Upsetting visit with consultant today

[working9while5]

I am 14+2 on dc 2.

Last birth was Kielland's forceps delivery and I had MONTHS of trouble after it, lots of pelvic pain and back and hip pain which has flared up nastily in this pregnancy.

After scan today (which is bloody late!) I was sent to clinic and I had NO idea why. The doctor asked vague open questions about how I was feeling about birth etc and I had no idea what she was looking for, so I just told her about my pregnancy and birth...

Anyway, eventually I said that my family have a history of needing post-dates induction on all babies and I would rather avoid an induction again. I would be happy to do spontaneous natural labour if it happens but I don't want to go through the whole strapped-to-a-bed, foetal monitoring, syntocin drip etc type of birth.

This is where it all changed. I said something like I would be happier for lower levels of induction e.g. ARM, and she said "yes but that's what you had, you had the lowest type of induction we can give you, you were dilated when you came in". I said I thought I had a syntocin drip and she said yes, you did.. but it only took four hours to get going so it was "just like natural labour"(though I know from the day that my uterus hyperstimulated!). It suddenly became as though I was saying "this is how I felt it went" just for her to say "no, you are wrong".

She kept highlighting how "straightforward" my birth was, she must have used that word ten times in five minutes. It was a "straightforward" case of a back to back baby, it was a "straightforward" Kielland's forceps delivery with "very senior doctors in the room" etc. Dh said he had felt there was a lot of panic and she said "well yes, they did lose the heartbeat at one point which probably accounts for that, but there was nothing sinister, the baby just turned and they couldn't hear it any more". She also said "induction can't have been that bad as you managed to deliver vaginally".

I burst into tears of course. I felt like I was being told that I was a monumental wuss and blowing everything out of proportion when I didn't go in there even aware that that was what we would discuss and I just answered her questions openly and honestly. I just felt like she was telling me I was lying and/or thick or that I was looking for an elcs she wanted to talk me out of - which I wasn't! What was the point in ripping my experience to shreds and telling me how "straightforward" it all was? For her, yes, perhaps... but no, it wasn't to me and it didn't feel at all like that on the day. AT ALL. Nor for the frigging NINE MONTHS I was virtually immobile because of pain after it.. or through all the feeding difficulties my baby had because he was a screamy forceps bruised sleepy baby.

Is this normal? I am really feeling shaky and upset after it. And I am not having it that a Kielland's forceps delivery is as straightforward as you can get!

Straightforward birth to me is no drip, forceps or need for anyone other than midwives. TBH what you described sounds traumatic to me (for both you and baby!) I understand she may deal with medically more complicated births and worse outcomes but to make you feel like this is unacceptable. What a cow! Hoping for a straightforward birth this time e.g no intervention needed. Hugs!

I would contact the supervisor of MW for normal births at your hospital ASAP they can come to your consultant appointments with you and make a plan, will really help. None of what you describe sounds normal, she sounds like an arse tbh, i would also ask to change consultants, this is also possible.

Yeah Wolfie, you got it in one there. I know I am not in the 1-5% of terrible, terrible births and in the grand scheme of things everything worked out okay so from a medic's point of view it is all a storm in a teacup but it was so dismissive... I could understand it if I'd gone in there screaming blue murder or going on about having a traumatic birth etc, but I didn't.. she asked, I answered. She quoted statistics at me about how second time births have only a 2-3% rate of instrumental delivery blah blah none of which I questioned, I simply wanted a plan for IF I went post-dates and needed induction e.g. I am hoping for a straightforward spontaneous labour this time, which does NOT INVOLVE A DRIP and want to plan for what would happen in the event that one was needed. You'd swear I went in there asking for the sun the moon and the stars!

I also agree NatashaBee that it seems a weird thing to call straightforward, while on the other hand saying there were very senior doctors there... which I understand there have to be for insurance purposes/safety with Kiellands. It is a high risk delivery, how is that straightforward???

Youtalkintome, I will do this.. I have a good midwife who can put me in touch with delivery suite midwives to do this I think...

Thanks for responses, makes me feel less like I was something she trod in!

That sounds anything but straightforward. I think some doctors forget that what to them is a 'straightforward' medical procedure that they see regularly is actually a major and terrifying one-off event in a patient's life, and can have consequences beyond the hospital stay.

I'd second asking for a new consultant, you're not likely to feel at ease with this one in future.

And as I say to so many women on here, you can of course decline induction even if you go over 42 weeks. I know that's not a choice all women are comfortable with, but it is a choice nonetheless

Do you know what the limit on induction post SRON is, Flisspaps? My waters went at 40+12 and I was induced 24 hours later. I think I read somewhere that it would have been okay to wait 48 hours and perhaps this is something to consider next time...

SROM I mean!

Ladies, I'd advice you not to continue with a pregnancy beyond 41 weeks. Studies have shown that the risk of stillbirth is higher after 40 weeks of gestation.

You can certainly refuse an induction, but perhaps try natural ways of inducing labour. Or maybe consider a c section.

I really think you need to be under the care (word that consultant seems to not have understood) of someone you trust and whose professional opinon you feel you can rely on. You really need to talk through what you would like to happen given any particular circumstances (e.g going overdue) and what they recommend.
Sending out positive birthing vibes for when the time comes. How about a lovely water birth with a supportive midwife, no nasty consultant and a beautiful baby who just glides into the world. :)

dance is talking a tinsy bit of rubbish.

Standard term is up to 42 weeks, even after 42 weeks the risk if stillbirth increases by only a very small amount.

NICE guidelines are happy for women to refuse induction at 41w and have foetal stress tests every couple of days instead.

working you probably didn't even see the consultant but one of her junior doctors who sometimes are lacking in bedside manners, to say the least. I've found female obs to be far less sympathetic than male obs, possible because male obs know that they couldn't possibly understand what we go through!

I'd definitely ask if you could get a midwife along in future, doctors forget what straightforward actually is because they only even see the non-standard deliveries.

All the best for future appointments.

What a horrible bitch of a consultant. Clearly loves the sound of her own voice and has no social skills or empathy. Try not to let her get to you. Hopefully you'll be able to see someone else next time. I had an induction last year and it was horrendously painful. That was without the drip -1 pessary only. It was far, far more painful than my first labour, which was a long back labour so not an easy ride either. I can imagine only too well how painful it must've been for you & you are definitely not being a wuss! I hope you don't need an induction this time. Ignore that bitch. x

Dance - normal pregnancy is up to 42 weeks. Placental decline can happen in some women as early as 37 weeks, so why not suggest no-one goes beyond that point if pregnancy?

Natural induction methods don't work, if they did then no-one would go fir post-dates induction. From other threads we have had discussions on it seems to me that you think c-sections are the answer to every woman's prayers if anything unexpected happens in labour.

working I think the advice varies from trust to trust following SROM with no contractions. But if your waters don't go or the only issue is going over 40+ weeks then there's no need for induction or augmentation if it's not what you want.

the risks of induction are not exceeded by that of going post term until +14.

that is 'on average' anyway.

in several trusts they will not ask for monitoring or induction prior to 42 weeks unless there is another reason. the NICE guidelines are there for all to read...

the average gestation for spontaneous delivery is 40+8 anyway.

and they may recommend you accept induction after 24 hours after membrane rupture, but again that is up to you.

Working, firstly your consultant does sound like a cow. You can change, just ask. If they ask why, tell them she belittled your traumatic first birth experience and you want to be under the care of someone who will take your thoughts and feelings into account.

Secondly your first birth experience sounds similar to mine.

I was induced at 42 weeks (allegedly, I suspect I wasn't actually much over 40, but that's another story...). I was induced with a drug unlicensed for induction, had uterine hyperstimulation, which thankfully was finally gotten under control, then drips, etc. a total of 52 hours of horrible, anxious, traumatic labour, a brutal forceps delivery (not keilands, thank heaven ) lots of damage, pain, and, like you a very bruised unsettled baby. I suffered pretty crippling PND partly, my counsellor thought, as a result of birth trauma.

When I found I was pg with Dd2 I basically told them that I would not allow them to chemically induce me. I would have a sweep (as many as they liked) they could rupture my membranes as a last resort, but they were not coming within 20 yards of me with any prostin. I said if they were concerned I would have a c sec. They were rather shocked and tried to persuade me otherwise but I was adamant that I would be refusing chemical induction no matter what.

In the event, I went into natural labour with DD2 on my due date . I had a completely natural water birth (had to fight for that too, though) with only a bit of gas and air at the pushing stage. It was a tremendous healing experience for me, and goes to show that one bad birth doesn't necessarily mean the next will be too.

I would suggest seeing someone, a counsellor, preferably, to talk through your feelings about your first birth. I think you'll find it really helpful to be able to be able to talk about what happened and how you feel about what happened.

Then it may be helpful to find an NCT refresher course if there's one near you. Mine was full of women who had horrible experiences first time round, it helped to know we weren't alone.

Also, and some may think this is nonsense, but I had weekly acupuncture for 3 weeks before my due date. I went into labour just hours after my last session. I saw someone recommended by the NCT as specialising in antenatal acupuncture, and the amount of movement during and after my sessions with him was astonishing. It can't hurt to try...

I really hope that your anxieties about induction prove to be a moot point, you go into labour around your due date and that you have a thoroughly different and healing experience this time.

Meanwhile, have an unmumsnetty hug and keep the faith.

db
xx

DanceLikeTheWind is wrong on this; current research suggests that up to 42 weeks of pregnancy the risk of stillbirth is static at around 1/1000, after 42 weeks it increases to around 3/1000.

Dance - dont think you should be using the word retards - it is offensive to most people.

Disclaimer - am not an obstetrician! But have to say the story you're describing - OP baby, induction, forceps delivery for foetal distress - sounds nothing like straightforward!

I had what I would consider to be a "straightforward" induction at 37 weeks for PROM (>24h having had an internal which was deemed to be an infection risk). Prostin x1, contractions for 24h, synto at 5pm (with epidural), fully by 10.30pm and ventouse assistance with no heart rate issues, no "senior doctors" (the on call registrar, who was lovely) and absolutely no forceps.

I can completely see where you're coming from with the levels of intervention you are and aren't comfortable with. Just remember everything they do requires your consent and if you aren't happy giving it then you can ask for a second opinion. You can also ask to see a different consultant if you feel you don't have a good relationship with this one.

This link elaborates upon the higher risk of stillbirth post 41 weeks.

www.seminperinat.com/article/S0146-0005(06)00100-5/abstract

Perhaps there's a more recent paper stating the opposite, in which case I stand corrected. I'd personally be uncomfortable about letting a pregnancy go beyond 40 weeks. The bigger the baby, the higher the risk of shoulder dystocia and that starts a cascade of problems like possible brachial plexus nerve damage, ventouse, forceps etc.

Flisspaps, I'm not saying that c section is the answer to prayers. Not sure where you're getting that from?
I'm simply pointing out a fact- they are far safer than forceps deliveries. I've already posted several links that prove the same. They also happen to be preferable to inductions for some women.
I'm glad you're happy with your forceps birth, but for most women it's a nightmare. It would certainly be a fate worse than death for me.
It is the leading cause of pelvic floor dysfunction and sexual dysfunction among women.

onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1981.tb01211.x/abstract

This link states that injuries to the head and spinal cord are most often the result of forceps deliveries.

Occult sphincter defects are common after vaginal delivery, especially forceps delivery, and are often associated with disturbance of bowel function.

www.nejm.org/doi/full/10.1056/NEJM199312233292601

The above article also states that fecal incontinence is most common after forceps deliveries.

DLTW I don't feel that getting into another debate with you is going to lead anywhere and is getting away from the point of the OP. I do wonder though if you've actually been in the position to have had to consent to forceps yourself.

Flisspaps, I don't think we've ever really had a debate. I've just stated facts- backed by sound evidence, so there isn't much to debate.

As for being in a position to consent o forceps- a labouring woman is vulnerable, exhausted and in pain. They consent to all sorts of stuff and then regret it later. The lucky ones don't.
It is because I cannot have a guarantee that forceps will not be used, that I personally prefer a c section.
I'm against forceps- I think they're barbaric. Any women in a situation where she has to consent to them has my deepest sympathies.