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 similar experience. Traumatic first birth with my eldest and then when trying for our second had lost 3 babies to miscarriage consecutively. My mental health and anxiety was not in a good place so I had a planned c section as I wouldn't have coped otherwise. It went smooth and over very quickly. The recovery is a little painful but was manageable after a few days and painkillers

I had a somewhat similar experience (though definitely not as bad as you). I was induced, on the hormone drip, very very long labour, epidural didn't work properly, became dislodged, hours and hours of no pain relief etc, ended in forceps and episiotomy. I was traumatised. Pain was horrific and the stitches and hemorrhoids were very painful after. I pushed for an elective C-section for my second. They do try to put you off as it's major surgery (& expensive) but oh my goodness the difference. It was calm, controlled, took less than an hour and the recovery was actually easier than the vaginal birth. In my experience the C-section was a much better option.

I had a similar birth experience with my first child - no anesthesia, back-to-back labour, 3rd degree tear, massive PPH, retained placenta that had to be removed in theatre an hour after the birth.
I was terrified of the birth with my second. I'd recovered well from the first, but was concerned I wouldn't if it happened again. None of the medical professionals recommended a c-section so I soldiered on.
At 36-7 weeks or so I got measured by a different midwife & they decided they wanted to induce at 38 weeks.
Waters broke, but labour didn't progress as planned - DS went back up the birth channel after being fully engaged; & was lying oblique across the birth channel 😂 Clearly wasn't quite ready.
Anyway, at that point the drs were concerned about infection & normal labour couldn't progress so c-section it was.
Honestly - so much better than the shit show that was my first Labour. Proper pain relief, everyone calm; no-one trying to pull my placenta out whilst was still attached... It was all done & stitched in 20mins if that. DS was fine (grumpy about the forced eviction!), I was fine, no PPH, placenta was removed, all stitching done then & there whilst I was asked with my child.
If I had my time again I'd choose c-section.
Good luck OP.

Sorry to high jack but in a similar place to OP. Though actually leaning the opposite direction. Can you explain more about how the drip for afterbirth is different than induction? I mean in the first birth if you had the drip why would that not cause your uterus to contract after labour anyway? Or do they stop giving the drugs once you give birth and leave you to try to deliver the placenta naturally/with the injection? In a second birth if you are induced do they just keep the drip in once the baby comes out?

Hi there, happy to clarify. The drip used to induce labour and keep the uterus contracted is oxytocin infusion, different concentrations. Oxytocin in general acts slowly, over many hours, unless given as one massive dose. Some women deliver the placenta naturally. Most women in the UK, especially women with any risk factors for excessive blood loss get a dose of syntometrin- a combination of ergometrin and a high dose of oxytocin mixed together. Some women, for example women with high blood pressure, will only get a high dose of oxytocin. The idea is to get the uterus to contract strongly and quickly a few times to expel the placenta and close the wound where the placenta was attached to the uterus. Even without epidural women don't usually feel much pain- looking into the eyes of a newborn baby is powerful analgesia. However, women report more cramping and after pains after the 2nd and every consecutive baby. This is because the uterus gets more efficient after first birth. We all get better with practice. PPH is a rare event outside the 1st delivery. Unless the woman has a Caesarean, either emergency or elective. The uterus is cut, alongside a few layers of muscle, skin etc. Which is why women after a Caesarean and any woman delivering vaginally with risk factors for PPH will always get a slow acting oxytocin infusion on top of fast acting syntometrin/massive dose of oxytocin. The infusion used to keep the uterus contracted after delivery doesn't cause intense pain. It causes cramping at most which is easily relieved by dihydrocodein or ibuprofen

Hi there, I am really sorry to hear you had such a rubbish experience. Your half-working epidural should have been sorted long before there was a need to do instrument delivery. You may want to speak to a Consultant midwife or Consultant anaesthetist to make sure it doesn't happen again. Especially in view that 1 in 10 women will need an emergency Caesarean even if they are booked for an elective. An elective Caesarean increaes the risk of baby being admitted to neonatal care unit with breathing difficulties. (This is because the stress of labour prepares baby's lungs for breathing). This risk is still elevated but less so after 39 weeks. I really do think you need to push for 1hour Consultant appointment. They are usually debrief appointment. But you don't need to discuss your last labour. You just need a plan for your next delivery. A personalised Consultant plan has a much higher chance of being adhered too.

Further to the earlier message... as someone who used to suffer from anxiety and who is generally prone to health anxiety I personally find plans A, B, C to cover every eventually very helpful

I'm so sorry, OP. I had a similar experience; I remember feeling myself drifting peacefully out of life while two surgeons tried to stop me haemorrhaging after my DD was born by emergency CS. Needless to say, I lived and went into another pregnancy three years later. My obstetrician didn't need to convince me to have a planned CS! While waiting to go into the operating theatre, I asked a nurse if I might haemorrhage again and he replied, "Madame, nous ne sommes pas au moyen âge ici." Very scornfully and rather nastily, I thought. An hour later, I was holding my DS. I was 40 by then, so I knew that I was already classified as "high risk". Therefore the scheduled CS was my best option but you may be younger and have more of a choice.

Good luck!

just for clarity (from an obs anaesthetist), it isn't always possible to get a unilateral epidural evened out. A wonky block should be assessed by an anaesthetist and efforts made (unless labour's cracking on at such pace that there's not time), but despite best efforts and excellent practice sometimes it is not possible. The most widely quoted figure is that 1:8 epidurals are inadequate to provide the sole means of analgesia for labour. There is no way to 'make sure this doesn't happen again' and the only way to find out if it will happen again is to have a go. We do often see women in anaesthetic clinics to go through the pros & cons of the analgesia/anaesthesia options when they've had a difficult time of it first time round and that should be easy to arrange.

it doesn't matter at all how well an epidural's worked in labour if a woman has to go to theatre as, if the epidural is naff, we would usually take it out and do a spinal injection (even really good epidurals sometimes don't top-up as well as we'd anticipate, so we always have plan B, C, etc). For an elective section plan A would usually be a spinal from the start. The anatomy and techniques for both are different and spinals are more reliable in terms of the local distributing symmetrically when an epidural's been a bit disappointing.

Thank you!

I’m now leaning the other way too for some reason my mind and body is just saying maybe trying vaginal birth again won’t be that bad 😭 I’m so confused right now

Hi OP, the mortality rate for c sections is higher because the majority of women having c sections are already high risk for a multitude of different reasons and many c sections are done as an emergency/ a last case resort. I’ve had two straightforward vaginal births so I can’t really advise but I think you’ve been presented figures with very little context

@rosiebutterfly I’m just very scared of surgery generally! So oddly, the vaginal birth doesn’t freak me out as much. It makes no sense.
But I’m also flip flopping as everyone who saw me in my lovely yellow phase after birth thinks that I’m mad to be even thinking about it.

Yes that’s weirdly all of sudden what I keep thinking, I keep thinking I’ve been through a really bad birth already and survived it surely it can’t be worse than last time and I’ve never had surgery either so oddly I’m leaning towards being more comfortable all of a sudden with vaginal and the csection seems more scary to me, no idea why I think maybe aswell I deal with situations better that I’m kind of just pushed into, whereas if I plan all along for a c section surgery I have all that time to think about what will definitely happen, my mind is completely messed up 😂

@rosiebutterfly I know it’s so confusing to work out what you want! Everyone has an opinion and like you say, you can’t just go “fuck it I’ve made my choice let’s do it now.” You’ve got to sit with that choice for months and turn it over in your mind again and again.

I also had my last one in Covid so I think a lot of the shitness was related to that so I do keep kidding myself that will be better this time. Even if it’s bad like last time I won’t be on my own again.

My first ended up being traumatic. Baby was breech, heartbeat monitor was on back to front and nobody noticed that her heartbeat was in the wrong place. She got stuck, my epidural wore off and I was rushed to surgery for an emcs. Horrific at the time.

Second time around I swore I’d have an elective cs. Half way through my pregnancy I began to consider the logistics of the recovery period with a newborn and a toddler as well. Opted for another natural birth on the strict understanding of intervention at the slightest problem.

Dd2 was born in about an hour and a half perfectly naturally. I didn’t even get time for an epidural. She came out like clockwork. Couldn’t have been more different. Absolute breeze compared to the first one.

Beet of luck Op, hope it goes well. 💕

This is my exact thought process, I have my gorgeous 18 month daughter who I love so much who constantly wants picking up and all she says at the moment is mama 😂 I just worry that with c section too I won’t be able to be the mum she needs for the first few months and concerned about recovery, I swore I’d never have another vaginal birth two weeks ago and now I’m thinking the opposite, so lovely hearing your birth story and congratulations again. It really is so so magical ( when you’re not fighting for your life 😂 )

Don't get pregnant again and adopt instead if you want another child. Win win.

I personally would not go for an ECS as I previously had PPH with my first. What I was not told is you actually have a higher chance of haemorrhaging in a section.

Maybe I was naive but I was reassured it probably wouldn’t happen again and went for another and it happened again.

My story is below.

I had a planned c section for my second birth after a bad tear with my first. Honestly the c section was fantastic and so was my recovery - much better than after the tear.

Post delivery oxytocin infusion is way stronger than the one used in labour. 40iu in 500mls at 125mls/hr Vs 10iu in 500mls at 3-60mls/hr. Doesn't really compare!!

OP, I'm not really sure what the relevance of the oxytocin infusion is? You'd be on a drip after a c section regardless. It's up for four hours and your spinal would still be effective and you'd have other analgesia too. Can't say you'd really know it was there.

In your situation I'd probably choose vaginal birth if I went into spontaneous labour, knowing how much more straightforward (and potentially healing) second labours can be. As long as baby wasn't a whopper

I just want little pain as possible to be honest this time around as first birth was a complete car crash and literally thought I was going to die, I’m sure some medical professionals did aswell who witnessed my birth as I was told they referred to have therapy after witnessing my birth, so I think it must have been pretty bad. Hearing I have to have the guarantee of drip again I’m assuming would be v painful and as second deliveries are more spontaneous the thought of not being able to have any pain relief with the drip scares me

I had a traumatic first birth and a third degree tear, went with an elective section with my second and I'm so glad I did. Everything was so calm second time round and the nurses and my midwife kept me informed for each step. I had a moment in theatre where my blood pressure dropped and I blacked out for a moment but even with that everyone was so calm and completely focused on me and baby, I still felt in good hands and relaxed when I came back round. Don't get me wrong recovery wasn't a walk in the park but as long as you keep ontop of pain relief and take it easy it's fine.

I realise you’ve had a ton of differing responses but thought it might help for you to hear my story. We had very very similar first deliveries.
Long and induced labour, failed epidural too, I still had pain all down one side. Then a 3l PPH, lost consciousness and woke up to midwives pummelling at my uterus trying to get it to contract, a crash team in the room and a terrified and tearful husband. Spent a week in hospital. Blood transfusion and stitches to repair tear.

It took 5 years before we decided to have another baby!

Second delivery was so different. Told I was to be consultant led and they explained I could not have a home birth (fine by me) but a c section was not discussed at all (although this was 10 years ago now)
Advised I would have a cannula fitted in labour to have a drip to help my uterus contract straight away.
i did end up getting induced (couldn’t believe I had gone overdue again) but once labour did start, it progressed quickly and I managed on gas and air. Baby was born (all 9lb9oz of him!), we were both safe and sound and I didn’t even notice the cannula or any pains afterwards. I was up and on my feet almost straight away and home later that day. It was amazing.

Third baby was born via c-section because she was a very awkward breech. It all went well and they were aware of my past PPH and I was in very safe hands. The only thing I will say is please don’t forget that a c-section really is major abdominal surgery. Recovery for me was definitely slower and more painful afterwards than my vaginal births (although I appreciate we are all different)

Hope that sharing my expediences helps you to have an understanding that a vaginal birth is certainly possible after what you went through.

Good luck with what you decide to choose, all the best x

My first birth wasn't too difficult. For my second birth I wanted another vaginal delivery but I had to have a C section because they could not get my blood pressure down even in hospital on bed rest it was high. Then my baby got into distress. Despite my worries the C section was so quick and straight forward. I healed quickly and had absolutely no problems. Afterwards I could not believe I'd been so worried at the time.