On April 17th 1992 I was delivered by caesarean section of a daughter at North Middlesex Hospital (from now on referred to as 'NMH'). Up until that point, most of my ante natal care had been shared by my GP and Community Midwife Kate as I was preparing for a home confinement. I visited NMH only for obligatory antenatal clinics. At 36 weeks my baby suddenly turned breech, having been cephalic (according to Kate) since week 28. At this point I was told by my doctor, midwife and NMH that I would have to go into hospital for the birth and one within three days gentle labour started.
I was grateful to the NMH clinic for seeing me at the request of my GP without an appointment to confirm that my baby had turned breech, however I am not happy with the overall care I received from NMH. As far as possible, I shall endeavour to describe these areas in a chronological order, although some of my complaints are against specific staff.
Antenatal Appointments; With the exception of scans, the shortest waiting time I had was 55 minutes. Seats were uncomfortable, with little opportunity to put feet up and relieve pressure from swollen ankles. Staff rarely introduced themselves, even when examining me. I am appalled at this basic lack of courtesy.
I was seen by Mr X twice. On the first occasion (21:10:91) he was dismissive of my concern at the appearance of a bloody vaginal discharge. I later found out possible causes for this type of bleeding from pregnancy books and my NCT antenatal tutor.
On the second occasion (10:04:92) NMH had scaned me, which confirmed that my baby was lying in a footling breech position so I would have to see the consultant. When he swept into the cubicle I assumed he was Mr Y (the named consultant on my green hospital file) and addressed him as such. I was corrected and subjected to a tirade on how he fulfilled Mr Y's role, but was waiting for the title. I still do not know what his position was.
He looked at my notes, palpated my abdomen, (which was a painful experience), declared the foetus to be too big to turn and said I would have to be booked in for a caesarean. I said that I did not want to have a caesarean and that I wanted to try for a natural delivery. He replied this was not possible because my pelvis had not been proved and the risk to the baby was too great - if the head was not born within five minutes the baby would die. I said I was not happy with this reply as it seemed that he was telling me that my body was inadequate even though there was no evidence for this. He stated that it was hospital policy to deliver all first time breeches by caesarean.
I then went on to ask that if I had to have a section, could it be by epidural, as, having had a general anaesthetic for a D&C in June 91 I had been very weepy and low for a week after, and I did not want a repeat of this, for myself or the baby, therefore I did not want a general anaesthetic. Mr X's immediate response was that he had never heard of such a reaction due to anaesthetic and it must have been because of the miscarriage. I was horrified with his response, presumption and attitude, as I pointed out that I had not had a miscarriage. The midwife (a fair haired woman who had moved up from Plymouth, named was Debbie) who was in attendance agreed with me about the general anaesthetic experience, yet still he did not believe either of us. Mr X had taken no notice whatsoever of the fact that I had prepared for a home confinement and left us with the impression that the only way I was going to have my baby would be by caesarean section under general anaesthetic. His final words were that I should make an appointment at 38 weeks, when he would book me in for a section, which would be either a Tuesday or Wednesday. At that point he left the cubicle as abruptly as he had entered. My partner and I left NMH feeling distraught.
When I saw my green file, he had written 'elective caesarean' in my notes. I had NOT elected to have a caesarean.
I phoned my community midwife when I got home and told her what had happened. She was sorry that the baby had turned breech, recognised my distress from seeing Mr X and later tried to arrange a meeting between myself and Mr X. Mrs F phoned me the following week (14:04:92) to arrange a meeting, which Mr X then cancelled. Mrs F told me that Mr X could not remember his earlier meeting with me. At no time did Kate discuss any alternative to a caesarean with me.
My show started on the Monday (13:04:92), and she came to see me on the Tuesday, at my request. She wanted to take me to NMH for monitoring, but did not explain why. I refused, as I was waiting for my mother to arrive from the Midlands. I had an antenatal appointment for Thursday 16 April with Kate, which she cancelled, because she had seen me on the Tuesday. She popped in later that week to collect my Green file to take to NMH so that it was there for the meeting with Mr X. At no point did she talk about the birth, or having a ceasarean. She actually seemed quite uncomfortable when she came to collect my notes. She did not talk about her role, and having told me that she had written in my notes that I agreed to go to hospital when contractions started (which I did not agree to) she offered no explainations as to what would happen next.
On April 17th My waters broke. I phoned the hospital to find out what the admission procedures were and was curtly told by a Mrs Thomas, to come in and things would be sorted out when I arrived. Having explained my situation (IE that I had prepared for a home delivery and was not prepared for hospital as I did not know what the procedures were) I did not find this reassuring in the least.
As soon as we arrived (my husband Marco and myself) we were taken into a room and I was told to change and get on the bed by a midwife called Tatenda. She wanted to attach monitors, she offered no explanation as to why. At each stage, I had to ask what was being done and why. I said that I did not want to be monitored, and was told that it was necessary to check for the baby's heart condition and to find out if I was really in labour. The monitors were attached to my abdomen and Tatenda left the room. My baby was moving around so much the belt kept moving (which Tatenda had seen), giving an unreliable read out, as at times, there was no foetal heart trace on the printout. I told her that my waters had broken, and that I had had several gushes since 7.30am. I was highly offended to be told that she still had to do a test to prove this.
A doctor came in and picked up my green file without introducing himself. Again, I had to ask who he was. This was Dr. Z. I said that I wanted a vaginal delivery. He asked me how I thought the baby was lying and said he would have to examine me internally first to determine how the baby was lying. I cried out in pain as he examined me, the prodding was so forceful that I tried to move away from him. Marco held my hand and tried to encourage me to relax. The midwife stood passively next to Dr Z throughout the whole examination. At no stage did she try to comfort me. I could not believe how painful the internal had been. At that time I thought that maybe this pain was normal, as a D & C is performed under general anaesthetic. He had discovered that I was 2cm dilated. He was not sure if he could feel a hand or a foot.
I repeated that I did not want a caesarean unless absolutely necessary. I also said that as I was only two cm dilated, I wanted to go home. He replied that I could not go home. This I queried, and was told that there was a risk of infection. Dr Z then went on to say that he would not let me go home anyway, if I had a vaginal delivery it would be episiotomy and forceps, that by hospital policy I had to produce my baby within 12 hours of the waters breaking and as they had broken at 7.30am, it was now 3.30pm, I only had four hours to go and I was still only 2cm dilated so there would be intervention. A section was hospital policy, that it was in the best interest for my child and the only way of guaranteeing a live birth. This was all said without a break. Dr Z then left us to think about what he had said whilst he went to perform a section. I felt as though I had no choice about how my baby would be born.
When he later returned to check my progress I said that I did not want another internal, would he please use a scan to determine exactly how my baby was lying. It took staff half an hour to find a machine, and then, he could not operate it. He said that he did not really know how the machines worked. Marco tried to help him, and a man in a white coat pressed a few keys. Having said that I did not want another internal I was given no choice about another internal examination. Dr Z said that I had to have one. The scan was immediately wheeled out, the gas and air was bought in, which I was told to use. Explaining that the mask made me feel sick, I asked for a mouth piece. This was refused. Again, the midwife did nothing to help me, she stood at the end of the bed the whole time.
Dr Z started examining me before I could use the Entenox. This all happened so quickly. Marco held the mask to my face and tried to explain how to use it as Dr Z shoved his fingers into my vagina. I cried out in pain again and struggled. It felt as though Dr Z was trying to examine my throat via my vagina and in addition, I was beginning to feel nauseous from using the mask. When he announced that he wanted the midwife to do an internal to confirm his findings, I froze. Tatenda immediately carried out his request without a word to me until after. This examination caused me no pain. I am angry that Dr Z was so brutal in his examinations, and that he took no notice what so ever of my obvious distress.
The baby was confirmed to be breech and by this stage, I was in no fit condition to argue against being sectioned. In addition, the gas finally began to have some effect on me. After the event. Dr Z left the room and Tatenda prepared me for surgery. She rapidly dry shaved me, the subsequent regrowth was unbearably painful. When I asked her how much hair would be removed, her reply was the longest, clearest explanation I received from her.
I told Tatenda that I wanted to see my baby being born, that I wanted to hold her immediately and that I wanted to see my placenta. I was frightened of surgery, yet there was no reassurance, no explanations of what was going on. I had to ask at every stage.
During most of my time in the labour room, there was a man in a white coat who sat in a corner of the room and did nothing, except read my newspaper, and at one stage tried to operate the scan. He did not once address me. This I find most peculiar, and another example of the general lack of respect for me.
I don't remember the journey to the pre-op room. Marco says that I was wheeled out of the labour room so quickly he only just had time to gather up my things before I completly disappeared. Marco was not told where to put my things, walked into the pre-op room and was told the gown he had found was not adequate, he would have to wear full theatre gowns. Fortunately, a porter came forward to find the correct clothing for him.
When I arrived in the pre-op room there were two anaesthetists (one male, one female) who were complaining to one another about having been called over to do an emergency section. They had been kept waiting for 40 minutes, and could not understand what the fuss was about. They did not address me once during this time and ignored me until I was about to be wheeled into the theatre when the female asked when and what had I last eaten.
From the time of Tatenda preparing me for surgery to when I was sat up for the epidural to be inserted, I was left lying on my back. This left me feeling light headed and unable to move myself, which I wanted to do. I felt trapped.
Once in the theatre I was covered with green sheets and monitors were attached to my chest and my right hand had a tube (drip?) inserted. At no stage did the anaesthetists discuss what anaesthetic they would be using on me. The epidural was set up. This took time as I had several injections of local anaethetic and then the anaesthetist had difficulties inserting the needle into my spine.
There was suddenly a panic and I heard voices saying,'The consent form, she has not signed the consent form'. I refused to sign it, I said I couldn't, I did not want to. Someone from either my right side or behind me put a pen in my hand, closed my fingers around the pen and put my wrist on top of a piece of paper, stretching my right arm across my body. I remember saying 'no' as I was told to sign it.
Marco was the only person to provide any comfort throughout the time in the theatre. Not one member of staff offered any reassurance about what was happening. I was shaking with fear, and Marco was the only person who made any attempt to try and help me relax.
The operation began. A few minutes later the doctor said that the next part was the bit most women found most painful, the muscles were being clamped. Then I was told that my baby was being born. I put my hands on the screen saying that I wanted to see my baby. My hands were smacked and removed with the words, 'you are entering a sterile zone'. I wanted to see my daughter. I kept calling out for her. Tatenda eventually bought her next to my head with the words, 'here's your baby. Are you happy?' and whisked her away before I could hold her. I kept calling out for my baby. I think the anaesthetist asked me if I could feel anything. Marco kissed me and I felt as though I was swimming. Infact, instead of more epidural, a GA was administered to knock me out whilst I was stitched up. This was done without informing me.
I came round to see a nurse or a midwife with a white plastic bag saying, 'this is your placenta, satisfied ?' and again, she disappeared rapidly. The three of us were left in the theatre. My daughter had been completely scrubbed and no protective vernix left. Had someone asked us, I would not have chosen for this to happen.
Marco told me a nurse had said that they had given vitamin K drops to our daughter, saying that they had not asked him as they had not realised he was the father, they thought he was the anaesthetist. He then told me that I had been knocked out for the stitching, which had taken about 40 minutes. I had specifically stated that I did not want a general anaesthetic to Mr X. Why had this not been put into my green file? A porter eventually arrived in the theatre. Marco helped him put me onto a bed and take us to the ward. Marco has since told me that the staff disappeared very quickly, without a word to him, as there was a change of shift.
I don't recall seeing a member of staff until 6.30 the following morning,( even though I was awake until about 2.30). This was not a pleasant experience. A nurse woke me up, carried my drip bag, catheter and drain bottle and made me walk to the toilet to wash myself. She told me that the catheter should have been removed after the section, and she wondered why it had been left in. I told her that I had had a caesarean by epidural at 8.45pm. Why was I got up so early? The whole episode was so painful I could hardly wash myself, let alone bend down to get into my toilet bag.
About 7.30am, a woman in a green uniform came round to say that breakfast was ready. I was hungry and asked for food to be bought to me. She said she would find out whether or not I could have anything to eat and disappeared. I asked a nurse for food, who said the same as the woman in the green uniform. About an hour later the first woman returned to the ward and I asked again about breakfast. She said I could have breakfast and to follow her. She rapidly disappeared along a corridor. I tried to follow her, carrying my drip, catheter and drain bottle. I collapsed four steps outside the ward in immense pain, calling for help. I saw a midwife for the first time since the operating theatre, a young, Irish woman called Lynda. She was horrified to find me and wanted to know who had said that I could get out of bed. Lynda helped me back to bed and got me a drink. The woman in the bed opposite me was ill and Lynda had to run around for the doctors who were seeing to her. It was 11.30am before I was finally bought one piece of toast.
I have since been told that one should not be moved, without support from two people for 24 hours after having had an epidural. Not once was I supported by even one member of staff, after Lynda found me, when I needed to leave the bed. She was surprised to find that my catheter was still in after the caesarean.
I was left without any means of raising help, beyond calling, until the Monday evening when I told a student Midwife that twice I had nearly dropped my baby trying to get her out of her cot because of the pain in moving. She then bought me a buzzer so that I could easily and safely call for assistance. I heard two midwives complain that one woman was a pain beause she kept using her buzzer.
Twice a day a trolley came round and midwives asked if anyone wanted pain relief. Not once did anyone explain what was available and for what reason. The first day I was given paracetamol. The following day, when I was in a lot of pain, it was not until the evening when I heard another woman talk about a suppository that I found out there was something more effective as a pain killer. It turned out that we were only allowed three of these.
I spent five very uncomfortable days in the ward. The hospital claims to be pro breastfeeding. I was frequently pressured by nurses who came round with a trolley of formula feed to give my baby (Freya) a bottle. I was also told that I should be giving her water. Twice, bottles of water were left on the cot trolley, despite me having catagorically stated that I did not want my daughter to have a bottle. I even had pressure from a couple of midwives to give my breastfed baby a bottle. One evening I had to wait for over two hours before a midwife came to give me assistance with breastfeeding.
In addition, whenever my daughter was feeding, if this coincided with a meal time, I had to argue my case EACH time to get the meal bought to me. I was frequently harassed by staff in the green uniforms to get to the dining room before everything was cleared away. I had to ask where all the facilities were. At no time did any member of staff volunteer this information, or explain ward routines. Breakfast was the only reasonable meal, cereal and toast. The cook chill food was over cooked, over processed, tasted awful and on two occasions lettuce was frozen and on another a slice of melon was only half defrosted. There was a lack of fresh food, and I have to question the nutritional value of the meals that are served up, especially in light of women recovering from major surgery and breastfeeding their babies. I only once got the meal I ordered. This caused me problems because I do not eat meat. I became anaemic. As a blood donor I cannot understand this, as to my knowledge, I have never been anaemic in my life.
I complained to several midwives about the pain Dr Z caused me. Each one said that many women had complained, but that they could do nothing about it.
The payphone was out of order from the Tuesday onwards. This was distressing as it meant seeking permission from a midwife to go to another floor to use a phone.
On the day my drain tube was removed, it got stuck, so the midwife had to call for a doctor to remove it. I had to wait for almost two hours. During this time the orderly (a woman in a green uniform) came to hassle me to go to lunch, left the curtains about a foot open and disappeared. I was semi-naked, feeding Freya and there were visitors in the ward. Fortunately, someone's husband drew them for me. On another day the same woman was dusting the curtain rails above the beds, including mine whilst I was eating, and Freya was next to me.
Generally, the evening staff were unfriendly, discourteous and more difficult to get hold of than the day staff.
I was offended by staff constantly calling me 'Mrs S' when my notes are clearly labelled that I am a 'Ms'. I frequently corrected them, indeed, I even requested that I be called by my christian name, but this only happened with the midwives mentioned below.
Three midwives helped to make my stay tolerable. Indeed, their very kindness and humanity must be praised. They are, Rose, Lynda and Theresa.
There were no free single rooms on the floor I was taken to after the section. At the last meeting with Mr X we were told that ALL ceasarean sections had their own room, and that I would have my own room. This did not happen. I was told by a couple of mums that they had got to spend their entire stay in a single room because they had hired T.V.'s, but they weren't supposed to say anything. I did ask for my own room, but even when one came empty, I did not get it.
As I was leaving the hospital, Dr Z walked in just as I had complained to another midwife about the pain he had caused me. Midwife Maggie said the same as other midwives, ' Lots of women complain about him, but there's nothing we can do. You must put your complaint in writing.' I turned to Dr Z and said 'You really hurt me when you examined me.' He just looked away and muttered, 'Sorry.'
At my six week check up, my GP found that I had a womb infection. Fortunately this cleared up with antibiotics (not so good for Freya's bottom) and I told my GP what had happened at NMH. She made no comment, but has given me a lot of time to talk through some of my nightmares and depression. She also referred me immediately to a Community Psychiatric Nurse and has since been instrumental in referring me onto a counsellor.
When I first found out that I was pregnant, I had to change doctors to get a home birth. The new surgery had refused to take us on when I had first made enquiries. I was told that as I was pregnant, this meant money to the surgery so we would be taken on! Our first meeting, with a Dr M, to arrange antenatal care was interesting, to say the least. When I told him that I wanted a home delivery he told me that I was a " bloody idiot", "It was too dangerous."
However, he would refer me to Mr Z rather than Miss W as he felt I would end up having arguments with Miss W. He also warned me to keep my mouth shut about my views on childbirth, otherwise the hospital would label me a trouble maker. As it turned out, he need not have bothered, since I have not once seen a consultant.
It was at the first ante natal hospital appointment that I saw a Dutch midwife, who could not see any problem in me having a home birth and referred us to the community midwifery service. I was left with the impression, through out my pregnancy, that I was responsible for securing GP cover, in the event one would be needed.
I am still wondering why, when I had told medics all along that I wanted a home birth, no one told me that I could still go ahead with a vaginal breech delivery at home. I was so terified of surgery I withdrew into myself. I still believed right up until the first cut I was going to get off that table and birth my baby myself.
See also Caroline's birth reports of her 3 HBACs - Caroline's VBACs