To think midwife is fobbing me off? *TW* mention of rape.

[Worriedandabitscared]

Good morning,

Sorry about the grim post so close to Christmas but I wanted to post in here as people tend to be more up front and honest than they are in pregnancy and I'm not sure if I need a reality check.

I'm currently 34 weeks pregnant and 6 weeks ago at my midwife appointment she asked me if I had any concerns about birth etc and I said I would like to speak to someone about the pros and cons of birth vs c section as when I was 14-18 (28 now) I was in a very abusive relationship where I was constantly raped (I don't know why I didn't leave, I was young and stupid) and whilst I know childbirth is different to being raped (obviously!) I'm worried about the psychological trauma that being in that much pain around my private parts and having multiple people around looking and touching my vagina would cause and I wouldn't want it affecting my bond with my baby, the reason I even mentioned it to her was because I had an internal the week before which hurt a lot as I had an infection and it made me feel weird and made me think about the previous relationship so she just said "okay" and that was that and I'm too shy to speak up.

At my next appointment I brought it up again as my husband said I needed to be brave and see if I could have the conversation and all the midwife said was "they don't do c sections routinely, vaginal birth is safer for baby and you don't want him to get hurt, do you?" Which obviously made me feel a bit shit, of course I don't want my baby to get hurt but I also want to protect my MH and I hadn't said I definitely want a c section as I know there's risks involved and it certainly isn't the easy way out but I wanted to discuss it with a professional.

The perinatal team came round on Monday and I mentioned it to them and they said they'd email my midwife who I saw on Tuesday and it was the same thing, she just reiterated that vaginal birth is better so it leads me to think I am being unreasonable but it's really stressing me out.

Please can someone give me a little reassurance that I should be okay? It's just so stressful, as if birth wasn't hard enough I need to worry about it triggering things I thought I was over, it's annoying too as I don't want to give my abuser any head space but it's so hard not to

Ask to speak to a different midwife. This one is not putting your care first and foremost. If you want a C-section, you should have one.

It is your absolute right to discuss the pros & cons to vaginal birth & a c-section. It’s then also your right to request a c-section if wanted! They are fobbing you off, you should have all the facts that you want and need to know. So you have the best information for you to make an informed discussion with. It is your body & birth.

So sorry for you past & also so so sorry for your team not listening to your concerns

No specific advice but someone should be listening to you.

OP, your concerns are perfectly reasonable, understandable and valid. As time is running short, you'll need to use PALS.

There's info and a link to them in the link below. Good luck and I hope you get the c-section you need.

www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/

I'm sorry for what happened to you and can understand you feel as you do. It is not uncommon for internal examinations to trigger unpleasant memories.

From what you say, your midwife appears not to be giving you the information to enable you to make an informed which takes into account your own personal circumstances.

Can I suggest you contact the Consultant Midwife where you are booked to birth. All Trusts have them. They will be able to support you and work with you to make a plan which is right for you. The best way to make contact is usually via the Labour Ward.

Your midwife is being awful. I had a section for mental health reasons and my midwife did not once press the vaginal birth option after I’d explained my reasoning to her. When she found out how late along my appointment with the consultant was, she rang the secretary there and then, told them off about how long I needed to wait for my appointment and got it changed! You need to ask firmly (though I appreciate that may be difficult) to be referred to a consultant to discuss the option of a section in line with NICE guidelines. If she refuses, or starts banging on about a vaginal delivery again, ask if there’s another midwife you could discuss it with. It might also be worth going back to the perinatal team and asking if they can help.

Your midwife is being utterly shit and fobbing you off. You have a right to request to see a consultant (doctor or midwife) and talk through your options in terms of a CS v a vaginal birth. I’d speak to her again, and tell what you need. ‘I would like you to refer me to a doctor or consultant midwife to discuss my birth options’ and if she won’t, ask her to document your request and her refusal (she won’t) and go above her head to her manager. It is not her job to counsel you and the way she has fobbed you off is unacceptable. I’m really sorry.

If you decide not to have a planned CS, then please be assured you will only be touched and looked at by those you consent to. Internal examinations are entirely up to you, and you can decline them if you choose.

Have you seen this resource? It may be really useful: www.thesurvivorstrust.org/pbpaftercsa

My gosh OP even without the trauma you have suffered, you should still be able to discuss your birthing options with a midwife. Def ask to see another one .

Your midwife should absolutely be listening to you, but just to mention it is always your right to refuse internal examinations. They aren’t essential. I didn’t have any with my 3rd child.

Shocking. I am angry on your behalf.

Ask for a different midwife, request a pros and cons discussion and formally complain.
Also for expediency do some research yourself and decide if you want a c section if you do demand one. You have every right to do this and make medical decisions for yourself.

Yes, you're being fobbed off. They're counting on it getting too late to do anything and you going into labour and (presuming it goes well) you'll get further fobbed off with 'you're both ok now'.

Contact PALS or you'll be given the runaround until you're in labour.

Be stern but polite. You need a better answer than that and it is her job to provide you with one. If she can't, she needs to pass you to someone that can.

Vaginal birth may be healthier or whatever but a c section is still safe and this absolutely sounds like a situation where one could be warranted.

I'm sorry for what you went through. You don't need to explain why you didn't leave. We all understand

You don't need a reality check, you need a better midwife. Can you get the number for head of midwifery and speak to them? I managed to get an email address during my last pregnancy, writing it down might be easier.

This is awful care, not just the refusal to discuss the actual pros and cons of birth modes but to discuss anything at all, after you were brave enough to disclose your past trauma.

Planned c-section is an acceptable choice and this should be discussed with you properly. But also if you choose to vaginal birth then there should be a discussion with you about consent, internals and any measures that might make the experience more comfortable for you.

Terrible for the midwife to just brush off your concerns.

Also you weren't stupid, you were a child and a victim and I'm so sorry.

Yeah you need to ring her and just calmly but firmly say, "I want you to refer me to a consultant to discuss my birth options as soon as possible." She's not allowed to refuse.

If she refuses, ring the practise or department, ask to speak to the head midwife or whoever is in charge. Explain the situation, get your midwife changed, and get them to refer you.

She's not going to be good for you if she's at your birth because she's already showing you that she isn't listening to you about your body.

When I had my first child I was surprised that they very clearly seek consent before checking how far along you are. There was nothing in my notes to make them treat me more particularly gently than they do every patient, so presumably that is their usual M.O. With my second I had some minor mental health problems and there was a perinatal mental health team (something like that!) who offered me a lot of support for a fairly low level issue. I had a bad mental health history and was amazed how much better the support was when I was pregnant.
Don't be afraid to ask for support. Do it for you, as well as for unborn. You may need to be persistent, but you can do that! Get your partner on board if needed.

Dear OP,
I am so sorry you experienced this and that your healthcare team are behaving in a way that is not in keeping with their professional codes of conduct or NICE guidelines. You are being entirely reasonable and actually very responsible to address this now and you should be supported in doing that. I would do a few things (or ask your DH to do some of them in your behalf if you don’t feel up to it):

Inform the hospital that you REQUIRE (not request) a new consultant and do not consent to being seen by that midwife again.
Request a referral to the perinatal mental health team - they should have experience of supporting women who have had or may experience birth trauma and should help you explore your options. With their support, if you want to, you may find you are able to attempt a vaginal birth.
If none of that is forthcoming (and I would go to the Director of midwifery directly to request it) then even at this late stage in your pregnancy I would consider changing your hospital if that is possible.

Good luck and take care

Absolutely disgraceful how she has treated you. I would speak to someone more senior at the practice and demand an appointment with a consultant. Failing that I would contact the maternity department of the hospital where you will actually give birth. You have a right to discuss options.

Good lord @Worriedandabitscared. I've nothing else to add other than to reiterate what people above have said- she is being at best utterly shit, at worst completely neglectful of your healthcare needs. Definitely ask to speak to a different midwife and definitely say that you would like to speak to a consultant about your birth options. "You wouldn't want anything to happen to him would you" is such a loaded and unfair question. Of course you wouldn't, but you'd also like to come out the other side with your mental and physical health intact! Excuse my language, but she is a dick. For what it's worth, there are some risks with every type of birth and many MANY women have c sections, both elective and emergency, every day without issues. Of course a straightforward, unproblematic vaginal birth is the safest thing for everyone, and if you could guarantee that then most people would probably opt for it but let's face it you can't, so it is ABSOLUTELY your right to discuss your options with a consultant and to choose a c section if it is right for you. I know it's really hard but definitely stand your ground on this, it is more than reasonable. Women are more than just vessels for delivering babies- we count too!! Wishing you luck, and lots and lots of happiness when your little boy arrives, you deserve it x

I am also angry on your behalf. You have a right to have a c section if you want one. You have got to be firm here. I’m not sure they will give you an honest pros and cons because it is in their interest for you to give birth vaginally, due to cost and resources etc etc (in normal circumstances). I’m sorry about your past experiences and whilst I can’t identify with your situation I have had a baby vaginally and also by c section. Vaginally took an induction and a week of hell, stitches and a retained placenta, loss of quite a lot of blood And years of PTSD. C section was planned for second due to placenta covering the exit so I had no choice and I was SO fearful of it but it was lovely - done in a really short time (even though it ended up being emergency rather than elective due to bleeding issues) but I was on my feet within 12 hours and driving in under two weeks. I was very lucky with my c section experience I realise, but I just wanted to give you an example that will show you the other side to the one you will no doubt be peddled. Good luck to you.

You deserve better care than this.

I was also assaulted and nervous about birth, it turned out absolutely ok (3 times!) but that's also because I felt respected and safe throughout. You should ask for a new midwife and support from the mental health team.

Congratulations on your pregnancy, no matter how your baby comes into the world I'm sure you'll do a great job

and whilst I know childbirth is different to being raped (obviously!) I'm worried about the psychological trauma that being in that much pain around my private parts and having multiple people around looking and touching my vagina would cause

It’s not that different and your worry is valid. When DS was out the trauma of what had just happened to me kicked in. I was nervous and panicky. DH had to take me to the toilet and I was just in shock. Struggled to even speak. I felt so physically vulnerable and damaged. It is quite triggering and does bring up bad memories.

That being said I would not have preferred a C-section. A straight forward vaginal birth is much easier to recover from and avoids major surgery.
It is your decision though OP and whatever you choose is the right thing for you. You should be supported by your midwife and you need to speak up.

Throw around ‘I think this will cause PND’ enough and they’ll basically give you whatever you want.

Sorry you’re suffering.

But I don’t think the NHS will do an elective section based on psychological trauma, unless you’ve had a previously traumatic birth or an assault that’s left you with lasting physical injuries as well. You could go private for a c-section.

In most hospitals they try to keep the theatres free for emergency c-sections, eg if a baby gets stuck or a mother in labour suddenly deteriorates and they need baby out quickly. Same with aftercare, a c-section means staying in hospital for a few days while with a natural birth you can usually go home after a few hours.

I know lots of women who’ve had planned c-sections but always for medical reasons eg baby was breach or mother had physical injuries from a previous birth, or high blood pressure etc.

C-sections come with their own set of complications and risks. And if it’s your first baby they’re even more reluctant as it makes a c-section or VBAC more risky if you decide to have another.

You could ask for an epidural so you’re numb below the waist?

OP totally agree with all above, this is poor care and you should ask to see someone else - either a consultant midwife or a consultant doctor ASAP.

As someone else said, I had no vaginal examinations for my second and third babies until they were born. For my second I had two quite bad tears so I needed stitching and these checked afterwards and then my third I was just checked once after birth and no-one went near the area again!

The trouble is when you are in labour you are very vulnerable to the staff etc you get and to what extent they respect your wishes (sorry to say). I had two homebirths and therefore was much more in control of examinations etc.

Just wanted to share my experiences and try and be realistic too. But it may be you can get some boundaries with regards to VE written in your notes that would reassure you. But with a vaginal birth there is always a chance there would be a fair amount of prodding (my first was induction and forceps and many many VE). So it may be you decide you feel more in control and comfortable with a c section.

Was it the perinatal mental health team who saw you? Surely they should be helping you work through some of these issues and to make an informed choice about what is best for you and your baby.

And of course you want the best thing for your baby, the midwife was completely wrong to question that. I worked out long ago that what is best for mum is often what is best for baby and there is no shame in that. You are not a vessel!! You are a human and your feelings and experiences are valid and important.

Best of luck to you.