How unlucky was I?

That is terrible. Yes a bad nurse can really break you during labor. My first was awful but I didn't know you could ask to switch. The second time I requested a nurse who had checked me who was super sweet.
 
@deborahs757 This. I had a very traumatic first birth and opted for an elective c section the second time and it gave me so much peace of mind leading up to delivery. The delivery was a very positive experience.
 
@daphne1 I apologize if you already did this or thought of it, but I really recommend making an appt with your OB and going over this list. I had a complication with my first labor and delivery that if I knew it would happen again I wouldn't have had more kids. My doctor told me in her entire career she's never had a mother have that complication in other deliveries. She was right and baby #2 came super fast and with 0 issues. If you have a great OB you trust they should be able to help you with this. Best of luck ❤️
 
@joegibson Definitely this. My OB literally went “so we’re not doing that again right?” As his opening statement in my follow up as his recommendation that I not get pregnant again. (I (literally) almost died 2x. Both circumstances were rare but repeat stats have limited research. So he was just like Nope).
 
@joegibson Thank you for the suggestion. I actually did this, and the OB reassured me that second births are usually easier, but I was left with the impression that from her point of view everything had gone well and kind of that I was being a bit of a drip in finding it so difficult to get over things (although PPD may have influenced how I saw this conversation).

She actually said that sometimes they need to threaten forceps (which sent me into a frenzy of screaming and crying and still gives me flashbacks) to get the mother to push properly.

The whole thing kind of made it seem like it wasn’t so bad and therefore was likely to happen again.
 
@daphne1 Labor and delivery nurse here. I don’t know all the details of your case, but I’ll give my impression based on how you’ve described it.

Nurses, midwives, and doctors see lots of complicated cases. By that standard, your experience is not super uncommon, nor does it sound like it was particularly dangerous/life threatening for you or your baby. For example, your baby was born at term, vaginal birth and not surgical or instrument-assisted birth, no underlying medical issues like high blood pressure or diabetes, no infections, hemorrhage, or NICU stay. (At least, none of those things were mentioned.)

However, that doesn’t diminish the fact that it was a frightening and traumatic experience for you, and your doctor shouldn’t make you feel wrong for feeling that way.

The vast majority of second births are significantly easier and shorter than the first. Your experience could have happened even without an epidural, and it can be hard to know why progress was so slow. Many times it’s due to the baby being in a wonky position. With PROM, the baby’s fluid cushion is gone meaning they have less wiggle room to get into a better position. That could also explain why your uterus seems to have been working so hard right from the start, to turn baby to the correct position. I’d recommend looking into Spinning Babies and optimal fetal positioning if you become pregnant again.

I wouldn’t necessarily let your experience sway you against having another child, or getting an epidural again if that’s what you decide to do at that point. If you do want to try without an epidural, I’d highly recommend getting a midwife (they do practice at hospitals!) and a doula to help you get through natural labor.

As for tearing, you might tear again (often a tear will form along the line of the preexisting scar tissue) or you might not. For the prolapse, I’d look into pelvic floor physical therapy.
 
@fernandosn This 100%! I had GD and preeclampsia and my medical team was very supportive (doula and OB). They did all the physiological supports and in my case, I avoided a tear on a vaginal delivery.
If you want to do this again, I highly recommend a doula. And seeing a maternal fetal medicine specialist - that second opinion helped when I was told my kid would be stillborn/IUGR.
Have a healthy 14 month old and I may have another.
 
@daphne1 I had a very similar conversation with my OB after birth. I told her that while my experience was just a blip to her, it was the worst day of my life and colored my entire experience of motherhood from the start. I truly do not think she cared. To them, a bad birth = mortality. They don't see the unintended, sometimes life-long psychological consequences of other birth outcomes.

I assure you it is possible to feel safe and supported during birth -- I have talked to many people who did! -- and it sounds like we both didn't have that the first time. It means finding the right providers who you actually know and trust. I've actually been to two different midwives now trying to find someone who is the right fit for me next time, and who understands my priorities.
 
@daphne1 If you decide to go for another baby, my advice would be to try and resolve your existing health challenges as best you can and find the best prenatal health care team you can find - a team that would focus on your specific situation and and not probabilities only, both before and during pregnancy and during delivery. Because as much as I love and trust science and statistics, carrying and birthing babies is so darn important and so unique to your body and your baby - so important that someone who knows your history needs to be present and truly in your corner to create the best possible birth environment and guide medical decisions for you in that moment.

I always dreamed of having 3 kids. My first labour was similar to yours; I had four of the issues you had and two other ones. When I was pregnant with my second, I, too, read about probabilities, especially of a subsequent 3rd or 4th degree tear, and consulted with 2 OBs; it was concluded that probability of another serious tear was low (and I still believe it's true, it generally is low). Unfortunately though, no one ever assessed me before or during pregnancy, and I became one of the few unlucky ones to have a worse outcome in that second labour (but a perfectly healthy baby). Looking back now, there were signs the outcome I had was very likely to happen - if only my specific situation and not just generic likelihood/advice was considered before and during labor. (I did recover ok and went on to have a third baby via a Cesarean.)
 
@daphne1 I forget what the requirements are for each flair so idk if this will be deleted, but imo some of those things sound like a provider problem ("unsatisfactory progress", extended pushing, threatened forceps, possibly the tear). Did you ever look up the maternity stats for your hospital? I know sometimes you don't have an option of hospital but if you do it can make a huge difference. There's two hospitals near me and one has better resources for emergency situations but the other has much better maternal outcomes in general.
 
@junkyarder I didn’t really have a choice of hospital, unfortunately. I don’t know if it’s possible to check out these stats where I am, but I can definitely find out!

TBH I’m not super happy with my OB, but I think a lot of them would have made similar decisions. She is the one who followed me throughout my pregnancy, so it was nice to have a familiar face, but there was a bit of a personality clash. If I were to get pregnant again, I would try to push more to at least be heard.
 
@daphne1 Its such bullshit we have to advocate so hard for basic care when we are already in a vulnerable situation. I don't have any stats but I bet you could have had a better outcome with a more competent OB, especially if you had issues with her before the delivery. Might be worth it to do some "ob shopping" before trying again. Sorry you had to go through that.
 
@junkyarder Where I am (not the States) the attitude is usually that you’ll take the medical care given to you and be grateful for it. Shopping around for a provider is not really a thing unfortunately! Bullshit is definitely the word 🙃
 
@daphne1 from your profile it looks like Canada? Not sure which province but I'm in AB and you can "shop" around to an extent...if you know someone with a good OB/midwife, or see one on rateMD, your family doctor should be able to refer to them specifically (if they are still taking patients). but of course, you end up with whoever is on call day of.

another option- if you have a specific hospital you want to be at, they can't refuse you when you're in active labor (even if your OB isn't based in that hospital).

ETA for some of your other questions, you could also discuss some of these questions with an OB that may affect your decision. Like if you will be considered a high risk pregnancy and they might recommend c-section or induction after a certain time or something. They should be able to let you know your risks of these things in subsequent pregnancies, etc. Your prenatal care might look different as well.
 
@daphne1 I encountered similar issues with the delivery of my daughter, my labour was ok but my daughter was posterior and I didn’t progress past 9cm, I spent 5 hours pushing, then my waters were broken and she immediately went into distress and was pulled out with forceps and an episiotomy 15 minutes later. Because it was an emergency delivery there wasn’t them for anything but a local anaesthetic and I felt everything - it really really sucked and I couldn’t bare the thought of getting pregnant for over 18 months after.

A few things made me feel better about having a second kiddo - the first is that second labours are on average significantly shorter than first labours (half as long). this article has some very useful stats about second births (sorry im not citing scientific resources but the article itself is written by a professor of midwifery in Australia). It says that if you had forceps in your first delivery you have an 80% chance of an uncomplicated vaginal delivery and that posterior babies are more likely to turn for second time deliveries.

About a year after my daughters birth I requested my birth notes from the hospital- it really helped me put together what had happened and the clinical decisions behind my delivery.
 
@daphne1 We are going to try for a second because after we got through the early challenges (the whole first year) my daughter is a delight and I definitely want to give her a sibling. I had a very similar labor and delivery / postpartum experience, and our plan for our second is to have a planned c section. I understand there are risks associated, but feel that the risk of what I experienced the last time around is too high to leave up to chance. It is inhumane to let a woman push for 4 hours when she’s begging for a c section (not sure if you did but I definitely did). This time around I’m going to make sure I don’t have to go through that again.
 
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