Birth options following 'assisted' first delivery

[spydie]

I'm now pregnant with No.2 and starting to worry about my options for the birth already. It's still very early days but I'm feeling increasingly anxious about the booking appointment as I know I will need to discuss my concerns, and need to start getting my thoughts in order. I'm worried about being pushed into something I'm not comfortable with.

As background, I had a very straightforward pregnancy with DC1. I had lack of movements for a few weeks and at 41 weeks, following another trip to the MAU it was decided to induce me. The induction was awful, I could not cope with the pain and contractions every couple of minutes from the very beginning. I remember begging for an epidural and being told I was only 2cm at about 5pm. I was given 2 lots of pethidine and my waters went at some point in between. Everything is very vague but I know I finally got onto the Labour ward at about 1am where I was told I was 4cm and baby was back to back. I had an epidural at that point and although I could not sleep I managed to rest. DC1s trace was a bit unreliable depending on how I was lying and I eventually got stuck at 9cm and wouldn't dilate any more. I recall the Dr saying she had not fully turned and her chin was not tucked in. I was put on the drip and a few hours later started pushing. DC1 had blood taken from her head and a clip put on for monitoring as her trace became more unreliable. We allowed the epidural to wear off but I couldn't handle the pain, it felt like my back was being snapped in two. After a couple of hours pushing I was taken to theatre for a forceps delivery with staff on standby for an emcs. The Dr that delivered her told me she would never have come out by herself and the cord was wrapped tightly around her neck. My DD did not cry at birth or at all for hours. I did not get to hold her until maybe an hour after the birth and she was not interested in feeding. I asked for help but I only saw a trainee MW who didn't seem to know how to help. Eventually a MW came in and told us she had to feed and fed her a bottle. I was completely out of it following the delivery and too tired to argue. I struggled to feed her, mainly due to my own pain and didn't get much help, so gave in the next day and she was FF from then on. Just typing this out and remembering it all again has made me cry.

Post delivery my episiotamy and general pelvic area was agony and I think I eventually managed to drive the car after maybe 3 weeks. I suffered pain for months after, as well as issues with having no urge to wee which still causes me issues now almost 2 years on. I'm also fairly sure the delivery has damaged my hip - I had severe hip pain following the birth and have been diagnosed with torn cartilage in my hip socket. I'm fairly certain that having my feet in stirrups with no feeling (epidural) was the cause - I cannot bring my knee anywhere near my chest without causing intense pain. I have been having physio privately for the last 9 months and am in pain most days and nights. I will probably need surgery at some point.

My notes later said the reason for the assisted delivery was maternal distress, which makes me feel like a complete failure. At about 4 months post delivery I became very down and struggled for the next 10-12 months. I saw my GP and did online therapy, I wasnt formally diagnosed with PND but I think its very likely I had it. I tried very hard to keep things to myself and didn't let on to anyone like the HV's that there was anything wrong. Not feeding her myself was a huge factor in how I was feeling, and even now I can cry about it or get upset if I see someone else feeding.

I know 100% I could not go through that again. I know that second time round I could have a perfectly natural birth but equally I'm terrified of the uncertainty. I'm also worried about further damage to my hip, and tbh I don't even know if it will cope with just being pregnant! There is a very large part of me that would like to have an elcs, but I'm scared I might have the same post birth experience of pain, lack of support, struggling to feed etc etc. I'm also worried of the hoops I might need to jump through to request one and the emotional stress involved.

I'm sorry this is sooo long! I'd be very grateful if anyone could share any similar experience they might have or words of advice

Have you been back to the hospital and talked through your Borge cowrie very and your notes? Different hospitals call this different things but all offer it, it can help you clarify what went on and gets a lot deeper than unhelpful phrases like maternal distress, and a lot of people find it really useful at working through a difficult or upsetting delivery. You can also ask your GP and go and have an obstetrician appointment to talk about your options in future. A planned section isn’t everyone’s plan A but does give you a calmer experience with fewer chances of things changing like in your first delivery. Alternatively you can talk about the points at which choices can be made, so for instance could decide that if you go into spontaneous labour then great, but if not you’ll prefer a section to an induction, or you are happy for an induction but if not progressing would prefer a section to the synto drip, or happy to give synto a go but if not progressing well then have a lower threshold to bail out for a section etc. Having a clear plan in place can make things a lot less frightening and let’s you to some degree choose your outcomes a bit more.

Borge Cowrie should be birth experience...

Ds got stuck and wasn't moving down so he was got out with forceps after I pushed for 2 1/2 hours. He also had shoulder dystocia but luckily came out screaming. It was horrible and painful and put me off getting pregnant again for a long time.
Dd was born in water with no pain relief in a midwife led birth centre after 15 minutes of pushing. Totally different.

It sounds like you had a hard time, OP. Far from being a failure- I'm not sure I would have managed as well as you!

I know there are no guarantees, but every birth is different. One of my friends had a horrible drawn out labour and forceps assisted delivery with no 1, no 2 was born in the car on the way to hospital!!

I think the best thing you can do is to get yourself as much information as you can, speak to your consultants and midwives and allow yourself to feel as in control of your pregnancy as possible. I think it is easier with the second pregnancy, I found I was able to be more assertive and less hesitant to discuss issues.

Good luck! I hope you are able to enjoy the rest of your pregnancy

So sorry to hear of all you've been through OP

I had a tough time too bc of a ligament condition I had, it was very long, very intense, and very sore. My joints especially pelvis and hips haven't recovered and pregnancy will almost certainly be agony pretty much right from the start again next time which is very scary.

I can't really give advice as I've only done it the once but my plans are: ask for help and be honest about everything be it physical or mental and accept all the help I can get (be that counseling, physio, etc. to a cleaner to help at home), do hypnobirthing (Maggie Howell has good downloads) to try and help me let go of past experience, and most of all be KIND to myself and try not to pile on the guilt and pressure, to just do my best and accept that knowing my limitations and asking for help is wisdom not weakness xx

Hi Spydie,

Firstly congratulations on pregnancy and I'm sorry you've had a difficult time.

I'm not sure if you have visited your midwife yet and had your booking in? If you feel comfortable it might be worth going through your key concerns about your previous experience and also for your upcoming birth and seeing if they cam arrange a consultant midwife appointment or perhaps even a consultant (ie obstetrician) appointment especially as you are currently receiving physio.

Depending on how far along you are they may not make the appointment for now but for nearer the birth. However it might make it easier to start getting that in place and get the discussion rolling.

You can also ask to see if they will go through your last notes with you to see if tat clarifies things futher. If the obstetrician said they baby would not have come out it sounds as though it was a true mal position of the baby that was the issue and going through the notes may help sort through events.

Also I know you are aware that your next birth could be totally different and you are correct. Being a first time mum being induced can be a factor in the baby not moving down and into position. You are more likely to be induced as a first time mum so you may find this is different. Equally a baby in a difficult position can be a cause of slower onset of labour and slower labour. Again this could be different in this pregnancy and also there are lots of ways a midwife can suggest to support you in helping baby into optimal position. Obviously this would be depending on your mobility and where you are in the pregnancy.

Hopefully good discussions with your midwife and possibly consultant will allow you to make plans that make you feel supported .

My toddler had just woken up but didn't want to read and run!

Best of luck with everything and keep asking questions/talking to your care givers.

Xx

Oh that all sounds awful, OP, no wonder you are worrying about it. I went into labour spontaneously with dd1 and contractions were strong and every couple of minutes from the start. After being at 7cm for a while the mw broke my waters and there was meconium, a transfer by ambulance from the mlu to hospital, dd was in distress, stuck, eventually came out with ventouse and I had to go to surgery to have all the placenta manually removed and transfusions to replace the lost blood. Looking back I was in shock for a few days.

Dd2 came out in less than three hours, no fuss, hardly any pushes and only made it to the birth centre as I insisted to the ambulance crew (that dh called when he realised THE BABY WAS COMING OUT!) that I wouldn't push! A couple of hours later I was munching a Greggs sausage roll and ready to get back home.

You can never no what a labour and birth is going to be like. I agree with the pp that you should contact the hospital for a birth debrief. There will be a patient liaison team as well that you could contact to talk through your care. Your mw when you see her will have notes (although I am not sure how detailed) about your previous birth so this will be where you can start to discuss your concerns.

Birth injuries and birth trauma left unaddressed properly are an all too common theme on these boards. My heart breaks for your reading your post OP, that is an absolute ton to go through.

What I’d suggest is this:

Get a birth debrief. That will provide a clinical overview of what happened and will allow you to tell your side of what happened and get a clinical explanation.

The trauma requires therapy. Please do this as you will be a lot more mentally “match for” for DC2. You will also be able to download and heal from DDs birth whilst prepping and managing the anxiety around the birth for DC2.

Lastly, you may very well have an uphill struggle regarding an elective CS (I hate that term). You would do well to re read your OP, re write what happened in bullet point form, keep the language emotion free, stick to the facts and when you come to conversing with midwives/doctors/consultants you have a manifesto ready that ought to leave the professionals in no doubt you have a valid case.

Good luck OP. X

Thank you Ladies for all taking the t8me to reply I've read through your replies a few times and they are very helpful.

@Bagel Dog borge cowrie did make me laugh but in answer to your question, no I have not done this. Perhaps I ought to... is this something I can arrange myself or through my GP?

@Danigrace I'm already noticing more pain in my hip at night so I'm very worried it will only continue to get worse

@babypeach my booking appointment is still a couple of weeks away. I need to summon the courage to talk it through with the midwife but I'm very worried they will be dismissive. If I ask for a consultant midwife or obstetrician appointment do they tend to be accommodating?

I will definitely find out about a debrief though. Has anyone ever had one and felt worse after? I know there are woman out there who have far worse deliveries than I had, I dismissed it as an idea when I was still on mat leave as thought I might be made to feel like I was overreacting.

I had a similar experience first time- induced, back to back, drip, forceps in theatre, episiotomy and tear etc. Pain was unbearable but the epidural worked perfect as soon as I was allowed it.

Second birth- induced again but proper contraction pains rather than constant pain, could talk through them all the way through to the end. DD came out in two pushes and I felt like superwoman after! No pain relief and I'd honestly do that birth again any day (but I'm not because DH has been snipped).

Good luck second time round!

Generally at booking they will check if you have any physical/emotional issues that could impact the you/baby in pregnancy /birth/postnatal period and take that into consideration when planning your care. It depends a lot on your trust and their policies but often at this point referrals will be made if necessary for example to a consultant if there are concerns about how you will physically manage the birth etc. As pp has said, note down any issues and note that you are receiving physio.

Also as a pp mentioned you can ask for a debrief which will often be with a consultant midwife or similar. They can help you understand and process what happened in your first birth. They should also be able to help you plan for your upcoming birth.

A medical referral to the consultant may be harder to get as you often have to meet specific criteria but I would say you definitely ought to push for one if you can to try and properly assess what the physical effects of you birth injuries are.

If your booking midwife is not helpful you can contact the pals team at the hospital and tell them you want to arrange a debrief. They should be able to get you in contact with who you need to get going.

Xx

The midwife will most likely refer you for obstetrician lead care anyway given your previous birth. You can always prompt tgis as your booking apt. This means you will have a consultant appt at the hoslital (how it works here) and then they will decide how to proceed with your care.

Haven't had any briefing but do look into it. They are for women who need them after their birth. That other women might have had worse births than you doesnt matter, you need to talk more about yours.

Typos sorry, feeding dd with a very bad headache! I need to go to bed!

OP I had a similar but not as awful experience with birth of DS 2 years ago. Now pregnant with DS2 and we had an appointment with the birth listening service last week. DH and I both found it really useful to talk over what had happened and the midwife suggested we speak to a consultant to discuss options for delivery this time around.
It was difficult to re live it all but made me realise that I hadn't dealt with the issues from DS's birth.
We're going to discuss options at an appt next week and it's already made me feel a lot less anxious and more positive.
I arranged the appt by calling the hospital but your midwife should be able to give you the info you need.
As others have said it sounds like you would benefit from this and hopefully will get you feeling more in control for next time.

That sounds a similar story to me with my first. Second baby was born at home in the bath 1.5 hours after the first twinge. Could not have been a more straightforward or different experience. I also think you'd benefit from a birth debrief and chat about your various options.

Hi OP, sorry you had such a rotten experience first time. I had similar, but delivery was non instrumental, so no long term effects on my health.

Like you I found the drip excruciating. I had constant pain and felt totally out of control at only 2cms dilated. Pethidine did nothing. I was howling and then told it was at least another 4 to 5 hours until the birth.

Fortunately the epidural worked, and I calmed down and got some sleep before I had to push. I too had the scratch on the baby's head and the monitor. None of which was adequately explained at the time.

I found that the mid wives were excellent, but the consultants were hell bent on intervening as much as possible with as little discussion as possible.

Fortunately I ended with a healthy baby and I only had 2 stitches, so was all good in the end.

Now for the better news. I have just had number 2. It was an almost entirely positive experience. I was induced again as I am old. But managed to avoid the drip (just about), and labour was only 1hr 20 in total.

I was really nervous about the birth. I desperately wanted to avoid the drip, as I was so scared of losing control again, but I was clear that there would be no drip without an epidural first.

The pain was fierce, but nothing like the unrelenting agony of the drip. I am so glad I got to have this experience.

I agree with others, you need a birth debrief and a sensitive midwife or consultant to help explore your birth options. There will be options that help you maintain more control. You also need to ensure your birth partner can advocate for you, particularly post birth. If you need help to establish feeding, that should absolutely be available. Have a plan for what practical steps your partner can take to make sure this happens.

I hope you have a better experience this time round