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?

Thank you. Sorry that you went through all that and had to go to such lengths to get the relevant information.

I can’t help with the tearing side of things but have you tried these to try and help with the discomfort - https://www.boots.com/boots-maternity-cooling-ice-maxi-pads-5s-10288931, Fridamom do them as well. I found them really helpful when I had discomfort! As well as the Fridamom witch hazel foam.

This, is not ok. Regardless of your trauma, which is bloody awful in itself and I’m so sorry you had to go through that, but it does not detract from this woman’s trauma. If she feels it was traumatic - then it was. It doesn’t matter outcome of baby. Patient’s have the right to full disclosure of their care, and she has every right to try understand what happened to her. So by saying “if your baby is ok then I don’t see the problem” is rude and dismissive of someone’s feelings.

computers automatically classify any blood loss over 500mls as a PPH although the majority of those are just slightly higher than normal blood loss and not any sort of emergency. The 3-4cm tear you are describing is a fairly common labial tear, they occur on the insides of the labia minora usually and can extend the full length of the labia from the clitoral hood to the bottom. They are caused when the labia reach full stretch as the head crowns and are incredibly common. Some are stitched if very wide or bleeding but many are left as they heal very well by themselves. I obviously can't make any remarks on what you were told during repair but I would usually talk women through what trauma had happened. 50% will totally forget that conversation and ask about it again during their postnatal care. You can definitely ask for a debrief but aside from not being aware it doesnt sound like anything is amiss.

I also had an awful labial tear that required stitches and was very uncomfortable. Mine was caused by my daughters head crowning. It wasn’t put down on my notes either nor was I told initially. It was another midwife that told me about 3 days later that I had an ‘unusual’ tear which would need a check to see if it was healing okay.

It looks quite similar, this is why I think it was also stitched up but the stitches have now healed. But it's quite red and angry looking, because it's rubbing on the other side.

In terms of position - it's nowhere near my vagina...it's much higher up, along the inside edge of one labia majora. Here is an illustration of the two...

I’m not an expert but I’d be concerned about the higher cut, the lower cut seems like a common area to tear during labour

OK, thank you for the inside knowledge. I lost 1.1l apparently. I definitely wasn't debriefed about anything - I was wheeled to a postnatal ward and pretty much left to my own devices until that evening when the shift changed and a new midwife introduced herself.

Midwife here...Tears like this are quite common OP...usually caused by crowning as everything down there stretches, not just the vagina. Ice packs for 10 minutes a few times a day can really help the recovery, as can applying Medihoney regularly if you can get your hands on it. Tingling/itching can be a sign of healing when the tissue fibres are knitting back together. However any redness/smell/ooze needs to be seen. It definitely sounds like poor communication from the obstetric team. I would definitely recommend a debrief, but also, if you can find the time with a newborn, write feedback to them. You can always contact the hospital and ask for a copy of your notes under the freedom of information act... you usually pay a small fee for this.

Just adding to the commentary from midwives to reassure you that a PPH is just excessive bleeding post delivery (anything over 500ml) as a result of any of the 4 T’s (tone, thrombin, trauma and tissue).

A labial laceration is usually caused by that stretching at delivery and unlikely to have anything to do with the ventouse cup coming off.

Labial lacerations can be uncomfortable but hopefully you will start to feel better soon. I assume it was the obstetrician who sutured you immediately post delivery after doing the ventouse and they should have gained consent and explained where the stitches were needed.

If you're in the UK OP you can absolutely request a copy of the full medical notes of the birth. I did after dds very traumatic birth. And yes, like me, while our children are OK, i very much wasn't (4th degree tear) and the physical snd emotional recovery took several years.

I had what I can only describe as a large graze on one of my labia and had a natural delivery. Stang like heck until it healed.

*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.*

Sorry, meant to say fully agree with the above!

Mine went from the entrance along the side of urethra up to clitoris. I don't know how long it was as it was all very swollen and so looked bigger than it was when it all healed.

Certainly looked hideous. I remember looking and thinking I would never be the same again. Probably about the same time as you - about 3 weeks later.

It happened after the head was delivered. I remember it. DC was born with his hand across his forehead.

I was told my notes were missing, then I was told they had been sent to the other hospital (I was transferred), then hosp 2 told me hosp 1 had them, then I was finally given a bland summary by a registrar. I wish I’d had a doula or some other witness. I had a horribly traumatic time and dc was injured, and looking back I’m certain I wasn’t told the whole story. At the time I just didn’t have the energy to press harder for details.

You need to make a 'subject access request' to your trust to receive your full notes, but they are often hard to decipher.

Definitely ask for a birth debrief.

sezzer87
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.

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The well-being of the patient (the mother) is equally as important as the baby.

While i am so sorry for what you've had to deal with, you are being incredibly dismissive of someone else's birth trauma.

The OP did not mention compensation or apologies, just wanting an understanding of how birth ended the way it did.

Doesn’t matter if baby is ok or not. The ops feelings and questions are valid. I had diagnosed PTSD after two births and it still
affects me to this day. Place a subject access request for your notes and request a full debrief with the midwife’s.

I got two of these. I didn't need telling as I felt it happening at the time (which was horrible!)

I also looked not long after and it was really frightening. I actually spoke to my GP and said is this what I'm stuck with now??

You can't see a thing now. I'd explain it as being like a black eye. It looks absolutely horrendous when it happens but when it heals properly, stitches are gone, and the swelling is gone, it'll be right as rain.

And yes, it was very, very sore! I could only use Triple Velvet toilet paper for weeks. Even Andrex felt like a handful of barbed wire.

I had exactly the same experience, I went in after my waters had broke and got sent home and then ended up nearly labouring in the car.

I also teared my labia, no one told me and I had also stayed in hospital for 4 days following the birth.

I also only found out when having a look down there about 15 days post partum because the pain felt like it was coming from an area it shouldn’t have been coming from.

I fought tooth and nail to get a debrief and kept getting fobbed off saying they would ring me back but I never heard anything. I contacted PALS and the head midwife rang me back within a day of contacting PALS and then came to my
house with my birth notes and debriefed me on the birth.

I felt like I was being a nuisance contacting PALS but we have a right to know what happened. I was told my tear was probably down to the fact that I laboured so quickly and they acknowledged they shouldn’t have sent me home. I felt so much clearer after my debrief.

The pain did go eventually and everything healed. I would also highly recommend the cooling pads and spritz for bits!

I had a tear. DD1 came out with her hand on her face and there just wasn't enough room for her head and her arm. It does all get better with time.

Thanks to all of you for sharing experiences.

It seems like this maybe happened when baby's head was crowning, based on other people's experiences.

Because I ended up having a forceps delivery with spinal anaesthetic behind a curtain, I have no idea what happened. I'm also baffled that they told me I was going to have an episiotomy to limit tearing, but didn't tell me that I'd torn significantly despite this?

Going to try to get GP appointment to check about pain and make sure it's healing OK, then contact PALS for help with record.

Well, OP clearly thinks it’s a problem! That’s why she’s posted.