you correct them when you had your de-brief with your health advisor after?

I pointed it out to midwife when no one asked to see my stitches

My active labour was very fast 2hrs or donut lead up was longer. It's how they record stuff that's all

It really winds me up though when people say they were in labour for hours and hours and hours - and I say this as someone who was induced and had contractions for several days

The thing is though, I was in ‘active’ labour with DD1 for 8 hours. Fine, that is when I was 4cm dilated and was admitted.
However, for 24 hours before that I was having 3 contractions in 10 mins, lasting 1-2 mins a time. They were as painful as the last 8 hours were. So it does feel a bit dismissive to say ‘oh its not proper labour’.

soydora

I understand it feels dismissive, I was in a similar situation to you as I said; however it’s factually inaccurate to call it anything other than what it was.

My notes were wrong too. They said I had baby on me and fed her for an hour after birth, when actually they whisked me away to stitch me up after about ten minutes.

Thanks for replies everyone, it's good to see it from other points of view as I've not really talked to anyone about it before.

So going on the definition of active labour - I was 4cm on Monday evening when I asked for the epidural, contracting regularly etc until Tuesday evening, so why is it not active labour? (Not being goady, just trying to make sure I'm informed!)

I'm concerned that if I have another DC and my records don't accurately reflect the level of time spent in pain/active labour last time then I won't be listened to properly in terms of pain relief, decisions about C-section etc. I felt so out of control around this birth that I really don't want to feel like that next time round..

Don’t worry Megadesk if you have another, it will be you who tells your midwife what happened “last time” - they don’t seem to have access to previous notes

Actually I’d be questioning why you were left contracting on syntonfor 24 plus hours at such a dismal rate of progress. The expected rate of dilatation for a first baby is approx 1cm an hour when contracting regularly. To leave you so long is to risk all kinds of nasty complications.

Do ask for that debrief and question the management of your labour.

Congratulations!

I understand about the correct language etc but I felt almost disbelieved about the degree of pain I was experiencing for over 24 hours, both times, before being in active labour. The label doesn't matter, horrific pain needs dealing with regardless.

@MatildaTheCat if you are progressing even if it is very slow and your baby is very distressed a you are lower priority on a busy ward.
It is entirely possible to be in active labour for more than 9 hours, my clocked time in active labour was 23.5 hours, but it was 40 hours from when my waters broke.

@Lonecatwithkitten
That is not true, if your baby is in distress then that is a high priority, always. What you interpret as ‘distress’ may not necessarily be actually fetal distress.
Slow progress however would not top trump an emergency, but it would be considered high priority even on a busy ward.

@babycatcher411 I typed not in distress and spell check changed it sorry. If your baby is not in distress and you are progressing even if it is very slowly you are not a priority.