I'm going to make a complaint

On Wednesday I had a meeting with a midwife/counsellor and had a look at my
medical notes, I had put out of my mind everything that had happened in the
week before Ada's birth and had tried to forget about it. The reason I went
to the counsellor was because I wanted to talk about how I had managed
labour and feel validated for the way I had not handled it well, which was
acheived, it was just in the process I saw most of my notes from the week
before it happened, so I've had to think about it all again and have decided
that I need to make a complaint. My first step has been to write down what
happened, so that when I make a list of more specific complaints these can
be put into context. So, here's the story, I would really appreciate
feedback, I want to make it as clear and consise as possible but without
missing anything out, I know on this group people will know something, but I
didn't go into much detail about the time I was actually in hospital, so if
you read it, please can you try and imagine you are sat in an office and you
know absolutely nothing about this case and see if I have provided the right
information, Thanks, Anne btw, the complaint is not that I didn't have a
c-section, more the general care and poor communication.

************************************************** *********************

On Sunday 5th June I was assessed on delivery unit, due to severe joint pain
related to my pregnancy, I was 38 weeks and 5 days pregnant. The doctor was
a female registrar, whose name I think was Dr Ding, or similar, who I had
seen in out patients on Thursday 2nd June.

We discussed that fact that my pain had not decreased and the addition of
Temazepam at night time had not helped and that I was finding things
unbearable. She performed a vaginal examination to assess if any progress
towards delivering the baby had been made, I used entonox to help as I found
this very painful, it was too painful for her to perform a stretch and
sweep. We also discussed the option on induction of labour, which I was
nervous of as I had had a previous unpleasnt experience with my 1st child,
after the discussion I was more open to the possibilty and also talked to an
anaethetist about pain relief options.

I was already taking the strongest painkillers that I was able to take at
home so it was decided to admit me so I could receive stronger painkillers.
I expressed desire that this be given intravenously rather than
intramuscularly as previously I had found I had a much worse reaction to IM
opiate based analgesia with no difference in pain relieving affect or
duration than IV analgsia. I was informed that this was possible and that a
doctor would have to insert a cannula and administer the drugs. This was
done on Lady Mary Ward at around 4pm and made me comfortable.

At around midnight I woke up and was in terrible pain, I called the midwife
and asked for a further does of pethidine, which she was unwilling to give,
I was unhappy as I had understood that the sole reason for being admitted to
the hospital was to receive analgesia. I did not wish to take oral analgesia
as this would have been identical to what I had taken the night before at
home and as the pain had not lessened would be very very unlikely to work.
The doctor was called and she also was unwilling to give me pethidine and I
agreed to take Tramadol, I was told that if it didn't work I could have
pethindine in an hour. An hour later I called the midwife again as I was
still in significant pain, I was told that I had to in fact wait 4hrs after
taking the tramadol to receive pethidine and was given temazepam, again a
drug I had taken the previous night which had not had the desired affect. I
drowsed a little but spent the majority of the next 3 hours counting the
minutes until the pain could be taken away. When the time was up I called
the midwife and was informed that if I wanted analgesia via IV I would have
to wait at least an hour, I was desperate and agreed to it being given IM.

The next day was Monday and I saw a lady doctor from Jane McDougalls team in
the morning, I expressed my desire for an elective c-section, partly because
I doubted my ability to deal with my pain as well as labour, but also as I
was concerned that given some of my pain seemed to be caused by an excessive
looseness of my joints and I was having particular pain in my hips and
pelvis along with the fact that I had had abnormal pain in my hips and
pelvis after my previous birth, that a vaginal delivery would risk more
significant damage as this baby appear to be bigger and at the time was
malpositioned. She said she didn't think this would be possible and
explained the risks of a c-section to me.

Later in the day I saw Dr Sterwin, who seemed strongly in favour of inducing
labour at 39 weeks, which would have been the following day. He also crossed
the pethidine of my drug chart, which I did not understand as that was the
sole reason for being in hospital, but at the time I don't remember having
any discussion with him about this, I think this was because not long before
he came to see me I had received IV pethidine and was feeling woozy.

The next 24 or so hours were very unpleasant, I was not receiving the drugs
that I had been in hospital to receive and was in a lot of pain and not able
to think clearly and find out what was going on. A very nice midwife, called
Karen, seemed to understand the amount of pain I was in and was able to give
me IM pethidine. I saw Jane McDougall on her ward round and she expressed
she did not want me to have a c-section but that she was happy for me to be
induced.

I was given the impression that this would happen on Tuesday as I was 39
weeks and the midwife, Karen seemed to think so to as in the evening she got
everything ready and I spend time being monitored and she got the Entonox,
so she could give me a VE and insert the gel, but at some point in
organising that it was decided that I was only 38+5, so it couldn't happen
until Thursday. This was incorrect as we were using the dates from my dating
scan which indicated I was 39 weeks on Tuesday 7th June and in my notes,
gestation given on other dates agrees with this, however at the time I was
relieved as I still felt very uneasy about an induction.

At some point I had another conversation with Dr Sterwin and I was given the
impression that the main reason I couldn't have a c-section was due to the
fact that I have a history of postnatal depression and that the immobility
after a c-section would increase the risk of this, despite recent research
indicating that this is not in fact the case. Karen spoke with the
anaethestist and said that I could continue to have pethidine until someone
from the pain team could see me, but that it had to me IM. I accepted this
as during this stay in hospital my reaction to IM analgesia had not been as
bad as my previous reaction. The result of this was that as I had so many
injections my bum and hips became very sore.

Karen told me that I was on the list for induction of labour on Thursday,
which surprised me as after the confusion on Tuesday I didn't think I had
agreed to be induced, I expressed my concern about this and she arranged for
me to talk to a doctor, and on Thursday I had another conversation with Dr
Sterwin, he was very understanding about the problems I had had with my
previous induction and noted on my notes that I should receive lower doses
of the drugs and for them to be increased at less frequent intervals. I
still felt very very uneasy, but decided to go ahead with a dose of prostin
gel, thinking that if that didn't work I could still refuse the drip, which
was what I was most afraid of. Karen gave me pethidine and provided Entonox
and examined me, she also asked if a student could repeat the exam and
insert the prostin, which I agreed to as with the Entonox and pethidine I
was comfortable. This brought on short, sharp contractions, which were
obviously not making any progress, but painful enough for me not to be able
to sleep. Around 4 in the morning, I asked the midwife for pethidine as the
joint pain had returned and I was struggling to cope with both that and the
contractions, she said no as it would stop any labour that was happening. I
asked the midwife who came on duty in the morning for pethidine but was told
the same, I was left in limbo as due to the fact I was still having some
contractions it was not possibly to give a further dose of pethidine, but
nor was I in labour and there was no space on delivery unit to take things
further. I felt very disillusioned and upset, I was in a lot of pain from my
joints and that seemed to have been forgotten and I was also stuck in a not
in labour, but not not in labour situation which was difficult to manage,
though it was dieing down, I regretted agreeing to the prostin.

Karen came on shift and after finding I had not receive and pethidine, very
quickly gave me some, which did help my joints, but suddenly my labour took
off and I was taken upstairs to delivery unit. In the many times things had
been discussed during the preceeding few days, the plan had been to have an
epidural in very early labour, when I arrived on DU I requested and epidural
and was told I didn't need one by a student midwife, eventually I convinced
her and the supervising midwife that it was what I wanted and the
anaethetist was called. The labour and delivery essentially went well, at
each stage where I made a decision I queried whether it would make any
difference to me being able to go home that evening (assuming the baby had
been born!) as it was a very strong desire to go home straight away. The
baby was born at 6.08pm and no time was I given the impression that I would
not be able to go home once the paper work was completed. We expressed that
we were happy to bring the baby back the following day to be checked by the
paediatrician as we knew that it could be a problem arranging that in the
evening. At around 10.30 a new midwife came and told me that I shouldn't go
home as there had been old meconium in the waters and it was not standard
procedure. At this stage I was ready to go home and my husband and left to
go and move the car closer to the hospital. I queried why this was the case
and what observations would be done and felt that as the baby had not evern
required suctioning that this was not necessary and asked for more
information about what signs I should look out for in both her and me. I
signed a self-discharge form and when the paperwork was completed we went
home. I later dicovered

Anne, is this the complaint you plan to send out or just notes to help you
get organized? I ask because if you do plan to send this out as-is, I would
make some suggestions.
1) List your complaints up front, perhaps even in bullet form. Basically,
you want to outline your complaint (ie "I was displeased with the lack of
communication during my hospital stay. I do not feel I was given
appropriate information in order to make informed consent", etc etc) You
can then add the actual story to give details, referring back to the
original complaints. "Failure of the staff to explain the consequences of
accepting Tramadol on future pethidine administration violated my rights to
informed consent."
2) Have someone proof-read your letter before you send it. I suspect what
you've posted is a very initial first draft (since it ends abruptly), so the
spelling errors and grammatical errors would be corrected in future drafts.
I also notice a tendency to use long sentences. You may want to edit your
longest sentences to be several shorter sentences.
3) Use "hot button" phrases so that you get more notice from the higher-ups
than someone who is "just" unhappy. For example, use of the phrase "lack of
informed consent" is likely to get attention since that is a legal issue.
Also, if you are able to look at the hospital's policies and find specific
policies that were violated, you can use the phrase "in violation of
hospital policy, Dr. X did this". If not policies, you can look at mission
statements, etc that are probably easily available online or in their
advertising materials.

Hope you get a response!
Amy


"Anne Rogers" wrote in message
...
On Wednesday I had a meeting with a midwife/counsellor and had a look at
my medical notes, I had put out of my mind everything that had happened in
the week before Ada's birth and had tried to forget about it. The reason I
went to the counsellor was because I wanted to talk about how I had
managed labour and feel validated for the way I had not handled it well,
which was acheived, it was just in the process I saw most of my notes from
the week before it happened, so I've had to think about it all again and
have decided that I need to make a complaint. My first step has been to
write down what happened, so that when I make a list of more specific
complaints these can be put into context. So, here's the story, I would
really appreciate feedback, I want to make it as clear and consise as
possible but without missing anything out, I know on this group people
will know something, but I didn't go into much detail about the time I was
actually in hospital, so if you read it, please can you try and imagine
you are sat in an office and you know absolutely nothing about this case
and see if I have provided the right information, Thanks, Anne btw, the
complaint is not that I didn't have a c-section, more the general care and
poor communication.

************************************************** *********************

On Sunday 5th June I was assessed on delivery unit, due to severe joint
pain related to my pregnancy, I was 38 weeks and 5 days pregnant. The
doctor was a female registrar, whose name I think was Dr Ding, or similar,
who I had seen in out patients on Thursday 2nd June.

We discussed that fact that my pain had not decreased and the addition of
Temazepam at night time had not helped and that I was finding things
unbearable. She performed a vaginal examination to assess if any progress
towards delivering the baby had been made, I used entonox to help as I
found this very painful, it was too painful for her to perform a stretch
and sweep. We also discussed the option on induction of labour, which I
was nervous of as I had had a previous unpleasnt experience with my 1st
child, after the discussion I was more open to the possibilty and also
talked to an anaethetist about pain relief options.

I was already taking the strongest painkillers that I was able to take at
home so it was decided to admit me so I could receive stronger
painkillers. I expressed desire that this be given intravenously rather
than intramuscularly as previously I had found I had a much worse reaction
to IM opiate based analgesia with no difference in pain relieving affect
or duration than IV analgsia. I was informed that this was possible and
that a doctor would have to insert a cannula and administer the drugs.
This was done on Lady Mary Ward at around 4pm and made me comfortable.

At around midnight I woke up and was in terrible pain, I called the
midwife and asked for a further does of pethidine, which she was unwilling
to give, I was unhappy as I had understood that the sole reason for being
admitted to the hospital was to receive analgesia. I did not wish to take
oral analgesia as this would have been identical to what I had taken the
night before at home and as the pain had not lessened would be very very
unlikely to work. The doctor was called and she also was unwilling to give
me pethidine and I agreed to take Tramadol, I was told that if it didn't
work I could have pethindine in an hour. An hour later I called the
midwife again as I was still in significant pain, I was told that I had to
in fact wait 4hrs after taking the tramadol to receive pethidine and was
given temazepam, again a drug I had taken the previous night which had not
had the desired affect. I drowsed a little but spent the majority of the
next 3 hours counting the minutes until the pain could be taken away. When
the time was up I called the midwife and was informed that if I wanted
analgesia via IV I would have to wait at least an hour, I was desperate
and agreed to it being given IM.

The next day was Monday and I saw a lady doctor from Jane McDougalls team
in the morning, I expressed my desire for an elective c-section, partly
because I doubted my ability to deal with my pain as well as labour, but
also as I was concerned that given some of my pain seemed to be caused by
an excessive looseness of my joints and I was having particular pain in my
hips and pelvis along with the fact that I had had abnormal pain in my
hips and pelvis after my previous birth, that a vaginal delivery would
risk more significant damage as this baby appear to be bigger and at the
time was malpositioned. She said she didn't think this would be possible
and explained the risks of a c-section to me.

Later in the day I saw Dr Sterwin, who seemed strongly in favour of
inducing labour at 39 weeks, which would have been the following day. He
also crossed the pethidine of my drug chart, which I did not understand as
that was the sole reason for being in hospital, but at the time I don't
remember having any discussion with him about this, I think this was
because not long before he came to see me I had received IV pethidine and
was feeling woozy.

The next 24 or so hours were very unpleasant, I was not receiving the
drugs that I had been in hospital to receive and was in a lot of pain and
not able to think clearly and find out what was going on. A very nice
midwife, called Karen, seemed to understand the amount of pain I was in
and was able to give me IM pethidine. I saw Jane McDougall on her ward
round and she expressed she did not want me to have a c-section but that
she was happy for me to be induced.

I was given the impression that this would happen on Tuesday as I was 39
weeks and the midwife, Karen seemed to think so to as in the evening she
got everything ready and I spend time being monitored and she got the
Entonox, so she could give me a VE and insert the gel, but at some point
in organising that it was decided that I was only 38+5, so it couldn't
happen until Thursday. This was incorrect as we were using the dates from
my dating scan which indicated I was 39 weeks on Tuesday 7th June and in
my notes, gestation given on other dates agrees with this, however at the
time I was relieved as I still felt very uneasy about an induction.

At some point I had another conversation with Dr Sterwin and I was given
the impression that the main reason I couldn't have a c-section was due to
the fact that I have a history of postnatal depression and that the
immobility after a c-section would increase the risk of this, despite
recent research indicating that this is not in fact the case. Karen spoke
with the anaethestist and said that I could continue to have pethidine
until someone from the pain team could see me, but that it had to me IM. I
accepted this as during this stay in hospital my reaction to IM analgesia
had not been as bad as my previous reaction. The result of this was that
as I had so many injections my bum and hips became very sore.

Karen told me that I was on the list for induction of labour on Thursday,
which surprised me as after the confusion on Tuesday I didn't think I had
agreed to be induced, I expressed my concern about this and she arranged
for me to talk to a doctor, and on Thursday I had another conversation
with Dr Sterwin, he was very understanding about the problems I had had
with my previous induction and noted on my notes that I should receive
lower doses of the drugs and for them to be increased at less frequent
intervals. I still felt very very uneasy, but decided to go ahead with a
dose of prostin gel, thinking that if that didn't work I could still
refuse the drip, which was what I was most afraid of. Karen gave me
pethidine and provided Entonox and examined me, she also asked if a
student could repeat the exam and insert the prostin, which I agreed to as
with the Entonox and pethidine I was comfortable. This brought on short,
sharp contractions, which were obviously not making any progress, but
painful enough for me not to be able to sleep. Around 4 in the morning, I
asked the midwife for pethidine as the joint pain had returned and I was
struggling to cope with both that and the contractions, she said no as it
would stop any labour that was happening. I asked the midwife who came on
duty in the morning for pethidine but was told the same, I was left in
limbo as due to the fact I was still having some contractions it was not
possibly to give a further dose of pethidine, but nor was I in labour and
there was no space on delivery unit to take things further. I felt very
disillusioned and upset, I was in a lot of pain from my joints and that
seemed to have been forgotten and I was also stuck in a not in labour, but
not not in labour situation which was difficult to manage, though it was
dieing down, I regretted agreeing to the prostin.

Karen came on shift and after finding I had not receive and pethidine,
very quickly gave me some, which did help my joints, but suddenly my
labour took off and I was taken upstairs to delivery unit. In the many
times things had been discussed during the preceeding few days, the plan
had been to have an epidural in very early labour, when I arrived on DU I
requested and epidural and was told I didn't need one by a student
midwife, eventually I convinced her and the supervising midwife that it
was what I wanted and the anaethetist was called. The labour and delivery
essentially went well, at each stage where I made a decision I queried
whether it would make any difference to me being able to go home that
evening (assuming the baby had been born!) as it was a very strong desire
to go home straight away. The baby was born at 6.08pm and no time was I
given the impression that I would not be able to go home once the paper
work was completed. We expressed that we were happy to bring the baby back
the following day to be checked by the paediatrician as we knew that it
could be a problem arranging that in the evening. At around 10.30 a new
midwife came and told me that I shouldn't go home as there had been old
meconium in the waters and it was not standard procedure. At this stage I
was ready to go home and my husband and left to go and move the car closer
to the hospital. I queried why this was the case and what observations
would be done and felt that as the baby had not evern required suctioning
that this was not necessary and asked for more information about what
signs I should look out for in both her and me. I signed a self-discharge
form and when the paperwork was completed we went home. I later dicovered

1) List your complaints up front, perhaps even in bullet form.
Basically, you want to outline your complaint (ie "I was displeased with
the lack of communication during my hospital stay. I do not feel I was
given appropriate information in order to make informed consent", etc etc)
You can then add the actual story to give details, referring back to the
original complaints. "Failure of the staff to explain the consequences
of accepting Tramadol on future pethidine administration violated my
rights to informed consent."

that was what I was planning to do, the story is to get the context

2) Have someone proof-read your letter before you send it. I suspect
what you've posted is a very initial first draft (since it ends abruptly),
so the spelling errors and grammatical errors would be corrected in future
drafts. I also notice a tendency to use long sentences. You may want to
edit your longest sentences to be several shorter sentences.

DH is on to that!

3) Use "hot button" phrases so that you get more notice from the
higher-ups than someone who is "just" unhappy. For example, use of the
phrase "lack of informed consent" is likely to get attention since that is
a legal issue. Also, if you are able to look at the hospital's policies
and find specific policies that were violated, you can use the phrase "in
violation of hospital policy, Dr. X did this". If not policies, you can
look at mission statements, etc that are probably easily available online
or in their advertising materials.


Thanks, I hadn't thought of that.

Anne

3) Use "hot button" phrases so that you get more notice from the
higher-ups than someone who is "just" unhappy. For example, use of the
phrase "lack of informed consent" is likely to get attention since that is
a legal issue. Also, if you are able to look at the hospital's policies
and find specific policies that were violated, you can use the phrase "in
violation of hospital policy, Dr. X did this". If not policies, you can
look at mission statements, etc that are probably easily available online
or in their advertising materials.


arrrgghh, this was such a good idea, but I cannot find anything relevant, I
cannot even find basic guidelines or standards for patient care, I've been
scouring www.addenbrookes.org.uk and www.nice.org.uk

Anne

I agree with everything that Amy wrote. Your sentences are very run on and
long, and several I had to read multiple times. I also agree with the
bullet points...people aren't going to take you seriously if you are just
writing out your entire birth story to them...they want to know what you are
upset about, and what you want them to do about it. Be concise, edit, and
be as impartial as you can be. It's a great exercise to write this all down
for yourself, so you can refer back to it and remember exactly what your
issues and complaints were.

Good luck
--

Jamie
Earth Angels:
Taylor Marlys, 1/3/03 -- My Big Girl, who started preschool, and loved it!
Addison Grace, 9/30/04 -- My Little Walker, who wants nothing more than to
go explore the world!

Check out the family! -- www.MyFamily.com, User ID: Clarkguest1, Password:
Guest
Become a member for free - go to Add Member to set up your own User ID and
Password

"V." wrote in message
...
Anne, is this the complaint you plan to send out or just notes to help you
get organized? I ask because if you do plan to send this out as-is, I
would make some suggestions.
1) List your complaints up front, perhaps even in bullet form.
Basically, you want to outline your complaint (ie "I was displeased with
the lack of communication during my hospital stay. I do not feel I was
given appropriate information in order to make informed consent", etc etc)
You can then add the actual story to give details, referring back to the
original complaints. "Failure of the staff to explain the consequences
of accepting Tramadol on future pethidine administration violated my
rights to informed consent."
2) Have someone proof-read your letter before you send it. I suspect
what you've posted is a very initial first draft (since it ends abruptly),
so the spelling errors and grammatical errors would be corrected in future
drafts. I also notice a tendency to use long sentences. You may want to
edit your longest sentences to be several shorter sentences.
3) Use "hot button" phrases so that you get more notice from the
higher-ups than someone who is "just" unhappy. For example, use of the
phrase "lack of informed consent" is likely to get attention since that is
a legal issue. Also, if you are able to look at the hospital's policies
and find specific policies that were violated, you can use the phrase "in
violation of hospital policy, Dr. X did this". If not policies, you can
look at mission statements, etc that are probably easily available online
or in their advertising materials.

Hope you get a response!
Amy


"Anne Rogers" wrote in message
...
On Wednesday I had a meeting with a midwife/counsellor and had a look at
my medical notes, I had put out of my mind everything that had happened
in the week before Ada's birth and had tried to forget about it. The
reason I went to the counsellor was because I wanted to talk about how I
had managed labour and feel validated for the way I had not handled it
well, which was acheived, it was just in the process I saw most of my
notes from the week before it happened, so I've had to think about it all
again and have decided that I need to make a complaint. My first step has
been to write down what happened, so that when I make a list of more
specific complaints these can be put into context. So, here's the story,
I would really appreciate feedback, I want to make it as clear and
consise as possible but without missing anything out, I know on this
group people will know something, but I didn't go into much detail about
the time I was actually in hospital, so if you read it, please can you
try and imagine you are sat in an office and you know absolutely nothing
about this case and see if I have provided the right information, Thanks,
Anne btw, the complaint is not that I didn't have a c-section, more the
general care and poor communication.

************************************************** *********************

On Sunday 5th June I was assessed on delivery unit, due to severe joint
pain related to my pregnancy, I was 38 weeks and 5 days pregnant. The
doctor was a female registrar, whose name I think was Dr Ding, or
similar, who I had seen in out patients on Thursday 2nd June.

We discussed that fact that my pain had not decreased and the addition of
Temazepam at night time had not helped and that I was finding things
unbearable. She performed a vaginal examination to assess if any progress
towards delivering the baby had been made, I used entonox to help as I
found this very painful, it was too painful for her to perform a stretch
and sweep. We also discussed the option on induction of labour, which I
was nervous of as I had had a previous unpleasnt experience with my 1st
child, after the discussion I was more open to the possibilty and also
talked to an anaethetist about pain relief options.

I was already taking the strongest painkillers that I was able to take at
home so it was decided to admit me so I could receive stronger
painkillers. I expressed desire that this be given intravenously rather
than intramuscularly as previously I had found I had a much worse
reaction to IM opiate based analgesia with no difference in pain
relieving affect or duration than IV analgsia. I was informed that this
was possible and that a doctor would have to insert a cannula and
administer the drugs. This was done on Lady Mary Ward at around 4pm and
made me comfortable.

At around midnight I woke up and was in terrible pain, I called the
midwife and asked for a further does of pethidine, which she was
unwilling to give, I was unhappy as I had understood that the sole reason
for being admitted to the hospital was to receive analgesia. I did not
wish to take oral analgesia as this would have been identical to what I
had taken the night before at home and as the pain had not lessened would
be very very unlikely to work. The doctor was called and she also was
unwilling to give me pethidine and I agreed to take Tramadol, I was told
that if it didn't work I could have pethindine in an hour. An hour later
I called the midwife again as I was still in significant pain, I was told
that I had to in fact wait 4hrs after taking the tramadol to receive
pethidine and was given temazepam, again a drug I had taken the previous
night which had not had the desired affect. I drowsed a little but spent
the majority of the next 3 hours counting the minutes until the pain
could be taken away. When the time was up I called the midwife and was
informed that if I wanted analgesia via IV I would have to wait at least
an hour, I was desperate and agreed to it being given IM.

The next day was Monday and I saw a lady doctor from Jane McDougalls team
in the morning, I expressed my desire for an elective c-section, partly
because I doubted my ability to deal with my pain as well as labour, but
also as I was concerned that given some of my pain seemed to be caused by
an excessive looseness of my joints and I was having particular pain in
my hips and pelvis along with the fact that I had had abnormal pain in my
hips and pelvis after my previous birth, that a vaginal delivery would
risk more significant damage as this baby appear to be bigger and at the
time was malpositioned. She said she didn't think this would be possible
and explained the risks of a c-section to me.

Later in the day I saw Dr Sterwin, who seemed strongly in favour of
inducing labour at 39 weeks, which would have been the following day. He
also crossed the pethidine of my drug chart, which I did not understand
as that was the sole reason for being in hospital, but at the time I
don't remember having any discussion with him about this, I think this
was because not long before he came to see me I had received IV pethidine
and was feeling woozy.

The next 24 or so hours were very unpleasant, I was not receiving the
drugs that I had been in hospital to receive and was in a lot of pain and
not able to think clearly and find out what was going on. A very nice
midwife, called Karen, seemed to understand the amount of pain I was in
and was able to give me IM pethidine. I saw Jane McDougall on her ward
round and she expressed she did not want me to have a c-section but that
she was happy for me to be induced.

I was given the impression that this would happen on Tuesday as I was 39
weeks and the midwife, Karen seemed to think so to as in the evening she
got everything ready and I spend time being monitored and she got the
Entonox, so she could give me a VE and insert the gel, but at some point
in organising that it was decided that I was only 38+5, so it couldn't
happen until Thursday. This was incorrect as we were using the dates from
my dating scan which indicated I was 39 weeks on Tuesday 7th June and in
my notes, gestation given on other dates agrees with this, however at the
time I was relieved as I still felt very uneasy about an induction.

At some point I had another conversation with Dr Sterwin and I was given
the impression that the main reason I couldn't have a c-section was due
to the fact that I have a history of postnatal depression and that the
immobility after a c-section would increase the risk of this, despite
recent research indicating that this is not in fact the case. Karen spoke
with the anaethestist and said that I could continue to have pethidine
until someone from the pain team could see me, but that it had to me IM.
I accepted this as during this stay in hospital my reaction to IM
analgesia had not been as bad as my previous reaction. The result of this
was that as I had so many injections my bum and hips became very sore.

Karen told me that I was on the list for induction of labour on Thursday,
which surprised me as after the confusion on Tuesday I didn't think I had
agreed to be induced, I expressed my concern about this and she arranged
for me to talk to a doctor, and on Thursday I had another conversation
with Dr Sterwin, he was very understanding about the problems I had had
with my previous induction and noted on my notes that I should receive
lower doses of the drugs and for them to be increased at less frequent
intervals. I still felt very very uneasy, but decided to go ahead with a
dose of prostin gel, thinking that if that didn't work I could still
refuse the drip, which was what I was most afraid of. Karen gave me
pethidine and provided Entonox and examined me, she also asked if a
student could repeat the exam and insert the prostin, which I agreed to
as with the Entonox and pethidine I was comfortable. This brought on
short, sharp contractions, which were obviously not making any progress,
but painful enough for me not to be able to sleep. Around 4 in the
morning, I asked the midwife for pethidine as the joint pain had returned
and I was struggling to cope with both that and the contractions, she
said no as it would stop any labour that was happening. I asked the
midwife who came on duty in the morning for pethidine but was told the
same, I was left in limbo as due to the fact I was still having some
contractions it was not possibly to give a further dose of pethidine, but
nor was I in labour and there was no space on delivery unit to take
things further. I felt very disillusioned and upset, I was in a lot of
pain from my joints and that seemed to have been forgotten and I was also
stuck in a not in labour, but not not in labour situation which was
difficult to manage, though it was dieing down, I regretted agreeing to
the prostin.

Karen came on shift and after finding I had not receive and pethidine,
very quickly gave me some, which did help my joints, but suddenly my
labour took off and I was taken upstairs to delivery unit. In the many
times things had been discussed during the preceeding few days, the plan
had been to have an epidural in very early labour, when I arrived on DU I
requested and epidural and was told I didn't need one by a student
midwife, eventually I convinced her and the supervising midwife that it
was what I wanted and the anaethetist was called. The labour and delivery
essentially went well, at each stage where I made a decision I queried
whether it would make any difference to me being able to go home that
evening (assuming the baby had been born!) as it was a very strong desire
to go home straight away. The baby was born at 6.08pm and no time was I
given the impression that I would not be able to go home once the paper
work was completed. We expressed that we were happy to bring the baby
back the following day to be checked by the paediatrician as we knew that
it could be a problem arranging that in the evening. At around 10.30 a
new midwife came and told me that I shouldn't go home as there had been
old meconium in the waters and it was not standard procedure. At this
stage I was ready to go home and my husband and left to go and move the
car closer to the hospital. I queried why this was the case and what
observations would be done and felt that as the baby had not evern
required suctioning that this was not necessary and asked for more
information about what signs I should look out for in both her and me. I
signed a self-discharge form and when the paperwork was completed we went
home. I later dicovered