Calling all Doula's/independent midwives- (especially those in Somerset!)- supporting women for subsequent births after traumatic ones.

[Thandeka]

Right- I haven't even decided if I am even going to go for a VB next time as DD's birth was the most horrific traumatic experience of my life and something I can never ever repeat. (oh and am not even pregnant yet but this is something preying on my mind so it's something I need to resolve before we start TTC). Basically everything went wrong, failed canulas, epidurals, ventouse, lots of pain, panic and I ended up with an oxygen starved DD who was in NICU for a week with suspected brain damage, pneumonia and various other things (DD is fine now though thankfully- still being monitored but very much a "normal healthy baby")

Anyhow if I was to decide to VB again (am pretty sure I can get a c-section next time because of DD's birth- which is very tempting apart from the "MAJOR ABDOMINAL SURGERY" aspect!!) then I have decided I would need an awesome doula to be with me throughout as well as an epidural but not too many top ups this time and being on all fours or squatting to push. Trouble is as these conditions can't always be guaranteed I think I am too scared incase what happened last time ever happens again. At least with a section although its crap for the mum at least you won't end up with an oxygen starved baby at the end of it.

My question is- can doula's support a subsequent birth after a traumatic history (I mean in expertise I guess- I am already seeing a pyschologist but if I do decide to VB then I need kid gloves and someone who really understands- not someone who has only doen "good births" IYSWIM?). Also how good are doula's at advocating for the labouring mother? I need someone who isn't going to piss off the HCP's but also someone who is assertive who going to advocate on my behalf to say- "look this woman NEEDS to have the birth experience she should have had first time so she ISN'T going to be on her back with her legs in stirrups for the pushing stage thankyou very much"

Anyhow just musing at this stage so any thoughts would be great.

Thandeka - I had a not-very-nice first birth and used an IM for my VBAC attempt which was in hospital so she was acting as doula. It didn't go how I was hoping and the baby became distressed so it was stirrups (which I remain convinced were there to stop me from kicking the doctor), rudeness etc. My IM wasn't in a position to contradict the doctors (fair enough) and tbh she was too worried about the baby to complain about the rough treatment I was getting. BUT (a very important but) I had spent the pregnancy getting my head around what I wanted and would do in each scenario. I was surprisingly able to stand up for myself when the doctors got a bit pushy and I was demanding a section the second things went wrong (and my IM backed me up on that). The experience was far far better than the first time around and did exorcise some of my demons.

Had the baby been ok I would have given birth in the pool, having negotiated the kind of low risk, mobile labour I was denied (for no reason) the first time around. I am sure I wouldn't have had the confidence to make sure I got that (or the ability to negotiate the NHS and find the right people to talk to) without my IM's help.

That is really helpful Haliborange. Thankyou.

I suppose I could do same go for VB but go for CS if it gets dodgy again- trouble was last time I was screaming for a CS (well actually I believe I was screaming for them to "KNOCK ME OUT WITH A HAMMER" but it was actually too late- so they had to go in with forceps and I had an episiostomy. SUppose the chances of that are less with a second birth but still not sure I dare take that risk.

It so depends on the midwife you get too- I had a cold faced one- and I remember at one point in my labour another midwife came and held my hand as I had been left on my own and was feeling urge to push, and for that minute I was calm but she couldn't stay with me :( that's why I want someone professional to hold my hand!

Sorry I have no advice but I will be watching this thread with interest! My labour wasn't as traumatic as some but I was treated quite badly, not believed until I arrived at hospital pushing, made to lay on my back in stirrups, episiotomy and ventouse (which I believe was unnecessary). I don't want ds to be an only child but I can't face the idea of going through that again and I know I'd spend the entire pg feeling terrified without a proper plan of action! I totally understand feeling torn between a calm cs and the unknown of a vb which could possibly be the lovely natural birth you should have had first time around.

Thandeka and haliborange, your experiences sound very familiar to me. I had 40 hours of intervention-free labour, although with hindsight a bit of intervention a bit sooner might have rescued me from the catalogue of disasters that happened between 40 and 42 hours. A number of important clues were missed or not passed on during midwife shift changes and I ended up with a CS under spinal block. DD was eventually extracted after refusal to come out with a ventouse and then being found to be very jammed in when I was opened up. The doctor had only one eye (seriously!) and in the effort to get DD out she cut things she shouldn't have and then couldn't figure out what she had cut and therefore couldn't stop it bleeding. A more senior doctor was called in from home and in the meantime my spinal block began to wear off. I was given a GA, DD was rushed up to SCBU and poor OH was pushed out into the corridor to sit alone and not knowing what was happening.

By some miracle we are all healthy and well now, and cross about what happened but keen to move forward. I spoke to an IM before getting pregnant as I was concerned about what to expect. As soon as I was pregnant I appointed the IM (sadly I have had to change IMs just recently as mine has had a situation at home which means she needs time off, but her back up is proving to be every bit as knowledgable and reassuring as she was,) and to date I have had excellent pre-natal care, with liaisons made with the NHS consultant who is most likely to support my VBAC attempt. (Had I been certain I wanted an ELCS she would have put me into the care of a different consultant, one who favours CS for 2nd timers.)

I have an appointment next week at 38 weeks to discuss my use of the pool, as recommended by the consultant. At no point have either the IM or the NHS staff I've spoken to so far given me any indication that I shouldn't be able to make a good go of a successful calm birth. You will notice that I haven't mentioned VBAC here, because they have all agreed with me that a VB is not the be-all and end-all, a calm birth resulting in a healthy baby and mother is, even if that means a second CS. We have discussed the circumstances surrounding a calm move from plan A to plan B.

Both IMs I have dealt with are happy to support me in the hospital - they find that the majority of their clients employ them because they want homebirths, but the next largest group are those wanting assistance to put a poor previous experience behind them, and are very well versed in dealing with this kind of client. The hospital I have booked into has experience of IMs coming in with their clients (the one I gave birth in first time round would not have been happy with her in attendance.) I'm hoping for a level of continuity that I did not have first time round, and the messages I'm getting from all of the people who will be involved suggest that this will be a more enjoyable experience all round. I am definitely looking forward to it, and very ready now!

Hm yes, the doctors were faffing rather when I was asking for a CS and kept going on about flipping forceps, but since I had had those with DD1 - and they failed - I had already agreed with ym consultant that in the same circumstances, with the baby high up, there should be no forceps attempt. when registrars start looking confused there is a lot of mileage in yelling "Ms X agrees I should have a cs in this situation!". Having my IM there meant she could tell them what happened last time. It was also good she was there because doctors kept saying marvellous things like "heart rate is only 40!" and she was looking at the monitor and telling them they were reading it wrong and that was the contraction. Kept me calmer to have her there, anyway. She was able to tell me things didn't look too bad and that it was normal for the doctors to take so long (I had watched too much ER and expected instant service). Afterwards she was able to reassure me that I had done everything right. I really needed to know I had given the attempt my best shot and that a crash section was absolutely inevitable.

Best of all, someone who was there throughout and who saw my DD born (because I didn't having been knocked out - I screamed to be knocked out too!) was able to tell me all about it and help me debrief. It was very helpful and I had much fewer low days afterwards.

i had a really bad birth and now ive found out im pregnant again and terrified i dont want a vb. i was 12 days late so induced, thorugh my labour i started bleeding, and then by the time i had him the blood was just gushing, and i had teard quite bad aswell, after that i just passed out and never got to really bond with my ds straight away, i woke up at ten o clok at night, with my heart rate going at 262 bpm, then they thought i was bleeding internally because my belly didnt seem to be contrecting normally. but it turned out my catheter was blocked. i returned home just in time for christmas and then 4 week later, i started heamorrhaging again when i got to hospital the doctor said he could still feel my womb in my belly which wasnt normal at 4 weeks after turned out i had an infection in my womb, due to the fact that id had afterbirth left in there for 4 weeks, and then had to have 30 tablets a day for 2 weeks nearly. and now im absoloutly terrified of giving birth again

Hi Thandeka,
(and others on this thread)
I have been a doula for a number of women that have had previous traumatic births.
The main reason I became a doula was to support women in this situation and to make it less likely women having traumatic births in the first place.
I tend to do many visits and get to know people as deeply as possible and talk through the first birth (or births) in detail, and then we work out what sort of birth they would ideally like.
What particurly caused the trauma the first time (specific interventions, attitudes, treatment etc)
Obviously, as a Doula, I can't provide medical care but I can help to organise meetings with senior staff at hospitals to get birth plans signed off (if care is outside of policy guidelines) and attend meetings as emotional and moral support.
I think a 'good' (whatever that means to you) birth experience can be very healing, for women (and their partners) and it is possible to have an entirely different experience.
I can be with a woman from right when labour starts (if thats what she wants) and ensure that the environment is kept safe and quiet and loving, whether thats at home, midwife led unit or consultant led unit.
There are a few birth stories on my website from women that describe their first and subsequent births-
www.magicalbirth.co.uk/13.html
In terms of other doulas experience- its best to see which doulas are in your area and talk to a few till you find one that has the experience you want, and that you feel happy and relaxed with.
HTH
Selina x

Hi!

I am using these Doulas; www.consciousbirthing.co.uk/
They are based in somerset and are great, you can phone them and find out more about how they will be able to support you in your situation.

If you are looking at using an IM these Julia Dufhie www.independentmidwiferyindevon.co.uk/
and www.unveilingbirth.co.uk/ were recommended to me.
Unfortunatly for me they were both away for my due date :( so am using NHS midwives with my doula. I think based on my midwife experience in north somerset I would have prefered to have got a loan to cover an IM. But my doula is great and is very supportive and happy to speak to the NHS midwives when I am not being listened too!

Good luck and I'm sure it won't be long before you find a great suppport person! :)

oh gawd is north somerset worse than north london for midwifery care?! YIKES! No it was north London where I had DD but we are moving to bath next week (is RUH shocking then?)

Thanks so much for the links. When getting breastfeeding support I met the most incredible independent midwife who I would love to support me in my next birth cept she is north london based- hmmm wonder if I can tempt her into a month holiday in somerset either side of my due date!

Haven't worked out yet- we are moving to my F--i-l's place first and trying to buy a place- thinking bear flat or larkhall but dont really know.

Hmmm maybe CS is the way forward then!

My DD is 6months now- so similar age to your DS - you'll have to advise me on what's good baby groups wise!

Thandeka, hi.

I'm a trainee doula, not in Somerset unfortunately :) But thought I'd tell you my two pennies worth, not only wearing my doula hat, but also wearing my mum-who-had-a-traumatic-birth hat.

Your situation is, as Selina said, exactly the reason many women decide to become doulas. Yes, some do it because they believe passionately in 'natural' deliveries & what you call 'good' births (and want to assist women to achieve that) but I would think the vast, vast majority of doulas do this work in order to assist women to have positive (or at least not negative) birth experiences, particularly if they had a bad initial experience. If you decide a c-section is the way forward, that's completely your prerogative & up to you :) I would recommend you perhaps have a chat with a couple of experienced doulas or IMs to discuss your first birth & see where you want to go from there. There's nothing bad about c-sections in themselves: they, as any kind of medical intervention, have their place & can be the right choice for some women. The only thing I would recommend is that you go into your second labour/birth having an idea of why you're doing what you doing & being relatively clear about what you feel is the right choice for you. Not for anyone else, but for you. If that means a c-section, go for it. If it means a vaginal birth with the presence of a lovely doula, go for that.

You have to remember, each birth is different. I myself had a doula assisting at the birth of my DS. I had an epidural through choice & all in all it ended up being a very traumatic experience. Believe me, having our lovely doula there made all the difference, to the point that a few years later I decided to train as a doula myself! :)

(oops quite a lot of :) there!)

Thandeka - we used IM's for DD1 (who was breech) and re-booked for DD2. She was fantastic for both is (unfortunately for us) currently in the process of moving to North Somerset and I'd highly recommend her. I don't know how long it will be before she's up and working again, but if you'd be interested I can find out and give you contact details :)

yes defo! I have a while before am up the duff again so please pass on the details-
am thandekatotango at hotmail dot com

Ta.

I've recently moved to Somerset and have been a qualified midwife for 10 years and Independent for the last 5. I've personally had a traumatic birth and a very healing birth experience.
If I can help in any way please phone me on 07939247462.
Joy Horner.