Tell me about your birth debrief, if you had one

[Thurlow]

I've got one next week, and I just wondered what they're actually like. Is there any discussion of how future births might go, or how your first birth might affect later births? Or did they just go through your notes minute by minute? Did you go in with any specific questions to ask, or did you just go with the flow?

I had a crappy labour - long, emcs and baby in NICU for an unspecified infection - but not traumatic. It's less that I have questions about how my labour went, and more than I have some real questions about the hospital's management of certain aspects.

My birth debrief was going through the notes with a midwife who explained as much as possible as to why things happened the way they did. The only thing she couldn't tell me was why they didn't top up my epidural when I was in agony and needed it (forceps, 4th degree tear, shoulder dystocia and I felt everything). However, it was very helpful to go through it.

She also answered all the questions we had (which weren't many). She wasn't able to tell me anything about future births as she said its best to speak to the midwife/team/consultant when or if we actually had any more.

My advice would be to write down your list of questions, anything they cant answer then and there ask them to take it away and find someone who can answer it and come back to you. Good luck.

Well mine was just a festival of denial and my 'perception' obviously due to the drugs.

Oh. Sorry starlight I'm a little worried about that too. I made a complain after the birth, and the letter back from the Trust brushed a lot of things under the carpet. Which is one of the reasons why I wanted a debrief.

Thanks craving. It's interesting that they can't/won't talk about future births. It's a little bit of a catch-22, really. I want reassurance that I've got a good chance of getting a elcs next time around, and that is genuinely factoring in to my decisions on TTC DC2. But obviously some decisions can't be made until you're pregnant.

Definitely ask about future births and what would be done differently to ensure you get better care or an elcs. Tell them that what happened this time is genuinely influencing your decision to extend your family in the future. Document it everywhere you can.

My DS was born not long before the guidelines changed but I think a lot of the reason they wouldn't speak about it was due to me having my debrief when my DS was about 3 months old and it was still such early days IFKWIM. I physically had problems with the birth which meant I needed to see a gynae consultant and that hadn't happened before the debrief.

What may be helpful is for you to speak to your own GP about it. I have seen my GP numerous times in the last 18 months due to the physical and mental issues I've had and she has said that she would back me up if needed (its not) for requesting an elcs next time.

At my debrief, I was told that I had an unrealistic view of childbirth. It would seem that being denied pain relief, being held down by two midwives for an unwanted episiotomy and told to shut up and concentrate on my baby whilst I had a third degree tear stitched up (without pain relief) was to be expected.

I have had a lot of counselling after the birth of my son. My DH recommended it after I dreamt about getting my revenge.

I would take notes and challenge any negative comment made to you.

mine was ten years ago. A very nice, senior midwife came to the house with my notes and frankly I didn't envy her. (at the time dh and I were both nurses working for the same trust.) Notes were a mess, traces not calibrated or properly labelled and boy did we have some bad practice to challenge.
She listened, apologised, took notes and fed back to the antenatal ward we were complaining about. Turned out the offending midwife had attracted other complaints including those from her colleagues and had resigned when disciplinary proceedings were started.
I was offered a lot of extra support during my next pregnancy which was very useful.

Peppermint, that's shocking. I'm not surprised you dreamt of getting your revenge.

I'm waiting to see if they can manage to talk to me about why my DD was ill. No one was able to explain at the time. I've told them beforehand that I want to talk about it, but I bet they won't have the right notes. Everything for me rests upon how I was left unmonitored for hours as my baby got sicker and sicker. Might have been a complete fluke, but if they want me to trust them with any DC2, I want to trust that it was nothing they could have done differently.

It's very odd that your thread should come up, as I was just thinking about my birth de-brief today (after 12 years). I hardly ever think about it nowadays.

In retrospect my birth de-brief wasn't great and didn't answer all my questions but, frankly, we were grateful for any kind of discussion about it at the time.

Our problem, in the main, was that neither of us were present at the birth of our dd and we just wanted to speak to someone who had witnessed her birth and could tell us about it. The de-brief was given by the hospital obs/gyn Consultant, who wasn't present at the birth, and was presumably on a sort of damage limitation mission.

But in the end we put all our energy into caring for our newborn (as the vast majority of parents do) and it takes a particular kind of person who can put together a complaint when simultaneously dealing with the newborn weeks and a form of ptsd.

The trace of my dd's heart was ruined by "a cup of water being spilled over it" . How odd. I wonder how often that happens and I further wonder how often it happens in a child who needs to be delivered by crash c/s?

A cup of water? That's just plain odd!

I remember sitting and typing the complain when DD was 3 weeks old. I'm a stewer. I'd stewed for 3 weeks and needed to get it out. Ironically, if I'd left it any longer I don't think I would have complained!

I found mine useful. I'd had a ventouse delivery through a dense haze of pethidine and I think all I really wanted was some way to turn the jumble in my head into some semblance of order, which I got. I also got some reassurance that I had no real reason to think it would happen again, which I also needed.

If I had had specific concerns about my care I'm not sure it would have really been the right forum, I might have thought about asking for a more formal meeting, possibly.

It was really productive. I had it 12 months after DS's emergency section.

The midwife went through the notes bit by bit, gave me a few extra details that I wasn't sure about, said I should never attempt another natural birth and have a section next time (I'd already decided that bit anyway!) and then she ranted about the dire post-cs 'care'. I came away feeing like a weight had been lifted off my shoulders. For the previous 12 months I'd assumed I was shit as I found it so hard when he was a newborn, but as I learnt the post-natal care was so lacking I was already stuffed even before we arrived home.

Mine was a bit of a mixed bag. The MW was very patient and spent 2 hours with us. It helped that I got a copy of my notes in advance and had read them and googled things I didn't understand. She explained why they went for forceps in reference to the monitor traces as we had been to NCT classes which implied that intervention is used when you go over time limits rather than because of clinical signs and as DD was born with an APGAR of 9 I was a bit dubious about the need to rush her out (obviously I am grateful that she was fine and accept that the traces show signs of distress).

However the elements of shit care that I got were basically put down to "perception" and she effectively apologised for them giving the impression of being a bit incompetant but denied that they gave substandard care in any way. I suppose this is reasonable as she wasn't there and can't open them up to legal challenge. At one point during my care the MW looking after me basically said that the registrar had made a mess of my stitching and afterwards the whole lot got infected and unravelled. The debrief MW just said that she shouldn't have said that, which just seems like arse covering to me, I still think that I may have had a reasonable recovery if the registrar had made better decisions or was better at sewing.

The post natal care was also poor - I had to piece together what care I should have had by eavesdropping on other mothers and then demanding what they had in terms of pain relief and tests for anaemia after having a blood transfusion. But apparently this wasn't really the case and just my perception.

The MW also said that she thought I would be fine to have another VB. There is no way I would ever do that again and I really wish that MWs wouldn't glibly trot out the "you'll be fine" line to women who would rather choose not to have another child than risk a repeat of the kind of experience I had. They never see the women who are too scared to have another as those women don't end up under their care again.

So - in summary - debrief was useful to get an explanation of some of the things that happened, not at all useful if you expect them to say, "fair point, we cocked up" or "yes we were too busy to give you the standard of care we would have liked" or even "we will learn from your experience and this is who I am going to talk to and what I am going to say to ensure that other mothers have a better experience" (this is what I would really have liked them to say).

Thanks everyone for sharing, especially where you have had a difficult birth.

I've probably given the impression that I want the mw to explain substandard care etc., but I don't - like others, I need someone to go through what happened so I can decide if I do, maybe, want to talk to someone else about it. It depends on what they say. I can cope with poor levels of care for me, but I think I will escalate if they caused DD to be ill.

And breath - YYY to your comments on women too scared to try again. There must be so many of them, who don't feel they need medical help for trauma but also know they will never do it again - no one knows about them.

Thanks for sharing, miaow. I can understand how you feel. I'm hoping that they won't do any fobbing off, though of course there is a possibility that they will. Hopefully they did pass a message on and someone learned some lessons.

Can I just ask, is it routine to be offered a debrief or did you ask for one? I had DS by crash c section 12 months ago & was spoken to briefly by the obstetrician for 5 mins whilst in recovery room off my head on morphine. That was it.

I rung religiously every other day for almost 8 weeks before anyone even rung me back with an appointment. Which was almost 12 weeks after the birth and with a midwife is never even met before.

They went through my green notes (ante natal) yellow (labour and birth) and purple (post natal) notes in every little detail. Because I was on a monitor and had the trace they were able to Marry that up with the yellow notes and explain stuff. They were able to tell me what happened in theatre (I had a ga) and if I hadnt had had a emcs that dd WOULD have got out. I was told if I was to be pregnant again I'd be able to go for a vbac or a elcs up to me

What they couldn't answer we're my really important to me questions. Ie could my situation be prevented in the future? (they don't know) why wasn't dd brought out for dh to see? (don't know) why was dh brought to recovery FOUR times and turned away (don't know)

Very frustrating. It let me draw a line under the whole situation but hasn't made me feel any more confident about having another

Where I live it isn't procedure to get a debrief. U have to nag n nag n nag like I did

Ah ok. I've thought of so many questions since that I'd like answering. I guess I will prob be consultant led if I have another so would have to ask them then.

Mine was quite easy to arrange, though it has taken about 3 months to get an appointment - but I just emailed PALS and asked how I got one, and then the midwives' PA got in touch. But I only knew it was available because a friend of mine hand one, and because of people mentioning it on MN.

The only person I know who was actually offered one had a shocking birth, she thinks they were trying to cover themselves!

I had to really push to get a debrief and only got it after 6 emails, daily calls and a letter from my HV to back me up. When we got there (4 months later) is was a waste of time. We saw a consultant that we hadn't seen before and could answer none of our questions without a wooly, non- committal answer. My best advice would be to go prepared and stand your ground - hope it goes well for you

I had two, one with consultant, very straight forward, balanced.
second with head MW very sort of brain washing really, coming at it from a totally different perspective.

Clementine - mine was the same.

Midwife was almost competitively unhelpful, banging the natural birth drum that I had so believed in but that ultimately hasn't helped a jot in my delivery. Rather than look at my birth and delivery she regaled me with stories of women who had sneezed out 11lb babies without a scratch. Fucking unhelpful when you are actively nursing a chainsawed undercarriage.

The doctor, however, had personally gone through a similar birth to my own and was extremely supportive, explaining that I would need to get checked out before my next pregnancy to check I had healed properly. And that my next pregnancy is likely to be closely monitored to see if there was any reason why I produced such an enormous child.

So a mixed bag.