Birth trauma counselling not what I expected - is this a bit hmmmm?

[hazeyjane]

My gp referred me for birth trauma counselling, and said that I was going to see a specialist MW counsellor at the hospital, who would go through the labour notes and listen to me about the panic attacks and anxieties I have had since having ds. (10 months old, has developmental delays, under investigation, born by elcs, in scbu for 8 days due to lung problems which consultant at the time said was because he must have been more prem than 39 weeks)

When I went in I was rather taken aback to find the consultant who had agreed my section, the surgeon who performed it and MW who i saw antenatally at the hospital. She went through the notes on the section, and said that as far as she was concerned ds was definitely term, the section had been uncomplicated (despite the fact I lost huge amounts of blood, had very low blood pressure throughout and had a terrible recovery). She said that she thought that rather than ds's problems being the result of being prem, that his problems were the cause of his lung issues at birth. She spent most of the time saying she wished she could get me to talk to women trying to get a section, so that they could hear how traumatic it can be, although she said that had ds been a vaginal birth his lung problems may have been worse.

I felt relieved to hear that ds's problems may not have been the fault of me having a section (i had to fight to get one, and then wished i hadn't had one), but felt completely confused by the whole thing. I thought that it must have been a strange coincidence they were all there, but when I came home and told dh, he seemed to think it was a bit strange and wondered if they were in trying to cover their arses.

I don't really know what to think.

Hi - just a quick one. Firstly - SO sorry to hear what's happened to you. Totally not surprised that you are having anxiety and panic. You .poor thing - have a big hug XXX
Yes- it sounds odd to me. Could it possibly be that they got their wires crossed and that the GP either thought the hospital would provide something different and they provided what they normally provide in terms of a post birth debrief, or that the GP wasn't clear enough and that the hospital thought that this was what had been asked for?

Can you go back and see your GP, explain that what was provided wasn't the form of counseling that you would like and ask for a referral for something that will help? Now that you have been through the notes, would you feel comfortable going somewhere else for birth trauma counseling? Somewhere neutral where nobody there was involved in the birth? If it was me (and it has been me!) I'd find it easier to be completely open about how I felt and how i had been affected and I'd be less suspicious that any response was the HCP trying to cover their arse. I you are having real anxiety and panic, then you may want to ask for several sessions of something - just a one-off might not do the trick.
Best of luck with it all, and another hug XX

That's not trauma counselling, you've had a birth debrief. Which I think is normally with a MW, going through your notes (a chance for women to ask questions, get some clarity, go over things with an informed professional etc).

It can be very valuable, but it's most definitely not trauma counselling.

The fact that your debrief was so well attended by HCPs responsible for your birth makes me think either that they are remarkably thorough at that particular hospital, or, I'm afraid, that they are afraid you are going to take some sort of action against them, and are indeed covering their arses.

That was definitely not trauma counselling. As soon as you mentioned the consultants I thought "arse covering". Their time is really expensive and meeting with you takes time away from their clinical duties. The expensive legal action in obstetrics relates to babies with avoidable injuries/illnesses as successful action means that the hospital has to cough up for lifelong care, so sending in consultants to tell you that it wasn't their fault is much cheaper. I really wish there was a way that you could sign away any right to take legal action in return for the truth.

I hope you get the help you need. Have you tried the birth trauma association?

Thankyou for your replies.

It is frustrating, because I now feel unsettled by the thing that I hoped would give me some clarity!

I think I will have a look at the Birth Trauma Association, and have a chat with my gp. She was very clear about the service that she was referring me to, so I don't think there was confusion on her part.

I so want to move past these feelings over the birth, there is so much going on with ds atm, that I just want to focus on him, and our dds, but I keep feeling distracted by these gnawing feelings over the birth.

I had a debrief after dd1's birth (long labour, 6 hours pushing, ventouse, 3rd degree tear) and like you was helpsay it was with a MW, who went through all the details of the labour, and in the circumstances (I was pregnant with dd2) it was helpful. But the fears I had after that labour were practical ones (ie I don't want to tear in two and suffer double incontinence!) The feelings I have over ds's birth are far more emotional, the whole thing just felt brutal, and I was in such a state afterwards that I couldn't hold him, and then he was rushed off to nicu. I really felt as though I couldn't talk about these feelings with the consultant, surgeon tand MW. I barely said anything, they just did all the talking.

Sorry to say this, but the meeting sounds even worse now that you add in more about your experiences. I can't believe the MW said that she wished she could get you to talk to women trying to get a section given your previous experience of VB. Neither sound like good experiences. Nor can I understand why you had to fight to get a CS in the first place - no wonder you were left wondering if this was the right thing to have done.

I would also suggest that you return to your GP and let her know about your experience.

There were some other ideas on this thread of organisations to contact regarding birth trauma.

thankyou for the link, breatheslowly, i posted on that thread recommending being referred.I would have gone back on, but didn't want to put the op off asking for help.

The more I think about the whole thing, the more peculiar it seems. After my section, when I was being wheeled around to scbu, the surgeon stopped me in the corridor crouched down and drew a diagram of my uterus, to demonstrate how unusual the veins on my uterus were, to explain why I bled so much (I know how mad this sounds!) I was allergic to the pain relief, and the operation had to be done on a massive slant because my bp kept crashing so low that I kept feeling nauseous and nearly passing out. Does it seems strange then that 10 months on he could remember me very clearly, but said that the op was straightforward?

Sorry to hear you've had a sad time.

I don't think it's unusual for the surgeon to remember you clearly. I think what he means by the operation being straightforward is that you may have slightly unusual anatomy but he still managed to carry out the C/S without major complications - as you would expect him to , he is a surgeon after all.

My midwife told me my blood vessels are probably why I bleed very heavily after giving birth, sounds similar to you.

It sounds like there was a mismatch between what you were expecting and what was delivered.

The surgeons behaviour doesnt sound that unusual though - they do like to draw diagrams and explain technicalities, and if you had a unusual anatomy it is possible that he would remember you because of that, but still feel that the operation could be carried out in a straightforward way. The slant/bp/allergy issues would be something that he would see as the anaesthetists territory rather than his.

It is also possible that the reason that there were so many people at your appointment is because they could have made a general decision to do debriefs in that way - it could be seen as being helpful for the surgeon to actually be there as after a section many people have questions about whether or not they should attempt further pregnancies or the mode of future delivery. Obviously I dont know if that is the case in your area or not, but its not necessarily a sign of arse covering.

I don't think that drawing a diagram of your uterus was odd. Imagine if you had moved to a different area and gone for another pregnancy, it would be useful to be able to tell the consultant there that there was something odd about the veins in your uterus. I was drawn a lovely drawing of my fanjo by the MW after delivery to show the different directions of tears. I was a bit surprised that the diagram didn't make it into my notes though.

Yes, I had a lovely drawing like that of my perinium after dd1, Breatheslowly!

Maybe I was getting caught up in the conspiracy theory of it all.

When it comes down to it, it doesn't really matter, ds is how he is, and we just have to get on and enjoy him and deal with problems as they arise.We probably will never find out the reason why he has the delays/issues he has.

As for me, whether I have ptsd or pnd, the anti depressants I am on seem to be helping me cope, and I don't really know whether talking it through with someone would really help anyway. Sometimes shit just happens, doesn't it.

I will have a word with my gp though, I would hate for someone else to be referred for birth trauma counselling, say specifically that they don't want a birth debrief, only to find themselves face to face with the hcps involved, who tell them that everything with the birth was fine, thus making them feel like they are making a huge fuss over nothing!

Well, it looks they are trying to cover themselves, which may mean that they are hiding something ... if mistakes were made would you want to pursue them (e.g. possibly taking them to court?). If so, you may want to seek a second opinion on your ds problems, if not, I would pursue trauma counselling. Lots of strenght in what must be a really hard time for you.

Sorry for your troubles, hazeyjane.

If you can, I think it would be really helpful to let your GP know what happened after they referred you for birth trauma counselling, because that certainly wasn't what you got. There's been some communication breakdown somewhere.

I think for someone traumatised and vulnerable, facing a 'panel' of HCPs like that when they are expecting a counselling session would be a pretty harsh experience.

I think that talking things through really can help and might even make your debrief experience make more sense. I remember my physio saying "that sounds horrendous and you have every right to cry about it" and it really helped to have someone external say that. Sometimes shit happens, but exploring your feelings about it and accepting your feelings about it can allow you to move on. Though I am beginning to realise that moving on can be a much slower process than I imagined. It really helps to have someone objective to discuss your experiences and listen to you.

I'm sorry to hear of your experience :(

I've had post birth counselling and it was, as you say, with a specially trained sr midwife.

One thing I would say though, re the arse-covering, what do you think they have cocked up that needs covering? Do you think your DS was delivered before 39 weeks and that was the cock up? YOu've probably thought of this already but can you track roughly when he was conceived? I thought dating scans were pretty accurate but perhaps they aren't.

I can't see anything else, from your OP, that would cause them to need to cover something up, if that makes sense? But if they delivered him too early then yes, that sounds like it could be a problem esp in ref to his respiratory probs.

It had never occurred to me that there was any sort of cock up tbh, I felt guilt about having 'chosen' to have a c-section, because I felt as though it must have been this (ie the fact that his consultant thought he was prem) that was the cause of all his problems, and that this was my fault. But as the consultant pointed out in the debrief thing, she felt it was very unlikely that my dates were wrong (I have very wierd cycles and in fact thought I was having an early menopause when i found out i was pg with ds, so can't really work it out)and only 15% of children with cerebral palsy (which we don't know if ds has, and which I hadn't mentioned) have cp because of occurrences at birth. In fact I wrote the hospital a letter after having ds, thanking them for his and my care, because they really were wonderful, especially in comparison to the hospital where I had my dds, where the treatment was so appalling that I discharged myself early.

I certainly don't feel that I would want to take anyone to court, and I have no idea what I would take them to court for! I suppose it was dh that first made me feel a bit hmmm about it.

I've made an appointment to see my gp next week, just to ask her if that is what she meant to refer me for, and whether i could maybe see someone else.

Hi - just seconding what breatheslowly said in her last post about having someone objective to talk things through with. I am having counselling at the moment and finding it very helpful to go through everything that happened and how I felt/feel about it all. Every time I go in I think at the start that I probably don't need to be there any more, but then the tears start flowing again as soon as I start thinking about it all... but having that space where I can talk things over, at my own pace and repeat myself as much as necessary, is a good thing and ultimately healing, I think. Wishing you all the best hazeyjane, hope that you find some help soon and your GP listens to you

Just thought i 'd let you all know that I spoke to gp this morning, who was fairly horrified by what had happened. She showed me the letter that she had written, which explained about ds's developmental delays (which the consultant said they had no idea about). She said they were either trying to jump in (in her opinion way to soon), in order to try and exonorate (sp?) themselves from any issues that ds may have, or the clinic she referred me to passed me on to them thinking that a debrief of this fashion would be better than counselling.

Either way she was pretty cross, she is going to write a letter and has asked me to go back to see her next week

Thankyou all again for listening to me witter on.

I am really pleased that your GP is being so supportive and I hope that you get to see someone that you find helpful. We have our debrief tomorrow, so fingers crossed we have a better experience than you.

I'll be thinking of you tomorrow, breatheslowly, I hope you get the help you are looking for. x

I am afraid that I agree that this was a (massive) arse covering exercise. I hear alarm bells clanging away. Get in touch with an independent association like the Birth Trauma Assoc. I would also get in contact with AIMS as soon as possible too. www.aims.org.uk they have been very good at seeking redress for someone else I know and wholeheartedly recommend a chat with them. You have nothing to lose. I would be very cautious about meeting anyone at the hospital again without taking someone along with you who knows a thing or two about birthing, birth practices and hospital protocols who is there for your best interests.

Hi hazeyjane - my experience of birth afterthoughts was nothing like yours. We had a midwife who gave us 2 1/2 hours of her time. It answered lots of questions for us, but there are some things we will never know (what ifs). I am way less angry than I was and I more or less accept that my crappy experience was more to do with communication issues and bad luck than poor clinical care (which is the impression we originally got). The only thing she didn't really accept is that I felt that the whole place was way too busy. I think she felt that it was not too busy to be safe, but I felt that it was too busy to provide the quality of care that I think it should. She had some good ideas regarding future care as I am very reluctant to go back to the hospital and as I will be having a CS next time I am concerned that I wouldn't get all of the post natal support that I would like. I am hoping to get some counselling as well, but they have cut the service at the hospital, so I will look for an alternative.

Good luck with your GP next week.

Breatheslowly, I'm glad your counselling session was helpful. I had similar worries about after care when I had dd1. I discharged myself on my 3rd day, despite still being unable to breastfeed and having suffered a bad 3rd degree tear, because the 'care' was so appalling. I made a complaint to the hospital about one MW who I heard laughing with a colleague about the fact that I had crapped myself, it was so horrendous, i was terrified of having dd2 there just over a year later. Amazingly it felt like a different hospital, the whole experience was so much better, I was very lucky to have a fantastic MW, and I think my previous experience had made me a lot more assertive.

There are lots of threads on here that give good advice on how to best be prepared for a c-section, that I found really helpful.

I really hope you find some counselling, do you have a good/undersyanding gp?

Thankyou for your advice Ishchel, I am going to wait and see what my gp says next week, as a family we could really do without this at the moment!

We've just moved house so I don't know our new GPs - I think I will try the counsellor the hospital used to employ as she is apparently a specialist in perinatal counselling.

If and when the time comes I will be having a good look at the advice on MN about having a CS as it is yet another unknown world.