Forceps and Third Degree Tear has ruined my life - why does nobody talk about the risks?

[neef]

I am starting this thread because I cannot believe that no other first time mum has experienced what I am going through, and I cannot believe that the medical profession lets women suffer these injuries in the 21st century. Why isn't Mumsnet all over this?
I am two years on from childbirth and I have lost all sensation in my perineum and outside of vagina. I am suffering prolapses and bowel leakage despite doing millions of pelvic floor exercises and spending hundreds of pounds on women's health physio. I have severe pelvic pain after exercising or even just standing for any period of time. My life will never be the same again.
If I knew of these risks beforehand I would never have consented to vaginal birth and would have insisted on ELCS.
What can we do to stop this and anyone else out there suffering with me?

Forceps are hardly used in the U.S. I don't understand why they are resorted to so often zoom the UK.

I personally think forceps should be banned unless cartoon is out if he question. Usually a c section is still an option when forceps are used. I'm the U.S. They move straight to c section.

I had a forceps birth with my first and have recently had surgery to lift by blaster to address in continence. I met three women on the ward who needed the same surgery. We had all had forceps.

Forceps are utterly barbaric.

Women should be fixed up by surgeons, if needed. That should be standard procedure. Not a few haphazard stitches by whoever is there.

I was stitched up after episiotomy and tear and the surgeon took such pride in the repair job. Wish women in the UKcould have that!

I'm 7 years on from birth of my first child. Also epis & 3rd degree tear after forceps delivered baby. After a long and natural labour, he simply got stuck on his way out, so we got rushed up to theatre and was nothing short of a blood bath. My tear took months of physio, a year of constipation (too scared to go the loo as it hurt so much) and painful sex and 7 years on, things are still not right! My son came out with scratches & bruises and a torsion to his neck which meant he found it hard to feed. Horrid. I had nightmares for months after. I had an elective section with my 2nd child and it was a 6 week recovery but so much better than 1st time round. Obviously I felt completely guilty at not being able to deliver my children naturally too! I completely understand x

So sorry to hear your story OP.

I ended up having forceps, episiotomy and 4 th degree tear with first child. Repair surgery under epidural - I will never forget the lights on the operating theatre. It was Massively Traumatic. Took months to recover. No follow up by nhs re trauma. My gp looked visibly horrified when examining me at my 6 week check. Various delightful analysis and rectal exams, physio has helped but still not right.
Pushed for ELCS for second child. It was a piece of piss by comparison. Walk in the park. Less pain, no ongoing issues, skin to skin with ds straight after birth rather than being rushed away from dd straight into surgery. Elcs was calm, managed and an entirely positive experience.

(Hugs) OP I really feel for you.

Mumsnet - definitely an area that needs attention.

For me also the trauma was
10 years ago. Not sure if mumsnet was around but if so I didn't knew about it. I couldn't talk about a 4 th degree tear with anyone. So I was traumatised, lonely and unsurprisingly developed pnd.

(Hugs) to everyone that's posted. Sorry it was long.

Artichoke, my forceps delivery was in a major teaching hospital in the US :(

(a while ago though). I wish my consultant had moved straight to c-section but I gave birth at a time there was a lot of talk about the high rate of c-sections in the US etc etc - I feel I was a victim of trying to keep the stats down in that particular hospital. As my next consultant said to me "well you pretty much did have a c-section just not in the correct area"

When I read the stories here, I give thanks again of how much of a bullet I dodged in terms of long term pain and incontinence. mind you, I really did nearly die. I was incapable of minding my baby on my own (and dh had to work - thank for for parents and MIL), was in excruciating pain for ages and it is only sheer luck (and possibly the presence of my MIL) that I didn't get a severe PND.

I think forceps should be assessed not for immediate outcome (as in healthy baby/alive mother) but for medium and long term damage. HazeyJane I know what you are saying but I don't think there is a woman on here who had a forceps delivery who doesn't wish she had instead assumed the risks of a c-section.

oh and whilst in hospital, waiting for my husband to arrive the following morning, he was late (slept in), I was a mess, crying my eyes out, a nurse walked pass and said that I had better toughen up as this is what motherhood is really like.

I was rushed into theatre for what was going to be an emergency c section after a long labour and baby in distress. Under GA they actually got her out with forceps - yes, episiotomy and third degree tear, took quite a while to heal - but it did heal. I had two further vaginal deliveries, only minor tearing with each of them. I only had gas and air with all three births so can't blame the epidural for dc1 difficult birth.

Childbirth can be life threatening and things can go wrong. You were very unlucky OP but I see no reason for your particular story to be more significant than mine. Best clinical practice has to be decided based on the evidence of much larger numbers of births, not individual stories. Changing the norm from vaginal birth to cesarean would, IMO, be bonkers. Most women do not need major surgery in order to have babies.

canyou I certainly don't wish I'd had a c section rather than forceps for dc1 - so your generalisation is false . A c section with dc1 would have made it harder to have subsequent vaginal births - I don't know what the thinking is now, but 20+ yrs ago when I had my DC it was rare to be able to have a vaginal birth after a c section. I went on to have two perfectly ok vaginal births after the (admittedly traumatic) birth of dc1.

you are right Catsrus. I was generalising. Not sure why you are skeptical - I was writing about a very personal and very traumatic episode in my life.

Who is saying that the norm should be changed from vaginal to caesarean? I don't believe this. But I do believe that in the case of a birth where a forceps is indicated, there should be better study of long term effects on the mother's health of choosing a forceps over a c section. I am genuinely glad it worked out for you but I had an incredibly frightening near death experience - before I even saw my newborn. And I don't put that down to luck. I put it down to bad judgement on the part of my obs.

I do need major surgery to have my babies.

I'm so sorry you've been through that.

I think they can be a bit too keen to use forceps tbh. I think they can also be far too keen to do an episiotomy which I'm my experience seems to be the big issue. Everyone I know who had a cut hasn't healed well. I refused a cut as I felt I would rather tear. I did tear second degree but it healed beautifully. I think cuts are an issue as they don't know what they're cutting through.

I can see forceps being necessary when baby is stuck and heart rate is dropping. Also with an epidural you might need more help as you lose sensation.
I think back in the 80s they were actually used as a matter of course. Mil said she had them for all three births for no apparent reason!

I don't think an elcs should be available as a 'choice' without underlying medical reasons though (I.e previous cs, complications in pregnancy or emotional needs are all medical reasons though).
It's not the easy option by any stretch. For every vaginal birth horror story you hear a cs horror story too. My aunt had to have full hysterectomy due to scarred tissue fusing her womb to her bladder. She's never fully recovered and still have severe bloating and pain.
Someone else I know went in for their third section and they found her womb had welded to something too. It's not without risk, particularly if you have several babies.

I'm so sorry you are going through this op. FWIW I asked for and had agreed an ELCS for maternal request - I asked at 16 weeks and my consultant noted it down at 20 weeks.
In the end I had placenta praevia anyway, but even in that high risk situation, my CS was a very positive experience (also painless). I had some post op pain but it was manageable with plenty of different painkillers (you really have to nag them or they'll try to just give paracetamol - I had dihydrocodeine and diclofenac as well).

So sorry to hear of your experiences op, I had horrendous tearing after a forceps delivery with ds, not to the extent of yours, but it took about three years to be generally pain free and seven for sex to be so, even so I was always grateful that I dodged the bullet of a CS, having to friends for whom theirs went hideously wrong.

I agree with what madwomanbackintheattic said, birth is inherently dangerous for both mother and baby and I think it is really easy to forget that in the west, we are lucky now that the vast majority of women and children survive it. The only way to guarantee avoidance of risk is to not have children.

I think you are absolutely right that the risks associated with forceps needs highlighted more ! A family member experienced something similar to you and I researched it and was horrified. I very very clearly stated on my birth plan that I did not consent to forceps under any circumstances and wished to go straight to c-sect if problems arose. This did happen and I'm so glad I did this, I had good recovery from emcs. I would have loved a natural delivery but all women shoul be aware of the risks with forceps !

Medics are very unsympathetic to women who are badly affected by birth, I find.

I had a forceps birth with dc1 which resulted in a 3rd degree tear. The wound then got infected and I still suffer continence issues now 6 years later. I received an apology from the hospital as that Part of dd's birth was badly managed and I had no pain relief at all for the forceps. However, at that point it was an emergency, dd had a clip on her head and her heart rate plummeted. When she eventually came out she had to be resuscitated. I'm not sure she would have lived had I refused and waited for a section. I totally agree though that no one ever, at any birthing classes or midwife appointments, went through the risks of forceps. There does seem to be an "avoid a section at all costs" attitude.

For my second birth I was offered an elcs due to the first but the consultant said he thought my second birth would be easier and if I wanted to try naturally he would put a plan in place so that there was no messing around if it wasn't working. As it happens my second birth was an absolute dream and instead of 52 hours it was under 2 hours. 3 easy pushes and ds was out. I'm so glad I went for a vb next time as it was very cathartic,

Catsrus

The solution is not C sections, and that is not what everyone is saying.

But the fact that a forceps birth often aversely affects the mother's recovery (even long term) needs highlighting.

Also, women should be fixed -up by qualified surgeons if they are ripped to shreds. Not just a few stitches by a MW or nurse.

Also women whose vagina's are seriously damaged should receive better long term aftercare.

Can't argue with that, surely?

Argh! Im pregnant with dc1 any suggestions for preventing this? Sounds horrific!

I too had forceps and 3rd degree injury with DC1. Then pph. Then infected wound, botched stitches and a subsequent operation to repair an anal fissure caused by the whole disaster. They wouldn't even consider a CS and the consultant apologised to me after for my 'care'. DC2 and 3, totally different, brilliant deliveries but I had insisted I had the right to a CS and refused consent for forceps at any stage. Then DC4, ten years later. Long labour back to back, foetal distress, I begged for CS, male doctor pooh poohed me, told me forceps would be so much easier....
I point blank refused to be butchered again and said I would sue if they came near me with forceps. Got my CS. Baby was huge, surgeon said I would never have got her out.
Yes, recovery from a CS can be tough. But in my experience, recovery from a botched forceps delivery is far worse.
You have all my sympathy, OP. There needs to be a rethink about our approach to childbirth and attitude to aftercare.

Elley

I found walking, just keep walking, while labour starts really speeds things up.

You don't want to start lying down until you have to.

I managed to avoid the bed until I was 10cm and it was all systems go.

I had to have forceps with ds1. No one even stitched me up afterwards. Gp referred me to a consultant gynae who examined me, said 'yea it's a mess down there, i'll put you on a waiting list for surgery but don't hold your breath'. He seemed to think it was for 'cosmetic reasons' I didn't want my cervix in my knickers, be pissing myself all the time and ever want to have sex again. The whole experience was utterly humiliating.

I have elected for a c section for my twins. I had the option of a natural birth, but after researching statistics of twin birth outcomes as well as taking into account that certain things start a cascade of intervention, I decided c section was safest not just for my babies, but for me also. with twins you are strongly advised to be induced by a certain date, and have an epidural, which of course all increases the need for intervention.

before I knew I was having twins, I researched intervention extensively and must admit I felt that I had 'peeked behind the curtain' and read information not intended for first time mums. I even noticed that forceps/episiotomy/vontouse was not covered in my NCT classes which was interesting.

I think there are some healthcare professionals who push of a natural birth 'at all costs', and the mother is just expected to deal with the aftermath. yes, the majority of births do not have lasting effects, but I think more thought needs to be given to not just the mothers physical well-being (we still have to live a life after giving birth!!) but mental wellbeing also. these sorts of interventions and after effects are so traumatic, and to have no prior warning of the risks is awful.

to all if you who have had a traumatic experience.

I had quite a big episiotomy, which wasn't pleasant but at least it stopped this kind of tearing from happening. The issue I have with my forceps delivery is the amount of force the doctor used, with his foot up on the table. I swear they used too much force to avoid giving me a c-section, I read stories about doctors pulling with their whole bodies like that and breaking the baby's neck and I always think, that could have been DS. Luckily he just ended up a big slash down his face where they had dug in which was very noticeable for 4 months. He wouldn't even try to feed for days and the midwife said it was likely to do with the head trauma. It doesn't seem to have caused any permanent damage though, thank god.

I'm close to tears OP. I share your anger.
Not much point detailing my birth, mentioning forceps, faecal incontinence and prolapse will suffice. Even though I can't run anymore and had to have a perineorraphy to widen my too tight entrance to the vagina (3 days ago and recovery seems a walk in the park compared to my postpartum), I am still considered a good outcome. I am continent (for now).

I'd like to address some points raised here (points I have read on MN threads before that don't relate at all to how I feel and therefore might not relate to your feelings either).

To comments such as this: "I think if a vaginal birth goes smoothly then the recovery is far easier than if you have an ELCS that goes smoothly - it's major abdominal surgery. The only problem is you don't know whether it will go smoothly beforehand."
I was well aware of this and this is why I thought a vaginal birth would be better. What I was not made aware of was the increased risks of faecal incontinence following instruments. My antenatal class did not cover faecal incontinence following childbirth. It covered urinary incontinence and that was it. My classes also explained that prolapse was a risk for later when in fact prolapse is inherent to childbirth.

To the "But your baby's fine" type comment. (To this day, this is the most common comment I have to deal with)
Yes, my baby's fine and I don't wish to imagine if my baby hadn't been fine. But I'm not. If two people are in a car crash and one got out unscathed and the other one didn't, you don't go to the injured one saying "But the other person's fine, why isn't that good enough for you?"
Both mother and baby need to be fine.

To the "but-no-one-could-have-known-your-baby-would-get-stuck" type comment.
No but someone could have talked about risks and rehabilitation beforehand (I never call my postpartum a recovery. How can it be a recovery if I can't run anymore? How can healthcare professionals talk about recovery when women are left with urinary incontinence or faecal urgency or worse? How dare they shall I say.)

To the "but-forceps-are-only-used-in-emergency" and "but-EMCS/ELCS-carry-major-risks-too" type comment.
Again, I was well aware of that. How come the risks involved in instrumental deliveries are not covered before birth? (before I gave birth, the NHS Choices page on assisted deliveries mentioned close to zero risk-I made them change that and they now acknowledge urinary and faecal incontinence-can still be better as it doesn't explain the horrible rehabilitation process but it's a start).
Look at most pregnancy books and rarely are risks associated with instruments actually explained. Faecal incontinence, prolapse and rehabilitation times even less so. Why is that?
I only joined MN a year postpartum when I randomly found threads talking about the very injuries I had sustained. I wish I had joined before giving birth.

neef No comment I make will give you your health back. I can simply hope that knowing other women feel and share your anger is useful in some way.

I think one of the issues is that the downside of a botched or failed VB are privately endured - the OP's ongoing misery is her own and there isn't really a cost to the NHS. A CS that's gone wrong typically means a lot of NHS cost - emergency interventions, longer stays, after surgery care etc.

I don't think the true cost of failed VBs really get counted because who really counts the cost of thousands of women experiencing pain and incontinence for decades?

catsrus I personally don't welcome your comments.
Calminacrisis I agree with you. Better approach (managing expectations) beforehand and better care afterwards.