how to get the best care during labour - Kings

[Lochie]

Hi Saila, I was also traumatised by first birth experience and so for second baby had a Brierley midwife - as per Sillywoman comment above, they maybe for you if you had a difficult first experience and became depressed as a result.

My second experience was so so far removed from first experience. I think the main thing to remember is you will never have the same labour twice. I was induced with both babies so had very medicalised labours however my second experience was much improved because:

- With Brierley you get a small team of midwives caring for you so you get contiuity of care. I cannot emphasise enough how pivotal continuity of care was in having a positive experience - they knew me and my previous birth issues and did EVERYTHING in their power to ensure the same problems weren't repeated. With my first baby (I was living in Sussex at the time so not connected to Kings) I don't think I ever really saw the same midwife twice during my pregnancy, labour, or postnatal care and so no one really ever had a vested interest in my care.

- COMMUNICATE all the time about exactly WHAT you are anxious about so that it is written in your pregnancy notes. When it comes to labour someone will be reading the notes and pick up on anything they can do to prevent similar problems arising.

- Be assertive about what you want and don't be frightened of saying so - even if what you want isn't the most natural of labours. I always maintained that I wanted an epidural and a second episiotomy if in hospital (despite fact this goes against Brierley ethos of natural birth). I did have to be really really assertive and go on and ON about wanting an epidural (they kept asking if I was sure grrr) - so maybe ask for one before you actually need one then if you change your mind at least you have asked early

- I had a large episiotomy with first child and was very very traumatised by it, I remember being in pain from it for about 6 weeks postnatally, so I really was so frightened second time around. I bought an EPI NO (there is a thread on this on the forum) and used it for a month or two before due date. Second time around I had to have a small episiotomy but it was in no way the same as the first time, it healed within a week, and I'd had a 9lb4oz baby - I do think the EPI NO had some part to play in only requiring a small cut

I am sure you will be fine this time as long as you express your concerns to your main point of contact (be it midwife or GP) early on. My experience at Kings was amazing, my midwife even managed to get me a private room as I'd been so sleep deprived after a long labour with my first child which led to me becoming depressed. So she really made an effort to give me a better experience this time - I honestly believe it is possible as long as you keep communicating.

Good luck

[claire101]

Hi Saila, I wanted to second the recommendations to make sure you get a debrief from your first labour with a consultant at King's. There's lots of good advice in this thread but a consultant at King's will be able to provide you with proper medical information about your first experience, and answer any questions you have in relation to your second labour.

It will be easier for them to do this if you get your medical notes, which you're entitled to a copy of (you may have to pay for the photocopying) from King's PALS. If you mention your due date to both the Harris Birthright and to PALS, then hopefully you will get an appointment in good time. Be persistent.

I had a very positive experience of King's when I had my baby, but realised a few months later that I had some outstanding questions relating to my postpartum haemorrhage. I saw lead consultant Leonie Penna for a labour debrief, who having gone over the notes I brought with me from the PALS service, gave me a clearer picture of what had happened and why, which helped reassure me for any future labours.

I'm sorry you had such an awful experience first time. But I'd urge you to get the NHS to give you the answers you need, from medical professionals with your notes in front of you, whether you decide to hire additional private help or not.

Good luck!

[Saila]

Thanks

I requested my notes soon after the birth and have them at home with me.

Not much was written down about my labour as no one was looking after me. They were all written up post birth by a midwife whose name I never found out.

I wrote about 15 drafts of letters of complaint, but they were so long and rambling I never managed a final draft.

The letter extended to my after care, when I found myself secretly hiding under my bed covers and syringe feeding my son cos I couldn't bear watching my limited breast milk being poured down my sons face and wasted.

Syringe feeding was brilliant and what my bf counsellor suggested but wasn't 'ward policy' so (and I prob shouldn't say this) I was sneaking up to special care, where he had previously been, and stealing the syringes etc needed and literally hiding under my covers feeding him for fear of being caught. Crazy.

Then my missed episiotomy infection and the midwife who suggested I try herbal remedies to sort the infection out...

Then finally they mistakenly gave me a second course of hardcore antibiotics when I was discharged. So I was on them for 15 days instead of the normal 7 days. This really helped the thrush...

As soon as I finally came off the antibiotics I was struck down by double mastitis within days. I must have been very worn out.

I ended up formula feeding after just getting to a point of no return and totally giving up.

[Pickle]

Sorry to hear you had such a terrible time. You would definitely benefit from either a private midwife or using one of the local midwifery groups - I was with the Lanes for the birth of #3 4 months ago and had care from Erika right through my complicated pregnancy and throughout my induction/labour.

I needed an induced birth, but she was fantastic at working with me making sure the things I was determined to have happen did happen (mobile labour despite being hooked up to drips and monitors), no hard core pain relief etc. I can't recommend her highly enough, an amazing lady. I met a number of other Lanes midwives while I was in hospital, they all popped in to say hi and boost my spirits, I would have been happy to have any of them looking after me.

With regards to syringe feeding, I was expressing colostrum prior to the birth and there were syringes, storage bottles etc. freely available and I was given lots of syringes to bring home too, so things seem to have changed. I do remember being given those rubbish little feeding cups with #1 five years ago, but didn't see any of them this time.

P x

[Kes]

Oh Saila, you poor thing sounds like you had a horrible experience.

I can't add anything on infections I'm afraid, but I wanted to mention that when I had my daughter the midwife was quite happy to give me an epidural, if anything she looked relieved I'd finally asked, this was St T's not Kings, but just to say not all of them actively discourage you. It was a long wait to get it as all anaesthetists were in theatre, but I got there in the end.

Also - I wholeheartedly agree with you feeling safer with a medicalised birth, but also feeling that you aren't supposed to say that! I went all out for a natural birth last time, was entirely confident in it and ended up with all manner of interventions, a C-section and months of feeling guilty for "failing" - stupid!

Good luck, I hope it's a lot better for you this time

[Knomester]

Salia, I'm so sorry to hear what a traumatic experience you had at King's during your labour and afterwards. Your concerns for your next labour and birth are completely understandable.

There is lots of wonderful advice here which I hope will help you have a better experience next time. I just wanted to pick up on one point which may be important for you (because you say that you would like to have a midwife or someone else qualified to be with you throughout labour), which is that being with a midwife team attached to a GP practice (Lanes, Brierly, Oakwood) will not necessarily guarantee that one of those midwives will be able to accompany you to hospital and throughout your labour.

I was with Oakwood midwives who were excellent, however, when I had to be induced at 42 +5, it was a bank holiday weekend, some of the Oakwood midwives were on holiday and it was an exceptionally busy time for labours and births. As a result, none of the midwives from Oakwood were able to be with me at King's. I don't think that this made a huge difference to my care during labour (my husband was with me and very proactive), although I would have appreciated the support my midwife could have offered, but it did mean that I didn't have my midwife with me as other posters have suggested to be the case (I don't know how common my situation is). I just wanted to make sure you are aware of this in case you choose to register with one of the practices and rely on them being there for you (when they may not be able to be).

For after care (once I was home), I don't know where I'd have been without Oakwood.

[Saila]

Hmmm

Thanks for all the tips and advice.

I'm aware I sound a bit moany and pathetic. Birth is tough, fullstop, for everyone.

I shouldn't complain as I came away with a healthy child in the end. Anyway. This was just to get some tips to try and prevent a repeat of last time. The tips have been very useful - so thnx again.

I've just made an appopintment with kings midwife to go through my notes.

I'm sure that'll help.

[Convex]

You don't sound moany or pathetic!

[midivydale]

You certainly dont sound pathetic! I have recently had my first baby and was v traumatised by the birth. I got so many lovely and supported pm's which made me realise i wasnt alone. I think you will find kings a better experience this time around. I would echo what everyone else have said and also do no be afraid to speak up! Sadly my community midwives couldnt make my birth (another story) but i was induced and looked after by a fantastic kings mdwife. I did end up in theathre which should have been a emergency ceasarian but ended up with episotomy ans forceps as it was too late. Traumatic but i was so well looked after! There was one doctor there who panicked me whilst i was being rushed o theatre and my partner noticed this ans simply asked for someone else. No one questioned this, she was promtly removed from theatre ans my son was delivered by the most calm, caring consultant and the anetheatist was fantastic!!

What i am trying to say is that the vast majority of staff in my experience are truly wonderful, and if u come across some that arent, you can say so.

I spent five days on the post natal ward and the staff were amazing most of the time. No issues at all with expressing or formula if that turns out to be your choice.

Again, if i was uncomfortable with someone i just pressed the buzzer again and asked for someone else.

Best of luck!

C x

[simonethebeaver]

Knomester, I had my baby with Oakwood and it was also a very busy time. I was a home birth so I did have an Oakwood midwife with me but at one point in my marathon labour they said I would have a Lanes midwife as my second as they were so busy. This is apparently not uncommon. However they also told me they had had to miss a hospital birth and this was really unusual. So I think you were unlucky.

[HMKing]

Hi there

I'm so sorry you had such a rough time with your first birth. I just wanted to quickly write because I have exreme anxiety when it comes to giving birth due to many negative run ins with doctors & a sickly childhood. So you can imagine how I view child birth! I'm due in 4 weeks but I have been seeing Christine Neillands to help me cope with the anxiety and previous negative experiences. I was really sceptical to begin with but Christine is truly remarkable and although I am not quite over the memories or the anxiety I'd say it has dramatically reduced and I feel so much less apprehensive. I just wish I had know about her sooner especially as she is v reasonably priced given the change I have experienced.

Good luck! X

[Jasmina]

Saila, I so feel for you. I had the Brierly Midwives and had a great experience. I had planned a homebirth, but ended up at Kings. I was scared as I had heard so many horror stories from my friends but my midwife stayed with me and ensured I was supported and my birthplan was adhered to (mostly). It felt good to have continuous support, someone with me who understood exactly where I was at and what I wanted and could communicate it to the staff at Kings.

I accessed the Brierly via the DMC Dr's surgery.

Good luck. xxx

[Belle]

I credit the Brierly midwife I had with cutting through the Kings bureaucracy and dealing directly with the ward midwife to get me out of there asap, when it looked originally like I might have to stay in (again) for an extended period. She knew the best thing for me at that point was to be home and she sorted it.

[esme]

My main advice would be prepared in terms of knowing what you want (water birth or whatever - tho you are likely to change your mind when in excruciating pain!) - and be firm. There are lots of agency staff and other nurses who are not quite as wonderful as those you see smiling and lovely on 'One Born Every Minute' (which is good to watch by the way to prepare yourself for every eventuality and get to grips with how it really is!)... Be firm in saying what you want and if you get a not so nice nurse or doctor and are unsure about their advice or decisions then ask for a second opinion and be strong. You will be fine xx