Unsure of next steps - (Some upsetting content)

[slowburner]

I am not sure where to seek advice about the planning of my second pregnancy. This board or another. I'm sorry this is long but it sort of has to be.

My first pregnancy was easy, no sickness, I carried well and was walking several miles, gardening, cleaning and doing weekly yoga until 42 weeks. The only time I had to slow down was when the summer heatwave of 32 degrees made me swell up like a balloon. I intended on a home water birth and although I knew that birth doesn't always go to plan I was very anti intervention and not a fan of the drugs often used in childbirth.

I went to 40+12 with no issues, my community midwives were happy I had a family history of lengthy pregnancies, I was fit and healthy. At +13 and +15 I was given scans and an hour of trace monitoring, all was well. However at the +13 appt the consultant decide dot give me a sweep, I had a show which was so significant a bleed i was totally unable to clean up and DH had to help. Even the nurse commented that it was quite a quantity of blood. I saw the community midwife at +16 who reassured me I was beginning to show signs of labour.

At +17 I started gentle contractions late afternoon, concerned by lack of movement I switched from community care to hospital delivery suite. I had two hours of monitoring which showed baby was not moving. The decision was taken to induce by ARM at midnight, my waters were 'like pea soup' according to the midwife indicating that something was wrong but the request for a section was refused. I was strapped to monitors, and so could not use the pool, could not stand up and move around but was on my back. At 2am I was 8cm dilated, at about 3am I suddenly had agonising continuous pain, I had not needed any pain relief and wasn't about to start now.

Unfortunately this was my baby becoming stuck and slowly starved of oxygen leading to widespread and significant brain damage. The midwife who never left my side kept repeating that the trace wasn't looking good but it wasn't unti 3.30 that alarm buttons were pressed and the senior doctor started ventouse delivery. DD arrived at 4am, I went into shock (as in needing a drip, and care from medical staff), baby went to NICU as a precaution due to low blood sugars.

Anyway, cut a long story short she was discharged from NICU at about six hours old, we were on post natal with no monitoring when she stopped breathing in my arms and turned blue. It became evident over the next fortnight that she had suffered massive brain injury due to the mismanaged labour - I should have been crash sectioned. DD is doing ok but life isn't exactly normal.

Since then all I can think about is a chance to have the newborn experience and bond with a baby. Since Christmas no less than six close friends have had easy natural births at our local birthing unit which recently opened. I am under siege from 'normal' pictures of mum looking tired with newborn, dad holding newborn, newborn sleeping, newborn feeding and the texts, mum and baby doing well etc which we obviously didn't get a chance to send.

I had come to terms with never experiencing a natural birth or water birth etc and just opting for an elective section but not knowing anyone who has had a section I am quite concerned that this is major surgery and although will enable baby to be born safe, will not mend my terrible memories as well as possible ly affecting my bond with baby. Going overdue is a major risk factor in this happening again, so I had considered aiming for my due date + 5 and then ELCS, I am not a fan of induction given what happened last time, plus I know I wouldn't be able to labour in water if I was induced.

Ultimately I want a healthy baby, but I just feel lost and unable to think about the birth without hearing from others who have had to make this type of decision. I am having counselling but this is outside their remit, I am not keen on a birth debrief because I don't want to listen to why they didn't act the way they should have done.

So sorry for the essay. I have totally outed myself ti anyone who knows me but I really do not know where to ask these questions!

Couldn't read and run, I'm so very very sorry you have been treated appallingly. I'm so sorry.

Hi slowburner. It sounds like you had the worst possible experience last time. I was induced at 41 +5 and ended up having a section at 42 weeks as I didnt progress. I would always opt, sorry i mean insist, for a section again for a number of reasons, but mainly that I would be in control. Reading your post I really dont know how you could put yourself through a naural labour, the fear and worry throughout your pregnancy of a repeat outcome would just be too much. I know a section is major surgery with it's own risks, but you are obviously a fit person so no reason why you shouldnt be healing well and quickly. As for the bond with baby, I really dont think it makes the slightest difference, you still get to see your baby as soon as it comes out and hold it straight away. Yes there are a few moments while they stitch you up but you leave the theater with your baby - noone else. I dont feel there is any loss of bond at all between me and my baby. What I am trying to waffle on about is, if you decide on a section, you know what will be coming, when it will be coming and you can plan for it, knowing that in all likelyhood you will have a healthy happy baby at the end, if you opt for a normal delivery you will be worrying from before conception, everyday and night that you will have the same outcome as last time. Sections are not wrong, a faliure or anything else, reading your post I would think it would be the most sensible thing. Nothing I am afraid will ever remove your memories of last time. Hope this makes sense and thoughts are with you.

Seriously - I am very pro "natural" vb and anti intervention and c sections. But reading your story, I would blooming well go for a elcs next time. You had a terrible time, with a difficult outcome - nothing can change that now - but having a cs this time won't affect your chances to bond with your new baby (it really really won't) and will save you what will almost certainly be an enormous amount of stress and worry.

Thank you both for your thoughts, I apologise if I portrayed CS as a failure in any way!

Many women who I speak to who have had children affected by birth injury do choose an ELCS for additional pregnancies for the peace of mind, I have been told I will be offered one without any argument. But labouring wasn't something I was bad at, in fact i did pretty ok given the circumstances.

it was the fact baby wasn't moving which indicated she was in a poor state and less able to survive birth, many babies need resus at birth but don't have brain damage. I strongly believe breaking my waters reduced her ability to protect her head which was badly swollen indicating labour had been hard on her. There is no doubt in my mind or her doctors minds that she should have been an emergency section.

I very much want two more children (not at the same time!!!) and I think if I were to go with an ELCS for the 2nd would i therefore be additional risk to have my 3rd as a VBAC?

I don't know the answers, slowburner, but I do think you are a very brave and caring mother and childbirth is just a tiny part of being a mum. I had a slightly complicated first delivery (though nowhere near yours) and am expecting my second. Based on my own experiences I think you will want to do whatever you can to avoid anything similar and that should be your guide, for your own sake.

I am so sorry that you had such an appalling experience first time round :(

If this helps, I had an ELCS for my second birth for various medical reasons which combined to make it the best option. Most of the mothers around here give birth in our lovely local midwife unit (annoyingly, next door) and I kept hearing reports of wonderful births. I felt very conflicted that I was having to go for a medical procedure in the big hospital, 45 mins drive away. My ELCS was brilliant, it was a really great experience. The MWs and doctors were very gentle and friendly, the whole thing was very calm and relaxed and I felt very in control. I spent a few hours in the recovery room BFing DS which are some of the best hours of my life ever. Before it, I felt like a bit of a failure but I am so glad I went for the (safer, in my case) option, I've honestly never regretted it.

I am not medically qualified in any way, but I'm guessing that when you had your sweep at +13, the significant blood loss indicated that something was wrong, and you should have been either immediately induced or had an emrgency CS.

It seems that the meconium in your amniotic fluid at +17 indicated that the 4 day delay was a bad clinical decision.

If you would prefer to labour, you could maybe opt for a full-blown induction at 41 weeks next time? If the labour goes on for longer than 20+ hours you could have the option of a CS for peace of mind?

Indication scares the beejesus out of me :( and I think I'm right in saying I wouldn't be able to stay in the birthing unit or opt for a water birth, so might as well go straight to ELCS.

Fwiw I also think that bleed at +13 was the first indicator of something badly wrong. Chuffin hurt too, DH had to help me walk to the car.

I too I am so sorry that you had such an appalling experience. I can't understand why you were left so overdue....just shocking. IMO I would go for a natural birth but at 40 weeks, or 39 weeks. Or a section at 39 weeks.

I opted to go overdue with the support of the head of community midwives, there were no risk factors, but I don't think anyone really took notice of that bleed.

Ty for the comments re CS, I am re reading and composing questions.

You poor thing

I opted for elec CSs. For me they were wonderful experiences. You can opt for the baby to be delivered onto you, and you can BF straight away.

The downer was the urinary catheter. It wasn't uncomfortable at all, but it was a total faff dragging it around until the next day! ( they seem to insist on keeping it in overnight).

Good Luck with whatever you choose.

Have you had any firm answers about what happened? I only ask as I think you may feel better informed about what might be suggested to you next time in terms of management etc.

Wasn't the doctor who performed the sweep shocked by the blood loss? Is there an option to have baby number 2 in a different hospital? How would you feel about being in the same place again, with possiblity of the same staff?

Op what a terrible series of events.

I can't begin to understand how you feel.

Fwiw when ds cane out he wasn't breathing as he was in shock and that is stuck in my head. He was fine after some oxygen but I try not to think about it.

I think you need to split it up into sections, some bits you may be able to do as you'd like, others might need a compromise and some will whatever has to be done to keep you both safe.

slow im so sorry you had such an awful time, you really were neglected by the healthcare staff and you shouldnt have been left so long at risk to yourself and your dd.

I had two normal VBs followed by a very traumatic 3rd birth, which ended in an EMCS, further emergency surgery, left me with lots of problems and PTSD. I am taking legal action action against the trust for negligence.

I think if you have no intention of taking action then a de brief wont do much good, the legal psychiatrist i had to see said that research shows it is no help in recovery.
Where in the UK are you?
I would suggest finding an ob/gyn who you can trust, go through everything with them and see where you end up. Do what you feel is right for you and your baby.
Dont worry about the bonding, i dont think it makes any difference. I know what you mean about not being able to send pics and hearing about peoples normal deliveries, stupidly i still feel very bitter towards people who have perfect births, i feel like i was robbed of my 3rd birth experience so youre not alone.

Oh my, you poor thing.

I had a very traumatic first labour which ended in an EMCS, so my 2nd and third were ELCS, more for mental than physical reasons than anything else.

With an ELCS you can have a birth plan. You can choose to have the baby on you once they have been checked over. You can have your partner cut the cord, they can be at the baby station/resus table (not sure what it is called) while you are getting stiched back up, either you or your partner can have the skin to skin.

After the ELCS you go to the recovery room and you can definitely have skin to skin there, more or less as soon as you get in there.

Wishing you lots of luck.

slowburner sorry to hear how badly you and your dd were let down during your labour.

Just thought I'd share my experiences.
I went to 40+14 with DD, wanted a homebirth but labour dragged on and on, eventually ended up in hospital and emcs, DS came 40+2, labour stagnated at fully dilated but never got the pushing urge - emcs with him too. Due to both my labours being exactly the same, I've opted for elcs with DC3 (due in 6 weeks). I don't want another cs but I think it makes sense given my history. I bf both of them til 12 months and, while I've not got a vb to compare it to, I don't feel I failed to bond with either of them. (I loved the catheter too, I could drink and drink and drink and not have to get up to wee...but then I am incredibly lazy )
Just wanted to reassure you that a)it's not a cop-out and b) you can still bond perfectly well with your baby and c)you won't have the panic/worry that you most likely will trying for a vb with what happened with your dd.

I hope you manage to come to a decision that you're comfortable with and best of luck with growing your family!

The doctor who performed the sweep did so, I screamed in pain, he turned to his student and said I was close to labour then left the room. Then I started to bleed and lost my plug, the nurse brought some wipes but I couldn't myself clean up (mortified) and DH had to help, the nurse comment on the amount of blood lost but it wasn't mentioned again.

The first day on NICU the same student was there. And she recognised us.

Re being told officially what happened then no we haven't had a debrief, I only know what my daughters doctors have told us. The paediatricians have already said that when we ttc then they will arrange a meeting with obstetrics ti determine options for pregnancy management.

slowburner, my first baby got stuck badly too, although thankfully she did not suffer any long term damage as a result of her birth. I had an emergency CS after 42 hours of fruitless labour (6 hours fully dilated, 4 hours pushing,) and DD was born with an APGAR score of 1. She went straight to SCBU and I was very poorly afterward, my blood pressure dropped to 70/40 after I needed to be suddenly put under GA after the spinal block started to wear off during the CS (my CS took nearly 2 hours rather than the more normal 20 minutes due to stuck DD - she didn't want to come out any way, and also the surgeon cutting through other parts of me that shouldn't have been cut.)

3 years later I had another baby, and employed the services of an independent MW right from the start. It made a massive difference to the way I approached my second pregnancy. We discussed all possible options and approaches to birth, and decided she would come into the hospital with me. DS was born so quickly and easily at home - by accident! - that we never acted out our plan. I know she has accompanied other women into hospital since my son was born, including a couple who had a situation that sounded very like your's but where the baby sadly died. This couple had a CS and the IM arranged to be there with them in the NHS hospital to provide moral support but otherwise she carried out all pre- and post-natal care of the couple and their baby.

I know IMs are expensive, but in my opinion they are the best option when your situation is tricky, and worth every penny. I cannot recommend mine highly enough.

Just need to point out it was the couple's second baby she helped them with, not the one that died.

I am rubbish at keeping up, but thank you all I am trying to keep up with posts!

Re different hospital, no, no chance. The one I gave birth in is the only level 1 NICU in the entire region, we've been told our paed will check over the next baby personally (we trust him) after it is born, and apparently NICU will be pit on alert when I go in to deliver (CS or VB) so I think it foolish to ignore those upsides even if it does mean being on the ward where I was before.

5inthebed I wouldn't want baby out of my sight for a second, would want skin to skin immediately and enable feeding immediately. Have teary eyed memories of the baby breast crawl. Can that happen with a CS? Catheter sounds horrendous, I'm not good in surgery, a wisdom tooth extraction under anaesthetic as a day patient led ti me collapsing at home!

lovesbeingwearngskinnyjeans that's a bloody good idea, the three step philosophy, might adapt that, thank you

Thank you for taking the time to reply to me, an acquaintance had an almost identical labour but they crash sectioned her within minutes of ARM despite her waters being clear, different day, different doctor, different decision. That one woman has spread through my group of friends, and said to my face the viewpoint that the hospital we both delivered at is just so wonderful as they saved her baby. They nearly killed mine.

Thank you backinthebox I might look into that, but not sure we can afford the cost, currently paying privately for DD to have therapy as the NHS therapists reckon she can manage, budget constraints are hitting hard now.

I had quite a similar birth to you with DD1. She also suffered a brain injury. The main difference is that she was a week early and there was no sweep involved but I was admitted with bleeding. My waters broke naturally and then I was induced. It was slow and difficult. She went into distress and was delivered by forces. She was blue and the next day started having seizures. An mri confirmed the brain injury. I agonies over what to do for my second pregnancy. I was reassured that it was highly likely to be easier but I decided I would not be induced again. I opted to do to term and then an elcs. Dd2 was born safe and well 3 days early and it was a very straightforward birth. Have also had ds without any complications but I worried a lot and would not have hesitated to have a cs to avoid another induction. Best of luck

Hi slowburner - just wanted to add my thoughts. With ym first DD - I desperately wanted a home birth and went to 43 weeks. I didn't want to be induced, and the lovely consultant at my 43 week appointment told me that DD had completely disengaged and an induction would likely end in a section, so she'd recommend a planned section. She said "I say this as a woman who has had two vaginal deliveries; one of them at home".

I completely trusted her and went in the next day and had DD by section; truly the most marvellous birthing experience. We asked them to keep the lights as low as they could, to have no music on (it was Christmas, I couldn't bear the thought of christmas cheese), and for skin to skin. She was huge (10lb), and despite that, she lay on me while they stitched me up - her legs were in the way, but they didn't complain/get huffy at all - they were amazing.

I breastfed for 13 months, and although I have nothing to compare it with, I fell in love with her the minute I saw her. My DH loved the section as he felt calm as well, and knew exactly what was going on.

The following year, we lost twins, and I delivered them at 23 weeks.

I am now 38 weeks with another DD, and my plan of action was always that if she kicked off natural labour (my first DD didn't) then I've give it a go, and if she didn't, I'd elect for a c-section. Too much at stake for a failed induction for my peace of mind. As it happens, she's breech, so I'm going in tomorrow to haggle for a date (as late as I feel comfortable and that they are prepared to let me go!). I think my point is that my first planned section was SUCH a positive, glorious experience, that I genuinely do not care how this baby is born; my birth plan is for her to arrive safely.

I do hope you find an approach you're comfortable with; I also found that the doctors and midwives at the hospital have been amazing with us, because of last year's experience losing twins - they are supremely aware of making things easy for you.

Good luck.