How do I give birth when I have a complete mistrust of the medical profession?

[MrsTittleMouse]

I'm worried that I'm going to be a second Starlight here (), but I'm pregnant with my second child and due in October and I'm having some serious issues with my next delivery.

Quick synopsis for those I haven't bored senseless already - my first birth was very traumatic, because DD was big and OP and the labour was very long and painful. I managed with very little pain relief in a MLU, but had to be transferred to a CLU after 2 hours of second stage. The consultant laughed at me and my birth choices and bullied me into a ventouse delivery. I was exhausted and used my last strength to insist that I didn't want an episiotomy and that if I did tear that I wanted him to sew me up (having quizzed him on his experience). I ended up being given an epi almost up to my cervix without my consent (DD was not in distress), lied to about it ("only a tiny tear"), and the consultant disappeared leaving the SHO to do the repair. I've had a lot of problems since with the scar.

This time around, I took DH to my CMW appointments for support and told her all about my experiences and she was very supportive. She has offered me an elective CS if I want and offered appointments with people from the MLU and CLU to discuss birth options. But now she is retiring. I have met the new MW once, and she was OK, but doesn't know my history and I'm scared that she won't understand just how difficult I'm finding the prospect of another delivery (VB or CS). And it has really hit home to me that even if she's lovely, and even if the people I meet from the MLU and CLU are lovely, that I could get completely different people while in labour who treat me as badly as I was treated during my first delivery and do anything they want to my body as I'll be too exhausted to stop them.

I have no idea how to get over this, as a homebirth isn't an option for us. DD became suddenly very ill an hour after her delivery (with no warning) and almost died, so we couldn't cope psychologically with being so far away from the paed team. We have the money to go privately (although that money had been ear-marked for a deposit for a house, so it wouldn't be something that we could do without serious thought).

Please help.

oh MrsT you do sound like you had a rough time of it! Much sympathy, I can totally understand why you feel the way you do.

Can you write a REALLY explicit birth plan and task DH with fighting your corner? Or if not, consider hiring a doula? Much less expensive than going private, but they will be there to fight on your behalf, and they won't be intimidated by overbearing consultants.

Fingers crossed you'll get people who respect your wishes, especially if you outline in your birth plan exactly why you feel the way you do, but if not IMO a doula would be an excellent idea.

Doula UK have a website to contact your local doulas - ours was fab.

HTH

I would suggest a meeting with the head of midwifery or consultant midwife and saying to her what you have said on this thread. It might be worth a referral to someone re the fear of the birth.. the baby has to come out somehow, and you need to address it sooner rather than later.

what is your gut instinct re the birth.. VB or el c.s?

I would also suggest a Doula- I had a v poor first delivery too (told my eclampsia- fits and all- was just anxiety ), for me the homebirth was ideal but obviously not for you so a Doula in hospital may well be the ideal solution, can you post onhere first see if theres anyone near you? thats how I found mine.

And please remember that the next birth may well be very different , mine was.

Good luck X

I would say absolutely get a doula
very sorry to hear of your experience

I am already seeing a counsellor about my fear of birth - I was referred by my GP. She told me that she was very confused and didn't understand what I wanted too. That's because I have no idea what I want. I know that the only way that I can have "control" over the situation is to have a CS. But for some reason I have doubts. I think that it's partly a pride thing that I did everything right last time and it all went so wrong and I want to prove to the bastard that cut me open that I can do it. And partly because I think that I already have a socking great scar on my vagina and I don't really need one on my abdomen too. And to be honest, sex is still so difficult that I wonder if it could get any worse.
On the other hand, I don't know how my epi scar will hold up to another delivery, and things were worse 6 months after I had DD (even sitting was painful), and I'm scared that contractions will bring back flashbacks to DD's birth and I'll freak out.
But then I think that a VB would probably be better for DD2, and that a CS would increase the chances of her crashing after her birth, and what if we're not so lucky?
And on the other hand again, what if some freakish situation arises where there is a crash situation and I have to have high forceps (I want natural VB or CS, and am willing to have a CS before it is really "needed" to insure this) and I end up even more traumatised?

Re: doula. I did mention it to DH, but he is really worried that if I had a doula as my advocate that he would be left without any role and would feel completely useless. I think that he sees it as an insult to him that I don't trust him to look after me, which touches a lot of nerves from last time (he knew that I didn't want an instrumental delivery, but agreed to it instantly and didn't stand up for me - he now feels really guilty and has promised me that I can have whatever I want for this birth).

Sorry, this is so long.

can you meet some doulas with your DH, so he can see we are there to support you both? the doula can give the father confidence in the process and confidence to be your advocate.

doulas are not a replacement, but a complement.

i am so sorry you are feeling like this

oh dear
well unless your dh has great experience with birthing then I would suggest the doula is there in an additional role rather than replacing him
he is there to support you emotionally and physically through the birth
the doula is there to enable him to do this
and to assist you in the birth of your choice
she isn't there just for you, but for BOTH parents

would an independent midwife be a possibility? pricey but what a great experience if she would support your choices throughout

cross posts lulu
sorry repeated many of same ideas!

I can entirely understand your mixed feelings - trying to decide what to do for the best is very hard. Is there any reason to believe that DD2 would be at risk of crashing this time round?

As for your DH's concerns about a doula - it's also totally natural, but if it's any help, we found that our doula supported both of us through what is quite a testing time even if everything goes normally! Far from excluding my DP, he actually found it was good to have someone to work with on supporting me - after all, I was totally invovled in the birth so was ignoring him anyway

Maybe suggest to your DH that you meet some doulas, without committing to having one, and see if there are any he likes? The idea of a doula might seem worse than when he meets one he likes, iyswim?

And if you put in your birth plan 'I would rather have a CS than an instrumental delivery' and outline why, your doula and DH can work together to make sure that happens.

I do know how you feel a bit - I had a CS with DS, and am desperate to have a VBAC when we have another, to prove I can do it. But when push comes to shove, if you go into labour and get completely freaked out, you can scream for a CS then and there!

I honestly think the right doula would really help - your DH needs to put his own feelings aside a bit and concentrate on what's best for you and for DD2.

Not easy to say to him, I know.

Good luck!

My birth plan last time was "natural or CS - no instrumental" which is one of the reasons that I'm so nervous this time around - who's to say that the medical team won't have exactly the same reaction to it?

I'm also worried that the very fact that I'm pregnant again will mean that they won't take my trauma from last time seriously. I think that they'll think that if it was so bad that I wouldn't be having sex, and that I'd never have another child. Actually we didn't have sex, this child was conceived with fertility treatment (that they don't know about - long story), and if it wasn't for the fact that I'm getting on a bit, I wouldn't have considered getting PG again when DD's delivery is still so raw and my scar is still such an issue.

I think I need to sit down with DH and discuss a doula again. We're going to see the gynae again next week - she's the one who took my scar issues seriously, so I'm hoping to find out how likely it is that the scar will be OK. To be honest, I think that unless there's a very good chance indeed then I'll be better off with a CS and not bother with a doula. Otherwise, as I'm almost 24 weeks, I suppose that I need to get my act together and start contacting women to interview.

There is no reason that DD2 would crash like DD1 - but then there was no reason for DD1 to crash either. It was completely unexplained (I got her medical notes from the hospital to make sure). I don't think that it's likely that it will happen to us again, but I know that DH and I would not deal well with being so far from a hospital, and obviously being terrified about the baby dying isn't going to help me labour well!

I would STRONGLY recommend you get an independent midwife. I did this with my second and third after a difficult first labour (large OP baby/forceps birth).

A doula is great but she doesn't provide your care in labour - only support.

Given your difficult experience last time has anyone suggested that you see a senior midwife to talk through what happened? I know that several of the hospitals I have worked in have had this as an option (in fact I think the chief midwife offered it). It may be too traumatic for you, but if you are going to deliver in the same hospital it might be the best way to work through your concerns.

Re the doula, my sister had a similar (although not so bad) experience with her husband panicking and going with the professional's advice and my poor sister feeling really stitched up. They had a doula (and home birth) second time around, and the interesting thing was how much better my BIL felt about the whole thing. It was clearly quite a healing experience for the family, and the doula made my BIL feel much more involved and empowered as well as supporting my sister. So it is something to consider. Having the right person there to provide that little bit of calm in the sometimes chaotic delivery room can make a big difference. An independent midwife would be another option, again about ensuring that there is someone you know is on your side. Which of course your dh is, but I do think that dads are in a very difficult situation when things seem to be going wrong, I think it can be pretty scary to see your wife in pain and very difficult not to go with the clinicians even if you know your partner isn't keen on the option they are presenting as the only safe way ahead.

sorry, I meant someone there who you know, and who is on your side

My Dh said much the same thinga bout Doulas, and my dh is fab in labour times. My reasons for needing a doula were more complex (sn kids, nobody but him able to care if transfer needed and scared alone). Meeting her, though, he fely much more confdent and as Lulu said, she was very much a comlpement to him

Would an indepedent midwife be able to care for me in a hospital setting? The reason why I didn't want one was because I thought that I would then be limited to a homebirth (which isn't the right option for us).

Luckily I won't be going to the same hospital where I delivered DD as we have moved house. I think that I would have a great deal of difficulty in labouring there again, because of the such bad memories. I have my notes from DD's birth and to be honest, I already understand exactly what happened. It's just that it was completely against my wishes. I had always had a complete dread of childbirth growing up, as instrumental births and very difficult recoveries have factored large in my family. I had hoped that optimal foetal positioning/going to a MLU/having an active birth/hypnobirth breathing etc. etc. would change all that, but I was wrong. Genetics overuled all that.

Forgot to say - thank you for all the replies and sympathy.

(as my Dh put it, he felt he could be there to support me jnowing the Dula was advocating on my behalf so he didnt have to worry about that)

"Would an indepedent midwife be able to care for me in a hospital setting?"

In theory she would only be able to act as your birth partner.

In practice most IM's play a FAR more central role than this. Mine did with my third who was born in hospital. She was the one who actually 'caught' him in the end!

More importantly, an IM would provide you with emotional support in the weeks leading up to the birth - this could make a huge difference to your levels of confidence as you approach labour.

MrsT - I think in your case an Independent Midwife might be a good idea because then you would be guaranteed to have a midwife that you knew and trusted throughout your labour. A doula is an excellent resource however, in your circumstnace, I think you need to know the person delivering your baby.

The chances are that you would have a normal vaginal birth, as the first baby has made the way if you like. It is more likely that having a vaginal birth will heal the issues both physically and mentally that you are suffering at the moment.

Independent midwives can work within the hospitals in certain areas - they have different agreements in different areas. It is worth contacting the IMs nearest you.

Also it would be worthwhile exploring what can be agreed at you local NHS hospital. You could meet with the senior midwife of the labour ward and discuss your concerns. It may well be that you can agree a plan of care with your community midwives. How many are there in a team? Could a community midwife come into hospital with you when in labour?

In my own area, that is something that could be agreed, but it could not be guaranteed which midwife would be with you.

The plan of care in labour would be agreed and all the midwives you meet would follow it.

I work in a labour ward and have met women who have come and agreed a plan with the senior midwife. They feel more confident because they feel that their concerns are being taken seriously, and that the midwives are all aware without them having to repeat everything again. We have had women who do not meet the criteria for the midwifery unit - eg breech or previous CS, being cared for midwives only and feeling fully supported. Some women have required repeat CS but they have felt fully in control of the decisions made.

My sense is that you need that control and having discussions with the senior midwife can give you that. If you do not come away feeling that you have enough support, then an IM may be the next option.

This has all been really helpful. OK, it looks like we have a plan.

I will talk to DH this weekend re: doula/independent MW. We will see the gynae next week and if she is positive about VB I will get straight onto the CMW and arrange a visit to the senior MW at the MLU (this is something that I've been promised by the first CMW). I am then set to get my birth plan set in stone by the manager of the MLU, which should give it much more weight. Plus we can get organised to quickly interview either doulas or independent MWs (dependent on circumstances at MLU). Possibly I can also see a consultant at the CLU in case things go wrong and I have to be transferred (as this is my main worry).

Otherwise, if my scar looks dodgy, I will arrange a visit to the consultant at the CLU (also something promised by the first CMW). In that case I think that a doula would also be a good idea, as I'm very nervous about surgery, so having someone to support me would be good. Also it means that I can instruct DH to stick to DD2 like a limpet () and still not be left on my own to be sewn up.

Roughly where are you in the country?

MrsT - can I just give you an award for the most number of acronyms in a paragraph? I'm swimming in CMWs, CLUs, BMWs, CCJs and ASBOs...or were those last three in there?

Seriously though, your plan sounds like a good 'un.

can I have a chocolate biscuit even though I'm not on the bench?

LittleMyDancing - Before I was a SAHM I was in a very TLA-prone profession. Chocolate biscuits all round I say!

PortandLemon - I'm in the SE.

Starlight - the delivery seems like such a long time away. I suppose I really do need to come out of denial and sort it out though. Or I'll have a dreadful rush and panic at the end, which isn't the best way to spend the third trimester.