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"Negative induction experience"

About: Maternity care (wards 68, 72 &73) / Labour suite The Princess Royal Maternity Unit / Maternity care (wards 68, 72 &73)

(as the patient),

My experience at PRM leading up to the induction was very positive.  I saw different midwives and doctors each time but felt I was in safe hands. 

I was induced at 39 weeks due to my age (I'd also had a day of monitoring the baby for a high heart rate at my 38 week appointment, so although it was just an active baby, it made me more agreeable to induction).  I'd had two natural births previously and wanted it to be as natural as possible so opted for the outpatient balloon method.  This went well, everything was clearly explained and the doctor checked I was okay throughout.   I was even offered gas for the discomfort (which I didn't need).  

At home I experienced contractions and cramping and around midnight the balloon fell out.  I called maternity assessment who were lovely and supportive and agreed that I would try to get some sleep as my waters hadn't gone yet and to keep my appointment to have my waters broken.   In the morning my mucus plug had come away but I didn't have contractions or a loss of waters so attended the induction ward for my appointment.
This is where I feel that things started to go wrong as the original plan changed and not really for any medical need for me or my baby but more due to staffing/ how busy they were.  Firstly the doctor was delayed due to an emergency (fair enough),  and then when a doctor did examine me they said that although they could break my waters but there wasn't space for me in the labour ward. 
So, they were  just going to give me Prostin gel as I was there anyway and it would help shorten my cervix more.  They didn't give me the option to go home and come back (which might have been better given there was no space in the labour ward for me - so why put me into labour?).  I didn't know much about the gel because it wasn't part of my induction plan so I didn't know it could cause hyperstimulation and this wasn't explained to me either. 
Just over an hour later I was experiencing hyperstimulation as I was contracting with less than a minute apart.  I asked the midwife if this was normal as in my previous labours they weren't as close together and as strong until I was close to giving birth.  They said they could be Prostin contractions and could ease off. 
I wasn't put on the monitor which might have shown what they were like.  In fact at no other point during the next five hours in the induction ward was my baby's heart rate monitored.  Despite intense contractions lasting 45 seconds and 20 seconds apart. I found this concerning because everything I've read about hyperstimulation says that the heart rate should be monitored. At the time however I didn't know this was unusual,  my concern was around the horrific pain I was struggling to cope with and whether I was going to make it to the labour ward to give birth- there was one point in the toilet that I was sure I was going to give birth there, and the pressure and  frequency of the contractions made me feel out of control (like the feeling of transition in my previous labours).   I told the midwife of my concerns because in my first labour I needed to send my husband to look for a midwife when I needed to push and my second labour was 2 and a half hours long despite being back to back.  I found the pain from this labour far worse than my previous labours but managed to get pain relief that made those births manageable.  I was only able to have one dihydrocodeine tablet and two paracetamol on the induction ward.   This really didn't feel enough to help me stay in control. I  felt I was almost hyperventilating, my body was shaking, I was sobbing with tears streaming down my face uncontrollably, and this escalated to screaming where I could not stop myself - all in a ward where the other patients and their partners could hear.   
I felt that I was probably going to have to give birth there and despite being in this state I felt I was still not a priority for the labour ward.  As whilst I was hysterical like this a midwife came to collect another patient who was ahead of me in the queue - they were not in active labour and were able to chat away and walk off with them. Whilst I don't know their circumstances, it really didn't help me to see that. 

Eventually the midwife agreed to examine me ( They had been reluctant to earlier) but did so at around 7.40pm - they found I was 4cm dilated.   

Just after 8pm I was taken to the labour ward (labour ward midwives were great) I able to have gas and air and my baby monitored (though their heart rate dropped and I had to move onto my side).  My waters were bugling and when they were broken everything intensified.  I was about to be given morphine , I'd been begging for an epidural,  but it turned out to be too late as I rapidly dilated from 5cm to 10cm in around ten minutes.  I have never felt pain like this in my life - I didn't think it could get any worse and I remember feeling like I could die from the pain. 
Fortunately though as soon as I was fully dilated I gave birth in one push (I don't think I could have stopped it to be honest).  our baby  was born within 30 minutes of getting to the labour ward and I was in shock with a 2nd degree tear.  Mentally I have struggled to come to terms with this birth experience even though we are both okay- the fear of what could have happened to my baby, the lack of control/autonomy and pain that I experienced. 
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Responses

Response from Evelyn Frame, Chief Midwife, Women and Children's, NHS Greater Glasgow and Clyde 2 years ago
Evelyn Frame
Chief Midwife, Women and Children's,
NHS Greater Glasgow and Clyde
Submitted on 07/01/2022 at 17:14
Published on Care Opinion at 17:14


Dear Septbirth,

Firstly, I would like to thank you for taking the time to share your experience within the PRM, and we always prioritise feedback from our women as an opportunity to improve our standards and quality of care.

I sincerely apologise for what you have described as an unsatisfactory experience, and not of the standard we strive to deliver.

I would be happy to explore your issues in greater detail, should you feel that this may be of benefit to you.

I have added my email address below, and would be delighted to hear from you.

Best Wishes,

Tracy Orr

Senior Charge Midwife, Labour ward, PRM

Email: tracy.orr@ggc.scot.nhs.uk

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