Thoughts about your birth experience?? (potential trigger warning)

[ifIcouldwalk10000miles]

Hi, I'm a newish nhs midwife, I love my job. Currently work on labour ward, have also been on a lovely birth centre. I'm very aware I look after women during birth and then move on quickly whereas that experience stays with that woman for ever.... and I know that I need to hear women's own perspectives on their experiences once recovered, in order for it not to become just a job. Wondering if you would be happy to tell me what it was like for you, what maternity staff could have done differently, what you would want your midwife to know.... I'm especially interested in experiences of induction. Very aware of potential triggers of trauma or planting fear for those who haven't birthed yet, so please respond / scroll with care. Thanks so much x

I do think we need to keep expectations of birth realistic, frankly our control is minimal, the only thing we can change is our own mindset.

I had no expectations with dc1. However no woman a few hours postnatally should ever be told as I was "you shouldn't have got pregnant if you weren't over being raped"...by a midwife (for the record I thought I was over it until mid emcs with the anesthesist stroking for hair, my chest decided it couldn't breathe). I can't see that as anything other than unkind in the circumstances.

Well obviously that is awful.

But I think most complaints about midwives could be seen from another angle, as I said above.

Birth by its nature is pretty horrendous and unpredictable. Midwives can only go by their experience (and be compassionate with it) but that doesnt mean they will get it exactly right every single time.

@Wolfgirrl I don't think PP are blaming the OP for the actions of others, they're saying 'these behaviours are the ones that left us unsafe and uncared for, perhaps try avoiding them'

Also, I do think we need to keep expectations of birth realistic, frankly our control is minimal, the only thing we can change is our own mindset is not true.

No, we can't foresee how a birth will go, but failing to provide critical information to women when requesting consent is little short of negligent and borderline malicious.

For example, knowing that:
(1) there is such a thing as a Bishop score,

(2) if it is

Dont assume any thing. I was a first time mum and I would have appreciated everything (and I mean EVERYTHING) being explained, especially immediately after birth when I just had no idea what was going on. Midwives often just seemed to assume I was up to speed with what ever was happening.
Though I dont think it helped that the midwife (head midwife? She certainly seemed like she was in charge) was Russian and there was deffinatley a language barrier which made it all the more confusing and overwhelming (I dont doubt her abilities as a midwife at all, but the lack of clear communication was terrifying at the time).

As others have said, dont assume first time labours take days either. I went to hospital to be checked over as I was bleeding quite a bit, this was around 2pm. Didnt get examined immediately and was sent home about 6.30pm 'to have a relaxing bath because it could be days before anything happened'. DD was born at 11.09pm, and even when DP called at 9.30pm we were told to try stay home a bit longer as it can be long and boring in hospital. When I got to the hospital I was examined and was told I was only around 3cm dilated (I think the midwife must have been wrong) so the midwife began to fill the birthing pool, I had DD in my arms when they turned the tap off she arrived so quick. First labours can be quick and I really would have appreciated not being fobbed off and told to stay at home. The speed also meant there was little time for pain relief beyond gas and air as everyone was so concerned about getting DD out, understandable looking back but I was in agony.

Do not ever scream for an ambulance and resus team on standby at least 3 or 4 times (thankyou Russian midwife, there was no misunderstanding there). I was fucking terrified me and DD were going to die, panicked and started screaming and nearly fell off the bed

Listen to mums, when I was being stitched up I didn't want DD on me, but no one would move her because they wanted to encourage skin to skin. I was terrified I was going to drop her, my head was spinning and I thought I was going to throw up. I think if you just ask what the mum wants and actually listen to her you probably wont go far wrong. You sound like you would be a lovely midwife OP.

Hi OP, thank you for asking. I was terrified of the possibility of induction throughout pregnancy but ended up being induced at 40+3 due to high blood pressure. Nothing doing for a few days but, a few hours before we were scheduled to talk about a possible c-section, my waters broke and that was that!

I think of my birth as a very positive experience in many ways but would say for me the thing for midwives to be mindful of (as I'm sure you are) is how induction can make things go almost literally from 0-60. I actually heard my waters break with a 'pop' before the deluge began and from that point until giving birth 6 hours later I was in agony I can't describe. I couldn't believe it could get so bad so instantaneously and thought something must be wrong, I thought the baby and I must both have been dying. I thought I would have to endure that level of pain possibly for days as a ftm and didn't realise the severity of the pain meant things were actually moving very quickly and it would all be over soon. All of those thoughts were terrifying but the pain was so awful and constant I couldn't speak to voice my worries. I think if midwives could empathise with how frightening that is for someone who has no experience of birth and no idea of what is normal that would be great.

In my experience the midwife on the induction ward was rather unsympathetic and said I'd just have to stay there with no pain relief and it was early days so couldn't be that bad (I was screaming like I was dying - as I thought I was). Luckily (?!) the baby's heartbeat started to drop and I was rushed to the labour ward with a crash team which confirmed all my worst fears, but I think the monitoring belt had just slipped as they didn't find anything wrong. I got to stay on the labour ward though and have pethidine which took the edge off (I asked for an epidural but the baby was crowning as the anaesthetist arrived!).

The midwife and student midwife in the labour ward were just fantastic and so lovely, as was the doctor who did the ventuouse. I remember so clearly that they gave me instructions on exactly how to push that were so clear and specific I felt really in control as I understood exactly what I had to do, even though I was terrified and in the worst pain. I was so grateful even in that moment and remain incredibly grateful now - I often think of them and my little girl is nearly 2. I had to have a third degree tear stitched up in theatre leaving my tiny baby screaming with my poor husband for hours, but the midwives stayed with him the whole time and supported him. They helped me feed her and change her when I came back and I will never forget how kind and warm they were although they had been working with us all night.

Know that, although it must be the hardest job in the world many times, there will be lots of mums like me out there who will think of you often even as their babies grow up and will bless you, although you won't know it. I know I'll think of my midwives every year on my daughter's birthday and many times in between for the rest of my life. Thank you for everything you do.

Not every labour presents the same. Trust women. When I turned up at the ward I had to really argue and insist, to be examined. They didn't believe I could possibly be in established labour because I was talking clearly and not out of breath. In fact, once examined, I was 5cm dilated, and there was a lot of huffing "why didn't you tell us?"
I did!!!

Since you asked about inductions, the other feedback would be that, on paper I was 14 days overdue, and for the last 4 weeks of my pregnancy had real pressure from midwives and health care workers to induce (including lots of guilt tripping about the stillbirth rate doubling (these stats are misleading at best) and what kind of mother I'd be if I was willing to risk his life like that!)

But the dates weren't right. I know for sure when I conceived, I knew my cycles, he wasn't overdue and was healthy and measuring well. I wish there was a way to adapt due dates and avoid the unnecessary pressure, or at least that increased monitoring would be seen as a valid choice, and medical induction wasn't pushed as the only option. Monitoring does cost the NHS in extra appointments, but induction leads to more interventions and surgery, which surely outweighs the cost of monitoring).

Having an artificial and imposed deadline caused a lot of unnecessary stress. Baby had never seen the calendar, and pregnancy lengths naturally vary.

I went into labour naturally at 40 weeks (by my dates) and 42 weeks by their dates. I'm so glad I waited till he was ready and had a natural labour.

Please question the need for inductions just based on dates.

One woman that complains of unnecessary examination may be another woman's complaint that she wasnt examined enough etc.

If women are offered necessary examinations with informed consent then you’ll get far less of either type of complaint from women.

I do get what you mean but taking an attitude of ‘well you can’t please everyone’ mean areas that do need addressing and changing, and things that genuinely would help to give more women better experiences and better care are overlooked. Sure women have different preferences and needs but things like informed consent should be a baseline norm in maternity care.

Currently pregnant with baby number 2.

Baby number 1 - first midwife (at MLU) was amazing. Calm, reassuring, was guided by me about the atmosphere of the room (e.g. when I was quiet, so was she when I wanted to chat she did). Explained what was going on during examinations. I'd love to have her again.

Midwife number 2 - after being transferred to hospital. Told me I wasnt trying hard enough, threatened me with interventions, told me I was a mother now and had to put myself 2nd. I was trying so hard. It broke my heart that someone suggested I wasnt. After birth I couldnt get my dress off to shower (it was an over the head job and i had a drip) - i asked for help and she said 'are you being a bit thick?' When she took me to postnatal she left.with 'I'm off for a break, even midwives need one'.

I guess just remember that what you say will be remembered by your patients potentially for the rest of their lives and you can make a stressful birth situation positive or negative by what you say and how you say it. Be kind. Remember what they are going through. Leave sarcasm at the door.

@blackcat86 I'm sorry to hear about your story. Our children are similar ages and I remember posting on a thread with you about sleep. You seemed to have it so together and I was struggling. I think I told you that not every baby was easy like yours seemed to be. I'm really sorry. PNA can do horrible things.

(Still) so grateful to you all for sharing. Just finished work and have sat and read all your stories. They will help me, they will make a difference. Everyone is different, each birth is different, I have been so aware I need to make some space to just listen.

@DuggeeHugs

But that is information that might go way over a lot of peoples' heads. A lot of people would prefer to let more experienced people make the decision aka the midwives and doctors.

And no doubt a story would pop up from someone saying 'the midwife scared me saying the induction wouldn't work as my something score was low, anyway she was really negative and it did work after all'.

I really feel like whatever happens they cannot win, as a lot of NHS staff cant.

However some of the accounts here are indefensible and just plain nasty.

@Wolfgirrl

But that is information that might go way over a lot of peoples' heads. A lot of people would prefer to let more experienced people make the decision aka the midwives and doctors.

It might go over some people's heads, but that's no excuse for not allowing women informed consent. The whole point of informed consent is that you have to be informed to give it. HCPs can't just decide that because it isn't easy it shouldn't be done.

If you hear the risks then decide to go with the induction and it works out then that's great - win win! The woman had control of that decision.

But not being told the risks, not being told there are other options, then having a traumatic experience could be completely avoided by HCPs being honest about the risks upfront.

Also, HCPs aren't there to 'win', it's not a competition to get one over on the patient. They're there to inform, support, safeguard and treat their patients with dignity and respect. If they do that, both HCP and patient 'win'.

@DuggeeHugs

But all the information is out there for those who want to know. Some people dont and would call it fear mongering to be ambushed with a list of things that could go wrong. I was very much of the blissful ignorance mindset, which actually helps in labour as you worry less & relax. My 36 week induction was successful and I actually put it down to my state of mind at least partly.

@Wolfgirrl a patient can still be given the information but ultimately say they’re happy to go along with whatever opinion/decision the professional has. Informed consent is such a basic legal requirement yet I often read how much improvement maternity care needs regarding this (and often coming from midwives and other HCP who around birth daily). Of course you’re not going to please everybody but you can’t write off properly informing women with ‘well that would just go over some women’s heads’

My first birth was an induction at 39 weeks due to GD, and because she was measuring small. The monitor didn't seem to effectively pick up my contractions, as I was given pethadin when I was already at 10cm. Dd was born by ventous in the end because I was so exhausted I couldn't feel the contractions let alone push effectively. My stitching was botched and had to be corrected in theater, separating me from my baby for hours. I got maybe an hour in the nice recovery room before I was turfed out onto postnatal. This was fine during the day but at night it was miserable. I sent my husband home to get some sleep, so I was alone, still wobbly from the spinal block, catheter in, with a baby having feeding difficulties. She would only be string fed, so I kept ringing the bell or wobbling off myself to get expressed syringes in and out of the NICU fridge, and finally in the morning someone told me they could be kept at room temperature for 4 hours. Why oh why did no one bloody tell me that before? Did they think I was doing the fridge hoky coky for fun? I was also desperately lonely, getting flashbacks to stitching when I tried to sleep and was desperately in need of the odd friendly interaction. Instead I heard the midwife chatting to the lady next door, who seemed to have a constant entourage around the clock and was on her second baby to boot.
My second was spontaneous labour just before my booked induction. Again because I did not have textbook regular contractions I was assumed to be in early labour, but this time at least i was checked and found to be in established labour. Second time, although it hurt more than the first time, was a better experience, and what made it was the recovery. Luckily the postnatal ward of doom was full, so we were left in the labour room for ages, and I was eventually put on the antenatal ward with only one other woman whom I knew from the diabetic clinic. I pushed for and was granted a same day discharge, which made life so much better.
Aside from the sense of abandonment the big problems with postnatal are 1, no snacks. I was starving all night after not managing to eat much during the day. 2, it's boiling. In antenatal classes we're told babies must not overheat, rooms at 21° max, then at birth we are told to wrap them up in the high 20's ward. I asked for advice on how to dress baby for the temperature. I was treated as an idiot who didn't know how clothes worked. Acknowledgement that the whole thing is a bit mad and reassurance the new baby will not die of heat stroke would be useful.
Thanks for asking

String fed, lol. Syringe

@Wolfgirrl

But all the information is out there for those who want to know. Some people dont and would call it fear mongering to be ambushed with a list of things that could go wrong

Now replay that in any other medical context. Heart condition? Cancer treatment options? Would you call it fear mongering? Would you expect to have to Google that? Of course not! And this is no different. It is literally part of the HCPs job to ensure women know what it is they are being asked to consent to. Wilful ignorance is a personal choice, it is not acceptable as a policy decision.

In my case, I didn't have time to Google anything. The induction came out of the blue following an appointment when it turned out things were going South really quite fast. I agreed because I was told I had no choice, it was the only way to keep DC1 safe. That was a lie - there was a choice, they just thought my ignorance was the better option for them.

By denying me that choice I lost nearly 6 days, and I'm not even an isolated case. It's now several years later and I'm still dealing with the memory of what followed, made worse by knowing that I would never have chosen an induction had I known the risks.

I’ve had 3 inductions, the most recent one just a couple of weeks ago. The first 2 followed a pattern of the pessary causing mild contractions that become more intense but I don’t dilate until the last minute, so examinations never show that I’m ready. After the first 2 births where I barely made it out of the induction bay, I was very worried this time round as I knew my husband wouldn’t be allowed to be there at the start and I wrote this all up at the front of my notes and said I wanted to be believed when I said I was experiencing painful contractions, and that I wanted a calmer room without the medical professionals panicking and caught on the hop.

Day midwife was lovely; night shift, when things ramped up, less so. Didn’t examine me saying examinations risked infection, kept telling me I wasn’t in established labour while I had contractions so bad I couldn’t talk through, said it was too early to call my husband or for me to have an epidural even though I begged because of my previous precipitous births. I laboured alone through the night buzzing the bell to ask for help and pain relief now and again (those were the only times I wasn’t alone, except until the very end).

Then I felt things really ramp up, after finally getting some pethadine, and I knew things were happening. I was still on the induction bay but mercifully the other bed in the room
Was unoccupied. The midwife said I had to lie on my back to be examined (I now know examinations can be done in any position, and that I had a right to refuse one and she could have used other cues like my behaviour and history to assess whether I was near the end). I managed this, in true agony as the contractions were radiating through my back and has turned into one mega-contraction without pauses. I felt an urge to push. She said not to push while she examined with a speculum. She said my cervix was only open a pinprick and she couldn’t break my waters. I felt the urge to push again and thought sod it, I’m doing it. One big push ... and I delivered the baby (and the speculum) and my waters.

My labour notes read as follows:
Rupture of membranes: 0 hours + 1 min
Duration of first stage: 0 hours 5 mins
Duration of second stage: 0 hours 0 mins
Duration of third stage [I spontaneously expelled the placenta]: 0 hours 5 mins.

My husband obviously missed the birth of our last child, our only daughter.

My thing, as I knew full well from my previous babies, is that I progress incredibly rapidly through dilation to delivery, and standard markers of looking for a certain number of centimetres just don’t work for me. I had explained all of this and made it very clear. I was not listened to and was treated like I was making a fuss about the pain. The midwife looked more shellshocked than me when the baby appeared - exactly the atmosphere I had been afraid of. I had nobody to advocate for me or even to rub my back through the contractions. It will take me a long time to recover from this experience and I get flashbacks to it whenever my daughter lies in a particular position as that’s how I saw her on the bed when she came out.

@ohtobeaseahorse thank you. Sleep was something I worked on with DD really early (mostly because of the lack of support and sheer level of sleep deprivation- would get hold that 'I do like my sleep" when she was waking every 45 mins to feed) so we had a pretty good routine by 4 weeks that gave me a lot of comfort and she slept through once I introduced solids. To be honest it was a bit of FTM smugness as now she's nearly 2 she's back in bed with me most nights! It's interesting to look back on the experience and things that may have contributed to the trauma of it.

All women really want (and deserve) in labour is to be listened to. So often, particularly in hospital births, they are not.

My first birth was traumatic and took a long time to recover from physically and mentally.

After about 18 hours I stopped progressing so needed syntocinon drip which caused distress to baby every time they upped it so they had to keep lowering it again. After several more hours of this I was so exhausted I had an epidural. Despite repeated placement this didn't work properly (gave complete numbness on one side and still felt full pain on the other).

I ended up with a failed ventouse then emergency forceps delivery with episiotomy and extended tear. Baby was nearly 10lb, back to back with an arm over its face. I then had a haemorrhage when I was being stitched up. All of this including forceps and stitching I had only gas and air for pain relief as they didn't bother topping the epidural up because it hadn't worked properly anyway but the doctors had been told I had an epidural. I remember being in absolute agony with the forceps and feeling utterly helpless. By that stage they just wanted to get baby out and how I felt was not important.

I had a midwife debrief meeting months later and it was such a waste of time. They read me my notes like I was making a fuss over nothing. When I said about lack of pain relief they said "it says here you had an epidural" and were surprised when I said I felt everything. All they could say was "of course you will have a much smoother birth next time".

I had an elective cs for my next one. It was amazing!

DS1's birth affected me greatly and I still have flashbacks 25 years on and it wasn't that bad compared to many from a physical perspective.

The first three hours were spent in pain, a lot of pain, with a back to back baby, on a public ward. There was a lady in the next bed with her DH and two boys under 5 running about. I asked for privacy and was told "no much too soon" you aren't dilated you just have a ripe cervix. When I was examined my private parts were loudly examined. I also felt I couldn't make a sound so as not to alarm or distress the children behind a curtain a few feet away. After a few hours on gas and air I was violently sick. Midwife came in and gave me pethidine without my consent. I knew I didn't want it because I'd had it after an op and it made me feel disassociated feom myself. When it started wearing off I was taken to a labour room because I was making so much fuss and told I would waste time and it meant I had to be accompanied by a midwife. I had an epidural shortly after because I was in so much pain. Shortly after the baby's heartbeat dropped and the midwife said oh it's a problem with the belt and hoiked it up again. Midwife said I was only a cm dilated and we would be there for hours, I was comfortable so she was going for a break, she also told my DH to get something to eat because it would be a long night. I was left alone for about 20 minutes and the heartbeat went again. Midwife and DH got back together and she hoiked the belt up again. I hadn't been able to reach the call button and was starting to panic. Within minutes I felt I wanted to push and she laughed but she examined me and I was almost fully dilated. So pushing started. Heartbeat disappeared again and as she started to hook the belt my DH took over and opened the door and yelled "I want a Dr in here right now". The head midwife arrived, took one look and hit the red button. Room filled. She got me on a birthing cushion thing to get the baby out quickly if possible - he had the cord wrapped around his neck, the cord was cut when he was still in the birth canal and the Dr who said he would use the ventouse and forceps if it happen fast said there was time for one more push. I don't know how I did it but I did. My baby was blue and had to be resuscitated and spent his first night in scbu. I had a tiny tear that didn't need stitching and felt quite pleased. I was given tea and then told to shower - alone. I had honestly never seen so much blood and felt very light headed. It felt extraordinarily badly managed and very uncaring. The following day the Drs kept observing ds saying her was very pale but generally the hospital was more interested in putting on pressure for me to let the press in for a photo. Christmas Day.

My second birth was early, 27 weeks, the baby had a severe congenital heart defect and didn't survive but the obstetric led care was faultless as we're the midwives.

My third birth, by then a high risk birth was marvellous but again obstetric led and I was very clear that I would prefer an ELCS rather than risk an one experienced or rude midwife. I was induced at 41.5 and made little progress - I refused to have my waters broken because the reg was an arrogant arse. At 8ish my waters went naturally and at 9ish they said they wanted to put up the drip because there was little or no progress, which I had read up about, so I agreed but only if the epidural was in first - by the time the epidural was in contractions started and within an hour I was ready to push. With the help of the kindest midwife from Senegal our baby was born within the hour - 8lb 13oz, so far 9+. No stitches. The nicest thing was that the midwife washed me afterwards very gently - no lone shower resembling an abattoir. But I honestly believe that birth was achieved because I was simply not prepared even to contemplate a repeat of the first which was a concoction of incompetence and unkindness. DH and I both realised the horror of the first birth after the perfectly managed third.

One question I have is why is there not a routine scan and discussion of options and risks taking account of the lie of the baby on admission. Surely that would be cost effective overall.

Finally that first birth left me with a very weak bladder and five years ago my anal sphincter started to let me down and my consultant confirms it is due to that first birth. These are consequences not properly explained to women or probably understood by midwives so there is a great deal to be improves which is rather concerning at the start of the 21st Century.

@OhTheRoses I'm so sorry for everything you have been through. I know I'm a complete stranger but I think you were amazingly brave to go for your 3rd baby after everything you went through.

@OhToBeASeahorse (and the resonance of your user name has just struck me) I can promise you that when I look at my perfect, 22 year old dd, every second was worth it. She was born 51 weeks after DS2 whom I still think of every day, but I am nevertheless blessed. She was my 5th pg to reach the 2nd trimester, my third to reach the third.

We wanted at least three children, possibly four and my only regret is not having been brave enough to have a third.

I would also add, if the op is still reading, the importance of reading notes and engaging brain before mouth. After an ERPC I was asked "Oh did you want it" when I came round in distress and when I was booked with DD the midwife, having taken the history (recording some of the pgs incorrectly) looked up and said "is this one planned?" I asked to see a consultant immediately who mopped me up and took over 100% of my care. DD was breach from 28 weeks and was to have been an ELCS but she turned between an apt on Friday and the planned section on the Monday. The consultant said it way my choice whether we proceeded but I could not justify an operation if it wasn't needed but was only prepared to have a VB if he could promise me I would be looked after by an experienced and kind midwife. He did. He also came to see me the morning after dd was born after he had finished his rounds.

Wow. It just goes to show how reliant it is on luck of the draw. Was it planned? Ffs.

I am still reading. Thank you again for sharing so much x

I haven’t read the full thread.

In my experience midwives are amazing people. My first birth was an induction and I wouldn’t have gotten through it with out the kind and caring guidance of the midwife. I still know her name 4.5 years on. She was amazing and it was like she was in tune with me (told me when to push).

Second midwife came across as grumpy- started on the phone, I was quiet / am quiet when I’m in pain so she was all “are you sure you’re in labour?”. Then get to the hospital struggling to walk (still quiet) she runs along the corridor leaving me, hubby and HC asst behind. HC asst at least had compassion to encourage me and tell me to go at my own pace. Then I couldn’t get on bed as it wouldn’t lower properly. I just got told “well if you can’t get in bed, I can’t examine you!”. Midwife got a shock when I was examined - I was 9/10cm dilated. However, I just didn’t feel as supported that whole birth thanks to her being so short and not believing me! Not a great way to be with labouring women.

So my advice is, listen believe and empathise xx