"My labour and delivery experience"

About: King Edward Memorial Hospital / Community Midwifery Program King Edward Memorial Hospital / Maternity

(as the patient),

I came into KEMH after my waters broke as I tested positive for GBS (Group B Strep) and thus required an antibiotic drip for the remainder of my labour. The attending midwife explained that as I was only 3cm dilated, a doctor would discuss with me the possibility of using oxytocin to induce my labour further. I consented to the hormone drip.

I’d planned to labour without an epidural, and requested nitrous oxide gas once my contractions began ramping up. I remember being told by the midwife that my contractions were increasing in frequency but that the duration wasn’t becoming longer. As I was in constant pain, I was instructed by the medical staff to continue breathing in the nitrous oxide. The gas made me feel like I didn’t really know what was going on some of the time. I’d chosen gas as a pain relief method because I wanted the opportunity to stop with it if I wished, but because the pain was so intense after I was induced I didn’t feel I was able to stop.

At some point, a doctor came in to break my waters further. I don’t doubt that I gave verbal consent for this, but as I was not fully aware of what was going on due to inhaling the gas, I do not remember discussing the procedure with them or having any risks explained to me. I didn’t know until later that an instrument was used to break my waters. Ultimately, this resulted in several deep scratches/cuts at the top of my baby’s head. I do not believe that I was warned that this might happen.

After the delivery, my partner noticed the scratches on our baby’s head and asked the midwife who delivered our them, what they were. They said that it was just dried blood from the delivery. Later, my baby and I were admitted to Ward 3. One of the midwives on Ward 3 noticed the scratches and asked me what had happened during the labour and delivery to cause them. I told them that my partner and I were told they weren’t scratches, that it was just dried blood. The midwife said that they were definitely scratches and suggested I have the paediatrician check them before we leave the hospital. The paediatrician looked at my birth notes and confirmed that the scratches were from the procedure where my water was broken.

I wanted to make a note of this incident as it was fairly upsetting to my partner and I that our baby was born with these scratches/cuts on their head. Though the paediatrician confirmed that the scratches are not infected and that the baby is okay, even the midwife who noticed them told me that the baby could be in some pain from the scratches. I also do not feel that I gave my informed consent for this procedure to happen due to the gas I was inhaling and the possibility that I wasn’t actually warned that these scratches/cuts could happen.

I would also like to make a note that while my baby and I stayed at the hospital in Ward 3 after the birth, I was advised that it might be a good idea to give the baby a formula top up on their second night, due to them not settling and second night syndrome. I had planned to breastfeed the baby, but as they were quite large at birth and my milk had not yet come in, one of the midwives suggested that my baby was overly hungry. They offered to weigh my baby to see if they'd lost enough weight to warrant a formula top-up. Before giving them formula the midwife advised that they’d lost 9% of their body weight already. I agreed to the formula top-up thinking that the weight loss was severe and formula was necessary.

The next few days my baby was pulling away from the breast and seemed to be expecting formula. I continued with the formula top-ups in the hospital as per the guidance of the Ward 3 midwives. However, also under the guidance of the Ward 3 midwives, I also persisted with trying to breastfeed, hand express, and pump to help make breastfeeding a possibility.

I was taken care of by MGP 5 antenatally, during labour and delivery and postnatally (see story here). When they visited us at home after we’d left the hospital, my primary midwife explained that my baby’s weight loss wasn’t actually significant enough or at such a stage to warrant formula feeding in the hospital.

Responses

Response from Jodi Graham, Executive Director, Women and Newborn Health Service 2 weeks ago
Jodi Graham
Executive Director,
Women and Newborn Health Service
Submitted on 09/11/2020 at 15:59
Published on Care Opinion at 15:59


picture of Jodi Graham

Dear KEMH patient,

Congratulations on the birth of your child, and many thanks for your feedback. We are always interested in hearing from our patients and their support people about their experience with our service. At KEMH, we endeavour to provide all of our patients with exceptional care, and a positive birth experience and I am sorry that you feel your experience on the Labour Ward of KEMH was not a positive one.

I am sorry to read that your baby suffered abrasions to their head due to the use of forceps during your delivery. As you may be aware, forceps is an instrument used to help deliver a baby when assistance is needed, to gently guide the baby out of the birth canal. I understand the hope that a mother has to be able to deliver their baby naturally and that it can be disappointing and worrying when, for safety reasons, other options have to be considered. The use of forceps is a decision that a doctor or medical team has to make, and your obstetrician or midwife should discuss with you the reasons for having an assisted birth. I am sorry that this did not occur in your case. There is a risk of injuries caused by forceps, though most injuries are minor and will resolve with a bit of time and healing.

I am sorry that you feel you were unable to give informed consent for the assisted delivery of your baby. Here at KEMH, informed consent is taken very seriously and we would like the opportunity to discuss this important issue with you. Should you wish to discuss this further, the KEMH acting Head of Department for Obstetrics would like to further investigate your concerns so that a more specific response can be provided to you. The KEMH Consumer Liaison Department can be contacted on (08) 6458 1444 to arrange this.

Breastfeeding can be sometimes challenging and I am sorry that you were provided with conflicting information regarding your baby’s weight. I am glad to read that with your determination and perseverance along with the support from the Ward 3 midwives, you were able to make breastfeeding a possibility for you and your new baby.

I would like to thank you again for taking the time to provide your story with me. Feedback like yours helps us to continue to improve the service we provide to the women and families in our community. I wish you all the best for the future.

Regards

Jodi Graham

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Update posted by KEMH patient (the patient)

Hi there. Thank you for your reply. However, my story was not about a forceps assisted delivery. The procedure I wrote about happened prior to delivery, and I did not have a forceps assisted delivery. I would appreciate a response in regard to the damage that occurred due to the procedure that took place.

Response from Jodi Graham, Executive Director, Women and Newborn Health Service 2 weeks ago
Jodi Graham
Executive Director,
Women and Newborn Health Service
Submitted on 13/11/2020 at 12:27
Published on Care Opinion at 12:34


picture of Jodi Graham

Dear KEMH patient,

Thank you for your reply and for pointing out that the abrasions that your baby suffered were as a result of induction of labour, not due to an assisted delivery. I would like to again apologise that this happened during your labour experience at the King Edward Memorial Hospital, and I apologise for the error in my response.

Informed decision making and the process of providing informed consent is an important part of the care provided at KEMH and is taken very seriously. It is important that our patients are aware of the benefits and risks of the options that they are provided during their care so that they can decide what is best for them and their baby. Should you feel comfortable, I would like to encourage you to contact the KEMH Consumer Liaison Department on (08) 6458 1444 so that a discussion with the KEMH acting Head of Department for Obstetrics can be arranged. We would like to further investigate your concerns so that a more specific response regarding your and your baby’s care can be provided to you.

I apologise again for the error in my response and hope that you will contact the service so that this issue can be investigated for you.

All the best,

Jodi Graham

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