Labour, Delivery & Aftercare
No concerns arose from the 4 ultrasounds. I had a very good pregnancy and only suffered from one bout of severe sickness which was treated with an injection at Huddersfield Royal Infirmary.
The midwife became concerned about the size of the baby towards the end of the pregnancy and told me that I should arrange to deliver Toby at Calderdale Hospital rather than Huddersfield Birth Clinic because she expected complications may occur due to him being large and long (Toby was 8lb 10oz when born & his length followed the 91st centile). The midwife suggested that if I reached term and did not go into labour that I would need inducing within a few days after my due date rather than the usual 2 weeks after.
Toby was due on the 5th of March and luck would have it that I began contracting at around 5am that morning. The midwife came to my home at 9.30am and said I was 6cms dilated and that she could feel the babies head, she instructed me to rind Toby's father at work and ask him to come home so we could make our way to hospital. The midwife said at the rate I was progressing that she expected the baby to be born and safely home by lunch time that day.
We headed to over to Calderdale hospital around 11.30am and as we made our journey my contractions became more frequent and painful. I believe it was at this point the babies position changed and that is why I felt severe pain in my lower back and bottom.
Once at the hospital I was taken to triage and told I was only 3cms dilated and told to walk the corridors until I progressed. I was in so much agony, I could barely walk and had to lie on the floor in pain. Eventually around 2.30pm the nurses took pity on my suffering and offered me a room so I could have more privacy.
Once in the room with my mum and husband by my side, I was rarely visited by midwifes. When a midwife did appear and check the babies progress, there had been none, yet I was in agony and contractions were coming one after another with little break between. I begged for pain relief but was told the anaesthetist was unavailable time and time again. The midwifes carried out multiple stretch and sweeps from time to time throughout the first stages of labour. Despite being in agony I was not given pethidine until after 6pm, entonox after 7pm and an epidural at 11pm.
At 9.30pm the fetal heart rose to 171bpm, at 11.40pm a blood test showed an abnormally large amount of white blood cells (almost double the normal range).
12 midnight fetal heart rose to 170bpm, at 12.30am the CTG was unreactive for 10 minutes.
At 1.30am my waters were artificially broken. The worst thing that can be done in posterior labour is breaking the amniotic sac since contractions are intensified which encourages the baby's head to descend and worsen the situation. The head must go through a long rotation of up to 180 degrees (normal rotation requires a 90 degree turn or less). Loss of amniotic fluid reduces the foetus's buoyancy, making rotation more difficult. A labour stimulant should not be used if the baby is in the wrong position.
At 2am the CTG showed decelerations and bradycardia to 90bpm for 5 minutes yet instead of arranging an emergency C-section the doctors chose to administer the labour stimulant Syntocinon.
At 4.45am the CTG was showed decelerations to 13bpm.
At 6.45am is reported straw colour liquor tinged with blood was draining.
At 7.10am I was finally fully dilated.
Pushing commenced at 8.40am but after some time I was advised to stop because my cervix had began to close again. The doctors then increased the labour stimulant syntocinon.
Finally at 9.30am the doctors suggested I have an emergency C-section.
Throughout the entire labour process the babies position is recorded as occiput posterior. I am concerned as to why if this is the case the membranes were artificially ruptured and pushing was encouraged. It is well reported that complications with the occiput posterior position can cause cerebral or intracranial haemorrhage. I also wonder why other than the midwifes suggesting I lay on my left side, nothing further was done to change the babies position.
Emergency Caesarean
Dr Abrahim took over delivery from Dr Butt during the emergency C-section because there was some difficulty delivering the baby's head which was deflexed height occiput posterior.
Upon birth Toby was limp and lifeless and we feared our son was still born. He was quickly rushed to the table and rubbed vigorously and had his airways cleared - he looked weak and did not cry. His APGAR score was recorded as 9, I feel this is a improvable lie. As soon as the nurses brought my son to me my first thought was 'what is wrong with him'.
Care/Lack of care
We were transferred to a ward and the nurses tried to latch Toby on to breast feed but he was too weak to feed and instead he was given 1 mil of expressed colostrum and placed back into his crib. After visitors were told to leave, I waited patiently for Toby to wake but he did not. Throughout the evening and night I waited to hear my baby cry for a feed but he did not make a sound. The nurses reassured me that this was normal after such a long complicated delivery and the drugs would take time to wear off. The next morning Toby had still not awoken or cried for a feed. They tested his blood sugars but the results were not at this point concerning so we continued to wait for him to show his hunger. The nurses offered to bathe him and upon doing so became concerned about the colour of his skin. We were then transferred to a private room and he was put on a billy bed for his jaundice. He just slept and slept and did not wake to feed. His weight plummeted. The hospital notes say he was breast feeding well but he was not. This is proven by the fact his weight which has been recorded continued to drop. His poor feeding can also be proven by the very few soiled nappies. My mothers milk had not come in by 9th of March. The midwifes repeatedly record concerns regarding Toby's colour, tone, grunting and lack of feeding.
The nurses record the following:
6th of March
Grunting and only few sucks on breast
3pm suckled for couple of minutes on breast but very sleepy
4pm remains uninterested in feeding
4.30pm 0.5mls colostrum expressed and given via syringe
6.30pm latched and suckled
7.50pm suckling again
9.50pm attempted to feed but not interested
11.30pm still uninterested in feeding despite encouragement
11.45pm (11 hours following birth) 1ml colostrum
7th of March
3.30am Toby is reported to have suckled - this another improvable lie! but I will never forget that night, waiting patiently for my child to wake to feed. He never did.
1.10pm 7th of March, Toby suckled for 5 minutes. Notes also state Toby fed well on demand earlier in day but do not record times or amounts. This is another lie.
6pm Billibed commenced
8.45pm noisy breathing, passed urine, not passed meconium, independently feeding, mum happy with this.
N.B. Mum was not happy, I was extremely concerned about my son, his colour, tone, his lethargy and his lack of feeding
9pm baby suckled for 5 minutes
8th of March
Blood tests show abnormal results for Hb, PCV & RBC levels.
12am notes show that baby had not suckled for 3 hours
3am baby breastfed
12.30pm breastfed
3.30pm 1ml expressed breast milk by syringe
3.40pm latched onto breast with stimulation but very sleepy, shown how to stimulate strong sucking
4.05pm suckled for 25mins, SBR 241mmol/L
6.30pm woke to feed, 6.45 suckling on breast
9pm tried to feed but too sleepy
9th of March
12.15am put to breast but too sleepy, few sucks
12.40am not interested in feeding
1am put to breast, sucked for 2 minutes, tried to wake up using damp cloth and suckled for 10 minutes
1.25am latched and suckled
3pm advised how to use breast pump and plan of action is put in place
9th of March 5.45pm expressed milk given via syringe
9th of March 10pm 45mls SMA given via syringe - first evidence of reasonable amount of feed administered
SBR up to 290 yet once again drops to 189 next day
Other notes say baby feeding well? had 25min breastfeed??? if that is so why are they administering 45mls SMA and encouraging expressing, bizarre. Notes also indicate my milk hasn't fully come in, so if he has in fact been breast feeding as well as these notes seem to record why isn't he urinating or soiling his nappies, why is his weight still dropping.
10th of March
2am Baby would not breastfeed so given small amount of SMA via syringe
3am asked to see regarding sleeping and failure to feed - plan to top up feed
11am midwifes concerned with Toby's jaundice, feeds, lethargy and decreased urine output.
Breastfed every 4 hours - suckling for 5 mins - midwifes feel it is concentrated & not much - 30ml top up SMA every 4 hours
10pm Toby had bottle feed
Child chronology notes say plan to breast feed every 3 hours then top up with 75mls which contradicts mothers chronology notes which say every 4 hours and 30ml top up.
Normal tone is recorded - this baffles me because Toby held his legs permanently in the foetal position and had tonic neck reflex for at least a year following birth, so I find it very strange that they say his tone was normal. I also find it strange that no-one has mentioned his unusual high pitched cry.
10.15pm recorded to have had wet and dirty nappy by this time
11 March
3pm mother concerned about babies feeding, took 20mls expressed & 40mls sma N.B. look at the amounts being expressed; only 20mls breast milk being expressed after 6 days??? what exactly has Toby been suckling all this time. Surely if he had been feeding as well as the hospital notes would like you to believe then I would be making more than 20mls breast milk every 4 hours.
Remains jaundice.
Biochemistry report show abnormal sodium, potassium, bicarb & urea levels
Blood test shows abnormal WBC, MCHC, Neut & Baso levels
12 March
Midwife is concern about baby lethargic & floppy, yet we were discharged the next day, in a bid to free up beds.
Care after leaving hospital
Toby bottle feeds but needs a lot of stimulation (wet flannel, blowing on face) to keep him awake, he takes around 90mls every 3 hours but it takes him an hour each time to drink it, he still looked jaundice for a long time after leaving hospital. Toby's feeding was constantly monitored for the first few months and we attended a baby clinic every Wednesday at Meltham Road Surgery Lockwood. Eventually Toby's struggles with feeding resulted in him having to have a nasal feeding tube and eventually a PEG feeding tube.
On the 5th of May 2009 we met with Dr Schwartz and she notes that Toby's head has not grown well since birth but does not point out any further concerns.
After that date, I begin to become more and more concerned about Toby's development. Each week I express concern at the baby clinic and in June 2009 I went to the doctors and begged him to get me an appointment to see Dr Schwartz. He said they could not move the appointment forward and that he would transfer my concerns to her.
When we went to see Dr Schwartz on the 4th of August she was annoyed that the doctor had not fully expressed the concerns to her and she said within minutes of us walking in the door that she could see instantly that Toby was far worse than they had described and that further tests would need to be done immediately.
This experience left me frustrated, Toby could of had been seen earlier. I had months of upset and being made to feel like a paranoid mother because the doctors surgery would not take my concerns seriously. The nurses that I saw every Wednesday must of known there was something wrong, Toby kept his legs in the foetal position most of the time and he has asymmetrical tonic neck reflex and he was so drowsy and failed to focus on anything. I had told the doctors that Toby's eyes seemed to swim in and out. Eventually this left him cross eyed. I believe Toby was suffering epileptic seizures from birth.
The midwife became concerned about the size of the baby towards the end of the pregnancy and told me that I should arrange to deliver Toby at Calderdale Hospital rather than Huddersfield Birth Clinic because she expected complications may occur due to him being large and long (Toby was 8lb 10oz when born & his length followed the 91st centile). The midwife suggested that if I reached term and did not go into labour that I would need inducing within a few days after my due date rather than the usual 2 weeks after.
Toby was due on the 5th of March and luck would have it that I began contracting at around 5am that morning. The midwife came to my home at 9.30am and said I was 6cms dilated and that she could feel the babies head, she instructed me to rind Toby's father at work and ask him to come home so we could make our way to hospital. The midwife said at the rate I was progressing that she expected the baby to be born and safely home by lunch time that day.
We headed to over to Calderdale hospital around 11.30am and as we made our journey my contractions became more frequent and painful. I believe it was at this point the babies position changed and that is why I felt severe pain in my lower back and bottom.
Once at the hospital I was taken to triage and told I was only 3cms dilated and told to walk the corridors until I progressed. I was in so much agony, I could barely walk and had to lie on the floor in pain. Eventually around 2.30pm the nurses took pity on my suffering and offered me a room so I could have more privacy.
Once in the room with my mum and husband by my side, I was rarely visited by midwifes. When a midwife did appear and check the babies progress, there had been none, yet I was in agony and contractions were coming one after another with little break between. I begged for pain relief but was told the anaesthetist was unavailable time and time again. The midwifes carried out multiple stretch and sweeps from time to time throughout the first stages of labour. Despite being in agony I was not given pethidine until after 6pm, entonox after 7pm and an epidural at 11pm.
At 9.30pm the fetal heart rose to 171bpm, at 11.40pm a blood test showed an abnormally large amount of white blood cells (almost double the normal range).
12 midnight fetal heart rose to 170bpm, at 12.30am the CTG was unreactive for 10 minutes.
At 1.30am my waters were artificially broken. The worst thing that can be done in posterior labour is breaking the amniotic sac since contractions are intensified which encourages the baby's head to descend and worsen the situation. The head must go through a long rotation of up to 180 degrees (normal rotation requires a 90 degree turn or less). Loss of amniotic fluid reduces the foetus's buoyancy, making rotation more difficult. A labour stimulant should not be used if the baby is in the wrong position.
At 2am the CTG showed decelerations and bradycardia to 90bpm for 5 minutes yet instead of arranging an emergency C-section the doctors chose to administer the labour stimulant Syntocinon.
At 4.45am the CTG was showed decelerations to 13bpm.
At 6.45am is reported straw colour liquor tinged with blood was draining.
At 7.10am I was finally fully dilated.
Pushing commenced at 8.40am but after some time I was advised to stop because my cervix had began to close again. The doctors then increased the labour stimulant syntocinon.
Finally at 9.30am the doctors suggested I have an emergency C-section.
Throughout the entire labour process the babies position is recorded as occiput posterior. I am concerned as to why if this is the case the membranes were artificially ruptured and pushing was encouraged. It is well reported that complications with the occiput posterior position can cause cerebral or intracranial haemorrhage. I also wonder why other than the midwifes suggesting I lay on my left side, nothing further was done to change the babies position.
Emergency Caesarean
Dr Abrahim took over delivery from Dr Butt during the emergency C-section because there was some difficulty delivering the baby's head which was deflexed height occiput posterior.
Upon birth Toby was limp and lifeless and we feared our son was still born. He was quickly rushed to the table and rubbed vigorously and had his airways cleared - he looked weak and did not cry. His APGAR score was recorded as 9, I feel this is a improvable lie. As soon as the nurses brought my son to me my first thought was 'what is wrong with him'.
Care/Lack of care
We were transferred to a ward and the nurses tried to latch Toby on to breast feed but he was too weak to feed and instead he was given 1 mil of expressed colostrum and placed back into his crib. After visitors were told to leave, I waited patiently for Toby to wake but he did not. Throughout the evening and night I waited to hear my baby cry for a feed but he did not make a sound. The nurses reassured me that this was normal after such a long complicated delivery and the drugs would take time to wear off. The next morning Toby had still not awoken or cried for a feed. They tested his blood sugars but the results were not at this point concerning so we continued to wait for him to show his hunger. The nurses offered to bathe him and upon doing so became concerned about the colour of his skin. We were then transferred to a private room and he was put on a billy bed for his jaundice. He just slept and slept and did not wake to feed. His weight plummeted. The hospital notes say he was breast feeding well but he was not. This is proven by the fact his weight which has been recorded continued to drop. His poor feeding can also be proven by the very few soiled nappies. My mothers milk had not come in by 9th of March. The midwifes repeatedly record concerns regarding Toby's colour, tone, grunting and lack of feeding.
The nurses record the following:
6th of March
Grunting and only few sucks on breast
3pm suckled for couple of minutes on breast but very sleepy
4pm remains uninterested in feeding
4.30pm 0.5mls colostrum expressed and given via syringe
6.30pm latched and suckled
7.50pm suckling again
9.50pm attempted to feed but not interested
11.30pm still uninterested in feeding despite encouragement
11.45pm (11 hours following birth) 1ml colostrum
7th of March
3.30am Toby is reported to have suckled - this another improvable lie! but I will never forget that night, waiting patiently for my child to wake to feed. He never did.
1.10pm 7th of March, Toby suckled for 5 minutes. Notes also state Toby fed well on demand earlier in day but do not record times or amounts. This is another lie.
6pm Billibed commenced
8.45pm noisy breathing, passed urine, not passed meconium, independently feeding, mum happy with this.
N.B. Mum was not happy, I was extremely concerned about my son, his colour, tone, his lethargy and his lack of feeding
9pm baby suckled for 5 minutes
8th of March
Blood tests show abnormal results for Hb, PCV & RBC levels.
12am notes show that baby had not suckled for 3 hours
3am baby breastfed
12.30pm breastfed
3.30pm 1ml expressed breast milk by syringe
3.40pm latched onto breast with stimulation but very sleepy, shown how to stimulate strong sucking
4.05pm suckled for 25mins, SBR 241mmol/L
6.30pm woke to feed, 6.45 suckling on breast
9pm tried to feed but too sleepy
9th of March
12.15am put to breast but too sleepy, few sucks
12.40am not interested in feeding
1am put to breast, sucked for 2 minutes, tried to wake up using damp cloth and suckled for 10 minutes
1.25am latched and suckled
3pm advised how to use breast pump and plan of action is put in place
9th of March 5.45pm expressed milk given via syringe
9th of March 10pm 45mls SMA given via syringe - first evidence of reasonable amount of feed administered
SBR up to 290 yet once again drops to 189 next day
Other notes say baby feeding well? had 25min breastfeed??? if that is so why are they administering 45mls SMA and encouraging expressing, bizarre. Notes also indicate my milk hasn't fully come in, so if he has in fact been breast feeding as well as these notes seem to record why isn't he urinating or soiling his nappies, why is his weight still dropping.
10th of March
2am Baby would not breastfeed so given small amount of SMA via syringe
3am asked to see regarding sleeping and failure to feed - plan to top up feed
11am midwifes concerned with Toby's jaundice, feeds, lethargy and decreased urine output.
Breastfed every 4 hours - suckling for 5 mins - midwifes feel it is concentrated & not much - 30ml top up SMA every 4 hours
10pm Toby had bottle feed
Child chronology notes say plan to breast feed every 3 hours then top up with 75mls which contradicts mothers chronology notes which say every 4 hours and 30ml top up.
Normal tone is recorded - this baffles me because Toby held his legs permanently in the foetal position and had tonic neck reflex for at least a year following birth, so I find it very strange that they say his tone was normal. I also find it strange that no-one has mentioned his unusual high pitched cry.
10.15pm recorded to have had wet and dirty nappy by this time
11 March
3pm mother concerned about babies feeding, took 20mls expressed & 40mls sma N.B. look at the amounts being expressed; only 20mls breast milk being expressed after 6 days??? what exactly has Toby been suckling all this time. Surely if he had been feeding as well as the hospital notes would like you to believe then I would be making more than 20mls breast milk every 4 hours.
Remains jaundice.
Biochemistry report show abnormal sodium, potassium, bicarb & urea levels
Blood test shows abnormal WBC, MCHC, Neut & Baso levels
12 March
Midwife is concern about baby lethargic & floppy, yet we were discharged the next day, in a bid to free up beds.
Care after leaving hospital
Toby bottle feeds but needs a lot of stimulation (wet flannel, blowing on face) to keep him awake, he takes around 90mls every 3 hours but it takes him an hour each time to drink it, he still looked jaundice for a long time after leaving hospital. Toby's feeding was constantly monitored for the first few months and we attended a baby clinic every Wednesday at Meltham Road Surgery Lockwood. Eventually Toby's struggles with feeding resulted in him having to have a nasal feeding tube and eventually a PEG feeding tube.
On the 5th of May 2009 we met with Dr Schwartz and she notes that Toby's head has not grown well since birth but does not point out any further concerns.
After that date, I begin to become more and more concerned about Toby's development. Each week I express concern at the baby clinic and in June 2009 I went to the doctors and begged him to get me an appointment to see Dr Schwartz. He said they could not move the appointment forward and that he would transfer my concerns to her.
When we went to see Dr Schwartz on the 4th of August she was annoyed that the doctor had not fully expressed the concerns to her and she said within minutes of us walking in the door that she could see instantly that Toby was far worse than they had described and that further tests would need to be done immediately.
This experience left me frustrated, Toby could of had been seen earlier. I had months of upset and being made to feel like a paranoid mother because the doctors surgery would not take my concerns seriously. The nurses that I saw every Wednesday must of known there was something wrong, Toby kept his legs in the foetal position most of the time and he has asymmetrical tonic neck reflex and he was so drowsy and failed to focus on anything. I had told the doctors that Toby's eyes seemed to swim in and out. Eventually this left him cross eyed. I believe Toby was suffering epileptic seizures from birth.