Had an emergency caesarean, ventouse or forceps? Did you get enough information?

[mummyhb]

Hi,

I'm really interested to hear from any of you who ended up with an emergency caesarean, ventouse or forceps delivery during labour.

I had an elective caesarean with DS one, but had an emergency for DS two. I didn't know what was going on, but had to sign a piece of paper that I have no memory of. At least I'd been through it before so sort of knew what to expect.

Was thinking this might be quite traumatic if I hadn't already known a bit about it. I wonder if I could have been better prepared?

Did you feel you had enough information to prepare for what happened? If you were in labour and things happened quickly or you were in pain did you get too much information or could you understand what was going on?

Would be really interested to hear others experiences.

ventouse. and no. had to be fast, no time for pain relief either. ouch.

I had an episiotomy, forceps, no pain relief. No informed consent. This was all "done" to me because the new junior doctor wanted to practice. My DH heard the doctor and junior doctor discussing it in the corridor as he went to make a telephone call to my DM. DH didn't realise they were talking about me until he came back to the delivery room to find the junior doctor thanking the senior doctor for the opportunity to use the forceps.

I had pre eclampsia and was induced(3rd attempt and as many sweeps) labour for hours and pus inning for hours. Eventually went in for section but they tried forceps. Worse thing that ever happened. Was cut and tore and still have bowel probs 4yrs on from it. Wish they had just done the section

I had an emergency c-section. All quite sudden as they were worried about baby. Remember being wheeled into theatre, scared and in agony. All I remember was that doctors and MW were kind and explained it was best for baby. I signed something while they were getting me ready for theatre. Had no idea what was going on.

Felt very down about the birth afterwards. My midwife sent me to birth debrief appointment where they went through everything with me. The form was in my notes. Shocked to read it as it had risks such as hysterectomy and death!!!!!!! No one mentioned that to me at the time (thankfully), but apparently I signed it. Must be to stop people suing when things go wrong?

Would have gone ahead anyway as they made it clear that baby was in danger. Think it would have been helpful to know a bit more. Didn't go to NCT. Wish I had!

A good friend of mine had a ventouse. She had an epidural and remembers a lot. She read her consent form and it terrified her as it said something about damage to baby. She agreed but spent weeks worrying if her baby was ok as he had a MASSIVE bruise on his head.

Would definitely have liked more info. Would gave still said yes, but I might have felt a bit more in control.

I had a consent form shoved in my face, with barely any time to read, as it was an emergency. I fully understand that bit
What confuses me if that my delivery notes say "failed ventouse" and neither OH or I remember them attempting this. It was as is it were justification for further intervention. I never did follow it up though

My DD's heart rate was being monitored by one of those sensors that attach to the head, suddenly her heart rate plummeted and I was hoicked out of my chair, onto a trolley, had a clip board shoved under my nose and was bellowed at to sign. I was unconscious under general anesthetic within 60 seconds of reaching theatre and (I was told) DD was delivered in 9 minutes.

I am completely and utterly grateful that they did all this, even though they never figured out, or at least never explained to me, what was wrong with DD to cause her heart rate to drop (for all I know it could be a sensor failure), my notes stated that she looked "shocked" on emergence, who wouldn't.

But, no one had explained what would happen if we reached the point of needing an emergency Cesarean, we'd discussed the possibility of a standard one because my Induction had been going practically nowhere for 48 hours, I was getting painful contractions but wasn't dilating enough.

The only thing I understood as I was run out of the delivery room was that my DD was in serious trouble and I inferred that quite easily from observing the heart rate monitor and everyone's actions. I do remember my DH's white and terrified face, he'd been half dozing in a chair and had no idea what was happening at all.

The whole experience was terrifying. I think it would have been a good idea if the possibility and process of an emergency Cesarean had been discussed with me and my DH, especially when it became obvious that the induction wasn't going to be straight forward.

I am still very, very grateful for what they did, DD is now a perfectly healthy 11 yr old but communication was poor, I do remember a lot of different midwives, perhaps everyone assumed that everyone else had explained things.

I had an emcs with DS1 and just had a ventouse for DS2. With DS1 I was very distressed, not able to breathe in the gas and air while they spent about an hour doing repeat blood oxygen tests before deciding he needed to come out now. Things were explained to me, the midwife was fab, Drs were awful and uncommunicative. I signed for forceps or csec and got a csec.

Second birth was very different, Dr was fab as were the midwives, they lost DS's heart beat and then got it back but it wasn't good. They could already see the head so pulled him out with ventouse. I was anxious about DS but could still breathe in the gas and air. Got very upset after as I didn't really know what was going on - I lost a lot of blood on delivery and they were concerned about both me and DS for a short time. All the staff were really calm but for about 5 mins the situation with both of us could have been really nasty. I feel like the staff explained enough - I am needle phobic and had to have a whole range of interesting needles, drips etc in a short space of time and too much information makes me anxious. I also hadn't prepared myself very well this time as I had been told that a VBAC probably wasn't possible so I was a bit shocked when they told me he was out - I never really believed it would happen.

I had a emcs. It was explained that ds was showing early signs of distress. The midwife thought I could still 'probably' push him out, but the doc wanted to do a section straight away because he had 3 planned sections to do and didn't want to be up to his elbows in someone else's uterus if it all went pear-shaped with me.
Although I realise that in a perfect world he would have waited around to see if I could manage to birth naturally, I appreciated his honesty and trusted that he was doing his best with the circumstances he had. So we went to theatre, had two goes with the ventouse then on to a section.
His attitude (and the drugs!) meant that it didn't feel rushed or scarey, just felt like 'oh well, if that's what we need to do to get DS out safely...'

If you go into hospital for anything else which you know may potentially involve a medical procedure then the risks are explained in advance.

I do not understand the defence of "well women might get scared" because in any other medical situation that isn't taken into account. There is a responsibility to tell women. It smacks of treating women in an infantile way not to offer this prior to labour. If it is done with the opportunity to turn down the offer, if women choose to, I don't see what the problem is. The fact that it is not offered as a something to be discussed routinely is more of a concern.

And do not get me started on the cost of this; it is not an excuse to justify properly respecting women and properly making sure they are fully aware of what they may need to consent too.

I don't see why this is actually such a debate either. The solution above is not rocket science and not difficult. The trouble is that discussion of the possibilities seems to be something that people frown on. I don't get why. A lot of women feel like they are not in control of the situation or understand what is happening in emergency situations and it is clear that this does add to the trauma some endurance. Having that opportunity and chance to find out before hand may save some of that part of that.

The point is women should have the choice to discuss this. Most currently don't.

I had a emergency section 7 years ago and I still don't know why. I had scar tenderness but my hubby thinks that the baby was decelling. I would really like to know why

Red tooth brush- thank you. Agreed! I don't think you could formally take consent for every eventuality beforehand because each case is different and the procedure will be done for different reasons given the circumstances which alter the specifics of the consent slightly. But more info - definitely. It seems such a horrible shock to many that their idea of birth (no one ever plans forceps or an urgent section) have 'gone wrong'. To be fair, many are understanding, accepting and grateful but a lot are less so.
I think that despite the likes of OBEM, a lot of people never think 'it'll happen to them' or have thought about it. Whereas in reality, 25% of births in this country are c-section and somewhere around 7% are instrumental.
I think just being aware of what can happen and why and what the risks are (in general) is important. As you say - women can opt out of being told, but there doesn't seem to be much chance to opt in. Especially if you've never really had cause to consider it.

i made sure to be informed about these eventualities before labour (as should any woman - here my mother and I disagree, she thinks you can 'know too much' which I still strongly disagree with).

So when it came to the forceps I knew what would happen and my explicit consent was sought for the necessary episiotomy (which I had mentioned in my birth plan as a 'do not do') so I felt my wishes were taken in consideration. Things were not explained but the hcp knew I knew.

I do think more care could be given AFTER a difficult birth - routine/standard of, say, ten session of physiotherapy, a routine check for prolapses, a reevaluation of the repair-work done (I had my GP check as I was concerned and she had no clue what was right/wrong - it took until my smear test with a nurse who happened to have once been a midwife to reveal I had a prolapsed bladder and urethra and that some of the stitches hadn't held). Routine appointment at, say, 3 months post partum with a gynaecologist or similar expert in lady bits AND physio appointment to tackle the very common issue of incontinence would be a start.

I had an EMCS with DS4 but it was a category 3 EMCS so almost an elective, I wasn't in labour but my waters had broken and I knew about 48 hours before it happened although they kept changing their minds about whether I was going to have a GA or a spinal.

He was born at 35 weeks and the chance of him going to nicu were brushed over. He was in for 4 weeks in the end. Nobody told me beforehand how bad the pain would be afterwards or that I wouldn't be able to go to nicu until the epidural had worn off. Nobody told me that I would be shaking so much that I wouldn't be able to hold DS when he was born or that DH would be sat with him behind my head so I couldn't see them.

With my DS I ended up with an EMCS after 3 days of labour which wasn't progressing. DS was distressed and he'd had enough. All I remember was being rushed down a corridor on a bed, doctors and midwives all shouting "we're going to do this and that" all while I didn't have a clue what was going on. Can honestly say I've never been so scared in my life. No consent form from what I can remember (not that I can remember much because it was all just a panicky blur). That was nearly 13 years ago and I'm still slightly traumatised! I was only 16 as well at the time so that probably didn't help. This time round I'm booked in for an ELCS, don't want to chance a repeat of last time!

I completely agree with RedToothBrush.

Learnasyougo the problem with "i made sure to be informed about these eventualities before labour (as should any woman..." is that you obviously knew there was information you weren't being given access to that was useful to you - I didn't.

I attended all my ante-natal appointments, NCT classes and read numerous "What to Expect" type books, plus the NHS website info and all the leaflets handed out at each appointment. Occasionally someone (not a medical professional) would speak in hushed tones about "horror stories" that "you don't want to know about" but I genuinely thought that I had been provided with and had educated myself with everything I needed to prepare - surely my caregivers (midwives) would be checking I had done everything I needed?

Nothing - NOTHING prepared me for my induction/hyperstimulation/back to back/Keillands forceps/broken down episiotomy/mismeasured blood loss birth. I was like a lamb to the slaughter. Psychologically I have never really got over that birth. If I had have known that the NHS tell you one thing on their website (see eg: forceps) and another on their consent forms I'd have known to only trust my own research.

It's the "unknown unknowns" for women that are the problem with the status quo.

I wholeheartedly agree about better aftercare being needed - you can bet if men gave birth they wouldn't be given a pack of paracetamol and told to get on with it. Although on incontinence treatment, one of the things that would have made the horror of peeing yourself uncontrollably in public easier to bear would be being informed of the likelihood beforehand!

Oh - one last thing - about the statistics that are rolled out as evidence that only the minority will have instrumental or CS births (so information not needed). This is v.misleading as it includes women having their 2nd, 3rd etc. babies who are far less likely to need any intervention.

Women expecting their first baby should be told the likelihood of needing intervention in a first birth.

I had an EMCS, signed the form that was waved at me when I couldn't even speak coherently from gas and air, let alone read it. DH was a bit shocked by the contents but I'd have signed anything at that point especially as DS was in trouble.
I did know what to expect from an NCT class where they went through c-sections, the people involved and what happens if you need one.
In recovery, the midwife asked me if I wanted to go through why I needed the EMCS and have a debrief, she said it helped avoid PND if women understood what had happened. I think that was a good thing to go through it then, although I was quite happy with the decisions that had been made.

When I had an ELCS I had to sign the form with all the details on it stone cold sober a couple of weeks before the operation. That was more scary! I understand the need for informed consent, but it's not like I could say no and suddenly not be pregnant and avoid the operation. What do they do if you won't sign the form but doing so endangers your life and that of your baby?

Chunderella I think the issue is more subtle than give/refuse consent. The issue is one of 'informed' consent and are we being given the requisite information before we consent? And is that time of exhaustion/stress/anxiety/pain when you're not able to safely delivery 'normally' the best time to be informing people of procedures, when there has been a 9 month lead up to the event that eventually caused the need for the procedure.

I don't think women want to fight for the ability to refuse consent to life-saving procedures during birth, they just want to be equipped with the relevant information about what will happen and what the risks vs benefit will be. Trying to make that assessment and trying to process the information so that you understand it and are ready for it during a labour/birth going wrong is not easy, not ideal and query not possible at all.

Chunderella because it appeared to me that the 'solution' that you were suggesting to the points being raised by the OP and others was they they could always just refuse the treatment, so there was no issue to be addressed.

My point was that there is an issue, it is not one of being able to consent it is one of being given access to the correct information and facts about assisted birth at a time when it can be digested and understood.

Our two points tie together with the almost academic question, "how can it be deemed to be 'informed consent' when 1) the pain an exhaustion of labour makes you (potentially) incapable of rational thought and 2) the information provided is scant at best - partly due to the urgency of the situation.