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?

I wa sutured by the obstetrician who wielded the forceps.

After my second labour I had a 2nd deg tear but the midwife felt too inexperienced to do it herself so called in an obstetrician to do it with/for her. I think I was a demonstration/training opportunity. She took over from the mw and did a decent job, I think.

This does seem like an ideal candidate for a Mumsnet campaign. I'm not sure how it can be brought to the attention of Mumsnet towers. I have started a thread in site stuff and reported it.

informed birth choices

Doesn't exactly seem like a sure fire way though. Does anyone else know how to wave a flag so they can see this?

Bue not misinformation, just your misunderstanding as I wasn't referring to just 3rd degree tears. I feel that anything other than the most minor tear should be repaired by a surgeon given the anatomy and the importance of good union and healing. It shouldn't be the case that someone who goes through forceps and 3rd deg tear heals better than someone who has a 2nd deg tear after an easy vaginal birth, just because the former actually gets an obstetric surgeon rather than a midwife doing the suturing.

Oh sorry, just saw my original post and saw that I'd said 3rd deg tears when I meant any tears really. Apologies for confusion, it's an emotive topic!

Obstetricians are surgeons.

Horrendous stories on here. I feel for all of you

I'm on my 4th pregnancy after 3 mc's and I'm so scared of something going wrong - I will be asking for a ELCS both because of this but also I've got scarring on my cervix which potentially could lead to failure to progress.

My biggest fear is that I won't get an ELCS, I will struggle and my baby will end up being dragged out with forceps and cause me and the baby untold damage.

My sister is an obs and gynae registrar and she has told me that having an epidural increases your chance of having an instrumental birth.

She has also said that forceps are there for a reason and they do a job but she has also admitted there is no way on this earth she would have forceps.

They are barbaric instruments and there is absolutely no way on this earth they are coming anywhere near me.

I'm only 10 weeks but I already have a consultant appt booked in for 14 weeks and I will be requesting my c section. I have researched the risks of both a c section and instrumental delivery and I will be fighting my corner.

I don't think forceps deliveries were automatic in the 80s rosey
I had DD1 in 1986 -I was 35 and agreed to be 'speededup' as I was tiring quickly .I did deliver normally 7lb 8oz baby ,though had small episiotomy and forceps were mentioned .(Meptid and gas and air) Student midwife was desperate to claim the baby as her 37th delivery .
Dd2was born 1990 .I was nearly 40 9lb 8oz .Mild shoulder dystopia but again an unassisted delivery with slight tear (gas and air)
Both cut and tear healed well .
I suspect my very positive experience was in part at least because delivery wards in those days were much better staffed and I had a much better level of support than , sadly, is offered now .
My DD2 midwifery (recent) training emphasised the importance of communication, informed consent etc.She tries to give the women on her care the very best support but it is not always easy when you work 14 hour shifts, sometimes don't have time for a wee never mind to eat , and no-one comes when you press the button for support .she works in one of te busiest maternity units in the UK designed for 6,000 deliveries a year .It currently deals with 10,000 She would love her job if she had time to do it properly .No consolation for those of you who have suffered I know but any Mumsnet campaign should in my view get the

Whoops
...Govt to follow through on it's promises re the training and provision of more posts in maternity services
I am hugely disappointed that The Duchess of Cambridge hant been roped in some capacity .

Our DS's birth was horrific too. Back to back (although they didn't spot it until he was born), episiotomy, forceps, 4th degree tear, DS struggling to breathe, horrendous aftercare in the hospital (so bad they apologised when I got the guts to complain 3 yes later).

We've been relatively 'lucky' - the only long term problem for either of us is my occasional incontinence, which is only now (DS now 3.5y) nearly under control via physio.

Only just started to think about another child... Physio said she'd write me a letter to support a csection request if I needed it.

Bue that's not true about always being sutured by who delivered the baby. I can't remember much about the doctors but it was a male obs who delivered DS and a female surgeon who stitched me up.

More awareness definitely needed but as a PP said, more research into what the risks really are and what can be done to reduce them.

I am still shocked to this day that the colorectal surgeon I was originally referred told me to 'blame my son for my injuries'. Absolutely unbelievable!

I think there is a big problem with the fact that women just have to accept incontinence and bad stitch jobs as "one of those things". As in "you have a healthy baby, what more do you want?!"

As if YOUR health and wellbeing doesn't count anymore once the baby arrives....

I wish I could say everything I want to say more eloquently but this topic makes my blood boil so I will be as brief as possible..

Basically, I just think women should be able to make properly informed choices about birth, given full information on the pros/cons of both VB and CS (as stated on this thread very little seems to be said about risks of VB) and without any difficulty, be able to choose whatever type of birth they want, be that VB, CS, at home, in hospital, waterbirth, whatever. And aftercare absolutely needs to be better, women should not be left like this after episiotomies, forceps, tears etc. Women and babies health shouldn't be put at risk by hospitals trying to reduce section rates. Disgusts me that the long term physical and mental health of both mother and baby isn't more greatly considered. It's not just about healthy baby, women need to be ok too. Can I just mention as well for anyone who for whatever reason would prefer a c section, the updated NICE guidelines from 2011 support women who want to choose this, basically it shouldn't be refused.

I'm not suggesting that everyone should have sections, I've had two myself which were fabulous experiences, but what I want to see is more honesty from the NHS, risks on all types of birth and interventions made clear during pregnancy. I want women to be able to make properly informed choices and get the birth they want without having to battle. We all have so much more knowledge about our health now than people did years ago, we shouldn't be patronised any longer. I would love mumsnet to do a campaign on this, would wholeheartedly support it.

I am so sorry, and angry, to read some of your stories on this thread. I really hope things can improve for you all

Op I'm sorry you went through the this, as I'm sorry that any woman has had trauma from birthing their babies.

I had a crash section that stole my life. It stole the first few years of me being a mother, it stole my life as a wife, and it stole my life as a human being with full mobility and functionality. It stole my mental health too.

A year of very intense physiotherapist manipulation and dry needling made my abdominal and pelvic floor muscles almost free of adhesions. My pelvic floor muscles and nerves were slashed through and I've no sensation in my lower abdomen 10 years on. I have a cold apron hanging down over my 12 inch scar.

Fwiw cesarean sections aren't the answer, I tried to have a vaginal birth, but was mutilated by a cesarean.

Sex life = pain
Running = pain
Jumping= pain
Tight waistbands=pain
Hugs= pain
Standing too long= pain
Turning suddenly = pain

And because the knife got my bowel, I had scarring which gave me violent IBS for years.

Birth is a dangerous event no matter which way you look at it.

And yes, I find no one wants to hear about, so I had to pay someone to debrief and work through the Post traumatic disorder. It still rears its ugly head when I let my guard down. It's the gift that keeps on giving.

I understand you've been assaulted in the most horrific way and I feel to for you, because I've also had the same experience, as have many women regardless as to whether they were mutilated through the abdomen or up the fanjo.

Cesarean sections aren't the answer. I've been recommended a hysterectomy because my womb is scarred so badly it's enlarged and in the wrong place in my abdomen held there by scars and adhesions.

Compassionate treatment post birth, with kind and comprehensive debriefing and unlimited physiotherapy might be a start to finding answers.

The apology I received did wonders for my recovery. Until I got that I really felt that no one gave two shits about me, and were unapologetic about the appalling mutilation I endured.

Maybe try and debrief with the hospital, and badger your GP for referrals for physiotherapy.

to everyone.

"The apology I received did wonders for my recovery. Until I got that I really felt that no one gave two shits about me, and were unapologetic about the appalling mutilation I endured."

I agree with this. A couple of years ago my dh was on a flight sitting next to the obgyn from my first birth (he was also a doctor in the same hospital at the time and later consulted with her on cases so she would be likely to recognise him). She said hello to him and he said "do you know who I am" and she said "yes I remember your wife's delivery vividly and would like her to know that I learned a lot from her case and would do things very differently now". I can honestly say that I found it hard to reconcile what happened me (despite ultimate good outcome for mum and baby) until I got that acknowledgement that she had made a mistake.

I had terrible problems after a third degree tear for both births.

10 years on and in a different country now I went to my doctor about my bowel incontinence and was sent for a sphincterplasty, it has helped enormously.

Also to help with my pelvis I have seen an excellent chiropractor, who has worked marvels.

Please see a chiropractor for your pelvis and ask to be referred to a bowel specialist OP

I went back to the hospital for 'birth trauma counselling' and ended up in a room with the consultant who agreed my section and the surgeon. The first thing the consultant did was give me figures about cerebral palsy and birth trauma, and that there weren't as many links as people liked to think (my ds was in nice when born due to being unable to breathe, there was a delay in putting him on cpap, and he is disabled - which is actually a separate issue from his birth, but at the time cerebral palsy was being investigated)

I had not actually gone to talk about this issue, I had been referred to them because of the nightmares, panic attacks and pain that I had had since my section. All of this was brushed to one side as 'within normal parameters' - massive blood loss, an allergic reaction to drugs used, phlebitis of the vein which left my leg swollen up to twice the normal size, chest pains and difficulty healing - all 'normal'. The implication was that it was me that wasn't normal.

The whole thing did nothing but make me feel like even more of a failure. When I told my gp (who referred me) she was outraged, and complained on my behalf - she described it as an 'arse covering exercise' as they were panicking about ds.

I gave birth abroad, and due to language complications I have no idea of tear damage that you all know about. There would also be no notes available. I had no check up after I left hospital, though I left by wheelchair as I couldn't walk.

I had an emergency forceps/episotomy due to baby getting stuck/back to back delivery and heart rate dropping.

I had a lot of pain for years afterwards and visited many different doctors. One actually told me "look, you just have to accept that your body feels different after childbirth". I think I also had PTSD for a while as it was all so traumatic but I had nobody to talk to about it that would take it seriously!

It's really refreshing (although sad for us all!) to find others in similar situations.

to all of us x

It really hurts to read this thread. What I hadn't understood is how a lot of muscles just can't be repaired. I also didn't understand the connection between prolapse and muscle damage and I didn't realise that having weak muscles is often not because you aren't exercising them properly but because they have been damaged by birth.

I really regret having my third child vaginally. It has messed me up. All the warning signs were there before hand. I had already developed a bit of a prolapse from the first two births. I even asked a registrar if another delivery might make it worse and he said sometimes these things get a bit worse after another birth sometimes a bit better. What a load of rubbish!

Anyway following the third birth I had a missed third degree tear. I was just stitched by a midwife when I should have been in theatre.The prolapses got worse and now I have developed anal incontinence.

I have had everything that can be repaired vaginally fixed but things will never be the same again due to the main puberectalis muscle having sheared off the bone.

As for the anal incontinence it is caused by damage to the internal sphincter which can't be repaired.

I am currently mulling over a new treatment called Secca.

Frankly it is impossible to discuss in real life. I look totally normal from the outside. I will have to psych myself up to ask for time off work for the secca treatment as I won't want to discuss it with anyone.

So much could be improved. Hugs to everyone on this thread.

Libraries sorry, by "surgeon" I mean obstetrician (in your case it was the registrar). OBs are surgeons! I was using the terminology used upthread.

MrsCaptain I see what you're saying. Have to say I would respectfully disagree! I have seen some very poor suturing of second degree tears by doctors (interrupted stitches on the skin layer for example, which causes soreness and tightness - MWs never do this). I think some MWs are much better than doctors and vice versa, it's more about the skill of the practitioner than their title.

Ah, yes, sorry. My confusion. I do of course realise that Obstetrics is a surgical specialty (or you'd worry about those sections!!). I just automatically associate 'surgeon' as a term with someone who is solely surgical and would always say Obstetrician. I didn't think that one through to the fact you were using the term more broadly

Bue I have also see some very poor stitching by doctors...junior doctors that is. However, a midwife who can repair a perineum and vaginal canal better than a consultant obstetrician is a very rare thing indeed. Honestly, it's complex anatomy with multiple functions. Is it really such a big ask that the most skilled person repairs you? Wouldn't we all want that for ourselves, our partners, our daughters? The only obstacle is practical -not enough obstetricians available to do this round the clock.

And I mean that as no insult to midwives -a consultant obstetrician who can support a woman through the whole labour as well as a good midwife would also be a rare thing!

Yes Mrs I agree that most bad suturing is done by junior doctors. If a junior doctor came at me with a pack of vicryl rapide I would probably leap off the bed (and no offence to them as they need to learn, but not on me, thanks.) I suppose the only way to really measure best practice in this area would be an audit of women's experiences of perineal healing accounting for the type of trauma and who performed the repair. I would love to see that study!

I think the training for perineal suturing is inadequate. It's not quite the "see one, do one, teach one" but it's not far off. Midwives and SHOs see a few, do a few and one of their colleagues then decides they've done it ok and signs them off.

Problem is all tears are a bit different and been able to do one one day doesn't mean that one the next week will be as easy to suture. So you have to hope if the person wielding the suture feels a bit out of depth that they're feeling brave enough to ask for help rather than just having a go. I'm talking second degree tears here but I'm sure that junior Regs go through similar for third degree tear repairs.

The other problem is that people who suture don't get feedback. It can take so long for problems to become apparent that the GP or surgeon trying to sort it never go back to the HCP who did the suturing and say this has happened to that person. It worries me a bit that I could be suturing women week in, week out and I don't know if months or years down the line they're having any continence problems, pain, etc.

God Bue yes. Maybe I should do a PhD on it!