any doulas or midwives able to give me some insight as to how abnormal my labour was?

[got2bequackers]

My waters broke with no previous indication that labour was on its way. However there was meconium in my waters so we were instructed to go straight in to the hospital.

By the time we arrived i had started contracting. I was hooked up to a monitor and the pads kept slipping if i moved so movement was severely restricted.

Within a couple of hours my trace showed that i was contracting 3 to 4 times in a 10 min period but they were not evenly spaced. Most of the time it felt that as 1 stopped the next one would start.

16 hours and no pain relief later (and believe me I begged) they decided i needed synto to speed it all up. I said that I needed an epidural if that was the case. They moved me to a delivery room and i got my epidural (thank god bearing in mind what happened later)

When they hooked me up to a new monitor the monitor was recording 3 times higher numbers during the contractions. ~ it seems the other machine was not working properly. Did this make them think i was only contracting mildly and therefore needed the synto? Or was the time just going on too long since my waters went?

Anyway 26 hours after we got to the hospital i was told i was fully dilated and needed to push. The midwife tells me that i was pushing well but after 2 hours it was having no effect.

The consultant said she wanted to try forceps. I asked why forceps were preffered to ventouse and she just said oh we will try ventouse if you prefer.

The venouse worked to get the head out but then she got shoulder dystocia and got stuck. A chrash team etc later they got her out. I am forever thankful that a 3rd degree tear, an episiotomy and several second degree tears all healed well and baby only suffered erbs palsey for about an hour.

My mum went to see the midwife. The midwife cried!

I am left thinking that i should have had a c~section. What i really want to know is that, under different circumstances (the ward was full beyond capacity) would the unusual, i think, labour have led to a section. Or was there no way of knowing it would have gone that tits up?

Not a hcp but the monitor numbers are no indication - you can't compare one monitor to another as it's dependent on what the base line is set to on that machine at that time. It's the relative changes on the trace that show ctx strength/duration.

got2be firstly, congratulations on the birth of your baby. Secondly, your birth experience sounds very traumatic. I'm not a trained HCP but it is important to appreciate that obstetrics isn't an exact science and the mw and drs have to make judgements about what's happening and what path of action would be best based on limited information and their experience. I would strongly suggest you contact the hospital and ask for an opportunity to review your labour with the head of midwifery (or her/his representative). With the best will in the world, it's difficult for anyone here to tell you what happened as we don't have access to all the information. (I mean all of this kindly as I had a traumatic delivery resulting in emcs with my DD which left me traumatised - although I didn't recognise it at the time).

So there is no real indication of intensity? The peaks were obviously much higher on the second machine.

At the time i did think the trace was just showing the frequency. But i read a thread on here that made me think I was wrong and intensity was supposed to be measured as well.

No way to predict really. Just on the info you have posted I am assuming the reason they were keen to use synto was in view if the meconium. You don't mention the baby's heart rate pattern. Were they worried about this? What did they find during vaginal exam?

The percentage rate on the monitor doesn't reflect the strength of the contraction in any way. It is largely dependent on where it is put. It is the frequency that is significant with synto. The strength is gauged by hand and by labour progress.

There can be some risks factors for shoulder dystocia ( instrumental delivery is one) but sometimes not predicted at all. Have you discussed events with the hospital? Often very useful in making sense of it all. Sorry got to dash for school run. But dint think, on the basis of what you posted, that a cs would gave been done. Difficult to say without seeing your notes/the ctg. Hope you are ok now.

Strangely it wasn't that traumatic at the time as i had no idea what was 'normal'. That and the fact the epidural was bloody brilliant.

I do think about it and i know i would never attempt a vb again. The consultant at the tear clinic agreed that a cs would be the likely option if i concieved again.

But the thing that has me really thinking is that my sil just had a baby at the same hospital. She has suffed pre~eclampsia throughout pregnacy and was admitted as she was blacking out and fitting. Rather than doing an emcs straight away they tried to induce her twice first! Emcs followed.

Am left with the horrible thought that this hospital may be putting people at risk in order to keep their cs rates down. Is this likely? I hate to think badley of the place as the midwife and the people on the postnatal ward were fantastic. And if they really didnt have any indication as to the fact it was about to go wrong then i am fantastically greatful to the staff for getting me and dd through it alive and with no perm dammage.

I'm sorry to hear you had such a traumatic birth, I strongly second the suggestion of going to the hospital for a debrief. They'll go through your notes with you and should be able to answer all of your questions, it can be really very helpful for a lot of women.

These people are also very good: www.birthtraumaassociation.org.uk/

How's the physical recovery going?

Sorry, forgot to link my link birth trauma association

Thank you for all of your answers. It is 20 months since dd was born and i am very lucky to have healed very well and dd is the strongest child you will ever wish to see. She hasnt stopped moving since she was born. Dh says that even in special baby care she was waving her good arm about! And by the time I got to see her both arms were a flailing! She doesnt even lie still in her sleep bless her.

I am a very very lucky mummy! Poor dh though he had to watch it all go on~ suprised he is not a gibbering wreck. But i have agreed that if we do have another he can wait outside!

Hi honey, as a doula and somoene who experienced a traumatic birth, I must say that it is not for me or anyone else to assess how traumatic your birth was ( although it sounds fairly horrendous!) the important point is that you were left in pain for hours, you had a complicated instrumental delivery that left you with a bad tear and your baby had a shoulder dystocia and complications. and you found it traumatic and upsetting

if is not normal or recommended you are denied pain relief in labour, it is not normal for the MW to only pay attnetion to the monitor, and to not feel and assess you and ask you how you are coping too

a faulty monitor is part of the issue, as is not being listened to

did you have the epidural? that in itself can lead to a longer second stage and higher incidence of insturmental delviery

it is hard to say if you shouyld have had a section... in hindsight it's easy to say of course, but at the time, if baby was descending with the pushing and looked as though he just needed a little help then instruments are the right choice, if the baby has not descended , then c.setion is better

i would advise you to make an appt to go through your labour notes with your hospital and get some answers

you can , should you have more children , request a c.s

Waters breaking at the start of labour can indicate a posterior (or malpositioned baby) this can also lead to painful but non productive contractions, that are irregular (in timing or strength) and labour can last a long time with stalls, without much progress.
Pushing with an epidural is more difficult as you cannot feel to push and can often lead to assisted delivery.
It does sound like a 'chain of intervention' and I'm sorry you had a difficult time.Do you know if the meconium was 'thick'? Were your waters a dark brown or just lightly tinged brown /green? Were you overdue?
In my mind, meconium in your waters led to constant monitoring which limited your mobility (making it less likely baby could get into a better position) and increased the pain you felt, continuation of a malpresentation made labour slow which led to the drip to speed up the contractions, which increaed the pain, which led to an epidural and this led to the assisted delivery, tearing etc
Meconium can be normal in an opverdue baby (indicatindg a mature gut) or can be old meconium which is well diluted or it can indicate fetal distress (which I assume they did not pick up in their monitoring otherwise they would have suggested EMCS)
More info on meconium here-
www.homebirth.org.uk/meconium.htm
www.birth.com.au/Variations-of-the-3rd-and-4th-stages-of-labour/Meconium-possible-interventions?p=1
I have heard many similar birth stories to this when I have supported women after traumatic births, hope you are ok.
Selina

CSs have their own risks. For most women, inductions work. I had a CS after failed induction but in the week it took me to have my baby, dozens of women came in for inductions and had healthy babies the very next day! That was actually the most upsetting thing for me - that it seemed to work for everyone else but not me!

My waters we slightly gree, i was not sure is was mec but it was confirmed at the hosp. I agree with the chain of intervention.

Progression of cervix siallaton was roughly similar after synto as was before. But i did get the epidural at the same time.

The lack of pain relief before this was largely to do with the fact that there was not enough g and a or delivery rooms to go around and i was low priority at the time.

Dd heart rate was ok untill a while into the 2nd stage. They said they were going to let me push for an hour, they let me push for 2. The head had only moved slightly after 2 hours and she was sharting to get distressed so they went for the instruments (honestly this is where 8 think a c section should have happened as midwife said rather forcefully to the consultant ~ but she has been pushing really well!!!!. I think the midwife knew it wasnt right and she was out of control and thats why i think she hugged my mum and cried after)

Jap~ i realise that inductions work for most people. But i am fairly sure they are not recommended for people suffering with eclamptic fitting.

Sorry to hear your labout was so long. It must have been very frustrating

who was having eclamptic fits??

Couple of posts up. The same hospital tried to induce sil twice after an emergency admission as she had been fitting. It is this that has brought all of my concerns to the forefront of my mind.

Sorry to hear about your experiences, especially the tearing and shoulder dystocia - that sounds really scary.

I had my waters break at the start of labour with obvious meconium in. I was on continuous monitoring but was able to be upright and move around a bit. My hospital started syntocinon a bit earlier than yours, can't remember the time exactly but the total time was 18 hours. I was pushing for an hour before they decided that DD was in distress and did an episiotomy and ventouse delivery.

I would guess that the tearing and shoulder dystocia you had was not inevitable and could not have been foreseen, most of the time it would be more like what I had and so a much quicker recovery than a c-section, which is after all a major operation.

Got2be, I had a similar experience to your sister, I was fitting, progressed to Eclampsia.
It's only now 9m later that I feel strong enough to go and talk through my labour, maybe your sister should too. With every fit there is a strong risk of brain damage or death to mother and/or baby. I had a history of quick labours so they let me labour with syntocin and epidural hoping to get her out that way. I'm so annoyed that they took that risk as every subsequent fit was taking a risk with our lives.
You sound like you had a truly awful experience as well. Hospital isn't in east Anglia is it?

It sounds a little bit like my experience (although mine was much less traumatic) - I find this thread quite interesting, especially the bit about malrepresentation.

My waters broke with meconium staining on a very busy day (the weekend before Christmas 2008) with no signs of labour. I had a bloody show a few hours earlier, and mild period pain, but nothing real. I was 38+3 or 4 (not quite sure anymore)

I got to hospital, where they checked me - my cervix was closed, but I saw the speculum being covered in thick green gunk when they took it out again after the internal, They gave me a sweep (ouch) and decided that there's no time for prostaglanding, but whacked me onto the drip straight away. Labour didn't establish, contractions came quite irregular and very painful. I first declined pain relief (irrational fear of starting off the "chain of interventions" and running out of options too early). At every contraction I felt like I had the most horrible constipation. I remember actually shouting "I don't want pain relief, I want an enema!". Luckily they could convince me to try G&A, and then Meptid. I believe her head must have pressed onto my coccyx, as it hurt badly (very badly) for weeks after, every time I needed the loo)

I had the same problem with restricted movement - plus when I was lying on my back, my daughter didn't like it, when I was lying on my side the transducer lost contact. They tried fitting a scalp electrode to get round the problem, but my cervix just didn't open enough, so finally they took me off the drip (after a total of 4 hours, and it being hoiked up twice), and the team of friendly surgeons came in, to chat to me about a section.

As I said, it was a very busy day, and I think I was the 5th or 6th section that day. There was no great hurry once the decision was made (it was actually quite relaxed once I came off the drip, and the baby seemed less distressed, too), and the section went smoothly.

I've only talked through the whole thing with my consultant a few weeks ago, when talking about options of how to deliver No 2 (will be ELCS) - he said, as I never dilated she would never have come out vaginally -
I asked whether the decision for the CS should have been taken earlier, or whether they tried the induction method, as the theatre was full etc. - he said the state of the ward (they were short of closing and turning women away for being too full) had nothing to do with it, and induction/trying to get it out vaginally would have always been definitely first choice, and that this was changed only when this wasn't found to be working.

I guess if I had shown any dilation at all, they'd probably would have tried to get her out vaginally, too. In a way, I'm almost happy, that given the situation, I didn't dilate, so didn't have to try that.

The consultant couldn't give me any deeper reason why it happened the way it happened, or why there was meconium, or why I didn't dilate, but said, that it's not totally unusual, and that I don't need to blame myself for anything. Didn;t answer all my questions, but I guess I have to live with that.

Anyway, thanks for posting, as it is kind of reassuring to read other experiences, which are not too dissimilar. - I'm sorry that yours was much more traumatic

I'm not sure about actual eclamptic fits, but I was induced when I was because I was rushed in with pre-eclampsia - felt at first very much like they were standing around waiting for me to seize! Luckily I responded fast to meds.

Thank you all so much. I know i sound like i want someone to blame but the truth is i just wanted to hear people say ~ they never could have guessed.

It is one thing dealing with it just being one of those things but entirely another thinking me and my baby were put at risk intentionally.

I didnt want a debrief as i was worried that i would leave thinking i still wasnt getting the truth. But, yet again, mumsnet has come to the rescue. Thank you all for sharing your stories, especially such personal ones.

I even managed to watch a whole episode of 1 born every min without turning into a total mess! So thanks again

Got2be the first part of your story sounds quite like mine, but after 40 hours of labour I got the CS. It was not straight forward. Sometimes shit just happens - the surgeon accidentally cut through parts of me she shouldn't have, she took so long trying to figure out what she had done the spinal block started to wear off, my baby was born not breathing, turned blue and was sent to SCBU and I was given a GA to complete the operation. Afterwards I was in High Dependency and my blood pressure kept plummeting dangerously low.

It's easy to wonder whether an earlier CS would have made things happen differently, but they happened the way they did, I can't change that, DD is well and healthy and so am I, and that's the way it is. However, I used what happened to make sure I was much better placed to enjoy the birth of my second child. I won't go into that in detail, suffice to say I made an unorthodox plan, had a complete surprise and a huge deviation from my plan, but my first labour meant I had put in enough mental preparation that the second birth was fabulous! (although some would say it could have been interpreted as traumatic, it was far from that for me.)

I couldn't change what happened first time, but second time I used an independent midwife. She went through the notes from my first birth with me and confirmed my thoughts that it was a shambles. She helped me put it even further behind me and get on with the job ahead of having my second child. You can wonder whether anything could have been done different till it drives you mad, but my advice is to not dwell on it and use the experience to make you stronger.