to feel let down after DD's birth?

[princesseggo]

I'm a long time lurker and just wanted to get an outside opinion on how things worked out/were overlooked around the birth of my daughter. Sorry if it's a long post.

My pregnancy with DD was very straight forward up until around 34 weeks when I started measuring big at my midwife appointments. (35 weeks but measuring 39 weeks etc.) Because I was measuring big I had two growth scans. The first I was told baby was fine and was on track to be 7lbs at delivery. The seconds I was told she would be 8lbs on delivery.

I carried on measuring big at every midwife appointment and it got to the point where midwives would sort of laugh and say 'well you've had two growth scans and everything was fine so i'm sure it's nothing to worry about.'

DD was very overdue and I ended up being induced at 41+6. My waters were broken at around 3pm and I was told to go for a walk to get things going. I was only given an hour to start having contractions naturally which just didn't happen so I was put on the syntocinon drip after that hour. The drip made contractions extremely painful and I had no gap in between them so endured 5/6 hours of contractions before getting an epidural. Long story short, the epidural just didn't work for me and would wear off after about 30 minutes.

After labouring for about 16 hours, I didn't manage to dilate any more that 4cm and after being on the drip for so long, my only option was to have an emcs. DD was born after about 2 hours in theatre trying to get epidural/spinal block strong enough to start the surgery. She was 9lbs 12oz and one of the doctors in theatre said that I would never have been able to birth her vaginally as she was so big. (I know babies are born a lot heavier but I am quite petite.)

As soon as DD was born, the epidural wore off again which meant that I had to be put under general anaesthetic. I didn't hold my daughter until 2/3 hours after she was born.

AIBU to feel let down by midwives almost ignoring my big measurements during pregnancy and feel like a birth this traumatic could have been avoided? I can't help but feel like things would have gone a lot smoother if I wasn't left to go two weeks overdue and labour for such a long time. I know birth in general is traumatic for a lot of women in a lot of different ways but I am honestly terrified of maybe having to go through that again.

Congratulations on your baby .

Yanbu. Sorry the birth didn't go as you'd hoped. Please arrange for a debrief in a few weeks or months. Mine was very helpful and I understood why we'd had a bit of a rushed emcs. In the mean time be kind to yourself, you will feel better in time.

I think there are a few things there that should've been done differently but there's a lot there that couldn't be changed.

My experience was very similar but my son was 11lb and scan estimates had him at 9lb - scans just aren't accurate.

The things I think were dealt with badly in your case:

1. You should have had epi as soon as the drip went on which is what I had and consultants told me was the best way. It's well known syntocinon makes for hard and fast contractions.

1. Your Bishops' Score should've been assessed prior to induction to see likelihood of success - it's far more likely that your induction failed because you weren't ready rather than the size of your baby.

1. Your anaesthetist did a piss-poor job - they shouldn't leave your side and they should be monitoring your level of pain constantly and making adjustments as necessary. My emcs was quite traumatic for a number of reasons but the theatre staff were utterly superb from start to finish and yours let you down.

If I were you I'd bring those point to the attention of the hospital.

Not the size of your baby etc. No one can measure it properly and babies over 9lb are reasonably commonly born vaginally.

I had a difficult first birth and sympathise, I have to agree with others though I am not sure what else could have been done, -if you had an earlier planned csection without knowing all this you might be sitting here now, possibly with complications relating to cs, wondering if you should have tried to have a vaginal birth.

Your feelings are totally valid. Don't let anyone fob you off with "well you and your baby are fine". I had a very long labour with my first with no pain relief. I eventually got gas and air for 3 hrs when they finally let me into the delivery suite. They then took it off me as they said I had "too much", despite gas and air wearing off almost instantly. So I laboured for the last 2 hrs of active pushing with no pain relief. I ended up with an extensive 2nd degree labial tear which took nearly a year to heal properly. Some of the things that mothers are expected to ensure are ridiculous.

As some have suggested, do go for a debrief (when you are ready, it was 2 years for me) it does help understand the clinical basis behind some decisions. It will also help you to make informed decisions for any future births. If you have the debrief and still feel that mistakes were made then make a formal complaint over your treatment.
Wishing you all the best.

Congratulations.

I feel your pain, I had a normal sized bump and delivered a normal sized baby, however me being petit she got stuck, too late for an emcs, after 2 cuts they still had to pull that hard they pulled a muscle in her neck which led to me doing mths of physio on her neck. Raise your concerns with the senior MW and enjoy your new bundle of joy

Yanbu to feel as you do. It isn't a competition of who has had the worst birth experience and people are all affected differently and those feelings are legitimate.

I think the issues here are related to the management of your labour and the fact that your individual circumstances were not perhaps considered (overdue, possibly large baby, not progressing in labour etc).

I think where some posters argue that they/others were petite (size 6-8 etc) and yet they gave birth to large babies is irrelevant - your body size doesn't determine whether you are able to give birth naturally to a large baby, rather your pelvis size, its positioning and positioning of baby are, which is what I assume your consultant was referring to.

I hope in time you are able to process your experience and that a debrief helps with that.

If you didn't dilate beyond 4th you couldn't have delivered a term plus baby of any size.
sorry to be so blunt but that's the reality.
You were lucky - I think - that there was no fucking about and they did the c section rather than prolong the inevitable.
I do understand that you feel something on terms of being under a ga however he main thing is you and your daughter are both fine.
I would focus on moving forward now.

@dataandspot "I was induced and also had no break in contractions. I didn't know that other people had experienced that. "

Me too! My epidural didn't work properly either. It is really terrible :(

I do kind of think the culture within the NHS is "vaginal birth at all costs". You only have to read stories from women with very, very strong and valid reasons (both physical and mental) to request a c section, who encounter massive opposition and denial, to see that.

It really, really isn;t. I'm a student midwife in the NHS, currently working on Labour ward. The moment a vaginal birth becomes unsafe we go to theatre, sometimes for a trial of instrumental birth, sometimes for a c-section. it is NEVER vaginal birth at all costs. Never. Our #1 priority is safety for mum and baby.

OP: I'm sorry you feel dissatisfied with your experience. As I understand it, your midwives sent you for 2 growth scans. growth scans estimate fetal weight by measuring abdominal circumference, femur length and head circumference. There is always a margin of error - it's not an exact science. And even if women are found to have big babies, we don't induce just for that - women have big babies every day of the week. You didn't dilate beyond 4cm, so your outcome actually had nothing to do with the size of your baby, but was concerned with the fact that your cervix didn't open.

It'd be a really good idea for you to have a formal birth debrief : many hospital s have a specialist midwife doing this. She'll be able to take you through your notes. We have to document EVERYTHING that happened in your notes, so it'll be a good record of what actually happened during your labour.

Personally, if I'm looknig after a woman and we have to go to theatre, I'll go through everything that happened with her afterwards, however I also know from experience, that what you say isn't always retained accurately (understandably, as women are usually knackered and hugely emotional after any birth, and often more so with a theatre delivery). You'll get a chance to ask questions at a debrief, and it may clarify a few points for you

Yes things didn't go according to plan. I'm not a medical person but measurement of babies isn't an exact science. I'm afraid I agree with people who have said you have had a healthy child and it doesn't sound as if your labour was mismanaged. If it was then you should complain.

Epidurals have a notoriously high failure rate. People don't like to admit it but it's very, very common for them not to work properly or only work on one side. I've seen them be resited lots (I'm a midwife). And no, not all London hospitals have PCAs as someone else mentioned. I work in one and we use top-ups. Some women just have very difficult backs to insert epidurals/spinals. It's a blind procedure and not necessarily the anaesthetist's fault.

Also, if you'd had an epidural before the drip was started it's extremely likely you'd have had a C section for slow progress as well. I can't think of any first time mum i've looked after in that situation who hasn't, not to say it doesn't happen but epidurals relax the pelvic floor muscles. Whilst trying to make a uterus contract artificially when it's never done it before.....you can see why it causes such a problem.

The thing with measuring bumps is it's also inaccurate. You can gauge a rough idea of how big a baby may be but it's subjective. I don't think the midwife could have kept referring you for growth scans but difficult to say without knowing what the reports said. Maybe you should have been induced a week after your due date instead of 2 weeks but then inductions increase your risk of having a c section massively anyway. You may have developed late onset gestational diabetes, it's very difficult to say. And I don't think it's necessarily your size that was the issue but the fact it was your first baby. I think most first time mums regardless of how big or small they are would have run into problems with a baby that big.

A general anaesthetic during birth is very traumatic when it's unexpected. I can understand why they allowed you to labour for a long time, they wanted to give you the best chance of a vaginal birth. I don't envy doctors having to make these decisions as it's easy to look back in hindsight and say maybe we should have called it quits earlier but likely would have been the same outcome by the sound of it.

I think a debrief, particularly around the anaesthetic issues, would be helpful. Epidurals are sold as the holy grail and I've looked after a lot of women who've been very upset, understandably, when they don't work. But no-one can say fr sure on here if anything was missed. I wouldn't be able to without looking at your notes and I think that would be a good idea for you. I hope you feel better soon.

Oh OP this sounds like a fairly standard yet stressful first birth

I am not denying the stress but I don't think they actually did anything wrong

Many small women have large babies

Do what you can to get the stress debriefed but I don't think there was fault just a horrible scary birth

Seriously can't believe all the fun telling you off on here. Fuck them.

I had a similar experience OP, baby is nearly 6 mths now and I'm still not over it. So much is made of the importance of vaginal birth, ideally unmedicated and in water, instant skin to skin etc for bonding and successful breastfeeding. For things to have gone so wrong right at the start is a headfuck and makes you doubt yourself, doubt your body, doubt your baby. It's SO upsetting.

You are entitled to those feelings, and entitled to help to process them. Do not stuff them down because you're 'lucky to be alive'. Aren't we all, every day? Doesn't mean life isn't sometimes unbearably hard.

I can't tell you what you need to do to get over it as I'm still not there myself. But I instinctively feel blaming the midwives won't help in the long run, as they did their best with limited information. But absolutely stand by your feelings, explore them and if possible overcome them. Don't let anyone tell you you aren't allowed to feel that way xx

I was told my first was going to be a 9lb+ bruiser, but in facr turned out to be much smaller 6lb 4oz.It doesn't seem to be an exact science.Stop casting round for someone to blame and enjoy your (big) baby!

Congratulations on the birth of your DD. Your birth experience was quite similar to mine in some ways. I had a very neat bump by my 2nd growth scan at 42 weeks he was showing declining growth. I had been in early labour for a week and a fourth stretch and sweep broke my waters and active labour started immediately. I had 10 hours of labour before the epi and drip. The epi stopped working on one side and after another 4 hours I'd only made it to 7 cm. My DP thankfully at that point pushed for a c section. The spinal worked, not that I cared by that point, but I only held my baby briefly as I was shaking so much it wasn't safe for me to hold him. In theatre he was told the baby wouldn't have come out naturally and I wouldn't have dilated anymore because the head couldn't move any further down my pelvis to press on my cervix. DP was also told in theatre to make sure I get an elective section if we have anymore children. I had a growth scan the day before DS was born and it measured him smaller than he was.
I don't think anyone else has the right to say you should just be grateful to be healthy and have a healthy baby as birth can be traumatic and what one woman is fine with another will not be. Your emcs sounds really difficult and a general anaesthetic requires a bit of recovery. Ask for a debrief when you feel ready and find out in advance of deciding to have anymore children if you can have an elective section.

I can see both sides of the story and you have my sympathy... I had a huge baby - 11.5 and half pounds and was overdue by 2 weeks too. I was also induced but had an epidural then after 9 hours, was taken to theatre for an emergency c-section. No-one knew or predicted my DD would be so large, and I didn't have any extra scans throughout my pregnancy despite being huge for my size (5'2").

I remember my dad saying to me at about 32 weeks that he thought I was bloody huge, but no-one thought to question it - even during labour, the doctor said he thought I would have an 8lb baby. I think I must have had gestational diabetes, but again, if I had been tested for it then I would know why my DD was so huge.
To be fair, the care I got from the NHS was amazing and totally too notch and neither me nor my DD would be here if it hadn't been for the NHS. I very much doubt I would have had an easy natural birth and I am bloody grateful for having the swift decision of the doctors to give me a c-section. It makes me shudder to think that I might have had an almighty vaginal tear and probably complications (incontinence?) had I given birth naturally.

Be thankful that you and your baby are safe and well. I can totally empathise with you but at least you had extra scans and they were aware you were larger than normal.

YANBU to be disappointed. Hindsight would be a wonderful thing. But please while I don't want to minimise your situation which was awful, please don't feel alone. So many of my friends have grim birth stories, as do I, and we have to remind ourselves we made it out the other side!
I was also measuring big, lots of growth scans, they said he was 10lb plus at 37 weeks so offered me elcs at 38. All went swimmingly well planned until they 'nicked' a main vein when they cut
Me open and I lost 4 pints of blood on the operating table. I say all this to reassure you that the alternative may not have been roses either. Ps he was only 8lb 4oz and I feel robbed of the natural birth! Still YANBU for you. Keep talking about it and don't bottle it up.

Great post lelapelutte

I felt much the same after DS1's (very similar to OP's birth) nearly 17 years ago. It was indeed a headfuck.

OP do all you can to explore this and have a debrief as suggested. You will be able to let it go in time. Remember that this difficult, traumatic and disappointing time will pass and you've years to build your relationship with your child.

Congratulations OP.

I had repeat losses before DS. When I got to antenatal classes I felt really uncomfortable with the way we were meant to plan birth, I already knew a lot could go wrong with pregnancies and was quite wary of the way it was, like cantkeep says, being portrayed as an experience that we'd have some control over.

As it happened, I ended up being induced (IVF pregnancy so couldn't go over term) and had a similar experience to the OP's - was in labour for a long time, epidural fell out at one point, at another point loads of people ran into the room as DS was in trouble and then left as his heart rate returned to normal, and I ended up having an EMCS.

I think the fact that I'd been through so much to get to the point of having an actual live baby meant that worse things had already happened, but if I ever manage to have DC2 then I'm insisting on a CS from the start.

Op, I think do a debrief if you can, then think about coping strategies for if you decide to have another one. There's unlikely to be any rush.

I am disgusted at a few of the comments here.

Even if the midwives didn't let you down, that does not invalidate your feelings. You are perfectly entitled to have found this traumatic and upsetting. I agree with those who suggest a birth debrief and when you feel ready for this, hopefully it'll help you move forward. You had a very traumatic birth and even if nothing could have been done to prevent it, of course it'll stay with you. I'm sorry you had such a hard time and I hope you can come to terms with what you've been through.

I hope you and your little girl are doing well now.

YANBU my first birth was traumatic, my epidural also didn't take and I had a section under GA. Afterwards I felt like I had failed, like I hadn't given birth and it hurt that many people had held my baby before I was able. I missed on those precious first moments, as had my partner. Of course I was happy that we were both safe but i still felt so sad about it.
My ds1 is 6 now and while I have moved on (and have two more children) I will always be a little sad about how his birth went.

I hate the "nevermind, you're both healthy, get over it" type attitude. If you went into hospital for any other procedure that's treated as fairly routine and minor and ended up with major emergency surgery or complications, you'd get a hell of a lot more sympathy.

Some of your story resonates with me. I measured big and had two growth scans. Baby measured big, but not alarmingly so. He was born at 8lb 10, slightly smaller than anticipated from the scan two weeks earlier. Long, lean with an unfortunately large lumpy head that definitely wasn't getting through my size 8-10 pelvis while lodged in a back to back position.

The labour was spontaneous shortly before due dates, but it was long. I was already knacked from 27 hours of regular contractions before being admitted for 13 hours of all nighter, 2 hours of pushing and an EMCS when we were both exhausted and began floundering. The word epidural was never mentioned, instead I was locked into a world of pain with two doses of pethadine (one of the biggest factors I struggled with).

He ended up being observed in neonatal for a few hours, and I ended up with 36 hours of HDU for symptoms of pre-eclampsia and reduced liver function (yeah, we both felt so healthy )

Initially I was relieved that it was over, then when the birth trauma set in over the next few months, I mistakenly thought it was too late to deal with it. I ended up getting support around DS's second birthday when partway through my second pregnancy as I had so much fear and baggage about the first. It was more along the lines of going to labour ward and empowering me with positive choices that were practical for a VBAC. Successfully achieving a VBAC (at the cost of a 3rd degree tear with forceps- yup, more back to back, considerably more painful and irritated the SPD for several more months) did help relieve that feeling of being cheated after labouring so long.

DS1's 3rd birthday was the first one where I didn't cry about his birth. Time had passed, and it was more about his enjoyment of the day than the first two. Now he's old enough to be at school, a lot of the emotion has faded and it's such a tiny fragment of his life, not the whole foundation of it.

Time is a healer, but debriefs and professional support can help speed it along.

Where a birth has a complicated delivery, there should be more attention paid to debriefing. Traumatic births are often a trigger for PND, and helping to rationalise it and be clear about implications for future pregnancy/ births could alleviate a lot of maternal misery. If all women put up and shut up, there will never be any progress on improving emotional outcomes of birth.

Definitely get a debrief when your ready.
You were very unfortunate that your epidural was patchy and didn't work sufficiently during your section.I do take issue with the midwife who said they have a notoriously high failure rate,this is simply untrue as many mum's out there will testify but some do fail and some like yours are not consistent so the top up for the section didn't work.
Arrange a debrief and if you feel you need it ask if you can have a debrief from the anaesthetist too.
And Congratulations.

Midwife here.

Your feelings about your labour and birth are absolutely valid. Women going through every kind of birth experience can feel deeply traumatised by it, even the ones who have a quick, apparently "easy" birth. There were lots of issues during your antenatal care, labour, birth and postpartum you need to debrief with the health professionals involved in order to give you peace of mind.

Without having been there myself I cannot judge on other professional's practice. However I can tell you the midwives were right to refer you for growth scans, and there was nothing more they could have done after the scans came back showing normal weight. As already explained by other posters, growth scans can be massively inaccurate, women can "measure big" or "small" while carrying a perfectly baby of a perfectly normal weight. Sometimes women measure withing normal ranges and their baby is however too small or too big!

During labour, there is one thing you comment that caught my attention: "The drip made contractions extremely painful and I had no gap in between them so endured 5/6 hours of contractions before getting an epidural". During an induction or augmentation of labour using the drip, the aim is for 3 to 4 contractions every 10 minutes. Please go through the notes and check that this was done like this. Contractions should never be "one after the other", because both you and your baby need the "rest" between contractions to be able to recover. Aiming for too many contractions in order to "speed up" labour is a serious mistake some health professionals can make. However, as I said, I was not there and what "felt" like "constant contractions" for you, may very well have been 4 contractions in 10 minutes. Sometimes the hormones of labour play havoc with our sense of time.

I believe the main contributor to your distress though was the inability to obtain a good epidural, and this is something that no one is responsible for, as explained before some very normal backs make it more difficult for the epidural to be inserted and kept in place. Expecting the relief of an epidural after hours of intense pain, and then finding you cannot have it, can make the pain and suffering even worse.

Also, ending up with a general anaesthetic and being unable to see or hold your baby is very traumatic.

Although by the way you describe your antenatal and birth, it seems to me there is very little that could have been foreseen in advance, you do need a debrief and the opportunity to be heard, and receive explanations and rationale behind several decisions made.

I hope you find some peace. Big hugs!

PS No, women should not all "be grateful" they have a healthy baby. Mental health problems after a traumatic birth cause non end of misery for women and their families, sometimes much worse than physical problems.

I can understand why you are looking for answers about what has happened. You had an expected, scary experience and while you and your baby are both ok, it doesn't mean it wasn't traumatic to go through. I had a difficult experience when my DS was born - the care we had was great but it took 2-3 years for me not to play his birth over in my head to try and process it.

Just to add about epidurals, I had one at the same time as the syntocin drip (inductions, pre-eclampsia). It took the 3 attempts to get it in and it wore off completely on one side. The anesthetist tried to resite it but couldn't so I laboured without for the last 3 hours.
I was offered an epidural again for pain relief following major surgery 2 years ago. It was in a different place on my back but the anesthetist was unable to get it in correctly and gave up after 3 attempts. Clearly my back is not easy to get an epidural into.