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Would you expect more from private OB?

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#1 MumLife2016

Posted 04 April 2016 - 09:40 PM

I gave birth two weeks ago to a healthy baby girl, 8p10o. As it was a weekend, my OB wasn't rostered on so I had his stand in Ob.

The birth wad great, he was so patient with me pushing, and guided her out with no tears at all. My midwife during labour and birth had to leave her shift 20mins after birth so was very rushed to get out of there, something about getting picked up to go away at 6am on the dot and couldn't be late.

After the birth the OB said he wouldn't be in tomorrow  (Sunday) to see me as that's his "family day". So my ob would be in to see me Monday.

After an hour of skin on skin, I had a shower. As I got out of the shower I noticed alot of blood flowing out of me. I hit the button on the wall to call a nurse to check if it was normal. A nurse arrived. I said "ummm, im bleeding" the nurse chuckled and said "oh she's bleeding, thats normal". I said ok.  The flow seemed quite heavy and the floor was covered in blood.

I got dressed, sat in a chair, picked up bub and tried to bf her. She latched on and then I had horrible tummy pains which I thought was after birth pains. A mw walked back into the room and I told her about the pain in my tummy. She told me to stand and go back to the bed. I did so and at that moment I thought I pooped my pants, I said 'I just pooed in my pants'. The nurse pulled off my pants and there were massive blood clots falling out. One was right next to where I was laying on the bed, about 20cm in size, so yuck.

The nurse hit the emergency red button on the wall and 5 other people entered the room. One was an anithesist who inserted a drip, they also inserted a catheter as I had a very full bladder and I kept saying I need to pee but I couldn't release the urine in labour or just after birth.

Anyway, the story is I don't accept blood transfusions, so I was supposed to have a very managed 3rd stage of labour to prevent PPH but with the change in OB, I guess he didn't read my file or the mw didn't let him know. And to be totally honest I forgot about having the syntocin drip inserted after birth.

The anethesist inserted the drip to start syntocin and a mw was manually removing the placenta that was left behind as well as trying to vigorously contract my uterus. I was worried about blood loss and and said so then the anethesist said "don't worry we'll give you a blood transfusion". A MW then said "she doesn't accept blood, I have the document here". Which she did it was right next to here on the vital signs machine.

Edited by MumLife2016, 04 April 2016 - 09:57 PM.

#2 MumLife2016

Posted 04 April 2016 - 09:52 PM

So anyway the MW stopped the bleeding and all was well. I had a blood loss of 1200ml and they said they'll give me an iron infusion when back in my room.

Do you think the stand in Ob should have been called back to debrief me or at least check on me? Either in the labour room after the PPH or my own room on the postnatal ward? I never saw him again and I feel he should have seen me to check all was well.

I was given an iron infusion the afternoon after the PPH but no one debriefed or spoke to me about the incident. The next day, Sunday, the stand in OB was on the postnatal ward as a mw told me. He just never came to see me and the mw said "oh well, I'm sure it's fine to remove your catheter, he hasn't said otherwise".

Then on the Monday morning my original Ob (who saw me during pregnancy) said "had a bleed did we"  I said yes "retained placenta", he said "we'll give you an iron infusion". I said they've already done that in Saturday afternoon.

Did he not read my notes? Surely iron infusion would have been noted. He didn't say anything else or debrief me either???

Do you think this was substandard care as my OB said during pregnancy what the extensive protocol will be to minimise bleeding and try to prevent PPH. I think there has been very limited communication between medical staff for my situation.

Am I over reacting? What do you think?

#3 SeaPrincess

Posted 04 April 2016 - 10:04 PM

I would have thought that at some point, the stand-in would have been apprised of your situation and history. Whether this would occur ahead of time, or whether he should have asked you if there was anything he should know is the question. I guess for next time, you'll know not to make any assumptions that they have discussed it.

In your position, I think the best thing would be to discuss it with your OB at your 6-wk check up. If they didn't talk before the delivery, it seems unlikely that they've talked afterwards.

#4 CallMeFeral

Posted 04 April 2016 - 10:06 PM

That does sound fairly haphazard medical care/communication, private ob or not. I'm sorry you experienced that.

#5 Expelliarmus

Posted 04 April 2016 - 10:07 PM

It seems well managed to me, but I was left from Thursday to Saturday with extensive bleeding that no one did anything about because it was considered 'normal'. I only got a blood transfusion for PPH because I also spiked a fever and they began testing me like mad. I complained about large blood clots but was waved aside. I complained about feeling very tired and cold and was waved aside. My sister said I was overly pale and was waved aside ... finally a midwife left a note for the OB when my dad said I was a bit pale. A blood test was ordered and then a transfusion but I ended up in HDU before it took place because of a raging fever they never did find the reason for. I didn't see the OB at all when in HDU and was discharged from there several days later.

I did see an OB on the post natal ward every day, even Sunday, for all three pregnancies though, including the delivery by the stand-in OB - saw mine the next day, a Sunday - so I find that unusual.

#6 Soontobegran

Posted 04 April 2016 - 10:12 PM

I am sorry this happened but to be honest the best managed third stage doesn't necessarily mean there will be no retained product and therefore bleeding.

I am glad you are okay but I think a chat with your obstetrician telling him/her how you feel about the apparent lack of communication would be a very good idea.

Good luck, hope that chatting will clarify things for you.

#7 SeaPrincess

Posted 04 April 2016 - 10:12 PM

View PostExpelliarmus, on 04 April 2016 - 10:07 PM, said:

I did see an OB on the post natal ward every day, even Sunday, for all three pregnancies though, including the delivery by the stand-in OB - saw mine the next day, a Sunday - so I find that unusual.

I didn't see my OB over the weekend, and when he came in on Monday morning to do the discharge, the midwives said he doesn't normally come to the ward early on Mondays either. But he came both times for me!

#8 lucky 2

Posted 04 April 2016 - 10:16 PM

What was the difference btn the plan for managing 3rd stage and what actually happened?
I presume the plan was made to reduce the chances of you having excessive bleeding, but really all care in 3rd stage relates to avoiding excessive blood loss.
If there is a difference btn the plan and what actually happened then I'd be asking for the reasons when you next see your OB, at the 6 week check.
What would have been the point of you having a medical plan if it was ignored.
I think your OB would have needed to update the covering OB as to the specifics of your pregnancy and any specific issues.
Then it would be up to the covering OB to follow through.

I hope you are feeling better now and congratulations on your new baby. :)

#9 Charlie & Lola

Posted 04 April 2016 - 10:53 PM

Congratulations on the birth of your healthy baby. I am sorry for what happened after the birth, you do sound very calm about it all - have you spoken to anyone about it, a sister, your Mum or a friend?

It sounds horrendous to me but I have had fairly 'normal' birthing experiences. I wouldn't be happy with the lack of communication between my care team. It also sounds like you were brushed aside/left alone by the medical staff which isn't ideal..

I know that some independent midwifery services offer post natal debriefing/counselling. It might be worth you talking to someone other than your OB I get the feeling he will convince you everything was perfectly fine.

#10 c.sanders

Posted 04 April 2016 - 11:09 PM

Lately I've felt that health care people are just so used to these things that they forget that for us patients it's not normal and we need some support to understand or manage these things. I'm really glad you are okay op. My first birth was quite traumatic and it took me a long time to get over it. But funnily to them it was all normal and by the book. I'd definitely suggest you address your concerns to your ob and ask for an explanation about the stand in and also why you weren't debriefed.

#11 premmie

Posted 07 April 2016 - 04:21 PM

While I haven't experienced anything like this before. Both my births were considered quite normal in this regard.

If your bleeding was under control, and you'd had the infusion and were otherwise well then its sounds okay to me. I'm sure had you still been unwell the OB on duty would of visited you. Its possible he checked your notes, so was aware all was okay, so didn't visit?

But I do think you should have a chat with your OB at your postnatal appointment. Like the PP said above to non medical people the experience can feel overwhelming and out of control - even if things to them are considered quite normal.

#12 PrincessPeach

Posted 07 April 2016 - 05:33 PM

I had a fairly straightforward birth in a private hospital, but I must admit my Ob didn't leave until after she was 100% sure the placenta was complete.

Also she came and checked on me before I left the birth suits to go down to my room to make sure everything was still ok.

I also had an Ob visit me every day - even Sunday.

I would certainly be mentioning your concerns at your 6 week check-up. I'm assuming one of the reasons you chose to go private was due to your birthing history and that you hoped the consistency of care would mean you wouldn't have to think about reminding staff of your needs.

#13 lurfest

Posted 07 April 2016 - 05:51 PM

OP, congratulations on your new baby.

I completely understand that doctors and midwives are rushed, that new mothers get worried, blah, blah, blah but you have a serious medical constraint (not receiving blood transfusions).  The failure to provide the drip after labour, and the nurse laughing off your bleeding (surely it wouldn't have killed her to say 'pull down your pants love, and I'll check to see if it's excessive'?) were unacceptable.  In your situation, I would be very angry and upset.  A woman who has just given birth shouldn't have to remind the OB of her medical requirements, or plead with nurses to check that bleeding isn't excessive.

#14 savannah_8

Posted 21 April 2016 - 06:51 AM

For a provate hospital I would expect a lot more from the back up ob and nurses combined. I would requests meeting with the hospital director to discuss what happened and voice your concerns.

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