AIBU to think this may be a good idea? Childbirth related

[Justanideamaybe]

Not a health care professional.
I am a mother who’s had a very near miss with a poorly managed birth , very close thing. My sister has had to deliver in a very dangerous way , my friend has serious injuries from a huge , poorly positioned baby. I’m just thinking , shouldn’t it be procedure to do an ultrasound on arrival at hospital in labour? Would it not be wise to have a quick look at where baby is, the position, the size , the blood flow through the cord? Give the mother a choice? My son was almost born bollocks first , huge, cord around his neck , he would almost certainly have suffered some oxygen deprivation and I some serious damage to get him out quickly. Luckily we were saved by a consultant who responded to the red button and c-sectioned him out within 8 minutes. It was a busy and chaotic night in that hospital and the dr that answered the red button complained that the ultrasound machine was ‘ the wrong type, a gynae machine, set to the wrong settings or something … but within 20 seconds she saw that my son was breech, strangled and fat… no way he was being dragged out by forceps. The right call was made and we all made it . If they’d done that scan on arrival at hospital, he’d never had been in danger in the first place. I’d have been wheeled up to wait for the inevitable section. Some babies are in the wrong position , tangled in cords , too fat and all kinds of problems that can make birth so risky. Why don’t they do a quick scan in labour? Just before birth? It could save so many horrible labours or poorly or dead babies . Why doesn’t it happen?

@teezletangler

It's a routine part of care in the rest of Europe and the absence of it in the UK has been frequently highlighted by European experts as one of the leading causes of porer obstetric outcomes in the UK.

Really? I'd like to see the source for this. I work as a midwife in Canada (granted not Europe but another western country) and it certainly isn't a part of routine labour care here. We occasionally do scans in labour to assess position. I have never heard of this being routine in the US either.

Do you do more scans during pregnancy? I'm in Malaysia and with DD I didn't have a scan in labour but it's routine here to have a scan at each drs visit (with private care anyway) so I'd had a scan at my 40 week appointment a couple of days before she was born that confirmed her position etc.

I think it's a good idea to have a 38/40 week scan to confirm position and look at the cord/placenta. Maybe not size as scans aren't that reliable for that I don't think.

How would the NHS fund all the extra cost of more machines more repairs more staff the NHS is on its knees already its costs an average of 7k for 1 person to have 1 baby normally up to 20k if complications

My son was born in May this year and he had the cord around his neck. I was induced for his birth so I'm glad I never went over any longer than I did. But it was the most terrifying thing I've gone through. I absolutely think you should have an ultrasound on arrival.

@Dddccc
The NHS already funds the poor outcomes of mismanaged births. Millions in some cases. It already deals with the outcomes of poor management of births. A planned caesarean costs almost the same as the average vaginal birth. An emergency section after a failed labour costs many times more .

Honestly, I think if you highlight this with people then you might be able to get some traction.

I had a very easy birth, as did alot of my friends and so therefore we wouldn't even think of something like this, which as you say could actually save a lot of lives.

However, having read this thread, seeing it in black and white, I would be happy to support something, whatever that maybe

I am not in UK but was also extremely lucky to have had an ultrasound 2 days before my due date which revealed a breech position, cord round neck twice and low fluid. Throughout my care the doctor had insisted she was head down so potentially moved in the last few days (not sure if that's even possible but) - I dread to think what may have happened had I not been checked at that point (I don't think it's routine here either) and also have friends who were not checked in this way and have had awful outcomes. I agree, it's just common sense - for the medical staff to look and see what you're dealing with at the point labour starts then make a plan accordingly to get baby out safely! From now on I'm going to tell any one I know who is pregnant to insist on a scan (all private here anyway) around their due date.

@arcof
Of course it’s common sense. Why would anyone risk it ? If you're paying for private healthcare I think it’s easier to ask questions , have expectations. Healthcare is free at the point of access in this country, it’s frequently not adequate though.

The biggest problem is there aren't many private hospitals to give birth in, except London, otherwise it is take what you are given & if you don't like it tough luck. Maternity care in this country is at best average & in the main poor. This isn't knocking the NHS, just the government's who refuse to fund it properly.

A scan won't tell you all the things you want to know - estimating size by scan at term is really inaccurate. Cords are the way they are so they can be squeezed in labour, a lot of babies have them around neck/body and are fine, there are better ways to check if they are an issue - that is why baby's heart rate is checked often. Often people will use portable scans to check if baby head down if there is any doubt, but this can also be felt on palpation or vaginal exam and then just confirmed on scan.
I'm not saying births couldn't be better managed in a lot of cases but routine scans are probably not the way to do it - they give only a snapshot not an overall picture.

I agree re scan I was lucky my baby was transverse. On my 40 weeks examination the midwife thought maybe baby was in wrong position and sent me to the general hospital for a quick scan on labour ward.

One of the doctors scanned me and quickly showed he was transverse.

Two days later I had c section.

mostlylurking I think that's the issue with cords, lots of babies are tangled or have them around the neck during the birth but they are fine.

As Birththoughts said, it would need proper assessing, as it could increase the number of babies born by section unnecessarily, or women feeling pressured to have sections I suppose. I had 2 planned sections post loss and they both went really well, but there is a risk. I would argue a planned sections is much less risky than an emergency one though.

However, a routine scan would be useful for identifying babies who have not turned head down, and to look at the condition of the placenta and cord. I had extra scans of the cord and blood flow from placenta during my next pregnancies, so it is possible to do these things.

@Dddccc

Maybe the funding could come from all the savings that would be achieved through preventing a good slice of bad outcomes for both mothers and babies. Last time I checked, an ultrasound machine was way cheaper than lifelong compensation for a child severely disabled by birth injuries and there was far less time involved in doing a couple of extra scans every day than repairing a 4th grade tear in a single woman, especially if you consider her subsequent quality of life.

My mum was a midwife (long time ago) and I'm sure she said something about how they used to do an ultrasound scan later in pregnancy back in the day, for this exact reason. She was baffled by how poorly managed my care was when DC didn't engage at all and there was risk of cord prolapse etc.

I absolutely agree they should do this though, it would potentially save a lot of trauma.

@OatyLatte

My mum was a midwife (long time ago) and I'm sure she said something about how they used to do an ultrasound scan later in pregnancy back in the day, for this exact reason. She was baffled by how poorly managed my care was when DC didn't engage at all and there was risk of cord prolapse etc.

I absolutely agree they should do this though, it would potentially save a lot of trauma.

I agree with your mum. She is probably my generation.

Yanbu
I live in a European country. And it's standard practice here to have a scan when you're in hospital.
I went up with high blood pressure and before inducing me, they scanned me to make sure baby was in the right place, weighed enough and looked fine. It was all very calm and reassuring

This would have saved me hours of unproductive labour. Baby was too big and not coming out that way. It took 27 hours of labour to find that out though.

I had a scan during labour, they couldn't feel DD's head and thought her bum was her head and she was breech. A scan showed her head was actually so far down, they just weren't able to feel it. I agree that it should be routine

Could this be a Mumsnet campaign? My friend lost her baby boy because he was an undiagnosed breech and the cord got wrapped around him when she delivered.

I always wondered this too. I'm in Ireland and it's the same here. It could have most likely prevented the trauma that was DD1's birth. Maternity care is abysmal here too unfortunately. Far too many horror stories.

@teezletangler

It's a routine part of care in the rest of Europe and the absence of it in the UK has been frequently highlighted by European experts as one of the leading causes of porer obstetric outcomes in the UK.

Really? I'd like to see the source for this. I work as a midwife in Canada (granted not Europe but another western country) and it certainly isn't a part of routine labour care here. We occasionally do scans in labour to assess position. I have never heard of this being routine in the US either.

Do you think other countries are investing in scans in late pregnancy/ labour just for fun, with no evidence that it improves outcomes? Doesn't seem very likely. I have family living in 9 other countries and all were shocked by how few scans the NHS provides, and especially zero routine scans after 20 weeks!

If you look at international stats it's pretty clear that NHS maternity care is not designed to optimise medical outcomes, it's designed to be as cheap as possible.

@teezletangler

It's a routine part of care in the rest of Europe and the absence of it in the UK has been frequently highlighted by European experts as one of the leading causes of porer obstetric outcomes in the UK.

Really? I'd like to see the source for this. I work as a midwife in Canada (granted not Europe but another western country) and it certainly isn't a part of routine labour care here. We occasionally do scans in labour to assess position. I have never heard of this being routine in the US either.

I'm from the UK but live in Europe. I can only speak of my personal situation and those of my friends here who have given birth here but you have check-ups every 4 weeks, 2 if you're high risk. Three ultrasounds are covered by your health insurance, the rest of the time it's ctg check, and a checkup for mum. You have the option to pay out of pocket for three more scans, it was only 60 euros so we went for it (peace of mind after a MMC). So I was scanned nearly every appt. I had high blood pressure and I was scanned every time I went to the hospital for checks in the last 6-8 weeks. I was induced early due to high blood pressure in the end. Before they induced me, again I was scanned to check baby was in the right position and size/weight estimates were looking good. Previously, I had been told that if I were to reach my due date, there would have been check-ups every 3 days at the hospital until labour started, including scans.

The stillbirth late is one of the lowest in this country and I'm guessing the pre-natal care is the reason why

rate*

Reading all this has absolutely terrified me, as my granddaughter is due to have her first baby soon. I was under the impression that giving birth with the NHS had improved since I had my own child under terrible circumstances, 40 odd years ago, but this year, I have heard so many horror stories, and all topped off by the death of a young friend during childbirth earlier this year. Are things really this bad for so many young mums these days? Should I recommend that my granddaughter has a private scan just before her due date? Is there any advice I can pass on to her to try and keep her and her baby safe?

@Speakuptomakeyourselfheard

Reading all this has absolutely terrified me, as my granddaughter is due to have her first baby soon. I was under the impression that giving birth with the NHS had improved since I had my own child under terrible circumstances, 40 odd years ago, but this year, I have heard so many horror stories, and all topped off by the death of a young friend during childbirth earlier this year. Are things really this bad for so many young mums these days? Should I recommend that my granddaughter has a private scan just before her due date? Is there any advice I can pass on to her to try and keep her and her baby safe?

Yes, to be honest, it is horrendous. Does she have a strong birth partner with her who will advocate for her? So if she asks for painkillers/ an epidural/ C-section they will make sire the medical staff will listen to her and respect her right to choose this? That will make it far less risky, because a large proportion of these tragedies happen because medical staff do not listen to the mother.

Also post-natal care is even worse so get her home asap. After sections I walked out both times after about 18 hours. It was soooo painful getting to the car but the best option by far.