Labour pain - can anyone explain (long)

[lunalovegood84]

I've posted on here a fair bit about my labour - I never talk about it IRL except occasionally to DH, so I suppose it's my outlet. Apologies if this is the millionth post you've seen from me on the subject.

I was induced at 40+13 by pessary around 5pm. Period pains started around 9pm and continued through the night. I was 4cm dilated at 11pm and 5cm at about 6am. I got my TENS machine on quickly and had some paracetamol.

The pain got worse if I lay down so I spent the entire night sitting or bouncing on a ball. However, it was never all that bad. I mean I winced throughout and felt miserable and sorry for myself but I've been in similar/worse pain with earache, sore throat, that kind of thing.

At 8am I was to get my waters broken and casually strolled down to the delivery room chatting away to the midwife etc, was examined and was 9cm dilated! I don't really understand this and from the reaction of the midwife and doctor neither did they as I was acting so normal and not in a huge amount of pain.

The next part is a bit fuzzy but after my waters had broken there was no progress in the next couple of hours so the syntocinon drip was started. It was turned up to 12 when the pain got really bad. As far as I remember it was a continuous pain - either that or incredibly close contractions with a bad pain underlying them. There was no respite at all in between. I ended up being on the drip for 5-6 more hours in a huge amount of pain. It felt like the bones of my pelvis were being ripped apart. During this time I was told that the baby was back to back; they pulled me into position dangling upright over the back of the bed where I stayed the whole time.

It was like torture. I went from someone chatting away normally and my usual self to screaming like a banshee the entire time. Nobody really talked much to me, or helped me change position, or explained anything to me (I have vague memories of them explaining things to DH). I was too out of it to speak much; I couldn't operate the TENS or tell anyone to so it buzzed away at full strength the entire time on my back. I remember the midwife acting pleased that I was now properly in pain, "it's not called labour for nothing". So was the doctor when she visited.

I did ask scream for an epidural at one point. To their credit the anaesthetist arrived promptly but then something on the monitor made them think my contractions were picking up and that delivery was imminent and I didn't get the epidural.

Anyway the end result was baby did not descend, I refused Kielland forceps and had a c section. Baby was 11 and a half pounds, all healthy afterwards.

I never had a birth debrief so I think that's why I have some unanswered questions:
How could I not have been in very much pain at 9cm dilated?
Why was I then in constant agony on the synto drip? Could this have been baby crushing nerves (I found this explanation on someone else's birth story)?
Shouldn't hcps be a bit more concerned that someone completely stoical up to 9cm, with waters broken and everything, then becomes off her head with pain? Rather than being seemingly pleased? Surely this was an indication of a problem?
Shouldn't the midwife have suggested/helped me change position e.g. all fours instead of talking rubbish, making DH toast and filling out endless fucking paperwork?
Could the fact that my waters were broken with a back to back baby be the cause of the failure to descend? Should positioning have been checked before this took place?

Thanks for reading if you got this far!

You need that debrief or it's going to torture you forever.

That sounds horrendous OP.
You really need to have a debrief about this.

I echo above posts. PLEASE get the debrief. Wholly deserved and rightfully yours to have. No personal experience but my bestie had a very traumatic first labour and felt the debrief helped considerably.

Not a midwife but here are my thoughts:

How could I not have been in very much pain at 9cm dilated?

Some women do not feel contractions painful at all and some like you find them very bearable.

Why was I then in constant agony on the synto drip? Could this have been baby crushing nerves (I found this explanation on someone else's birth story)?

Synto contractions are nearly always much harder to cope with - they are artificial and with this in mind the NICE guidelines state that before a synto drip is set up this should be explained and an epidural offered. There are not many women who can cope with synto contractions without one, in my experience, unless its only for a short time.

Shouldn't hcps be a bit more concerned that someone completely stoical up to 9cm, with waters broken and everything, then becomes off her head with pain? Rather than being seemingly pleased? Surely this was an indication of a problem?

Their attitude is odd. I suspect that in a birth centre you would be encouraged and told you were coping so well etc. At least I am very surprised you were not offered further pain-relief. I know a birth centre was not possible due to induction.

Shouldn't the midwife have suggested/helped me change position e.g. all fours instead of talking rubbish, making DH toast and filling out endless fucking paperwork?

YES!

Could the fact that my waters were broken with a back to back baby be the cause of the failure to descend? Should positioning have been checked before this took place?

Very much so. I cannot understand why, from what you have written your waters were broken at all. Doing so with a baby in a sub-optimum position can wedge the baby in the poor position and they can no longer turn into a better one easily.

I would be going for a birth reflections and asking why your waters were broken and why you were not offered an epidural with the drip.

I don't know if you are planning any more babies but the good side to this is that the fact you were coping so well before your waters were broken is a good sign that if there is a next time you have a very good chance of a lovely birth.

I had backto back pains - it was horrific on the drip too and wasn't allowed to move due to heart beat monitor. First midwife wouldn't acknowledge it coz it didn't show back to back contractions on her screen but second felt my tummy and said I was having constant contractions. Never found out what happened and would have liked a debrief but didn't know it was an option. Go for it if you can xxx

Yes - debrief.

I thought it was normal to be offered an epidural with a drip these days.

Thanks for the replies. I definitely want to speak to a HCP about my experience. My area either doesn't offer a formal debriefing programme or doesn't publicise it, so I know I could probably arrange one informally but haven't got round to it. It doesn't affect me day to day, it's just that I look back on it with horror and i am a scientific sort of person who needs an explanation for EVERYTHING.

We are planning to TTC in a year or so, so I think that, if all being well, when I am pregnant again I will arrange to speak to someone regarding what happened and planning for my next delivery. (Although I know what the plan will be. It's either I do it all myself and everyone else fucks off with their interference, or I get a nice ELCS if overdue or huge baby again.)

But I am now considering a debrief sooner, so thanks for the food for thought.

I thought it was normal as well. They practically tried to force me into an epidural when I was induced until I snarled at them I didn't want one.

You need to find out what happened OP so you can move on. Ask for that debrief and have your questions written down ready so you cover everything.

Mabel - thanks for your replies to my questions. I had gas and air and i think I was offered diamorphine which I refused in favour of the epidural which I didn't get.

I had been keen to avoid the drip. The doctor knew this, but when she examined me at 9cm her explanation was that once things had been started artificially it was better to continue down that path. I didn't realise having waters broken was a big deal so I consented. From this moment they always seemed to think that baby would be out in an hour or two, so the drip was started "just to help me along", etc (paraphrasing but that was the gist).

Good for you for refusing the forceps though, especially considering how big your baby was. I know someone who was refused a section for a large baby and failure to progress, and the forceps delivery of her her 11lb baby left her with serious tearing.

So, despite the completely unacceptable way you were treated after the syntocinon drip, thank goodness they didn't try to get the baby out vaginally.

Do go for a debrief.

As for future deliveries, I can tell you that I had an ELCS a month ago and it was bloody brilliant. Highly recommend them

i had an emcs 10 months ago after a long stop start labour leading to a failed ventouse. a lot of what you have written rings very true with me OP.

I haven't had a debrief either but I wish I had. we are ttc dc2 and i'm hoping that if and when we conceive I can talk to the hospital about what happened during dc1's birth.

I started labour naturally, laboured at home for about 15 hours, went to hospital, was 5 cm. was still 5cm 10 hours later, was put on the drip and had waters broken. clip was put on baby's head for monitoring.

up till then, I had had tens and g&a. later had diamorphine which made me very sleepy, slowed things down and has left me with big gaps in my memory. I don't remember ever being offered or indeed asking for an epidural, but this may have happened. I certainly didn't have one.

dd was left occipito posterior (may have spelled that wrong) which as I understand it means she was back to back but then turned a bit to one side so the wide part of her head was trying to come through the narrow part of my pelvis. I am happy to be corrected if anyone knows different!! I realise now that the breaking of my waters was probably the wrong thing to do because it stopped her turning further round and going into a better position. the failed ventouse was I think more to turn her than to get her to descend. by the time we went to theatre, the sintonocin drip had been cranked up to 60

I refused forceps and went straight to emcs.

i think you're right that the sudden onset of the pain much have indicated a problem because, while the pain did get worse on the drip, it was nothing like what you have described, especially if you were coping so well before.

i hope you get some answers

I was induced at 38 weeks (SROM). I was like you, except my labour was incredibly quick! Pessary went in, started contracting...just felt like period pain. Went over to delivery suite where they started the synto-whatsit drip, and holy shitballs....the pain began! I only had the drip in for 20 mins, as baby became extremely distressed, due to the fact that the synto-whatsit stuff made that 20 minutes just one big never-ending contraction! So drip was taken out, and DD was born just over an hour later.

Midwife said afterwards that labours that are induced with hormone drips tend to be quite brutal because you are essentially forcing your body to do something it doesn't want to do, and is not yet ready to do on its own. That's the only explanation I got!

Definitely go for that debrief. I had one at seven months post birth but had it again last week where they went into much more detail as I'm now 26 weeks and am an undecided VBAC after EMCS.

I think it's possible if your waters had not been broken the baby might have been out without problems anyway. Especially since you could then mobilised to help the baby rotate and descend. It's quite acceptable for them to have just used the pessary and them allowed things to progress without further interference - that's how its supposed to work ideally.

Ime Drs and midwives do not take you seriously if you are not writhing around in agony and screaming your head off.
With ds1 I went in with regular contractions. Was put on a monitor (not examined) and sent home with instructions to take 2 paracetamol.
Thank god I stated bleeding when I got home because when I went back in I was 6cm dilated!
The midwife did have the good grace to look embarrassed and offered to run me a bath!
wasnt too bad pain wise tbh. It's not much fun, obv, but he was out in 6/7 pushes.
With ds2 he was overdue and I was in slow early labour for days
I went in on the weds morning and was told I was 3 cms dilated and I could go home or go onto the labour ward.
I went home.
Managed to cook dinner for Dh and ds1.
Went in early hours of Thursday morning but was only up to 4/5 cms dilated so they broke my waters and ds2 was delivered 3 hours later! Again, only 6/7 pushes and out he came.
Much more intense than ds1 but still not awful.
So....no, it's not unusual to be ok in labour. It does seem a bit unusual that your baby's size was not picked up on scan or midwife exam though!

I've emailed the health board to ask how to go about getting a debrief.

Seaoflove - yes that they were OK with going straight to cs was definitely a good thing. I think they had to since I refused to consent to the forceps but they were OK about it.

Baddz - interesting to hear your experiences. They actually were concerned twice that baby was too small. First time was just by tape measure at 33 weeks - growth scan then showed 95th centile baby. Then at 39+5 a scan due to mild high bp estimated baby as about 75th centile or 8lbs 12. They were concerned at the drop in centiles. Ha - if only!

I don't have great experiences wrt sizing scans tbh...
With ds1 they scanned me on the Thursday afternoon - I was in labour but thought it was sciatica and they said 7lbs.
He was born the next morning weighing 4lbs 15oz :(
With ds2 (I went to another hospital for his birth!) they gave me regular growth scans after 28 weeks due to what happened with ds1.
I had too much fluid with ds2 and they said he was an average size baby.
He was 8lbs 4oz :)
Hope you get some answers x

When I had the synto drip, I was told you pretty much always have it alongside an epidural because it is so intensely painful. Not sure why they didn't give you an epidural when they gave you the synto.

luckiestgirlintheworld I heard the same thing! I had said in my birth plan (turned out that went completely down the shitter anyway) that under no circumstances would I have an epidural...but my midwife warned me before the synto drip went in that I should probably re-think that idea, because being induced with synto is notoriously brutal! I did manage to crack on without the epidural...but I think that was a combo of a pretty good pain threshold, and the fact that DD was in such a hurry to get out - I didn't have time for one even if I wanted it

Yes to the de brief op. With ds my waters broke and i went into spontaneous labour (waters had blood in so I had to labour in hospital). Contractions got to every 6/7 minutes but I didn't progress past 4 cm so 24 hours after waters going I had labour augmented with the torture device that is the synto drip. Very much like yourself ds was back to back and when the drip worked i was in constant pain. It was agony. I was contracting every 2 minutes but when they did a ve I was still only 4cm so they wouldn't let me have an epidural (despite me screaming for one). The bitch mw said "you're not even really in labour" which made my blood run cold.Ds was born 3 terrible hours after the ve and after 6 hours on the drip.

Why was I then in constant agony on the synto drip?
Could be crushed nerves, but could be having a back to back baby-It's meant to make the contractions "merge".

Shouldn't the midwife have suggested/helped me change position e.g. all fours
Yes. So should mine. being on your back with a b2b baby is agony. I was told I had to stay like that to moniter the baby. This is poor care.

Shouldn't hcps be a bit more concerned that someone completely stoical up to 9cm, with waters broken and everything, then becomes off her head with pain?
Yes. This is poor care.

You received very poor care. I think a de brief sounds like it would help. I was offered counselling at my 8 week check after ds was born and I really wish I'd taken my gp up on the offer. I'm 35 weeks pregnant now and for the first trimester I woke up in tears about ds' birth a lot. What has helped me is understanding that i had shitty care. I spoke at length to the gp about it and she helped by explaining some of the things that just shouldn't have happened (the main one being denying me an epidural-it's not in the gift of the mw) and saying to me that yes, back to back labours after waters have gone on a synto drip are the most painful. Made me feel like less of a drama queen (which is very much how the mw in hospital made me feel)

I was told to go on a drip and review if I needed an epidural later. This was 2014, so it may be NICE guidelines but they are not always followed. The labour ward was packed. Wonder if this was a time issue for them. I am sorry for your horrible experience.

Your story is remarkably similar to mine that I wonder whether it is my birth story you're referring to regarding the nerve damage.

The only part where yours and my story differ is that I didn't have a reasonably painless time up until 9cm, instead I was having a reasonable, but nothing too arduous time and got stuck at 3cm. I was 40+14 when I went into hospital for a scan and they wouldn't let me leave (well, they sent me to antenatal to speak to a registrar who never turned up. I had been having contractions since 5am the day before and they suggested I stay due to some concerns they had with low levels of amniotic fluid so I just carried on having contraction after contraction in the antenatal waiting area. For many hours, because the maternity ward was full).

I knew nothing about the position of the baby as nobody checked, but I suspect he was posterior, as I had an anterior placenta and because of events that followed.

Eventually space became available on the delivery floor and I was moved there, introduced to my midwife. I was in not too much discomfort really. The only thing that really hurt was going for a wee. Something about when my bladder was at empty brought on an almighty pain that saw me writhing in pain. I thought these were contractions but I now know different.

Found to be 3cm still, after 50 hours of labour (20 so far in the hospital by this point) it was suggested they break my waters. I was exhausted and wanting to see progress, so agreed. Nobody checked for how the baby was positioned. Big mistake!

So midwife broke my waters and said: "I'll be back in four hours to see how you're getting on."

What followed was an almighty, searing pain that I cannot put into words. Like yours, the pain was constant or I'd get a few seconds of it easing, but then it be at absolute peak of pain lasting for, well I remember one went on for ten minutes. I went doolally, actually losing my sense of where I was in the room with the pain. I remember thinking that I had no idea I was even capable of feeling this much pain and why had I not passed out yet. And still I thought this was what labour was meant to feel like.

After three hours of this (I'm a stoic) I started to seriously lose the plot and remembered that losing the plot is a sign of transition. So I got DH to get the midwife in, convinced I must be at 10cm. Midwife checked me and I was.... 3cm still.

I could not believe it. How could all of that have been for nothing. And I had transition to come??!!! So then she suggested syntocinon. I agreed under condition I have an epidural first (I knew I could not take pain any worse than what I'd just been through. I still couldn't believe that that was supposed to have been the manageable pre-labour).

Well, the epidural failed (it had only partial effect) but it did take away the truly searing pain and left me with regular pain around the abdomen, like cramps. So I had gas and air for those.

I stopped using the boost button on the epidural and just let it wear off as it wasn't doing anything but by this time I was getting along fine with just the gas and air. It is at this point, I believe, that the nerve damage I sustained, was complete hence not feeling anything except abdominal contraction pains, which were hard but not mind-warping.

Anyway, synto drip got me to 10cm but baby wasnt descended so forceps got him out, the 10.5 lber that he was. Injuries to his face (not from the forceps, those marks were visible but different) showed signs that he was stuck sideways in my pelvis. Breaking my waters had been a DISASTROUS plan, as he had got wedged, as a pp suggested.

I was left with mysterious total incontinence that no one could explain, and catheters fell out. I was kept in post natal for a week while they investigated. A bladder x ray involved having a fluid syringed into my bladder via a catheter to fill it to capacity to check for leaks (or a fistula - their biggest fear). The radiographer asked, conversationally, how it felt and I said "pleasantly cool". He was shocked as I was supposed to answer "like I'm desperate for a wee". I could not even feel a sense of fullness, never mind hold even a drop of wee. He said he'd make a note of that, as it wasn't normal.

When pregnant with my second child my midwife kindly scheduled in a chat with the consultant obstetrician to go over what happened and make a plan for next time. It was he who explained that in all likelihood the baby's head was crushing nerves that run around the pelvis, in an effort to find a way through. Crushed nerves have only one way to signal they're being crushed: pain. And lots of it. He shook his head and asked why I had not asked for an epidural I was in so much pain. (Well the midwife had fucked off for a start, and I really though that that was what labour felt like).

Because it was such a long labour (contractions started at 40+13 and I had my baby at 40+16) the nerves conked out (and they took months to heal). The consultant assured me that normal labour would not feel like this. The pain would not be as bad. And if it was to see the signs again, I was to go for a caesarean. This was put into my maternity notes.

Well, ds2 was an easy-peasy labour in a birthing pool with just a bit of gas and air that I barely needed, if I'm honest (but was nice to have). I remember only one contraction that made me think "ooh what a corker that one was" and the next one had me pushing out a baby in big, satisfying heaves. None of the contractions I had with ds2 came even close to what I experienced with ds1. And I had none of the nerve damage the second time around, either.

The pain you felt was NOT normal. Believe me, I've had what you had and I've had a regular labour and the two are poles apart. I know I had nerve damage because it went on for so long (70 hours) that I suffered nerve shock and it took months for the nerves (for both control and sensation) to heal. Maybe your nerves were crushed too but just not for such a prolonged period that it got so badly damaged but enough to have sent you through the roof with pain.

If you decide to have more children, you may be surprised how easy you find it. I couldn't get over it. As I held my newly-born baby in the pool I said to the midwife "but, but that was so EASY!" because I remembered what my first had been like.

Thanks for posting that Roly. Sorry you had such a crap time the first time round but hearing that a second can be easier is very reassuring to me. I'm getting very worried about the pain as I'm due in 4 weeks. Can I ask how the epidural was? Looking back I'm not sure how they would have managed to get one in me as the contractions were so fast and hard.

Thanks to everyone who's relayed their stories - it helps to know I'm not alone in having a truly shitty time!

NickyEds - it could very well be the back to back part that caused the constant pain. I can't believe they made you be on your back. I wasn't ever on my back, apart from briefly for examinations - even in the early "good" part of my labour the pain was strong lying on my back so I stayed upright the entire time. For the synto drip part I was upright, draped over the back of the bed - OK they could have helped me into different positions to try them out, but I can't bear to think how much worse it would have been lying down!

RolyPolierThanThou - it might very well have been your birth story I read. I am sorry that you suffered such bad nerve and bladder damage - that must have been incredibly hard with a newborn baby as well. This forum is great for putting into perspective that DS and I escaped completely unscathed. I hate it when people gloss over traumatic birth stories and say that a healthy baby is all that matters. Of course it's the most important thing, but the mother is not just a walking pelvis and all too often she is left with injuries. I might look back with horror at what I went through, but the outcome was that DS and I were both fine and I made a complete recovery very quickly. For that I do feel very lucky.

I am glad to see that you had a good second birth. Part of the reason I posted was to see which of my very different experiences of pain was the "real thing", so I'm delighted to hear that you reckon a second birth would be more like the earlier part!

Do look up the Birth Trauma Association's Facebook group. It's a really good place to vent and also get help if you found your birth traumatic.