Birth plan said no ventouse or forceps

[LouM10]

I gave birth in September and in my birthing plan I said I would rather have a CS than forceps or ventouse. I had an awful experience. Was meant to be having a homebirth but could not get in touch with mw. Ended up getting to hosp when I was 8cms with no pain relief. After a while on gas and air at the hosp. I eventually had an epidural. My husband couldn't even keep his eyes open so he didn't realise what was happpening. Had major bp issues so they said if I hadn't delivered within an hr they would take me in for a cs. I was in no fit state to tell them I didn't want a ventouse but it was in my birthing plan.

I ended up with an episiotomy and ventouse and am quite upset that they did this. Are they allowed to do what they want regarding your birth plan?

[Lovethesea]

With my first birth they used emergency high rotational forceps (leaving me with lasting damage) rather than a c-section because it was safer for DD. I was 10cm and had been for hours (mw error), she was malpositioned so never coming out and in serious distress.

It was later explained that a c-section (which they prepped me for in theatre as they prepared to try forceps in case forceps failed) would require DD to be pulled back up the birth canal to come out which was riskier than turning her and yanking her out.

I was offered an elcs before I ttc again and I took it. Great birth, simple recovery and no more childbirth for me ever again please.

I'd second again getting someone to go through your notes. It's usually not what happened as much as not being listened to, feeling very vulnerable and utterly uncared for and perhaps let down by your DP. I saw a maternity psychologist before my second birth but really needed that support straight after my first but the consultants suggestion to my GP was never put to me by the GP.

[cardamomginger]

You poor thing. It sounds like an awful and extremely distressing and traumatising experience. You must have felt terrified and powerless when you were at your most vulnerable. I think that you are completely normal for feeling the way you do about it. I had a traumatic birth in September last year and like you the birth I got was very different from the one I had planned. The shock, the stress, the trauma and the lasting effects (physical and psychological) mean that you cannot just move on. I'm not surprised that you feel that you don't want any more children right now. Even though I will be ELCS for any future pregnancy, I can't imagine being able to face pregnancy and birth again right now. Birth Reflections has been suggested and the opportunity to go through your notes with someone and understand why things happened the way they did might really help. Some specialist birth trauma counseling might also help. XX

[Triphop]

Has the ventouse been followed by a physical problem for either you or the baby? (This is not to diminish the psychological impact, I'm just wondering if you had a specific problem after the procedure.) You said you'd read up about ventouse before the birth and decided against, but I'm wondering what you read that put you off, and if the outcome you worried about is what came to pass.

I hope that made sense!!

[Poppet45]

Oh I forgot to add, if you were having BP issues the last thing you would want would be a section. Mine, and everyone I know whose had one, went all over the place - queue vomiting, shivering and shaking so bad you can't even hold your baby. Mine also prompted a big bleed - another side effect of a section that's not linked to a ventouse, and I ended up in HDU. If I could have lift out forceps or ventouse, rather than high or rotational forceps or a c section that's what I'd pick.

[Poppet45]

OP you poor thing, you've really been through the wringer, am shocked that your HB midwife was a no show - that's terrible. Unfortunately birth plans are not legally binding, and are indeed just a sort of wish list for if everything is going okay. You can get more detailed and specify what you want to happen in all sorts of less than perfect scenarios too but then you run the risk of the document being so long and unwieldy it won't be read - particularly when things are going wrong and people are running around in a hurry. You need your DH or a doula to verbally argue your case when you can't (I say this but my DH didn't do it either). FWIW I remember when the doc came in and said I needed to go to theatre for either a trial of forceps or a section, and after 19 hours and a failed waterbirth and two hours of pointless pushing I said over and over 'no forceps just a c section' because I didn't want the damage and was so tired I didn't have the strength for any more pushing. As it turned out what I signed (in a spidery Guy Hawkes post torture hand, and despite my clear verbal opinion) was consent to either procedure, and they were going to try for rotational forceps first but DS was just out of reach. The weird thing is that even though you are totally out of it, it's illegal for your DH to consent or not on your behalf. Stupid I know.

[BikeRunSki]

If you were having blood pressure problems, then I can't see an aneathatist (sp!!!) being happy about giving you an anaesetic for a CS anyway.

For what it's worth my "waterbirth" became and emcs.

[gasman]

Sorry things didn't go the way you wanted.

I think you sound like you would really benefit from a birth reflection type service.

You may also find it useful to know the way in which health care professionals regard birth plans. As others have said they are 'wishlists' and in a dynamic situation where woman may end up in a situation they could or would never have imagined we cannot rely on them absolutely.

For example I have sited epidurals in several women who had "I do not want a epidural" in their birth plan but who for a variety of reasons have changed their mind. I believe that it would be wrong of me to deny someone analgesia because they had written down prior to ever experiencing labour that they didn't want an epidural. There is a converse argument which says that they were in a better position (ie not in pain, possibly suffering from effects of gas and air/ pethidine) to make a decision pre-labour but essentially we act on what people wish in labour.

With respect to your ventouse it would be usual for at least verbal assent to be given by you to medical staff(assuming that there was no crashing fetal emergency at the time). I don't know how clear your recollections of the discussions at the time are. Certainly, medical staff would be looking for you to verbalise your disagreement with their plan.

It may help you to know that at 10cm dilated there are quite different risk profiles with respect to ventouse vs. c-section (ie I believe that at that point in labour a c-section may be more risky, but someone who has access to YOUR medical notes would be in a much better position to comment.).

[Tangle]

I'm sorry things didn't go as you hoped - and that your wishes were seemingly ignored.

From what you write it does seem as though the HCP's didn't communicate with you very well as to why they felt ventouse was the best course of action, and that you have a lot of unanswered questions as to why various things happened.

We can offer all manner of possibilities as to why they did what they did in the way that they did - but ultimately I'd suggest you get hold of a copy of your notes (PALS should be able to explain how, and help you organise it) and that you make an appointment to go through them with a MW or Obstetrician (again, PALS should be able to help - or your GP. If there is no service of this nature in your area, or if you come away with as many questions, then you could arrange an appointment with an Independent MW who would probably charge you about £50 for an appointment to go through your memories and your notes to try and help you understand what happened and why).

One other thing that struck me is that it sounds like, for whatever reason, when it came to it your DH wasn't in a position to be able to support you as fully as would have been helpful. If you do decide to have another child could I suggest you consider hiring a doula, so that there would be another person there who could act as your advocate and share the load with your DH? I did read that atm you have no intention of having more children, but emotions can change. Sorry if that's presumptuous - it just struck me that it might help if you do change your mind.

[VivaLeBeaver]

Its normal to not sign a consent for a ventouse or forceps. If they said to you we need to do a ventouse they wouldn't necessarily expoect you to say "yes, that's fine, go ahead". Most people are not that talkative by then. So as long as you didn't scream at them to stop, etc then its implied consent which is a valid form of consent.

But I'm sorry you didn't have the birth you wanted and agree that talking to someone about it may help.

[vj32]

Have you had a look at your notes? I am going to arrange soon to look through my notes with a midwife. I think everyone did the best for me and baby, just want to check what it says. Is this service offered at your hospital?

I'm surprised your midwife didn't explain about birth plans though - mine said it was just what I wanted to happen if everything went smoothly. In the end it didn't- I had an emergency c-section. I would assume that if you had problems with your bp they would not want to take you for major surgery if there was a safer way for you and baby. I'm surprised they don't seem to have asked for your consent though - my Drs and midwives were very careful to explain everything at every stage.

[motherinferior]

I am sorry you didn't get the birth you wanted - but this way does at mean you can have a home birth for any subsequent babies if you change your mind; it is very hard to find midwives ready to support a home birth after a C-section (both the Royal College of Midwives and the RCOGP recommend against) because of the (small) risk of scar rupture.

I'm very glad, for that reason, that I did have the episiotomy/ventouse route for my first baby.

[LouM10]

because I was having major bp issues and didn't want a ventouse?

[coccyx]

Why would they offer you a C section if he wasn't stressed and just needed a hand to get out? Bizarre. move on

[LouM10]

They did not ask me if they could do it. My son was in no distress, the only problem at the time was my bp and the rim of my cervix wouldn't move out of the way even after being induced. I understood a cs was a major operation but after reading a lot of material I decided ventouse was not what i wanted. I would have preferred a natural birth and I did put I would only want a cs if they needed to get him out quickly.
Tbh, I always wanted 2 or 3 children but I don't think I want anymore now. A mixture of the problems with getting the mw out at home (I'll add the mw was from a different hosp. to the one i gave birth in) and also the dis-regard to the birthing plan. The thought of having to give birth again terrifies me. They gave me an hr to get him out, he wasn't stressed so it wasn't for his benefit that they needed him out. if he was getting stressed and ventouse was quicker than cs then I could understand it.

Thank you for sharing your stories too

[Ripeberry]

Why were you against Ventuse or forcepts in the first place? When I had DD1 they wanted to try a 'new' suction cup and were trying to get me to sign.
I just told them to use normal stuff so DD1 came out with a ventuse.

I was angry that they were trying to get me to consent to something untried when I was vulnerable

[Blu]

Poor you, you sound very traumatised by the whole thing. Maybe start with your hospitals PALS (patient liaison) department - sometimes there are de-briefing appointments with midwives in which you can talk through what happened, and why. If after that you feel there are grounds for a complaint you can proceed - there will be a leaflet telling you how, and PALS should advise you.

As regards Birth Plans - they should be about preferred strategy..."my preference is to try natural low intervention methods first...if this happens I would like to try that.. if possible i would like to give birth upright....if intervention is indicated i would like to be told what, why, and what are the likely outcomes of doing nothing..." A birth plan should also include contingencies, because obviously birth often does NOT go to an idealised plan.

[BikeRunSki]

A birthplan is a wishlist. The medical team's priority will be to get the baby out in the safest possible way for mum and baby. This is rarely a CS, as there are risks associated with this - it is likely that at the time a ventouse was safer for you than a CS.

Is your DC fit and well? Are you well - physically and mentally (how upset is "a bit upset") ? Are there any lasting issues? Are you acheiving anything by dwelling on it?

(Put in context, friends' baby died at 2 days old. Investigation found fault with mw practices during labour and infection introduced. Couple were asked if they wanted to sue the hospital. They decided not to, as, in the end, it would not acheive anything. Their child is still dead and the NHS would just be worse off).

[Blackduck]

I was the other way - they were already to do CS when consultant said 'nope 10 cms, coming out this way' Tried vontuse, no go, so forceps....
Frankly my view was you do what is necessary (ds in major distress)

[mousymouse]

I had a ventouse delivery with ds, but I don't remember signing anything. just the consultant coming in and explaining what they would like to do. and asking if I am OK with this. I was, btw and dc was out quickly, in my case the ventouse was only needed to stop dc slipping back in iyswim.

[mrsravelstein]

unfortunately i think birth plans are often pretty redundant, and especially so once there is any sort of emergency or something going wrong.

and even if you/your husband had reminded them you didn't want ventouse, they may still have wanted to do it if if was the quickest safest way to deliver in their opinion.

with ds2 the doc was very keen to use ventouse after 42 hour labour, and both myself and dh had to pretty much have a stand up row with her to insist that i wanted a section instead.

[Primafacie]

Sorry, x-posted with everyone!

[Primafacie]

It sounds like you had a hard time. I'm shocked that you couldn't get a midwife for your planned homebirth.

When you say you were in no fit state to decline the ventouse, did they ask you the question? Did you tell them as they were approaching with the ventouse that you did not want it? Were you told about the pros and cons of the ventouse vs CS? For what it is worth, I think a birth plan is just the abstract expression of the mother's wishes, and quite often the hospital cannot abide by it. This being said, I also the misfortune of having my birth plan completely ignored and I am sorry for you. Have you had a post birth meeting to discuss what happened? I had one with the head of midwifery and I found it helped me to get closure.

Good luck, I hope you find the answers you are looking for.

[LouM10]

i'm sure the only thing I signed was the consent for the epidural

[LouM10]

In my birth plan I had 'no forceps or ventouse' The only thing I consented to was my epidural. I was spending most the time trying to wake the other half up. I was quite panicky due to bp. I know i didn't verbally say yes you can do it. I have unfortunately no idea whether I nodded. When women are in that state though, they are hardly at their most rational which is why birth plans are there. i thought anyway. I haven't spoken to anyone about it. Not sure who I could spk to. Thank you for your replies so far