Having both doctor and midwife present in labour when they are relatives

[Sleepyhoglet]

My mum is a midwife and has many years of experience. We don't have a very close relationship and she lives quite a long way away but now I'm pregnant I think our relationship might change. My dh is a doctor. Would it be weird for the hospital staff if I have these two as my birthing partners ( assuming I'm allowed two)? I'm really nervous about the birth - eg worrying about it already and not due till November and feel that having 2 professionals whom I trust will help me to relax. I've heard so many horror stories about long dangerous labours, midwives not recognising breech etc so hope that my mum and dh would look out for me.

Errrm, yes. And no.

A birth related professional in the room can swing things either way. They can be a complete, absolute, nightmare, or very helpful.

If you're not close, but understand how each other think, and she is there to support, not steal the show, mum should be fine. But you don't sound that convinced that her presence is a good idea.

Without being disrespectful in any way to DH, unless he is either an anaesthetist or an obstetrician, he is going to get treated as standard dad. Because he will know about as much as standard dad does. Perhaps a bit more if things go down the interventional route, but not much. He will perhaps be expected to get on with things a bit more than standard dad..... Like hold gas and air, sick bowl, hand........

I've said that and realise it sounds rude.... My DH is a doctor. He was treated as standard dad. Because he was. As CorusKate says, they are there in their capacity as family, not doctor.

My husband is a GP, who during his hospital rotation had worked on the ward, and helped deliver babies, in the room in which I gave birth to both dd1 and ds. And that was only 18 months prior to my first delivery. He'd sat in on clinics with my consultant. He had just qualified and was looking for local GP work - there was none at that time so he was actually locuming in the medical ward in that hospital!!

This was in a small island community and only to be expected and the midwives were fine. Dh kept mainly away from the business end apart from actually seeing her head delivered. He refused the invitation of the consultant to admire what the consultant called his "embroidery" of my 2nd degree tear.

I'm sure everyone will be very professional.

I also don't have a close relationship with my mum, and I thought pregnancy and birth would bring us closer, but it was just another way to try to assert her dominance. I'd be a bit worried about her presence putting you under stress in labour, but that's something only you can decide.

Best of luck!

I'm just worried the hospital won't spot something and I've read bad reviews of the midwife team. Again irrational but I didn't want kt get pregnant because of my fear if birth and pregnancy so not unexpected. I would rather have a c section, even if that sounds naive, because I feel there is more control. I have no medical reason though so it won't happen.

I had dd in the hospital where dh worked. There isn't really an alternative - I couldn't get a new husband. To be honest I felt more confident and to be completely honest staff do up their game (perhaps cos he's a doctor but also cos they know and like him). He certainly just acts normal and doesn't tell people what to do etc. I did have to ask a few times for things to be explained to me in simple terms as they tended to give him the complex version. That said I think we were also given more info and I liked that.

I wouldn't have wanted my mum there and wonder if it's a good idea if you don't always get on.

I am going to be very frank.

Your family are probably the worse positioned people to "spot" something in your pregnancy and delivery.

Because they are emotionally involved in it, and too close to see the wood for trees.

There is every chance they will feed off your anxiety, and perpetuate the situation. With anxiety comes escalation, with escalation come the "my birth plan went in the shredder" stories.

If you are genuinely concerned with the care offered locally, go and ask to look round, read the CQC reports for the unit, check the friends and family test, and get informed. Speak directly to people that have delivered there. Don't rely on a review. It could be very out of date. Or just a late night rant. And if you are still fearful, ask to book somewhere else. You have a right to do this. You may not get to deliver there, because if you call a blue light ambulance in labour they will take you to the nearest place that offers maternity services. But that may offer you some reassurance.

And, if you can, start learning how to relax. Yoga. Hypnobirthing classes. Anything. You need to believe that our bodies are designed to do this, that you can cope, that most women do OK. Because we do.

It isn't that mum and I don't get on, I suppose we just aren't very close! In some ways I'm really not ready for this pregnancy.

Can I refuse forceps?

Are you ok sleepy? You sound really quite anxious about the whole thing?
Would it help to try to explain a bit more why you don't feel ready?

Because it could just be usual pregnancy 'oh my god I know nothing about babies, how will we ever cope?' Or it could be a bit deeper than that.

You can refuse anything you want - but most interventions have some important uses.

Forceps (low cavity ones) are useful if baby is low down, nearly out and you're exhausted or perhaps they get worried about baby and want it out sooner. A ventouse is for the same reason.

In my birth plan I had down that I wouldn't consent to high cavity / rotational forceps as although these are rarely used, these are the ones that can have more serious negative consequences and in this case, a c section can often be done instead.

But having said all that, I had a truly wonderful birth. Labour is hard and painful but I never found it scary. And afterward you feel AMAZING like you've just conquered Everest and you have a gorgeous squishy baby that smells lovely. Ahhhh...

My DP was at both my deliveries, he is a doctor but was there as the expectant father... In fact I don't think the midwives knew until we were chatting afterwards with DC2 that he was a doctor who had come straight from work on a night shift in another hospital!

But I agree with rempy posts.

How many weeks are you OP?

Sugar and spite I suppose because no one else in real life understands what I'm feeling like. Dh is so excited but he doesn't have to go through all the tests and sickness and labour. I've always been frightened of ghe labour but excited about having children. I really wanted to adopt or have a surrogate mother at one stage because of pregnancy uncertainty. Then I agreed to try and have our own as we are ready in so many ways but was shocked when it happened so quickly.

A lot of colleagues and friends who live near me have had horrible births. One has a damaged back from forceps, another was dragged down the table with forceps after a 38+ hour labour. It just seems that bad births are normality. I'm quite small down there both hips and other part and am worried about stitches as well.

Ah the horror stories, I remember them well.

If you look at the current stats (from the nct site):

• 25% of births are by c-section (10% elective, 14% emergency)
• 13% of instrumental delivery (equal split between forceps and ventouse).

So out of the women not having a planned c section, 73% will have an intervention free birth (I've not included inductions here for simplicity).

So if you just look at the numbers, your chances of having a straightforward birth is much much higher than having an intervention.

I know it often sounds different because people like to tell the story of their terrible birth / their bravery / their overcoming adversity. And also lots of us with brilliant births are often reticent to tell our stories for fear of sounding smug / making others feel bad.

You don't say what kind of doctor your DH is but possibly he may not be helping as all the Doctors that I'm friends with only ever see difficult births / after effects of difficult births as the midwives deal with all the straightforward ones. So they can have skewed views of intervention too.

As for your question about your size - you are designed to grow the size of baby that you can carry and deliver safely (in the vast vast majority of cases). My DH is 6'4, I'm 5'0 and our DC was very long and skinny when born (but a good weight) and fattened up fast. As I said, I had a great labour and no stitches, just a couple of grazes.

The biggest thing for me for the whole process - pregnancy, labour and then breastfeeding is to have confidence in your body. Feel positive, assume that it can do the things its designed to do - it probably can!. And then if for some reason those things aren't going smoothly, you can get help with them.
But you'll have a hell of a nicer time if you can start from a postive approach. You might find hypnobirthing helpful with that.

Dh is a gp registrar. DM prob wouldn't be able to get here for the birth anyway but once I'm telling g people I hope she will be able to reassure me. I'm only 7 weeks.

You're only 7 weeks, and clearly very worried already, So I'm going to suggest you do not ask for or read birth stories on mumsnet or from your friends, because even without meaning to people will give you far more information than you want.
I suspect you need to look into some positive birth type thing, like this maybe, although I have no direct experience of this. Not all births are 'bad', and not all sections are given for medical reasons, so don't rule that out either so an option.

It's funny - I'm a vet and I felt very positive about birth because I kept in my mind that animals just get on with it. Occasionally they have problems and then we help them deliver but overwhelmingly, when left in peace to get on with it, they manage brilliantly. And that's without birth plans, antenatal classes, birth partners, monitoring and all of the education and forewarning we humans get.

I had a lot of intervention (c-section first time, heavily monitored induction second time) but I'd still class my vaginal delivery as the single best experience of my lifetime. It was hard and sore and tiring and a challenge but I knew my body was doing its job and my only role was to let it.

Mammals give birth and breastfeed - it's what we've evolved to do. Your body will do its job. I don't know if that will help you but I agree that reading Ina May Gaskin would be a good start. Good luck :)

Sleepyhoglet Tue 08-Apr-14 00:22:14
I'm just worried the hospital won't spot something and I've read bad reviews of the midwife team. Again irrational but I didn't want kt get pregnant because of my fear if birth and pregnancy so not unexpected. I would rather have a c section, even if that sounds naive, because I feel there is more control. I have no medical reason though so it won't happen.

Hello, I've just read the above and want to let you know that you are completely wrong.

Firstly, being extremely anxious about pregnancy and childbirth can be and is classed as a medical reason for an ELCS.

Secondly, you are not being irrational. Its a recognised issue, though its relatively new so not all healthcare professionals are as aware of it as they should be. Its unusual but not unheard of.

Before I got pregnant I was so anxious about it, I sought help.

I found that there was a hospital close (not my local one) by which had someone with a special interest in the subject. I believe he is unusual but he is leading the way in helping to understand the problem and support women on a national level and his interest seems to be reflected in the general philosophy of the hospital. With the help of my GP I was able to get a referral to see him, and he reassured me, saying that if I got pregnant there would be no problem in getting an ELCS. I cried my eyes out with relief when he told me. He also made a really big point that my anxiety was enough for my ELCS to be classified as medical need despite the attitude and misinformation out there from other people and the press.

I got pregnant shortly after that, and I have a date and am booked for my ELCS already. I'm 18 weeks. Getting the date has been an enormous weight off my shoulders as I had this fear that everything he had said would be ignored and they wouldn't stick to their word. But they have been brilliant at the hospital so far.

My point is this; anxiety is a medical condition. If you read the NICE guidelines they were updated in 2011 to reflect the fact that there are a small number of women who find this anxiety so bad that they would prefer an ELCS and they were not getting the help and support they needed in certain parts of the country and they wanted to try and make care more consistent within the NHS. They support the principle of women having an ELCS for any reason in theory, but really this is primarily about women who suffer from anxiety.

The guidelines have been controversial. Not all hospitals are as progressive as the one I'm at. Sadly some are actively going against them due to other political pressures as they are only guidelines and don't have to be followed and this ideal of consistent treatment within the NHS has not materialised. It is very much a postcode lottery - though, as in my case there is a little more flexibility than for other issues, if you have the means and ability to consider other hospitals. I appreciate this isn't possible for everyone though. But the NICE guidelines have had the positive effect of putting anxiety in pregnancy and about childbirth on the map; many more people are taking this seriously than were previously.

If you really felt that an ELCS was the right way for you to go, it generally is possible to get one on the NHS. Like I say it does depend on where you live as to how difficult this proves to be. It can be very easy but it can also be a bit of a battle. That said there are very few places that ultimately refuse completely.

I don't know whether this is the right pathway for you. It may not be. You may find other ways to cope and find other methods that offer you the reassurance and support you need.

I simply wanted you to be aware that you do have this option contrary to what you think, and for you to realise that your thoughts are not as 'irrational' as you might feel right now, so that you realise you have more choices and that there are people out there who see this is as a real issue and want to help. It doesn't make you 'less of a person' or 'pathetic' in anyway. Just different.

Sugar and spite I suppose because no one else in real life understands what I'm feeling like.

How do you know this? After quite a long time on MN I have realised that just because no one says this in real life, doesn't mean they feel like it.

There are all sorts of taboos and fears in expressing such views. I would like to bet you probably haven't talked to someone in RL about this either for that reason. Think about all the reasons you haven't talked about it and then assume that other people are doing exactly the same thing.

It took me a long time to have the confidence to talk about it in real life. As in years. And only after I had spent a long time researching the subject, so I knew that how I feel was 'legitimate' in that research has found that it is a much more common problem than we would normally think. When I did, I picked the most open minded friends I had, and I was able to explain my fear well using what I had found out to be able to back up how I felt with a certain amount of stuff behind me to rationalise it.

They were very good about it, and it made a lot of sense to them in the end. I haven't spoken to them since getting pregnant but I think they are supportive of me and certainly won't judge me for it.

I really wanted to adopt or have a surrogate mother at one stage because of pregnancy uncertainty.

This is me^ and its a common theme expressed by women who have fear of childbirth.

Then I agreed to try and have our own as we are ready in so many ways but was shocked when it happened so quickly.

Likewise, even with all my planning and preparation. I think I found it more difficult to cope with as a result. I'm only now beginning to get my head round it. I've told very few people so far; even people I'm close to and are important to me. I still feel like something will go wrong and if I'm honest I probably will feel like that the whole way through.

??A lot of colleagues and friends who live near me have had horrible births. One has a damaged back from forceps, another was dragged down the table with forceps after a 38+ hour labour. It just seems that bad births are normality.

This is part of the problem. We are influenced more by the experience of those we know than the statistics or from any other source of information. You can be a very logical and rational person about risk and have a very scientific background but throw this out of the window because you 'see' the possible effects first hand. Its an emotional response that gets the better of you rationality. Its normal. Its rational. Its understandable. How you deal with this conflict of information is the key though.

I'm quite small down there both hips and other part and am worried about stitches as well.

Yep… again familiar. But it doesn't mean its a problem either. I've read enough to know that small women can have even big babies without any problem at all. My problem is getting that to compute…

Red toothbrush- no one is real life understands because I haven't told anyone I'm pregnant yet apart from dh! I'm sure lots of others do feel like me but I'm not able to engage with them. I feel lonely but am grateful that I have mumsnet to share my concerns.

Thanks red toothbrush. Your post is very sensible. On some ways this isn't only about childbirth. I'm an extremely anxious person generally and have a need to feel in control. I'm not sure how my dh copes! Eg sometimes I need things done immediately and get very stressed if it can't happen. I have another thread at the moment about giving blood and the booking in session. I think I'm doubly stressed because it is on a work day and I don't want work to know about my pregnancy.

I'm the same as in its not just about childbirth, but that is the focus of my fears. Again for me its very much about needing to feel in control and very little is about pain as such. This is very common indeed.

The hospital were aware of my anxiety at my booking in appointment because I had discussed things before getting pregnant, and my midwife did suggest that I got some support with their mental health team to help with my anxiety over the course of the pregnancy. It may be worth asking if they have this in your area so you can explore various possibilities that might help you cope.

I was very, very worried about this and how I would be treated and what it would involve and whether I would be taken seriously and whether I could trust them. I've been to two appointments now - the first was a quite honestly disaster - but the second was very productive in the end. They did seem to learn what some of my triggers were in the first appointment, so tried a very different approach for the second which suited me a lot more already.

The hospital I'm at takes the attitude that women with anxiety usually need more support and part of giving mental health support is simply nothing more than just about building up a relationship with the hospital midwives so they understand you and so you can start to build up more trust with them.

From what you've put on this thread, you do seem to have a certain amount of a lack of trust in the hospital; anything that might help improve that for you, so maybe this might help you.

I do think marking yourself as someone with anxiety about the pregnancy is a positive rather than a negative thing for this reason alone. They are making some exceptions to what they might normally do, to help me feel more in control. Including some things that I didn't think would be possible but they have reassured me that they can tailor my care to help. I've been pleasantly surprised at what both the hospital and the community midwives have said might be possible (this is two separate authorities I'm dealing with).

I think its also important to realise that whilst women can have very similar fears, there is no 'right' way to treat it. Even NICE have freely admitted that there is very little research into what helps women most and that it is an area in urgent attention to improve the gap in our knowledge. Plus everyone responds differently to different things. So it is a little bit hit and miss in finding the right thing.

For example I was offered a referral for CBT but I turned this down; I know there are a lot of MNers who have found it very helpful though. I know a lot of other people have found hypnobirthing helpful. Doulas or independent midwives are another option; they haven't got the same emotional involvement but can advocate for you or potentially question the midwives caring for you. And then others swear by going for a homebirth as the statistics suggest this can be potentially safer for mothers than a hospital birth (more so for second birth than first).

Going back to your original post about asking whether having your midwife mother and DH doctor there, is a bit of a red herring in a way. I'd ask whether this is just about spotting something going wrong. Is it also about how confident you feel in yourself to assert how you feel and be in control of the situation, rather than just do as you are told.

It sounds like don't really know what your rights are and again I don't think you fully know what options you potentially have (eg you dismissed an ELCS outright as you didn't know its a medical issue and the fact you are asking whether you can refuse forceps or not is telling). This is what YOU perhaps need more than people with a certain medical background.

My concern, particularly with your mother with her being a midwife, would be whether their ideology and understanding matches your preferences. They need to understand your emotional needs far more than your physical ones. I get the impression, you haven't really discussed your fears with either of them yet.

I think more than anything, this is where you need to start - you may find that you are somehow at odds with them or that they don't fully understand your 'irrationality'. I think having confidence and knowing what you want in your own mind, rather than confidence in their experience is really important.

Hey Sleepie!!!

I'm 12 weeks now. I'll admit I feel EXACTLY how you do. I do have an anxiety disorder.

Even down to the hips issue. I'm relatively narrow down there and have got SPD, painful but plenty smaller girls have given birth than me. My perspective is, If women for thousands of years ago can deliver, so the hell can I.

However give me a sleepless night and my baby has trisnomy, I'm having a failed amnio and I'm in tears over it.

Whilst having a baby is natural and a big thing, I think so is having anxieties about it. If we didn't, then we wouldn't look after ourselves enough.

A GP once said to me....nobody's life looks good at 2am.

Ps. Not implying you have an anxiety disorder btw! Just saying I do anyway!