MNHQ here: Have you had a bad experience with your treatment during pregnancy, labour or childbirth? Ask Leigh Day's lawyers about your rights here

[BojanaMumsnet]

Hello

We at MNHQ have teamed up with a law firm, Leigh Day, to provide a free online clinic on maternal health rights. The clinic will run from today, and the Leigh Day maternal health team will be responding to questions from Monday. Please take a look below to see what kinds of questions they can take and to see how this will work. We hope you find this useful, and please do bear in mind that there will be experiences posted here which may be upsetting to read.

Thanks
MNHQ

Terms & Conditions – between Leigh Day and visitors to the clinic

Free online advice clinic
Leigh Day is delighted to be teaming up with Mumsnet to provide a free, online legal clinic, offering advice on healthcare and treatment issues during pregnancy, labour and childbirth. The advice will be provided by senior lawyers from our maternal health team, who act in cases where there has been a failure in treatment and injury to a mother and/or baby during labour and birth.

Many women are unsure of their rights particularly regarding consent in relation to antenatal, labour and postnatal care. The clinic will provide free advice and raise awareness of issues for women to consider when planning pregnancy and childbirth, or after the event.
We work with charities, such as Birthrights, MASIC, Group B Strep, and other organisations who, like us, are committed to offering choice and improving safety and care for mothers and babies.

The clinic will take the form of a 'Q&A' session on Mumsnet’s website, with members of the public posting questions on a dedicated public discussion thread. Our specialist solicitors will take necessary any additional detail via private messaging (username: LeighDayMaternalHealthTeam) before posting up answers and advice. This is to check for a conflict of interest.

The clinic will run for a week from Monday 4th November to Monday 11th November. We will do our best to provide all answers during the week but, at the latest, by the Friday of the following week. You can find information on where to go for more help once the clinic has ended here. You can find some advice on how to raise a concern with your doctor about your care or treatment here.

Please note that we can answer questions concerning consent and issues in childbirth, specifically in relation to maternal injuries such as:

• Perineal tears – third and fourth degree
• Injuries following caesarean sections
• Poor care during the antenatal period of your pregnancy. For example, from mismanagement of pre-eclampsia or gestational diabetes
• Sepsis after childbirth

We can also advise on injuries or sub-standard care relating to your child, including:

• Cerebral palsy
• Birth asphyxia and brain injuries
• Fractures to the skull, legs, arm, shoulder and collarbone
• Failure to diagnose fetal abnormality

We also represent families at an inquest if there has been stillbirth or death of the baby after birth.

What to do if you’d like to post a question

1. If you have a question about your rights in pregnancy or childbirth, please post it online during the week, providing as much information as possible, including if relevant a concise history. Remember that this is an online forum and can be viewed by the public – including any hospital or service provider. You can use the private message facility to disclose any information you would prefer to keep off the public forums.

1. Please send your name and the name(s) of any relevant service providers by private message to: LeighDayMaternalHealthTeam so the information can be passed on to our maternal health lawyers. We cannot post a reply until you have sent this information by private message.

Terms and Conditions – please read
The advice provided to an individual poster is based only on the information provided by that poster. Advice on this thread is also particular to the individual who has asked for it and will be specific to that person’s situation and cannot be taken to relate to another individual’s situation or potential case. Mumsnet and Leigh Day accept no liability for any loss suffered as a result of an individual choosing to follow advice provided to another poster's question on the thread. Please take care if you choose to apply that advice to your own situation - it is recommended that you first take advice from one of the sources we have suggested here.

Leigh Day’s lawyers, all of whom are specialists in clinical negligence, particularly relating to injuries to mothers and babies during childbirth, will be providing free advice in respect of the clinic. Any personal information collected as a result of the clinic will be held by Leigh Day and will be deleted after 18 months. If you wish to make a complaint about the service you received, please see Leigh Day’s complaints policy here.

Edited by MNHQ to extend the clinic

[NiamhMumsnet]

We're closing the thread to questions now. Thank you again to Leigh Day's Maternal Health Team and everyone who posted questions.

Thanks
MNHQ

[LeighDayMaternalHealthTeam]

Thank you to everyone who has taken the time to share their experiences with us. We wish you all the very best.

Leigh Day's Maternal Health Team

[LeighDayMaternalHealthTeam]

@HufflepuffBean

Hi and thank you for making this post!

I've had a lot of issues with pregnancy, Labour and birth.

During my third pregnancy (the first two pregnancies I had ended in missed miscarriages at 6 weeks and 9 weeks respectively) I had severe bleeding at 6 weeks and was admitted to EPAU. That night a foetus passed and I had an internal scan the following morning. The lady doing the scan just said "it's empty" and left the room. No sympathy whatsoever and she just seemed in a rush to leave. It was confirmed I'd miscarried and to go home. I bled for another week and went on with my life, and had a blood test where they confirmed I was no longer pregnant as my HCG had dropped. I was never told how much by, just that it had. Four weeks after the miscarriage, and 3 weeks after the bleeding had stopped, I had emergency surgery for my burst Fallopian tube. It was confirmed that was another foetus and had been missed on the scan and the results of the blood test had indicated there was potentially still an ongoing pregnancy but this hadn't been chased up. I could have died (I lost over 3 litres of blood and became hypothermic) because people missed things or didn't chase them. What can I do about this? I've tried PALS but nobody seems to care.

Now onto my fourth pregnancy...

I found out I was pregnant at 4 weeks. I had had lots of previous losses so was very cautious. At 6 weeks I began having shoulder pain and wanted to be checked out due to the previous ectopic. I was put on EPAU again and booked for a scan the next day. The man doing it was trying to force me into all sorts of odd positions and the scan was very painful and he put the wand in way too far. This was also in front of several other staff. He looked for a little while and then told me that my baby was too small and had stopped growing, and that I'd miscarry soon. I asked him directly what the chance was of this pregnancy continuing and he said none. The midwife said she'd put it at 1%. Due to my previous records I was offered medical management that day. I said no and went home, with another scan booked at 8 weeks. There's no bleeding or anything and when I went for the 8 weeks scan, by some miracle my baby was a lot bigger and had a heartbeat. If I had had the medical management I would have terminated a viable pregnancy. I feel awful that I could have lost a very wanted baby and it was only because I said no. Is there anything I can do about this? This doctor is disliked at the hospital and is known for making mistakes, yet still practices and does ultrasound scans. How many other women has he done this to I'll never know.

Also, during the labour of my son (that same pregnancy) I said specifically I did not want an episiotomy. One was performed anyway without consent. I feel like I've been mutilated. Do you have any advice about this?

Again, thank you for making this post.

Hi @HufflepuffBean

I am very sorry to hear about your experiences and that PALS has not been helpful or supportive. I completely understand your desire to do something about the care that you have received and the fact that other women may also be receiving poor care.

Please note that we can only advise in relation to issues arising from care provided to patients in England and Wales. If your care was in Scotland there is a different complaints process (see post above).

Third Pregnancy

From what you say above you seem to be concerned that the scan during your third pregnancy was not performed as carefully as it should have been and there was a failure to properly consider your blood tests results.

You have the right to make a complaint about any aspect of NHS care, treatment or service, and this is firmly written into the NHS Constitution. Speaking to PALS is one way of making a complaint but it doesn’t always result in a full investigation. Everyone who provides an NHS service must have their own complaints procedure and you can often find information about the complaints procedure on the Hospital’s website. The Hospital should formally investigate your concerns and respond in writing.

If you’d like support, Citizens Advice have an online guide and template letters for complaining about an NHS service. Alternatively, you could approach a clinical negligence solicitor for advice on investigating a claim.

In order to succeed in a clinical negligence claim you would have to show that the management of your miscarriage and missed ectopic pregnancy fell below a reasonable standard of care that you would expect from a medical professional and that appropriate medical management would have changed the outcome. Expert opinion will be required in relation to both elements and will look at whether the emergency surgery should have been avoided but also at the longer term consequences such as any impact on future pregnancies.

It is important to know that English law provides that if you wish to bring a claim in clinical negligence, you must do so within three years from the date of injury.

Fourth Pregnancy

You also seem to be concerned that that the scan during your fourth pregnancy was not performed as carefully as it should have been.

To succeed in a clinical negligence claim you would have to show that the information and advice you received was negligent and that you have suffered a physical or psychological injury as a result of that negligent advice. Unfortunately, the law does not provide adequate redress where the repercussions of negligence could have been very severe but, thankfully, did not occur.

Again, you can make a complaint to the hospital about the care that you received and you can ask that the hospital tell you what training their clinicians receive and that they look at changing the training so that these types of mistakes do not happen again.

You have the right to take your complaint to the independent Health Service Ombudsman if you are not satisfied with the way your complaint has been dealt with by the NHS and where you have concerns about a medical professional repeatedly making negligent mistakes, it is possible to complain to their regulatory body (usually the General Medical Council or Nursing and Midwifery Council) who may undertake their own investigation.

Episiotomy

I am very sorry that you received treatment that you did not consent to and I can only imagine how that makes you feel.

Decisions regarding medical treatment should be made by women based on clear and complete information and ideally women should be given information about the possible need for an episiotomy before labour.

An episiotomy is usually only considered if the baby is in distress and needs to be born quickly, or there is a clinical need, such as a delivery that needs forceps or ventouse, or a risk of a tear to the anus. If your doctor or midwife feels you need an episiotomy when you're in labour, they should discuss this with you and obtain your consent. The exception to this is if are unable to make your wishes known in which case treatment can be given without your consent in order to save your life or prevent serious deterioration in your condition.

Making a complaint or investigating a claim may give you some answers about why your wishes were not followed and you may receive some reassurance that the hospital is going to change its practices so that other women do not have similar experiences.

For additional support and advice you may wish to contact the Birth Trauma Association (//www.birthtraumaassociation.org.uk).

Thank you for sharing and I wish you all the best.

Lauren Tully

[LeighDayMaternalHealthTeam]

@Adollop

In 2001 I have birth to my third child. I was told by the midwife just to do what came naturally, I'd know what I was doing, in the meantime she sat filling in paperwork. I believe I pushed too soon, I hadn't a clue really, I tore badly and have had problems with that area ever since, a lot of pain. I feel extremely upset about this and it affected my sex life ever since. I also suffered pmd which could partly have been due to the pain I was in afterwards. I was also left alone with baby and my partner for at least 3 hours afterwards in the delivery room as they were too busy to do anything with us. I've never done anything about this. Should I have? Could I?

Hi @Adollop

I am sorry to read about the injuries you sustained during the birth of your third child in 2001. The normal rule is that the period for bringing a claim is three years from the date of the injury or the date when you first became aware that you had sustained an injury (“date of knowledge”), although there are exceptions if a person does not have mental capacity or is a minor. I am afraid that on the basis of the information that you have provided about the dates, you would be out of time to bring a claim, unless your date of knowledge that I have referred to, is within the last 3 years.

There is, however, a very good organisation that supports women who have sustained perineal injuries in childbirth. I do not know if you have heard of MASIC Foundation, but you may wish to contact them for support: //www.masic.org.uk

Sanja Strkljevic

[Wheredidigowrongggggg]

Hello. I felt I had to write something when I saw this. I had nasty third degree tears with my second baby. The damage was bad because I had a midwife who didn’t realise my baby was back to back (first baby also back to back), and I was pushing for 30 mins without knowing the damage. It was quick so no pain relief. I cannot describe the pain. I do recall the consultant giving a brief lesson To the midwife on how to tell the baby was back to back when she intervened. Rushed to theatre and baby came out with forceps. Damage was external but also internal tears at various points due to prolonged fruitless pushing. Definite lasting effects from that. Urgency when pooing is immediate - when I’ve got to go, I’ve got to go. I imagine this will be a real issue when I age.

For all of this, and despite knowing that the damage was caused by someone else’s lack of knowledge, my baby emerged alive and well. I emerged alive and pretty much well. I couldn’t give two stuffs about faecal urgency because the team as a whole saved our lives. With both my babies, 50 years ago the babies would have died, 100 years ago we’d both be dead. How on earth can I want anything from the NHS other than to say thank you?

Do I resent the midwife? Of course not. She was doing her best, No doubt after a long shift with no breaks and back to back babies. She was junior and she made a mistake. Shit happens. She will never miss a back to back baby again I’m sure. Instead I thank god for her and the 11 people in theatre who saved our lives and put my perineum as back together as possible.

We live in a blame culture. Sometimes that’s appropriate. If I knock someone over with my car because I’m on my phone or drunk, that’s unforgivable. I deserve to be sued. When it comes to life saving medical treatment which goes wrong because people are invariably overworked, underpaid and doing their best in difficult circumstances, I don’t see that taking more money out of the NHS is the way to go. I winced a bit at seeing a law firm seeking fees through mumsnet under the guide of ‘helping’ - and lets be honest that’s what they are after. They earn money from dealing with other people’s misfortune and it feels like they are seeking more publicity and fees From here, mumsnet, a potentially rich source of maternity related claims. Perhaps Leigh day could instead lobby for more money to go to the provision and training of midwives before people have their babies rather than seemingly seek to encourage litigation thereafter?

I don’t work in the NHS. I have no vested interest in my stance. I just resent high profile ambulance chasing which potentially takes money away from frontline care and puts it into lawyers’ pockets. I am forever grateful for everyone who looked after me and my babies. Instead of feeling resentful when I run to the loo, I thank god they saved my baby. I can’t imagine wanting money from the very people who did that for me.

[LeighDayMaternalHealthTeam]

@HufflepuffBean

Hi and thank you for making this post!

I've had a lot of issues with pregnancy, Labour and birth.

During my third pregnancy (the first two pregnancies I had ended in missed miscarriages at 6 weeks and 9 weeks respectively) I had severe bleeding at 6 weeks and was admitted to EPAU. That night a foetus passed and I had an internal scan the following morning. The lady doing the scan just said "it's empty" and left the room. No sympathy whatsoever and she just seemed in a rush to leave. It was confirmed I'd miscarried and to go home. I bled for another week and went on with my life, and had a blood test where they confirmed I was no longer pregnant as my HCG had dropped. I was never told how much by, just that it had. Four weeks after the miscarriage, and 3 weeks after the bleeding had stopped, I had emergency surgery for my burst Fallopian tube. It was confirmed that was another foetus and had been missed on the scan and the results of the blood test had indicated there was potentially still an ongoing pregnancy but this hadn't been chased up. I could have died (I lost over 3 litres of blood and became hypothermic) because people missed things or didn't chase them. What can I do about this? I've tried PALS but nobody seems to care.

Now onto my fourth pregnancy...

I found out I was pregnant at 4 weeks. I had had lots of previous losses so was very cautious. At 6 weeks I began having shoulder pain and wanted to be checked out due to the previous ectopic. I was put on EPAU again and booked for a scan the next day. The man doing it was trying to force me into all sorts of odd positions and the scan was very painful and he put the wand in way too far. This was also in front of several other staff. He looked for a little while and then told me that my baby was too small and had stopped growing, and that I'd miscarry soon. I asked him directly what the chance was of this pregnancy continuing and he said none. The midwife said she'd put it at 1%. Due to my previous records I was offered medical management that day. I said no and went home, with another scan booked at 8 weeks. There's no bleeding or anything and when I went for the 8 weeks scan, by some miracle my baby was a lot bigger and had a heartbeat. If I had had the medical management I would have terminated a viable pregnancy. I feel awful that I could have lost a very wanted baby and it was only because I said no. Is there anything I can do about this? This doctor is disliked at the hospital and is known for making mistakes, yet still practices and does ultrasound scans. How many other women has he done this to I'll never know.

Also, during the labour of my son (that same pregnancy) I said specifically I did not want an episiotomy. One was performed anyway without consent. I feel like I've been mutilated. Do you have any advice about this?

Again, thank you for making this post.

Sorry to hear about the issues you've had @HufflepuffBean. We will respond as soon as we can.

[HufflepuffBean]

Hi and thank you for making this post!

I've had a lot of issues with pregnancy, Labour and birth.

During my third pregnancy (the first two pregnancies I had ended in missed miscarriages at 6 weeks and 9 weeks respectively) I had severe bleeding at 6 weeks and was admitted to EPAU. That night a foetus passed and I had an internal scan the following morning. The lady doing the scan just said "it's empty" and left the room. No sympathy whatsoever and she just seemed in a rush to leave. It was confirmed I'd miscarried and to go home. I bled for another week and went on with my life, and had a blood test where they confirmed I was no longer pregnant as my HCG had dropped. I was never told how much by, just that it had. Four weeks after the miscarriage, and 3 weeks after the bleeding had stopped, I had emergency surgery for my burst Fallopian tube. It was confirmed that was another foetus and had been missed on the scan and the results of the blood test had indicated there was potentially still an ongoing pregnancy but this hadn't been chased up. I could have died (I lost over 3 litres of blood and became hypothermic) because people missed things or didn't chase them. What can I do about this? I've tried PALS but nobody seems to care.

Now onto my fourth pregnancy...

I found out I was pregnant at 4 weeks. I had had lots of previous losses so was very cautious. At 6 weeks I began having shoulder pain and wanted to be checked out due to the previous ectopic. I was put on EPAU again and booked for a scan the next day. The man doing it was trying to force me into all sorts of odd positions and the scan was very painful and he put the wand in way too far. This was also in front of several other staff. He looked for a little while and then told me that my baby was too small and had stopped growing, and that I'd miscarry soon. I asked him directly what the chance was of this pregnancy continuing and he said none. The midwife said she'd put it at 1%. Due to my previous records I was offered medical management that day. I said no and went home, with another scan booked at 8 weeks. There's no bleeding or anything and when I went for the 8 weeks scan, by some miracle my baby was a lot bigger and had a heartbeat. If I had had the medical management I would have terminated a viable pregnancy. I feel awful that I could have lost a very wanted baby and it was only because I said no. Is there anything I can do about this? This doctor is disliked at the hospital and is known for making mistakes, yet still practices and does ultrasound scans. How many other women has he done this to I'll never know.

Also, during the labour of my son (that same pregnancy) I said specifically I did not want an episiotomy. One was performed anyway without consent. I feel like I've been mutilated. Do you have any advice about this?

Again, thank you for making this post.

[LeighDayMaternalHealthTeam]

@Adollop

In 2001 I have birth to my third child. I was told by the midwife just to do what came naturally, I'd know what I was doing, in the meantime she sat filling in paperwork. I believe I pushed too soon, I hadn't a clue really, I tore badly and have had problems with that area ever since, a lot of pain. I feel extremely upset about this and it affected my sex life ever since. I also suffered pmd which could partly have been due to the pain I was in afterwards. I was also left alone with baby and my partner for at least 3 hours afterwards in the delivery room as they were too busy to do anything with us. I've never done anything about this. Should I have? Could I?

Thanks for your message @Adollop. We will respond as soon as possible.

[Adollop]

In 2001 I have birth to my third child. I was told by the midwife just to do what came naturally, I'd know what I was doing, in the meantime she sat filling in paperwork. I believe I pushed too soon, I hadn't a clue really, I tore badly and have had problems with that area ever since, a lot of pain. I feel extremely upset about this and it affected my sex life ever since. I also suffered pmd which could partly have been due to the pain I was in afterwards. I was also left alone with baby and my partner for at least 3 hours afterwards in the delivery room as they were too busy to do anything with us. I've never done anything about this. Should I have? Could I?

[LeighDayMaternalHealthTeam]

@Mynameisnotthis

Hi

Interesting topic! My DD was born through EMCS. had to have a growth scan at 3 days overdue and baby was shown to be large. First midwife we spoke to said I’d need a section due to side of baby as she’d likely get stuck and cause a medical emergency. The doctor we spoke to soon after that said there was no medical need for a section but they’d induce earlier than the standard time frame if I wanted. Booked in to be induced same day but went into spontaneous labour soon after. Quickly progressed to 10cm but no involuntary pushing. Made to push 3 times every 3 minutes for an hour before being take to theatre. Forceps weren’t possible due to baby’s position so emergency section.
After baby delivered they struggled to stop bleeding. A major incident was called. I lost 3.5 litres. It was all very traumatic. I ended up under general anaesthetic as they sorted it all. However I had already had a post partum haemorrhage with first baby so assumed same had happened again.
My debrief/birth counselling session was delayed to nearly 6 months later where I was told that actually the bleed was caused by the incision being made in the wrong place. The cut was then torn as baby was removed.

It was explained as a complication of surgery, one that the doctor had not seen herself before and the reason why the consultant was called in.

Is it really as simple as that or would I have the basis for further complaint? 3 weeks later I was readmitted requiring IV antibiotics due to infection which I was told I was at greater risk of due to the amount of blood lost and the amount of time I was ‘open’ in theatre. Also, I was sent away with no treatment for the suspected infection only to have to return 2 days later. I still have pain now. Overall a poor experience. I had similar poor care after first baby but I think the time for raising a complaint about that has passed.

Thanks in advance!

Hello @Mynameisnotthis

I am sorry to read of the very difficult time that you had following the birth of your DD.

I understand that the care that you received was in Scotland. We can only advise in relation to issues arising from care provided to patients in England and Wales.

However, I attach to this email a link to a guide to making a complaints about NHS care in Scotland www.mygov.scot/nhs-complaints and www.nhsinform.scot/care-support-and-rights/health-rights/feedback-and-complaints/complain-about-a-gp-pharmacy-dentist-or-hospital-in-scotland

You are entitled to obtain a copy of your medical records under the General Data Protection Regulations 2018.

You may also wish to consider approaching a clinical negligence solicitor in Scotland for advice on investigating a claim arising from the care that you had received. There are time limits within which claims for clinical negligence must be brought at Court. I understand that in Scotland, as in England and Wales, the time limit is 3 years from the date of the injury or the date when you became aware that you had suffered an injury. However, please do check with specialist clinical negligence solicitors in Scotland about the time limitations.

I am sorry that I am unable to offer you any further advice, but I do hope that this has been of some assistance.

Sanja Strkljevic

[LeighDayMaternalHealthTeam]

@Mynameisnotthis

Hi

Interesting topic! My DD was born through EMCS. had to have a growth scan at 3 days overdue and baby was shown to be large. First midwife we spoke to said I’d need a section due to side of baby as she’d likely get stuck and cause a medical emergency. The doctor we spoke to soon after that said there was no medical need for a section but they’d induce earlier than the standard time frame if I wanted. Booked in to be induced same day but went into spontaneous labour soon after. Quickly progressed to 10cm but no involuntary pushing. Made to push 3 times every 3 minutes for an hour before being take to theatre. Forceps weren’t possible due to baby’s position so emergency section.
After baby delivered they struggled to stop bleeding. A major incident was called. I lost 3.5 litres. It was all very traumatic. I ended up under general anaesthetic as they sorted it all. However I had already had a post partum haemorrhage with first baby so assumed same had happened again.
My debrief/birth counselling session was delayed to nearly 6 months later where I was told that actually the bleed was caused by the incision being made in the wrong place. The cut was then torn as baby was removed.

It was explained as a complication of surgery, one that the doctor had not seen herself before and the reason why the consultant was called in.

Is it really as simple as that or would I have the basis for further complaint? 3 weeks later I was readmitted requiring IV antibiotics due to infection which I was told I was at greater risk of due to the amount of blood lost and the amount of time I was ‘open’ in theatre. Also, I was sent away with no treatment for the suspected infection only to have to return 2 days later. I still have pain now. Overall a poor experience. I had similar poor care after first baby but I think the time for raising a complaint about that has passed.

Thanks in advance!

Hello @Mynameisnotthis

We will send you a PM regarding your post.

Sanja Strkljevic

[LeighDayMaternalHealthTeam]

@ChilledBee

This is for a friend who I have been a Birth Partner for 2 out of the 3 times she has given birth. She's due again soon... and she's considering a knitting needle herself (no exaggeration).

Her first labour was an induction. 20 hours from time her waters were broken ,nearly needed forceps but didnt. Just as they were about to use the forceps they found her waters had reformed a bubble or hadn't been broken properly to start with(!). They were broken and baby quickly came down and was born quickly.

Second labour I was present, labour stalled at 9cm after spontaneous start and progressing steadily. Her waters didnt break. She was then fully dilated but didnt make progress even though they gave the baby time to come down before she started to push. After an hour of pointless pushing, the midwife broke her waters and the baby was born quickly afterwards. She said a big bubble of water had formed in front of the baby and was stopping the head coming down.

3rd labour I was present- spontaneous labour. She spoke to antenatal midwife about needing her waters broken to speed things up. After discussion it was written on birth plan and signed by midwife to say she understands the risks/lack of benefit. We attend in labour and get a really nice midwife. Friend is 5cm. She discusses breaking waters again and MW says she cannot due to guidelines. Friend tries to explain that if she waits that long, she could go 4 hours with no progress but lots of exhausting contractions. Midwife says it doesn't speed up labour (true according to research but not true for my friend). Ignores birth plan.

Midwife goes on break. Other midwife takes over. Friend explains situation to other midwife who says she will do it if she wants. She does it and finds she has made about 1cm progress in 3 hours. Midwife on break comes back just as baby is being born, so again, it worked for her. Midwife who broke her waters said "Christ your membranes are like a duvet", when she was examining the placenta after birth.

This time she is in a new hospital (needed a bigger house after all those kids) and thinks it will be even harder to get them to just break her bloody waters because it works for her and shortens her labour. Her antenatal midwife helpfully said "I would but I won't be there."

Is there anything legal that means you can request such an intervention against guidelines?

I brought this up at doula training where I compared it to elective caesarean and they said it is totally different so she can't ask on the same merit and they reiterated that research concludes that it doesn't speed up labour where as a caesarean section on request will avoid mental harm and that her BPs and MWs should focus on supporting her through the pain rather than securing an intervention(!).

Hi @ChilledBee

Thank you for your enquiry and I’m sorry to hear of the difficulties your friend has experienced with her previous deliveries.

From a legal perspective, guidelines themselves are not legally binding and there is a certain amount of discretion which can be applied on a case by case basis. That said, ignoring guidelines may lead to legal consequences if something were to go wrong so medical professionals have to be sure that any actions they take are in the best interest of the patient.

I would recommend your friend to have a full discussion with her midwife, obstetrician (if she has one) and possibly even her GP about her previous labours and her wishes for the management of this labour. She should ask for her wishes to be documented in her birth plan and ask the medical professionals to ensure that the records from her previous deliveries are available for her new hospital. That way they will be able to see that her previous labours have been aided by the breaking of her waters. It may also be possible for her GP to correspond with the hospital in which your friend is planning to give birth to make them aware of her history.

If, when it comes to her labour, your friend encounters the same issues as before, she should ask those caring for her what guidelines they are referring to and for details of the risks and benefits involved in breaking her waters. That way, there should be a full discussion and if nothing else, your friend will have a better understanding about why they can/can’t adhere to her wishes.

I’m sorry if this is not the answer you were hoping for but I wish your friend the best of luck with her forthcoming delivery.

Olive Lewin

[LeighDayMaternalHealthTeam]

@AnyMinuteNow

Thank you and very helpful.

So no specifics of naming the provider just so long as you know hcp type. I see. Thanks.

I have heard many many horror stories on MN of such cases as you wouod sue for. I hope plenty will see this thread and take up your advice, there is certainly much assault in womens care (non consensual and unnecessary procedures).

@AnyMinuteNow - glad the answer was helpful in the end!

[Mynameisnotthis]

Hi

Interesting topic! My DD was born through EMCS. had to have a growth scan at 3 days overdue and baby was shown to be large. First midwife we spoke to said I’d need a section due to side of baby as she’d likely get stuck and cause a medical emergency. The doctor we spoke to soon after that said there was no medical need for a section but they’d induce earlier than the standard time frame if I wanted. Booked in to be induced same day but went into spontaneous labour soon after. Quickly progressed to 10cm but no involuntary pushing. Made to push 3 times every 3 minutes for an hour before being take to theatre. Forceps weren’t possible due to baby’s position so emergency section.
After baby delivered they struggled to stop bleeding. A major incident was called. I lost 3.5 litres. It was all very traumatic. I ended up under general anaesthetic as they sorted it all. However I had already had a post partum haemorrhage with first baby so assumed same had happened again.
My debrief/birth counselling session was delayed to nearly 6 months later where I was told that actually the bleed was caused by the incision being made in the wrong place. The cut was then torn as baby was removed.

It was explained as a complication of surgery, one that the doctor had not seen herself before and the reason why the consultant was called in.

Is it really as simple as that or would I have the basis for further complaint? 3 weeks later I was readmitted requiring IV antibiotics due to infection which I was told I was at greater risk of due to the amount of blood lost and the amount of time I was ‘open’ in theatre. Also, I was sent away with no treatment for the suspected infection only to have to return 2 days later. I still have pain now. Overall a poor experience. I had similar poor care after first baby but I think the time for raising a complaint about that has passed.

Thanks in advance!

[ChilledBee]

This is for a friend who I have been a Birth Partner for 2 out of the 3 times she has given birth. She's due again soon... and she's considering a knitting needle herself (no exaggeration).

Her first labour was an induction. 20 hours from time her waters were broken ,nearly needed forceps but didnt. Just as they were about to use the forceps they found her waters had reformed a bubble or hadn't been broken properly to start with(!). They were broken and baby quickly came down and was born quickly.

Second labour I was present, labour stalled at 9cm after spontaneous start and progressing steadily. Her waters didnt break. She was then fully dilated but didnt make progress even though they gave the baby time to come down before she started to push. After an hour of pointless pushing, the midwife broke her waters and the baby was born quickly afterwards. She said a big bubble of water had formed in front of the baby and was stopping the head coming down.

3rd labour I was present- spontaneous labour. She spoke to antenatal midwife about needing her waters broken to speed things up. After discussion it was written on birth plan and signed by midwife to say she understands the risks/lack of benefit. We attend in labour and get a really nice midwife. Friend is 5cm. She discusses breaking waters again and MW says she cannot due to guidelines. Friend tries to explain that if she waits that long, she could go 4 hours with no progress but lots of exhausting contractions. Midwife says it doesn't speed up labour (true according to research but not true for my friend). Ignores birth plan.

Midwife goes on break. Other midwife takes over. Friend explains situation to other midwife who says she will do it if she wants. She does it and finds she has made about 1cm progress in 3 hours. Midwife on break comes back just as baby is being born, so again, it worked for her. Midwife who broke her waters said "Christ your membranes are like a duvet", when she was examining the placenta after birth.

This time she is in a new hospital (needed a bigger house after all those kids) and thinks it will be even harder to get them to just break her bloody waters because it works for her and shortens her labour. Her antenatal midwife helpfully said "I would but I won't be there."

Is there anything legal that means you can request such an intervention against guidelines?

I brought this up at doula training where I compared it to elective caesarean and they said it is totally different so she can't ask on the same merit and they reiterated that research concludes that it doesn't speed up labour where as a caesarean section on request will avoid mental harm and that her BPs and MWs should focus on supporting her through the pain rather than securing an intervention(!).

[AnyMinuteNow]

Thank you and very helpful.

So no specifics of naming the provider just so long as you know hcp type. I see. Thanks.

I have heard many many horror stories on MN of such cases as you wouod sue for. I hope plenty will see this thread and take up your advice, there is certainly much assault in womens care (non consensual and unnecessary procedures).

[LeighDayMaternalHealthTeam]

@AnyMinuteNow

I was also interested to see if there had been a successful claim for psychological harm against a health provider, but I couldn't see that answered?

Also, wrt providing specific details by pm, I couldn't see that answer to that either?

Thank you

We have successfully concluded claims for individuals who have suffered psychiatric injury.

In order to bring a claim for psychiatric injury the individual must prove s/he has suffered a recognised psychiatric injury (i.e. a diagnosable condition). It is not sufficient for them to only prove fear, upset, distress, horror, anxiety or grief.

The leading case of Alcock [1992] 1 AC 310 (House of Lords) separated persons who suffered psychiatric injury into two categories:
• Primary Victim
• Secondary Victim

A primary victim is usually someone who could reasonably foreseeably suffer physical injury as a result of the health providers actions. For instance, a mother who suffers injury to herself as a result of a mismanaged labour or whose child suffers injury at birth will be a primary victim. A primary victim does not have to suffer actual physical harm to qualify.

In the vast majority of clinical negligence cases the patient will qualify as a primary victim.

A secondary victim is someone who has witnessed the injury caused to another person. The position of a secondary victims is more complicated and has been subject to much case law. To assist, I have outlined the criteria that needs to be satisfied to bring a secondary victim claim:

1. The psychiatric injury arose in witnessing the injury or death, or extreme danger or discomfort to the primary victim;
2. The injury arose from sudden unexpected shock;
3. There were close ties of love an affection between the primary and secondary victims;
4. The Claimant was present at the scene of the event or witnessed the aftermath a short time later;
5. Injury of that type to that Claimant was reasonably foreseeable.

In answer to your second question it would help us to provide more detailed advice, specific to your particular concerns if we know the type of health provider i.e. GP, doctor/nurse/midwife in an NHS or private setting, involved.

Emmalene Bushnell

[LeighDayMaternalHealthTeam]

@LeighDayMaternalHealthTeam

Thanks *@AnyMinuteNow*. Maria will respond asap.

Sorry *@AnyMinuteNow, that should be Emmalene* will respond asap.

[LeighDayMaternalHealthTeam]

Thanks @AnyMinuteNow. Maria will respond asap.

[AnyMinuteNow]

I am referring to pp q's, as I can't see they've been answered? I haven't asked myself, or pm'd you, but did want an answer to that and my own pp q.

[AnyMinuteNow]

I was also interested to see if there had been a successful claim for psychological harm against a health provider, but I couldn't see that answered?

Also, wrt providing specific details by pm, I couldn't see that answer to that either?

Thank you

[LeighDayMaternalHealthTeam]

@Dogsaresomucheasier

Just out of interest, has there ever been a successful case of a woman claiming damages for psychological injury caused by poor care during pregnancy and birth?

Dear @Dogsaresomucheasier

It is possible for a woman to claim damages for psychiatric/ psychological injury in cases concerning negligent care during pregnancy and birth. In order to bring a claim for clinical negligence, it is necessary to establish that the doctor or nurse involved in your care was negligent and that the negligence caused your injury. There are 3 main heads of loss that can be claimed:

• General damages: this is a sum of money to reflect the pain, suffering and loss of amenity that you have suffered as a result of the injury.

• Special damages: this is a claim for the expenses that have been incurred as a consequence of the injury. These are numerous and diverse and may include loss of earnings, cost/value of care provided, medical expenses, travel/transport costs, aids and appliances, accommodation/adaptation costs.

• Future losses: this is a claim for the losses which might reasonably be incurred in the future. This may include loss of earnings and loss of pension.

The claim for psychiatric/psychological injury falls under the general damages head. In order to claim such damages, there must be a recognisable psychiatric injury. The Judicial College’s Guidelines for the Assessment of General Damages in Personal Injury Cases provides guidance for the assessment of such damages. The Guidelines can be helpful in order to establish a ballpark figure for the likely award within the range or to see if there is any scope for arguing that a particular case falls outside the Guidelines. You can also refer to comparable case law.

Maria Panteli

[LeighDayMaternalHealthTeam]

@AnyMinuteNow

Can I just ask you cannot answer a question without the specific name of the service provider?

Does it alter the advice/legal position depending on whether the gp was in say, one part of london or another? Obviously it would alter by country or even maybe in wales, but by nhs trust or private?

I just wonder what difference it makes to the law depending on the specific provider?

Dear @AnyMinuteNow

Claims against healthcare providers in England and Wales are most often brought in negligence; this does not vary by location, nor by service provider.

To bring a successful claim in negligence, you need to establish that the healthcare provider owed you a duty of care (this is almost always the case in a healthcare/patient context), that the care was substandard, and, that the substandard care caused you harm.

The identity of the Defendant in a clinical negligence claim can vary, however, depending on the context in which the care was provided. For example:

• If you were bringing a claim arising from the poor care provided by, say, a midwife, obstetrician, doctor or nurse, the Defendant would usually be the NHS Trust under which the hospital operates.
• If you were bringing a claim arising from the poor care provided by a GP, then the Defendant may be the GP or the partners of their GP surgery.
• If you were bringing a claim arising from the poor care provided by a private surgeon at a private hospital, then the Defendant would usually be the surgeon and possibly the private hospital.

When considering who to pursue a clinical negligence claim against, it is important to consider the likely ability of a Defendant to pay compensation in the event the claim is successful, and the extent of the insurance cover they have in place. This is a particularly relevant when pursuing a claim against a doctor who works privately, as their insurance providers may, depending on the circumstances, refuse to provide cover under the policy in place or try to argue that the insured’s actions have the effect of invalidating the policy.

Where the alleged negligence occurred after April 2019, claims brought against GPs now benefit from state indemnity through a body within the NHS called NHS Resolution (the equivalent body in Wales is called NHS Wales Shared Services Partnership, or NWSSP).

Emmalene Bushnell