"Traumatic birth"

Antenatal care

•Almost every time saw different midwife or obstetrician. I felt no continuity of care.

•I have POTS, Chronic Fatigue, Joint Hypermobility, anxiety, depression and PVCs (began during pregnancy).

•One obstetrician told me I should get an epidural to manage my heart rate due to my POTS. Don’t believe this was recorded anywhere.

•On my discharge summary is only anxiety, depression and hyperthyroidism (I don’t have hyperthyroidism).

•Never asked what my birth plan was, except during labour when I said “early epidural”.

• I believe early epidural for POTS is advised.

Admission

•Before birth, it was noted that my iron was very low. Midwife said Dr. would never give me an infusion at 26 weeks (too early). I self-sourced a different clinic who recommended and gave an infusion late last year (important later).

•When I called from home I recall I was told being at 5-1-1 was not enough to come in, needed to be at 3-4 contractions, lasting a minute, within 10 minutes.

•Came in much later than I would have liked, already in significant pain.

•Overheard midwife complaining that everyone comes in at once.

•After hours of waiting and in pain was told to go home because pain was due to UTI (which - it turns out - I didn't have). Was given a script for Cephalexin for it.

• Told my contractions needed to be ‘more intense’ before I would be admitted. I was unable to walk and being dropped to my knees with every contraction.

•I refused to leave. I was in immense pain, knew it was coming and felt sheer panic at the thought of going home. In addition I was now meeting their 3 contractions in 10 minutes criteria.

•Midwife in triage came back and said it was my lucky day and I could be admitted because it was quiet but I was probably going to be sent home anyway.

Birth

•Was only offered gas for pain management, despite early epidural being part of my birth plan due to pre-existing heart/blood pressure condition. However I was offered was a mat on the floor to protect my knees.

•I found one midwife was dismissive, condescending, and essentially told me I needed to learn to breathe through the contractions, this was normal. They told me they gave birth to their kids without pain relief.

•Repeatedly told me this is my first labour and it will likely last days.

•It seemed they ignored me mentioning POTS.

•I requested morphine but I believe a senior clinician scared my partner away from it by saying they would hate for the baby to have to be resuscitated in Intensive Care.

•Was very clear to me they didn't believe the amount of pain I was in and I believe they thought I was exaggerating.

•Eventually they offered endone, barely took the edge off.

•I was in so much pain I was suicidal at this stage, wanting to smash my head on the floor.

•I felt a senior clinician kept gatekeeping the epidural, telling me a doctor will never approve it because I wasn’t dilated enough.

•After pushing more on the senior clinician, was able to speak to the Dr who advised they could give an epidural, but it might prolong labor.

• Finally had the epidural, this is when they started monitoring both mine and the baby’s heart rate.

•Baby’s heart rate was hard to monitor, was dropping in and out so was advised that I keep switching sides. This continued for a few hours.

•To get a better measurement a different monitor was going to be attached to the baby’s head. It was then I believe they were clearly surprised to discover I had dilated much further and the head had progressed significantly.

•Contractions grew more intense, and there was evidence of foetal distress. Baby’s heart rate was dropping with each contraction so decision was made at 9am to get a vacuum.

•I was advised to start pushing as they were getting the vacuum ready. Because of distress Dr decided to perform an episiotomy, though I felt my baby was making plenty of progress.

•As soon as the Dr. performed the episiotomy, the baby was born. I lost 1.5 litres of blood.

•Baby had cord wrapped around neck twice. How long were they in distress for? My baby was only monitored after the epidural, and it seemed to me like the Drs had no idea that this was the case.

•Baby was in OP position and that could have been why the contractions were so intense, I believe it’s possible the epidural actually moved things along.

•POTS and joint hypermobility is associated with a precipitous labour.

•Not sure why I had an episiotomy given that labour was progressing and the baby’s heart rate issue seemed to be happening the entire time. I have read that episiotomy’s are not routinely done anymore and are often worse than natural.

•No debrief whatsoever.

•I heard a midwife say in regards to my blood loss that’s because of the doctor.

Post Natal

• My partner couldn’t be there past 8pm. I recall the midwives were barely around. I couldn’t walk properly because of the episiotomy, was light headed every time I stood.

•Pain management was inconsistent and insufficient - had to request it or it was forgotten. Was attempting breastfeeding sitting up on wound - the only way I was shown.

•I had symptoms of blood loss. There was endless to-ing and fro-ing about either an infusion or a transfusion. Eventually was discharged with neither, and told to take supplements.

•I was never offered a lactation consultant, despite having pain and issues with latching.

•Have since discovered that baby has a lip and a tongue tie and it impeded their ability to latch and feed.

•Had to be the one to follow up regarding my UTI, was told different things from different people. Home nurse clarified the test was negative.

After effect

•Not long after the birth I went to the hospital for unrelenting heart palpitations. Discovered my iron dropped from 80 to 4 after giving birth.

•I feel I have anxiety/PTSD from the experience, I care for my baby as best I can but still worry this had also had an impact on them.