What went "wrong" with my childbirth...?

[bt98]

I have a 17 month old son and am still getting my mind around the whole birth experience. I knew it wouldnt be a walk in the park but I was not expecting psychological trauma either. When I try to talk about it with my partner, he clams up, saying it's too horrible to think about, watching me suffer and seeing all the blood and guts on the floor (his words), he just leaves the room if I talk about it.

I really need to deal with this if I am every going to have another baby. Some of the questions I have which remain unanswered are things like...

• Why didn't my epidural work? After a brief period of relief I could once again feel all the contractions in my front and back after getting the maximum dose. I could move around on my legs and still needed gas and air all the way through labour. The anesthetist was too busy to replace it on the night. I expected this to be my lifeline for getting through labour but it failed me. Is it something that I did wrong or might easily happen again?

• Why did the midwife take away the gas and air at the crucial pushing stage, when the pain was worse and I was most scared? I remember arguing with her, she just refused and later another midwife said she would have let me have it, so is this really a judgment call and should you have to argue in the midst of labour for desperately needed pain relief? So much for freedom of choice and having a birth plan when they spring these changes on you at the worst moment.

• Why didn't they take pre-emptive action when they knew all along my baby was posterior and it being my first birth it would be that much harder?

• In the end I had maternal exhaustion and couldnt push at all. I had an episiotomy and forceps delivery, I hemorrhaged > 700mls, and there was concern over placenta remaining inside. Is this normal and is it likely to happen again? My haemoglobin was 88 after the birth and I was very fatigued, tearful and depressed for weeks afterwards, though this might be a normal effect of all the sleep deprivation?

I had a debrief after the birth with a midwife but all these questions led to vague inconclusive answers. I feel bad about my birth experience even all this time later, it was not what I had hoped for, and my partner says the only reason I could possibly contemplate doing it again is I have blocked out the worst bits and was too high on the gas to remember. Is he right?

I pretty much feel that the birth was the start of a psychological roller coaster ride that I am still on 17 months later, I have not felt sane for a day since, having a baby has changed me so much.

Thanks for reading x

I had a traumatic labour with ds1. It ended with a 3rd degree tear which was stiched in theatre, after being told that an epidural wasn't available as they were too busy.

It took me 18 months to stop feeling sick any time I drove by the hospital. The smell of newborn babies actually made me gag.

When I fell pregnant with DS2, I just sobbed at my booking in appointment, and was referred straight to the consultant.

He went through my notes with me, explained exactly what had gone wrong (he was quite pissed off actually, because he said I'd been very miss - managed).

Then he wrote my birth plan! In red ink!

It was followed to the letter, and I had a wonderful labour and delivery.

I think you need to speak to a professional about this, to see what actually went wrong, and what was just part of the labour. In my case, ds had such a wide head, he was actually stuck - one of those things. But denying me an epidural, and the trying to ger me to push on a birthing stool was just stupid!

Chunderalla Interesting about the NHS, I was overseas when I gave birth. The main anesthetist was busy in c-sections all night and the backup was called in from home, although it still took a few hours. I'm unsure of her experience but she seemed to know what she was doing. I am most keen to know if there is something about my physiology (as one poster mentioned) which means failed epidurals are a higher risk for me... in which case I should really go for a different method of pain relief next time.

I second the recommendation of a doula! It was the best thing I did, people asked why I'd bother as a doula but it's different when it's yourself and I couldn't be there to support my OH.

It sounds like the positioning was the first problem - was you induced by any chance? Were you suggested to change positions?

No reason to have the G&A removed and with a posterior baby you would have been in more pain than normal.

No way to know what happened with the epidural, you could ask for an appointment with an anaesthetist to discuss it. I saw one and they found that my back isn't suitable for one so I had to deal with labour on just G&A, which isn't too bad really. You could also ask for an appointment with a Supervisor of Midwives (you can just call triage and ask to be put through to one) even though it's a different hospital they can still go through everything and explain it all.

The bleeding etc is probably all connected to the position and episiotomy. They probably gave you the injection in your thigh which can increase the risk of retained placenta and they would have had to be working pretty quickly to get everything sorted. I don't think it is an issue you need to worry about for future.

For future, look into all the options, seriously consider a doula! Get yourself reading spinning babies website, train your OH up to know your options. See an anaesthetist and SoM whilst pregnant.

You can do it, honestly! My eldest daughter's birth left me with PTSD and an upside down T shaped scar, they insisted I had a CS the next time as it's a very high risk scar but when I got a doula I pushed for a VBAC and I had a second. The biggest issue to get past is the psychological scars, I would not have been able to have a VBAC first time if I had pushed for one as I wasn't in the right place.

I am definitely going to get a doula next time :)

I will try to get a medical debrief before I even get pregnant again, I think that's important as I want to enjoy the experience from the start not dread it.

Gas and air is wonderful (when it kicks in) and in my experience it did way more than the epidural. Which I know is not normal...

They actually turned the little guy's head with a suction cup just before pulling him out with forceps. (He was LOP if I remember right, having been ROP for the last couple of months of pregnancy?) Until then I was laying on my back or side, with the head of the bed raised. I did also insist on pushing on my hands and knees on the bed as I heard this reduced the risk of tearing, but I just got too hot and in too much pain without the gas to concentrate. That's when they said you have you push him out, or face forceps. To which I yelled: GET THE FORCEPS! I think I was just relieved to have a choice at that point, other than all the pain and no progression.

I have checked the Spinning Babies website and it's starting to become clearer now, my position did nothing to help him rotate. The difficult thing is, I trusted both the midwifes, I know they were experienced, I think they are lovely ladies who supported me before, during and after my birth. And yet they seem to have made some poor choices on my behalf. That plus the failed epidural led to a horrible first birth experience. I dont want to blame anyone I just want to avoid it happening again.

Thank you for your continued answers, this has helped me a lot.

If you don't mind me asking, be rough if you like, what area are you? I can see if there is someone who would specialise, I know if you were local to me my doula would be good (says a lot I'm not saying me, eh )

Sadly a lot of midwives (and I won't say all because some are fantastic) are not up with all the knowledge, especially for things like spinning babies. You also get some like the awful quote that I saw on Facebook that think they are the ones delivering the babies and making a woman into a mother so they don't really care what you do it's their job. The ones you had who thought it there place to take the G&A away were making your birth about them.

Even before I trained as a doula I took my own education as very important, I never accepted anything I was told because I was told it, I had to research it all and if they told me it was a given I would make sure it wasn't (my OH used to cringe when they told me things because he knew I'd make sure they were wrong). Unfortunately you don't get to go away and come back with birth but you can educate yourself as much as possible, educate your OH on the important points, write a birth plan (there's a way to do it!) and hire a doula.

I would agree. My doula second time was utterly amazing at suggesting positions and techiques to get Dd2 into position. In my first labour they just wanted me upright, and broke my waters thus jamming Dd1 into the wrong position with far less chance of turning.

Ironically early on I instinctively wanted to get on my hands and knees with my head down but overrode it as I knew I had to be 'upright and mobile'. I now think my body had the right idea and was trying to reposition her by not fighting gravity to do it.

I'm not in the UK either but I certainly had the gas and air taken away at the pushing stage. Well actually they took it from me at the pushing stage from DD1 (and quite rightly so because I was frankly orbitting pluto.....) and with both DD2 (enormous baby long labour various issues) and DS (v. rapid labour 59 minutes all told) they replaced the G&A with oxygen v. quickly 'to help baby'. But a big difference is that (if we ignore DD2's birth and that was rather different) I wasn't in distress and didn't feel ignored (was v. much ignored throughout DD2's birth and the aftermeth though.........)

"I assume the 1 in 8 who complain of incomplete pain relief probably includes the following:

• totally failed epidurals
• partially effective epidurals
• denial of epidural"

No - it just includes the mothers who have an epidural who need other pain relief.

Viking "orbiting Pluto" (love that description!) is not a bad thing!

The neocortex, the thinking brain, is what we have that animals don't. That means that during birth it is the one bit that is totally useless - if it had a use other mammals wouldn't be able to do birth - so you need to be totally out of it, if you are thinking the neocortex is switched on and you are not working from the part of the brain that controls birth.

Yes G&A isn't a natural part of childbirth but if taking it away is going to make you think then that is a bad thing. G&A leaves your system in one or two breaths so if they think you're overdoing it they can say "you're overdoing that, ease up a little" or they can just leave you because if you've overdone it you will pass out, breathe clean air and come back round.

And all of this is why I said in my last post that not all midwives are up to date and feel that they were superhero capes and have to save us from ourselves. A doula's job is to put the cape on mum and dad and fade herself into the background unless there's an issue she really needs to help with.

One woman in 10 'doesn't get the pain relief she wanted' (Quality Care Commission survey 2010)

1 in 8 epidurals leaves the mother in need of other forms of pain relief.

I think there's a bit of unpicking to do with the first statement, but that survey is hard to track down online.

I wish there was a 'like' button for your last post confuddled

Hi Op,

An elc would be a serious consideration for you, as someone else said its the lack of control throughout, is bad enough when Nature itself is going against you let alone your own MW.

Birth plans are a load of crap. Its all lovely giving first timers this little thing they think will help them, a rudder to guide them, when in reality, you have chosen epidural, but your hospital MW who is totally random on the moment you walk in, may have other ideas ( like mine) even if she is willing to get you one, she may be busy...

Birth and labour is un predictable, you say you don't want to load your friends but why hide it if they ask you, warn them its not pretty..I don't like this idea that women are told their bodies can do it, just listen to a whale cd and light a candle and pop it out. Then when it goes wrong, you hold up your birth against this idea you have been sold. We need the truth.

Def talk to some one about it. I had a wonderful ELC second time, which cancelled out five years of flashbacks and trauma from my first labour.

bt98 I noticed that you have said that you didn't have the urge to push. There is a phase in labour called rest and be thankful, it occurs when women get to 10 cm but have no urge to push, it's like a break to prepare you. Not all women get it but it maybe this occurred for you and the HCP around you didn't see it.

minifingers That stat is really interesting I think I would fall into that 10 in 10 because a) I wanted a home birth as part of my pain relief (b) they were not able to fill up the birth pool.

I know birth plans get sort of mixed reviews but I think it depends on what you think they are for and how you use them. For me it gave my partner and I space to discuss and decide which course of action we would take in a massive range of scenarios. I felt confident that whatever happened he would understand what my wishes were and would be able to articulate them to midwives, doctors, surgeons. My birth did not happen as I would have liked it but many many things that were really really important to me did happen.

I had ptsd after birth. Emdr really helped. Wd prob help your husband too.

Bt,
Your labour sounds quite similar to mine, and I'd like to thank you as I had never heard of posterior births before (!) and I realise now that's what mine was. (Back in agony etc throughout). I had no contact with the hospital or midwives etc after the birth so have always tried to make sense of it in my own head.

I believe there is a certain percentage of women who epidurals just 'don't work' for - I am not sure why. The problem with them as well is that they lower your blood pressure so if you already have low blood pressure and they keep topping you up trying to get it to work, your BP will dip very low. Mine read 60/? when I went in to distress and so did baby. This was 24 hours after waters broke and contractions started (I never remember a pushing sensation it was all forced).

I had a (emergency?) forceps delivery with epiosotomy once the Dr was called to the room - I believe baby was at this stage stuck and too far down and a Csection could not be performed but again this is speculation from my own memories!

I left hospital in a wheelchair as I couldn't walk and it was about a month before I felt I could walk properly and not like a wild west cowboy...

I did dwell on our birth story for a couple of years afterwards but then started to focus on the 'thank god we are alright' and now I just feel blessed as at one stage it just all felt so close to the edge and scary. I guess I'd just encourage you to think that your next birthing experience will be better.

confuddledDOTcom I think a well trained doula would make such a different next time. I am in the south east - back then I was in NZ, and the midwife was assigned to me when I was about 4 months pregnant, so I knew her fairly well by the birth. On the night however she'd been working 24 hours straight so I got a backup midwife come in, who I had met once before. They both visited me up to 6 weeks after the birth too, along with a very kind student midwife, and they were so supportive although I was usually sobbing every time they came round the house to see me.

After the birth was incredibly tough for me. They insisted my mum come out from the UK to help me as I was close to a PND diagnosis. I had major breastfeeding issues, depression, anemia, mastitis x2, undiagnosed granulated tissue, and my baby was not doing well with feeding. None of them noticed his tongue tie which meant he was completely unable to latch, and he lost so much weight that he fell from the 25th to 2nd percentile in weight under their care. They strongly insisted I keep trying to breastfeed and avoid formula and when I finally made the decision myself to switch to formula after 3 gruelling months and another mastitis, he actually began sleeping, putting on weight, and life just got rapidly better for both of us. He was 50th percentile by the time we left the country. So I suspect there were some technical mistakes and errors in judgment. I know I cant blame all my problems on other people, but I did expect the medical advice to be on target.

Next time, of course, I will know a heck of a lot more in the post-birth area, so I think I will cope better with all of that, fingers crossed. If a doula can help me through the birth better, then having another baby will be quite a different experience I imagine.

WanttobePosyFlump Yes my BP was low throughout pregnancy. They never mentioned foetal distress - perhaps there was none. But I will check my birth notes too see. They told me it was 50/50 whether I'd need an emergency c-section at the end, depending on the forceps. A couple of hours after the birth I got up to use the loo and nearly passed out! I was incredibly shaky and weak and faint and had blood down my legs. No one was there to help me physically, I was left alone while my partner was in shock/tried to sleep.

I too walked like a cowboy for a while! I think that is normal after episiotomy. It felt like cut glass sitting down. After a few months it was still severely aching when I walked more than 10 mins so I saw my GP and she said I had granulated tissue along my scar, the skin had been stitched unevenly, leaving part of the inside bit on the outside (rubbish explanation, sorry). She put silver nitrate all the way up inside which I think effectively cauterised it, it burned and hurt like hell on an already very sore part of my body!! Anyway the reason I say all this because after that healed it felt MUCH better and I could walk, sit on the floor, etc without pain. So if anyone has a similar sore ache afterwards it is worth getting checked out.

I would just like to ask one more question in you experiences - re making noise during labour. I'm just curious. Some people say: dont scream and moan, save your energy or put it into pushing. I still dont understand this. I guess I was around 6cm when I started involuntarily moaning, loooong low moans, and it was like that all through each contraction without the G&A (I was sucking on am empty tank for a while - ha!) There was no choice for me, it surprised me even, so how are you supposed to choose to not moan and put your energies elsewhere?

Bt98 I mooed too, it was completely involuntary and a bit embarrassing as I spent most of my labour on a ward

I mooed, moaned ect. There is a difference between mooing and moaning which are deep and low down and come from deep inside and high pitched scream which is high up and fearful. The deep low sounds are helpful and also should provided good HCP with sings of how far along you are. High pitched screams means the women needs help to address fear and relax/embrace labour.

I came across this yesterday it's a really clear outline of the stages of pushing

MyDarlingClementine - as a doula I have to disagree with your description of birth plans. I had them myself for my third birth, my fourth was at 29 weeks so we were caught out, as we were with my first at 31 weeks and my second we already knew would be a planned crash so not a lot to write in a birth plan. I would always recommend them to mothers, whichever they were up to. The power of a birth plan is in the writing - if you spend pages waffling on about the finer details then it will get flung.

I also disagree the way you talk about a section. There is nothing that would indicate an automatic section unless bt wants one. I can understand it helped you and for many women it does but for some it is not the cure for the past - you don't know which way bt would fall. After one CS that left me with PTSD even the thought of the second one had me shaking and sobbing. My consultant couldn't figure out what was going on when she had me sign the consent forms.

Mooing is totally normal! What they try to discourage is when you expend all your energy through your voice - although there are still some of the "hold your breath and push" school. It's a bit like a tennis player though I always think. Actually, when you think about it there's two types of noises that tennis players make, the normal grunting as they hit the ball and the scream that some (usually female) players do that's totally pointless and gets criticised.