Denied pain relief in labour and now frightened about another birth

[Helpmefiguireitallout]

Thank you for reading, this is going to be a long post. My little girl is now 2 months old. I started losing my mucous plug and had water dripping out at 41 weeks around 5pm on the Friday. I phoned the birth centre and a lovely midwife told me to come in. I came in and she then said she examined me, told me my cervix was closed completely and to go home and call when things change. Well, I ended up getting my first contraction at home and from then on it was absolute agony. I was so shocked because the pain went from 0-100, around 3 in 10 minutes. I rang back and she told me to come back again. The car journey was awful.

She had to examine me again, this was absolutely awful as I was in so much pain but she was really calming and a total pro at examining so it wasn’t as bad as it could have been I suppose. So then here is where the problems started… she finished her night shift and had to go, but before she did, she examined me again and I was 1cm. I was then left with the most uncaring Midwife and students I have ever encountered.

I worked in a maternity ward for 7 years up until a couple of years ago, I still work in the NHS but in a clinic now. I am well aware of the good and bad, as well as what is usually offered to labouring women, I worked in a London Hospital, so it was busy busy busy. I also started training to become a Midwife myself but stopped for various reasons. I know how some Midwives can be as I witnessed it myself over the years, and I just hoped that I would be lucky and would get a nice team looking after me. Well that didn’t happen at all.

I was in a small birth centre room at this point screaming my head off in pain with every contraction and shaking uncontrollably. The Midwife gave me a shot of pethadine, which really seemed to help, although it didn’t take the pain away fully it stopped the shaking and made me really sleepy. They couldn’t examine me again for many hours which is fair enough to reduce the risk of infection but it would have been nice to know if I was any further along. Anyway they did examine me again eventually and was still 1cm, pain was obviously bad I was crying, was offered 2 x more pethadine that did nothing these 2 times but it did stop the shaking.

I was begging for an epidural but was told no repeatedly. The reason was because I wasn’t 4 cm yet, and in order to get an epidural it needs to be done in labour ward, but I am not allowed in labour ward until at least 4cm. I asked for gas and air, they said no repeatedly for the same reasons above. All they kept saying was to eat a sandwich, reapeatedly, I have never wanted to scream so badly in my life because they weren’t listening to me. I was telling them I can’t eat or drink… well I was trying to drink but eating was out of the question. I explained that I would throw up everywhere but they wouldn’t stop going on, they even got my Husband involved trying to convince me. I was crying telling them I don’t need a sandwich I need pain relief over and over again but they still wouldn’t accept me not eating until they brought me some toast which I physically couldn’t eat. They were actually laughing at me, saying what do you want me to do? WHAT I WANT IS PAIN RELIEF!

I was screaming in pain when the cherry on the cake arrived… they were going to move me to the shared antenatal ward. They did move me, still no gas and air allowed, I was screaming so loud with every contraction every few minutes. The other patients and partners were laughing and sniggering, also tutting. I am sure the other women were terrified that they had this level of pain to come too so they were probably laughing to distract themselves. I begged for pain relief and to be moved. They refused, still no gas and air allowed.

I know that on my ward women were given entonox on the antenatal ward, and it was no issue at all. They were also hurried through to labour ward for a private room if they were screaming the ward down and scaring other women. This went on for the whole night until around 8am when the first lovely Midwife came back on shift and came to see what all the screaming was about. She was asking the staff member why I was left in this state with no Entonox and not getting me over to labour ward? The staff member was arguing with her, she said I am the Midwife in charge go and get some entonox. Not even 2 minutes later I had Entonox… when they had lied to me earlier saying they don’t keep it on the antenatal ward it’s only on the labour ward they aren’t allowed to use it here. While having Entonox she examined me again and I was 4 cm. Finally!!! Moved to Labour ward. She was an actual angel… I feel like she saved me.

I took the gas with me not letting it out of my mouth and I was in heaven, the pain was like waves of a feeling but no pain at all. Why had they denied me this for so long? Anyway, straight to Labour ward where a lovely anaesthetist gave me an epidural. It was amazing! I had to press a button every 30 mins but before I was allowed I had to ask the Midwife to take my blood pressure before topping up. They broke my waters and they were full of meconium, I then started getting a really high temperature.

This is when the problems started again… her and her student went on their break at the same time and by the time they got back the epidural had stopped working. They didn’t believe me… and kept telling me to press the button which I was but it wasn’t doing anything, turns out it was empty. I was finally allowed a top up and the anaesthetist arrived to fit another supply. She must have accidentally done something wrong as from then on it was all agony and screaming again, the Midwife and student didn’t believe me until finally the anaesthetist came back again and tried to figure out why it had stopped working.

At this point the shaking started uncontrollably again. I asked for gas & air while we waited for her to return as she was busy and had to leave. I was in my element with the gas and air and they kept trying to take it off me as I was using it too much. It got to around 2pm and doctors came in to review me as I was now 7cm but had been 7cm for far too long with no progression. They decided to do an emergency c section. My epidural was topped up in theatre and actually worked this time.

I was shaking so hard they had to strap me down. My little girl was born and had an infection, had breathed in her meconium so was struggling to breathe and was taken to NICU. She had breathing tube, feeding tube and cannulas. The treatment postnatally was an absolute shit show and my baby wasn’t with me I had just got to give her a kiss on the operating table when she was whisked away. They put me in a postnatal ward with everyone else’s babies. I asked them if they thought this was appropriate considering my baby was in NICU and I was still numb… couldn’t meet her properly yet. The Midwife responded by saying what is the problem with being around other babies??? We can’t give you a private room! I persisted that it was not nice and they moved us to a private room.

We were both on antibiotics and eventually she came down to join me in a shared NICU/Postnatal ward. We were then both moved back to the postnatal ward which was hell. Purely because of the noise, other families are so so inconsiderate and loud. We had people moving furniture around and throwing suitcases around at 2am. The woman next to me had a drug problem and social services were taking her baby away. We got to hear her whole life story from the other side of the curtain. It was awful… she was kicking off constantly and then crying constantly, part of me felt sorry for her. It was a lot to deal with, we all complained but they wouldn’t give her a private room so we all had to listen to her on the phone constantly to social workers about her court case the next day and her baby being removed.

We were finally discharged after a total of 5 days. I don’t know if I can go through this again but eventually I want to give my daughter a sibling. I am terrified of being left in pain again until 4cm, what if the same happens again? Personally I think as soon as they broke my waters and saw the meconium and my high temp and high blood pressure, they should have took me for a c section straight away. I sit here and think sometimes how long was my little girl struggling for in there… thank god they got her out when they did. Why did they hang around though? It was hours and hours since they broke my waters.

I am obviously going to ask for a planned c section next time, if there is a next time. I have lost all trust in that hospital and all medical staff. I feel like a couple of them enjoyed watching me suffer. All I needed was the gas & air and I was coping really well but they denied me this for 13 hours, only when that angel Midwife came on shift and got me some was I able to cope. Has anyone ever experienced similar and what did you do for your next babies?

Also, OP, if your baby had to be pushed up the birth canal for the section, that explains why you had such a rough recovery from the C section. Believe me, recovery from an elective is a million times easier.

It’s worth checking if the section was at full dilation. If so, there can be implications for monitoring the cervix in a future pregnancy. Hopefully there won’t be any, but worth double checking.

I’d really strongly recommend having a proper debrief/reflections meeting rather than just getting copies of the notes. Reading between the lines a bit there’s some fairly straightforward stuff they can explain, but the things I suspect you’re going to be most interested in is the quality (or kindness) of care and that is not going to be well reflected in the notes (nor will it be anything they can do anything about if you just read the notes and stew it over alone). There’s no rush to do it but it probably will be more productive than reading a load of cryptic notes.

Also we hadn’t slept for 2 days… neither had any of the other parents probably. That doesn’t mean that you can literally throw your suitcases around, bang your furniture around because you want to move it all at 2am, and literally ignore your crying screaming newborn. The couple opposite wouldn’t even comfort their baby. It was pure torture, how is anyone expected to recover and care for a baby when both the mother and father haven’t slept. He couldn’t go home at first as I couldn’t even walk or get myself to the toilet let alone lift our baby. No one helped me at all. I was really ill with an infection too and so was my baby. Other women and partners are so inconsiderate, I would never behave like that on a shared ward.

I'm sorry you had a tough time. From my own experience, I can only say that time is a great healer. I onmy have one (but for other reasons) but can see what your experience might make you feel about the future. Deal with the now for now, though.

It might be worth trying to work with your GP, HV, and, if suitable, the perinatal team to ensure that your mental health isn't impacted by the experience.

Not had time to read the whole thread, but has anyone mentioned the possibility of a birth debrief in a few months? Maybe mention to your GP or HV. I found this very very helpful as it was an opportunity for me to understand and ask questions, and also provide some learning points for the team (my issues had nothing to do with staff behaviour/bedside manner)

I couldn’t read this and run. You poor thing. Please, please - when you feel up to it mentally - make a formal complaint through PALS. It’s quite normal for a birth like this to take a long time to mentally heal from. Keep your baby close and the oxytocin is going to help.

I had a terrible first birth with lots of gaslighting about pain levels in the first 20 hours, baby born with sepsis and a NICU stay. You don’t need to consider now about whether you want to do this again. Give yourself lots of time. By the time my DD was just over 2 I was ready to consider it. We have a 3y 3m age gap and it works beautifully. My second birth was an induction at 39’weeks which I demanded and went as planned, very quick and only gas and air. It really helped me heal mentally from the first one.

You don’t need to think about the future yet. Focus on the now. This one is behind you. You never have to do that one again.

Ask for a debrief.
I read NICE guidance years ago (apologies if it has changed) and there is no minimum dilation to be offered an epidural. If this is still the case, it is a good question to ask the hospital. A close friend of mine had a similar traumatic first birth, went through the debrief process and was recommended for an ‘early epidural’ for a subsequent birth. When she got pregnant again she had this stuck all over her notes and she had one as soon as she went into hospital.
I hope this helps

Our stories are so similar. I was nearly 42wks pregnant, meconium in water, had all the interventions, wasnt diluting, days of labour etc to end up with an emergency c section.

With baby number 2 I requested an elective section citing all of the above reasons as so why I would not allow my baby or myself to be subjected to that again.
They agreed. It went reslly well. No stress. No pain!

Also agree with this. I had a debrief before my second birth. It was helpful. I was furious though: a lot of things where I thought i had just not been listened to, they had in fact disgusted how high risk the situation was from me. This was a mistake. I needed information.

Until it happens to you it’s hard to imagine how traumatic medical gaslighting can feel.
i had a very different birth but the same
outcome - a total lack of trust in the medical profession and the hospital. I’d say the first year I was traumatised, the second year I was
angry.

It took until my DS was 2yr 3months to decide we wanted another child enough to go through it again, but I won’t lie and say it doesn’t pray on my mind.
What I will say is I’m a very different person this time round. I’m consultant led as a result of last time and I’ve been very open and frank about what went wrong and what I won’t accept this time around. No one has even remotely quibbled my desire for a c section. I have said if I go into spontaneous labour before my c section date I’ll try for a VBAC but equally I could have had it planned as a EMCS in circumstances of labour.
I’ve also written quite a detail birth plan, which ironically I didn’t last time because i was happy
to follow medical direction, but this time I don’t trust them to act appropriately or to inform me of their actions or to act on my best interests. So I’ve written up what my needs and expectations are with relevant NICE references so at least I can advocate better for myself if I feel things are deteriorating.

if you do want to make a complaint, you have to do it within a year I believe - which is hard because in the first year I wasn’t mentally well enough to relive it all. I’ve been offered a debrief but I darent have it while pregnant because if they try to deny or justify (which they will) I will lose my mind and I’m trying to go into this calmly positive.

In my experience (5 babies) shaking can be a normal, if scary part of labour, especially if you're stressed. If you're releasing a lot of adrenaline it can cause shaking so I've always had it immediately after giving birth and sometimes during, if I was stressed too. Also an indicator that things might not go very quickly, as adrenaline isn't great for dilation

Have you looked into if your hospital offers a post birth debrief or reflection type appointment, I know people who this has massively helped. You will definitely be able to have a planned c section for your next baby and would be consultant led from the start as you had a previous c-section and they are very pro a section rather than a VBAC. If you wanted a natural birth with the support that all women deserve but unfortunately don’t get would you consider going private if that was an option for you based on location and cost.

Reading this has brought back a lot of memories about my 1st birth. I was denied pain relief, and eventually offered paracetamol because I looked like I wasn't coping (those were the exact words of the midwife). When I was eventually taken to the labour ward it was too late for an epidural. I wont even tell you what happened after that!

After a year or year and a half we decided to have a second. I felt stronger with voicing my wants and needs, but also felt waaaaaay more listened to because it wasn't my first time - which is horrible but true! First time round I felt sniggered at when saying I was in pain, second time round was a different ball game!

Give yourself time, speak to a counsellor if you need to. But I will say, going through the 2nd birth with ease (cant think of the right word so will say ease) made me realise just how horrific my first labour was and brought back a whole wave of other emotions there. A bit like "ah this is what couldve happened if I had been listened to first time".... be kind to yourself, take your time, heal, talk to whoever you need to talk to. You will get there.

I had awful vaginal birth with first. I had my second a year ago, decided immediately on elective c-section. No issues, no having to justify my choice, it was agreed easily with consultant over the phone in a 5 minute call and date set for 39 weeks. I worried about going into labour before but I would have just called up and requested c-section at first sign of labour. That wasn't necessary though as I didn't go into labour beforehand. Elective c-section was a lovely experience. Recovery was easier physically and mentally.

I had a similar birth story to you but with much nicer midwives involved. I was also in agony until 4 cm although I was allowed gas and air but sadly it made me too sick to take it. I had pethadine which didn’t do much. Took about 12 hours to get to the magic 4cm where I finally was allowed an epidural. Thankfully mine worked though. I’m so sorry yours didn’t. I didn’t have a button to press that I remember. I then got to about 6cm after more and more hours, baby got infection, I got infection, emergency c section and antibiotics for us both and a week on the shared ward. Absolute hell. No sleep for a week.

anyway I went for a planned section with my second and the difference was incredible. So calm and just so so much better. I could plan childcare for my first. I could go into the operating theatre feeling very together and with it and not the shaking exhausted mess I had been with my first. I was only in hospital for a night and recovered so much quicker because I wasn’t exhausted and recovering from an infection. If I were you I would opt for a planned section. No one could tell me why I had failure to progress and so this made me think it could easily happen again. I’m so sorry you had this experience. I can’t imagine how horrible it would have been to have the failure to progress and horrible midwives - that’s awful.

I also had unbearable pain from early on after labour started with my waters breaking and received little sympathy on first presenting at hospital. I was 3 cm dilated and told to ho home but the car journey in had been so painful I couldn't face the movement. I stayed in the car in the car park screaming blue murder with every contraction and already feeling like a complete failure for not coping. After an hour we went back to the ward and because my waters had broken with risk of infection they said they'd admit me if I accepted induction and also said I could have an epidural. So from that point my story got a lot better than yours...until the post natal period. I lost a lot of blood but no one explained that I had to stay until day 3 if I wanted my iron levels checked so I went home on the evening of day 2 because the ward was so noisy and I couldn't sleep. Five days later I still had not had more than 2 hours sleep a day and was highly adrenalised and anxious. I was a gibbering wreck, tbh. Turns out this was because I was severely anaemic and they were amazed my milk was flowing so well and my baby was thriving. I had to be readmitted for a blood transfusion and was given sleeping tablets and, fortunately, I started to recover well. This was all years ago but I still feel angry that I received no emotional support when I first arrived at hospital and that the severity of my blood loss was not noted and treated accurately on the post-natal ward. I think the reason I am not really traumatised is that I had really lovely midwives on the labour ward and once the epidural kicked in everything went pretty well although I had long labour (31 hours in total). I don't know if it helps knowing that someone else has shared elements of your experience, @Helpmefiguireitallout. I haven't thought about this in ages though - do give yourself time to get over it, although a formal debrief (not a thing when I gave birth) may help. I sometimes think I should have made a formal complaint about the aspects that were not well managed so, yes, do that if you need. I'm not sure I'd opt for an elective CS to manage a subsequent birth; as someone else said second and subsequent births can be very different, but if that's what would help you when the time comes you should request it.

This whole experience sounds really rough. I struggled with early labour a lot too, but pethidine took the edge off entirely and gave me a nice hour or so of being a zombie where I could rest and dilate. I'm quite surprised they didn't realise something was wrong when pethidine didn't even touch your pain. Hot stabbing pain sounds more infection based as you've said, although it could also be from other issues in the area like old scar tissue on the uterus.

I now live in a country where there's no pethidine, no gas and air, on demand epidurals are rare, and elective C-section is unheard of. Water births are also hard to access and you can't do one if you have group B strep (which I did last time). Very apprehensive about my next baby, as I really benefitted from pethidine, gas, and the bath last time.

I too had prodromal labour and experienced the most insane pain from 1cm dilated. Turned away from hospital and laboured with 3 in 10
contractions for 3 looooooong days. I was begging my husband to knock me out as it was so sore. I got sepsis and then EMCS.

Second birth was meant to be a planned c-section but I went into labour beforehand. Theatre was full so I basically tried for a VBaC for 18 long hours. Didn’t dilate past 2cm and ended up with another EMCS.

All this to say, I totally believe you. It’s insane how painful labour is. Especially for us women who feel it full throttle from the get go.

Planned c-section all the way. And then a plan b in case baby has their own plans like my DC.

Oh OP, I’m so sorry you went through this, it is so so awful. I had some similar aspects with my first birth, including a horrible midwife who laughed at me. That’s the worst, isn’t it? When the person who is supposed to help you just doesn’t care. You can almost manage the pain better when you know someone is helping you.

what helped me was a birth debrief with the assigned midwife from the trust. She explained what had happened based on the notes, agreed about the bits that were unacceptable from my perspective, and said she would feed that back. You can search for this online or ask your GO to refer you. I read the CQC report for my hospital and one of the actions was for all theatre staff to introduce themselves, which they did, almost excessively. It sounds like you know the NHS well so I would recommend you do put in a complaint.

To process what you are feeling, the debrief and talking to friends really helped. You might even want to talk to your GP and/or get some counselling. Birth trauma is a form of PTSD. The birth trauma association may also be able to help https://www.birthtraumaassociation.org/

in terms of the future, an elective c section is a good idea. You also need to have a serious conversation with your DH and explain that he needs to have your back. He is your interpreter when you are in too much pain to speak or negotiate. He needs to be assertive and advocate for your needs and wishes. The other thing you could consider is a private doula to be one of your birth partners, again as another advocate.

my second birth was so much quicker and better and I had lively midwives but I know that is a lottery.

Wishing you and your precious bubba all the best.

I was worried they'd decline the c section from the beginning. Later on I was worried baby would come before it and my midwife said if I started having signs before the planned date to call delivery suite and I'd still get a section. It didn't come to that so I'm unsure if they really would have or not.

I was told by my health visitor after my traumatic birth I could get a 'debrief' where someone sits with you and explains why things happened as they did. I work in the medical field so understand why things happened as they did for me but may be worth it for you? Or indeed putting a complaint in with PALS to get some answers.

Everyone is dealing with their own personal story in a post natal ward. What do you mean by moving furniture around and throwing suitcases? You sound pretty critical of every single other person in your narrative

Whilst it does sound like they were being overly harsh, OP’s comments about other mums tutting and sniggering make me think this PP is right and she was really panicked and surprised by how much it hurt. And not tolerating it at all well. I’m not trying to be mean, but just being honest from what she’s said.

As I say I do think they sound harsh, but there are things in place for safety about pain relief in labour. You can’t just keep having more and more, it’s not safe for baby, especially if she wasn’t in full, active labour.

I was in a similar situation 10 years ago as you interestingly with my first baby also having meconium in the water and I was in extreme pain at only 2cm and also violently shaking and giggled/scoffed at.
I completely understand your reasons for posting on here but from my experience no one will truly understand being in that situation unless they have been like us, and you'll receive all sorts of irritating and uncompassionate comments which will sadly just upset you more (I've been there!).
What caused my issue was an unnecessary sweep. So for my second baby my midwife wrote "no sweep" all over my notes which was disregarded as the midwife did a sweep without asking for consent, during an examination. I only realised after when the pain suddenly and familiarly went from 0-100. I expressed surprise only to be told "oh yes that'll be the sweep I gave you to hurry things along".
Unbelievable. If I could go back in time I wouldn't just check they'd read my notes I would go in vocally making my wishes clear from the off.

Congratulations on your baby, I am sorry that labour was such an awful experience for you. Great advice already about birth debrief, hopefully that would help.

You should absolutely make a complaint, however my advice is to stick to the key issue of pain relief. Otherwise they will try to fob you off.

Advising you to eat and drink in labour is important, and absolutely the right thing to do, however I completely understand why you couldn't eat - I was the same!

Not getting a private room when baby was in NICU - this is upsetting, but also often standard practice following epidural so you can be monitored unless baby is very unwell - I was put in a private room but that was very unusual in my hospital, I appreciate others may be different.

The complaint about the ward being noisy - noise in wards is normal, not everyone can have a private room.

I don't want this to sound in any way unsympathetic, I just know that they can easily explain away these aspects and it may dilute/distract from the main issue of pain relief.

Submitting a complaint t can be cathartic in itself, however be mindful that the response may not be entirely satisfactory either. It caused significant upset and further trauma for me, I ended up complaining to the NMC, and a serious adverse incident investigation was carried out due to negligence and significant harm to my baby. It was a long process, and almost 2 years before it was fully resolved, but my boy is doing really well now.

Maybe consider using a patient advocacy service for support through the complaint process if 1 exists in your area.

Overall though, look after yourself and enjoy your baby.

I also had a traumatic birth which led to a c section. I had the loveliest caring midwife and student however when she went their shift finished, I was given the worst midwife imaginable and ended up with a c section. Reading your OP really reminded me of that day.

The lovely midwife came to see me and my baby the next day and she told me to ask for a debrief when I was ready and contact PALS. She also wrote me a lovely hand written letter which I received in the post from her with all this information! A couple of months later I did have the debrief she suggested and it did help me move on a bit.

Have a debrief with the hospital OP. Also be aware of post natal depression. The whole episode robbed me of enjoying the first few months with my baby.