stressed at the prospect of going to hospital (vbac related)

[BettyFriedansLoveChild]

Had DC1 two years ago, long drawn-out induction of several days, finally ending in a c-section. It wasn't 'traumatic' as such, given that my or my baby's life was never at any point in danger, but it was a deeply unpleasant experience that has left me nervous about going into hospital a second time. (Got bullied into the induction, continually monitored and told to stop moving every time I tried to change position, put on a synoctin drip, head midwife, consultant and anaesthetist all came into the room together and told me I 'had' to have an epidural so that they could up the dose on the drip. Ended up with epidural, drip, catheter, monitoring on the baby, monitoring on me, completely unable to move for the best part of 24hrs. I'm quite a sporty, physical person and this was my idea of absolute hell.)

I'm hoping to have a vbac for DC2, due in a few months. I had a consultant appointment a few weeks ago, which went badly (I tried to negotiate for intermittent monitoring; he told me that it would be constant monitoring. End of). Now every time I think about going in to hospital I can feel adrenaline surging through me to the point where I have to start doing deep breathing exercises to calm down. I'm worried that when I go into hospital, I'm going to be so stressed and worried about what they are going to do to me that labour will slow down and I'll end up with another section.

We've tried to think up several ways round this, but had to reject a few options due to logistics / cost. Eg:

Home-birth - ruled out because community midwives won't attend, and we can't afford an independent one. Have also been told that I can't attend the very nice birth centre at the hospital.

Doula - would have to be a trainee for cost reasons, but neither DP or I are really 'people' people, and I would feel odd having a stranger present at the birth.

Handheld monitoring - they don't have handheld monitors at the hospital, so we are thinking of buying one ourselves - has anyone successfully done this?

Hypobirthing - although as I understand this, this is more beneficial for people who are scared of giving birth rather than scared of hospitals per se.

Has anyone else been in this position and managed to come to a satisfactory solution?

I tried to negotiate for intermittent monitoring; he told me that it would be constant monitoring. End of

He can't do this. You have the right to refuse.

I would complain to your midwife supervisor stressing that this is causing you distress now and that you are being bullying into something you are not comfortable with.

Exactly what RedToothBrush said! It is your body and your baby, they cannot do anything without your consent. I would complain loudly to the supervisor of midwives about the way you've been treated so far

If you want a homebirth you are "allowed" one, they may advise against it but if you decide to go ahead they have a legal obligation to send a midwife.

I had a consultant appointment this week about VBAC too. I was told that I needed constantly monitored but they were 'telemetry' style - something like radio transmitter. So while it's always on, I can be very mobile and even use a pool. I was pleasantly surprised by this because I had imagined constant monitoring to mean 'strapped to a bed'. Is this why you don't want constant monitoring? If so, worth checking out?

Hi redtoothbrush, CantUnderstand and the borrower, thanks for responding.

I know that I have the right to refuse (although theory and practice are very different, and its very hard to be assertive when you haven't slept for several days, are in pain, and are faced with three medical professionals telling you what to do). This is the source of the stress - I'll be going into hospital in a combative mode, expecting to have a fight on my hands.

I don't really want a home birth, but am feeling pushed into an unassisted one at the moment. The question of whether they are legally obliged to send a midwife seems like a bit of a grey area, and I don't think that there is a guarantee that one would actually show up (in London, all hospitals desperately short staffed, so what do they do if there is literally no-one that can be released from the labour ward to attend me?)

borrower - yes, I'm worried about being strapped to a bed like last time. My hospital doesn't have hand-held monitors (I'm not sure why, since they don't seem like a particularly expensive piece of equipment).

I think that my next course of action is going to be to make an appointment with the supervisor of midwives and see if she comes up with a different approach to the consultant.

Change hospital? If you're in London presumably there's more than one in reasonable distance & they might have portable monitors?

My situation is very different, but is anxiety related. The consultant midwife I have seen has pretty much said, to keep discussing things with them, and they will be willing to bend the normal rules on certain things because "the last thing they want is for me to be so distressed and afraid that I will attempt to do it unassisted". I've never at any point suggested to them that I would, though I will admit it has entered my head, but this midwife is a specialist in anxiety so has clearly seen it all before. I really hope you see someone who realises this and can help you.

It might be worth consider trying the following tact - You need to feel more in control and that you feel bullied down a route you feel you do not consent to freely and that you are under duress to do so. You might also mention you are now considering a homebirth as a result (do not mention how you feel about going unassisted). Not necessarily say you want one, but say you are considering, because you have lost trust in the hospital staff to listen to you.

If you are careful about how you word it, and point out how you feel under pressure to do what they say, you might be surprised at how much they will do to accommodate you. The trick is to try and get them to make some sort of official record of how you feel and how much pressure you are under - they do not want to put themselves in a situation where you later come back and say, I raised this before I gave birth and I was ignored and was forced into x, y or z. Use the words, "bullied", "duress", "not respecting how you feel", "not being listened to".

Ultimately, what they want, is for you to be in hospital rather than home and ultimately they don't want a potential lawsuit on their hands. They might not want you to refuse to have monitoring, but they would rather compromise at some point which suits them, than have a bigger mess on their hands.

Consent is a massive issue, so make it crystal clear NOW that this is not what you consent to, because now you have the presence of mind and time to construct your argument and articulate how you feel. Right now YOU are in control and YOU can set the scene for when the drama starts. Whether you believe that or not. Do your assertive and fighting stuff whilst you feel most able.

I would recommend writing it down before you go, and using that as you will feel more confident about what you say, and why this is a problem for you and you are less likely for your mind to go blank under pressure. (Also if you write a copy for them, hopefully since its the basis of an appointment and what you discussed they will stick it in your notes, and there its there in black and white )

I'd also look up information about VBACs and find out whether constant monitoring is standard throughout the country. (I rather suspect it isn't). Arm yourself with information about VBACs and monitoring. My suspicion is that it is a hospital by hospital policy and that this consultant is a box ticking, jobsworth monkey but I'm not 100% on that, and I don't know if you have any other medical conditions which is why he says you have no option.

I really hope it works out and you find someone sympathetic who is willing to listen to you.

Hi Betty.So sorry to hear you had a bad experience last time and that its affecting how you're feeling this time.
I echo what others have said re meeting up with the supervisor of midwives. She isn't just there to receive comlaints, hopefully she will be able to answer all your questions, explain the reasoning behind some of the decisions the consultant has made and generally reassure you too.
Continuous monitoring is favoured by doctors in a vbac as they feel it will give them early indication of scar rupture and unfortunately intermittent hand held monitoring which is generally performed every 15 mins in the 1st stage of labour may miss this.
But there is a compromise.
I am fairly certain your hospital will have fetal scalp electrodes for their monitors.
These can be attached directly to your babies head (once your waters have broken) during a vaginal examination and record the heart beat that way. They have a long lead attached, and because the contact is constant you will be able to move around, change position, stand, sit on a birthing ball, within a few feet of the monitor.
That way you get some freedom and control and they get their reassurance that baby is ok.
I had this style of monitoring for 2 of my dcs. It was great as i bounced on a ball for hours and the midwife would never have been able to record the heartbeat! It just leaves a small scratch on baby's scalp.
Through it all just remember that its perfectly acceptable for you or your dh to ask these 3 questions about anything they staff want to do.

1. Why is it needed?
2. Will myself or baby be compromised without it?

3.Is there an alternative? I also think hypnobirthing is great for everyone regardless, you dont necessarily need to attend a course as natal hypnotherapy CD's can be purchased at a reasonable price on line. Take care and good luck.

RedToothBrush talks a lot of sense, it is definitely worth fighting now while you are able to instead of worrying about it and hoping they will listen to you during labour.

I also had a horrible time during my first labour and was bullied into things I did not want so I completely understand the fear. What I did second time around was book a homebirth and a doula. I know you said you would feel strange about that but theres a good chance the midwives on the day will be strangers to you so it might not be so different. You can choose how involved you want the doula to be so if you would rather she waited outside and just popped in occasionally you could do that. For me it made a huge difference knowing there was going to be someone there for the sole purpose of standing up for me and making sure I was listened to.

I had a vbac recently and had similar fears to you - though I hadn't had the horrific experience of induction etc as my cs was planned, as dd was breech.
In the end though my fears (and birth plan) were irrelevant - I got to hospital at 8cm and ds arrived within the hour. I hadn't quite intended to leave it that long - my labour didn't match the expected pattern and things moved quickly after my waters went - but by the time I got to hospital I couldn't have cared less where I was. I think they strapped a monitor on but I hardly noticed and not sure how much attention was paid to it - just dimly remember getting tangled in the wires when I turned to sit to hold ds (delivered kneeling over back of bed).
I guess what I'm saying is 1) stay home as long as you feel safe and comfortable, and 2) the monitoring belt will still allow you to get into different positions than on your back.
My vbac didn't exactly go as planned - no birth pool, dimmed lights, music, breathing exercises etc etcetera, just got to a bare brightly lit room, flung my clothes off, shouted and screamed and there he was . But for me that was the best way I think!

I hear you are searching this all out.
I do a birth preparation technique that is about birthing from within, and finding inner answers. I am in edgware if that is near you at all.
you may want to just explore more right now.
I also read about the doula question. For myself I always sort of managed to find a training doula who I clicked with who needed births for experience, if money is an issue. And it can help to have a non hospital voice supporting you in whatever way you need.

Hi OP, your birth story and current situation sound identical to mine, I am seriously considering homebirth due to the fact that I feel the hospital are setting me up to fail. I haven't mentioned my thoughts on homebirth to the hospital yet but given my last labour, weight and a previous PPH I know what reaction I will get, the thought of going in to hospital for my labour with the current attitude of the staff makes me panic to the point it has crossed my mind to have an unassisted or unplanned homebirth but obviously that it silly and dangerous. I really don't know what else to say other than your not alone.

Hi Drowning in Lego, sorry to hear that you are going through the same thing. This week I had a very positive conversation with the Supervisor of Midwives (I got her name off the hospital website and phoned her directly.) She let me put my concerns in writing, and I will be meeting with her next week. She disagreed with a lot of the things that the consultant told me, so `i am feeling much more positive! Perhaps this kind of approach would work for you too? - let me know if you manage to make any progress.

RedToothBrush - your advice upthread was genius. Thank you so much for taking the time to type it out - it was incredibly helpful when composing the email to the supervisor of midwives. I think that you are right about getting everything in writing as an official record.

Thank you to everyone else who replied!

You don't have to be continuously monitored at all, so don't worry.

Also you going told a midwife won't attend you at home is cheap, they have to provide one if you choose to birth at home.

Have a look at the AIMS website, there's a publication on there called 'AM I.Allowed?' - well worth a purchase.

Aargh autocorrect!

Going should be being
Cheap should be crap!

Lol