To question the "partners only in active labour" current NHS policy?

[RainMinusBow]

Define "active labour." How can this be determined?

I'm confused why you'd refuse VE?

Oh, lots of reasons. It's painful, can slow down labour, is not strictly necessary, may be triggering for sexual abuse survivors...

I was 4 cm with my first and gave birth 24 hours later.
I didn't have vaginal exams with my subsequent two ( though I did check myself out of curiosity)
Second birth was 2 hours start to finish.
And third was 8. Both those births the midwives made it with about 40 mins to spare.

There are probably some guidelines on the aims website if you need more support with declining ve's

It's not shakey medical ground at all.
They are responsible for the patient and the patient alone. They are offering medical treatment. They do not have to permit anyone else in.

The offer is birth partners are allowed in active labour.

They will try and guess when active labour is without a VE. The patient as a competent adult who's about to become a parent needs to understand that THEY are risking their Bp missing the birth.

My active labour was 1 hour. It went from 0-100 in 5 mins.

They didn't believe I was pushing when I was. Because they didn't believe I went 4cm to pushing is 15 mins. The baby I pushed out proved otherwise.

When I was in labour my exh was sent home both times until active labour. I was high risk so had to stay in but he was sent home both times until I was going into delivery suite. Maybe it was because I went in both times around midnight but I think they already do this is in some cases

I'm confused why you'd refuse VE? Do you refuse smear tests too?

I’m not the OP but am a rape survivor and can’t face VE’s from just any healthcare practitioner. It needs to be someone female, who I’ve known for a long time, and trust. My smear is also overdue because of this. Lots of women have experienced sexual abuse and assault.

@BrooHaHa

*Article 3 of the European Convention prohibits inhuman and degrading treatment. If caregivers fail to provide care which is needed to avoid preventable suffering – such as pain relief – then this could amount to inhuman or degrading treatment.'

I think from this you could argue that refusing to allow a birthing partner unless the patient consents to an invasive intimate exam would be illegal. Refusing to allow them full stop probably not a legal issue, but making it conditional on a vaginal exam may well be. I think the hospital would have to draw up a policy for determining active labour in the event of refusal of a vaginal exam, based on behaviour etc. And then you'd have to get the woman to understand that a birthing partner would only be allowed when in active labour as defined by this policy, accepting that it may be less accurate than a vaginal exam would be.*

That's an interesting interpretation you've done there! Article 3 is talking about inhuman or degrading treatment such as denying pain relief. Having a partner with you is neither inhuman nor degrading. Pretending that it is is just ridiculous.

OP, your previous post about not being allowed a home birth anymore was very clear on your decision. You say you're going to either have an independent midwife, who will cost you several thousands of pounds, because you d want to catch Covid in hospital. Fair enough. But you also say you have no money, have spent your savings on fightIng your ex for your other children, and that if you have to you're happy to freebirth even though your dp wanted you to have the baby in hospital when you first became pregnant.
So why are you now going on about having a VI in order to ensure your dp is allowed to join you in hospital when your in active labour? The vastness majority of women don't object to letting midwives get on with their job. The minority who don't want a Vi, or indeed any other intervention, would need to discuss this with their midwife first in order to come to some other agreement of how progress can be monitored, and to ensure the midwife can explain fully the risks of mothers taking a particular approach to their child's birth.

It's not shakey medical ground at all.
They are responsible for the patient and the patient alone. They are offering medical treatment. They do not have to permit anyone else in.

I said shaky legal ground. And I think it would be, if you decided the only way a woman would be allowed a birth partner would be to submit to a stranger's hand being inserted up her vagina to probe her cervix. An outright ban would be less contentious.

You can refuse any intervention you want.

It's your body.

What you can't do is demand something that may put others at risk. It is absolutely your right to refuse ve, but please understand the ramifications of this in these unprecedented times.

As an aside, ve isn't just looking at dilation. It also picks up things we may not see otherwise. Malposition, malpresentation, cord prolapse etc.

Again. It wouldn't be.
They wouldn't mention that.
They would say.
You can summon your BP when in active labour.
There is then the real possibility that that would be missed.

Global pandemic means people need to realise they are not that special or important in the grand scheme of things.

I belive its actually at the point that you are taken to the private labour sweet that your partner can join you.

If you don't want an exam they'll probably determain by intensity and timing of contractions.

That's an interesting interpretation you've done there! Article 3 is talking about inhuman or degrading treatment such as denying pain relief. Having a partner with you is neither inhuman nor degrading. Pretending that it is is just ridiculous.

Not at all- it would be degrading to be forced to submit to an unnecessary intimate exam before you could be rewarded with a birth partner. 'Good girl, now you've let me stick my hand in you, you can have a birthing partner (even though we can tell you're in active labour by looking at your behaviour)'.

And once again they won't be saying that.

It's fine you don't want a VE. But other methods of estimating your progress may not be as accurate and as a result you may progress quicker than predicted and the baby may arrive before your partner is summoned.

Of course it's your right not to have VE’s, that said it doesn't mean that you get to keep you, partner, otherwise everyone could do the same. There is a reason that they are doing this. Given the fact a dad in his mid to late 20s has died 10 days after the birth of his child, from Covid-19 that they are totally justified in trying to protect an entire labour ward. He could have passed it onto anyone there including his newborn and no one wants that. Good luck

You should never ever be forced to have a VE or any other medical procedure you are uncomfortable with. Ever.

That said, it is harder to determine active labor without it and therefore you may be without a partner for longer than if you had the exam. Not a huge deal but just something to consider.

I think you accusing midwives of blackmail however is atrocious and rude and completely uncalled for at a time where everyone is under complete stress and being worked to the bone. Awful.

I agree VE should be only with consent and have no consequences for refusal. There are other ways to tell. I was pushed into one (despite previous trauma being on my notes) for my first child and they basically used it to dismiss me. Told me to go home as I wasn’t in Labour- baby was born unassisted two hours later.

My trust hasn’t banned home births thank God as I don’t know what my options would be. My first labour was 3.5 hours total land I’ve been advised to expect another precipitous labour meaning I’m unlikely to make it to hospital (45 mins drive)

After several very painful VE’s in my first labour, during one of which I was begging the midwife to stop and she refused (actually refused to take her fingers out of my vagina), I didn’t have any in my second or third labours. No drama, they weren’t needed, the midwives were fine with it and they were far more relaxed, comfortable labours than my first. To an experienced midwife it’s generally obvious from your behaviour how close to giving birth you are.
I think in your circumstances OP home birth is a far better option. If I was due a baby any time soon I’d opt for a home birth.

Your body, your choice. Keep looking at information on birth rights etc and your IM will give you lots of ways to communicate your decisions.
Vaginal examinations are offered but you can choose to refuse as with all treatments.
Agreed, they can give medical professionals an estimated idea of progression but that's not the only way.
Also, VE can introduce infection and can cause/slow things down if it stresses you out.
If you are totally against them, I would also suggest you ask your IM about what to expect during an emergency c-section as this also needs to be addressed.
You might also benefit from discussing after care with your trusts if you have an emergency c-section such as dvt and what surgeons do it which way.
You are going to do just fine!!!

And once again they won't be saying that.

I'm not arguing with you- I was responding to the people insisting that the choice would be a vaginal exam or no birth partner. If you go back to my post at 15:01, I said exactly what you're saying, that they'd need to use other methods to determine the onset of active labour and warn the woman that it might not be as accurate.

@HoffiCoffi13, OMG?! Surely that's assault/abuse?
You said stop and refused and she took advantage of her position, no?
Was there no one else in the room to advocate?
I'm so sorry that it happened!!

I think you accusing midwives of blackmail however is atrocious and rude and completely uncalled for at a time where everyone is under complete stress and being worked to the bone. Awful.

I'm not, because no midwives are actually saying this- it's a hypothetical scenario.

So if my Trust were to say "VE or no partner" (and this hasn't been clarified), is that lawful?

But they're not saying that. They're saying "active labour or no partner". Quite different.

@Randomness12 How does one know they are "definitely past 4cm dilated"?

@Soontobe60 We do have limited funds. Parents from both sides have agreed to support financially as they fully support our decision.

Tbf my hospital wouldn't even let me stay when I presented after 12 hours of back to back labour at only 3cm. They sent me home in a lot of pain.

@RainMinusBow with my last home birth, I wasn't examined at all. I was left in peace to get on with things, and it was wonderful. My next home birth will be attended by a specialist home birth midwifery team, which it just happens to be how it is in my county.