Not Listened To

Sophie

Wednesday, 9 June 2004

I had a pretty good pregnancy. I wasn’t even tired. I worked full time up to 36 weeks. I was sent for a growth scan at 36 weeks because the midwife was worried that my baby was small. I knew it was merely because I had a busy job – on my feet all day – and I was probably just too busy so that the baby hadn’t had a chance to grow. As soon as I finished work, she grew more. During the pregnancy I was concerned about the narrowness of my vagina. I’ve always been quite narrow in that department and I did say to my midwife during the pregnancy,

‘Look, I’m narrow in that department when anyone has examined me, will that cause a problem during the birth?’

‘Oh no, no, no it all stretches,’ she said. So I thought ‘OK, right’. But I was still concerned about that. As it turns out, I wasn’t listened to. I felt like my concerns were waved aside. I was never examined to check on everything and to check on my concerns until I was in labour. For smears and everything I’ve always had to have the very smallest speculums. And so of course I was concerned through my pregnancy that it could be an issue about tearing and things like that.

My midwife had a really good reputation. She was one of those bossy, nicely bossy people. In Dunedin Hospital when she says jump, they jump. When you’re a first-timer and you don’t know much, it’s kind of good to have that motherly overbearing approach.

At 38 weeks and 1 day I had the indication that baby was going to arrive over the next few days: I had the ‘show’. That was on the Saturday morning and then on the Tuesday I went into labour, about 4am. About midnight that night I went into hospital. The midwife said to me I wasn’t in fully established labour! So what she did was she gave me some pethidine and a sleeping tablet, and she sent me home for some sleep, and hoped I’d wake up the next morning in established labour.

But I woke up the next morning no further ahead and so I went into hospital about 10 in the morning. They found out that my waters had actually broken. So I had to have her that day because they’d done this test for a bacteria. They hooked me up and I had no sort of say in the matter. I was given an epidural and syntocinon to get me going because I was only 3cm dilated after 30 hours of labour.

The syntocinon got me going fairly quickly but the epidural didn’t work properly. I only had it on one side. I could still feel the labour pains on my left side. So they came in and got another guy to try to see if he could fix it. He couldn’t. It was bearable because I could only feel half of it. I had a trainee midwife there too and she was absolutely wonderful. My baby was born at 4.45 in the afternoon.

My husband was holding the mirror at the end of the bed and I saw Sophie’s head come out and I saw a small tear. I thought ‘That’s not too bad’ because I had always thought the head was the biggest part. So anyway I saw the baby’s head come out and then my husband put the mirror down and they actually let him deliver the rest of her and I thought that’s OK. Then they got one doctor to come in. It was a little Asian girl. She came in and did some stitching and then she found there were some bits that she couldn’t manage as it turned out so she got her boss to come in and her boss did some more stitching and that was my first indication that things were difficult.

The midwife did say to me,

‘I did think of doing an episiotomy for the first time in five years’ she said ‘But I thought the tearing could have happened anyway, even if I had.’

After the two doctors had stitched me, suddenly all hell broke loose. The midwife ran out and got the consultant to come in. From the sounds of it I started bleeding heavily. The consultant couldn’t see, so she wheeled me across the hallway to the theatre. The baby was fine through all this. I didn’t know but my husband had dressed her and he was holding her. He was told to come into theatre and to keep me occupied. I’m glad we had the trainee midwife there. And I was busy thinking,

‘I should be busy feeding this baby, shouldn’t I?’

Thankfully the trainee midwife was there to hold my hand. They were having to push my stomach down hard to stop the bleeding. The midwife was with the specialist down the business end and I heard them counting something. It suddenly dawned on me months later what they were counting: the swabs inside of me. It turned out that I had loads of internal tears as well. The worst of it was the internal tears. I had nearly 4th degree tears, almost right back to the anus. I was told I had over 30 stitches in total. I was in theatre for over an hour. I was in shock and I was cold and all the rest of it. Nothing was ever explained to me. Obviously they were trying to be careful what they were saying and everything. The next night I had 3 units of blood. They kept me in the delivery suite with the epidural for pain relief for the next two days. I had drip things in both hands. I couldn’t hold my baby properly. She had to latch on to me lying down. I couldn’t do anything. She was born on the Wednesday and it wasn’t until the Friday that I could actually get up and then start learning to be a mother. I wasn’t well for weeks afterwards.

Then it turned out that I had adhesions [scarring]. I went for the six week check with the midwife and she had a look at me and found I was all closed over in the vagina. So I went to see the consultant when Sophie was about three months old. I had my first surgery. The specialist cauterized the adhesions and said I could improve the vaginal opening with dilators. That didn’t work. I was supposed to have follow-up appointments but I got lost in the system.

I went to the receptionist and said I needed follow-up appointments and the receptionist said they were 4 months behind their appointments, ‘I’ll see what I can do’. And I never heard back. And it wasn’t until the following year, months later when I saw my midwife in town on a Friday night. I told her that I’d been trying to get appointments and couldn’t. She was horrified. So she got me on to someone different. And soon after that I had the appointment. And then after another 3 months later I finally had my next lot of surgery, a ‘Fenton’s procedure’ to reconstruct the vagina.

I was busy with the baby. I didn’t have time to think about going to ACC and all the rest of it. I thought, ‘I’ll just get on with it really’. There was nothing wrong with Sophie. She was only 6 lb 5. I hate to think what she would have done if she had been bigger. I still don’t understand how the tearing internally happened.

I’ve got my notes from Dunedin Hospital. And I had the resolutions committee here and they went through my notes. They thought Sophie’s head descended too quickly. The midwife of the resolutions committee thought that from my notes maybe my midwife hadn’t had a chance to do an episiotomy because the birth was so quick but then I talked to the doctor about it all last week and he said it takes 30 seconds to do one. He seemed to rubbish that idea.

I had trouble getting a midwife for my second pregnancy because of what had happened. I had to tell my story about 50,000 times. The specialist I saw during the second pregnancy said, ‘The repair is great, it’s a really good repair, you could attempt a natural delivery with a controlled cut but the same thing or worse might happen again’. The opinion amongst specialists was that first of all you should preserve what you have. I’ve had these doctors ask me if I have any problems with my bowels but that’s been fine- I’ve had a very, very lucky escape. I wanted someone to look at me and give a proper opinion so I could make an informed choice about the next labour. I wanted to have a specialist because I thought after all I’ve been through, I deserve it.

It was all ongoing for 18 months after that first birth. It was hard for my husband because he’d never seen me so sick, he was beside himself. I had that initial traumatic first birth of becoming a new parent and then I had the adhesions. The first round of surgery was when the baby was three months old. Then finally 14 months later, after that, I had the final surgery which worked. We were never able to make love in all that time. That side of things just didn’t work. It just couldn’t. It hasn’t been easy that’s for sure. Thankfully I have a really understanding husband.