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Childbirth

Share experiences and get support around labour, birth and recovery.

Petrified for second birth after traumatic first birth

80 replies

rosiebutterfly · 08/01/2025 10:48

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?

OP posts:
Kosenrufugirl · 22/01/2025 11:32

ChickpeaPie · 21/01/2025 22:25

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 realised after I posted that the oxytocin concentration in after the delivery drip is a lot higher (even though intuitively, it doesn't make sense). The oxytocin drip in labour is to bring on the contractions which do hurt, whether they are induced or not. The oxytocin drip post birth is to gently keep the uterus contracted after the placenta had been expelled. A woman can expect a bit of cramping, easily relieved by dehydrocodein or ibuprofen (cramping is to be expected anyway after the birth of a 2nd and every subsequent child).

A Caesarean section is a major abdominal surgery with a cut thought the skin, abdominal muscles and the uterus which are subsequently stitched up. Yes, the spinal provides amazing pain relief during the surgery and for a few hours afterwards. However, the post-operative pain requiring strong pain killers is still there for a few days afterwards.

Kosenrufugirl · 22/01/2025 11:50

rosiebutterfly · 21/01/2025 22:55

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

Hi there, I understand your apprehension regarding the drip, please see my message above. The cramping from postnatal drip does not even come close to the post-operative pain after a Caesarean.

Have you tried seeing an anaesthetist about your pain relief plan in labour?

Most epidurals could be tweaked or adjusted unless it's a dire emergency. Even then, there is an option of a pudendal block which is not a very technical procedure (not according to a couple of obstetricians I spoke to on our labour ward). Pudendal block is very similar to a numbing injection during a dental filling.

It's very common to have a team debrief in Maternity after a serious incident such as a woman losing 2.5 l of blood. Just to see what we could learn and how we might do things differently in the future.

All things being equal, a woman is more likely to suffer an excessive blood loss after a Caesarean, whether it's elective or an emergency.

Whatever method of delivery you chose, the team will be aware of your previous haemorrhage and lots of precautions will be put in place.

I hope it helps

Kosenrufugirl · 22/01/2025 12:05

Further to the above- pudendal block won't help with the pain of the contractions, the best pain relief would be a good working epidural. However pudendal block could be used if there's no time to provide or fix an epidural and instrumental delivery is needed.

May09Bump · 22/01/2025 12:21

I was persuaded to go induction again for my 2nd and had a 1st birth very similar to that you described. It was a big mistake, similar errors occurred again despite me telling them it wasn't going well. I would strongly consider a managed C-section,

I came close to losing my daughter and 9 years on I still have spinal damaged caused by the birth.

Whilst a C-section is surgery, if planned and recovery taken seriously, I know of 11 people in my friend circle who have had a calm positive birth experience compared to my experience of inductions.

Greybeardy · 22/01/2025 14:25

A few thoughts that may be helpful (hopefully!)
-re. the mortality associated with c-section vs vaginal delivery, the numbers do seem a little frightening when you look at as it's been presented to you. Those figures do include the 6 weeks post-natal period though and include things like infection, blood clots etc, not just 'deaths on the operating table', so if you do chose a section don't go into it thinking there's a 1:4000 of dying on the spot! Another way of thinking about it though is that current numbers show 1:4000 chance of mortality with a planned section, that means 3999:4000 chance of not dying.

If mortality for a vaginal del is 4:100,000 (1:25,000) and for a section is 25:100,000 (1:4,000), then for about 99,980 women per 100,000 the outcome is the same irrespective of the mode of delivery and nationally IIRC there are about 100,000 elective sections/year (convenient for the maths!) so for the enormous majority of women the mode of delivery doesn’t make any difference to whether they survive or not. Clearly every death related to childbirth is an awful thing, but you’re actually looking at an incredibly rare event either way.

These numbers are for a 'whole population' though, and for some women it's obvious from the start that they have factors which may increase/decrease the risk (often women with cardiac problems/pathological placentas/other odd stuff that crops up in pregnancy).

The rare risk of dying also has to be balanced against the risk of morbidity ('non-death' complications, like tears, bleeding, infections, psychological trauma etc) for the of women who don't die, and the relative risks may be significantly different with the different modes of delivering. One thing that no one seems to have commented on (although maybe I've missed something along the way) is that you've had a colorectal surgeon involved in this decision making process & that kind of begs the question of whether there's something else that needs factoring in that has been a bit glossed over in this thread that that rather than the bleeding risk might be the really important thing.

-re. having 'the drip' post-partum. It's used for uterine atony for both sections and vaginal deliveries so not having a section doesn't necessarily mean you wouldn't need it after delivering. The drip usually only lasts for 4 hours though (and it's worth remembering that the numbness from a spinal for a section would be working for quite a bit of that time, and even once it's worn off the other analgesic component of the spinal will still be helping). Some units though use a long acting analogue of oxytocin as a single shot (so essentially equivalent to 'the drip') for all women having a section and it's not flagged up AFAIK as being an increased risk of post-op uterine pain compared to having a single shot of short acting oxytocin (which is what other units use) so it may be that having a longer the infusion also doesn't make much difference to post-op pain.

-re bleeding, there's lots that can be done whatever mode of delivery someone choses if they're known to be at higher than usual risk (and often just planning for the worst means it doesn't happen!) so depending on the exact risk factors and what happened last time there may be other things that they can do to reduce the chance of a haemorrhage again (in addition to planning to use the synto drip). It is worth remembering that what most normal people think is a lot of blood is quite different to what most HCPs think is a lot! 2.5L is certainly a proper haemorrhage, will trigger the emergency protocols etc and absolutely it'd be best if it didn't happen, but it's also well within the realms of what an obstetric/anaesthetic/midwifery team will be used to managing if necessary (and the fact you survived the last time is a pretty good indicator that you'd survive again if it were to happen this time!). For some women there's some comfort in planning a section because it means that everyone's already in the room to deal with bleeding if it does happen, but for others the attempt at a vaginal delivery that might go smoothly, but equally might not, is worth it even if it does end up with a bunch of us barrelling into the nice quite labour room to fix a bleed in the end.

-ultimately you really cannot plan for everything in childbirth and you only know it is going to be normal (by either route) after it was normal. Your team can advise you re the relative risks for you as opposed to the risks for all women, but ultimately quite a bit of it comes down to what risks you're comfortable-ish with and what things are most important for you.

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