Second pg after first ended in brain injury for baby - doula Q

[EyesDoMoreThanSee]

a bit of history My first pg was easy and fun, I was healthy and followed a pretty low key approach favouring minimum intervention, home birth and yoga every day. Due to going very overdue I was eventually told I required induction but only on the Monday, on the Saturday baby stopped moving, a mistake made by doctors during the delivery meant that my gorgeous girl suffered brain damage and stopped breathing in my arms at six hours old. She survived thanks to spectacular intervention by the neonatal team but parenting isn't quite how I hoped it would be, I am on first name terms with many therapists and doctors secretaries at our hospital, ironically the one that failed to prevent my child being delivered safely.

Anyway. I want another child in about 18months time. There are no mental health midwives in our PCT and there is no current provision for therapy for my husband and I. I have been to hell and back and I know that the next pg will be emotionally very taxing, I would be an idiot to attempt a home birth due to the complications with my first baby, and so I have no option but to deliver in the same unit as last time. I am considering therefore the option of hiring a doula to support me and to have another person present during labour that I can trust.

Does anyone know if doula's offer support in such circumstances? Where mum has had a difficult previous delivery and wether they would give emotional support throughout the pregnancy? I have no idea of costs but DH although keen for another is the epitome of the 'stiff upper lip' brigade and can't even handle me bursting into tears at the sight of a pregnant woman!

I hope that this is the right place to post and I have spared the gruesome details so as not to cause tears for pg Mnetters.

Hi,
Sorry to hear about your experience. The last labour I had was dry difficult for me as I had been through a labour a year before where the baby hadn't survived and although we knew it wouldn't, was still traumatic for me and I was so very very desperate to get this baby out, see it was healthy and hold it in my arms. I took a doula with me... She knew my history. the baby's head got stuck and I had a very inexperienced midwife who kept telling me she was going to have to call the dr in. Which was freaking me out totally. My doula could see I was getting very very anxious because drs (to me) mean something is wrong and I couldn't actually string a sentence together. So the next time the midwife said anything about calling a dr in my doula stepped in and said "you are making her very anxious, this is not helping, I'd you want her to get the baby out you have to help her This is not helping her... So either call the dr in or try and guide her" she literally took the words out of my mouth. I was so incredibly great full. So yes, I would say take someone with you who gets where your coming from. As your midwife probably won't.

I don't know if you have the budget, but I had a very poor first birth experience (not with as long-lasting effects as yours though) and I hired an independent midwife from the start of my second pregnancy specifically to provide a single person who could give continuous support throughout my pregnancy and be an advocate for me when I went into hospital to give birth. She was not allowed to act as a MW while in the hospital, but that was not an issue in our situation. The MW we employed offered massive support and expertise, far more than I thought we would get. She took my husband on one side too and had a private 'man' talk with him, as she pointed out that no man could be left not knowing if his wife and child were safe and not be affected by it.

I used Purple Walnut Midwife from Oxfordshire. I know she has dealt with women who have had very tragic outcomes from their first pregnancies and hired her to help second time. I can really recommend her.

I think only you know what will work for you in these sorts of circs. I have a brain damaged 8yo after birth injury, but my perception of the events (which have been mostly backed up by the negligence case) mean that in the event of a future pg, I would be focusing on cfm (except in reality, I have a consultant's letter advising elcs).

As it happens, it was dc3 that suffered the birth injury (she has cerebral palsy as a result), and dh and I felt that we would be unable to cope with a fourth child in those circs, so the advice is unlikely to be put to the test.

In your situation, I would strongly advise debrief from the hospital (not sure if you are already involved in a negligence case or not), and then counselling to rootle about in your own experience of events for a while. I know I suffered horrific flashbacks etc for many years, but often when you are in the thick of it dealing with a toddler or baby with a disability, you compartmentalise the trickier issues. You are so busy with the grinding daily routine of therapy and specialists that you don't have time to navel gaze and give yourself time to process it. This hidden stuff can knock you radically off course with a subsequent pg, or other life event. (I had a breakdown after about 6 years, having been the capable of anything model mother in the interim, completely out of the blue).

Hopefully after the counselling, you'll have a clear idea of which aspects you are likely to need the most support with - and can discuss with a specialist doula.

It's very personal as to whether you would prefer more or less medicalisation, obviously, and very dependent on where you feel the mistake was made previously. It does sound to you as though you feel that you may not have been forceful enough with pushing for intervention earlier? So a doula may be ideal. In my situation, the lack of monitoring was the primary issue, so I would be insisting on cfm. It's a very personal thing.

Good luck x

(I know you said there is no counselling available - you can seek support through the Birth trauma association etc) I managed to get counselling through uni, but some employers offer some services through affiliated organizations etc.

Thank you everyone for replying, sarahmia I am so sorry for your loss

I have tried to access targeted therapy for us, but there is nothing, I do have some support through my employer and we have also been to relate but we need more constructive targeted healing therapy. The mental health team (Uk) have assessed me and said I do need support but until I have a breakdown I will not get help as there simply are not enough services to go round. We do now have access to a specialist health visitor and she is trying her very best to get us support for as and when we try for another (realistically next summer) but I need some reassurance I will be able to access support before we try for another. I do not wish to go for a debrief as I have enough recollection of the events and I know that they should have sectioned immediately on arrival at the unit but did not do so, we have that as a given by the team that look after DD.

Re the doula vs independent midwife I have considered both but I think it will come down to cost and I am not sure how much they cost. I am not based near oxford sadly backinthebox otherwise your midwife sounds perfect. madwomanintheattic I do realise I might fall apart in the future, for me the whole cascade of intervention is a real concern and in fact if i had the guts I would go for a birth centre option but I am now considered high risk, maybe for #3 if #2 is ok.

backinthebox re the MW talking to your husband I do want somewhere for him as much as for me, he saw the nicu crash cart appear at the end of my labour and never told me until six months later, the midwives in the unit knew DD was in severe trouble and hit the alarm but she stunned them by breathing at birth. Quite why they then didn't put her under monitoring I will never know.

EyesDoMoreThanSee, most IMs cost around the £3000 mark. Even if you go the way of a doula, and are not in her area, the Purple Walnut lady may well be able to give you the details of a reputable doula near you. Something to keep in mind perhaps.

Hi,

I am sorry for everything you have been through, it must be incredibly hard some days - I was just wondering if you could access support from a clinical psychologist via paediatric services? I (when not on may leave) work at a children's hospital and many of the families I see we offer support to. Your local paediatric services may not have much to offer but its worth asking the paediatrician of there's a paediatric psychologist AND see if you can access your regional paed hosp and neurology services - or even a national specialist centre. IME you need to badger people to get referrals and then badger away some more to get up the waiting list. More specialist centres have psychology and clinical nurse specialists who could offer you some support re all you have been through.

Sending you best wishes.

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