Debrief

This post was originally published on my self-hosted WordPress site.  For a whole host of reasons, that didn't work out so, ta-dah!  Back here.

Original post date: 20 February 2014

Well, I've sat here for 5 minutes trying to come up with a snappier title and failed miserably so there you have it, debrief. It is, after all, about my debrief.

On Tuesday afternoon (18th February 2014) we went to meet with the consultant who had seen me during labour and ultimately returned to put me back together again.  Lovely midwife was also there and I was so grateful that she had called to move my appointment to the end of a clinic as we ended up being there nearly 2 hours.

I didn't quite know what to expect.  We started talking simply about how I was feeling but we quickly moved on to the crux of the issue; was I given too much Syntocinon?

The simple answer was pretty much yes.  I was surprised how easily the consultant admitted it.  I had gone in there expecting them to want to cover themselves but as a friend pointed out to me, it's not worth their while and the NHS have learnt that honesty is the best policy in order to get people to trust you again.  I couldn't agree more.

They admitted that the Syntocinon should've been managed better.  I asked whether it was increased at the rate usual for a standard induction and the drug chart would support their admission that yes, it probably was.

I felt such relief, and relaxed so much.  They had confirmed what I had suspected.

I asked whether the Syntocinon had contributed to the rupture and they agreed it had.  Again, huge relief.  Whilst she couldn't say confidently that my uterus wouldn't have ruptured without it (because that is something we could never prove, nor would I want anyone to prove or hold anyone accountable for), she felt that it was certainly a major contributing factor.

I raised concerns that the midwife who looked after me that day wasn't very experienced and they agreed that a different midwife should've probably been assigned to me.  I feel sorry for the midwife in question, I think it just all went over her head a little bit.  To be fair to her, she followed procedures, she increased the Syntocinon the required amount, at the required times, but it should never have really been increased with me.  I was labouring quite well on the smaller amounts.  The consultant showed an emotion that suggested she knew this, and remembered having to ask for the Syntocinon to be turned down on two occasions.  By then the damage had begun however.

We also raised concerns that she wasn't very encouraging.  I mentioned that the only times she really spoke to me were to complain that she couldn't get a good enough trace on the baby or to ask why I hadn't had an epidural yet.  I said I found it really disheartening and that I didn't feel at all encouraged or supported in my decision to continue to breathe through my contractions, as I had planned and practised.  We mentioned she had pretty much said, "I told you you would need an epidural" when my resolve did eventually break.  We also raised that her continued faffing with the monitor had probably put the anaesthetist off and contributed to the epidural not being sited properly.  They were disappointed to hear all this.  They sort of shook their heads but didn't comment too much on it, just apologised that we felt this way.  I felt bad ratting out a midwife, but sometimes, you just have to be honest about the care you've received.

The consultant admitted that since my experience, she has made a point of writing, "Experienced Midwife needed during labour" on women's notes.  She said those in charge should read the notes and see the complexity of cases but in my case, they clearly didn't, so she makes a point of doing it now. I appreciate so much that new midwives need to learn things as they come up, and I'm sure VBAC's, especially induced ones, don't come up that often.  I would've much rather them say, I'm not confident in handling this, can I perhaps have some help from time to time.  Sort of like a CPD exercise almost.  At the same time, the ward was so busy there wasn't much room for anyone to assist or oversee fully.

I talked about how I felt about the whole thing; guilt, sorrow, anger. I said I felt embarrassed that despite all my research I still allowed myself to be submitted to a Syntocinon induction.  Above all else, that's the overriding thing I feel.  I knew it shouldn't have been done yet I submitted so willingly.  I think I was so determined to have my VBAC that I was maybe blind to the increased risk.  More fool me.

I talked about how I felt robbed of my chance to have a perfect birth.  That I often felt I didn't deserve hat had happened because I was so confident and positive about birth.  At this point I could see lovely midwife had teared up slightly.  We'd had many conversations about what I did and didn't want during labour whilst I was still pregnant and she was always so supportive.  She called me yesterday to follow up briefly and told me I should be proud that whilst it did go wrong in the end, I stood up for my rights and choices in birth.

I was pleased with how much they had clearly learnt from what went wrong with my case.  The whole team involved have had a debrief, especially as the consultant was concerned about them suffering from any after effects from witnessing what happened.  She is the personal mentor to the Dr who delivered Woody with the forceps and they have had a few conversations about the birth to understand what happened and what could be improved.

I asked whether I could ever class it as a successful VBAC since Woody was born vaginally.  She sort of smiled, then deadpanned; "No, nothing about this birth was a success!"  Other than the fact they saved me.  I'm here, and so is Woody.  It could've been a hell of a lot worse.

We really wanted to congratulate the whole team on how well they dealt with the emergency. Some day I really hope to see some of them again and thank them personally.  If any of them ever stumble across this little corner of the internet, thank you.  You saved my life and that of my baby and you should all be incredibly proud of the job you do.  I hope one day to join your ranks and continue the amazing work you do.

I mentioned that I was keen to carry on talking about my experience and should they ever want anyone to talk about rupture to students or midwives or whoever, I was really happy to be involved.  She said I should come and talk at one of their team meetings and so she's taken my number to try and get something arranged.  Which is exciting.  I'll get to rub shoulders with a whole room full of actual midwives (I'm a midwife fan girl, I'll admit it!!)

Andy and I came out and both agreed how relieved we felt.  I don't think we'd call it closure, I don't know if either of us will ever have closure on what happened.  It was the most traumatic thing we've ever been through, it has brought us closer together, Andy and I, I think we both have a new found respect for each other in a way, the things we both experienced that week.  But we felt very relieved and immensely grateful and thankful to everyone involved in helping put me back together again