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

Some good advice here too:

caesareanbirth.org/if-your-caesarean-request-is-refused/

Probably better off making an appointment to speak to the consultant than to the midwife.

You need a midwife you can discuss this with and who will address and listen to your concerns. The C-section is one part of this. In addition it should be possible to reduce internal examinations etc to a are minimum if you think that will help you feel more secure (because my waters broke a little early I received no internal examination until I was about 9 cm dilated so this is possible). There are probably loads of other things that an experienced, decent midwife would be able to think of and discuss with you. Being dismissed like that is unnacceptable.

I had a similar issue. I was referred to the VBAC midwife at 36 weeks (I'd been saying I wanted a c Dec for month and was ignored) who said giving birth vaginally was no different to having sex and I'd clearly managed that. My response was that I didn't know how she was having sex but she should seek some professional help! And then I walked out, went to the front desk, asked to speak to the midwife in charge and PALS there and then. Within 24 hours I had a specialist midwife experienced in dealing with tocophobia and a date for my elective section.
I found out that the vbac midwife was a life long single woman who had never had sex. Fuck knows what she thought happened!
Don't accept this insensitive care and insist on the right type of midwife. Vaginal delivery may turn out to be right with you if you have the support of a trauma informed midwife or c sec may be right but either way you need a midwife and obstetrician that are sensitive to your fears

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.

Yep this is UTTER bollocks. And shows the poster knows fuck all (there are very few places in the country where its possible to get a private c-section).

However whilst the guidelines say you can have one, you DO NOT have a right to a planned CS. You DO have the right to the most appropriate care for your medical needs. Which may be a CS (Subtle but important distinction) Many hospital trusts are very difficult about a CS on request even for mental health. Others are not. But at the moment I can imagine even the best of them will be leaning towards discouraging for covid related reasons atm.

I'm only repeating what other people are saying but I feel so strongly about this I can't not say something - your midwife is a twat. Change midwives. Register a complaint. Your birth, your choice, your way. All UK women are entitled to a section if that's what they feel most comfortable with. The NHS is not a free service, you have paid for this birth in the taxes that you and your DP have paid and will continue to pay. Your DP needs to be instructed to advocate for you if you (understandably) cannot do so yourself.

My understanding is that trusts are encouraged to steer women away from c-sections because they are very expensive as much as anything else. The risk rate for a section is conflated between elective and emergency which gives massively skewed statistics. 1 in 4 women has a section anyway.

Do not let this person push you around. A healthy baby is NOT the only outcome you want from this situation. You are still a person. You still matter. A healthy you AND a healthy baby is the only ideal outcome here.

Hi OP, I don't know if anyone has suggested it of if it's even possible but I think the support of a doula or private midwife (can't think what the proper name is) could be invaluable to you. Just to make sure you are listened to.

I had an awful time with the NHS from start to finish. They wouldn't go by my ovulation dates (I charted) only my LMP despite having very long cycles, I couldn't have a home birth and just seemed totally disinterested in me.

I ended up at a unit which I was ok with until I visited and someone was giving birth loudly and they told me in a dismissive/disgusted way that they didn't like people screaming in child birth as it really wasn't necessary and just made you tired. I had to have extra scans as I was slightly underweight and they thought I must have an eating disorder then at the scan they said they were so glad I wasn't really fat like the usual people they see for extra scans. I was then told I couldn't give birth at the unit as (due to them going by my LMP) I was past my due date and as they'd told me I should be under the hospital nearest the unit I would now have to go over an hour from my house to that hospital to give birth and it was too late to get into my nearest one.

I was due to give birth any day, totally stressed out and ended up getting a private midwife, she sorted everything, it was very expensive but I could have a home birth, she got me into the nearest hospital if I needed to go in and she just listened and respected me. It was such a different experience to anything I had with the NHS. I just think getting a doula to help you navigate all this might be worth it if you can xxx

I'm so soy you got that response.

I am not a medical person, but I've had two kids. Both induced and both born vaginally.
Setting aside your specific situation just for a moment, I can say that I am glad I had vaginal births. This is because I healed fairly quickly and I was able to get on with looking after my baby and toddler...I believe you can't really lift things for a while after a c section, although I am sure someone with more knowledge could confirm/refute this.

As for the actual birth, yes there are a lot of people looking at your intimate area. Personally, I was in too much pain (not scaring you and it is manageable), and just wanted them both out safely, to really consider it. I had the same consultant for both (I requested her the second time) and I really trusted her. That might be something to consider?
You could also insist on an all female team, although I am not sure if that would be possible if, say, the anaesthetist on duty was male.
I did find they tried to preserve dignity as much as possible, so you aren't totally exposed or anything.

All the above is just intended to try and reassure you if that's the path you choose. Having said it all, the way you have been treated is awful. I think you do have the right to a c section of that's what you choose. Pregnancy on its own is difficult enough, without this extra stress being piled on you. I think I would be insisting on a different midwife.

Also, the women I know who have had c sections are absolutely fine, so don't let her scare you. It is your choice.

So sorry you're going through this and I wish you the best for a healthy pregnancy and safe delivery.

Echoing what everyone else said about asking for a different midwife and your rights to discuss and choose your own method of delivery.

Also I have been in a slightly similar situation recently- last year I was assaulted and didn't have time to process it before covid happened and then getting pregnant. It wasn't until during my pregnancy that I started to become anxious surrounding the birth and the fear of not feeling in control and not feeling safe.

I ended up choosing a home birth, even though it was against the guidelines as I have a high BMI. I was supported by a consultant midwife who after explaining the risks and their recommendation that it would be a labour ward delivery agreed that I was making an informed choice that I felt was safest for me and my baby.

In the end I gave birth two weeks ago today via c section, I developed pre eclampsia post dates and so needed to choose between induction and c section. Induction risked too many unknowns for me, and I was worried it would lead to interventions that I didn't want such as forceps/ventouse. I felt that a c section, while having its own risks, carried less unknowns. My consultant midwife and dr agreed with me and I gave birth the next day.

The birth was wonderful. The idea was completely against my original plan but it was still amazing. Everyone in the theatre was so kind, friendly and respectful. We had our choice of music playing and they talked me through everything they were doing at my request. They had minimal people there when I had my catheter put in, and the consultant midwife who I had built a relationship with was the one who did it and shaved me and who placed DS on my chest as soon as he was born.

I can still remember exactly how he felt when he was put on my chest and how happy and overwhelmed with love and joy I felt, and that's something I wasn't sure I would experience during the lowest points of my pregnancy.

I think the most important things for me was having people I had a relationship with and who I felt listened to me and who I trusted. They planned my section for a time when the wonderful midwife I loved and the dr I had just met the day before but also felt comfortable with were free so they could be there. I also had a birth plan which covered a c section even though I had planned a home birth, and I wanted everyone involved in my care to be aware of my history but not to mention it in front of me.

Please ask for a different midwife, and I hope you find one who can support you in the way you need. I was so worried that a negative birth experience would trigger PND and affect the early days with my baby. Even though I didn't get the birth I originally wanted it was a wonderful experience, and I hope it is the same for you.

Oh, also DP was invaluable to me. It was very hard up until 37 weeks because all of my appointments I had to attend alone and I completely clammed up and couldn't speak when the topic was broached. It wasn't until our home birth assessment that he was able to be there and advocated for me when I couldn't. From then on he was allowed to attend all of my appointments, and I'm not sure I could have done it without him.

I haven't read all replies so sorry if already been said, but I reccomend a book by Penny Simpkin called 'when survivors give birth'. Its aimed at both professionals and women who have experienced abuse.

Also, your hospital should have something like a birth choices team who you can see and discuss your birth options, failing that there may be a midwife or consultant who specialises in the care of vulnerable women and the health dof midwifery who you could discuss your concerns with.

Another voice here saying your midwife is being totally unreasonable - and I'd go so far as to say negligent in her duty of care towards you. I had an elective c section due to tokophobia - you should absolutely be given the choice, and it is in the NICE guidelines that you are given the choice. You should speak to another midwife - and the peri-natal mental health team in your area.

OP, I am actually seething for you right now.
ANYONE can request a Caesarean section for ANY reason, according to NICE guidance. I’m not going to go into the ins and out of vaginal birth vs c-section, but both can be traumatic for hundreds of reasons.
Please try to change your midwife. If that doesn’t work, contact PALs, contact one of the midwifery managers, contact the Head of Midwifery. Are you already under consultant care for any reason?
Traumatic birth experiences often happen because the woman feels like she wasn’t listened to and I would hate for this to happen to you. Midwives are meant to empower women, and your midwife is not doing that. She is making you feel like a shit mum before you’ve even given birth.
I so so pray that you are able to get this resolved and have a wonderful birthing experience for your baby.

💐 Oh my goodness OP, I'm so sorry that happened to you and that your midwife is being shot. A history of sexual abuse or rape is a completely valid reason for wanting an elective c section.

And you were not young and stupid, at 14 you were a child under the age of consent who was groomed and raped 🙁

And I feel like we need a Mumsnet campaign to highlight how women are being refused their right to consider an elective c section. I have read so many stories on here but this one is appalling.

{Leaves the thread feeling angry and triggered}

To echo everyone else - definitely complain about that midwife, request a different one and insist on a referral to a consultant to discuss a caesarean if that’s what you want. I found that while most the midwives I came into contact with are very pro natural delivery, the consultants were happy to book me in for a caesarean. You need a different midwife as a first step though!

Oh you poor thing op!

I think others here have give you good advice on the practicalities, but I would also highly recommend you do the Positive Birth Company digital course, which is video based so you and your partner can watch together.

Here is the creator's free YouTube stuff so you can get a feel for it, but the point of it is so you go into childbirth with a good idea of how the process is likely to unfold, with coping mechanisms and a really solid understanding of your own birth preferences, how you can communicate those and how they intersect with what the medical team may tell you.

One of the best things about it is there is access to a Facebook group which people post their birth stories on - c section, vaginal deliveries, ones that went smoothly, ones that went less so - but all positive experiences. I think it could be really helpful for you while you think about your own preferences.

Contact dr. Rebecca moore at make birth better. They are not doing best by you. You have been so brave to repeatedly voice concerns. I am so angry for you.

best of luck with birth OP

It is totally your right to have the birth you want but you have to be very firm. You also don’t have to agree to any internal exams they are routinely done but not medically necessary. I didn’t have any with DC2 and4.

@TotorosFurryBehind

And I feel like we need a Mumsnet campaign to highlight how women are being refused their right to consider an elective c section. I have read so many stories on here but this one is appalling.

{Leaves the thread feeling angry and triggered}

The OP hasn't requested an ELCS though.

Having spent years raising awareness on this subject and having an ELCS, it doesn't half annoy me that we are now in a position where the default position is all this stuff about an ELCS being a magic bullet.

The number of posters who fail to read what posters (not just this one) say on the subject is staggering.

Many women are going down this route because of poor care, lack of mental health awareness, a previous traumatic birth and poor understanding of the issue. If they are given this they often have VBs and a very positive experience.

There is research backing this up.

I'm all for women who absoluetely want an ELCS getting one, however this has slipped into a method to avoid addressing some of the wider underlying problems in maternity that affect all women an the standard of care they recieve.

Its not helpful.

We need basic standards and women centred care not banging on purely about 'rights' to ELCS. That ultimately only benefits women who are able to navigate and advocate for themselves and disadvantages the most vulnerable women who perhaps need better care and support most.

I'm sorry you are being treated this way by your midwives, they should absolutely be supporting you! I don't know if you are on Facebook but there is a very good and knowledgable group called 'planned Caesarean section support group UK' they will definitely be able to help you with regards to your rights and how to make sure you get the birth you need!

You’ve heard it already OP I’m sure but just one more time-

You are not being unreasonable you should be able to discuss your options with a consultant and your MW is behaving irresponsibly.

For the poster who ‘doesn’t know anyone who had a CS for mental health reasons’

You might know me, I would have told you that I had one because baby was breech. I am a liar (in some circumstances!)

Please insist on having a consultation with your consultant obstetrician to discuss this. Many women don’t realise you have a right to have at least one consultation with the consultant obstetrician in charge of your care antenatally even if your pregnancy is going swimmingly with no issues. There are pros and cons with each approach but you deserve to have your concerns discussed and taken seriously and to be supported to make a decision based on what will be best for both yourself and the baby overall. It sounds like the first midwife planned to arrange this for you but for whatever reason it didn’t happen. You should not have been dismissed in this manner by the second midwife you spoke to (with a layer of emotional blackmail about wanting your baby to be ok). That’s not ok in this day and age. Mental health of the mother has to play a role in this particular during this pandemic surely. Your concerns are valid (which isn’t to say I think you necessarily would not cope with a natural birth or that might not be what is best overall in your case, but you want to discuss it and so you should do).

Ask to speak with a different midwife. Birth can feel very like rape. Took months of therapy to make the connection (my body and hind brain clearly had, I just couldn't explain it) and it explained why I had such an issue following birth.

You might know me, I would have told you that I had one because baby was breech. I am a liar

Me too.

Tell her " I need to speak to a senior doctor asap. Please arrange that and make a formal record of my request with the date and time on it.".

As orange slice said, she won't refuse.   Talk it out with a doctor. 

I can't imagine what you went through in the past. Neither could I imagine what my labour and childbirth would feel like. None of us can before we do it. We're all unprepared, all anxious. Mine felt utterly different from what I had imagined.Labour pain surprised me by its similarity to the painful period cramps I had in my teens. Belly and back, in waves. No vaginal pain. When it came to (assisted) delivery I still felt zero vaginal pain thanks to local anaesthetic.

The other thing no first-timer can imagine, is how it feels in the moment you first see and hold your baby.

    So,  try not  to let that awful  past memory overwhelm your anticipation of childbirth.  No matter how you decide to deliver,   this IS  a  completely new experience unrelated to the past.  You  have found  real love and a very different physical experience with your husband. So trust yourself again.  You did overcame fear, you found love, and  now you're going to do that all over again.