Questions about labour, birth plans, and care

[scaredofbirth]

I am 25 weeks pregnant with my first child and throughout antenatal care have been experiencing some issues. I find it very difficult to explain to people including medical professionals, my partner knows the reasons but I haven’t been able to tell anyone else yet. Due to my past life experiences (not connected with medical settings) I struggle with physical contact from strangers and am terrified of hospitals for multiple reasons. I have found scans, and the medical checks quite anxiety inducing and uncomfortable, and lying on the beds with people standing over me scares me and makes me feel like I have little control over my body.

I had to go in for a check over after an incident and the doctors there were male, I was practically in tears behind the curtain and my partner says he felt awful seeing how distressed I was.

In the past I have refused to undergo tests that involve me being unclothed for connected reasons.

I have done well so far and despite spending all day and night worrying before appointments, have attended them all and got through them without being too much of a mess. I haven’t told the midwives that I find these difficult although they have picked up on my nervousness and reluctance.

I’m worrying about how I will cope with labour and the appointments approaching it. Reading the notes they give out, sweeps and internal examinations are mentioned and once it reaches that point struggling through isn’t an option for me, I am just about managing to cope with the normal tests by having my partner with me at all times.

I struggle to speak up when people I see as holding authority over me want to do something that makes me feel uncomfortable, sometimes I zone out and it’s like I’m watching it happen from outside of myself, this can mean other people don’t notice I am stressed. I have had a mix of people allowing me to arrange my own clothes and paper coverings and wipe gel off myself, and others who just do it without asking or warning - the latter being quite upsetting to me, and to be honest causing me to spend the rest of the day and night feeling very on edge and down in myself. The emotional drop after an appointment is quite overwhelming, I tend to spend the rest of the day very withdrawn and quiet and I cry easily, my partner has witnessed this.

My question is more about how to convey to the midwives when the time comes what I am and am not comfortable with, when they need to give me space and how to approach me when I am frightened. I have had in-depth conversations about this with my other half and he understands what I think I need and has agreed to advocate for me if I struggle to make my needs known, but I think I need to open up this conversation with my midwife and explain just how important it is that my fears are taken seriously.

I am worried they might not ask consent or pressure me into internal examinations before and during labour, or that students may be invited into the room when I really need privacy and distance and careful use of language to avoid upset.

I am also scared that if I disclose the reasons behind it then they might want me to take part in counselling or that social services could get involved, despite the cause happening many years ago now and in a different country.

Basically lots of fear, and while I have been coping, enjoying being pregnant and looking forward to meeting my baby, I’m scared about the process that has to happen first. I’m not scared about the pain that comes with labour, I’m scared of the people involved and the procedures, of the medicalised environment, and not having control over what happens to me.

I know this post sounds garbled, it’s been difficult for me to write about so I might not have made much sense, but if anybody can offer some reassurance, maybe advice from women in similar situations on what to put in a birth plan to highlight these needs, or even just stories of women with similar experiences and their own labour and what helped them I would be hugely grateful.

Would showing your midwife this post be an option? With my first, I wasn't comfortable disclosing that I'd been raped previously and that I can't bear being touched until it got to the point where I just couldn't cope any more. Everyone was very understanding and just wished I'd felt safe enough to confide in them earlier.

Once I did open up, I was offered female only health care providers and with my 2nd child, dh was the only man in the operating theater which made a huge difference to my comfort levels. My consultant also went an extra mile to try and ensure that all the things which I might find triggering were avoided wherever possible.

Telling your midwife might be easier than the worry you’ll have with every appointment.

You can write on your birth plan what you want and don’t want. Or words that make clear that touching and exams are a concern of yours. Hopefully someone will be along soon with some specific advice on this.

They should always ask for your consent before an examination, although with someone standing over you i appreciate this might not be enough. Can your OH stay with you at all times rather and protect you from unnecessary things e.g. someone else wiping you and making sure you have time and space to make decisions. Can he act as your protector? Keep him with you rather than have him seperated behind the curtain?

And in terms of councilling you don’t want. You don’t need to go into details. Just saying something like “for reasons I’d rather not go in to I need you to manage my care like this: please do x, y and z and don’t do or say a, b or c”

Tbh if I were you I would consider requesting a c section on the grounds of maternal mental health. You might breeze through labour, you might find it healing or empowering or whatever, but you might not.

If you are set on a VB, I suggest you find a private doula who has a good relationship with the hospital to advocate for you, and to find a hypnobirthing course. I found that hypnobirthing helped me feel more in control of my body.

I would agree about asking your midwife to read this post or a printout of similar next appointment. I don't want to alarm you but for one of my births no-one even read the birth plan until after the (sudden) delivery.

I think you need to make this clear to your midwife/team as soon as possible as things can happen quickly and it is best your care team are aware before. I expect she can put it in your notes. Hopefully she can then advise you how best to flag this up for other professionals and what to include in the plan.

Thank you for the replies, I know I have taken time to respond but that’s only because I have been thinking about what you have all been saying and discussing it with partner, it’s really appreciated.

I have a midwife appointment tomorrow so I am back in the cycle of panic over it and will be until it’s over.

I have a letter I wrote to my partner near the beginning of our relationship (it was easier to explain things to him that way than talking at first, before him I hadn’t been ready for a physical relationship for over 5 years, after the incidents) so I am using that and the post I made to make a slightly more coherent letter for the midwife to read when she gets a chance, leaving out details of what happened to me, but making sure it’s still clear about the effects and my worries around labour and ante natal care.

I don’t feel in a space where counselling would be useful to me if offered, I don’t want to discuss the details of what happened to me other than with my partner who has had a gradual drip feed over the last couple of years, and shown more than enough understanding. So I won’t be going into why I react the way that I do with the midwife.

I have asked my partner to stay right beside me during future appointments and during labour, that’s a brilliant idea thank you, I have also asked him to keep talking to me while we are there, I’m hoping it will make me feel more present, he has agreed and is going to take a much more proactive role in speaking up for me. We are also in the process of talking through what could happen in labour and how he can help in each situation. I tend to gravitate towards him for comfort when I am frightened anyway, which he is well used to by now, so it makes perfect sense. I think I will make sure this is conveyed to the midwife so she knows and can tell others that he is going to be my voice.

Someone mentioned a C section as a possible alternative. I have considered it over the course of the pregnancy, but for the same reasons I plan on refusing an epidural ( fear of not being able to move and being stuck on the bed with strangers around me) I will be going for a VB. I’m aware it won’t be easy, and I’m not looking for it to be a healing process. I also know I could end up needing a C Section or epidural anyway, but I’m hoping I can avoid those things.

I have heard that a water birth can be quite hands off and like the idea of the water as a barrier I can utilise in some ways so will be seriously considering that.

There is also an element of me wanting to do something natural rather than having that taken away from me by the people who did this to me, they have taken so much already that I couldn’t bear to think of them taking away this experience as well, I thought for a long time that thanks to them having children would be out of the question for me, but I managed to get to the point where it was possible, if that makes sense.

Thank you all for replying and I will let you know how the conversation goes.

@scaredofbirth I didn't want to read and run.

I second the doula option. They will be able to support you, and your partner if he starts to find it tough too. You can say as little or as much as you want to them, and they should be able to hold your 'space'. A water birth is also a really good option, as is hypnobirthing.

Attending Antenatal classes, to prepare you for the ins and out of labour whilst you are not in it, might also be a good idea?

I used to work with an amazing midwife, Kathryn Gutteridge, who supports many women with similar issues, mainly relating to previous sexual trauma, but would also understand the issues you are describing. You could contact her, if you feel comfortable doing so? Here is a little bit about her: www.rcm.org.uk/kathryn-gutteridge. She is based in Serenity Birth Centre in Birmingham.

Take care x

I know it’s a few weeks after I first started this post (hope this name change worked properly so you can see I’m the poster, obviously didn’t want this thread connected with the rest of my details).

I wasn’t able to bring it up in my next midwife appointment - which was a nightmare of one and left me feeling horrible afterwards but

In the end I ended up seeing my consultant for a growth scan originally. I have only seen her once before but she is a very calm, reassuring type.

I had a bit of a panic episode when the midwives were doing checks before the appointment (just bloods and the usual) and she popped her head in. Once we were back in her room this opened up the chance to bring it up, with some encouragement from my partner.

Although I didn’t go into detail with her, we were able to talk about the fact that I had been worrying a lot before each appointment and that I wasn’t at all comfortable with the hands on aspects of the exams for past reasons I wasn’t able to explain at that moment, or having lots of people around me doing things at once.

It’s a bit of a relief having some of that out in the open, even if the background reasons aren’t there.

I now have an envelope in my notes containing a brief notice for the midwives I see, just saying that I can get frightened and explaining some of the things that make it easier for me, including my partner being there. She considered putting something on the front of my notes but thought it was best it wasn’t there for everyone to read hence the envelope idea.

We talked a bit about being able to say no to things and how consent is important during anyone’s antenatal care, using my partner as an advocate, asking for them to stop a moment if I need to, and how they can limit numbers of people present, and explain things calmly and carefully.

It’s actually a huge relief to just have told someone that much and to know that the people I deal with will be aware that I need them to be a bit more cautious.

I have another appointment with the same consultant soon, she made a point of ensuring I see her to avoid changing faces, and I may even ask a bit more about the birth plans (it’s supposed to be discussed in the next midwife appointment but I feel I can be a bit more open with the consultant so might expand with her) at that one to discuss how to work things.

So all in all, while it hasn’t all been explained or sorted, the door has certainly been opened and the discussions begun so I’m feeling a little bit more positive that things are able to be solved and a little bit less anxious about whether I’m going to be listened to and able to cope.

I am attending antenatal classes as well so it should help me feel a bit more informed.

Well done - you have taken a step to reestablish control. Your DP sounds like a good 'un. Best of luck with it all.

It’s me the OP again

My baby arrived a few weeks ago.

Labour was a complete shit show. I can’t help but think I should have taken the advice and gone the planned C section route.

It started off really well, I let them do the first internal as I figured we needed to know where I was in the process. It was hard but I managed and was 5cm on arrival, coping with contractions extremely well even the midwife commented. Me and my partner had been really working on calming methods.

Got to the delivery room and settled into everything, all still fine, then a midwife did an examination despite me clearly begging her not to, partner was making tea for me from a tray and heard me crying and came over, tried his best to step in and make her stop with no luck. She ruptured my membranes without explaining what was happening, despite me being in tears, noticing her pick up the hook, and shouting at her not to. I had flashbacks during this and constantly throughout the rest of labour.

Then had the balls to tell me not to get upset when I got up sobbing and leaning on my partner.

Downhill from there resulting in multiple times I wasn’t listened to or explained to, labour stalling at 7cm for hours, I’m convinced it was because I was terrified from that point on and more interventions needed.

Won’t say any more because it’s already very outing.

Really struggling with the aftermath. To be honest labour made me feel like I was raped again.

I’m still having vivid flashbacks, panic attacks, bursting into tears because I can’t cope with the images and despite holding it together when the midwives and health visitors come (mainly because I no longer trust them at all, despite pretending) I’m a mess and can’t see a way through it.

I love my baby, the moment she was delivered i couldn’t stop beaming (was then separated from her for ages) but mentally I’m broken, it’s like I’ve gone right back to the beginning, feels like I have no voice anymore.

Just holding on for my baby and my partner at the minute. He feels like he failed me, every time he pointed out my wishes and tried to advocate for me he was shot down, childbirth wasn’t a good experience for either of us, although of course we are glad our baby is here and healthy.

Examinations are marked on my notes as consent given despite me clearly objecting as are several procedures. It’s all so ridiculous.

I’m so sorry this happened and disappointed for you OP! The idea of having your waters broken without your consent it horrendous for anyone, nevermind for you....

Are you planning to complain?

I don’t know that there’s much point in complaining and I really don’t have the emotional strength to at the moment. It takes everything I have just to care for my baby and put on a brave face at the moment.

If I did it would probably be waved away as just one of those things anyway. I don’t know if I might put in a complaint when I feel more able, depends on if I can reach a point where I’m in a slightly better place.

I'm so sorry to read this. I went through something very similar with my first, ended up having hallucinations and flashbacks to my rape during my emergency section with dc1. Please talk to someone, I tried to cope on my own and failed massively. He's 4 now and I'm still having psychotherapy.

No one called Social Services on me even when I tried to leave dc1 in NICU claiming he was a doll, they just got me help. I would also recommend complaining or at least providing feedback when you feel up to it but don't rush. It took me six months to be able to write it down without feeling despair or rage.

If you don't feel up to talking to the GP/Health Visitor, the Birth Trauma Association has a closed facebook support page which was a life saver for me, quite literally. There is a link at the bottom of their web page (www.birthtraumaassociation.org.uk/) or it's searchable on facebook.

I would also recommend getting out of the house as soon as you feel physically able, the friends I made in those first few months of trying to put myself back together whilst coming to terms with motherhood helped a lot. Plus it helped me regain control if that makes sense as I was taking my life back. Proving that I could cope as a mother even if it was very much a fake it til you make it sort of thing.

Have you thought about a doula or hypnobirthing?