Not informed about birth injury- is there a "full" version of medical notes to request?

[Frogglingalong]

Posting again about my postpartum bits...

Having finally got the hand mirror out three weeks after birth, and having had increasing discomfort in the vulva (pressure, rubbing, burning) I have realised I have a long, seemingly healed and maybe stitched incision or tear along the length of one labia on the inside, so several cm long.

Was not mentally present during a lot of birth, but husband recalls a lot of blood splatter during a failed ventouse, and I was told I'd lost a lot of blood, which was listed as postpartum hemorrhage on discharge notes, but I'm 99% sure I didn't hemorrhage after birth, and delivery of placenta was quick and intact....

Firstly, this is f-ed up, right? I feel pretty sick. If I was injured they should have told me, right? I was told about the episiotomy and told about looking after incision, but all the time there was a whole other bit of scarring to look after?

Secondly, will there be a more reliable record of this? I'm assuming there's a fuller record than the discharge notes of what happened when I was in hospital has anyone ever requested this, and if so how and what kinds of info did it have?

I'm not sure about where it's recorded but have you requested a birth debrief? A midwife (assuming it's the same in other areas) will sit down with you and go through your birth, mine went through a lot more than what was on my discharge notes

I've booked one of these appointments, but the earliest available was December...wondering if I would be able to make sense of records myself before then

Is your baby okay?
If so then I don't see what the problem is.
My baby was late diagnosed for something and ended up brain damaged, there were no apologies or compensation for that so i highly doubt they'll see an issue with you having a tear they had to stitch up and perhaps didn't tell you.

My baby is fine, and I'm grateful for that and really sorry about what happened to you and your baby,

But I don't think it's a tear that got quietly stitched up. I think the ventouse was used incorrectly (they did it three times before starting on the forceps), by doing the ventouse wrong they left a fairly large incision which is now causing me pain (and presumably will continue to do so) and then covered this up by falsely listing postpartum hemorrhage on my dispatch notes to explain the blood loss figure...is that not a reasonable thing to want to know about and possibly complain about?

I'm so sorry about your baby and your experience!

One of the huge problems with birth trauma is people saying to women 'well your baby is ok'. It so diminishes how they feel and any trauma they have suffered.

A healthy baby doesn't stop a women feeling traumatised by her birth and she shouldn't be made to feel that her feeling don't matter because her baby is well.

It does sound like a labial tear, which I had and caused a lot of bleeding which was put down as pph. I was told what had happened though. The stitches were very irritating.

The OP hasn't mentioned apologies or compensation.

You are projecting, which is understandable given your own experiences - for which I am sorry.

But please don't beat up the OP who has a perfectly reasonable desire to understand what has happened to her.

Women exist and are patients too. A healthy baby doesn't mean birth injuries for the mother don't matter!

OP, you could try a subject access request for all medical notes taken during your time in hospital for delivery and post-natally. I'd maybe contact PALS and ask about getting a copy of all your notes and go from there.

I'm not an expert but I think you can still have a PPH with an intact placenta.

They’re not covering up anything by saying you had a PPH. A PPH just means higher than usual bleeding after delivery of the baby and bleeding from a tear is one of the common causes.

Ok, well ordinarily I would say that 3 weeks postpartum is too soon to be looking at your bits or worrying about their appearance. My best friend told me not to look but I did after a month or so and I thought I was all healed but that it didn't look the same as before and I was a bit sad about it. A few months later it did actually look and feel the same as it did before. Your whole genital area has been through a major trauma but it is one your body is designed to go through multiple times and heal from. Even if you did suffer labial tearing you weren't informed about and it looks a mess right now, it doesn't necessarily mean it won't heal up nicely in time.

That said, if you are in a lot of pain I would get checked out. Do you have a postpartum checkup scheduled? Can you ask for one?

I wasn't aware of this, I thought it was something specific...

are you now signed off by the midwife? If still under their care get them to have a look, if not book in with GP to check healing/check for infection if you now have more pain?

birth injuries should be given more sympathy, they are a really hard thing to deal with and of course we have the hormonal rollercoaster post birth which doesn’t help either… gentle hugs.

OK, that's a less sinister explanation!

Do you mind telling me a bit more? This is a long wound, maybe 3 - 4 cm long, along the inside of one labia majora - I can't think how that would tear like that

PPH just describes higher than usual blood loss. The commonest causes are (in no particular order): the uterus not contracting well; part/all of the placenta not coming out; tears/episiotomies; blood clotting disorders. It would be completely normal to repair a tear at the same time as an episiotomy and the ventouse cup coming off doesn’t necessarily mean anyone was doing anything wrong - sometimes it just doesn’t work. Hopefully the debrief will clarify exactly what happened.

I don't really care what it looks like. But I've basically stopped wearing maternity pads, or even knickers at night because it was rubbing and making the whole area feel like it was burning, and I haven't yet managed to walk beyond the local shop because it hurts after 5 or so minutes of walking or standing

You can easily get copies of your notes, but I found that mine were rather vague and didn't mention how bad the tearing was, that I had stitches, etc. Just something like foreceps: four pulls.

I couldn't face getting mine until years later, so that's great that you can meet with the midwife in a few months.

It may be from something termed a labial laceration. This isn't always a tear and isn't always stitched as can be superficial. They would stitch muscle and the episiotomy. The ventouse sometimes doesn't work and they shouldn't attempt more than 3 tractions. Instrumental births and tears often end up with heavier blood loss. Like someone else said ask for a debrief or you could go email the hospital 'pals' department with questions about your birth especially if you don't think you were correctly informed or debriefed at the time of what happened to you.

Maternity pads do rub. They're very uncomfortable. I switched to big knickers with a very soft normal pad early on. After three weeks hopefully the bleeding is starting to diminish a bit?

Could you try period pants for the daytime? Or even put a damp flannel in your underwear if you don't have visitors. You could keep a supply of clean damp flannels in the fridge for extra coolness.

Like I said, I would get checked out for the pain but you might just need more time. Your body has been through a lot, especially with the failed ventouse attempts and the forceps. I wouldn't necessarily worry you've suffered any permanent damage at this stage. If it still hurts in a few weeks then definitely have it looked at though.

Signed off from midwives now, so it'll have to be the GP.

I think part of why I'm so upset is no one has examined me since delivery, even though I spent 4 days on a postnatal ward. On the first day I had to ask 4 different people over the course of 8 hours for a new maternity pad (had spinal anesthetic so couldn't change it myself). And I was told not to come to hospital in the first place even though I was almost fully dilated and ending up starting to push in car there. Feel like there's literally no healthcare there.

I saw a midwife councillor after our DC arrived. I only knew about her because my boss was her next door neighbour, no obe in the hospital directed me to see her. I saw her whilst still in hospital. Pages from the night of the birth were missing from my notes. Her report back on this and my Doula’s evidence were part of a hospital enquiry. The birth was general anaesthetic and our DC was tiny but my wound scar is very long. You are entitled to full info and more treatment. Don’t let anyone tell you that the main thing is that your DC is ok. You should both be ok, likewise any trauma your partner has around a difficult birth also matters.

Ok, thank you. I hope I'm just being overhasty and it's still healing.

No-one told me that I had torn internally during a failed ventouse, and had stitches. I read it in my own notes and asked a midwife to examine me who confirmed it.

It’s really not ok and you are right to be concerned about this.

No-one told me that I had torn internally during a failed ventouse, and had stitches. I read it in my own notes and asked a midwife to examine me who confirmed it.

It’s really not ok and you are right to be concerned about this.

OP I had stitches and such and found that the pads were really irritating so bought some natural, bamboo fibre ones that seemed to help. Not the point of your post but thought it might help you with the irritation.

Also a cool pack for knee injuries, it’s got soft gel stuff inside and it goes in the freezer.

How does the 3-4cm wound differ in appearance and position to your episiotomy wound?