Mothering › Forums › Pregnancy and Birth › Birth and Beyond › What would you have expected from a midwife, ob and/or doula in this situation?
New Posts  All Forums:Forum Nav:

What would you have expected from a midwife, ob and/or doula in this situation?

post #1 of 41
Thread Starter 
My son was born via emergency c-section. I was given GA because the epi would not kick in fast enough. I talked to DH recently, and feel a lot better about everything except this:

During/after the surgery, no one came to us and talked about what had happened, or if the surgery went bad or good, or even how DS was doing (or where he was?). I didn't see the ob who preformed the section ever again, and I didn't see the midwife until the next day.

I woke up totally freaked by various wires and such hanging out of me. I was in a completely different room, and their were strangers (medical techs, not the ld nurses i had seen pre section) explaining to me that that was my 'pain ball', this was my incision, here is your baby. He's hungry.

I feel strongly that the MW should have been there to tell me all that, or tell my husband at least. That being said, the section was late at night-- my son's certificate says 11pm, and my husband says I was first 'with it' at 1:30 -2 am. is it unreasonable to have expected the midwife to have stuck around? Or the ob? If we had had a doula, would it have been above and beyond for her to stay after they decided on the section?
post #2 of 41
I have not had a c-section but here's my 2 cents...

I think your midwife (as your primary care provider for the past 9 months) should have stayed with you until you were fully 'with it'....to provide moral support, help with BF, and just hold your hand. The exception would be if MW had some emergency at home, but that could have been communicated to DH. I would expect the same from a doula.

I doubt the OB was still in the hospital 10 minutes after you were stitched up. My OB (after vaginal delivery) left within 5 minutes of baby being born. Umm, ok.
post #3 of 41
I would think they should have had nurses there. Your midwife could have been off duty or attending another birth. I hope she checked on you as soon as possible though.
post #4 of 41
I had a c/s under general too, after transfer from a birth center. When I woke up my mom and DH and a nurse were in the room. My midwife had to return to the bc while I was out because she had appts, but she came and saw me later in the day after her appts were all done. The OB who did the c/s came and saw me the next day briefly, but another OB who had attended came the same day to tell me a bit more about it.

Of the OB I wouldn't expect them to stick around, but I would expect them to come in at some point during your stay to check on you. The midwife, that late at night, I wouldn't fault for going home, especially if she has other clients to see in the morning. But like mine I would expect her to come by to see how you were sometime in the next day or so. I didn't have a doula, but I would think she would remain until you woke up at least since she is supposed to be there to support you, but I don't know.
post #5 of 41
From my perspective, I think the OB or midwife would not be obliged to stay to talk with you, especially in a hospital setting and at that hour. They should have a competent nursing staff who could take care of post-op. stuff. However, it would have been appropriate and a nice touch for the midwife to talk to your husband if he left the OR with the baby and she had the time. She could have explained a little more about why the section was needed, how you were doing at that point, what to expect post-op. But maybe she had to go put out another fire. It's hard to know. It was appropriate and doing due diligence for her to come the next day.

Again, if the OB had the time, it would have been nice for him/her to come update your husband on the outcome of the surgery and to come back and check in on you the next day. But I would not necessarily expect it.

If you'd had me for a doula, I'd have expected to stay until you were out from under the anaesthesia and you had initiated breastfeeding, had any questions you thought of answered, and you and your husband understood your immediate post-op pain management, mobility, food, and recuperation options/instructions. Since you were under GA, I probably would not have been in the OR with you as I would be for a section with an epidural (usually the dad goes with baby, and a doula is allowed to gown up to stay with mom for repairs), but I would certainly have stayed. An emergency section is definitely a time when you'd want a familiar face with you upon waking from anaesthesia, and a doula would stay for that, not cut and run (no pun intended).
post #6 of 41
The midwife should have been there when you woke up, unless she absolutely couldn't. I don't think the time matters, because births happen late at night all the time. A doula should also have stayed if possible, but she may not have been allowed to see you until you were in the maternity ward.
post #7 of 41
Thread Starter 
Thank you so much for the responses. I feel so much guilt for choosing this particular midwife. It's an odd situation where I don't even know if I had a bad experience or not. Or if the professionals around me short changed me or not.

To clarify, those saying that the ob/MW need not have stuck around, who would normally inform my husband that the baby was born, or that I was out of the OR? (No one did this for us, so the baby was mysteriously hanging out in the nursery under a warmer for some time after birth, and my husband wasn't informed that I was out of the OR, so I could see the baby)

And when would you have received information about what had happened an why? By the time of my 6 weeks pp check, my MW had forgotten that I had even had a section.

The reason I ask is that I feel like something was missing-- and we are on track to have another baby with the same practice and hospital in a few months. I don't have much experience with surgery, but on tv, doesnt the someone come out and say that everythign went fine. (and then there's hugs and music? lol).
post #8 of 41
I had much the same experience with my first. Except I wasn't under GA. No idea who delivered my dd, MW didn't stick around, I think some ob came in at some point, but not the one who delivered. My doula did check up on me, and brought me some beautiful pictures of my labor, which I'll always cherish.
But I had such a rough recovery and such a hard time nursing, I really could have used some help with nursing immediately following birth, and just more support all around.
I got the feeling that since I was a "failure" to the BC ect... that no one wanted anything to do with me again
post #9 of 41
Thread Starter 
Quote:
Originally Posted by MaryLang View Post
I got the feeling that since I was a "failure" to the BC ect... that no one wanted anything to do with me again
s. I felt the same way. OT, but a few minutes after they decided on the section, a woman came into the (rather small) hospital and I guess, was ready to deliver. I still remember how breathless and excited my midwife was. She ran in and breathed "there's a woman about to give birth in the triage!!!" The next thing I remember is being rolled into the ER and breathing into that mask. According to my DH, there was about half an hour where we were just left alone waiting for the section, and then when it was time, it somehow became 'emergant'. I was shocked at how insensitive this woman could be when we had spent so much time together over the last year. As if I just wasn't interesting enough.

ETA: just to clarify, this woman came in before i had my section. I believe my mw was in the OR with me.
post #10 of 41
a doula would stay after, until baby successfully latches and you are ready for her to leave(thats what i would do anyway(i'm a doula))

i think a nice nurse should have been there to do a similar job to what the doula would do.

a HB transfer midwife should have stayed with you, like a doula would. a hospital midwife should have been in the hospital for you to talk to, even if it wasn't "your" midwife. i would understand if the mw was busy with another woman though at that time.

an OB usually only stays for what they NEED TO BE THERE FOR. (i.e. cut, stitch and run) i'm not saying its right, but thats what's expected there should have been an OB around somewhere for you to talk to, even if not YOUR OB. or you should have been able to talk to your OB the next day or something.
post #11 of 41
I didn't see the OB that did my surgery, but he was the on call and I don't like him anyway, so that didn't bother me. I had nurses with me the whole time as well as my doula. My doula didn't leave until after I had been reunited with the baby and nursed and told her I was good to go (and it was late, too, he was born at 10:21pm). I think it took about 2 hours before I was able to go to my room and hold him, it was my 3rd c/s so the surgery took quite awhile and then an hour in recovery (he was down in the nursery getting suctioned and monitored because he had swallowed so much gunk and had trouble breathing at first). Anyway, my doula came right to recovery with me.

I don't think I'd necessarily expect the MW or OB to stick around since they usually have other women to attend to, but it seems weird that you didn't have any nurses there. I had one the whole time in recovery and then two in my room while they got me and the baby all situated.
post #12 of 41
Oh, and my OB did come by first thing in the morning to talk to me and check on me, so even though I wouldn't expect an OB to be there right after surgery, they should definitely come around at some point to talk to you about the surgery, check your incision, answer questions, etc.
post #13 of 41
Mine was a diff experience b/c I wasn't under GA, but I had a late night c/s. The on-call OB introduced herself and went over the surgery before we went to the OR. My CNM was with me the whole time, as was DH. Everything gets a bit fuzzy for me after DS was delivered (I was fighting with everything I had to stay awake to see him delivered once they placed the epidural--so very tired after laboring for 2 days!). I remember being taken straight back to my labor room to recover, and both the MW and the dr. came back with me. The dr. said she cut me and stitched me up so I would be a good candidate for a VBAC but said she didn't think I'd be able to deliver vaginally. My doula and her soula both waited to leave till after I got back to the labor room and they'd seen the baby and made sure I was ok. Don't remember if my doula tried to help me latch DS? I know the nurse gave him to me and told me to hold him skin to skin, but I gave him to DH as soon as the nurse left b/c I couldn't keep myself awake any longer and didn't want to drop him.

In the days after the surgery, all of the midwives in the practice visited me as they came on call (and I had seen all of them in my long labor!). I don't remember seeing the OB ever again and didn't expect to since she was not my primary caregiver.

In OP's case, I would have definitely expected a doula to hang around till after you woke up (she's there to support you through labor and the birth, and it seems to me that's not done till you are good and awake after a surgery). With the MW, I think that would depend maybe on whether you had a birth center/homebirth MW who transferred with you or a CNM who delivered in the hospital. I would kind of expect a CNM to go on home and visit you the next day (although she should definitely have spoken to your DH about the surgery!). I would think a MW who transferred with you would want to stay and be with you till you knew what was going on since the whole hospital visit would have been so unexpected.
post #14 of 41
Quote:
Originally Posted by texmati View Post
To clarify, those saying that the ob/MW need not have stuck around, who would normally inform my husband that the baby was born, or that I was out of the OR? (No one did this for us, so the baby was mysteriously hanging out in the nursery under a warmer for some time after birth, and my husband wasn't informed that I was out of the OR, so I could see the baby)

And when would you have received information about what had happened an why? By the time of my 6 weeks pp check, my MW had forgotten that I had even had a section.
The nurses or th OB who just finished the surgery have always been the ones to inform the husband/family as far as I know. Was he not allowed to go to surgery with you for some reason? I think the hospital dropped the ball in your situation. It's pretty typical for OBs and midwives to be just "on call" at night but there are staff nurses who should have been there when you woke up and been able to help take care of you and make sure you didnt' freak out upon waking. They should have talked to your husband about how to help take care of you and baby.
post #15 of 41
Quote:
Originally Posted by texmati View Post
Thank you so much for the responses. I feel so much guilt for choosing this particular midwife. It's an odd situation where I don't even know if I had a bad experience or not. Or if the professionals around me short changed me or not.
It was bad if YOU define it as bad. "Traumatic" for one person is "no biggie" for somebody else.

Quote:
To clarify, those saying that the ob/MW need not have stuck around, who would normally inform my husband that the baby was born, or that I was out of the OR? (No one did this for us, so the baby was mysteriously hanging out in the nursery under a warmer for some time after birth, and my husband wasn't informed that I was out of the OR, so I could see the baby)
So, you went into the OR, husband was made to wait outside, and nobody came to get him to go with baby to the nursery? I would expect A) that he could go into the OR to be present for the birth, and B) that he could accompany baby to the nursery and be with baby until you were awake and ready for baby to be brought to you.

Quote:
And when would you have received information about what had happened an why? By the time of my 6 weeks pp check, my MW had forgotten that I had even had a section.
Ouch. I would expect that the midwife would come see you the next day, explain what had happened, any unusual findings regarding your anatomy, baby's position, placenta, cord, etc. that would explain why the c-section was needed. I would be really hurt, personally, if my midwife forgot that I'd had a c-section. She ought to have at least looked at the chart, you know?

Quote:
we are on track to have another baby with the same practice and hospital in a few months.
Are you cool with this? Do you have other care options available that you want to investigate? If you stick with this practice, do you want to question them about what happened last time, lapses in your care, how things can go different/better this time around, what your expectations are, etc.? Are you planning a VBAC? I'd definitely talk with them about provider support, what you can expect in terms of being informed about your condition, anything that gives you pause or that you want reassurance about. It sounds to me like a lot of your care sort of "fell through the cracks," nothing outright negligent, but what if you had wanted DH to be with the baby as soon as possible after birth or you'd had other particular requests that were either ignored or not known due to poor communication within the care team? For example, did you specify what kind of suturing you wanted - single or double layer, and do you know what you got? When did you find that out?
post #16 of 41
I probably wouldn't want to birth at the same place with the same people again until I'd had a serious talk with them about how things went wrong last time. I'd want to be very sure that things would be different next time.

I didn't see the doctor who took care of me or the OB who did the section at all again after. I didn't even see my doctor who had followed me during pregnancy at all. I kept asking when a doctor would see me and none of the nurses could really tell me. I think I finally saw a student doctor and then a resident the day before I left,but they couldn't tell me much about my section.

Luckily I had a doula and she stayed with me the whole time for the section. I sent her with my son when they had to take him to the nursery and send me to recovery. She was my back up doula. My main doula arrived about an hour or so later and I'd just gotten back to my room and she tells me she was the one who bright my son from the nursery and placed him in my arms. I really don't remember that much though since I was so groggy from lack of sleep for close to 3 days and all the meds.
post #17 of 41
I've never had a midwife, or a c-section, or even given birth for that matter, so my experience is just as a doula and having attended births with family members that had sections.

A would be surprised if a dr stayed after the birth. Not that it wouldn't be nice-- but would be surprising to me. I've never seen one after. The midwife I believe should have stayed until you were awake, unless as others said, she had to go to another birth. In this case, she should have absolutely spoken with your husband and let you guys know.

As a doula, I can't fathom leaving a birthplace with the mother still under sedation. I've been to lonnnnng births before that ended up in surgery, and I still waited until after the mama was out of recovery and into her postpartum room.

I would definately look into a doula for your next birth. It sounds like especially after this experience it would be reassuring to have at least ONE person there who is there throughout, and is always a familiar and constant face.
post #18 of 41
Thread Starter 
Quote:
Originally Posted by jeninejessica View Post
I would definately look into a doula for your next birth. It sounds like especially after this experience it would be reassuring to have at least ONE person there who is there throughout, and is always a familiar and constant face.
Thanks. I did actually interview doula's before this birth (the GA one), but was turned off when one said that she'd leave if I got an epidural. And my midwife insisted repeatedly that she'd be with us the whole time. I really do wish we had someone. This time I'm bringing my sister. She's level headed and she'll stick with me through anything.
post #19 of 41
My experience with my two unplanned, but vaginal, hospital births, was that my midwife was with me throughout labor and for a few hours after birth, basically the same amount of time as she would have been if I had birthed at home. She does not have privileges there so she was basically acting in the doula capacity. With my second birth my daughter was sent to NICU and my husband accompanied her, while my midwife stayed with me for a couple of hours. The doctors did rounds in the mornings to check on us and then we did our 2-week and 6-week follow-ups with our midwife.

Quote:
was turned off when one said that she'd leave if I got an epidural.
For what reason???
post #20 of 41
Thread Starter 
Quote:
It was bad if YOU define it as bad. "Traumatic" for one person is "no biggie" for somebody else.
Well.. one of the really hard parts about my experience is the total lack of memory. The two people who were with my are my husband and my mom. They both seem to have really different opinions about how everything went down. Both seem really disturbed by it-- but it was a panicky time. Having a bad experience doesn't necessarily equal trauma, you know? But both of them seem 'traumatized'. Talking about the DS's birth at all almost always leads to heated arguments, tears, or awkward silences.


Quote:
So, you went into the OR, husband was made to wait outside, and nobody came to get him to go with baby to the nursery? I would expect A) that he could go into the OR to be present for the birth, and B) that he could accompany baby to the nursery and be with baby until you were awake and ready for baby to be brought to you.
Yes, the plan was for him to come back to the or with me, but by the time I got there, it became an emergency. It's a very small hospital/small ld floor. Apparently there was no one left on the floor between me and the other laboring woman. He waited out front of the OR doors for a while. He heard a baby cry, and someone did come to tell him that the baby was born, but could not come out of the OR/ he could not see him. Then he waited out in front of the room they said I'd be moved to. Then he waited out side of the nursery. Apperantly, someone (med tech that we'd never seen before) finally asked him if it was his baby that was in the nursery. (the hospital has a no healthy baby in nursery policy, so ours was the only one in there). TBH, this is the part of the whole thing that tears me up everytime. My son and husband deserved to be together, and someone should have made that happen. My son should not have been lying in a warmer all alone for his first half an hour of life. Not when my husband was just steps away.

But it's not my memory... not my trauma.

Quote:
Ouch. I would expect that the midwife would come see you the next day, explain what had happened, any unusual findings regarding your anatomy, baby's position, placenta, cord, etc. that would explain why the c-section was needed. I would be really hurt, personally, if my midwife forgot that I'd had a c-section. She ought to have at least looked at the chart, you know?
I know. I can't believe her name came up in the ICAN recs of who I should see about a VBAC. She's the only midwife that practices in a hospital in our city. She has left the practice where I'm at, so I won't see her again.

Quote:
Are you cool with this? Do you have other care options available that you want to investigate? If you stick with this practice, do you want to question them about what happened last time, lapses in your care, how things can go different/better this time around, what your expectations are, etc.? Are you planning a VBAC? I'd definitely talk with them about provider support, what you can expect in terms of being informed about your condition, anything that gives you pause or that you want reassurance about. It sounds to me like a lot of your care sort of "fell through the cracks," nothing outright negligent, but what if you had wanted DH to be with the baby as soon as possible after birth or you'd had other particular requests that were either ignored or not known due to poor communication within the care team? For example, did you specify what kind of suturing you wanted - single or double layer, and do you know what you got? When did you find that out?
I don't know if I"m cool with it. I'm seeing a totally different dr, whom I like. but does not seem particularly vbac friendly. She seems direct, and not airy fairy at all, and is going to go over all my op reports with me next appointment, and expressed disappointment that the the reports were not available last appointment. I'm hoping to find out about double layer suture etc at my next appointment.

TBH, the midwife did come and talk to us the next day, but at that point we were both so shell shocked. I know she talked to us about how much blood was lost, and that the baby was sunny side up, that his heart rate had dropped, but we did not take that opportunity to ask why the baby was in the nursery alone, why the nurses did not go find my husband to let him know that he wasn't there. When we asked her about it at the postpartum check, we got a very chipper, "oh well, we must have just missed you!", since my husband did go wait outside the room I was supposed to be wheeled to.

At the same time, I get that it was an emergency section, and maybe it was such an emergency that there really wasn't anytime to give my husband clear instructions on where to wait, or what was happening, or where the baby was.

And I was very happy with the postpartum experience, all things considered. I was emotional, my baby screamed every waking moment, and breastfeeding was a nightmare, and I was in pain from my incision.

But he never left our side again-- not for weighs, or ped checks, or anything. There were no visiting hours, so I had multiple family members in the room with me at all hours of the night. It's a baby friendly hospital, so the LC was literally amazing-- And the staff never mention formula, or bottles. The hospital is extremely conveniently located, to both my parents and our homes. I, personally have very little memory of being separated from my son, my husband said he immediately brought him into my room once he found out that I was out of the OR. (No hospital staff let him know that either). I had an on-Que ball, and have no memory of being stuck in my bed-- I was up and walking the halls by the next morning.

I have heard some horror stories afterwords in other hospitals-- (all those people sound very happy with their experiences). Routine 6 hour separations of mom and baby after a section, no night rooming in allowed, not enough breast pumps, staff pushing bottles, not having pumps available postpartum, no bf support etc. We only had a run in with a crummy night nurse that insisted our baby was crying too much because he was hungry.

I'm scared to change dr's. It will be expensive, (2-3000 dollars) and for what? From what I'm reading on this thread, I shouldn't expect any more personal treatment than what I received. I don't want to go to a bc, and this is the most natural birth friendly hospital in the area, it seems.

I feel that I don't have any strong convictions about the birth I want anymore. I don't care about laboring in water, or skin to skin after birth or eye goop or anything. I just want to be part of the process, and I want DH and i and baby to be together. And I want to remember it, and have a story to tell of my own.
New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: Birth and Beyond
Mothering › Forums › Pregnancy and Birth › Birth and Beyond › What would you have expected from a midwife, ob and/or doula in this situation?