Was Birth Plan a factor in our baby?s death?

[rzl]

We went to an ?active birth? workshop where we were told us that a woman knows instinctively how to labour and should never be coached to ?push? through her contractions as this will upset her natural body rhythm. The teacher was quite evangelical about this so we put it in our birth plan.
She also said that our birth plan should include a point that pain relief should not be offered until asked for, because when in labour you are likely to take anything that is offered without thinking.

I am now wondering if these directions contributed to the situation that lead to the death of our baby?

Our baby died twelve days after he was born; he had been starved of oxygen around the time of his birth which severely damaged his brain.

My wife started her labour at a midwife-led birthing unit but was transferred to hospital after twelve hours due to lack of progress. However, by the time she arrived at the hospital (by ambulance) her waters had broken and she was pushing fast.

My wife had laboured actively through the night using only TENS for pain relief. By the time she had been transferred to the hospital she was tired and exhausted and just needed someone to take control and tell her what to do.
Unfortunately, the midwife did not seem confident enough to take control of the situation while my wife was confused and directionless.

The midwife didn?t instructed dw to ?push? but maybe she tried to, in a roundabout way by saying ?breathe through it? as the contractions came. But dw was floundering, in pain and shouting for a c-section ?get the scissors now!!!?
The midwife didn?t offer pain relief but started filling up the pool which is when it all went horribly wrong. (I have discussed this elsewhere at www.mumsnet.com/Talk/1365/411674)

Our birth plan didn?t state that we wanted a water birth but perhaps the mv thought it would be in keeping with the ?natural birth? style of the plan.

Since that terrible day my dw feels that holding out rigidly for a ?natural birth? is foolhardy and if we have another baby she wants it to be by c-section.

I'm so very sorry. Please don't blame yourselves. Your wife's birth plan is no different from lots of others. And the midwifery and obstetric staff are supposed to over-ride any plans if mother an/or baby are in danger. Getting in touch with PALS and going through your wife's notes sounds like an excellent idea, as well as contacting SANDS, if your wife feels up to it.

Don't blame yourself, these things happen. My baby was also starved of oxygen at birth. She lived but is severely disabled. I still do blame myself but know deep down it really is just one of those things. I was monitored until the pushing stage -its very hard when the baby is in the birth canal - and everything seemed fine. But she was grey and still. They recussicated her.
I don't know if it all went wrong during the labour or something had happenend before. I never will. I#m still waiting (3 years on) to meet with the midwives to discuss what could have gone wrong but I care for my daughter 24/7 and will for ever

Oh I am so sorry. What a tragedy. No, you mustnt blame yourselves. Doesnt everybody's birth plan say very similar things anyway about not intervening unnecessarily, not pushing pain relief etc, and its usually ignored anyway, or at least pleasantly dismissed, because how in God's name is anyone to know anything about labour until they've experienced it? It is up to the midwives to explain what needs to be done and why, and obtain consent, without being obsessed with adhering to a woman's birth plan, written long before the birth actually unwinds. You and your wife must not blame yourselves. Sadly, it does sound from your description as though the care you recieved may have contributed. Please dont think your birth plan was responsible. I am sure the hospital should agree that an elective section would be best in the future.
With kind thoughts and sympathy to you both.

I'm so sorry to hear about what happened to your both and your baby. In these cases it is absolutely normal to blame yourselves but you are not in any way at fault.

When you have your next child, if your wife wants a c-section, so be it. Stick to your guns and make the birth as managed as you need to.

But right now you need to deal with your grief and understand that this didn't happen because of something you did or your wife did. Now and then births do go horribly, horribly wrong.

I hope that the future brings you the joy of a healthy child to help replace some of this pain.

I am so terribly sorry to read what happened to you and your wife. It is a tragedy, but I do not think that your birth plan would have been the problem. If teh medical staff had realised that there was a problem, they would have with your instant consent overridden it. Sometimes problems in labour can develop extremely quickly and unpredictably, and no amount of planning will prevent or circumvent sudden problems. I have a hunch that the placenta came away too early- this should only happen after the birth when the baby's circulation has switched to its post birth routing.

I feel desperately sorry for you, but I do not think that the plan was to blame. May you both start to heal as soon as possible.

I'm so, so sorry about the loss of your son, rzl. Losing a child is utterly heartbreaking, and I can't think of any parent that doesn't think, what if? This questioning and self doubt is part of the normal grieving process, and has been horribly exacerbated in your case by having to go through an investigation and inquest.

I'd second recommending SANDS, as others have done. The online forum to me was a lifeline when I lost my daughter, and during my subsequent pregnancy.

I am terribly sorry to hear of your loss. Please don't blame yourselves, it sounds like a terrible tragedy.

I hope you find some comfort in the messages on MN

Deae rzl and wife,

I can only reiterate what everyone else has written on this thread, i'm really saddened that you have had to go through every parents worst nightmare.

A birth plan is just that....a plan.

It is never a legally binding contract. When a situation arises that will require care that goes against any item in the birth plan, an experienced midwife will explain why, for example, continuous monitoring needs to be commenced or why you should be directed in pushing rather than allowing your body to take over.

I can only comment on the information which you have told us but it really does sound that the midwife's lack of experience certainly had a bearing on the horrendous birth experience that you had.

It's hard to comment on whether or not your wee baby was deprived of oxygen in pregnancy or during labour, but whatever was the cause, you can be totally sure that your actions and requests for labour had nothing to do with the outcome.

Unfortunately during the grieving process there are certain stages that you have to go through in order to finally 'accept' ( I hate to use that word) what has happened. The worst one of these is guilt. You WILL come out the other end of this at some stage...I don't believe that time heals but I do believe that it make remembering things easier.

My condolences to you all, I'll be thinking about you and I hope that you will eventually get some peace. Take care of each other.

rzl & mrs rzl
I have nothing useful to add to all the excellent thoughts & advice on this thread, but just wanted to add my symathies at your awful loss.

I am so very, very sorry

I agree with the rest

The birth plan is only relevant if things are going well.

I wrote "have a baby" on mine as I had no idea what would happen I thought maybe I wouldn't be setting myself up for disappointment if I didn't get my hopes up IYKWIM.

However if I had written something I would fully expect the medical staff to ignore it if there were any serious complications.