Internals - was mine necessary?

[MurderOfGoths]

I'm worried about derailing another thread, but it's brought up some quite horrible memories of DS's birth. Something I've never actually talked about before, not even with DH.

I was induced 2 weeks early, due to being very ill with hyperemesis, not sure if it's relevant, but thought I'd give you all the facts.

I'd been pushing for 2 hours with no sign of DS and without an epidural (they'd turned it off about an hour before I started pushing) when the doctor gave me an internal, I didn't know it was coming and it hurt a lot, I tried begging her to stop but she didn't. I thought I'd screamed in pain, but DH has told me I never screamed or even raised my voice during labour.

Turns out DS had twisted his head and was stuck, so needed to be delivered by ventouse.

Did she need to do that internal? It's one of the things that upset me the most, and I found the birth really quite upsetting in general (aside from the ventouse, it was nice to feel nothing from the waist down).

I feel quite sick and shaky just thinking about it.

She had no right to examine you, without your consent, or warning.

However medically if she was going to deliver the baby using an instrument, would need to examine you to work out what position baby was in, and where abouts babies head was, so she would be able to work out whether its possible to deliver the baby vaginally, what instrument to use etc. but ultimately, she should have explained this to you at the time, and gained your informed consent prior to just examining you. She should also have stopped when you asked her to.

Thank you, that's helpful to know. Not having any of it explained to me really hasn't helped me. So thank you again.

This is another example of how childbirth is not about the mother but all about the doctors or midwives.

I'm sorry OP that you were treated in this dreadful fashion. There was no need to perform an internal exam on you without your explicit consent. You were assaulted. You must always be giving a choice.

I would even go as far as to suggest that your DS was perfectly positioned and the doctor just wanted to hurry the birth along or practise using the ventouse - I have witnessed this on more than one occasion - especially near the end of a shift.

Once again OP, I'm so sorry you were treated this way.

Glinderella, what are your credentials?

Erm, I'm not sure it is wise to comment on the baby's position, nobody here can possibly know it's position at that point and I'm not sure it's helpful to the OP.

OP that's a horrible experience. No wonder it's on your mind. You can ask for your nets from the labour and a debrief if you think it will help. I hope you are ok.

Notes not nets.

"I would even go as far as to suggest that your DS was perfectly positioned and the doctor just wanted to hurry the birth along or practise using the ventouse"

After two hours of pushing without epidural and with SPD I don't really care about that. I was grateful for the ventouse.

I would go with what was said by a pp - an internal without consent in assault. Not stopping when instructed to do so is assault. All medical procedures require consent. And certainly ofi there was any misunderstanding she should have stopped when asked.

I ended up having a really long labour with DS1 and because things were progressing so slowly, I had a lot of internals done at different intervals throughout. It didn't really occur to me to 'mind' but I ended up with a nasty infection in my uterus after DS's birth and I had to take two courses of strong antibiotics to get rid of it, and I was advised by GP and community mws that the infection was v likely caused by the number of internal exams. I wish someone had told me there was a risk of that because the infection was hard to shake, I ran a high temp and I was always weak and shaking until I got rid of it, not to mention the thrush (caused by antibiotics) that made bf v painful and of course DS ended up getting it in his mouth too.

What I'm trying to say is that I definitely think mws / drs can be a bit casual about giving labouring women internal exams without consulting them or telling them there might be a risk involved, and it can be uncomfortable or even painful as well as quite traumatising.

Ginderella, I have never heard such utter rubbish in my entire life.

LittleMiss I got an awful infection after birth as well.. hmm, never connected the two before.

This is really shabby. I was totally "in the zone" throughout my labour (hardly said a word at any point and have no real recollection of anyone who was there) and even so everyone who was going to do something explained what they were going to do and asked if I was ready even when it was hard for me to reply. I think having the confidence that that will happen is important for being able to get and stay "in the zone" actually. I understand things can be rushed at the end of a long labour/pushing phase but she should at least have told you it was coming. Maybe worth asking for one of those debrief sessions you can get? I think if you feel sick and shaky even thinking about it you haven't been able to process/come to terms with it and need to talk it through with someone. Can you start with DH?

I had terrible HG and SPD by the way (went into hospital to give birth in a wheelchair and STILL throwing up!), so I really sympathise. The labour was the only bit of my entire pregnancy that I have any positive feelings about at all! So I was lucky with that.

kalidasa - Strangely although labour was really tough going, I was just so glad it was over, DS had arrived safely and I was no longer puking all the time that I did have a bit of a hormone high after!

murder - I didn't do a formal hospital debrief after labour but I I'd get to speak to head of midwives a couple of months after about concerns I had and I requested my notes back (DS was born just before they started doing that automatically) and I found between that, chatting to other mums and letting some time pass I started to feel better about things. Might be worth giving the hospital a ring as a starting point? best of luck with it all

The internal might have been necessary, but assaulting you to do so never is.

Hard to tell, but sounds like she did need to do the internal - but it also sounds like she was insensitive - she definitely should have asked / warned you about what was going to happen. Unless it was all quite urgent at that point and she was so worried about the baby she just wanted to get the facts ASAP?

Like I said, without the doctor's story it is hard to tell - but am sorry you felt so violated and you should definitely mention it if it is upsetting you so much. I hope your baby is perfectly healthy now?

Past a certain number of weeks (is it 24?) the birth isn't all about the mother, its about the baby too. Obviously any intrusive measures should be properly explained to the mother, but equally these professionals will have been witness to situations where the outcome will have been far more distressing (sorry if that sounds harsh). In the process of labour and any drugs that have been taken, your recollection will be different from the people trying to ensure both mother and baby are happily united at the end of it. These people are not closet sadists, they are just trying to ensure mother and baby are alive and well at the end of it. Op you said your baby's head was twisted and he was therefore stuck and had to be ventoused, the internal exam would have given the doctor the knowledge she needed to perform that proceedure effectively. Whilst it was distressing it was done in an attempt to protect you and your child. Childbirth is dangerous. If your child was in distress and danger now and the quickest and therefore least risky way of ensuring his well being was that kind of examination I am sure you would agree with no hesitation.

Thing is notany, regardless of good intentions, an examination without consent is assault. Regardless whether the OP would have agreed if given the chance, not asking and going ahead is assault. There is no evidence in what the OP said that stopping for 30 seconds to explain what was going on and to try and ensure that the OP wasn't in too much pain would in any way have compromised the baby.

Also, regardless of whether it it medically indicated, regardless whether it is vital, any woman in labour has the right to refuse medical treatment. And that includes internals. Not saying it would have been a good idea to do so, but she remains an autonomous human being with rights.

"In the process of labour and any drugs that have been taken, your recollection will be different from the people trying to ensure both mother and baby are happily united at the end of it"

I wasn't imagining it if that's what you are asking.

Grindecella, you think the baby was perfectly positioned, really? After two hours of pushing? And a qualified Dr saying otherwise?

OP, yes it's important to do an internal to work out if there is a malposition, but they should have stopped when you told them to, should have explained what they were doing better.

And if you feel up to complaining then please do. You can just write a letter detailing your experiences to the head of midwifery. Say that you would like all staff to be reminded of the importance of stopping when told/asked to.

Sadly the Dr is likely to be leaving the hospital in the next fortnight as everyone moves in August so the complaint might not reach him. But really the midwife there should have been your advocate.....I've seen a dr ignore a woman before and I immediately also told him to stop. Which he did.

Sounds like the examination was completely necessary.

Are you quite sure you weren't asked/told about it before it happened? Does your husband confirm that?

I don't believe you imagined any of it but you do say you thought you had screamed out but your husband says you didn't so perhaps your memories are not quite the same as what actually happened.
I know that my recollections of my labour are different to what my (undrugged) husband tells me happened!

You should have been asked and I would request a debrief to put your mind at rest and give your views.

"Are you quite sure you weren't asked/told about it before it happened? Does your husband confirm that? "

Yes and yes.

The reason I thought I wrongly thought I yelled was because my throat was dry and I wasn't making as much noise as I was trying to make.

I wasn't drugged either. The epidural had been turned off an hour before I started pushing (so it had been 3 hours since I'd had it) and I hadn't had anything else.

If you're sure then you definitely need to have debrief.
I wasn't disbelieving you! Honest!
The OP gave the impression that your recollections of the birth were different to your husbands. I didn't mean to upset you.
It was badly handled but I hope that knowing that it was best for your baby will help you deal with it.