To think that this could be possible - covid birth

[DaisyEM]

I had my first baby during the pandemic, and I’ve never fully understood why much of it happened the way it did.

As a bit of background, my waters went at 31 weeks but I didn’t go into labour, so I was induced bang on 37 weeks (with checks in hospital every 3 days to monitor for infection).

I was called in at 9pm for my induction, and by 11am the next day I was having contractions. After several hours I was recording that I was getting three contractions lasting around 60 seconds every 10 mins. I told a midwife to be told just to sit tight. During a 2hr period I pressed my bell three times as I was so sure I was in active labour and every time I was dismissed. By the time they finally said they would check me I was 9cm and rushed round to delivery suite. This was really stressful and at this point I already felt like I wasn’t listened to/ignored and it didn’t fill me with confidence.

As soon as I got in delivery suite I was 10cm and needing to push. I pushed for 1.5hrs before they did a forceps delivery, then and there in the room without an epidural or gas and air.

I still to this day have no idea why I had a forceps delivery. NHS website says to allow up to 3hrs for pushing for first babies.

I’ve since had my second baby and my experience was completely different. It was so much more positive and I felt like I was in control and could have a say in what was happening.

My hunch is that when I had my first baby, they didn’t have any space for me on the delivery ward and so they kept stalling me when I was saying that my contractions were coming close together. And then the only reason I can think of for the forceps delivery is because they needed the room back. Baby had constant monitoring during my labour so I know there weren’t any concerns with him.

What does everyone think? I suffered PTSD following my first birth and had counselling. My pregnancy was complicated and my baby was unwell after he was born so that has a lot to do with it, but the thing that bothered me the most has always been the forceps. I had a birth debrief and when I did my birth plan for baby 2 neither the consultant nor the midwife could give me a reason for the forceps delivery.

I also recently spoke to a friend who’s a nurse and mentioned that I wasn’t allowed gas and air first time, and she said that there was an oxygen shortage during the pandemic, so I guess that could be why they didn’t let me have gas and air 🤔

it’s always bothered me and I feel like I can’t get any straight answers, so would be good to hear what others think.

I’m so sorry to hear about your experience.
In case it helps, where I gave birth it was 1hr of pushing then instruments, but also depends on monitoring of the fetus.

What exactly do you want now,OP?

I'm not based in uk, I'm presuming you might be, apologies if not, here you can request your hospital notes under the Freedom of Information Act. Is there something similar where you are. Sorry you went through this.

Surely 3 hours is the maximum and within that there will be monitoring of you and your baby.

Yanbu at all to feel bothered by it now OP. I see you've already had a debrief with a midwife. Do you think some sort of counselling might help? Your Obs & Gynae Psychology unit might be able to help.

I also had questions (unrelated to covid) and health visitor told me the hospital has a route to talk to the senior midwife or doctor for the ward to review what happened.
Maybe ask the HV team? If its still on your mind now then don't wait any longer xx

You can request a meeting for someone to go through your hospital notes with you. I did but it was 11 years ago so things may have changed but it really helped me process things.

@comoatoupeira oh wow, so they only allow for 1hr of pushing? At my local hospital it’s 2hrs, but for some reason they only allowed me 1.5hrs, not sure why. Wish I could remember more details but honestly I completely blocked it out x

@raysan I had a birth debrief with my consultant about 6 months after my birth, but he couldn’t tell me why I had forceps. Told me baby wasn’t in a difficult position and no issues with his heart rate etc during monitoring. I accepted it at the time, but then I only found out from my midwife this time around when doing my birth plan that they only allowed me 1.5hrs of pushing instead of the usual 2hrs x

It sounds similar to my first.

I had suction not forceps, it was traumatic, its been 16 years.

My second baby over 3lb more, came quick without much pain while I was all all fours. 😳

I think first time birth is traumatic for most people.

Hope you feel better soon.

Disgraceful that you u were deprived of gas & air.

I had a similar experience 17 years ago with dd1. They were so dismissive of me and told me I was very early stages and it was going to get a lot more painful so I needed to toughen up… dh requested a second opinion and the doctor was there very quickly (I was the only woman in labour that night). He discovered I was 10cm and rushed me to deliver. Dd was in my arms 25 minutes later and I was in shock. 30 minutes before they were trying to send me home but I refused to go (thank god). She was a shit mw. When I had me second pregnancy she wasn’t allowed to deliver any care to me as the relational had broken down and there was no trust (that’s what my notes said - doctor added that as he was furious with the mw). There were other bits of poor care but that’s the relevant story. I used to cry watching one born every minute because mine should have been text book but the mw failed me, made dh sit across the room from me “out of the way” so she could teach a trainee and left me feeling like I was failing in the early stages of labour. I’m not sure I found the answer as 17 years on I’m still a bit angry/bitter but my second pregnancy was so different and that did help validate my feelings.

@GettingFestiveNow thank you, I’ve already had counselling. It’s only since finding out that they only allowed me 1.5hrs of pushing instead of the usual 2hrs that I’ve started wondering why some of the things that happened did, and since having my 2nd baby and it being a completely different experience x

It is normally recommended to consider intervening after an hour of pushing, partly because it takes time to move around to theatre etc. if it is required. It is entirely reasonable to suggest intervention (forceps / ventouse / transfer to theatre) after an hour of pushing. If there were any concerns about fetal condition then that will push things forward. Because you were fully dilated on arrival in Delivery Suite then there will have been concern about how long you had actually been fully dilated for (nobody can know) and that would also lower the threshold for intervention.

During Covid there were concerns about the risk of infection to healthcare staff in the room from using gas and air. Some places stopped using Entonox completely, others would use if swabs had been reported as negative and others if there were no symptoms.

Specific hospitals also had such high numbers of patients on oxygen that it was borderline impossible to maintain the pressures in systems.

I am pleased that your second baby was a more positive experience for you - if this was also a vaginal delivery it is important to remember that the successful outcome was made much more likely by the first delivery.

Everyone can automatically access their medical records here.

It will have been to do with fetal monitoring, I.e. the baby was starting to get distressed

It could have been because the baby was showing signs of distress but was too far down for a c section. That's what happened with my first and I ended up with a double epistiomy and forceps. I was then sewn incorrectly and needed 3 corrective surgeries afterwards.

I totally get the PTSD element of having a birth like this. Like you my second was altogether a completely different experience

I'm sorry you had a bad experience. At the very beginning of the pandemic, there wasn't much understanding about how Covid was spread and I remember there were vague concerns that gas & air could increase droplet spread, so I think it was temporarily withdrawn in some places - though I worked in obstetric anaesthetics in the first wave and my hospital never stopped using it. That might explain that bit.

As for the forceps at 1.5 hours, we can't really tell you as none of us were there. Allowing up to 3 hours 2nd stage is unusual, and would be more likely in someone with an epidural already in - though some of that time would be allowing "passive descent,' not actively pushing. It may have been necessary because your baby was getting distressed, or you were becoming unwell, or were simply exhausted and no longer able to push effectively. It's incredibly unlikely to have been done with the aim of getting the room back sooner though - instrumentals increase the chances of needing stitches, or other complications, so it's not likely to have reduced the time you spent in the delivery room! I can hear how scary you must have found it, but please don't think they were just trying to rush you out of there; there will have been another reason.

I had a different but equally dismissive experience resulting in ptsd.

I would genuinely think about why you're going over this and what you want? I am not recovered but realised there was no point in trying to get an explanation several years later when I felt well enough to try.

You do what you feel you need to, for me I've realised it's best not to think about it.

gas and air isn’t all it’s cracked up to be.
birth is birth

I had forceps with my third. I have no idea how long I was pushing. Big baby, back to back, epidural. Awful. We were both fine. I never questioned it tbh. Why is is bothering you OP?

If the baby was in distress and early it may have been more important to assist the delivery. I had a ventouse delivery with ds (now late 20s!) and it was as you describe except I pushed longer, resisting intervention, and it probably ultimately helped neither of us. Your debrief should have covered this though. Ime the mw notes are pretty brief so will probably not be all that helpful. .

Your waters went at 31 weeks but you didn’t go into labour until 37 weeks? This is not possible. Once waters have gone, there is a risk of infection. My waters went and I was taken in to be delivered the day after.

Your waters went at 31 weeks but you didn’t go into labour until 37 weeks? This is not possible. Once waters have gone, there is a risk of infection. My waters went and I was taken in to be delivered the day after.

I also found gas and air pretty pointless.

I’m sorry you’re still feeling scarred by your first birth OP. I also found mine traumatic (very painful, very long and dd wasn’t breathing at first which was scary as hell). Have you considered some counselling to talk it through? I had a couple of sessions and found it immensely helpful.

If you birthed in the UK your notes should document the reason/s for all decisions made during your labour. So, in an adequate debrief, the clinician will be able to read your notes and answer your questions. For example the notes might read

Plan: for trial of instrumental due to maternal exhaustion/fetal distress etc.

I’m sorry you had a difficult experience and I’m sorry you’ve had a less than helpful birth debrief.

Perhaps getting a copy of your notes and reading them yourself might help?