Botched C-section

[xiona]

My daughter went into labour 4-5 weeks early and because the baby was breech it was decided to section her.There was a lot of confusion in the labour suite and she was given little or no choice. An epidural was not offered.Three days after the birth she was visited by a Consultant(not her own) who informed her that her womb had been damaged and that there would be a need for effective contraception as she would be unable to carry any more babies.and that an artery had been cut in theatre. She didn't elaborate., my daughter was still too unwell to respond. Prior to her discharge I telephoned her midwife and asked that she be seen by her own Consultant to explain what had happened. She was,and little more was said as she was not present.She was discharged on the monday 10 days later,when baby finally gained 40grams(She was 4.7oz at birth)When the midwife didnt appear on the Tuesday I telephoned her GP as she was unwell and quite distressed, he put a call out but she failed to answer, and her Gp saw her and prescribed anti biotics. Today she went back to the Dr. as there was still no midwife and she is still unwell.Another GP has prescibed more antibiotics and wanted swabs from her wound and from the vagina. The nurse was horrified at the amount of bruising and could not take swabs from below.

What I would like to know is this- where do we go from here.

Who do we ask for a second opinion?

The lack of post natal care is a separate issue, but I feel that her and her partner who is furious need to seek out the best possible care as she is still very fragile and clearly not well.

[mistie]

so sorry to hear this,

having had 2 c-sections myself thay are not the nicest thing to have to go through.

why was there bruising, there shouldnt be.

 

yes get a second opion. a friend off mine is claiming off the nhs for her c-section.

 

i hope things get better.

 

mistie

[mazzab]

Hi

 

It sounds like your daughter had a rough time of it. Childbirth in general can be tough, and when it does not go according to plan it is enourmously upsetting for mum, dad, grandparents and everyone else - including the midwives and doctors. I hope she is recovering. I take it from the initial post that the baby is fit and well? If not my apologies.

 

I am a GP, but recently spent 6 months working as a junior doctor in Obstetrics & Gynaecology.

 

It sounds to me that what is needed here is not a "second opinion" on what to do now, but a proper explanation of what has already been done. It is a fact of modern working patterns in the NHS that any care delivered out of hours (Ie between 5pm and 8am) is very unlikely to be delivered by the consultant in charge of your case. This is not doctors being lazy, but a consequence of the European Working Time Directive, which limits the hours anyone can work unless self employed.

 

Decisions when labour is slow or delayed are often made very quickly because minutes can be the difference between a healthy baby and a handicapped or stillborn baby. This may be why your daughter feels she was not really informed what was happening, and why she was not as fully involved in the decision as should be the case in an ideal situation. It sounds to me as if the doctors who made the decision to operate, and actually did the surgery need to find a good deal of time to sit down with you and your daughter and go through what happened and why.

 

I suspect that this may help you both understand the current situation better than seeing several other doctors who were not there at the time. I would suggest you take this avenue first, as this may help you more than seeing lots more consultants with diffent views and personal axes to grind. If you start to sue the doctors concerned they may not be willing to have the same sort of frank discussion for fear of both a confrontational meeting, and of prejudicing any future legal case. I have often found that poor communication, in the heat of battle, so to speak, is the real problem in situations like this.

 

As an aside I took the examination for the Royal College of General Practitioners: I had to spend about 100 hours watching videotapes of my own consultations to select 10 that showed me consulting to the standard required. I also spent at least that much time reading about and practising consultation skills and methods before I started videotaping at all. When I did the examination for the Royal College of Surgeons I was not even allowed to ask patients questions during the clinical part of the examination. I wonder if this explains why many Surgeons (including Obstetricians) are not great at talking to / with their patients!

[ScarletPimpernel]

Every NHS Trust should have a Patient Advice and Liaison Service whose function is to deal with just the sort of concerns mentioned. They will be able to facilitate a meeting with the doctors of the sort suggested by Mazzab.

 

As part of a university course some time ago, I looked at patient complaints, both at the hospital I was working in at the time, and nationally (from the Health Ombudsman's records). Something over 90% of non-clinical complaints were due to communication problems.

[mazzab]

I have just realised that I didn't answer your main question - who do you ask for a second opinion.

 

If that is really what you feel you need then the first port of call is once again your GP who is perfectly entitled to refer you to another consultant or hospital for opinion, either on the NHS or privately. If your GP refuses because he does not see a clinical need (which he is also entitled to do) then you should discuss with him why he feels that is the case. Once again communication between you, your daughter, and the doctor or doctors concerned needs to be open, frank, and non-confrontational if possible.

 

I wonder if she needs to be seen by the obstetric team if there is any concern about post operative infection - this may need more than just random antibiotics, and the surgeons are best able to decide if there is a serious infection or not

 

Remember the GP and the consultant probably want your daughter and grandchildren to be be well as much as you do.

 

Get Well Soon, and hope this helps!