Birth fears putting me off ttc #2

[working9while5]

I've heard MN childbirth is a good place to air your birth trauma woes, so here goes. I would really appreciate any feedback on a plan of action to help me prepare for another pregnancy and labour.

I had ds at 40+12 following SROM at 40+11. 2-3cm dilated on examination, syntocin drip started at 9 am. Labour didn't really start until around 12.30. I had the epidural at 5pm when I was only 4cm dilated, even though I was managing well with controlled breathing, because I was due a VE and I'd had a painful one in the morning and I knew it would throw me off. Shortly after my uterus became hyperstimulated. Staff were coming in and out and asking me to move, mentioning "suspicious" signs on the trace and saying that he seemed to be falling asleep so trying to move me from side to side etc.

At 10 o'clock, I was 9cms dilated and staff said I would begin to push in an hour. I began pushing just before midnight. I pushed for an hour and a half and then ds was stuck (deep transverse arrest) so I was rushed to theatre for trial of forceps. Ds was delivered by Kielland's forceps at 2.20am with an Apgar of 5.

Up to the delivery, it was ace. During the trial of forceps, I was very "out of it" and almost felt out of my body and the staff were arguing a bit about what to do, and I could hear them say "one more push and we'll have to section" as they lost the heartbeat on the trace. I remember pushing and throwing up, then another push and then he was out. Still, so far, so good..

It's the image of him that haunts me. He looked like a dead baby. He was totally floppy and blue and he didn't cry for a minute. The memory of that minute and the panic inside me and "this can't be happening to me" is the trauma. He was very badly bruised by the forceps and I found him very hard to look at, which caused bfing problems and postnatal anxiety attacks as I would wake up sweating and screaming believe he was wrapped in the blankets dead etc, not helped by very slow recovery in terms of my pelvis and actually my hip, which still troubles me. I also have some (cringe) occasional fecal incontinence.

I don't know what I want. I want to want to ttc and I want to know how I can avoid all of this next time. I found the fact that it was all so calm and peaceful but yet so unpredictable and barbaric hard, really. I know birth is unpredictable but I was so calm last time, and I just don't feel I will be again.. If you could guarantee me that my baby would be healthy and well I would do anything, but I am nervous, not least because I am the ONLY person on my mother's side of the family to deliver vaginally and it was hardly straightforward. My grandmother and aunt lost babies in labour , my grandmother in very similar circumstances but after a 72 hour labour.

Any thoughts? What can I do between now and a next delivery (if I am lucky enough to get pregnant)? Who should I ask? I appreciate my birth wasn't as traumatic as many others, but I feel I need to think it through to help me commit to ttc.

I'm so sorry you've had this trauma. I hope you're starting to recover.
How do you feel about a planned section? I had one, and it was great; painless and calm. My baby had an apgar score of 9 at 1 minute, and 10 at 5 minutes. There was no trauma - it was a wonderful experience, and I had a very easy recovery.
It sounds like you'd have a good case for elcs.

Thanks for your response.

Re: ELCS, I won't lie and say the thought hasn't crossed my mind! I have been thinking about it and I suppose what I would really like some good and impartial information about why my birth went as it did. I found at the hospital, the information I was given was very much couched in a particular way as I suppose they were worried I was going to sue or complain or something like that, even though I was more or less happy with my care. I just feel I don't fully know what I can and can't control about this process.

I've been doing lots of reading and I think that malposition/induction/epidural were probably key factors, so part of me would like to go a very natural route BUT I am put off by the realisation that I broadly followed the same labouring pattern as my mother, her sisters, my grandmother etc and having read some of the literature, it would seem that the force of contractions and slow dilation (I was contracting and had stop/start labour from term!) is something that leads to an outcome like I had... I feel the difference is that last time I believed that it would all be fine no matter what and even though I had a good outcome, I can see it's a lot more shaky/unstable than that. I am not cheered by the statistics on stillbirth in this country either.. that is my greatest fear.

On the other hand, it's a second baby and everything was so stretched during birth maybe a baby would shoot out? But only if I am contracting suitably? The consultant said during birth that it seemed I would have a very long labour because I wasn't responding well to the syntocin.

If I were in Ireland, I think I would ask to wait until 40 + 7 to see if I would go myself, and if I hadn't, I would like a section. I wonder if this is a viable option?

Sorry, the reference to Ireland is because I know that this is something they often do with people who had obstructed labours in the hospitals there, as there is a lot more consultant led care.

I haven't been through natural labour or trauma, so I'm not the best person to give advice; I can only sing the praises of elcs. I felt great even in the early days, and now my baby is 16 weeks I've already been hillwalking. By 10 weeks there wasn't even any tenderness left in the scar area - it's as if nothing ever happened.
I'm sure you will soon have lots of replies from people who have suffered traumatic births. I've read about women who've suffered birth traumas getting consultants to agree to elcs before ttc.
Nobody can predict what sort of labour you will have - if they could, noone would ever have emcs! The most predictable outcome would be with an elcs - of course, even that is not totally predictable. But it's much less risky. Also, you would have a roomful of highly trained doctors and midwives with you throughout the birth, rather than having the risk of being left alone while mws attend to other births.

It may be worth looking into options to speed up your labour. It's all based on anecdotal evidence, but red raspberry leaf tea is supposed to strengthen the uterus so that contractions are stronger, making labour shorter. I used it from 32 weeks, gradually increasing my dose, and my labour from first contraction to 10cm was 7 hours! My mum had to have a section when having me due to dilating too slowly and me going into distress, so I was concerned I would experience the same. Also consider hypnobirthing, this didn't work for me, however the more relaxed you are the quicker your body produces hormones for birth. Finally, hold off on the epidural unless you feel you can't cope without it, as you are more likely to need an assisted delivery after an epidural.

I did both of those last time I'm afraid . Given that I'd had contractions (some quite strong!) for 11 days before the real deal, I had some practice at it too.. and I have fond memories of listening to the tape and finding it almost hallucinogenic at points. I was very relaxed in labour itself, which is not the easiest when you are strapped to a machine with drips on either side.

I could have coped without the epi without the vaginal exams, so one thing I have considered is refusing them unless they seem absolutely necessary. I took the epi when I did because there was one "due", it never occurred to me to say, "actually, I'm labouring here, I'd rather you didn't go poking around in my nethers, it's pretty clear I'm a long way off the pushing stage".