feeling slightly sick... just got independent obstetric report re dd2 birth injury (sorry, long)

[Romy7]

just got to get a few things out... dh not here and i need to blurt.
no real surprises (i've seen the existing traces etc) but there are factual inaccuracies and no mention of the fact that they knew she was in poor condition and had crashed the paeds before she was born.
atypical deceleration at 1421 (as associated with cord compression) followed by intermittent loss of traces.
1440 'appears likely that that there is variable deceleration'
1452 'the tracing would be cllassified as suspicious'

all else is intermittent auscultation (handheld not trace and handwritten on notes - the student midwife did both - wasn't checked by midwife until 1533 when she realised dd's head was cold and crashed the paeds and senior midwife on duty - between them they essentially dragged her out whilst the student sobbed in the corner)
1536 'nuchal cord x1, shoulders tight ++'
1539 resus and apgars.

essentially he is saying unexplained as there should be a prolonged period of bradycardia to explain her condition at birth.

Oh God, I am sorry. I'm dreading getting mine. I need to know, but sort of don't want to either. Much of it is a blur, with only small recollections (which I don't know if are a true reflection) like you and sometimes I wonder if its not best left that way.

I feel sick with you. I hope for you, and others (me ) that it helps us to understand and move on. I feel incredibly hateful towards certain people, perhaps the wrong ones, and I have to let that go, but can't.

What do you do now? Have you got a full enquiry going on? (Sorry to be nosey)

I am amaze you have a clue what theya re talking about, all the reports we get are so complicated.
all I know is someone fucked up and It wasn't me.

I suspect lots of people fucked up.
Including me

Have you had independent legal advice?

I had slightly weird birth with ds2 (nothing too serious but could have left me with bladder damager). When I read my notes afterwards I found that there was a long paragraph inserted about how the doctor had explained the risk of bladder injury in great detail and I had agreed to this. This was a conversation that did not take place. This was before we'd entered the disability world with ds1, and before I realised that notes go 'missing' all the time in cases of birth injury etc and so I just laughed and showed dh and we sniggered about the fantasy conversation. I see it in a much more sinister light now.

All that to say you are probably right not to trust what the notes say or what the student midwife said. However, you may not be able to argue against them. It certainly sounds as if she was not supervised adequately.

I'm not surprised you feel sick. I'm sure you are angry beyond belief. Have you had counselling? Whatever happens I think that's essential really to come to terms with something so big and unfair and difficult. Whatever happened.

thatis a bit much isn't it...

May I ask how you got an independent obs report? Did you instruct someone? Via a lawyer?

I am in the slightly weird situation that Nathan was very good when he was born (pink, crying no resus, apgars 9 10 10)and the cause seems to be something weird my body does in labour.

I have had a great debriefing meeting with my obs who is an authority in the field of brain damage following birth (Lawrence Impey in Oxford) and who I trust so much that I will want to go back to Oxford for any next babies. This was at his suggestion when Nathan was a few months old. He put everything on the table including the traces and said that I would be able to find an expert who would be willing to say that I should have a section at some point. He then put everything in writing.

Both myself (lawyer) and my husband (scientist) are satisfied that my care was good (qualified mw at my side at all times and careful monitoring by registrar) and that no one was negligent. Somehow that makes things easier, no one to blame, just one of these things.

What do you plan to do now?

these reports take so long, we have been wiating about a year to get someone to do a report and they want £300 an hour
so it has to go back to legal aid. at this rare dd will be 100 before we know

feelingbitbetter what ever happened happened, It wasn't your fault.
I have found persueing a "case" has been the only way to get answers.
I now know that it was nothing I did, although proving someone else cocked up might not happen, at least I know that.

still waiting for answers about dd's birth. Have her birth notes and they are photocopied with bits missing, tippexed in bits etc etc

I am sorry you are all going through this.

Romy, is the independent ob's report saying that there was no negligence ? It does sound as though the student was not supervised correctly and as a result her notes and recollections may not be correct also.

Maybe your legal help could try another ob and stress this point?

Hope you can get some answers, all our important reports have arrived when my husband has been away and I've sat sobbing in the bathhroom

Hope your LO isn't too bad with the chicken pox.

The doctors always lie. They lie and lie and lie. It's a huge scandal. There was no disability involved in my complaint, but I complained about my treatment in hospital and the doctor involved simply wrote lies in the report about what he had said to me and I had said to him. Just made it all up. It made me feel as if I was going mad, and made me much worse. It's a bloody disgrace.

mabanana.........Sorry I don't think that is very helpful,

Is the independent obstectrician able to provide informed speculation as to what probably happened?

Can you find out what level of supervision should be provided for trainee midwives?

I don't know how else you can get around a suspicion that the hospital are not telling the truth except to get statements from the individuals attending the birth (assuming that they are willing).

With ds I arrived at hospital fully dilated. 6 hours later trainee midwife had not noticed that waters had not broken (I had asked). Only when heart rate monitor showed ds was having problems did she run out of the room to find more experienced people. Did my notes say any of this? No.

For my second child I put in my birth plan "no trainees".

It's true though. It would have helped me to know that doctors routinely lie when you complain. I really doubted myself and felt much worse - as if I was going mad. I think the OP needs to know she's not alone, that they will lie to cover their backs, and she should not doubt her own recollection

Romy I hope you're OK. It's awful reading these reports even though you want them...I guess it just brings it all . We received DS's a few month ago (he had a massive haemorrhage due to incorrect positioning and overuse of the ventouse) and I sat there in tears reading it. I hope that you are able to find some answers.

feelingbitbetter I also do not see how you could have done anything wrong. I think (from your other posts) that you do something medical?, but that is irrelevant. if I would have a legal problem I would be the first to hire a lawyer rather than do my own case, I would also make the most rubbish conveyancer.

Romy

It will probably be impossible to prove that the student mw made up readings unless she admits to this. It also seems to me that not many smw would pretend that the baby had a heart beat if it did not. The consequences are too immense and there are no negative consequences for hitting the button.

I do think it can safely be said that once there has been a suspect trace it is no longer reasonable to have a student in charge, there should have been a handover to an experienced midwife, and/or as was done in my case, a registrar kept an eye on my baby's trace from a side room.

sorry you and others on this thread are going through these battles. Goosey and and Madmouse's points seem very sensible. Hope you have some independent legal advisors you can talk through the report findings with.

We have been through this with dd. All I can say is, I am glad I went through with the legal side of it, getting it all looked at etc. We didnt get the outcome we would have liked (half the notes were ODD and alot seemed to be missing) but we are glad we did it. It gave uus closure from it and it also made sure if anything came up in the future a complaint has been lodged and we can take it further.

I know its hard but have a glass of wine and try to remember why you are doing this. See a counsellor if you need to (I did) Its all a complete headfuck, i know

Thank you madmouse and 2shoes. Rationally I know its not my fault but I let things happen, things that if I hadn't been out of my mind with pain and exhaustion I would never have allowed. If I hadn't tried so hard for a natural birth, if I'd not coped so well, if I'd demanded help sooner, if I'd insisted on DS being seen by a doctor instead of allowing those stupid fucking bitch midwives to dismiss me as some neurotic mother if if if........things could be so different and my DS would not be suffering now.
I'd die tomorrow if I could just turn back the clock and save him from this.

I know its not my fault - they were supposed to look after us and they didn't. I hope our enquiry, as painful as it will be, will help me get rid of this anger and guilt.

Hijack over. Sorry Romy this isn't about me. I hope you eventually get some answers and some peace.

I dont think you get rid of all the anger but you certainly get rid of the guilt. You were in the hands of professionals. They were suppossed to be there for you. You cant deliver a baby by yourself

thanks guys. i was in a bit of a state this morning and have been crying on and off all day, but have got it out of my system now and so feel a bit stronger. i don't know whether to feel better because there are so many of us having to do this, or worse, but thanks to all of you...
this was the independent review of the notes that was instructed by the solicitor, and i wasn't expecting it for months so i was caught on the hop a bit (esp with chicken pox, no sleep and dh being away this week lol!)
the solicitor wants the expert to go over the last 39 minutes again, as he can't explain why if the sonicaid readings were accurate, dd2 was in the state she was (he has said that that the 3 minute delay between loss of hr and delivery wouldn't have explained the outcome.) there were 14 minutes from the last handwritten fhr by the student mw until delivery which is within the 15 minute guideline for forceps delivery, although they 'deviated from the normal and usual practice by not monitoring the fetal heart rate continuously during the second stage of labour in a woman with a previous caesarian section'.
but he says impossible to prove that continuous fetal monitoring would have resulted in a different outcome...
but he has no idea, because there aren't enough traces or readings to suggest at what point she became acutely hypoxic... which is actually what i was afraid of all along. (at my 'debrief' with the obstetric consultant he told me monitoring had been inadequate and apologised.)
solicitor wants to push the expert for a balance of probabilities, and an independent neonatal expert opinion, but will have to go back and request more legal aid funding.
she says 'even if it cannot be proved that the heart beat was slow from the time the continuous monitoring stopped, is it not a reasonable inference to draw on a balance of propbabilities that there were problems during this period when only intermittent readings were being taken?'
my best guess is that the eventual outcome will say 'yes' but 'even though it deviated from normal practice it was not negligent'...
but i guess i will need to ask more questions about students and supervision, and also ask them to note the factual inaccuracies of the medical notes/report.
the bit that worries me more than anything is it looks on paper as though nothing out of the ordinary occurred until after she was delivered and they 'discovered' a problem, (the report says the student delivered and the paeds were crashed subsequently etc), when in reality the student had already been banished, and the senior midwife on duty and the paeds crashed, because they knew there was a problem. i don't want to think they were trying to protect the student or writing it up differently on purpose etc, but it just makes my skin crawl a little...
thanks for listening, anyway. i guess i'll just have to go through it slow time and get it all down in a letter to the solicitor...

Glad to hear you are feeling a little stronger. look on it as a good thing that your report has arrived quickly as waiting ages is crap too.

Your own statement of events will be considered too. It is a long process so if you can't face dealing with it put it aside for a week or 2 and have a break from it.

Romy, sorry you are going through this. I'm sure that all you want is the truth, and hope that you can find some way of getting closure.
Glad to hear you're feeling stronger - it's quite a lot to take in on top of DD being unwell! Hope that she gets better soon!

I complained twice to the hopsital about my care just before and during labour with DD2 (I had an abruption) and I have been fobbed off twice, basically told that nothing could have been done any different and her condition is sad but inevitable. (I was prepped for a CS, and then left to labour; before labour 2 MWs failed to realize I was having an abruption, tho I raised concerns.)

I'm afraid I just threw in the towel at this point because the anger it was causing me was not helping me, my marriage or my DDs. I felt I was going to be consumed by rage and guilt, and that it would ultimately be less damaging, costly, time-consuming etc to concentrate on making our family unit, and DD2's quality of life as good as it can be.

The two MWs who screwed up my care are still practising, tho I know that at least one of them suspects she should have done things differently (she said as much to me).

I believe wholeheartedly, based on the evidence of my experience, that the NHS rally round other staff members to cover up inadequacies in care. I KNOW this, but the NHS made me feel I was dillusional and going mad.

TBH I still feel a lot of guilt, but it is all much less raw now (nearly two years on) and DD has emerged much less impaired than we had been led to believe.

Sorry, long rant and ramble, but just wanted you to see you are not alone in having this kind of experience.