Advice needed - forceps recovery!

[EDmummy]

It has been incredibly interesting to hear from the professional end of this discussion. Thank you very much SBryan and sillywoman. I really hope that this information/advice helps other expectant mothers. I was pleased that my midwife (Oakwood) helped me stick to my guns as I healed superbly even though I did end up having two 3rd degree tears. I am perhaps one of the lucky ones to have no lasting effects.

SBryan, you advice about pelvic floor exercises is spot on!

[redemily222]

Obviously this touches the hearts of many women. Some words of reassurance for you. I had chronic SPD with the pregnancy of my first child 4 years ago now. I couldn't walk as my pelvis had over relaxed and had to resign myself to giving birth lying down with no movement whatsoever. After a 2 day labour my son was eventually born in theatre via forceps delivery. My legs were put in stirrups and i consequently couldn't walk for 2 weeks - I couldn't actually put one foot in front of the other. The episiotomy took so long to heal and eventually, at 6 months post birth, i found that i had mildly prolapsed in both bladder and rectum which was what was contributing to the feeling of laying an egg!

No doctors seemed to be able to diagnose quite what was wrong so I went to see a gynaecologist who sent me to a physio at Kings. I was put on an intensive programme of pelvic floor exercise and the results were astonishing. It made me realise that post birth after care really is appalling and that (especially with episiotomy) there really should be some form of follow up. I know too many women who have suffered the long queues of the perinieum clinic at Kings, only to be put on intensive pelvic floor exercise regimes.

Finally, after 2.5 years i felt as though i could go through another pregnancy and what with exercise throughout and an hypnobirthing CD, I had the most incredibly fast and natural birth without so much as a tear. One hour from start of contractions the very active astonishing birth of our baby girl. There is hope I promise you and after being a birth scare story monger, i really do feel as though i could do the whole thing again now.

Hold on in there!

[chiquita83]

really useful debate!

[born&brED]

I can't tell you how useful all this information and advice has been - I haven't come across many people who have dealt with a forceps recovery (or similar), so I'm amazed at the response to this! I really am feeling much more positive about it all now.

Thank you, SBryan for all that really useful information. Now I understand why medical practitioners may advise or even demand an episiotomy. I had heard that they cut away from the perineum towards the thigh in order to avoid a 'front to back' tear (yikes!). It really must be dreadful to witness severe tears when a woman has refused something that should take a shorter time to heal.

At the same time, I can also see the point EDmummy is making - maybe you were lucky! About your midwife backing you up - I guess that really did help and encourage you. The Oakwood midwives were only available for home birth the night I had my son due to staffing issues, and, although I stayed at home for the first 25 hours of my labour (including 2 visits form them and using a birth pool, I was so mortified at my 1cm every 7 hours progress, and so in pain, I took myself off to Kings. Luckily I had an absolute angel of a midwife who was just amazing for the next gruelling 21 hours, but I did miss having an Oakwood midwife there, after doing my birth plan with them! I do wonder what may have been different - maybe nothing at all!

Redemily222 - more encouragement - thank you so much! I'm so happy to hear about your wonderful 2nd birth (and so quick too! I think the length of mine was the worst part). I completely agree about the lack of after-care for women who've had instrumental births. Why not cut that perineum clinic queue and offer the pelvic floor programme at the first post-natal check? My midwife did tell me to do them, but I thought that was just a routine thing and not for me especially. Does anyone know where I can get hold of this programme (hmm, without the queue, ideally!)?

Thanks for mentioning the perineul massage, Molly - I'd love to know the answer to your question. Anyone got any advice regarding it. Anna_r - i really hope the birth of your next child goes well - here's hoping for no (or little) tearing!

I really hope that expectant mothers read this too! I'm already planning what i'll be doing next time round!

Thanks again everyone!

[SBryan]

Hi,

I'm glad you found the info useful. It's nice to be able to help, particularly as I'm on mat leave at the moment so just used to being Mummy. Sorry I haven't been able to reply earlier.

born&brED, it sounds as though you had a long and difficult labour, and it will take a while to recover, both physically and mentally. The good news is that subsequent labours tend to be much quicker, as the body remembers what to do and how to do it, so the experience is very unlikely to be repeated. Antental perineal massage can help to prevent tears; not always(!) but its a free, easy thing to do and doesn't do any harm, so I'd certainly recommend doing it. There's a wealth of information online about it.

There's no evidence that things like Mamasure are any better than pelvic floor exercises, and they're free! You do have to do them every day though, and properly. If anyone has any stress incontinence post childbirth (when you run, cough, and sneeze) then don't suffer in silence.... see your GP who should be able to refer you to a pelvic floor clinic, or classes. They're run by physiotherapists or specialist nurses (although I'm not sure about King's as I work in North London) and there's an incredible number of women attending them; you're not alone. It's good to do these things now, when you're young, as after the menopause things often get worse, by which time you've been suffering a long time. Please don't be embarrassed, gynaecologists are extremely used to seeing these problems, it's what our job is all about!

And, lastly, 15=20% of women have an assisted delivery, so there are lots of people out there in the same boat, you're not alone (and 30% have a caesarean, the antenatal classes paint a very rosy picture of childbirth indeed!).

[ludoscotts]

hi I would say if you are still getting pain/discomfort 6/7months after the birth def go and see the doctor.

I had a 2nd degree tear and had quite a few stitches.

A year after the baby was born I was still in discomfort, was ok day to day but If I touched the area it was tender, and using tampons or intercourse was a real no-no! my poor husband had to wait until I was drunk enough to give it a go and I would spent the next day in pain.

After a year I had to get over my embarrassment and go and see the doctor. After being refered to kings it turns out the I was sewn up too far leaving a ridge of skin over the opening which was causing the pain.

It took till my daughter was 22 months for all the appointments to come through and I had a small op to open the area back up and get it re-sewn.

after a few weeks to let the new set of stitches heal I was all sorted- no pain as it should be.

It really is worth going to see your gp and just see as it took 10 months from the first appointment at the doctors to the operation.

I wish id gone sooner.

Also if your gut feeling is that there is something wrong stick to your guns.

The first doctor I saw said about the stitching being done too tight and he said just wait until you get pregnant again and you will tear again and we will sort you out then!!!

As demanded to see someone else as there was no way I could try for a baby with the pain I was in so that was never an option.

in the end all is fine and we are trying for baby number 2 now but stick with your gut feeling, dont be embarrassed and look after yourself.

hope it all gets better for you soon

[The Nappy Lady]

SBryan,

I think every woman should have someone like you in their close group of friends, thank you so much for the words of wisdom.

:))

Molly

[Ann]

I agree with all the recent posts.. To anyone soon to have a baby, it really isn't appropriate to refuse an episiotmy at all costs.

My second baby was a forceps delivery following previous C/S for breech presentation. I was delivered by Maggie Blott who was then a Senior Registrar, most of you won't know what a brilliant Obstetrician she is ( she no longer works at King;'s) . My cut was extensive but it healed well; God knows what mess I would have been without a cut. I felt the right decisions were made for me at the time.

What no-one could have foreseen (including me) was the resulting haemorrhoid situation, I did not look human!

That said it did all clear up over the weeks and more importantly it didn't stop me enjoying my newborn son.

[sillywoman]

SBryan Wrote:

> And, lastly, 15=20% of women have an assisted

> delivery, so there are lots of people out there in

> the same boat, you're not alone (and 30% have a

> caesarean, the antenatal classes paint a very rosy

> picture of childbirth indeed!).

Ahem!!!! Careful please SBryan!

Actually I do my best to paint as accurate picture as I can, with stats (Caesareans not yet 30% in any of our local hospitals thank goodness), and anything else I can think of to try and get across the reality of childbirth without sending My Mums & Dads screaming in horror from the room. I try to avoid 'rosy'& stick to facts, figures and evidence as far as possible.

[chiquita83]

Yes, heard the C-section rate is lower than that in this area - any idea what?

[born&brED]

haha! Well, whatever the figures, I now know I'm no loner in the assisted delivery boat!

Good news - went to see the doctor today (lovely lady GP to save at least some embarrassment!). She said pretty much what ludoscotts said she had (I think) - I have a ridge along the scar as it has 'overhealed.' So have been referred to King's perineal clinic - hooray! She said they are likely to try creams and possibly freeze-removing it first, then at a last resort might un-stitch and re-stitch. The prospect of that scared me at first, but having read what ludoscotts said, I'll be up for it if that's what it takes.

Husband's reaction: 'Is it a perennial clinic? So you have to return throughout the year then....oh no!'.

Thanks again for all your advice, ladies! Feeling so much more positive now.:)

[SBryan]

Actually, sillywoman, I didn't say it was a bad thing that antenatal classes paint a rosy picture. In fact, I attended them in my pregnancy for precisely that reason; so that my non-medical husband would hear a more positive view of childbirth to counteract all the medical horror stories he'd heard over the years. And to go into too much detail about complications would unnecessarily terrify most people. Besides, I'm not sure that any amount of theory can ever prepare anyone fo the realities of childbirth.

It was more a comment about the fact that, in spite of thinking they know what may happen, a large number of women and men are understandably shell-shocked after the event. NHS classes don't have the post-natal debriefing that NCT courses do, and many women feel isolated in their feelings as a result. Which is a shame, because the stats bear out how many deliveries are complicated by an intervention of one sort or another.

The c/s rate at King's is 24%. There are a wide number of factors which influence it; what proportion of women delivering there are having their first baby, the average age of the mothers, the percentage of twins delivered at the unit, the number of women wanting a c/s after having had a complication in their first birth (eg c/s or third degree tear)..... I could go on.

born&brED: I'm glad to hear you're feeling more positive, and good luck with the perineal clinic.