Wednesday 1 August 2012

And like that a victory!

Sometimes it is difficult to keep a positive outlook when it comes to clients birthing in hospital.  This was never borne out more than in a recent experience where a twin mum to be was bullied (and no I'm not being emotive) and harassed from 25 weeks pregnancy.  Which charm school do some of our Consultants, Registrars and Midwives go to?  I would be living such a carefree and monied life if I had a pound, just a single pound, for every time I hear that a pregnant woman has been told 'Do it my way or your baby(ies) will die'.  In the case of my twin mum her babies had to be delivered at 37 weeks or they would die.  At 38 weeks it was increasingly more likely that they would die.  She declined induction and caesarean section.  Her babies were happy, moving nicely, her placenta was good and her fluid levels were high.  And yet every appointment she went to, she was told 'your babies will die'. 





Is fear really the way to get pregnant mums to agree to hospital decisions?  What happens when that same fear that hospitals breeds cause pregnant women to hide away with their unborn babies?  What happens to those babies that actually need a doctor to help with their birth?  Scaremongering? Me?  Well surely it is the new language of birth?  I've watched bits and pieces of One Born Every Minute and then I had the misfortune to tune in to The Midwives (which is another birth reality programme) and I hate them.  I really and truly hate them.  Fear on the screen.  The air turned blue as I watched an experienced midwife, who in her own words had attended 1000s of births, tell a young woman that she felt that this would be a quick labour and then offered diamorphine.  Now when women talk through their pain management options, they are told that pethidine or diamorphine shouldn't be given in the final 4 hours of birth because it can compromise the baby.  Sure enough, the baby is whisked to the resuscitaire because of the affect of the drug.  I'm not a midwife (and frankly this wouldn't encourage me to become one) but even I know that there are other ways to help a woman manage her pain when the baby is coming fast!






So back to my twin mum.  Despite all threats of dying babies, she remained strong and waited until she went into spontaneous labour at 39 weeks and 2 days.  And man did she labour beautifully.  Not a sound.  Barely raised the level of her breathing.  At one point a consultant came in and said 'Ooh I hear you are 3cm.  I'll pop back later and get some synto up.  We don't want you still hanging about at this stage tomorrow'.  My lady declined.  No indication for rush, babies and mum perfectly happy.  Despite getting to 10cm, the birth ended with a double forceps. Twin 1 was in an awkward position and not pressing down enough on the cervix for her to push him out, plus there was some meconium.  I do wonder if the midwife breaking her waters at 9cm had anything to do with that.  So having survived weeks of bullying, one might imagine it was plain sailing from there.  I regret to say.. nope!  There was another level of bullying to come.  There's something about a smaller twin isn't there?  Just causes panic and protocol driven measures.  Blood sugars galore.  He was born under 6lbs (wonder what he would have weighed if the hospital had its way at 37 weeks) and his brother was over 7lbs.  She was told that she would have to supplement as there wasn't enough breastmilk to get his sugars up.  Mum wanted to express but was told by the midwife that it was too early to express and not worth it.  Despite all of mum's efforts to exclusively breastfeed, the pressure was on to give formula and it was constant.  When mum and dad said that they wanted to discharge themselves they were told that the police and social services would be called.  They were sufficiently frightened enough to do as the doctors wanted in order to get home.  Dad told me that he was afraid he'd never be able to bring his family home (and in fact didn't believe it until they had shut the front door behind them).






So, where is the victory I mentioned in the title?  Little twin, twin 1, struggled with breastfeeding.  Mum was breastfeeding twin 2 and feeding twin 1 expressed breastmilk in a bottle.  The victory was the first breastfeed, since birth, by twin 1.  It's not all sorted yet, but he's getting there and both boys are gaining weight.  My client has told me that she will never go to that hospital again should she become pregnant again.  I don't blame her.  They fought her till she broke.  The best time was during labour with the most gorgeous of midwives who wasn't worried that there were two babies.  Strange to think that that was the most peaceful time.


My crazy pair

4 comments:

  1. Hi Mars, I think I saw the same programme as you
    last night where the midwife offered diamorphine. I thought,but I may be wrong, that the midwife offered the drug so late on because the mother was in alot of pain from an old injury? I don't know enough about childbirth to know whether there is a better alternative. From what the programme makers showed the mother was only given this option. It was an old pelvis injury I think? But it was very late and unable to sleep I was only half watching. Interesting stuff though. As a member of the public I thought the programme was good, in that it did tell mothers to be to go straight to hospital if the baby stops moving. I did experience some scaremongering when I had my first child, "He will be very tiny" blah blah blah, but being an extremely laid back person I chose to ignore it, he was a healthy 6lbs. Same weight I and his dad were! xx Loveday xx

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  2. I agree that it was good that mothers were told to get straight to hospital if baby stops moving, though I would hope that that is made clear at antenatal sessions. Some of the practise, ie the casual dismissal of the mother expecting her 5th was terrible. Any good midwife will know that a mother who has had at least one child before will recognise the signs in her own body.

    To give diamorphine so late in labour, knowing that the baby was imminent is still, in my opinion, a terrible decision. Water could have been offered as another option or if the pain was that much, a spinal/epidural could have been offered with much less of a risk to the baby.

    Sadly, 'good tv' equals horror stories. There were so many 'scares' in it and if midwives can't treat women with care and respect, they ought not be in the profession.

    Yes... this is one of my bugbears. So despite my rant... thanks for reading and commenting.

    MammyDoula (Mars) xx

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  3. UPDATE: Twin 1 is now mainly breastfed and is no longer keen on the bottle. Mum is over the moon. :D Well done that boy!

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  4. I had gestational diabetes with my little baby. At the 36 week mark I was scanned and it was found that the baby was on the big side for this time. I also had a meeting with a doctor who said they wanted to induce at 38 weeks, as the gd meant a higher rate of the baby being still born. Luckily I have a very supportive partner, and I also had a fabulous doula who supported me in my choice not to. Once I had had this conversation, and agreed with them that I would be induced at the 40 week mark, there was NO follow up with me - so much for how scared they were about still birth!

    In the end my beautiful little baby was born naturally in a relatively quick delivery with no complications (aside from some natural tearing) at the 38 week mark anyway.

    Oh, and she was actually a little on the small side anyway - 6lb 1 oz. So much for it being a big baby.

    Anyway, I could go on at length about issues I had with the hospital support at the delivery (my doula and I had to remind them to delay cord clamping, as they seemed to want to rush us out... being told to push BETWEEN contractions... being offered drugs for 3rd stage after a very smooth and drug free 2nd stage)... but I wont.

    I'll just say it pays to be an informed Mum, and that I love what you guys as doula do and support. Keep up the good work!

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