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Concerns about childbirth

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firetracie | 22:30 Thu 27th Nov 2008 | Health & Fitness
15 Answers
My daughter is expecting her second child on 18th December and she's getting really upset at the moment.
Her first baby was overdue. She was left until she was 12 days overdue before being induced. Baby was born face up, suddenly went into distress, no heartbeat and a large episiotomy had to be performed because they said they had to get him out NOW! He weighed 9lb 14oz. Her recovery was difficult as the cut was performed in haste and the way she was stitched wasn't good and caused her many problems in the months following.
This baby is charting at more than her first. But, because she is tall (5ft 10in) , her midwife tells her it's 'acceptable' for her size. Because of the intervention she had to have last time she is becoming increasingly concerned that she will have to experience it again. She just doesn't want to be left until she's nearly two weeks over and have to go through the same again. She's asked her midwife if she could be induced within 48 hours. Her concern is that he's just going to keep getting bigger she will struggle to deliver him without the same intervention.The midwife says if the baby's ok and there's no physical medical concern then there's no need to do anything. But I feel her psychological concern and what happened during her first delivery is enough for referral to a consultant obstetrician for discussion. She has been told that only her midwife can make that referral and her midwife won't.
She doesn't want to be delivered early - she just doesn't want to go over 2 weeks.
Does anyone know what her rights are? What she can reasonably expect or ask for? Can she insist on a referral? If she does she's worried that her midwife who is likely to be present at the birth will treat her differently. She feels so upset because no-one is listening to her fears and concerns. If anyone has any advice or experience I'd be so grateful.
Thanks in anticipation.
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she needs to talk to someone, maybe her midwife, so express just how distressed she feels. there must be options.

I do feel for her. my first was 10 days over and weighed 9lb 7oz, and I'm only 5'3! but... the second was only 8lb 1oz and arrived a day early. they do say that the first is more likely to be late, so maybe that's true.

I do think she should have a back up plan if the baby doesn't arrive within a couple of days past the due date. tell her to behave like a mad woman, that usually gets some attention :o)

The poor thing!

Has she explained to her midwife how strongly she feels and why?

Could she speak to her GP and get them to speak to the midwife.

You might get some quicker responses if you post in the pregnancy section as well.

I hope everything goes well for her and baby x
Question Author
Thanks so much for your responses. Her midwife is unresponsive to her concerns and she's worried that if she bypasses her she will be treated badly subsequently.

jen - where's the pregnancy section? I didn't see that.
Question Author
Hi sara - I also feel that she needs a back-up plan because I know if she gets to her due date and nothing has happened she's going to be in bits. It may not be necessary - as it wasn't with you - but just knowing that there's an option will make so much difference to her state of mind.

She's got off the phone in a huff tonight because I've been saying you need to insist and you need to demand - and she's said there's no point because nobody's listening to her and nobody's interested in how she feels so she might as well just give in and accept it will be the way they want it to be.

Sorry, but I've had 2 kids and I never felt like that and if she feels like that then someone, somewhere is failing her - in my opinion.
Pregnancy section...

http://www.theanswerbank.co.uk/Family/Pregnanc y/

Your daughter may be able to get some nice support in there as well.
oh your poor daughter, I think 2nd babies scare us because we have the 1st birth to remember, but not all births are the same.

To answer your question, i would suggest that she speaks to her GP and asks if they can refer her. Also ask the midwife for a stretch and sweep on her due date (or as near to as they can).

she should be entitled to see a consultant at her request, Ive heard of women being offered C-sections through fear of giving birth so they must hear her out and help her. If she gets no luick with her GP then maybe a call to the hospital will help her cause.

if it helps any it does sound as if perhaps babys position was the reason for the problems rather than weight last time around. There are ways to try and get baby to be in the optimum position which she may try to help reduce the chances of this baby being back to back.

at 5'10 a baby of 9lbs 14 at 42 weeks is probably quite common and normal. Im 5'6 and had my son 17 days overdue and he weighed 9lbs 6oz. He was a 6 hour labour but got stuck after hios head was born. I was all ready (and scared) to go through it all again and yet when his sister was born i was in labour less than 2 hours and she didnt get stuck at all. She also weighed 9lbs 6 but was born at 40+3 after a very thorugh swepp by a consultant 2 days before.
Your daughter should request a n appointment with an obstetric consultant. She is entitled to it! I can really sympathise, as my son was a difficult labour, and due to meconium aspiration I required an emergency C-section.

As he was very unwell I've already had a follow-up with my consultant, and have told him that if I do have any more children I will be requesting an elective C-section. He's perfectly understanding about this, and has reassured me that my next labour will, in all likelyhood, be perfectly normal. But he also understands that it will be an incredibly anxious time!

The midwife should listen to your daughter, and make a referral, even if it's just to discuss options!

Perhaps your daughter would benefit from you going to her next midwife appointment. It's easy to be railroaded into decisions you don't want when you are on your own. However, if you are there to support her they may well take some notice!

Alternatively, she could write a polite letter to her midwife requesting a referral to consultant, which will have to go in her notes! In which case, they may take a little more notice! If she's open to the idea of an elective C-section, she should write in the letter that she wishes to discuss this with her consultant.

Good luck!! I hope she gets somewhere!!
i know i go on about it all the time, but this is the kind of thing the local patient advice and liaison (PALS) service deals with - queries and concerns about what you are able to expect from NHS services. they can often mediate on your behalf, and car is not compromised if PALS has been used. you will fnd their number on your local PCT website, or in your phone book
car is not compromised?? i mean of course care is not compromised!
Question Author
Hi sar, jen and red

Thank you so much for responding to my question. I was worried that I'd get nothing back and, although it concerns my daughters experience, she is still MY BABY, despite being nearly 30 and expecting her second child! lol

I know that all she wants is for someone to take her concerns seriously and for a contingency plan to be in place should she not deliver within a couple of days of her due date.

Thanks red for your reply. I know that what you describe is the norm for second births. They're generally easier and quicker and I hope that her second experience will be the same. But she needs to know that if it doesn't happen that way she has an option. And right now no-one is giving her that option - or, which I think is atrocious - is even prepared to discuss a birth plan which she feels is acceptable. Tonight, talking to her on the phone, she's kind of given up. She's said that no-one is interested in her - as long as baby is ok she's incidental! How awful is that.

She had a sizing scan today and was told by the doctor who was at the scan that he was going to be big and if she wanted to discuss options she could be referred by her midwife to a consultant. Then the midwife told her that there was no physical reason for referral, consultants were too busy dealing with genuine medical problems and no-one would agree to see her! So she's thrown her hands up in surrender and cried again tonight in the belief that she has no choice.

Can she demand a referral? Surely her state of mind is a medical reson for consultation? She's worried about alienating her midwife who is likely to be there at the birth and that it will change the way she is treated. Understandable, but if it gets her peace of mind now I think it's worth it.

What I really want to know is that - if she insists on being referred is her midwife obliged to do it?
lol you need to ask the PALS service - they can find out for you - anonymously if you want
she really shouldn't be allowed to get so upset whilst pregnant.

I reckon she should go to the hospital, sit down and refuse to leave without someone addressing her concerns. go with her, or see that she takes someone who can remain calm but assertive. take a packed lunch!

btw, as my first was big they tested me for gestational diabetes the second time.. which produces big babies. my test was negative but it's worth bearing in mind if she's mad enough to do it again :o)

Question Author
Thanks elgin and bedknobs. Your answers are great.

My daughter was too far into labour for c-section to be an option last time hence the emergency episiotomy and subsequent trauma.

And I'll definately visit the PALS website and see what we can get from there.

Can't thank you all enough. Love and thanks
Question Author
Hi sara

Yeah, they had the same thought re the diabetes after her first so this time she was tested and found borderline. So she had to go again and was negative thank goodness.
if the doc at the scan said she can be referred if she asks then she should tell the midwife that. If the hospital is busy they will still try and get her in.
Is there another midwife available that she can transfer to?
bednobs suggestion is great, talk to PALS.
or call the obs ward and ask if you can get an appt direct, lie if necessary and say you cant contact the midwife and being so close you dont want to have to wait for letters to be sent etc.
All this stress is certainly not going to help her, a mum needs to relax in these last few weeks and prepare for birth, not be worrying about who will go through her birth plan and an obstinate midwife.
I really feel for her, and you as i can see how much you care about her, what a great mum you are x

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