Would I know I had coil fitted during an emergency c section?

[Bumpy123]

I was recently reviewing my dischage notes from my emergency c section I had in January. My notes say that I had a long acting reversible contraception inserted during this procedure. While the doctors are confirming with the hospital if this is the case AIBU to not know that I've been fitted with a coil?

AIBU: Yes, surely I should feel it.
AINBU: You should be able to feel it. It's probably an error in your notes.

Thanks.

I have never felt my coil. In theory you are supposed to feel the strings with your fingers if you try to, but personally I never could.

It could be an error in your C-section notes, or an error when the midwife filled in the form. I vaguely remember a discussion about coil during my first pregnancy, I would say most likely one of the last prenatal appointments with the midwife but it could have been at the hospital too. I don't think it had anything to do with the C-section though, it was just something I could opt-in for in my birth plan.

I’m immediate thought (as a medical professional) is it’s a documentation error. Multiple c sections are done every day in that same theatre as you and notes will frequently be done at the end of the theatre list. It wouldn’t be impossible to mix up a detail in the notes and mistaken something that happened in another case. Obviously still a serious error and needs reported and rectified in your notes but certainly less serious than fitting and IUD without consent! I would ask for a gyne examine to clarify if there is in fact an IUD there if not contact pals to ask for the notes to be examined and corrected. If it’s a documentation error please remember doctors are human too and it is very possible that doctor done up to 5/6 c sections that day often in an emergency with no time to write the notes of the previous case before going to potentially save the life of another mother and baby. Not excusing the upset this has caused you just providing context. 💐

I think it would be incredibly unlikely this would happen (as in for it to have been inserted). Firstly it wasn’t on your consent form and there are checks when doing a procedure so if it wasn’t explicitly there it just wouldn’t have happened. And if it DID happen and wasn’t in the consent it would have been a never event and there would have been a discussion with yourself and formal apology and a reporting of the fact you had a supplemental procedure you didn’t consent to. But also cannot see it happening during an emergency c section. I had the exact same thing happen trial of forceps in theatre then c section if unsuccessful and it just wouldn’t have been feasible - and consent was checked by the team.

What has probably happened is some junior doctor or midwife that day allocates to do all the discharge summaries made a mistake and put that in or accidentally confused your discharge with someone else as they probably did about 15 or some silly number. It is bad but probably just a transcribing error. The best thing to do is someone needs to check your operation notes - it will be the most contemporaneous and accurate account of what was done as would have been written immediately after the finished the procedure.

^ This.
And if it was, and you didn’t consent, don’t bother with PALS . Go straight to a medical negligence lawyer.

Coils hanging about near emergency treatment … Not usually unless requested … in advance of your emergency procedure. 😳😳 huh?

Get onto pals. They could facilitate getting a scan or similar carried out to determine what is in position or if nothing at all. Then the notes need to be confirmed one way or another.

Feel it or not? Well it depends upon the coil. Your DH / partner is likely to be able to feel some of them. You should have had a choice of which type to have fitted. Involving DH too.

Get it checked, and raise the roof if it was carried out without permission. Whether or not you choose to keep it in position as a preferred contraceptive method.

You may not be able to feel the strings - they can end up tucked up around your cervix. I'm on my fourth Mirena and have never been able to feel the strings except for the first couple of weeks after fitting. You will likely need an ultrasound to confirm either way. I'm so sorry you are dealing with this.

How bonkers. My money is on a box ticked by mistake - not acceptable but better than the alternative!!

I guess the quickest way to find out might be to see the nurse at your GP surgery and ask them to check? They should easily be able to tell if you have a coil in place.

Ask your GP/practice nurse for a strings check.

Ask GP to get sight of your consent form. You would specifically have had to sign to consent to it. If they did it without consent - you have an issue.

If you signed to consent to the operation and it was in the small print that they were going to do it - but it wasnt clearly explained, then you have an additional issue.

I can't feel the strings on mine, but at my scan last week the tech saw it clearly in the right place.

I can't feel it at all and wouldn't know it was there if I hadn't consented to having it put in during another procedure under anaesthetic, after it was explained.

Very odd to do it without your consent. I'd say more likely it got written in the wrong notes by mistake. You can get a scan to see if one is there.

A copper coil or Mirena? I think the Mirena you might feel the strings, but no physical symptoms other than very light periods once they resume.

Copper coil, strings can be difficult to detect, but as well it might take a bit more getting used to (relatively large T bar, maybe x2 or x3 bigger than the Mirena) and can cause period like dragging sensation and spotting until you body gets used to it the first time. Can take a few weeks/months to settle down to forgetting about it (although great as not hormonal), but if you felt pain at first you may have just thought that was your body returning to shape.

If it was inserted, just as well you read your notes should you want to conceive again.

On some level though, I could understand one being inserted if getting pregnant again would be at considerable risk to life. Say if a high number of high risk pregnancies already. Still shouldn't be without consent, but I'd totally agree with the logic.

If your husband was there the whole time would he really not have noticed?

Hopefully it's an error on the notes.

1. if you can’t feel any strings in your vagina please see your practice nurse to examine you. If there is a coil there without your consent that is serious and you will need to liaise with the hospital PALS team about this incident. If the coil is there and you don’t want it, the practice nurse can remove it for you.

2. either way please flag this to PALS because if it is a documentation error it is still important to be noted and acted on in the hospital (has it happened before? Can the drop down box be made more obvious?) if it was inserted without your permission that is a very serious error indeed and will be investigated.

Finally, a plea as a GP- we will be happy to check the coil for you, but we do NOT have your hospital records, consent form, operation notes etc we only get the same discharge summary that you do. So in contrast to some of the well meant advice above please do not ask your GP for these documents, you need to go via the PALS team to investigate and/or complain and you can request your hospital records from the hospital team directly.

It's far more likely to be an error. I reckon there's at least one error on most of those notes in the bits I understand without googling.
DD was once measured as 192cm aged 4yo. 🤣

A copper coil is not 2 or 3 x the size of a Mirena. All coils (in current use in the UK) are essentially the same shape and size. Few mm in it either way.

@Bionlible I stand corrected, you are quite right, I should have looked it up before I posted! I have now goggled and maybe only mm in it versus other coils... I was convinced the copper one quite a bit larger, maybe as everyone's experience of other coils is of no pain. Copper one great as not hormonal, but in my experience takes a while to settle.

Either way this is a cock up but if you’ve had a coil fitted without consent I agree go straight to medical negligence lawyer.

Their question is have they actually been given this or is it just an error in the notes (obviously still unacceptable, but less so than the implant actually being put in)

I was barely 19 when I had my oldest (almost 20) and that 16 years ago and didn't get a choice, I was TOLD I was getting the coil.

I was shocked to see when looking up contraception options after my youngest that on the page that its still not really a choice for teen parents (nothing has been 'pushed on me' in my 20s/30s though even though I have multiple kids and I'm high risk).

They 'say' its the patients choice but teens cannot opt out of the referral and once you are there they basically bully you and wouldn't let us leave until we 'agreed'.

I ended up not getting the coil only because they fucked it up, they ended up damaging my cervix and abandoned it... it was pretty traumatic and I was suppose to go back but needless to say I avoided the sex clinic like the plague after that (so all it does is put people MORE at risk).

So from my experience I could totally believe that some facilities would take it upon themselves to fit one without even telling you.

I also suspect this is an op note template with a load of stock text which has not been correctly deleted. Bad enough to warrant a heartfelt, grovelling apology, but not as bad as fitting a coil without your consent (which would be “consider suing” bad, IMO).

if it’s been inserted without your consent then that is assault.

But I agree with pps way more likely there’s just been an error with notes.

That’s if one was actually inserted as opposed to the notes just being incorrect.

hopefully it’s just a clerical mistake. If they have fitted a coil the lawyers would be getting involved.

I think you'll need to get a check from the nurse or whoever can check these things - I've never had one.

I would be leaning towards thinking they didn't fit it and that it was a clerical error. Which shouldn't be made but honestly who can say they have never in their life made an admin mistake.

If they have fitted one without your consent I would be going absolutely mad! Yes I know I just said about mistakes but that IMO is not a little mistake.

Hopefully it is the 1st. Stressful for you either way

I can’t believe they would put one in without consent!! How shocking. I hope you get to the bottom of it OP