Is this an acceptable labour/birth?

[GoldPlatedNineDoors]

Dilated from 3cm to 9cm in the space of an hour.
No epidural given as was at 9cm.
Once pushing, pushed for three hours without a MW being constantly at the business end.
Only G&A pain relief offered.
Local given for episiotemy.
Forceps used.
Pushed the placenta out.

Tbh I think it seems ok. 3 hours pushing seems excessive but not unheard of ...
Dilated - yeh I also did that quick.
No epidural at 9cm - yes, too late for one then
push 3 hours - ?? not unheard of though
mw not being constantly at business end - ok so long as she was there overseeing you properly
G&A - prob only thing offered due to being fully dilated
local for epis - yeh, I had that
forceps - yep common
placenta - yes

Do you think the birth was unacceptable?

Sounds very similar

Dilated 2-10cm in 90 mins
No epidural
Pushed 2.5 hours with midwife running between 2 of us
Gas and air
Episiotomy, god knows if local given, was passed caring!
Second degree tear (again!)
Pushed pacenta out

One healthy baby, thats all that mattered to me.

Do you feel unhappy with the care you recieved. Do you feel trauatised by the use of forceps? Do you feel you need support to come to terms with your birth experience?

I think what is an acceptable birth is subjective. There is little point in judging anyone else's birth experience.

It is my friends labour. She isnt traumatised by it but said it was horrific and I was shocked at how long she pushed for. Three hours??

I cant remember delivering my placenta, but didnt push it out.

Im not judging, just worried for her that it will stay with her.

where you attended well? did the midwife support you and try different things during that 3 hours of pushing? were you informed and your consent gained as these things happened? how do you feel about it?

x-posts..

My first 2 placentas came out by themselves, my last 2 I had to push out and was quite shocked that I had to push them out! I just assumed they came out themselves as my first 2 had!
With my 4th labour I went from 0 to fully dilated in 10 minutes!!
The most I ever pushed for was 15 minutes so I think I've been very very lucky!
It probably will stay with her but I think in time she'll regard it as less horrific. Also, she could mean horrific in different ways - not necessarily how you see horrific iykwim ..

This is interesting because for me, pushing the placenta out was the one part of my birth experience that somehow came as an unpleasant surprise. I mean, I knew it wouldn't exactly just fall out but I didn't expect it to be so hard. I suppose there just didn't seem to be any payoff compared to pushing the baby out :) And to be honest, if I had been pushing for 3 hours before that point, it would probably have felt even worse - as it was, I was exhausted and resented having to do it when i just wanted to hold my baby at that point.

On the other hand, I also didn't want either the injection or any tugging going on, so in reality it was the best way for my in the circumstances.

I hope your friend feels better soon. Has she written down her full birth story herself anywhere? Might be helpful.

On paper (or on screen!) that birth seems perfectly acceptable, albeit pushing for 3 hours is quite a long time.

I think what your question does though, is highlight that no matter what happens during childbirth, the primary factor for a healthy psychological outcome, is how the mum FEELS about what happened.

I wonder if your friend can pinpoint what in particular has triggered her bad feelings about her experience? Did she feel unsupported? Scared? Uninformed? Uncared for?

I'm sensing perhaps she did, since you mention in particular, the point that a MW did not attend the "business end" 100% of the time during pushing.

Feeling scared, due to lack of support; and feeling mistrustful of caregivers during labour, no matter how straight forward things were otherwise, would absolutely cause a mother to worry about what happened during her birth.

It sounds almost the same as my first birth.
Dilated 3cm to 10cm in 30mins, no epidural as was too late, pushing for 2.5 hours, only gas and air offered (and that taken off me as I couldn't concentrate on pushing) local given for episiotomy and ventouse used, then pushed placenta out. I thought it was a totally fine birth, in fact am quite happy about the way it went.

It is possible to have a very medicalised birth and the mother come out mentally unscathed PROVIDED she has good emotional support. If a woman understands what is happening, has some sense of control and is respected by her carers it makes a huge difference.

There are women who had very "normal" births who have post traumatic stress inspite of no obvious complications. Sadly many women feel a strong sense of shame that they have these feelings when on paper they got off very lightly compared to some traumatic births. Some women judge themselves very harshly.

I think that the natural birth brigade has a lot to answer for. I believe that the best ante natal teachers encourage women to have an open mind when approaching childbirth. There is no shame in having an epidural, or forceps or c-section or any other medical intervention. Having a "natural" birth or breastfeeding does not make someone a superior being.

I'm not sure what your question is - acceptable in what way? Are you concerned at the level of care she was given?

I had a three hour labour but it was the other way round - 2 1/2 hours from 0-10 and then half an hour of pushing because baby had turned OP.

I was only offered G&A as I was at home, I didn't use it. No forceps, managed 3rd stage due to PPH.

I did have a midwife there for the latter part of it.

ReallyTired It really isn't the "natural birth brigade" that is responsible for this. That really isn't the point here, to my mind.

There is a lack of freely available, decent NHS antenatal care and preparation in this country, as well as a lack of continuity of care during labour. It is THIS that creates a climate of fear around birth, and women often end up feeling bad about their experience, regardless of how things went for them.

Women who don't feel cared for, feel scared; and women who are scared during labour often have problems with the way they view their birth experience regardless of how things went.

What women need for more physically and mentally healthy birth outcomes, is dedicated one-to-one care during pregnancy, labour and the post-partum period. It's that simple.

If women feel informed, and included; if they have access to the SAME, familiar midwife (or small group of midwives) throughout their pregnancy and their labour, they feel safer, and that would go a long way towards enabling them to feel good about their birth experience, intervention or not.

Similar to mine except I had 4 hours of pushing, a midwife (and student) with me constantly and no forceps. I was quite happy with my experience despite it being far from what I'd put on my birth plan (hollow laugh at the memory), but that's because I had an excellent midwife who supported me throughout and always listened despite the constraints circumstances put on me.

I felt a lot worse about my first birth, in a hospital, with an epidural and very little pain than I did about my second.

I actually felt like I had cheated, had not experienced it properly, like I wasn't a proper mother...yes, I did feel pressure to experience the pain I suppose.

But I think a lot of this came from the hospital experience - I was treated like I had no feelings, didn't need any information, was just another person on the production line.

I was laughed at by the healthcare assistants, (they said my suitcase was too big) cleaned up very roughly after giving birth, ignored when I was really ill from the drugs, and that included my baby being ignored as well as I couldn't get to him when he cried - and it took hours to get a doctor to help.
Then they wouldnt't let me go home for many hours for some negligible reason.
I was made to feel like a little girl and a stupid one at that. And nobody was around to hear the baby's heartbeat dropping massively, they just hooked me up and buggered off - he could have died if my mum hadn't been there and gone to get help.

It was awful.
Giving birth at home hurt far, far more and was terrifyng and traumatising but in a different way. And I had more of a sense of safety and control because I was at home and people were there to help.

Trauma is unrelated to what happens often. Straightforward, textbook deliveries can be unbelievably traumatic. Long, complicated deliveries can be positive.

If your friend was traumatised, she was traumatised. Has she considered a debrief? The Birth Trauma Association is also excellent.

FWIW, my 2nd stage with dd was 8 hours, though I only actively pushed for 5. Labour all told was 31hrs and it took a lot of counselling and a bit of a breakdown following ptsd and pnd to get over it. DS was a 37hr labour and repeat emcs but the most positive experience in the world.

I dilated that quickly, and yes, no epidural.

With DC1, I pushed for about two hours, with just some gas & air. Hard, but not horrific for me. Midwife swapped in and out of room, seeing other people and coming back to me every so often. Luckily I didn't need forceps, or episiotomy. Though I did have a 2nd degree tear, so needed stitches.

Placenta just slipped out without me really noticing. However, had much more trouble with placenta with DC3 (and midwife had to manually remove it) which I found more disturbing than the actual birth, strangely.

I considered all three of my births to be really good experiences, and was pleased I didn't need/have epidurals.

If it offers your friend any comfort, I dilated just as quickly with DC2, but my two hours pushing went down to just 7 minutes the second time round! The midwife only just made it into the room for the head appearing, apparently.

Was it the lack of pain relief that your friend struggled with? I can understand that being upsetting if she had planned on having it. I would recommend her having a doula (see Doula UK website) next time if she wants someone constantly with her. I had one and she was brilliant.

Sounds normal to me. What were you expecting it to be like?

I agree with those who have said that it is about how the woman feels herself. Regardless of what others think or what they have experienced.

Does she feel that she was a bit abandoned as the MW wasn't more closely monitoring during pushing? Is that why she thinks it took three hours. It does sound very exhausting to be doing that for so long.

If it feels wrong for her, then it probably was IMO. Not to say that it could have been done differently (no idea) but I think that just because some people have gone through worse doesn't mean that she can't feel unhappy at how things weren't right for her.

That being said, I also believe that while acknowledging that, there is a need to move on. Get past the negative experience and enjoy the new baby.

Just read Badgerina's post above - excellent post. I think that for me, having a doula there at my births gave me that sense of being supported (having DH there too, obviously but the doula gave a sense of confidence because I knew she'd done this many times, whereas DH, like me, hadn't). Because I felt in control the whole time, I felt good about the births.

Oh, and midwives just can't be there constantly with current staffing levels. With DC2's birth there were 2 midwives on duty and a full delivery ward, with several emergency CSs going on - I got very little attention because others needed it more. Not the MWs fault.

"I felt a lot worse about my first birth, in a hospital, with an epidural and very little pain than I did about my second.

I actually felt like I had cheated, had not experienced it properly, like I wasn't a proper mother...yes, I did feel pressure to experience the pain I suppose."

Why do some women feel like the cheated because they had an epidural? Frankly its ridicolous. Certainly I felt judged by my NCT class for having an epidural with a 5lb baby. (After 28 hours I was so tired and I think the epidural was the best decision in the world!)

The NCT have pushed very strongly an agenda of natural birth rather than supporting women having a choice. It is OK not to want whale music or to to feel pain. There should be no shame in the medicalised route and epidurals should be on demand.

Yes, but saying it's ridiculous doesn't make me feel any better.

I still don't know why I felt guilty about it and he is 9 now.

It is probably something to do with my own sense of inadequacy rather than any pressure that came from other people.

I think though in hindsight, some people did say, Oh you lucky thing, it sounds really easy' and stuff like that.

Which was very unhelpful. I felt like saying, do you want me to do it again?

Why do some women feel like the cheated because they had an epidural? Frankly its ridicolous.

It's not ridiculous. You're talking about someone's feelings.

No one can MAKE you feel a certain way. No one has that amount of mind control over you, certainly not the NCT, whose MO is to promote "healthy birth", not necessarily "natural birth".

Your emotions are your own, and are lead by the way YOU think. If you feel like you cheated, then that is sad. It's likely you NEEDED that epidural, and if you chose it because you wanted it, then more power to you!

A birth debrief might help you to adjust the way you view your choice to have an epidural. That in turn, might lead you to feel more positive about your choice.