Labour after baby loss (termination for medical reasons) - advice please!

[Thefrogwife]

I'm 35 weeks pregnant and due in mid-August. Last August, I lost my first baby at 14 weeks. We had to have a termination following the 12 week scan which showed huge cystic hygroma and hydrops (fluid round organs) - we later found out she had Turner syndrome which leads to fetal death in 98% of cases.

I had to have a medical termination, so was admitted to a Bereavement Suite on the Delivery Unit, given medication to induce delivery, then had to have vacuum aspiration with a spinal anesthetic to remove the placenta which got stuck. It was pretty physically and mentally traumatic.

My mental health suffered quite a lot but I wasn't able to get counselling on the NHS, but had a number of sessions with a private counsellor, a lot of which focused on differentiating between this new pregnancy and the previous one e.g. to mentally prepare when going for ultrasound scans.

My plans for labour have been very informed by wanting to avoid, as much as possible, triggering memories of what happened before, particularly as my due date is literally two days before the anniversary. For example, I am reluctant to have an epidural, as the spinal anesthetic took a long time to administer, the anesthetist was visibly stressed by the end and kept saying I had tough back ligaments, and I ended up with nerve damage in my leg that lasted six months.

Crucially, I wanted to give birth in the midwife-led Birth Centre at our hospital, to avoid being admitted to the Delivery Unit where I lost the first baby. As the pregnancy is low risk, I've been led to believe this was the most likely option. However, I have now discovered that almost no-one actually gives birth at this unit- only about 15% of people admitted to give birth at the hospital. Have asked the midwife team for clarification but not had a response. I had a bit of a freak out yesterday, suddenly confronted by the idea of being in an identical room, probably in identical weather, with the same staff, being brought the same sandwich and yoghurt etc etc

I realise lots of women must have had similar experiences of either baby loss or just really traumatic birth experiences, and then have to give birth again in the same hospital, so I was wondering if anyone had any advice about what I can do to try and basically not have a awful flashback experience if I do end up on the same ward. Am a bit skeptical of birth plans now that I suspect I have no choice about birth place, but perhaps things I can include that might help?

Thank you.

Everyone is different, even if we had similar experiences, you choose how you want your birth/birth plan to be.

I gave birth to my boy at 21 weeks (obv didn't live), placenta was also stuck, they couldn't get it out, had retained placenta and had to go back to hospital 2 days after giving birth to go under GA to get all retained bits out.

For the birth of my second DC, I wanted to be around all of the doctors and nurses as humanly possible, I wanted constant monitoring, I wanted all the drugs, epidural, pethidine etc.

You do you OP.

It may be worth asking for an appointment with an anaesthetist to talk about the pain relief/anaesthesia options? Even if you do go to the midwifery led unit, it’s possibly helpful to have had this conversation ahead of time in case things don’t go quite as you’re hoping.

Also, many labour wards will also have 2 operating theatres so if you were to need to go to theatre again it may be possible to ask to not be in the one you were before if you felt that might help.

most units should have a midwife with a special interest in mental health - if you’ve not spoken to them yet it may also be with it to see if they have any advice/ can help supporting specific requests.

Hi @Thefrogwife Im wondering how you got on? I've come across your post as I too had a TFMR at 14 weeks for you extensive cystic hygroma and T21. I'm sending you so much love because I know the heartbreak of the diagnosis. I too had to go back to surgery for retained placenta, twice over a 4 week period. It was traumatising to say the least. It's been 10 months now and I've delayed TTC due to all the fears I have, similar to you so would be interested in hearing how you got through in the end. I hope it all went well xx

Hi @Lulabella22 . I'm sorry to hear you've been through something similar.

The birth experience was both better and worse than I expected. On the plus side, my labour was very short (11 hours from start of contractions to baby). On the negative side, unfortunately the first stage of labour went really quickly, but the midwife who assessed me didn't really listen and sent me home (even told me to take a paracetamol and have a shower when I phoned up again from home- twenty minutes later my husband had to phone back to say I needed to push and we had to start the hour long journey back again with me terrified I was about to give birth in the car, trying not to bear down). I'm pretty sure this is why the second stage was hugely drawn out, 5 hours of pushing, because my contractions slowed right down as soon as we got back to hospital.

Basically everything I was worried about happened - I was fully dilated when we got to hospital, they let me push for an hour at the Birth Centre before moving me to the Delivery Unit (where I had not wanted to go), then I got taken to the Operating Theatre for a spinal anaesthetic, ventouse and then forceps. There was an awkward moment when my husband handed them my birth plan (which literally just had brief details of the TFMR and what I was anxious about as a result) and the midwives all started being really nice to me (it was prob obvious to them already all the things I wanted to avoid were inevitable). The one group of staff who wee very good were the anaesthetists- my normal midwife had got me a phone appointment to discuss with one what happened last time and why it went wrong, and the anaesthetist team all seemed to know my story when I got to Theatre and were very reassuring, talking me through what was happening.

Being in the Operating Theatre again was awful, I can't pretend otherwise. One of the two surgeons who appeared to do the episiotomy was the guy who had talked us through the post mortem consent form a year earlier. I'll be honest, I was not really mentally present when my son was born; I'd been doing a safe space visualisation with my counsellor literally the day before and that's where I was.

Then I heard him cry, he was alive, it was over.

The first couple of weeks postpartum were very very difficult, because of the massive hormone crash and that I was dealing with the impact of a difficult birth on top of the previous trauma. I had a lot of upsetting dreams (when we were still in hospital, I dreamt we were being discharged and I went to get my boy, but the little box we buried my girl in was there instead) and I was very angry and couldn't stop reliving moments from the labour. I also had a lot of problems with breastfeeding (midwives couldn't get him latched and just gave us formula- I had expected more help- I have manged to get him 50% breastfed now) AND I now have a prolapse as my rectum is bulging into my vagina due to birth injury. (again, no NHS support, have private physio)

And yet

it was worth it. He was born a year to the day after our disastrous scan and is now almost 10 weeks old. Every day at the moment he is changing and we can see more of who he is, he can make different sounds and likes to "talk" to us, he smiles and tries to laugh, he's grabbing at the fabric on the inside of his moses basket because he's learnt to use his hands. I feel stronger too everyday.

The first therapist I saw said grief doesn't get smaller, but your life gets bigger around it. I suspect we will not try for another child, I think our family is complete now, but if you want to, don't let the previous trauma put you off trying again. You can be broken by something but also much tougher than you think at the same time.