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

Also, I'm so sorry you went through that as a teenager x

No specific advice but while NHS doesn’t routinely offer c sections as an option - your experience justifies you being able to have one if you want.

Can you find out who is head of maternity unit and email them cc’ing director of hospt, saying you’ve raised this but the staff member has been unwilling to discuss with you.

I am sure you’ll then be able to have a conv w the head of midwifery, and make a call.

You don’t need to mention your midwife’s name in email but they will figure out who it is. She is being spectacularly insensitive. Am sure you can also switch midwifes if you want.

You have the right to have the birth you want, and in your circumstances a c section is a perfectly reasonable request.

If you can, please get a copy of The Positive Birth Book ASAP and read it. It is very empowering and gives you the right language to get what you want from your birth.

Agree that you probably need to ask for a different midwife, or for a referral to the obstetrician so that you can talk about it properly.

If you do decide you want to try vaginal birth, all of the internal checks are voluntary and you can decline them. You can chose to do your own cervical examinations. The only time someone has to be up your vag is if you need stitches afterwards.

My birth plan is to have a vaginal birth with pain relief, but if that isn’t working I will have a c section rather than forceps delivery. I am choosing to have a c section under general anaesthetic rather than spinal block for similar but different reasons to you. My midwife is fine with my choice and yours should be too.

Please read the book and become an empowered birth-zilla and advocate for what you want.

www.amazon.co.uk/s?hvlocphy=9045240&hvnetw=g&hvadid=259101397804&k=positive+birth+book&gclid=CjwKCAiA8ov_BRAoEiwAOZogwZJR2agQuiQX939aygm3wF5VBZ3nap70US0JRsihtiKlgQmQjzctbRoCRSwQAvD_BwE&ref=pd_sl_24c06eh0av_e&hydadcr=21638_1763682&hvdev=m&hvqmt=e&tag=mumsnetforu03-21&hvtargid=kwd-302648929163&adgrpid=53111005197&hvrand=8533523911139486486

OP - I an so sorry to hear about the abuse you were put through as a child (and at 14, you were a child, and none of this is in any way your fault).

You've had excellent advice already. But one thing I will add in response to a poster upthread who said trusts don't like ELCS because it takes up theatre space they need for EMCS. This is only partially true - can't speak for all regions obviously, but my consultant told me when he booked my ELCS (due to DS's size) that my trust's rule of thumb was to only book 2 a day. So it's not that they won't do them but that they have to manage theatre resources carefully. (I was very nearly bumped to the next day's list due to a very busy day with emergencies - having arrived at 8.00am I didn't get into theatre till 5.00pm).

I have to say my ELCS was an entirely positive experience, I recovered quickly and within a year you could barely see the scar.

It's also a rather sobering thought to remember that one of the reasons NICE recommend ELCS at maternal request is cost - although the birth alone is more expensive for an ELCS, when you factor in the follow on costs of vaginal birth (prolapse, fistula and other pelvic floor repairs) the average overall costs to the NHS of ELCS and VB aren't that different.

Good luck and a virtual hug - I hope you are supported in getting the birth you need.

If money is tight you can pick up the Positive Birth Book on eBay secondhand too, that’s where I got my copy from:

www.ebay.co.uk/itm/154248673900

Btw, its quite possible that the reason you are being fobbed off is covid related.

A CS is an operation - they need more staff for it, and they have to consider the possibility that there will be complications in their planning. Given they are trying to reduce as many routine operations as possible, I'd be mindful of this and the covid situation.

This isn't right but its also not a normal situation. Its perfectly possible they are freaked out about what the situation in the hospital in Feb will be.

I think you need to keep this in mind unfortunately. From what you've said you don't sound like you are dead set on a CS and from seeing lots of posts like this, I tend to lean toward saying where I see this that your issue is needing the proper and appropriate emotional support and reassurance from the hospital (which phobing you off is exactly the opposite to) rather than necessarily a CS. Its about needing a good relationship with them so you trust them.

It doesn’t sound like you want a c-section per se, but want some reassurance a vaginal birth won’t trigger trauma. Forgive me, if I have misunderstood. It’s a perfectly reasonable conversation to have and annoying that you are being lectured on safety, when you clearly already understand that element plus the safety of your mental health isn’t being weighed against it.

I haven’t got anything useful to say other than I’m sorry you are being let down and not listened to. I’ve had a vaginal birth and a c-section. There are pluses and minuses to both. Recovery was harder with the latter. In both situations bodily autonomy goes out the window & people are ‘doing’ things to you. The c section is close to genitals I guess but not directly at them. I haven’t, thank god, been raped, so I can’t say which would be least traumatising.

Well done for pushing to be heard, even though it’s outside of your comfort zone. Love to you.

@WeeWelshWoman

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.

Do they let you choose on the nhs? It’s a genuine question. It’s over 20: years since I had a baby so I’m not clued up on how maternity services are now.

OP that would be great if you could choose. I never really understood why they think a vaginal birth is safer, when a section is done under surgery conditions. I had a planned section as my baby was breach. Good luck💐

I'm so sorry you had that grim experience. You can refuse all internal exams during pregnancy - nobody will blink. I refused throughout my pregnancies because of recurrent miscarriages, but there's no need to give a reason; your no is enough.

Your midwife is shroud-waving and it's wrong of her. Go up the chain. I hope all goes well for you and your baby.

I am so sorry you went through that abuse as a young woman. Life can be very cruel and unfair. You were amazing to be able to get out of that situation, and you deserve to enjoy your pregnancy and birth and life with your partner and your baby.

Your midwife is wrong - on a lot of levels. The cornerstone of her role is to be your advocate. To help amplify your voice and needs and she has not done that. Also, it is not her choice to make! Even the most supportive Midwife would need to refer you to the Obstetric Team to discuss this further and to make the decision.

My recommendation would be to go above her head - you have given her 2 opportunities to help you and she has not done this. Check the website for the hospital where you are booked and try and get through to the Head of Midwifery or one of the PMA team. There will be someone at a senior level who will be able to support you.

It is unfair that you have to do this - she should have just referred you to the Obstetrician as soon as you raised it. You would be well within your rights to send in a formal complaint about your care so far. You could just copy and paste what you have written here.

I hope you get sorted and you have a lovely peaceful birth, by whatever mode of delivery feels safest to you. Both physically and psychologically.

It's not just about the vaginal birth versus the CS OP, it's about having a midwife who listens and takes on board your concerns. I'd go as far as to say a midwife who doesn't isn't safe. Women often know when something is wrong and professionals should be prepared to listen to that.

Your midwife should at the very least be reassuring you about how they can help you to manage your very legitimate fears and concerns. I'm so sorry they're not.

Make sure you change midwife to someone who specialises in dealing with women who have been traumatised so you can talk through your options. Good luck OP

I also think the irony is the midwife doesn’t want OP to have a c-section yet her attitude, refusal to actually listen to OP about her body and her concerns and lack of empathy is exactly the sort of thing that is going to lead to a woman to lack confidence about being properly supported during a labour and birth.

A study showed that listening to women who request a c-section, discussing their concerns about vaginal birth and offering a c-section actually resulted in far more women being confident enough to change their mind and try for a vaginal birth then just flatly saying ‘No.’ to a request.

Just want to reiterate other posters in saying please please report this incident to PALS as well as taking it further to get the discussion you need. It's not about a C-section per se, it's about her dismissing your concerns and not entering into a dialogue about your specific needs.

Hospital teams are sometimes better at working together than community teams, perhaps move over to their care as the current midwife has let you down.

I'm sorry, OP.

You'll note 'we don't do routine C-sections' isn't an answer to your enquiry, just a statement of policy. It appears designed to fob you off. Some midwives have a starting point against C-sections, in part with an evidence base.

If after considering the pros and cons/risks then you decide you want one then you insist. If a midwife fobs you off, speak to your consultant. If any HCP disagrees, ask them how many times they have been raped.

Good luck and I hope all goes well.

@Worriedandabitscared you need to speak with a counsellor really. Ask to be referred to a specialist/ consultant who will specialises in maternal mental health care (I know you're not suffering right now, but they can help discuss your fears and help prepare you) xxx

As all have said you should absolutely be able to discuss the option of a CS.

Also think about some counselling. I had about 5 sessions of counselling from a specialist perinatal psychologist due to past trauma before my birth and it really helped.

Not sure what the NHS situation is for this but could you ask to be referred ASAP or could you afford a few private sessions?

I was lucky that I had a good community midwife with both of mine, but I was also under consultant care because of my mental health, and she was amazing.

I would recommend you put something in your birth plan if you feel able. It’s the midwifes on the ward at the time you give birth that will either make or break it for you. When you go in they should read your birth plan straight away and discuss it with you, how they can help you feel more comfortable and safe etc.

In the end it wasn’t as big a deal as I thought it would be during the labour - adrenaline and endorphins took over I suspect - but after my first, I had stitches that were painful for a couple of weeks after the birth and the pain from that was difficult for me mentally, even with a yummy newborn to cuddle.

I agree they are fobbiing you off and if you have the energy, complain.

I had an elective c section and from what you've said I think that could be a really good option for you.

I've also had a vaginal delivery and I would go for an elective c section any day of the week.

Good luck OP and congratulations on your baby.

You need to speak to another midwife, or ask to speak to a specialist or consultant midwife who has worked with abuse victims before.

I brought a c section up in one of the early appts and my midwife put me down for being consultant led as a result. I had a chat with a consultant and had the pros and cons discussed. It wasn't until a while later that it was signed off etc but it was discussed as an option without a fight. I was told that physically for baby a vaginal delivery is safer, but when you look at the whole picture and my mental health, it was agreed that a c section was probably safer for the two of us as a package.

Hope you get to speak to someone more helpful OP. Your midwife is being shit, that's really unacceptable. You choose how you birth.

Definitely request to speak to another midwife!
It probably doesn’t help but when I had my baby earlier this year I was worried (obviously not the same way as you) but I was so bothered by the contractions and then high on the gas and air I didn’t even notice the midwives let alone anything else. I feel like a c-section would have been more nerve-wracking and feel more invasive as I would have been more fully aware as to what was happening. But again obviously a completely different situation, some people have terrible v-births and wonderful c-sections, just thought I would share my personal pros and cons/thoughts. Hopefully whatever you do all goes well for you, and enjoy all those lovely new baby cuddles!

Not all staff will read your birth plan unfortunately. It's not something you want to be explaining to different people on the day. I know people say c sections are major surgery, and I suppose technically they are, however, I was up and about within a day, home after one night etc. No probs feeding etc.
Also the scary statistics that we're fed, encompass all the emergency sections. There is very little risk with planned sections.

Please feel free to PM me if you have any questions OP.

@HikeForward

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?

You absolutely can have a c section for this reason.

You also don’t need to go private just to have one. My friend decided she was having an elective c section (no medical or mental health issues involved) and point blank refused to discuss anything else or any other options available to her. It was her third doctor who decided that she could have one. Multiple midwives tried to tell her otherwise but she was set in her choice and once she realised she wasn’t getting anywhere with that one she requested a new midwife/doctor as was her right.

I haven’t read any replies but your midwife is crap. You have every right to have a csection - read the AIMS and NICE guidelines. C section is major surgery so they have to get informed consent which means they have to tell you the pros and cons so you know what you are consenting to it but you absolutely should have the choice.

Ring the hospital and ask to speak to a pma midwife or the matron in charge and explain your issue to them. Pma midwives are professional midwife advocate, it’s there job to help you get the best birth for you. The ones I saw were amazing and they even came to my consultant appointments with and help me negotiate things out of guidelines - I was desperate for a VBAC (vaginal birth after c section) and they helped me get it. I got my VBAC about when it was looking like I may have to down the route of an elcs the consultant booked my c section for he my PMA were on duty. Alternatively tell the midwife you want to be referred to go the consultant for a csection or she can record in your notes that she has refused to do so. Maybe you can speak to her on the phone when your DH is around to support you or write it down and show her.

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.

This isn't true. NICE guidelines state that women who want a planned caesarean have the right to have one. Please contact Birthrights, who deal with this kind of thing all the time (www.birthrights.org.uk/contact-us/)

You are ABSOLUTELY entitled to an elective section. The midwife is there to offer guidance but how you birth is your choice.
You should be offered some CBT as well, but you don't have to take it, you can say. I and they still have to offer you a section.
I'm so sorry she's being so shit, she actually needs reporting and you need to see someone else. Definitely ring and speak to the head of midwifery. Don't worry about being difficult, I imagine they will be shocked to hear you've had this experience with one of their staff and will get things sorted very quickly for you.
DM me if you need any support on your rights xx