Birth #2 anxiety. Please help!

[TerrifiedOfGivingBirthAgain]

Please be gentle. We have decided to try for No 2, DS1 is 3 and I had a rubbish birth with him.
I'm in the process of weaning myself off the antidepressants. I'm not even pregnant yet but thought of giving birth again is making my anxiety go through the roof. In particular the feeling of being coerced into birth choices by medical staff who railroad over your preferences because they (think they) know best. I'm quite a passive person and the thought of standing up for myself against an opinionated strong willed HCP is so daunting. Especially when you're in active labour and half out of it yourself.
I was told in my birth debrief that my next pregnancy would be consultant led, but I'm thinking thats even more likely to end up down the labour ward - medicalisation - interventions - crappy birth path.
I think my biggest fear is that I'm going be unadvocated for like last time. I've never felt so infantilised, alone and unsupported as I did when I was in labour last time. The thought of giving birth in hospital is just awful.
I can see myself ending up freebirthing not out of choice but because if I notified the hospital, I'd be guilt tripped and coerced into going in there.
I like to do my homework and be as prepared as possible as it helps me feel more in control, so we did a face to face hypnobirthing course while pregnant. My first birth was 17 days late by hospital dates, 5 days late by my dates (we only DTD once that month so I knew for sure when it was!), and the later it went on, the more pushy, patronising and coercive the HCPs became. I was desperate for a natural birth so held out as long as possible.
After going back and forth for regular scans, they held me in for hours and hours and told me that they wanted to induce me that day as apparently they'd detected a drop in the foetal heartrate. I pushed for a balloon catheter rather than having a pessary as I was concerned about hyperstimulation, but for some reason they refused to offer this apart for VBACs. Instead, I agreed on the basis that I'd be able to make use of their birth pool as they assured me they had a wireless underwater monitor.
So we went back in later that day and was given the pessary. Sure enough, within an hour I was having back to back contractions because, hyperstimulated. My hypnobirthing training went out the window as I panicked and DH was so far out of his depth that he was flummoxed and basically did not much more than bringing me drinks periodically. Once my waters went and I was finally given an actual birthing room, I was told that actually they didn't have a working wireless monitor and hadnt had for a while, so a birth pool was out of the question and I was attached to the monitor, flat on my back, and wasn't allowed to move as each time I did, they temporarily lost the heartbeat.
DH retreated to the other side of the room, next to the midwife and there I laboured like a cow for hours on end. There was no interaction with the midwife apart from monitoring the vitals and no encouragement from anyone. Not a single request on my birth plan was adhered to, I had midwives shove their fingers up my foof without even asking, although I specifically said no vaginal checks unless absolutely necessary in my birthplan.
Eventually I asked for an epidural, which didn't work and finally some pethidine which gave me a couple of hours respite.
After 23 hours of labouring, 1 red alert and lots of delirium, they decided I wasn't progressing fast enough (quelle surprise, in that position) and I needed to have a C section. I was desperate and agreed. I ended up with sepsis and a 2 week hospital stay while they worked up to industrial strength antibiotics to try and get it under control. It frightened me how unable I was to advocate for myself or even move my own bodyweight during labour. I've come away traumatised and the thought of being that unempowered again has me hyperventilating and booing my eyes out.
Can you offer me any emotional or practical support?

Anyone?

Sorry you had such a terrible experience.

I’ve had a traumatic first labour too and I’m pregnant now with my second. I also dread going into labour again. In my case I was induced at 40+1 bc a scan showed the baby didn’t grow at all for the previous 4 weeks and indeed she was born very small and so skinny, just bones.

so I was induced for the right reason, but pain started pretty much right away after the pessary and no one believed me, or cared, I guess.

I am able to stand for myself though, I refused sitting on bed, had the monitor on but balanced on a round ball, and that helped my pain, somewhat. Anyway, it will too much to write, but ended up after 31h too exhausted to push and the baby was delivered by forceps. I agreed to it, agreed they will try 2 times and if failed, c-section, I would have agreed to anything at that point, after so much pain.

I don’t know what else I could have done, apart from asking for an epidural earlier than I did (foolishly I still tried not to have any drugs), maybe I could have been more rested and able to push. the epidural worked for me and I quickly went to dilate to 10, quickly as in a few hours.

I don’t know what much else you could have done either. If they saw a drop in the heart rate, even if that was a fluke, they couldn’t have known or taken the risk. I think it was the right reason to induce you. You could have asked to stand or for a ball or a chair. It was wrong and abusive they checked you internally without permission. It also sounds your husband was as overwhelmed as you and didn’t offer any support.

I think it was the right decision for you to agree to a CS, you were in so much pain for so long, and your body was not ready to go into labour. What else could you have done? You couldn’t have foreseen the infection. That was on the doctors, or bad luck.

I have a midwife app tomorrow and I will ask for a planned c-section, and hope I go into natural labour before. I don’t a c-section but I also don’t want an induction. I was given a very good advice that I didn’t take before, that worked for my sisters and friends, to walk a lot, like 20000 steps if our want to naturally induce labour. And also to walk a lot even before that, regularly, but not to this extent obviously. I plan to do this this time, as the consultant is saying, based on my previous history, they won’t let me pass 39 weeks.

I don’t know what advice to give you apart from having someone else with you, family or friend that can advocate for you and knows your wishes. Or have a private midwife or doula there as an advocate.

I don’t think you could have done much to change the outcome, you are right to be angry at a lot of the care you’ve received, but not at ourself.

there is no way assert total control over labour, the only thing you can do is have someone with a cool head that can advocate for you, while also keeping mind some decisions will be made on a balance of risks. Good luck

One more thing to add, I know a lot of inductions are done unnecessarily but the risk of still birth is real. I know a woman who had a still birth at 40 weeks, 2 days before she had a planned CS.

She is not a good friend, though we have a friend in common.
I asked my friend if she had any reduced movement or any growth scans. She doesn’t know and she couldn’t ask, but she doesn’t think she did, she had a successful uneventful pregnancy and birth previous to that one. And that pregnancy was deemed without risk too.

As far as I know they never got an answer to why.

She got pregnant and had another baby after this a few years later.

I also had a traumatic first birth and was consultant led for my second. Second was a breeze quick, and midwife was amazing. I remember thinking afterwards that I suddenly got why some women enjoyed their birth as it was so different. I think that anxiety plays a huge part and I tried before hand to keep saying that this birth will be different and I felt stronger to advocate for myself. I was very honest about how I felt in the run up with the hospital. It is traumatic to have those memories and feelings but I feel lucky to have now had a positive birth experience.

Sorry that you had that first birthing experience. I echo what a pp has said about getting a private midwife. Would that be an option for you? That could work with you in the pregnancy and act as an advocate for you when needed.

@TerrifiedOfGivingBirthAgain I'm so sorry you went through that, it's eerily similar to my experience. I don't have any advice as I'm scared of my second birth too, but I'm trying to look at the bigger picture - a healthy baby is the goal. I'm planning on getting private therapy and going back on antidepressants after the birth if it's in any way similar to the last one.

Thanks for the responses. I'm definitely hiring a doula next time. The one who did my hypnobirthing course is also a registered childrens and adults nurse and teaches hypnobirthing so she is very experienced and hopefully would take the pressure of my DH to be my sole advocate. I agree with PP that he was overwhelmed.
In hindsight, the decisions we made at the time were the right ones, but it doesn't take away the frustration and regret about the way we were treated.
I'm reducing my antidepressants atm before we start trying which isnt helping with the anxiety. And I've always managed to bury my feelings from the birth but now we're about to try again I've really had to face up to them.

I'm going to aim for a homebirth as going back in to hospital is just too much I think. And if it goes overdue again, I'll just opt for an elective C section

I had a traumatic first birth too - not quite the same as yours but it involved a badly handled induction with minimal “care”, one appalling midwife, and an emergency c section due to total failure to progress.

I then had DC2 4.5 years later by ELCS after much agonising. Couldn’t decide whether to try for a VBAC or go straight for an elective. In the end, I decided to book an ELCS for 41 weeks and decide whether I still wanted a CS if I went into labour before. I didn’t labour so I had the section.

I agonised about it hugely. In the end, what tipped me over the line was that I felt the odds of me getting the VBAC I wanted - spontaneous labour, water birth, minimal intervention - were not in my favour. My worst case scenario was a badly managed VBAC and instrumental delivery and I felt the only way I could avoid that was via ELCS. I didn’t have enough faith that my wishes would be respected on the day - my experience with DC1 was that care was dependent on the midwife’s preferences rather than on my views or clinical indicators.

I would definitely have a think about what scenarios you are most keen to avoid in a labour/birth context, and which options give you the best chance of avoiding them. I agree a doula is a good idea.

Is some therapy an option? If you’re anywhere near London or if they do Zoom/Skype options, I recommend Parenthood in Mind - great organisation. Also recommend VBAC, planned C-section and Birth Trauma Association Facebook groups if you’re not on them already. Good luck, my feelings about the birth really dominated my second pregnancy to an extent that was not ideal.

Hi. I’m also having, maybe not anxiety over my second birth, but I would like it to be different to last time (induced at 37w, made it clear I wanted pain relief, epidural failed, nothing else offered, they didn’t take the wire out of my back so was stuck lying down in serious pain, coached pushing and then surprise surprise forceps).

Youre right in that nobody seems invested in helping you to give birth unassisted, it just feels like a conveyor belt that they want to Shove you along as quickly as possible.

My obstetrician said last week that this time ‘you will be given 3 hours after ARM and if we don’t feel you’re making progress quickly enough we will put you on the drip, as we don’t want you clogging up a delivery room’. Er, no. I know my body and this time if I don’t feel labour has started after 3 hours I will have the drip, but that will be a judgement for me.

That said, please don’t home or free birth after a Caesarian. It’s incredibly risky and although I’m sure you have a lot of trauma from last time, it would be even more traumatic if something went wrong and you blamed yourself. Would an elective c-section appeal? It would remove some of the uncertainty. 💐

Thinking of you, OP. I had a very difficult first birth, but a fast & easy second one. It can be so different second time xx

@Kindofcrunchy you're right, a healthy baby IS the goal, but at what unnecessary expense to the mother? It makes me so angry that maternity care is so chronically underfunded and understaffed and leaves so many women with preventable injuries or trauma.

Sounds difficult but I think a lot of the problem was your panic and inability to cope with the pain. Your hypnobirthing went out of the window as you say. Your birth partner sounds pretty unprepared too

@MyBuggyIsOutToGetMe thank you. I'm Manchester area so I'll see if I can get some help on zoom.

@Cuppasoupmonster the statistics show that a HBAC has significantly higher chance of giving birth vaginally than in an obstetric unit, and the risks aren't significantly higher, so I'm going to chance it I think. I'm literally 3 minutes down the road from my nearest hospital, so if something went wrong, I'm not far from help. I'll be booking an ELCS if I go overdue. I'm definitely not being induced again. Ever.
Home Birth After C Section Info

I don't understand why they are so happy to induce first time mothers without informing them of the statistics of a successful intervention free birth, and recommending a c section. Of all the first time mums who were induced that I know, a vast majority ended up with an assisted birth or a c section after a long drawn out labour. Knowing what I do now, I'd definitely prefer an ELCS. My sister had an assisted birth after being induced and didn't heal properly for months.

@Ivy90 yes you're right, that was down to hyperstimulating which meant I couldn't relax between each contraction. I've learnt from that lesson and will be hiring a doula!

OP, I totally agree with you on induction. I would probably have tried it anyway if I’d been given a better understanding of benefits and risks, but I had no idea that so many induced first time births end in emergency sections. I certainly wouldn’t have consented to a second induction.

@Ivy90 , that seems a little harsh, though I agree many partners are not prepared for the reality of birth, let alone trying to advocate for you with medical staff (I felt equally let down by my DH).

Inductions often induce contractions at a much faster pace than natural labour without necessarily helping you to dilate. In an induction, you’re less likely to be able to move around freely and help baby shift into a better position because of the monitoring. So it’s not just about how well you cope with pain. Some babies just don’t come out easily and if you don’t labour spontaneously, I think there’s often a reason for that. Add in unsupportive medical staff and it’s not a great combination.

OP I’m so sorry you went through this. I had an ELCS a month ago with my second DC. They offered me induction twice in quite a pushy way, I said no thanks I’m not mentally prepared for that and what’s the alternative? They said c section so we went for that. The key thing here was that this was my second child, I’d heard too many friends tell me terrible stories over the years about induction and I had one very kind and honest midwife advise me that she saw lots of inductions for my type of pregnancy (big baby, not gestational diabetes) end in an emergency section. I have no doubt in my mind that were this my first pregnancy I would have taken the induction. My DC was born at pretty much 10lb, it would have been a hard labour if I’d have been induced.

I think unfortunately first time mums do often end up agreeing to medical interventions they had hoped to avoid without proper discussion as they have not experienced birth before so are unsure when/how to advocate for their choices. All I can promise you is once you’ve been through it once you will feel so much more empowered to advocate for yourself second time around. I’m not a pushy person at all but I was very clear with the doctors when they were pushing for induction that this wasn’t for me and it was amazing how quickly we moved on and talked about the alternatives.

If you want to have a natural birth the I’d really recommend a doula who can advocate for you before and during your birth. I would also say that an ELCS is a very well managed procedure and I felt safe, cared for and informed at every point.

I have to be honest and say I don’t regret my induction, it wasn’t great but it means I can hopefully have a straightforward birth this time. The process of labour is also good for the baby as it squeezes the mucus out of them which lessens the chance of breathing problems after they’re born.

You must of course make the decision you’re happy with, but do bear in mind that you’re more likely to be transferred than not, and if this happens you’ll be less likely to be able to ‘control’ what takes place as the hospital than if you started there.

@MummyJ36 @MyBuggyIsOutToGetMe yes I don't get what they hype is on induction. They're so eager to get you on it. I've got 3 sisters who had inducted 1st births. 2 ended up with c sections and further complications and the other had an assisted birth. Plus my c section. Doesn't make for great stats. Thank goodness for your midwife being honest!

Thanks everyone for all your encouragement. I'm feeling a lot better since putting a plan in place. I started CBT yesterday too which will hopefully help with the anxiety.

@Cuppasoupmonster there is that I suppose. I got to 7cm last time which will hopefully mean next time would be smoother as my body knows what to do. 57% get transferred 😬I suppose if it comes to that, I'd be needing the medical intervention anyway. At least prior to that I wouldn't feel pressure from being on the clock or the surroundings.

Believe me, I agree with you, but unless you have pots of money to go private (which I would definitely do if I could) then it's just the reality of the NHS :( my son is almost three and I'm only just getting over my experience of birthing him tbh. I just want the next birth over and done with ASAP so I can be done with NHS maternity "services" and put it behind me. Sorry, I know that doesn't help you much :(

There are a number of factors which make a vbac more or less likely to be successful, look them up and take it from there. In your shoes I would probably go for an ELCS and make it as lovely as I could - choose the music, dim the lights etc and then ask to be transferred to your local MLU for post birth care if you have one nearby.

First pregnancy so can’t comment on your experiences however, I would speak to your Doctor before weaning off antidepressants. I have found that pregnancy can increase anxiety and there are medications you can take that are safe in pregnancy eg Sertraline. I’m no expert but it really if worth speaking to GP before doing this particularly if the birth of already giving you anxiety you want to be as relaxed as possible to enjoy your pregnancy and your new baby when they arrive. Good luck x

@Inscad I'm weaning off with the help of my dr I was on Sertraline but though it is generally considered safe in pregnancy, there is an increased risk of heart defects if taken in the 1st trimester, and increased risk of withdrawal symptoms for the baby if taken in the last trimester. Plus I don't know if any long term studies have been done on children whose mothers took sertraline in pregnancy- whether it affected their long term mental health. I've chosen not to risk it.

I had quite a similar first birth. You mention hypnobirthing a lot.
the thing is, hypnobirthing doesn’t guarantee you a straightforward birth. If you had managed to keep hypnobirthing (whatever that means) it wouldn’t have changed anything at all.
17 days late is LATE. I have two friends who have had still births at far less late than that.
I totally understand feeling infantilised and you’ll feel much more confident second time around - I did.
however I really feel hypnobirthing is a bit of a con. You will have the birth you end up having and we are lucky for medical help. Look at the stillbirth/maternal death rate 100 years ago. Look at it 200 years ago.
I’m not trying to be mean but I feel you’re mourning the birth you just weren’t, for whatever reason, going to have.