about my feelings regarding giving birth again?

[JamesAndTheGiantBanana]

I really would like to know if I'm being unreasonable because I'm getting myself into a bit of a prematurely angry state thinking about having my next baby.

1. I'm terrified I won't get an epidural, and I've heard it said so often that they might say "Let's just see how you get on" that I feel quite defensive about it (I've done it drug free before, I know how I get on: I. Do. Not. Cope) I wish I could just ask for an elective so the outcome was more predictable.

2. I'm feeling real horror at the thought of giving birth in front of a crowd of people (again) in a brightly lit room with everyone gawping and telling me what to do. I'm really scared of this, and I feel angry that people would want to watch. I don't want more than my dp and a couple of midwives there, and I'd like it to be a bit dimly lit. Is this unreasonable?

Not sure you have a 'right' to an epidural and if you do have one there might be conditions e.g. in our hospital if you have an epidural to have to be on labour ward rather than in the birthing unit so instantly much more medicalised, needs more people (not nec all at once but there will be more trailing in and out over the course), will be brighter etc. And it can be both too late for one or given there is a finite number of staff, there may be other more pressing needs (e.g. my dh did my canula during my pph as there was no other doctor available because several births went wrong simultaneously and there was a crisis). Why not aim for the epidural but have read around and be open to other forms of pain relief - my best (of three) labours included morphine and it gave me a very managed, controlled labour in a dim setting with just me, dh and the midwife.

Absolutely agree with everyone else that YANBU and to make a very clear and simple birth plan that is explicit about your wishes. And to brief dh.

I think my dh got so so fed up with me wanting to talk through all possible scenarios and what my wishes woere before ds1 was born but my biggest fear for labour was that I would be in too much pain / drugged up to make sensible decisions and knowing that he could speak up for me really helped me to feel relaxed about it.

Second time around (elective section) I explicitly wrote on my birth plan that I didn't want anyone there who didn't absolutely need to be. I work as a surgeon and know that its not uncommon to have a few on lookers or people wandering in and out in this kind of scenario. All people who have a job relating to your operation - not random punters off the street but I didn't want anyone who didn't need to be there floating around especially as after my mat leave I was going to work in that hospital and might well have been working with some of these people! On the day it was clear that they had respected my wishes and came and asked me if I wanted to be introduced to everyone there and have their role explained to me but I didn't - I was just happy that they had listened to me.

Back to you - the birth you describe is totally reasonable if all is straightforward. I would maybe write on your birth plan that if extra people need to be called in, and circumstances permit, (ie not crashing emergency) then you would like to have everyone who comes in to the room to be introduced to you and the reason that they are there explained. I mean this SHOULD happen anyway - you are a person and not a piece of meat - but sometimes it doesn't. Then if, for example, 3 obstetricians come to see you you could ask to have only the one who is the most senior and ask the others to wait outside (I mean your dh could ask this on your behalf). NOT unreasonable at all and if I was seeing a patient in my job (not obstetrics) I wouldn't be offended in the slightest if a patient asked this.

Also explicitly ask for no student midwives or doctors.

Good luck!

ooohhh no would not have like people watching..... didnt even like the young gorgeous male doctor coming in to pop my waters!!!!!!!!!

cross posted with hannahsaunt - i'd been going to ocme back to post that while you should make your wish for an epidural crystal clear I think you need to work out ways in which you will manage if it doesn't happen. Even if you are giving birth in a hospital that has an anaesthetist that is just on call for the labour ward (most larger hospitals will have this but smaller ones often don't, especially out of hours) they may well be tied up with emergencies meaning that they can't get to you in time.

I think finding ways to cope will make you feel more in control and hopefully help you to manage your pain. have you tried a tens machine? I found that and gas & air pretty good (the tens def made a difference as stopped it for one contraction and really vreally noticed!) although I had a section at 9cm so no idea how well it works for second stage....

Good luck (OH and let the 100% YANBU - a MN rarity indeed!) help you to have the confidence that your midwife WILL listen to your concerns and take them seriously - YA so NBU!

agree with hannahsaunt

there are so many ways to cope with the pain.

starting with breathing, water, TENS, gas & air and then going into additional things like massage, aromatherapy, and then pethidine/diamoprhine then epidural

if you don't want a brightly lit room with lots of people looking at you, then i would try to avoid epidural, as it does increase your risk of needing an instrumental delviery and you will certainly have more monitoring etc

what is it about the pain that you can't cope with ? the relentlessness? the pain itself? feeling out of control?

if you want to be in control, an epidural will not give you that, you will be immobile and subject to more protocols

JamesAndTheGiantBanana was it a large /busy hospital for your first birth? Re the epidural, a smaller, quieter hospital may be more likely to get that epidural sooner. My hospital has 24hour epidual cover, do you know if your does? Off course emergencies will always be going on, but it may help to be in a smaller setting??

James - I'm sure if you contact your maternity unit and tell them you need to have a chat with a senior midwife soon, due to an unhappy experience last time, you will get to speak to one - I would be surprised and horrified if they refused.

Debriefing what happened last time, and making sure that the senior midwife knows what you want this time round should set your mind at rest.

{{{hugs}}}

icarriedawatermelon, yes it was a biggish hospital. I'll be delivering there again, as I said I can't go to the birthing centre because of my bmi.

lulumama, I had gas and air last time, wasn't offered anything else and I was too out of it with pain to ask for anything. I'm scared of being pretty much delirious with pain again, mostly. I was ok til they made me lie down at 4 or 5cm, who knows how I'd have coped if I could have remained upright.

I did feel out of control, but that's inevitable as staff seem to follow a protocol because of my weight which involves me having to lie flat, have an IV and an internal monitor, even though things are going ok. So if they're going to do that anyway I may as well not be in screaming agony too. I'm hopeful that I can avoid an instrumental delivery despite an epidural, because my body virtually "vomited" him out last time, pushing was out of my control, I just aided it along.

The thought of not having an epidural is very worrying. If they said no epidural, I think I'd refuse to lie down, refuse to go along with their protocol. In fact I'd tell them to stick their protocols up their arse.

Thanks for all the messages, I appreciate you posting!

Did you actually ASK for an epidural?

I have noticed that midwives pay much more notice to the requests of second timers so I'm hopeful that you would get what you want. They know that you know what you are talking about.

They can't make you do things like lie down, go ahead and tell them to stick it up their arse, you can get away with it when in labour A more simple but shouted 'No, I don't want you to' worked really effectively for me at one point.

Not sure if this is relevant, but I have just remembered how much I yelled and bellowed during my second delivery, and how much this helped, compared to the attempt at yogic calm I tried during the first one.

james i really really feel for you.

dc3 is now 5mths old - i was in complete denial for the entire pregnancy and finally admitted to my midwife how absolutely TERRIFIED i was of giving birth again.

Luckily she referred me to someone to talk to about it. Thank god. For me it was trust - i didn't trust myself to do it, i expected the midwwives to take the pain away and basically do it for me.

My labour from start to finish was about 4 hours. (my first labour about 52 hours - no joke)

What i found helped was not fighting the contractions, and imagining the marshes near where i live.

Sorry to waffle on, what i'm trying to say is it WILL be different this time, you deserve the birth you want and if you can TALK through with someone about your previous birth experience.

Really good luck.

i would just add to make sure DH is absolutely clear about your wishes & able to DEMAND them for you should you be in similar position again (too pained to request anything)

Also, is there anyway that you could find out what different hospitals protocol are in your area? Could your local nct help???
My friend also has high bmi but was still able to have more control over her ds's birth than you seem to have.

Good Luck - you will soon have a gorgous new baby to bring home

I'm so sorry you were treated so badly with your first labour .

Did anyone take the time to talk through why the protocols were there? What risks were they trying to mitigate? What were the pros and cons of the procedures their protocols told them to do? From what you say I get the impression you were told they "had" to do this and that and the other, but still don't understand completely why they were necessary for you in that labour. Most areas have some kind of "birth afterthoughts" service - your GP should have the details if you don't fancy calling the maternity unit direct.

At the end of the day, you're not a hospital employee and so their protocols are their problem - not yours. The hospital may recommend against a homebirth, but if you do some research into a homebirth and decide that you and your DP are more comfortable with the risk/benefit profile of a homebirth than of a hospital birth then there is nothing that they can do to force you into hospital. Similarly with any intervention they might suggests during the birth (either at home or hospital, from VE to internal monitors) - they may recommend them but it is ultimately your choice. You might find these phrases by Mary Cronk useful.

How did your DP do on defending your wishes and arguing your corner last time round? If you don't fancy a doula, do you have a close female friend or relative that could act in that role (and would obey specific instructions to stay near your head)? DH and I decided to use IMs as we wanted to go into the birth knowing and trusting the MWs. It worked so well for DD1 that we booked them again for DC2 - that pregnancy wasn't so straight forward in the end, but our IM came with us into hospital and did a fantastic job as our advocate in helping us to achieve the best birth we could in circumstances that were far from ideal. Having good support meant I felt protected, not threatened - have a think about what you could do to have people there working for you not for the hospital.

At the end of all that, you're not being at all unreasonable, and I really hope you have a better experience this time round

James, that's exactly what pushing is meant to be- this forceful PUSH PUSH PUSH thing they do in UK hospitals is incomprehensible. Once you start pushing it's extremely difficult not to, iyswim. It would suggest to me that the thing that I think they worry about in deliveries with women on the larger side, which is that your uterus will be less efficient, is not a problem in your case. Point that out to your midwife- how long was your second stage?

If I were you I would write into my birth plan that I absolutely want to stay mobile and upright unless there is clinical evidence that I shouldn't. Labouring on your back is definitely a LOT more painful and increases the chance of the baby presenting at a slightly difficult angle.

I felt terrified too. My 2nd birth was much better because my body remembered what to do. I didn't get to hospital until I was 10cm dialated and it only took 20 minutes of pushing compared to 2 hours and an episiostomy the first time. I went home the same day. Get a tens machine and isotonic sports drinks - much better than the dextrose tablets. Amongst my friends they have all agreed the 2nd one is the easiest. My friend insisted on a c. section as she hated giving birth. Even though medically she could give birth emotionally she couldn't deal with it. They gave her one. Just think of the lovely baby at the end.