Another traumatic birth, can anyone help me understand what happened

[Bumblebee412]

Hoping someone can help me understand and process what went on

For history first birth, induction, major post partum hemmorage resulting in blood transfusion and a 3rd degree tear.

I was given the choice of elective c section but opted for vaginal birth. I didn't do a birth plan as I knew my birth would be consultant lead and mostly out of my hands anyway but has said due to previous tear if there were any issues I wouldnt want forceps or ventouse and to go straight to c section.

Fast forward and spontaneous labour 2 weeks before due date, contractions get to every 5 mins within 2 hours of starting get to the hospital 40 mins later and they are every 3 mins and 4cm dilated so straight to gas and air. Asked for an epidural which was done but quickly became apparent it failed. I had just been checked and was 7cm so they were going to resite but they became concerned with something on the monitor and the emergency button was pulled and lots of people came in. Quickly checked again and within minutes I was 10cm. The consultants made the decision that they wanted to use ventouse or forceps to deliver baby to which i said I didn't want either of those. I caught a look on my midwifes face and just remember saying to her 'we don't have time for that do we?' to which she just shook her head.
They decided to do ventouse due to the previous tear and as no time to do epidural again they gave me a local anesthetic instead. They had to do an episiotomy but ventouse worked and baby delivered quickly. I don't understand why an emergency c section wasn't done instead though.

I am so grateful to have my baby but having a second birth and having complications resulting in the emergency button being pulled I am a mess. First birth it was me they were worried about but this time it was baby although I was never told this.

I found out from my discharge notes that the reason for instrumental delivery was 'abnormal CTG' then there was another collum that said, abnormal ctg, pathological ctg and fetal bradycardia. I also found out from the notes that the cord was round baby's neck. My partner said there was a lot going on so he can't be sure but he thinks baby's heart rate went down to 60 at one point but he might have been looking at the wrong thing.

I honestly feel traumatised by this and regretting not picking an elective c section and if one more person say we'll at least you're both here I will go mad. Of course I know how lucky I am but that doesn't change how I feel.

I feel like I could never risk another vaginal birth and like my body just can't give birth without problems and there's something wrong with me

That sounds really frightening. It sounds like you went through a lot and found this birth pretty traumatic. The fact that you and baby survived, doesn't make this is any less true or your feelings invalid. It will take time for you to process this, so ask for a birth debrief if you think you would find it helpful and you can ask your gp to refer you to perinatal mental health team if you would like more support.

Congratulations on your baby, OP please understand that this is completely not your fault.

If they baby is already in the birth canal a C-Section can be very difficult, for example they may have needed to use forceps to push the baby back up to allow a C-Section to be performed. So that might be a reason why they couldn’t have done a c-section instead. This should have been explained to you at the time.

It sounds like the doctors involved hardly spoke to you, like they just told you what was happening. This is wrong and it shouldn’t be this way.

The cord around the baby’s neck though it sounds scary it is actually very common and often doesn’t cause any issues.

I’m so sorry that nothing was explained to you, either when they were doing things to you or about your baby’s health afterwards. How is little one now?

As for feeling like your body can’t give birth without problems it doesn’t sound like you’ve really been given the opportunity of a straightforward birth. With your first being an induction which comes with a higher risk of PPH anyway and the second being consultant lead where it sounds like you were strapped to machines the whole time. It would be completely understandable if you didn’t want to have anymore DC, or if you did to have a c-section but a completely different approach to vaginal birth mighty work out for you too!

Please don't beat yourself up at all about not having picked the elective c section. Both options carried risks and it is impossible to know what is going to happen. For what it's worth I think birth is hardly ever completely straightforward - it doesn't mean your body 'can't do it' or you've failed. Virtually everyone I know has had one thing or other happen that they hadn't expected or wanted. This isn't to dismiss your trauma at all - just to say that this is very normal and doesn't mean any kind of failure at all.

Would you be able to book a birth reflection appointment at your hospital? A midwife can usually go over your notes again with you and explain exactly what happened. I think this could hopefully be quite healing for you. All the best OP

The cord around the neck is surprisingly common and not something to be concerned about at all.

Did you have continuous monitoring? You should know that it's no longer recommended (NICE and Cochrane reviews) as it results in a higher number of unnecessary interventions (with their own risks attached) than it prevents fetal/maternal injury/death. It's near impossible to maintain good contact all the time with continuous monitoring so it can look like there's a problem when there's not - like thinking the heart rate has dropped.

You could/should ask for a debrief with someone from the team who performed your care.

If you get pregnant again I highly recommend looking at the Nice guidelines for care during pregnancy and birthing options as well as looking up the most recent Cochrane report on the subject as that will give you information based on high quality and recent research.

Sadly some medical professionals don't keep up to date and work to guidelines that are no longer best practice (or most likely to result in a good outcome for mum and baby). It can be hard for younger, more recently trained staff to challenge them. But if you are informed then you can insist on best practice.

You also had every right to say no to the forceps/ventose/episiotimy and the midwife should have supported you in that.

There are a range of factors which may lead to continuous monitoring being recommended. They're here if you're interested.Section 1.10.4

www.nice.org.uk/guidance/cg190/chapter/Recommendations#monitoring-during-labour

Basically though, once the baby has gone a certain way down the birth canal it's very difficult to do a section as you'd need to pull them back up again (which could potentially cause more complications).

If you contact PALS at the hospital you gave birth in, they can ask to have your notes reviewed and answer any questions you have.

Hope you feel better soon.

Thankyou all for your replies, it helps to hear other people's perspectives on it.

We definitely will look at doing the birth reflections when things have settled down a bit.

It's probably worth mentioning for those who commented the CTG was because baby has a heart defect so I knew that was going to be the case and would rather have had that than not, I was helped to move whilst still attached when I wanted to.

I'm just trying to enjoy every moment of little one and not focus to much on the negative. My body grew a miracle after all.

It would have taken a lot more time to do the C-section, considering your epidural didn’t work, 2nd might have not worked either, or if worked, it would have taken some time to make you numb, for the doctors to prepare you etc.

the baby was in distress and close to exit, so to speak, hence she/he were delivered so quickly with the ventouse

they should have explained it to you better, but maybe there wasn’t enough time, plus people under pressure can be stressed

have the birth reflection, write all your questions in advance and take all the time you need until you understand everything

congrats on your baby x