"Critical feedback for birth event"

The following relates to my experience with Midland St John of God Hospital and the birth of my first child.

I’m currently 39 weeks pregnant with my second child. My Northam midwife, urged me to submit feedback following my first baby’s birth as it had been a disempowering event. At the time I decided rather to focus on caring for my baby. Now, facing a second birth, I wish to lodge feedback.

Labour started well and as planned at the local hospital’s birthing suites. I had laboured at home for approximately 4 hours.

Approx. 10 hours later, I was put into an ambulance with a midwife and a volunteer ambulance officer and was taken to Midland SJOG. Although I had progressed to 7cms, baby was lying in a posterior, chin up position and despite efforts, the local hospital’s team could not turn them. My cervix was swollen and contractions were becoming sporadic. It was thought that a minimal amount of syntocinon, might help.

Shortly after getting in the ambulance, the active labour began. My child was born 20-30 mins. after arriving at SJOG.

Critical feedback regarding SJOG care:

•On arrival the initial midwife stayed with me but ‘handed over’ to a SJOG midwife. I recall I was told by the SJOG midwife to ‘push’ 5-6 consecutive contractions with ‘everything I have’ else my baby might not survive (baby’s heart rate dropped). I believe I did considerable damage to myself while pushing so desperately resulting in a long, complicated recovery. I was later told by the initial midwife that they thought that the baby wasn’t showing distress signs as it was normal for baby’s heart rate to drop at that stage.

•I was given an episiotomy with limited warning and told it ‘had to happen’ to get the baby out. A ventouse was also momentarily used. Again, I was told later by the initial midwife that these were not necessary.

•I was on my back and at no stage allowed or invited to move. I believe other positions may have avoided the requirement for these interventions and resulted in less damage.

•Shortly after my baby was handed to me, and after a very brief breastfeed, they were taken out of the room without explanation. My partner followed to an ‘acute monitoring room’ where apparently, they were to be monitored due to potential signs of low oxygen (marks on skin and oximeter). Despite enquiring, limited information was given to my partner from the doctor about timeframes and process for our baby’s return. It was over an hour before I saw our baby again. All tests came back fine. I was later told that the delivery doctor was junior and it was possibly their first birth and they had ordered several additional ‘precautionary’ tests.

•The midwife who came to transfer me to the ward was kind, empathic and offered as much explanation as they could. I was very distressed, not knowing when I’d see my baby again. It had been the first time since arriving at Midland that I had felt heard, seen and respected.

•Another doctor came in to stitch up the episiotomy. They were reassuring but after about 10 minutes of stitching under local anaesthetic, reported that there was still a trickle of blood and they couldn’t locate the tear. Soon after, a code blue was called in an adjacent room and they had to leave. The doctor plugged me up with gauze and told me they would be back in an hour to remove it. It stayed in place for approx. 6 hours and was only removed after several midwives had paged them. By then I was in extreme pain. Several midwifes told me that this should not have been in there so long. By the time the gauze was removed, a large haematoma had formed. A second doctor was called to assess the haematoma. I was directed to have a second strong course of antibiotics (the first was straight after the episiotomy- apparently standard procedure) to head off infection forming. No apology or explanation other than the antibiotics were ‘now required’. As I was breastfeeding by then, a second course of strong antibiotics in a single day was not ideal.

•NB/ I found the midwife team generally to be lovely, helpful and knowledgeable, however they seemed overstretched and overworked. They came in for checks, said they’d be right back and either not return or return several hours later.

•On day 3 I was told that I’d require a third dose of antibiotics at which point I questioned whether it was absolutely necessary or if it was a ‘precautionary measure’. Two doctors and a midwife were promptly brought in to ‘put on the record’ that I was ‘refusing treatment’. Arms folded, I recall one of the doctors aggressively told me that it was foolish to not take them as if I become unwell I won’t be able to take care of my child.

•I was told I required a session with a lactation consultant and was given nipple guards and told by the consultant my nipples were ‘too flat’ to breastfeed without aids. Two days after being discharged I stopped using the guards and went on to breastfeed my child until they were 18 months old. This was a very disempowering and inaccurate opinion.

•My discharge paperwork incorrectly stated that I had had ‘gestational diabetes’, which I did not. Other mistakes in the paperwork included the name of my doctor and my home address.

•None of my information from Midland SJOG was uploaded to MyHealth records. My pregnancy book was also never returned to me and I assume it was lost somewhere in transit.