My birth experience looks like a disaster waiting to happen due to: (1) Dangerous midwife (2) Lack of consensus between health practitioners

[nothingsoextraordinary]

This is my first pregnancy (37+3) and it's all going pear-shaped! Advice about how to avert disaster would be much appreciated.

In a nutshell:

(1) I'm immobilised and in terrible pain due to pelvic girdle pain. I also have other health problems requiring strong medication that knocks me out for about 6 hours at night. Luckily I have a very supportive DH, who is caring for me at the moment and looking forward to playing a key role in our daughter's care too. However, we are told he will be allowed in the maternity ward for only a few hours each day, and there will no care available for my daughter from nurses. This is despite paying for a private room. I have no idea how either my daughter or myself will manage to eat and get washed. This is stressful and humiliating. I am at risk of PND already and really feel my dog would be promised better care at the vet's.

(2) Both an NHS physiotherapist and a private osteopath have emphasised to me that I must NOT lie back/have an epidural/put feet in stirrups/sit down for labour, at the risk of suffering permanent pain and immobility. The physiotherapist was very strong about this and I got the impression there were internal politics going on, as I had said nothing to indicate I was planning this sort of labour. That said, I have no idea how I would hold a squatting/kneeling position for any length of time in my present condition, and felt forced to consider a planned C-section. I was still weighing up my options yesterday when a most unpleasant midwife informed me, apropos of nothing, that they will do 'whatever they have to do to get the baby out' and 'physiotherapists swan in for half an hour but they don't know what labour involves'. She clearly does not consider permanent damage to my pelvis a real risk - and I will be definitely going ahead with a planned C-section as a result. However, I feel caught in the middle of some professional bad-feeling, with no real support in making a difficult decision. I feel I didn't get the chance to talk through the pros and cons surrounding natural labour with a professional.

(3) My consultant is on holiday and I haven't yet had an opportunity to request a C-section. Of course, I'm on tenterhooks in case labour begin early! I spoke to an SHO who said she could do nothing in the consultant's absence - and it won't be possible to speak to him until I am 38+5, which seems to be leaving things very late to plan and book a C-section. The possibility of ending up in the labour ward having that midwife 'do whatever they have to do to get the baby out' is causing me great anxiety.

(4) Regarding pain medication, the SHO has prescribed a cocodamol regime (30mg). I understand this drug can affect the baby's breathing, and I'm concerned that our local maternity unit has no special care facilities and won't be able to cope. However, I'm also at a loss to know how to manage such unbearable pain. The midwife I spoke to yesterday told me that the medications I was taking were very dangerous and I was to stop them. She also said that the doctors were untrustworthy because they thought only of the mothers, and couldn't be relied upon to consider the baby's position. I'm very reluctant to trust her on this, but I'm also concerned that she may have a point.

Any thoughts/advice gratefully received. I simply want to make the wisest decisions for the health of myself and my daughter.

Thanks for the info everyone. A quick update:

One phone call to the Head of Midwifery resulted in an NHS appointment with my Consultant for tomorrow (Tuesday) morning. She couldn't have been more helpful and has talked to staff at the Maternity Unit about our case. We suspect we're the unit's Most Hated Couple now, but at least we have an opportunity to move forward with the decision-making process tomorrow.

Northern Ireland does not seem to have PALS. Nor do doulas seem to be readily available. And (outside the capital city of Belfast at least) there is no opportunity to deliver a baby on a private ward (when I said we were paying for a private room, we're paying £40 a night for the room only).

Thanks again.

nothingsoextraordinary PALS in NI is the Patient and Client council. Hope all goes well tomorrow and for the rest of your pregnancy.

So glad you feel you've got someone talking to you and working with you now - fingers crossed things stay positive and the consultant is helpful :)

Don't worry about being Most Hated Couple - at the end of the day you'll only have contact with them for a few more weeks and then, to them, you'll be a piece of paper. Hopefully this way you'll have a much better birth to look back on and no lasting problems as a memory of your stay!

Thanks! :) I'll update tomorrow.

How dis you get on?

Hi there, I see that you have already been given lots of excellent advice.

Just posting to say I hope all works out and I am thinking of you as currently in a similar position.

Thank you for the encouragement.

After seeing the consultant this morning, we are booked in for a C section at 38+5. Our baby is on track to weigh over 8 pounds at this time.

Our consultant was absolutely furious at the letter we had written to the Head of Midwifery. We had spoken with great care - but he found it 'appalling and offensive'. He flatly contradicted that the midwife taking our tour had said anything to undermine the physiotherapist's instructions (despite not having been there himself to hear it). He also pointed out that this was a much-wanted pregnancy (he knows this because he treated me for endometriosis previously) and consequently, we must have known what would be involved (we had no way of knowing I would spend the last two months in a wheelchair). He said he felt we had responded to our situation in a most unnatural and unpleasant way (whether that referred to our letter to the Head of Midwifery or our desire to discuss a C section in the 39th week, I am not sure).

I tried to point out that, given the anxiety created by conflicting advice, it was impossible for us to wait until the 38th week of pregnancy to discuss a C section. He said we could have turned up in labour and requested it at that stage. We simply hadn't known that would be acceptable - it sounds like a crazy way to make a considered decision.

We could see that he was upset and annoyed beyond all reasonableness. Having secured a date for a C section (and being confirmed in our suspicion that this maternity unit is not a safe place for a woman with Pelvic Girdle Pain to attempt a vaginal delivery), we felt we had nothing to gain from continuing to upset him. We offered to withdraw our complaint, and he seemed instantly pacified.

I don't know what to think, except that complaining to consultants is a very unpleasant business. It has been intensely upsetting but is now in the past.

Good luck to those ladies in a similar position, and thanks so much to those who have shared advice.

omg, what a dick. He had no right to speak to you like that, no matter what you and DH have decided to do about the complaint. If you were feeling v sneaky, (or evil hee hee), I'd put both complaints in after lo here and all the delivery worries out of the way - one for midwife and one for him.

Seriously, it is not acceptable for him to be an arse. I say that as a doctor!!! The consultants are still pretty much treated as gods in NI hospitals esp by the staff working with them. I wonder if there have been a few complaints in about their department recently and that's why you were treated so poorly today.

V cross on your behalf. Hope the delivery goes much more to plan x

What a knob!

I suppose one consolation is he must have been hired for his technical expertise, given he clearly wasn't employed for his communication or social skills...

Hope it all goes well and all your healthcare people pull their fingers out now.

That sounds horrible. I wouldn't have any faith in the idea that you could just turn up in labour and request a CS. I bet you would find that a consultant wouldn't be available, a registrar wouldn't be able to make the decision and they would string you out until it was too late. Sorry to be so cynical. I found my maternity unit quite receptive when I made a complaint, except that I never said the word complaint, I just asked my consultant to "investigate my concerns" so that any lessons could be learnt if possible. So I guess it never hit their complaint numbers.

Good luck - not long now!

I would not retract the complaint, and I would ensure the Patient and Client Council also had a copy on file.

Clearly he thinks he can bully anyone who makes a complaint into retracting it - do they have to publish the number of complaints received in their annual report or something?

Glad you have the CS sorted though!

They almost certainly have to publish the number of complaints made. It is really difficult to understand why he found it "appalling and offensive". If he doesn't think a complaint is justified then presumably what ever mechanism they have for investigating complaints would find this and the process has worked. His comments are bizarre. No one would expect to end up in a wheelchair in their first pregnancy, no matter how much the pregnancy had been wanted. I am only sad that this is the only maternity unit available to you as it would be tempting to change.

nothingsoextraordinary just to ask a question, I know its very late into the pregnancy but why don't you move to a different hospital? I changed my hospital several times during last pregnancy (baby born 6 months ago), not for complaints reasons but solely due to handiness.

Thanks everyone. I would love to change hospital and have been feeling so anxious that it may be worth doing. However, all other maternity units are at least an hour away, so will try to stick it out here for now. I'm confident that this unit is competent for anything except PGP. Perhaps now we're on the radar, we'll be disliked and competently handled in equal measures!

When we're safely out of the woods, I'll think about resubmitting the complaint. I know it could be helpful for others in the future.

I am sorry to hear you are suffering so badly with PGP/ SPD. I had it and the last few weeks of my pregnancy was hellish.

If its any consolation women with SPD often have quick and easy labours. My labour with dd lasted about 3 hours and I had a 3 minute second stage. SPD is caused by an excessive amount of relaxin and the reason you are in so much pain and finding hard to walk is that your ligaments are exceptionally loose.

I had a physio who recommended giving birth in a supported kneeling position or standing up and having an active birth. Its difficult to have an active birth in a consultant led unit.

Have you tried the natal hynotherphy/ hypnobirthing CDs?

I am not surprised you feel anxious. I think its very unprofessional of a midwife to say the doctors are not trustworthy. Surely its not a midwife to tell you that should stop medication. The SHO has been to medical school and would be risking his career if he damaged the baby.

You can ask not to have THAT particular midwife look after you.

I had terrible spd with dd1 but straight after birth it was gone completely. MW did keep trying to get me on my back and I simply said no as it hurt too much. DH did have to stick up for me with mw but that was for other issues.

My experience is that mws will give you the care you need after baby is born.

I'm now on my 2nd pg and this time it's twins. I expected terrible pelvic pain but apart from the odd twinge it's fine. Balance is a bit of an issue

Purely anecdotal, but I was in a wheelchair with SPD and recovered incredibly quickly from birth - by day 2 I was ranting at nurses "Why does everyone want to know how my vagina is? My vagina is just fine, now GET ME CODIENE FOR MY PELVIS!!!"
The pelvis pain was gone in a fortnight but it took another couple months to build all my muscles back up.

I also recommend the Hypnobirthing book - I was very chilled out during labour thanks to it.

Bizarre (and very unprofessional ) that the consultant was so defensive. If it were me I'd probably withdraw any complaint for now and go with the flow, whilst keeping the number for the HoM on speed dial as she seems to be the only member of staff acting in a responsible manner at the moment! But I'd also make detailed notes on everything I could remember of what the MW said and what this consultant said yesterday - and then, once everything's calmed down after the birth, I'd look at going back with all the extra ammunition I'd just been handed. Given one of the items on the complaints list is now that the consultant is a rude, overbearing bully I'd be inclined to insist on the entire procedure being done in writing so that I could not be subjected to his bullying again (something the Patient and Client Council should be able to advise and assist with - whether you choose to take it further or not).

You could also make it less personal by taking the "I want to raise this issue as feel some staff did not react well to my circumstances and improvements could be made when dealing with similar cases" rather than a "I want a grovelling, abject apology" approach. (Not that I don't think you deserve the latter, but I try and take a step back and a deep breath and work out what the real goal is - and if that's improving the service then looking like you're not out to get them might be more effective. I don't know if its the same in NI, but in England there is such a tight connection between liability and compensation it can be very hard to get to the bottom of things or instigate change as the NHS have a strong commercial interest in not admitting fault).

I'm so sorry he was such a pillock - even if he felt you were completely OTT in your reaction a much more appropriate response would have been along the lines of "I'm sorry the team explained themselves so poorly that you felt driven to take such measures" not "how dare you venture to criticize us - you don't understand plain English spoken to you and are behaving like a silly hormonal woman". Grrrr!

Anyway, I really hope you can have a peaceful and calm end to your pregnancy, that the birth goes well and your LO thrives and that your PGP self-resolves very shortly after the birth :)

(Sorry - realised that parts of that could come over as very patronising, which was not my intention at all )

@QTpie"I am not familar with NI (am in the UK)" - I just wanted to point out that NI is also part of the UK. Not wanting to politicise the thread but just thought you should know this. :)

Wow. What a nasty bully.

I would write down every word of that exchange now, while you remember it. Both the bullying language and the frankly ridiculous suggestion that you turn up on the night and ask for a CS - yeah, that's really taking a proactive approach to sorting out your concerns

Then I'd be as nice as pie until the baby was here, then submit a complaint that makes the original one look like a Valentine's message :)

Seriously - that doctor just tried to intimidate you into withdrawing a complaint. For the sake of other women after you, nail him.

I'm disgusted.