Midwife just does not get it (long birth story, sorry)

[Trinaluce]

I tried to keep this brief, but not possible, so please bear with me!

Contractions with dd started at 6am on the Saturday, went in Saturday evening when they were 4 minutes apart, got sent home again. Went back in on Sunday morning, got sent home. Went back in around 11pm on the Sunday begging for some pain relief as the TENS unit pads wouldn't stick (so I just kept getting electrocuted, great fun). By 2pm on the Monday my waters still hadn't broken and I think I was still only 6cm. They broke my waters for me then refused to let me even attempt a water birth as they thought (they weren't sure though) there was SLIGHT staining, so 'the baby must be in distress'. Cue being hooked up to the monitors (her heart rate did not change from that point until she was born. Distress? What distress?!) By 7pm I STILL wasn't even close to 10cm so they gave me an epidural and hooked me up to a drip to induce me. At which point the shifts changed and the midwife (let's call her The Biatch) who came on barely spoke to me, except to call me 'Dear' (which I HATE ). At one point she even left me on my own (husband had been taken off to be fed, lucky bloody men), stuck in the bed because of the epidural obviously and unable to reach the call button!
From here on I'm a little hazy, but I know it was late into the night when Biatch asked 'Ok, you want to start pushing?' 'Am I finally at 10cm then?' said I. 'What? Oh, er, yeah' was her not-entirely-convincing response. So, pushing began, probably - I had no idea as she gave no coaching or help despite the fact I couldn't feel what I was doing. At one point dh actually yelled at her 'Do you want to actually communicate with my wife and tell her if she's doing anything right?!' By half three ish (Tuesday morning now) though it was finally decided that I wasn't getting anywhere (no shit Sherlock!) so they'd prep me for surgery, the consultant would have a look and use forceps or go for emcs if necessary. Sadly, dd had apparently got stuck and it was emcs or nothing. By this point I was exhausted, had eaten nothing in about 36 hours and had had maybe two hours sleep. DD was (thankfully) fine, but it took me a long time to be able to come to terms with what is, in my head at least, a 70 hour labour. A midwife will not recognise it as such because I never really got into active labour until the Monday afternoon. I had no pain relief at all until the early hours of Monday morning thanks to the completely useless TENS unit, despite having had fairly strong and regular contractions from the word go.

The problem I now have is being pregnant with Child The Second and having to have an idea what to do. Given my family history (mother and grandmother both had to have sections, grandmother definitely had the 'wrong-shaped' pelvis, mum has never been given an official diagnosis), I accept on some level that a section is very likely to be necessary, but at the same time I can't get over the grief the section caused and the feeling of failure as a woman. I tried to explain this to my new midwife and got the stock response of 'Well you and the baby came out healthily so it doesn't matter how it happened'. Well I'M FUCKING SORRY MRS, but it matters TO ME. I cannot tell you how many times I've heard this reply and how fucking sick of it I am. I'm not fine. I still have flashbacks. I'm crying typing this and it was two and a half years ago.

I also can't talk to anyone I know about this as no-one I know has experienced anything approaching this length of labour - even my mother's was an 'easy' 36 hours, and her waters broke of their own accord. My BIL had the gall to say to my face that I had an easy time of it - his wife popped out her first in 3 hours and her second before they'd even had time to fill the birthing pool.

The oddest sensations of all of this though is firstly the guilt that my husband may never get to cut the cord (again, not helped by BIL saying how wonderful it was and how much he'd missed out) and secondly the guilt that my daughter may one day have to go through this.

I probably had a point here somewhere. - hunts down the back of the sofa- Ah, there it is. My question to all those who've managed to read this far is: given these circumstances, would you even attempt a VBAC or would you go for an elcs and save the hassle (and retain some level of control)? Also, how do you make people understand that it IS a big deal and that I certainly did not take the 'easy way out'?

can't help with your main q i'm afraid but please don't feel guilty about your husband not being able to cut the cord! mine didn't rate it - wasn't interested at all in cutting it with child no 2.

You are me. Down to the brother in my case that said I took the easy way out. No, I pushed for 8hrs and still ended up with a failed ventouse, manual rotation and emcs.

It took until dd was 3 for me to seek proper help for the crippling flashbacks and nightmares. I felt like a failure as a woman, a mother and I had so many blank spots about my dd's birth. I could have written your OP word for word.

I'd advise you to see a decent counsellor and an obstetric consultant who can go through your birth notes in detail and advise you.

I'm so sorry anybody has to feel like this.

I can't help with your decision as I had a really awful natural birth and and opting for an Elcs but I say screw people like that!! Only you and your husband know how bad it was. At my hospital they have a senior midwife who offers a birth debrief service where they call up your old notes and work through things with you. If I was attempting another vb I'd definitely do it. Do your PCT do anything like this? It might help?

ok, first of all , I am truly sorry you are feeling so awful.

I would urge you to contact the birth trauma association

the 'oh well, as long as you're healthy' is such a bloody cop out isn't it?

You are not 'healthy' - you are distressed and traumatised and scared and anxious and dreading the birth. Flashbvacks woudl suggest PTSD

I would discuss your first birth at a debriefing with a senior/consultant midwife. THe hospital might well have some sort of birth afterthoughts service

you need to feedback the lack of communication from the MW which led to a lack of confidence in her care.. if you have an epidural that does not wear off in time for pushing, you will struggle as you won't feel it !

the pelvis issue might be a red herring as it is quite rare to have the 'wrong'shaped pelvis

your DD might have got stuck as your waters were broken too soon and she was not in a great position and being immobile due to the epi would not have helped progress either

so you really need to go through your notes

when you feel clearer about last time, then move on to making a decisoin

for me, VBAC was the way forward, and even if i had a section again, i would have known i'd tried. as it happend , i had a spontaneous natural birth.

re the 70 hours.. established labour is recorded from 3 - 4cm dilation, so it is dismissive of the pain taht went before, but it was real and it did happen and you needed support

My sympathies, I understand where you are as I had similar feelings.

it's ok to be angry and pissed off and want to scream about it. you have been left upset and your feelings need validating

Never allow anyone else to let you question if 'healthy you & baby is all that matters', you went through it all, you know, end of.

Personally, I would try for a VBAC but...with conditions.
Finding a supportive hospital/consultant/MW/Community MW.
The one you have seen so far sounds like biatch number 2!

IMO:
your labour started spontaneously - good
you were progressing (albeit bloody slowly, but was a first birth) - good

you were yo-yoed to and from hosp - not helpful
then you were put on a monitor (assuming lying on a bed?) - bad
epidural - can be unhelpful (esp if still lying on a bed as I assume you were?)
told to push when not necessarily ready/10cm - bad
given no support/advice/encouragement at this point - bad

It's hard to imagine how on earth you were meant to succeed with this sequence of events.

However, given your family history, an elc-s would also be worth considering, even if you rule it out and decide to try for a VBAC.

Join the Yahoo Vbac group - i've found it very informative & helpful (aiming for a HBAC in April).

You may even want to consider a home birth, or at least staying at home as long as poss, as the hosp trips did not help you with DD.

And also, look into trauma counselling/post-birth support, see if the hosp has anything or find one through your GP.

Oh god, you've had a horrible time and no-one has tried to help you with it at all.

Can you find out if your hospital has a birth debriefing service? I had a traumatic time with DD1, but my mw referred me to the service in my hospital. A mw (who had nothing to do with your care) takes you through your notes and discusses what happened to you. In my case, they also offered to get either the anaesthetist or surgeon in to talk to me also (DD1 was em c-s under GA). It was hugely helpful in helping me come to terms with what had happened, and also in letting me know the course of events in the later stages, when I was out of it.

Regarding the VBAC vs elective C-S question, it really depends on why your baby got stuck. DD1 was a brow presentation, so there was no reason why I shouldn't have a VBAC (have actually had 2 now). This is also something you could talk through at the birth debriefing.

Ask your hospital's PALS service if they can help find someone you can talk to (look here).

And, FWIW, DH only cut the cord for DD3 and only then because the (lovely) mw gave him no choice. It didn't make the slightest bit of difference whether he did or did not.

Good luck with getting the help you need.

PS I have a funny feeling I posted on Showy's threads about her DD's birth too

You did Poledra and very helpful you were too. I still remember each and every one of the MNers who took the time to talk to me and share their experiences. Which sounds a bit stalkery on reflection.

You could also, if really worried about it, try and find a pelvic chiropractor - not sure of exact term - the Yahoo group know more.

Thank you all for your responses: particularly ShowOfHands - was becoming convinced that not one other person in the coutry had experienced anything even vaguely similar!

In answer to Poledra: I did go and sob my heart out to my GP, but unfortunately the only one on that day was the least sympathetic (I've always found her like that no matter what I've gone to her for) and she said go to your health visitor. So I went and sobbed the story out to the health visitor - she said she needed to get me the number for the birth afterthought group at the hospital (which wouldn't have been the hospital I gave birth at). When she finally got me that number (a week later) I never managed to get through to anybody. After a week trying to call them I gave up, too exhausted to bother any more.

I have thought about a birth debrief, but like a post I saw on babycentre I'm not sure how I'd cope with seeing their 'version' of events - particularly if it differed significantly to how I remember it.

I have wondered (as I intend to go back to the same hospital for this one) about asking not to let The Biatch anywhere near me - the only trouble is (PLEASE don't misunderstand me here!) she's black, and the only black midwife I was aware of on the whole team, and I don't know if the hospital might misconstrue my reasons! (There was a case at my local hospital a year or so ago where some stupid woman informed the staff that she didn't want any coloured people involved in her birth...) To make it absolutely clear, that is NOT my reason!

Trinaluce, I'm so sorry to hear your story and it makes me a bit as it clearly wasn't the birth you wanted.

First of all I would see if your doctor/midwife/hospital can refer you to a specialised counselling service. Round here it's called Birth After THoughts and is for women like you who've had trauma during labour and delivery.

Secondly, I wouldn't give up on a VBAC, however I would suggest that to give yourself the best chance perhaps you could do a pregnancy yoga class. If the class is worth its salt as well as yoga it will talk to you about what and why your body does what it does during labour and delivery, it'll cover effective pushing at the third stage (for future reference drop your chin to your chest and push as if your trying to do a big poo ) and may even talk a bit about active birth.

You're right, your birthing experience is a big deal and if your midwife doesn't get it then get a different midwife.

Where are you Trinaluce?
If you're in south yorkshire I can't point you in the right direction for support.

I'm in Milton Keynes. If you pay attention to the news, not a place well known for its maternity care.

I checked at my booking whether the biatch that destroyed any positive experience I might have had still worked at the hospital. I had every intention of refusing to let her anywhere near me. Fortunately she has moved on.

Trinaluce, let me try and assure you that what happens first time doesn't necessarily happen again. I can also tell you what I did second time, and what happened, in order to give you a few ideas.

I had a 42hr first labour, with 4hrs of pushing a baby who wasn't ever going to come out that way due to a badly positioned head. And thanks to a set of really good horse-riding pelvic floor muscles I pushed her really well - her head was being well and truly squished by my efforts. I went through 3 shifts of midwives in the hospital, and none of them were particularly helpful. On the evening of the second day the head MW popped her head round the door to see what was taking me so long, and immediately said 'get a doctor!' Shortly after I had a CS which started out with a spinal block but due to incompetence by the surgeon ended up with a general anaesthetic due to the spinal wearing off. I spent 2 hours open on the table while the doctor first of all tried to figure out why I was bleeding, and then resigned herself to waiting for the consultant to come in from home to stitch me up. During all of this my baby was delivered with an Apgar of 1 and rushed off to SCBU, and my husband was pushed out into the corridor partway through and given no information. My aftercare was appalling, and I was in no state to complain as I was so ill.

For my second pregnancy I spoke to an independent MW even before I was pregnant, and decided I was going to spend the family holiday money and have an IM. I started off with one IM, and for various reasons had to switch to another IM at 32 weeks. I had no problem at all with the first MW and it was only down to her personal circumstances that I had to switch, but in hindsight it was the best thing that could have happened. She was brilliant.

She had de-brief sessions with both me and OH, active birth sessions, came with me to the hospital appointments I had, and helped me devise my birth plan. I planned a hospital water birth with the help of both the IM and the hospital consultant and MW. We went over with a fine tooth comb what I would decide to do if things weren't going to plan, and although my IM was very pro-natural birth she spent a long time discussing with me what to do if labour did not progress, and I wanted her to start demanding a CS long before things got to an emergency if it was clear I had another baby who wouldn't come out naturally. She was also going to come to my house from very early labour and help me decide when to leave for the hospital and also to help me to leave again asap, so could spend as little time in the hospital as possible. I did not feel confident to have my baby at home as I lived a long way from a hospital in case of emergency.

And here's what actually happened. I was hopeful that I would be in labour for anything less than 42hrs and would give birth naturally. Anything better than that would be a bonus. I actually gave birth in the corner of my bedroom in under 4 hours. My baby arrived so quickly the speed even surprised my IM. At 2am I called her and thought she would think I was wasting her time as I had a 15 minute conversation with her with no sign of anything like a contraction. She arrived at my house at 3.30am and found me fully dilated and convinced me to stay at home. My baby had his head in a slightly less than favourable position too, so she coached me through getting him into a good position, and once he was in that good position he just came out without any conscious pushing from me.

So I had two births as far apart as they could possibly be. I would say don't be afraid of a VBAC. If you opt for it go into it informed - there is lots of good advice on MN. And if you can afford a little bit of money, get a doula to come and speak up for you when you are not able. If you have a bit more money, get an IM. I would say mine was some of the best money I ever spent and made the difference between me having a panicky birth in an ambulance (or even unassisted at home!) and confidently having a fabulous homebirth that I felt elated by. I felt I had put my plan in place but felt bold and informed enough to be able to change it when the circumstances necessitated it. If I were ever to have another baby I would still plan a hospital birth with a IM, but would fell absolutely calm and ready for whatever labour could throw at me. It has made that much difference.

Sorry this is such a long post. I wanted you to read the full story so you could see all kinds of things are possible, given the right help. And when you have had a bad birth you DO need help to get your head in order for the next time round.

Hi Trinaluce.
I had an emcs after a labour lasting from Tuesday til Thursday. I only got to 4cm even after going into spontaneous labour,having the synto drip,keeping mobile and upright etc etc. I started off at home,I had an independent midwife free of charge is a friend of the family.
No one who is having a baby ever expects that they'll have a c section (unless planned of course).
When I got pregnant again I just could not decide whether to try for a vbac or not. I didn't decide until 39+6 when I asked if I could book an ELCS!My bump was huge and I had loads of extra scans. In the end I went into labour again and had decided that if this happened I'd give it a go. After hours an hours of contractions I went into hospital and was a huge 2cm . I was admitted and even though I begged for a section (as I just knew the labour was going the same way)they wanted me to keep going.
Eventually I had a section after still only being 2cm's(and baby was in the perfect position unlike dc1).
It was an amazing experience and totally calm,a lot more like an elective. They pulled the screen down so we watched DS being born and they showed him to us so we could announce the sex which was a surprise.
This time I have NO feelings of failure whatsoever,and have accepted that my body just cannot do it.
I am pleased that I tried the vbac though as I might think 'what if' if I hadn't.
Of course I still feel envious of ladies who have had 'natural' births especially vbacs but my 2nd birth definitely laid the ghosts to rest even though I still had 'failure' to progress.

For what it's worth my Mum slipped three babies out easily so hopefully my DD will follow her!
Sorry my post is so long but I wanted to reply as my first birth was particularly epic!

Good luck.

Trinaluce, I had a first labour very like yours (although just 23 hours, not 70!) ending in emergency cs and can totally empathise with your feelings of failure, frustration, other people telling you you have "taken the easy option" etc. I had flashbacks for a long time and couldn't talk about it without crying for years.

I know lots of people recommend going back to the hospital to talk it through using the PALS service, but one of the reasons I didn't do this was because I had no faith in them taking me seriously, especially when during a routine appointment in my second pregnancy I read "8 hour labour" on my notes - it was 23!

I chose to have an elective cs for my second baby and it was an amazing experience, totally calm and happy and wonderful. It made me feel in control (something I definitely wasn't in my first birth). It was a weird mixture of "laying my ghosts to rest" and making me realise just how terrible the first birth had been. The doctors were smiling and telling each other jokes and the radio was on, and the atmosphere was so different from the first time when nobody spoke and nobody said "congratulations" and all I could see were grim faces. I thought "Ah, so this is how it should have been". But realising just how bad it was made me better able to cope with it mentally, if that makes sense.

Do your research. Decide what you want. Make sure it is stuck to. Good luck.

Trinaluce

Your labour sounds very similar to mine. I had regular painful contractions from Friday night until Tuesday lunchtime when my DD was born by EMCS. She was back to back and forehead presentation which meant my labour progressed incredibly slowly and, as she was trying to get out with the widest part of her head first, she got stuck.

I don't think I've experienced anything like the same level of grief / anxiety as you've suffered, but I did feel very guilty and also a complete failure for a while afterwards.

And I still think 'why me' especially as I'm now suffering from secondary infertility and undergoing investigations to find out if scarring from the EMCS is causing this :(

Like others have said it sounds like you need some form of counselling. Also I recommend reading your notes from the birth if you can. I have done this, and it did help me realise that there wasn't much I could have done differently given the circumstances and DDs position, which helped with my feeling of guilt.

Hi

I had a similar experience although my MW was lovely but i felt like i had failed due to hvaing a section. i wanted to try VBAC for my 2nd and it started off ok but then she got distressed and my scar was in danger of rupturing due to very intense contractions so within of a couple of hours being in hospital i was taken in for another section but this time was so much nicer as i had not had to endure such a long labour (36hrs) and i actually recoverd much quicker mentally too. I still have regret that i will never be able to do it naturally and i cry buckets when i see one born every minute. it was something i always wanted to experience but i am slowly coming to terms with it.

if i decide to have DC3 then i will probably opt for elcs so i don't have to go through the disappointment again.

Just remember every birth is SO different so you may have a very positive experience whichever way you decide. good luck.

Just picking up on one of your smaller points - your DH should be able to cut the cord in an ELCS - at my hospital it is standard to offer it. Neither myself nor my DP wanted this though as we thought it a bit gross.

Can you afford an independent midwife?

If you can - get one for your next birth if you decide to do a VBAC. I re-mortgaged my house to pay for mine, and it was worth it.

I had her with my third. Long labour. I took me 24 hours to get to 8cm then another 24 hours to get to full dilation. Only pain relief gas and air. Would have been begging to be shot by Tuesday night had it not been for midwife.

It can make a really big difference being looked after by someone who really cares about you and who knows how you feel. Someone who's completely on your side and putting your needs and your baby's needs above everything.

I wouldn't attempt a VBAC unless I had guaranteed and certain excellent support. But I would go out of my way to get this before chosing a C/S.

Loads of good advice here, especially re debrief. You can also get a copy of your notes for an independent birth trauma counsellor or midwife to go over with you.

Also, you might want to consider a doula, she could support you and protect you from evil midwives advocate for you.

Thanks for all the responses.

I hope nobody takes this the wrong way but it does kind of come across that the way to get a decent experience is to have money! (Which we really don't as we're hoping to be moving house before or soon after baby arrives...)

Advice has all been very helpful though and I'm feeling much better. I think I was having a hormonal day on Monday: I just woke up NEEDING some resolution on the whole thing!

until the emcs, your experience sound like mine - 3 day labour, only 14 hours of it recognised as painful, total lack of communication from medical staff, pain releif basically useless until the epidural was FINALLY granted, induction without it being explained why. I was REALLY lucky to have 1 good midwife in the several shifts I saw, who fought for me to have pain releif, and occasionally explained what was happening. And then was luckier still to have an obstetrician on duty who was an expert in forceps deliveries. And a baby with the constitution of an ox who was unfazed by the whole experience.

But I'm planning to try and have a de-brief if and when I'm next expecting (hormones keep telling me to try soon, logic says not in a zillion years) - our hospital offers a debrief to anyone who needs it, and I really want to know what went wrong with the first labour.

I know this isn't much help, but I, too, am a bit sick of the 'well, you're both healthy' and 'other women have it so much worse than you' attitudes from some family and friends. Neither helps me get away from the horrifying nightmares I've had, or the panic whenever I see an advert for One Born Every Minute! Hope you get some resolution and you're able to smack your BIL in his smug face at some point in the future :)

I can spell relief normally, apologies...