Petrified for second birth after traumatic first birth

[rosiebutterfly]

Hi all,
looking for some advice or words of truth, my first birth was an absolute disaster I was induced, 5 day labour, hormone drip, forceps? Severe PPH (2.5litres) 3 blood transfusions and a week hospital stay, after this birth I had various discussions with the midwives and even colon surgeon and they suggested that people with these sorts of traumatic births usually go c section next time.
Ive had this in my head until my consultant meeting today, I felt like I was being persuaded not to go c section.
I was told that the risks are a lot higher and mortality is 1 in4200 which seems really high to me.
i was also told that if going c section or vaginal birth I’ll need to be put on the hormone drip regardless of delivery after I give birth to control my placenta and help my uterus contract as it failed to last time which is why I had such a huge hemmorhage.
I’m just really feeling confused and low now as that death rate has really freaked me out and the thought of going through all the vaginal risks again with what happened last time to have to be placed on a drip afterwards anyway really makes me feel uneasy.
just wondering if anyone else experienced a similar scenario and what would you do?

I had a difficult first birth with eventual forceps delivery under spinal block. I also had a haemorrhage. It was not as big a volume as yours and I'm sorry you went through that.

I was very afraid about having another baby and it took me 7 years to get to it!

I had a debrief with a consultant and they told me that from the notes they weren't sure what specifically had caused my haemorrhage so I could choose freely if I wanted a C section as they felt it was possible I could haemorrhage either way but knowing that I had previously had one they could put controls in place.

I also wanted to avoid induction as from the debrief I don't think the drugs I was given in labour (which had started naturally) were helpful to my outcomes

So in the end I spoke with my midwife and decided that if I went into labour naturally then great but if there was any hint of not progressing or indeed if there was talk of induction, I would be ok to request a c section then. I was concerned about recovery from the section, I obviously had a 7 year old who needed walked to school and various other things.

I did go into labour naturally and once labour properly started, my son was delivered very quickly. It was amazing and could not have been more different from my first birth. I look back on it fondly. I also didn't have a haemorrhage despite checking every 3 seconds.

I don't regret my decision at all but I think if I had an elective section it would also have been good and a much calmer experience.

Hope sharing my experience and decision making process was helpful to you. I wish you the very best.

As someone who has had 2 homebirths, in your situation, I would have a planned section.
I think that would be the least stressful situation for you

Woah I’m so sorry you went through that, forceps was traumatic even with the epidural Iet alone without it

I’m so sorry you had a traumatic birth but it was lovely to read your next positive experience, I think if I didn’t need the hormone drip regardless I may be swayed to try vaginal again but the thought of that happening anyway makes me lean towards c section x

I had a traumatic (although not as traumatic as yours) 1st delivery and opted for C section for second. I don't regret my decision at all. Much calmer, controlled and bonded far easier/quicker with baby 2. A vaginal delivery could have been a lovely experience too. I'll never know and I don't care. The choice was right for me at the time to remove the stress of another traumatic experience.

This is your choice to make and to do it on the reasons that are purely right for you.

Wow congratulations on your two home births, what an amazing experience that must have been thank you for your opinion and I do think you’re right

Thank you so much I think c section is the right decision for me, as I wanted calm and controlled just wish she wasn’t as brutal with all the risks and complications straight away lol

Just reading that back, it sounded a little conceited, I didn't mean it to be. I just meant that I am a believer in doing whatever is right for your own situation and wheras vaginal births with minimal intervention are what most women hope for, ultimately the safety of both you and your baby (and your sanity!) are the most important factor. After your first experience I would be so scared too and a planned section seems the calmest way and you would be mentally prepared and in control the whole time.

I think I would probably do the same. On the mental/mindset side, I found hypnotherapy birth prep very helpful. I had been concerned about having a panic attack in labour or when being prepped for my section. You don't have to be planning an unmedicated birth for it to be of assistance, and I had a "plan" for using it for both a section and my eventual vaginal birth. Worth looking into. You may already have mentioned this, I skimmed the thread a bit after the first post because I still find birth stuff a bit tricky so apologies if you did!

I had a similar experience with my first and was absolutely terrified to give birth to my second. Gruesome, very long, back to back and Keillands forceps left me quite traumatised and in pain for months afterwards.

But .. the human mind is a miraculous thing because the birth of my second baby wiped away all the horror, flashbacks and nightmares of the first time. It enabled me to rewrite the story.

I was refused a c section.

For all of my 2nd labour I was in total denial that I was about to give birth. My mind refused to believe it was happening. Somehow I was able to ignore the pain. I spent the whole of my labour bar the last 2 minutes in the bath. I refused to go into ‘that room’ (delivery suite) and insisted to everyone that asked that I was fine. I wasn’t of course, baby was imminent. I reluctantly climbed onto the bed in delivery suite and out she came. I didn’t even push. I played no part in it. My body knew what to do.

You can do this OP. Just remember you are in charge. Do labour your way.

Just adding to my post that yes, I would push for a c section in your situation. 2nd vaginal birth was ok for me but I wouldn’t have chosen vaginal if the consultant had said yes to a c.

I had an almost identical first labour to you. Only addition was I had a 3rd degree tear and retained products - but all the rest including forceps, PPH, transfusion etc. It was horrific and to this day is the closest I have come to death.

There are no circumstances in which I would have had another vaginal birth - no way. I asked by consultant what would she do differently the next pregnancy and she said well I'd scan you and maybe induce early if it was a big baby like your first. I never went back to her. Found another obgyn who completely supported my desire for a c section - actually I'd say she did not want to preside over the shit show that another vaginal birth might have entailed.

OP you need a c-section. I have no idea about the hormone drip thing - I can't remember if I had that with the c sections but I had no pph or bleeding or anything after my c sections. Imo the pph was a direct result of a too-long labour, misapplied forceps, and basically a traumatic labour.

Think about the long term consequences if you have a second vaginal delivery like your first. You may, like me, have been lucky and dodged incontinence etc. I was not prepared to risk it a second time.

Sorry to be so certain. Of course this is your choice and other people will have other opinions. But I consider my 2 c-sections to be the two best decisions I've made for my health.

thank you so much, your opinion really helps as i'm leaning to csection

that is so shocking you were refused, i am glad your second birth went ok but that is not right at all .

oh i'm so sorry it sounds identical, I missed out i had a 3b tear and they gave me an episiotome before hand aswell and did nothing! i was being stitched for a long long time it was awful - i really appreciate your direct and sensible reply it has also really boosted me to go for c section, i've made up my mind and I'm going to proceed that way

Yes I had an episiotomy as well as the tear too. When I spoke to my new obgyn about a c-section she said "well to be honest you kind of had a c-section but just in the wrong area"!!

My recovery from both c-sections was straightforward. I chose to leave hospital the day after the second one. The recovery from a normal vaginal delivery would, of course, be easier than a c-section but nothing compared to recovering from your experience. best of luck to you.

Hi there it's a labour ward midwife again. The drug concentration in the hormonal drip to help the uterus stay contracted after delivery is much lower than the concentration needed to bring on the contractions. It will feel like mild after pains which dihydrocodein will be able to eliminate completely. Dihydrocodein is freely available on maternal request in maternity. Ibuprofen is also a suitable drug most of the time. You can also request an epidural in labour which will take care of the after pains too. It's not an easy decision, I know. Please do bear in mind that elective Caesareans on maternal request are only booked after 39 weeks to minimise the risk of baby being admitted to neonatal care unit with breathing difficulties. 1 in 10 women will go into labour before their scheduled elective. In this case the doctors will revisit the care plan with you. An emergency Caesarean is more risky compared to an elective Caesarean or a vaginal birth. It would be good to be mentally ready for every eventuality. Is there a perinatal mental health team your community midwife could refer you to?

I have had 3 c sections
1st emergency 35 weeks for
pre eclamsia failed induction
2nd emergency twins 34 weeks for pre eclamsia
3rd elected 39 weeks all went completely fine recovery good

@rosiebutterfly apologies if this has been said already.

I am a labour suite midwife and what stands out to me in your posts is your fear of the hormone drip. The drip you get post delivery is not the same as the drip you get to induce labour. It doesn’t cause painful and regular contractions it just keeps your uterus nice and contracted post delivery. In my trust it runs over 4 hours and most women have no issues with it so don’t worry about it causing lots of pain.

You will get pains as your uterus contracts post delivery but this would happen if you didn’t have the drip (and a uterus that contracts normally post delivery without the drip).

A lot of women go on to have very healing and straightforward vaginal deliveries after a first trauma and lots choose an elective section.

Your team will be prepared for PPH in either scenario and you will be in good hands whatever your choice.

Thank you so much for your explanation, no I am petrified and have PTSD from birth ontop of already suffering CPTSD, I keep mentioning the drip as it seems impossible to me to consider vaginal again as the thought sends me into panic and despair the drip is an additional factor on top of what already seems impossible 😂😂 don’t get me wrong in my first birth I never ever wanted a c section I was vaginal all the way hence going to forceps I begged no theatre this time I think after everything today although the c section is scary and uncomfortable, vbac would scare me more

I had a horrendous first vaginal labour, over 24 hours, nothing happening when I was quite dilated, had epidural and babies heart rate dropped, so had forceps and they cut me, there were around 12 people in the delivery room. Baby went straight to special care unit, with low sugar and stayed there 5 days. I had to be sewn up which took over an hour. Second labour, I wasn’t keen on cessation and it wasn’t particularly pushed, I went in at 1.30pm and baby was delivered at 3.30pm with just the midwife and my DH, no pain relief apart from gas and air, was such a nicer experience, no stitches, so hardly any aftercare needed.

Hi there I can clearly see you are petrified. I am just not sure why you keep referring to VBAC. VBAC stands for vaginal birth after Caesarean. VBAC risks are much higher compared to a vaginal delivery, especially a 2nd vaginal delivery. I am not saying you shouldn't request an elective Caesarean. I just want you to understand the risks involved with both options

I had a very traumatic first birth. Had a planned section second time round. It was so different - peaceful and beautiful. I was petrified too and I don’t think I could have done VBAC. I felt under pressure to try too. If you want a planned section, stick to your guns.

hello thanks for your message, my epidural failed last time and only worked one side and I cannot explain the excruciating pain of it going in I don’t think the lidocaine worked I think I it was more painful that my birth lol. I don’t know anyone that has managed to have an epidural the second time around, everyone has been too quick is that quite common? It’s such a hard thing I think if i was pushed into the situation of having vaginal it would probably be fine but given the choice it just scares me so much

re. epidurals, second labours are often quicker than first, but if a woman does want an epidural there's still usually time to site one - just ask for it as soon as you start thinking about rather than holding on until your desperate. You'll probably remember from last time we usually tell women it's about 40mins from starting to site the epidural to getting decent pain relief - occasionally women do get to fully and push a baby out before the epidural is working well, but it's not that common. There may be alternative pain relief options where you're planning on delivering - remifentanil isn't universally available, but if it is where you're delivering then it may be worth exploring if you do decide to try for another vaginal delivery.

re. the one-sided block last time - that isn't terribly uncommon (about 1:8 epidural's don't give great pain relief) - doesn't mean anyone did anything wrong and also doesn't mean that the same thing would definitely happen again. Often if a block starts off on the wonk there are tricks we can try to get it evened out (but if labour's cracking on at speed there may not be time). Some women find that a unilateral block is worse than having no epidural at all because having one pain-free side emphasises how painful the painful side is.

Spinal injections (the normal default for c-sections) are much less likely to be problematic and give wonky blocks, so if you do decide to have a section don't worry too much about that.