OBEM - 08/02

[hermionestranger]

No one else?

I made it through the whole episode last night without tears. I made it through most of the thread without tears.

Then I saw your post MrsDV :(

I was in bits for last night's obem. pam you can request a section instead of forceps. I refused point blank to have forceps when delivering ds because of fears I have regarding their use. The consultant said they would have failed anyway when she came to persuade me, but I wasn't budging from my decision, and even had it stated explicitly in my birth plan that I would not have forceps, and would proceed straight to a section if the need arose. Which, unfortunately, it did.

Livingdead - you've just described my delivery. Forceps with no pain relief (apart from local jab for the epi.) I had avoided an epidural to decrease the risk of an instrumental delivery . They couldn't use a vontouse. I had been commpletely calm until that point (DH couldn't believe how quiet and non-sweary I was throughout...) but having the forceps inserted and used I lost control and screamed. The pain was utterly indescribable. Poor DH is more disturbed than me because I have blanked a lot of it out. He still remembers the amount of force being used and the blood.

And then I had a manual removal of placenta.

DH now refuses to watch an 'birth horror story' programmes, as he calls them. But like that DH last night, he was fantastic, despite being utterly terrified. And DD was fine. He got to spend the first hour with her as I was taken into theatre for the manual removal and to be stitched up....so I got an epidural anyway. Just afterwards.....

You don't need gestational diabetes to have big babies. I'm 5"7 size 12 an my first was 9lb15, threatened forceps but got there in the end with mcroberts and episiotomy. Dc2 was 10lb 6 and was no bother at all. I'm ttc now and feel really worried after watching last night

That baby with shoulder distocia was lucky to make it out alive. And her poor mother's nethers must be in bits. You know when things are going badly wrong when the medical staff get all hushed and purposeful and calm.

Wow. I just watched and it was awful. That poor couple. DS's birth was very similar (pushed for 2.5 hours, MW and docs unsure of position) except that 'luckily' after all that pushing he didn't descend at all and was too high for forceps so I ended up with an emcs. I just sobbed and sobbed from when they told me until he was born (with a bit of puking mixed in during the op). He ended up in NICU too :(

I've just had a 10lb baby. A very easy, straightforward birth

And there was no prior indication she was large. Scans and midwife both suggested an average size

It's not to do with the size of the baby. Poor laragh was just in the wrong position

Ifancy I'm feeling a bit wobbly too. It brought back DS1's birth to me - shoulder dystocia - although thankfully they got him out a bit more quickly and he didn't any lost lasting effects. Those seconds where I was waiting for him to cry were the longest of my life. He was so battered and bruised that it took him a week to breastfed properly. I have subsequently had DS2 and DS3 and there was no question that I wouls try for a vaginal birth again after the trauma of DS1's birth. My two ELCS's were so calm and civilised in comparison! Unfortunately shoulder dystocia is hard to predict.

The problem with SD is that it's quite unpredictable and you don't find out it's happening until the head's already out and the cord almost certainly compressed somewhere along the way by the pelvic bones. Women can have a 10lb baby without a hitch, or at the very last moment the baby can ever so slightly turn and the shoulders get stuck. I didn't pick up on whether this lady had GD. I still didn't really understand why they didn't try getting her on all fours to get gravity on side. Although by the time you have SD, it's difficult to resolve through positioning.

I think she got a spinal block before going for forceps, that might be the reason she wasn't on all fours.

duchesse - she'd had a spinal for the trial of forceps/potential section. So no movement possible at all. No avoiding that though, it was good she was 'pain' free although that doesn't detract from how very hard it must have been for her.

They had been pushing on all fours in the room and she suddenly had a drip and the consultant refered to syntocinon so maybe they tried some of that too. To try hep with 2nd stage. Probably tried all sorts that was edited out.

I wish they would give a run down of what is actually being done. Maybe an onscreen list, for example

'Now trying changes of position and syntocinon as the pushing is taking ages'

So it's not intrusive but at least we aren't trying to spot the management.

But then maybe most people just watch and enjoy, as compared to mn that try to pull to pieces understand

My bloody family wouldn't let me watch it last night so I'm seeing it uninterrupted this morning online, hence the gaps in knowledge! How big was the baby, do we know? Looked about 10lbs+. Did she have gestational diabetes?

You see there is something the matter with me

I didn't find it distressing. I thought it was a case where there was immenent danger and that the best practice was quickly followed and performed in a calm way.

Mother has good pain relief [a spinal. Brilliant. Lucky. At least the physical pain was removed, although the terror and the sensation of pulling will have persisted ]

Proper team assembled. Very senior midwives, obs, a paed team, plenty of runners, a scribe, a timer, anaest on stand by. Ideal.

Proper atmosphere of calm hard work. Excellent. No panicking. Lead role talking through her options, describing her actions, vocalising the plan ahead. Ideal. A second help [the midiwfery sister] acting as promper, expert witness, sensible ears.

Also looking at it, and I don't think there was editing, the forceps were applied and the head delivered in one contraction which is absolute textbook. The perfect forceps delivery.

So in reality - an emergency dealt with in a safe and successful way.

See there is some thing the matter with me. For sure. Maybe it's because I'm in the business, but most I know found this hard to watch too. I don't, I see a task that needs doing. As the midwife said, you can stand and go arrrggggh or you can get on and make it alright.

We women are good at that. We get on and make it alright.

I hope the mum is ok, looks back, maybe watches the programme and thinks 'God I did good. I stayed in the moment, I kept with them, I birthed my baby in the toughest way. It was so fucking scary but she was lucky to have me be so calm and push so hard for her'

If you read this - You did briliiant mamma!!!!!!!

worried- the point is that that situation could very easily not have turned out all right. There only very few real birth emergencies in which losing the baby and/or mother are a real possibility and shoulder dystocia is one of them. That baby could also have suffered serious and irreversible brain damage in the minutes she was deprived of oxygen.

Don't I know it.

You can't be crippled by fear though, because actually any birth could end thus. You have to trust your knowledge, apply what you know and trust the birthing process - which is a good process and for the majority it works a treat. Act when it is needed and sit on your hands the rest of the time.

All good midwives can knit. Keeps us from interferering

worriedsilly That is such a lovely thought, that the Mum did so well I mean.

I had forceps deliveries with both DC1 & 2. DS was back to back with cord wrapped round twice, and DD1 had cord wrapped x 4 round her neck. I had to pant while they untangled her after her head was delivered.

I felt like I'd failed, and DSis, who was with me during DD1s birth, was pretty traumatised. DC3 was born at home, as the thought of going to hospital was something I didn't really want to contemplate. I have always been proud of delivering DC3 myself, with no epi and no forceps. But reading your post, it has dawned on me that I can be proud of myself for delivering DC1 & 2 as well .

My DD3 had a serious cord entanglement (6 x the upper legs and abdomen), which meant that very luckily her head got nowhere near the way out and it was straight to crash CS for us. Getting stuck on the way out is way worse than a CS.

It took me a long time to get over DD1's DS birth. (emotionally and Psychically)
I felt that I had done something wrong to put the baby in that position, to make her turn back to back etc.

Before her birth I hadn't really of DS. After her birth I researched it and started to feel better than it wasn't something I could of controlled really and was just unfortunate but it did take a long time. Thankfully I did as we had DD2 21mths later so it didnt put me off for life! Hers was a much better birth that was 4 hours total as compared to DD1's 27 hours!
However after watching last night im very glad I didnt see that before DD2's birth! Glad I was the head end!
It bought back all sorts of memories both good and bad.

Ifancy. Not wobbly now much but it did take a while for me to drop off last night. DS didnt have SD but was a feet first tiny baby who went into distress and I wasnt still fully dilated (possibly no pressure as well from his head being as he was breach/feet first birth). I think I mostly block out the way he was got out with lots of twisting and pulling and two sets of forceps. DH later told me the pead walked away shaking his head.

My beautifull little boy deserved better. There is a picture of him on my profile, though I always put in a disclaimer that some may find it upsetting

I watched it afterwards on demand. One thing that wasn't clear to me, was whether Laragh's mum was induced? She didn't seem to be in labour when she arrived, so I'm assuming induced?

Then the baby wasn't descending, despite a previous straightforward birth... and they were using the drip to ram the baby (who was in an awkward position) even harder into a gap it wasn't fitting through.

Then, the OB couldn't work out the position until in theatre, yet decided to rotate the head manaually and then pull it out with foceps.

The whole thing just seemed to me like a car crash waiting to happen. If she was induced, then if it was for postdates, she might easily have not gone into labour because the baby was in an odd position. I know, hindsight's a wonderful thing. I just don't understand why the medical professionals opted for trial of forceps rather than straight to c-section. It seems to me entirely possible that this medical emergency was a direct result of all their interventions, no matter how well intentioned. Thank god the baby and mum survived, although obviously not unscathed. Who knows whether the baby will have been slightly deprived of oxygen, and if so the neurological effects might not show up for months or years. I thought it was a shame the programme didn't show the baby after discharge from hospital and also that they didn't clarify whether or not she suffered any immediate injuries.

It was horrific to watch and had me in tears like many others here.

Kanga- It was anything like mine it was hard to predict.

DD1 was in perfect postion for birth when I went in to be induced at +14 days.
Painful contractions that just werent doing anything. I took 27 hours for me to get to 10 cm despite the painful contractions. MW couldnt understand why they were powerful but not getting me anywhere. She had turned back to back during the labour so I was taken to theatre for forceps with a possibility of c section if that didnt work. They turned her with forceps then used ventouse to try pulling her out... she was then stuck fast with SD. Nothing you could of predicted really. Both my DD's turned back to back during labour so im guessing thats just my body.It has an odd shape.

I presume they try forceps first as its a C-section is major abdominal surgery that isnt necessarily an easier option. Quite often a few pulls with forceps helps baby out fine.

Ob usually wait until theatre to absolutely confirm position as it's less painfull when the spinal is an and a whole lot easier as the muscles are much more relaxed.If the vertex has moulding the fontanelles are really tricky to 'read' then going fright back and feeling the ear is a good indicator. That is best done with brilliant painrelief and legs in lithotomy.

As the rest we will never actually know so pointless speculating really.
If the head did deliver in one contraction as it appeared, then actually it would appear forceps were a good choice as a full descent in one contraction is the aim of the game with forceps.A good indicator that the pelvis and the vertex match.

Not counting the subsequent sd of course! Obviously if anyone knew that was going to happen it would have been a straight section.

I can never understand why I had a full spinal and rotations etc done in the labour ward and not theatre, there was a full team in there too, does it mean there was no time to go to theatre or they were busy, i wonder? Or did I not need one?