Fast first labours - risks, whys and traumas?

[podmumlet]

I had what was for a me a super, super speedy first labour in January and birthed a gorgeous 9lb 2oz DS.

I woke at 1.30am thinking I had diarrhoea and a rather crampy tummy, and after 2 rather intense bowel clearings (TMI) and still feeling like I needed the loo I realised at 2.30am, I was in labour!

Got to the hospital at 4.45am and had baby in my arms by 5.15am.

Now, while most think this is a fantastic story, it wasn't that good a thing to go from 0 to 10cm dilated and shoot a big bub like a cannon ball out my foo foo. As a result, I had 3C degree tears and stitches, and really haven't made peace with myself down below (can't even bring myself to look, and nookie is sadly not high on my priorities)...

Anyhoo, I think I am having a delayed reaction almost 10 months down the line(at least something was slow!!) to the speed of this labour . Because it was so speedy, the contractions were truly intense, and while I had done hypnobirthing and knew about building up the endorphins to manage pain relief, there was no time for any of that to happen, and the birth centre didn't have time to fill up the birth pool. In fact, my labour notes say I was out of control?? :( Although, not entirely sure I agree - I wasn't cussing or refusing support...

I find myself with so many questions rushing around my brain and I was hoping to get some mumsnet perspective and experiences:

1. Why was the labour so fast? Is there anything I can do to slow it down next time? Is it because I drank too much raspberry leaf tea (I was having up to 4 cups a day towards the end)?

2. If you had an equally fast first labour, was your second labour even faster?
   I was advised to seriously consider a home birth next time, but I am a bit nervous about that in case I tear again, and I lost a lot of blood last time round.

3. Would a C-section be advisable bearing in mind the possible speed of the second labour and a possibility of tearing again?

Thanks for reading this rambling post, and really look forward to hearing your thoughts and experiences.....

Still somewhat shellshocked.

i think it would be a good idea for you to speak to the hospital and ask for a debrief and a copy of your notes.
you get to sit down with a midwife (hopefully one of the ones you were with, or your community midwife) and just talk through what happened, why it might have happened how it did and how to deal with your feelings now.

I had a long first labour, 6 hour second labour, and ds3 was born in 48 minutes (from first contraction to holding him in my arms!)
I too felt utterly shell-shocked and it was all really quite weird for the first 24 hours, although thankfully I didn';t tear with him despite him being 9lb 11
my 2nd 2 were both born at home

I wouldn't want to sway you either way really with regard to having a c-section next time.. that's something you could discuss witht he midwife who would be able to tell you all the pros and cons of it. I think having had a 3rd degree tear they would definitely be open to the suggestion of it in your case, but you'd need to weigh that up with the fact that a c-section is major surgery and has its own set of risks involved.

1. I don't know but I suspect it is to do with genetic childbearing ability on your part and positioning of the baby on your DS' part. I would be really surprised if raspberry leaf tea was that significant a factor but in your shoes I too would be put off using it again!
2. I had a fast 1st labour and faster (but only slightly faster) 2nd and identify with what you said in relation to my 2nd although luckily I didn't tear as badly. If we have another I would want to be prepared re possible unattended home birth, but there's fast and fast, and I reckon I would be fine to get to hospital in time so long as I set off at the beginning of labour, given I would definitely recognise the onset of labour.
3. I would be surprised if a C section would be necessary in your case.

I would think you have good odds of a better delivery next time as you'd recognise labour contractions, so you could go to hospital straight away, and you can write on your pregnancy notes "FAST LABOUR WITH FIRST BABY" so the midwives know! To reduce tearing, you could do some perinatal massage with oil.

It does seem quite a while to still be suffering from your tearing, so might be worth getting an opinion from your GP on that - hope you are OK.

I had a fast first labour - 4 1/2 hours from first twinge to dd1 being born. I agree, it is shocking, scary and unbelievably painful. Like you, I was advised to have a home birth with no 2, which was an option I took up. My second birth was absolutely lovely. It also took about 4 1/2 hours, which surprised me as I assumed it would be much faster. However, I felt much less panicky and much more in control. Having a home birth meant I had two midwives present instead of the very patchy care I'd had in hospital. (I think hospital midwives assumed that because I was a first timer, I would be labouring for hours. They were wrong and hadn't bothered to check. But that's a whole other rant.) I was also very surprised during birth no 2 that the pain stopped in between contractions, in marked contrast to speedy birth no 1. In fact, it was really not bad at all on the pain front.

I think there is every chance that your 2nd birth could be fine. It will probably be different from your first and I wouldn't be thinking c-section unless there were other complicating factors. I suspect there is absolutely nothing you could have done to slow labour down. Your next labour could be a lot faster than your first, so it might be worth thinking about a home birth. And, I don't want to scare you, but I think for anyone who has a history of quick labours, it is probably worth getting your midwife to talk you through what you need to do if you or your dh needs to deliver the baby before you get to the hospital or before a midwife arrives. (Proved very important to us with dc3!)

I had a fast (2h15) labour first time round. I was fine with that - it was intense and painful and I would have struggled to cope longer than that.

My next was 6 hours and virtually pain free, followed by my third very similar to my first.

My fourth was very rapid - baby suddenly in my arms, and that was e hardest to deal with emotionally.

My fifth was the longest - 10 hours.

Could you ask for an induction? I chose induction with DC3 after a speedy 2nd labour which left me in shock. I didn't want a home-birth, nor to be having the baby in the car...

It was perfect. Slowed labour down to 6 hours, time for an epidural, controlled pushing, no stitches.

hello ladies - and thank you for your time and detailed responses :)

thisisyesterday - i did have a debrief with a midwife who wasn't at the birth. She was able to decode some of the shorthand for me, but obviously wasn't able to add any further perspective or detail to what was written.

She was the one who suggested a possible homebirth and said that due to the tear, I would have an early appointment with an Obs Gyn to discuss option. The only real reason I would consider a CS is because of the fear. :( I still need to read up more on the pros and cons of each for a second labour, but I also learnt (and believe it to be true) that fear results in a Failure To Progress (or Fear, Tension, Pain)... And major surgery seems preferable to intolerable pain, a failure to progress, and a cascade of intervention... :(

LCadbury - I agree, I probably wouldn't need a CS, but again, might want one because of the fear. But honestly, I would rather deal with the fear and have another vaginal delivery, and not take such major decisions from a fearful position.

Thanks about the childbearing hips :D . I always used to say that in jest, because I have a pear-shaped figure - maybe it turns out its true :D

I (apparently) have healed well, but am still sensitive and fearful... Was wondering if it would be worth doing perineal massage now even though I am not pregnant? Boy, do I wish I did more of it earlier..... :(

neolara - Sooooo pleased to read of a pleasant, yet also fast, second labour. Will definitely learn about what to do if the midwives don't get here in time! I know what you mean about midwives not taking you too seriously. Upon our arrival at the birth centre, she was meandering about like there was all the time in the world and wanted to do all the usual checks in the triage room. I got weighed and I couldn't sit still enough for even my blood pressure to be checked. They sent me straight through and I at the first check, I was 9cm and 30 mins away from bub in my arms!

midthgappp - wow, what a range of experiences. I guess there really is no telling......

coffeeaddict - actually, this is a super sensible idea. I think I will opt for this instead of a CS. That said, if I can manage my fears, I ideally would want another natural birth without induction. But this is my new second choice! Thank you.

i thought of something else as well yesterday, which is that there are ways of reducing your risk of tearing.

for example some midwives will place a hand over baby's head as it crowns and just ensure that the head comes out slowly and you have time to stretch.
I did this for myself with baby 3 as midwives hadn't arrived when he was born!

there is a case for perineal massage too, which apparently can help
and water birth is said to help in terms of tearing because it softens everything up.

I think an important thing though is you feeling safe. Like you say fear will cause your body to produce adrenaline and everything to slow down etc etc and can end up with lots of intervention.
again, simply from a personal point of view, my homebirths were way, way, way less stressful than my hospital birth. It was so nice to be in my own surroundings, I felt confident enough to do things my way rather than being bossed around by midwives and I felt safe because I had DP and 2 midwives with me (for number 2 at least)... I strongly believe this is what enabled me to have the lovely birth I had with ds2. ds3 of course just shot out and would have done wherever I was I think lol

that said, for some people the thought of being at home and away from medical assistance (if they're far from a hospital) can be stressful in itself and they may prefer, and feel more comfortable, in a hospital...

The only other thing I will say is that it's early days! your baby is only 10 months old. Give yourself time to heal and to come to terms with it all. You'll know when you are ready to try and conceive again, and when you feel ready to go through anothe labour

I just wanted to post as I was 6 hours with my first (1st twinge to delivery) and 3 hours with dd2 (90 mins officially)

DD2 was a lot easier to mentally come to terms with and prosess. The labour was easier too as I knew it would be intense and quick and I knew each 1 would be 1 less.

However, the midwives still didnt believe me I was in labour until 5 mins before I delivered. I dialate v quickly- still no tears this time (had a 2nd with the first) and I enjoyed the experience

I really think that if you have a fast birth people think 'lucky sod' but it isnt that lucky

I want 3-4 children and would not like a home birth- EVER. Yet I have tried to discuss options- as i want to know how the labour will be before I concieve and all mw's I meet laugh it off and dont seem to realise I do not want a homebirth.

Hi Pod.

I had a fast first birth ,officiallly 40mins, although probably more like 4 hours, midwife mentioned a link between pre eclampsia and fast birth, as she had had a similar experience. I was so worried dd2 would come quick, i called the midwives early, and it ended up being a 24 hour labour! MW said it was like a first delivery.

I guess it was that way because i was so ill the first time.

Hope it goes well for you

good luck

I had a fast first birth with DS. Was having random pains for about a week beforehand and overnight before the day he was born but nothing major.
Got up at 6am and had a shower and washed my hair. Still nothing more than mild period pain.

It was about 8.30 that my contractions started properly. I had a bath, DH rang the hospital to let them know I was in labour. About 9.30 I stood up and thought my waters had broken they hadnt Rang hospital again and they asked for me to come in. Still not unbearable pain, was expecting to be sent home. Got to hospital at about 10.30 (got part way and realised we'd forgotten my notes!) and was examined at about 11. Was 6cm so told to stay in.
At about 11.45 I was told my blood pressure had shot up and I would be transferred to the CLU. In the lift, my body decided it wanted to push. Midwife told me dont be silly, its going to be hours yet, stop pushing. I told her I wasnt doing it on purpose, my body was pushing, not me. Lots of encouraging not to push and have some g&a. My mum spoke to my dad (probably just gone midday now) just after we got to the new delivery room and told him it would be hours yet. As she was on the phone, DS got distressed and about 10 people rushed into the room. DS was born by ventouse at 12.25.
I have recently realised there is probably a chance that he was distressed due to the midwife insisting I was not allowed to push yet, when he was ready to be born.
I had an episiostomy for the ventouse, no pain relief except the g&a (none for the stitches either). That healed very well, but I've also been left with a moderate rectocele.

Length of labour - 4 hours. Possibly could have been shorter and simpler with a different MW...

I'm pregnant with DC2 now. Due to being under consultant care atm because my rectocele, I cant plan for a homebirth, not that I'd want to though, in case DS wasnt distressed for the reasons I came up with. My plan basically involves getting to the hospital the second I am sure I'm in labour. And ignoring anyone telling me not to push if that is what my body wants to do!

PS I am pear-shaped

Have you asked your mum about her births? Might help to rule in or out a genetic link.

My birth and my mums births were scarily similar (found out after the event of course!).

They should be able to manage the crowning to help with tearing issues.

I had an obstetrician deliver DC3 who was completely 'hands on' in the delivery, slightly to my shock, since this had never happened before! He 'got in there' and stretched everything in advance as the baby's head was coming.

It helped that I had an epidural so I wasn't desperately pushing or out of control. The whole thing was very slow. Afterwards I had an intact perineum and apparently he is known for this (I overheard midwives talking). So it IS possible.

It also made me wonder why this isn't standard practice, since at post-natal 'sharing birth stories' no-one else seemed to know what I was talking about...

my births were exactly like my mothers..apparently fast births can be passed down.

my first was 2.5 hours and because I was sent home from the hospital I nearly gave birth in the car.

second time the were suggesting home birth but I really dont like the idea.
instead I went straight to the hospital and told them last time was fast...so I went in and the midwife stayed in the room and this time labour as just under 2 hours start to finish.

I didnt tear either time, but I think its just luck. I also have small babies and did loads of perineal massage with oils.

Second time was much more relaxed as I was not panicked and made it to hospital in time. I also explained to midwife that I was afraid of tearing and she was very good coaching me and telling me to stop pushing when head was coming out. And she was very much using her hands to guide.

Try to think positively about the second time.