1 in 3 first time mother's need forceps or vaccum

[KayBM]

Just stumbled across leaflet on rcog site...it was published in April 2020, so too late for me! But it says 1 in 3 women who are first time mother's need forceps or vaccum. Pretty sure there should be a bit of discussion about this with midwife...

The leaflet also says that for women who don't want an assisted birth they should consider a caeserean.

Just wondering if any first time mother's out there have been told this? Do you think women should be told this? Anyone think this should be on the NHS site too?

Anyone else think that a natural birth is highly unlikely for a first time mother? I wonder what the induction rates and c section rates are for first time mother's too?

@stargirl1701

Just sounds like a stealth brag to me, but okay.

Erm this is a strange thread. Anyone can read anything they like on the internet, it ask their midwife, who I seem to remember was quite clear about the stats because I asked. No one is "not told", they can find out if they ask. Lots of people would rather not fill their mind with negativity. I was clear that I would refuse instruments and go straight to c section if there was a problem.

Wincing reading these just thinking about forceps delivery. Had this with my first spent 4 days in hospital along with a transfusion. Had to fight ridiculously hard with the consultant to get an elective c section with my second. Just awful and the damage will never be repaired.

But even with the information, what can you do?

I can see in some situations there is a choice, e.g. induction vs planned c section etc.

But if you're in the end stages of labour and baby needs a hand but is too low down for a c section, what choices are there to be made then? You'll just be lying on the table as they wield the forceps thinking aboutal the scary stuff you read.

I didnt do much reading about labour or birth and I'm glad I didnt now if I'm honest. I had a go-with-the-flow attitude and low expectations which I think prevented any mental trauma.

@Peridotty please don't worry.these threads are not helpful. Do try to keep walking if you can, it does improve baby's position and application of head to cervix. Apart from that just be guided by your body and don't overthink anything. I had an intervention free birth, long and hard , but perfectly possible and I was fairly old.

@Wolfgirrl

As I said, postnatally things were a fucking disaster.

With DD1 I had to be resuscitated at 11 days post birth with multiple infections and sepsis after an allergic reaction to an IV antibiotic.

It's not bragging. If I had done as much thinking about the postnatal period as the third trimester and birth, I may have fared better.

I failed but I was also failed by those whose job it was to support me.

It’s interesting to me that the stat refers to first time mothers. I had an unassisted birth with an epidural with my first. The whole experience was obviously painful but relatively straightforward. However my second was a different story. As soon as I went into labour it felt very different. My contractions were much, much more painful than they had been with DS1, and unlike with DS1 they were very erratic and didn’t get steadily closer together. And once I finally reached active labour, I progressed to fully dilated very quickly and so didn’t have any pain relief, despite being in agony. I kept thinking that as the pushing stage is notoriously much faster for second births that it would be over soon- an hour and a half later I was still pushing and getting nowhere. It transpired that DS2 was back to back with his head tilted backwards, so he was pretty much lodged up there. So I was whisked into theatre for forceps, and he also needed to be turned before they could pull him out. So from my experience the position the baby is in was the biggest factor, not whether I was a first time mum.

@Wolfgirrl

The laid back approach suits you and that's great. But this hasn't helped me and many others.

I actually asked my midwife for information about assisted delivery and wasn't told virtually anything. This is what I find unacceptable.

Sometimes there are choices between a high forceps delivery and EMCS. Some women may prefer to have a planned c section than take such poor odds on a natural birth and some may feel let down by not being fully informed by medical professionals.

Of course the fact is for women with bad birth injuries from assisted birth...there are also the years of dealing with prolapses, pain and discomfort. Also sometimes multiple operations later in life. This is not insignificant to women who are badly affected by instrumental births and that is just physical effects, there are also women and their partners who suffer PTSD. PTSD caused potentially because they're told they should be fine, and when they're not everyone says well it happens...

@stargirl1701

That must have been very scary, but I just dont see how it relates to this thread (other than implying we all had instrumentals as we were sedentary and lazy).

Not at all.

Our lifestyles are sedentary. I accepted that and tried my best to mitigate that. There's no value judgement in it. That is reality in Scotland in the 21st century. I am less physically capable of giving birth than my grandmother. Fact. No judgement.

I have advantages over my grandmother but in terms of physical capacity for birth, she wins, hands down.

@Wolfgirrl possibly limited yes, but I can make choices like trying to avoid epidurals, staying still, lying on my back - things likely to increase need for assisted birth. I can advocate better for myself in the moment and make sure DH is knowledgable too so I can give informed consent, something clearly lacking in many women’s experience. If doesn’t mean in the moment my choices are limited by necessity, but at least I won’t be shocked and terrified at the sudden need of intervention in the way many women seem to be because they don’t know how high risks are.

@KayBM sorry I just scanned the thread but couldn't see your birth story (if you have one)?

My local hospital releases maternity stats every month on FB, from memory I think their induction rate is 40%. This month 56% of births were spontaneous VBs and 44% were c sections or assisted deliveries. And that is overall not just for FTMs!

@Wolfgirrl

I do appreciate your comments.

We are all so different...but I do wonder if we would expect to go into any other situation like a planned operation without extensive information? Would that be acceptable when it could have life changing consequences?

I hope you healed well after your forceps delivery

@BuffaloCauliflower

I do see what you mean, but what if the pain was absolutely overwhelming? Would you take an epidural, feel like a failure then await the inevitable instrumental delivery? Or try and battle on and become more distressed and exhausted?

I'm not trying to be difficult, it is just how I see things in my mind.

Didn’t need instrumental intervention for dc1 but did dc2.

@KayBM

Thanks. I think I have a bit of a rep on here for being brutal/difficult, i genuinely think the culture around pregnancy and birth is turning more and more toxic, and put this opinion across where appropriate.

With regards to the planned operation - I would want the main facts. Such as what recovery will probably be like, the success rate etc. I probably wouldn't ask what instruments are going to be used and whether there are other ways of doing it etc.

I've recovered okay thank you, I do my pelvic floor exercises religiously. It's not the same as before but it's not bad, so I'm happy to settle for that.

@stargirl1701 I absolutely agree.

Modern lives are the opposite of what we need to optimise "best fetal position" - we need to be scrubbing floors on our hands and knees, farming grains/veg my hand type of thing.

These exercises get a brief mention instead of being prescribed as essential, to be completed daily x times or for y hours...

We had 1 ELCS (breech) and all the rest were unassisted vaginal deliveries in my NCT group. So we clearly weren’t 1 in 3.

We all had lovely positive births in 4 different settings at a very busy time of year (Sept babies).

I was really scared of having an episiotomy so I read as much as I could about how to avoid one so:

• very diligently studied the hospitals near me for their stats on %of women with emcs, % with episiotomies, % forceps etc etc and chose a birth centre with the lowest %.
• did perineal massage - it's awful
• kept active throughout pregnancy
• got a late scan to check on baby's position was not back to back and was ROA
• I was upright during delivery and walked around a lot
• limited pain relief during labour - epidurals tend to slow labour down and increase % interventions

Thankfully ds1 was born in a water birth with only gas and air and I had a small 2nd degree tear, took 4 hours. Ds2 arrived much quicker - we didn't actually make it to the hospital so I didn't even get gas and air

@RandomMess

There is an episode of Life and Birth on iplayer at the moment, a young yoga teacher (super fit, healthy, probably spends more time than anyone on her hands and knees or upside down!) has a forceps delivery after a marathon labour due to baby being back to back. They had to turn him first. Whereas I've seen OBEM where very very overweight mums have a quick and straightforward birth.

Out of interest, those of you that did antenatal groups, what were the outcome for the other members?

@wolfgirrl

Mentioning a transfer from homebirth, delayed emergency ambulance, at least two sets of rotational forceps incl. Kiellands and a tear as well as an epsiotomy will probably suffice.

Needless to say I am suffering physically and emotionally. However, there will be many more women like me out there and some have it much worse. At least my baby is really healthy and we're alive. For that I am thankful to the maternity staff.

My family members also have the best not to worry others outlook...and I still like them! It is only my opinion that this isn't helpful.

Hope you're staying safe during the outbreak.

I had ventouse delivery with my first- it was nothing to worry about, I didn’t really notice what was happening. No epidural needed, 12 hour labour and home 5 hours after.

Second delivery was unassisted (3hours), but with a partially retained placenta so I ended up with a spinal block in theatre for a manual removal afterwards. Don’t google this if you are sure what that involves.

@Wolfgirrl I will never feel like a failure. I have preferences and hopes for birth but I also am very aware I’ve never done this before and don’t know how I’ll cope. I know I can do as much prep as possible to cope, a lot of that for me is being able to keep calm, but knowledge is power for me and how I feel safe so if I know I’ve done all I can but the road to baby ends up being different, well that’s just the way it is. I am hopeful my knowledge of the risks with things like epidural will be compelling in dealing with pain - but that’s how I work. As I said before, I knew the risks when I signed up.

My sister had an horrific birth with lots of medical cock ups resulting in a severe rectal prolapse that took years to fix, I know my body could be changed for life from this, but I made that choice with facts not a magical idea of beautiful hippy flower birth - but I’m still going to try and make that happen!

Neither my midwife or consultant ever so much as mentioned an episiotomy ventouse or forceps when I was pregnant at all until I was 3 hours into induced labour and had had my epidural. Consultant then informed me episiotomy and ventouse were necessary and said he had to go prep equipment for it but never explained why it was necessary or the process.While he was out of the room the midwife examined me and told me I was fully dilated and asked if I was ready to push as it looked like the consultant may have been too quick to judge. I was very much ready and very glad I did. The consultant came back to talk me through the process but never got a chance. Things were well underway and my da was in my arms 10 minutes later. Definitely think instrumental delivery should be explained as standard during your antenatal care because i has no idea what kind of delivery I almost had until after

@KayBM

Gosh that sounds very painful. Glad to hear you are somewhat on the mend.

Your story is quite interesting as home births are supposed to reduce the risk of an instrumental delivery, however the transfer to hospital rate for FTMs is quite high. Would you have done anything differently if you had been more informed?

@buffalocauliflower of course everyone wants to avoid complications and damage etc, nobody would choose it! Good luck, I hope it goes smoothly for you.