Charlie: “So this is what a full hotel looks like…”
Vaggie: “Think it’ll survive until Extermination day?”
Charlie: “I don’t know if I’LL survive to Extermination day.”
Vaggie: “Aww, babe.”
Charlie: “Seriously, who keeps ordering pizza??? We all already KNOW the cannibals will just skip it and try chewing on the poor delivery person!”
Vaggie: “My bet’s on Angel Dust. He’s not exactly thrilled the place got filled up with ‘shit smiling judgmental prudes.’”
Charlie: “Whyyy didn’t I remember the cannibals have a whole dress-code thingy?”
Vaggie: “They are being polite about it though.”
Charlie: “They keep eyeing Angel Dust’s exposed thighs like they’re chicken wings.”
Vaggie: “And if they wanted to eat him up in any other way, he’d be thrilled.”
Charlie: (growling) “Some of them keep looking at YOUR thighs as if they were-”
Vaggie: “Anything other than property of Charlie Morningstar?”
Charlie: “-Vaggie they want to TEAR YOU APART!”
Vaggie: “And they’re not actually trying it, which is polite, even if they’re still talking about how angels might taste whenever I’m in the room.”
Charlie: (pout) “You taste good.”
Vaggie: “Not like that, babe.”
Charlie: “How could the rest of you not taste good too??”
Vaggie: “Ask the cannibals. Meat flavors based on where the meat thing lived and what it ate, something something- What if angel steaks taste like artificial food coloring?”
Charlie: “I like those-!”
Vaggie: "I know." (laughing) “Maybe that’s another reason why you’re the woman of my dreams.”
Charlie: “Am I?”
Vaggie: “The one and only.”
Charlie: “You’d never… think about leaving me for someone else?”
Vaggie: “NO?”
Charlie: “Someone a little more badass maybe?”
Vaggie: “Not possible. You called heaven out for being total bullshit. In a song.”
Charlie: “Maybe someone you had an instant and deep connection with?”
Vaggie: “Like the woman that bandaged my eye socket and took me home with her and nursed me through physical and emotional hell all because she also thought sinners might be people worth caring about?”
Charlie: “Well what about someone who… is just better? At the whole. Everything.”
Vaggie: “Literally who. Who the fuck-”
Charlie: “Carmilla?”
Vaggie: “Car-hhhhHHH." (chokes)
Vaggie: "AHAHAHAHAH! Charlie! WHAT!?”
Charlie: “She’s cool. She’s one of those, those muffin things right? Angel Dust said-”
Vaggie: “A milf, sweetie. It’s milf and PLEASE also listen to Husk’s reality checks whenever Angel Dust opens his well meaning but dumb as shit whore mouth.”
Angel Dust: (distantly) “My HOT and SEXY whore mouth heard that, toots!”
Vaggie: (yelling back) “Then go stick a dick in it!”
Angel Dust: “I’m tryin’~”
Charlie: (used to this) (ignoring them) “So the whole private training battle song thing was, not a turn on for you? At all?”
Vaggie: “If I ever call Carmilla Carmine ‘mommy’ it’ll be because she just signed my adoption papers.”
Charlie: “Oh! Okay! Juuuust wanted to check.”
Charlie: “…..”
Charlie: “Are you gonna ask about me and the head-to-heart I had with-”
Vaggie: “No.”
Charlie: “-because I was literally thinking about you the whole time-“
Vaggie: (smile) “That just took a perfectly non-worrying thing and made it sound bad.”
Charlie: “Is there a thing like a- an elf??”
Vaggie: “Aunt you’d like to fuck?”
Charlie: “Well not ME personally. But Rosie is very impressive.”
Vaggie: “You looked more impressed up in heaven.”
Charlie: “Huh? Heaven??”
Vaggie: “Nothing- never mind. I do actually have a lady-related question for you though.”
Charlie: “What does heaven have to do with- what?”
Vaggie: “I think I’m in love.”
Charlie: “WHAT!?”
Vaggie: “She’s ripped out my heart and I want to thank her for it.”
Charlie: “Th-thh that’s wait how when-?”
Vaggie: “Charlie.”
Charlie: “-y, yes?”
Vaggie: “Can we keep inviting Susan over, even after Extermination day?”
Charlie: “…”
Charlie: “Susan.”
Vaggie: “Charlie please? Please? She's the granny I don't deserve and desperately need in my life. Please please please please-”
Charlie: “But, Vaggie- She HATES everyone!”
Vaggie: “I know!”
Charlie: “And she SAYS it!?”
Vaggie: “And it’s so fucking cool.”
Charlie: “She said you dress like a hooker!”
Vaggie: “Angel Dust was furious. I think he would’ve thrown a punch at her, in defense of hookers everywhere, if Husk hasn’t grabbed him.”
Charlie: “A LAZY hooker!”
Vaggie: “That one hit home and I’ll cherish it’s sting forever.”
Charlie: “She’s not NICE. She doesn’t even PRETEND to be nice like the other cannibals do!”
Vaggie: “Isn’t that great?” (grinning) “She’s like, the anti-Alastor….”
Charlie: (sigh)
Charlie: “I guess… being brutally, painfully, rudely honestly about your feelings is… not the worst thing someone can be.”
Vaggie: “YES! Can we adopt the creepy old mean lady?”
Charlie: “She can visit. We are NOT inviting her to LIVE here.”
Vaggie: (smiling)
Charlie: “….”
Charlie: (drooping) “…not unless she wants to.”
Vaggie: “Thanks, sweetie.” (kiss) “She never would. She hates us all and especially the hotel. Ask her and she’ll tell you, in detail, how all our decorating ideas are terrible and she’s only here to grab the free snacks, shove some angel leftovers in her basket, and then fuck off to her own perfect home back in Cannibal Town.”
Charlie: “So why scare me like that by asking? SUSAN in the attic! Ughghgh…”
Vaggie: “’cause it’s nice hearing you’d be open to it anyway.”
Charlie: “Mmrmph.”
Vaggie: “I like remembering that you’re like this.”
Charlie: “Whipped marshmallow.”
Vaggie: "That Angel Dust again?"
Charlie: "Maybe."
Vaggie: "I've got a better word for you."
Charlie: "Like 'girlfriend?"
Vaggie: “Like amazing.”
Charlie: (snorts) (smiles) "Heh. Alright, flattery accepted."
Vaggie: "My wonderfully, adorably dramatic, heart stopping and breathtakingly passionate girlfriend, the most incredible person I've ever met, who-"
Charlie: (laughing) “Now who’s being a sweetie?”
Vaggie: “Charlie, I’m seri- whoah!”
Niffty: (lifting up floor board vaggie was standing on and peeking up at them) “Hey guys!”
Charlie: “Niffty!” (hug lifting vaggie to safety) “W- hi! Um! What is it?”
Niffty: “A bad day not to wear underwear!”
Vaggie: “And a good day to Die.”
Niffty: "I WISH!" (GIGGLES) “News from the hotel gossip line! S.O.S from Husk- he says Angel Dust and some cannibals are fighting over who gets to put the new pizza delivery in their mouths while Cherri’s taking bets and also shots.”
Charlie: "Shots of alcohol?"
Niffty: "Laser gun!"
Charlie: "Nooooo I thought we'd cleaned up everything after Pen's last inventing spree!"
Niffty: "Missed one. She keeps missing too. She fried the pizza."
Vaggie: "Instead of?"
Niffty: (GRINS) "The pizza delivery person!"
Vaggie: “Ugh. We look away for Ten. Minutes.”
Charlie: “Well that’s not- that’s not TOO bad! At least Sir Pentious isn’t-”
Niffty: “His corpse is in the lobby.”
Charlie: “-right. Okay.”
Vaggie: “Why is he a corpse in the hotel lobby this time?”
Niffty: “The cannibals accidentally ate his tongue while he was trying to show Cherri how long it was and then he choked while proving he has no gag reflect and can unhinge his jaws.”
Charlie: “Oh.”
Niffty: “The cannibals want to snack on him again but Susan keeps yelling at them about ‘crumbling standards’ and ‘back in HER day-‘”
Vaggie: “I love her.”
Charlie: “I’m right here.”
Vaggie: “You kinda love her too right now.”
Charlie: (pulls face) “She can come to dinner every other week. If we live. For now though, let’s just, um.”
Vaggie: “Go save the snake man?”
Niffty: “That man is DEAD!”
Charlie: “Resuscitate. We should go resuscitate the snake m- Sir Pentious.”
Niffty: (giggles) “And I’m gonna go order another pizza boy~” (scurries back under floor board)
Vaggie: “Wait, Niffty-”
Charlie: “Niffty! Are YOU the one who’s been-? Vaggie NO-”
Vaggie: (spear out) (in pursuit) “GET OUT OF THE CRAWL SPACES RIGHT NOW AND COME BACK HERE, YOU LITTLE-”
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WIBTA if I reminded a friend he owes me money?
@aitathrowaway321 for finding later
I (20s, they/them) lent a friend Johnny (fake name. 20s, he/him) about $300 for rent about a year and a half ago. He was panicking because he'd bought a small tattoo that week, and had thought he'd budgeted for rent, but realized he forgot about another bill.
I'd once not had enough for rent and a friend who wasn't well off, without me asking, had offered to lend me the money for rent. It had been an incredibly kind act, and though I'd paid that friend back a few months later the first second I could, I've always remembered it. So I offered to do the same to Johnny (who knew this story) as a sort of pay-it-forward and that he could just pay me back when he was able, no rush at all. I also at the time had an okay job where I made enough to be able to do this, and Johnny's job was pretty awful.
Johnny was very thankful and agreed. At first, he'd bring up the debt a lot himself (I would never bring it up) and continually promise to pay it when he could, to which I'd be like - just as soon as you comfortably can, don't stress! And he mentioned it A LOT. Multiple times every single time I saw him at first. But eventually he stopped mentioning it entirely.
The two of us had this in-joke, and Johnny realized he could buy something related to the in-joke. He swore he'd buy it for me as a birthday gift (I didn't ask) and it would be so much fun, very soon after I lent him money. It would have been a nice gift, but it would've cost at least $200. In my head I decided that if he decided to get me the gift instead of paying me back I'd be happy either way, bc it's nice to be thought of. All I said aloud was that it would be a lot of fun, and it was a very kind thought from him. He would then regularly bring up buying me this gift for months. Then my birthday passed and I didn't get anything at all from him. Which was fine, I didn't ask for gifts! But then he stopped bringing up buying me anything OR paying back the money.
Now it's been almost a year and a half, and he seems to have entirely forgotten he ever owed me. I wouldn't mind so much - times are hard! - and it's not like I'm going to be angry if someone is spending money on nice dinners and pretty clothes instead of saving up for a no-deadline debt to a friend. People need to have nice things to get through life. But he keeps getting new tattoos and piercings (we go to the same parlor, I know they're pricey) and he recently planned and went on a big trip with a friend. It's not as if he hasn't had the ability to pay me back in the last few years. I also got laid off from my job, and $300 is a lot more to me than it used to be.
It's not so much that I want the money back as it is that I'm hurt he spent so much time talking big about paying me, and then when enough time had passed just dropped it entirely. I've had an issue in the past when after I got an okay job, suddenly people who had ghosted me were begging me for money (didn't know my salary but just assumed bc of the job title). And having been in awful situations, I tried to help where I could anyway, but then after getting the money they'd ghost me again. Johnny hasn't ghosted me, but he seems to have decided not to pay me back and pretend it never happened.
We have an event coming up where people will be paying for things and everyone else will be paying them back immediately - just bc it's easier to do things like buy tickets all at once and then pass them out, and easier for a restaurant to have one bill and then people venmo each other after. I was considering having Johnny pay and then tell him he can take it out of his debt to me.
I'm unsure if this is passive aggressive and rude, or if it's a good way to gently remind him he owes me without being a jerk about money - if he is still just struggling financially and hasn't forgotten, I don't want to rub anything in or make him stressed. I don't want money to ruin a friendship, but I'm feeling hurt.
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“Every year, about 25,000 (UK) women who give birth — approximately 4 per cent — are so distressed that they meet the diagnostic criteria for post-traumatic stress disorder. That makes birth one of the biggest causes of PTSD in the UK according to the Birth Trauma Association charity – probably coming second only to sexual abuse and rape. Hundreds of thousands more women are traumatised. This is a major health crisis. And yet it is barely discussed…
According to figures from NHS Resolution, the arm of the Department of Health and Social Care that handles litigation, 62 per cent of the total clinical negligence cost of harm in 2022-23 (£6.6 billion) related to maternity.”
When my husband and I left for hospital on a Friday afternoon, we had no idea what would happen. The next few hours would change my life. For good and bad. It had all started with a cervical sweep the day before. I was 40 weeks and 4 days pregnant and, frankly, I’d had enough. My pregnancy had been uncomplicated in terms of my baby — she was healthy throughout, albeit had spent much of her time in the back-to-back position. But I had found the nine months increasingly difficult. From around 20 weeks I’d suffered from pelvic girdle pain, which, for me, meant increasingly agonising pain in my lower back. Walking and other everyday movements became difficult. The only place I felt vaguely comfortable was in water. Swimming was a relief.
Women are offered a sweep to help induce labour. A midwife inserts their finger and sweeps around your cervix. It’s about as basic as you can get. They’re trying to separate the membranes of the amniotic sac that surround the baby from your cervix. This then releases hormones, which may help start your labour. “Some women find the procedure uncomfortable or painful,” NHS guidelines say. I found it excruciating.
“Oh,” the midwife said, as I lay in a rather compromised position. “I might have broken your waters.” This didn’t make sense to me. I’d always assumed that when my waters broke, I’d know about it. Apparently not always, and I was instructed to call the hospital if contractions hadn’t begun within 24 hours as I was now potentially at risk of infection.
They didn’t start. And I did what I’d been asked. The voice on the phone was chirpy — everything sounded fine, stay at home, we’ll be seeing you soon enough. Half an hour later, my phone rang. “Where are you? You’re meant to be at the hospital,” the woman said angrily. I needed to come in immediately to be examined.
It was late Friday afternoon and it was busy. We took the last of the beds in maternity triage. And my waters broke in earnest. That solved the mystery, I suggested. No, I was told, and the water birth I’d hoped for was out of the question — too risky.
Strong and regular contractions started immediately. We were moved to a glorified cupboard that had been turned into a makeshift holding room. I was denied any pain relief because it was “too early”, and told that someone would bring me some paracetamol when they came to “examine” me.
It seems obvious when you think about it, but I had never been told what being “examined” meant. Nor thought about it. It sounds medical. But it’s literally a midwife sticking their fingers inside you. I was 3cm dilated. Plenty of time to go, apparently. It was 9.30pm. I felt sick and in enormous pain. Both were dismissed — until I vomited everywhere. And lost control of my bowels. This would happen several more times over the coming hours. I felt utterly ashamed. Again, it’s common — but I hadn’t been told.
I continued to ask for pain relief and continued to receive none. An hour later, I was 7cm dilated — in full labour — and finally received some paracetamol. There was no space on the labour ward. In just another half an hour, I was fully dilated and ready for the baby to come out. No one seemed to know what to do. The midwives were panicking. And that made me scared. This was my first baby. I didn’t know what to expect. We were rushed to the ward. Already, nothing had gone the way I wanted, or the way it had been talked about at National Childbirth Trust (NCT) classes. Eventually, I was given gas and air to ease the pain. But only for about 20 minutes. Apparently it was “distracting” me too much and I needed to push.
Two hours later there was still no baby and I was in agony. A doctor arrived, took a brief look and said cheerily, “You’re going to be fine. You’re going to get that baby out.” And then he left. My maternity notes state, “PLAN: continue pushing.” I have no idea what this refers to — like so many of my notes. There was no plan. If there was, it wasn’t one I had agreed to. Finally, after another hour the decision was made that the doctor would use a ventouse — a suction cup that sits on your baby’s head — to help deliver my baby. Apparently I consented to this, but I have no recollection of doing so. And I’m ashamed to say I didn’t know what was being asked of me. My doctor didn’t use the word ventouse. He used “Kiwi”, which is a type of ventouse. At the time, I didn’t know what either were.
I remember screaming in pain and then my daughter finally being born. She was placed on my chest for less than a minute. I was examined, told I had a fourth-degree tear that must be repaired and that I needed to sign a consent form for surgery straight away. “Look at the state of her,” my usually mild-mannered husband said. “How can she possibly sign a form?” I couldn’t. The writing on that form is barely legible, but they would not proceed without it.
I had no idea what had happened. I lay in an operating theatre in pain, silent tears rolling down my face. I was frightened. The anaesthetist was amazing and stayed with me while I was repaired. I am so grateful for that, at least. But I also feel guilty about it. It was half past three on a Saturday morning and she was the only anaesthetist on duty at the London hospital. Other women may well not have received the pain relief they needed because of me. “Will I be able to have any more children?” I asked as I stared at the ceiling.
After surgery I was moved to the high dependency unit (HDU) and reunited with my daughter. I finally held and fed her for the first time. That morning is a blur. My notes tell me we stayed in the HDU for five hours before being moved to a ward. It was there that I attempted to understand what had happened to me. I was in pain, barely able to move and soaked in blood. I asked various midwives to explain what had gone on. They repeated that I’d had a fourth-degree tear, but I didn’t know what that meant. One line, in scribbled handwriting, stands out when I look at my notes: “We don’t have any written info about fourth-degree tears.”
Eventually, a midwife appeared with some information they’d printed off after googling it. As I read it, I sobbed. I was 35 years old and thought my life was over; that I would be incontinent. And still no doctor came to explain. The medic who’d delivered my daughter was eventually marched to my bedside more than 48 hours later.
I am perhaps unusual in that I’ve always wanted children. We had done what many middle-class suburban couples did at that time and attended NCT classes. The underlying message of these was: try to avoid a caesarean section at all costs. “Natural” births were best, and even better just to breathe through it. No need for pain relief. I remember in our penultimate class bringing up the subject of tearing during labour. I had seen a TV feature on it that week and it struck me as important. “If most of us are going to tear to some degree, it would be really helpful to talk about that,” I remember saying. “It would be good to know how best to care for ourselves afterwards, that kind of thing.” The answer was no, there was no need. Instead, we proceeded to get on all fours and “moo” like cows and then practise putting nappies on a doll.
Up to nine in ten first-time mothers who have a vaginal birth will experience some sort of tear. The least invasive kind involves only the skin from the vagina and the perineum — the area between a woman’s vagina and anus. These tears usually heal quickly and without any treatment. Second-degree tears involve the muscle of the perineum and require stitches. Third and fourth-degree tears are the most serious. These involve not just tearing of the skin and muscle of the perineum but the muscle of the anus. In fourth-degree tears, the injury can extend into the lining of the bowel. These deeper tears need proper surgical repair under anaesthetic.
I don’t really have any happy memories of the first few days or weeks after we left the hospital. I was completely in love with my baby, but I felt shellshocked. I couldn’t process what had happened and there was no one who offered to help me. A different midwife was sent to our house every couple of days to weigh our daughter. I had no milk the first few days and she had lost a fair bit of weight. Even when my milk came in, I found breastfeeding painful and difficult, in large part because it hurt so much to sit down.
I cried quietly every day for several months. Often it would come completely out of nowhere. I’d be talking or watching television and I would just start to cry. Several midwives wrote in my notes in those early weeks the same phrase: “Mum is anxious.” I don’t think I was. I was traumatised. Several weeks later, I was told that I was “lucky” by the midwife examining my stitches. Apparently the doctors had done a “wonderful” job at repairing me and it looked “beautiful”. I now know that I was fortunate to be repaired properly and immediately after the birth. But the last thing I felt — then or now — was lucky.
After several months I desperately needed to have some control over my life again. I had never felt so helpless, lost and infantilised. But my overarching feeling was anger. I wrote to the chief executive and chair of the hospital to complain and was invited in for a debrief. The head of midwifery was lovely, apologised and followed through on her promise to try to prevent other women facing the appalling lack of communication I had. The hospital now has a specialist perineal health clinic too.
But the attitude of the consultant obstetrician whom I met with my husband floored us both. It was about six months after the birth, but I was still under the care of a consultant urogynaecologist. (I subsequently had two further operations: the first 14 months after giving birth to remove an undissolved stitch that was causing pain but hadn’t been spotted, and another six months after that.) My urogynaecologist had told me not even to consider giving birth vaginally again. The risk was too great, he explained. If I tore again, there was a 30 per cent chance I couldn’t be repaired and I’d be incontinent. The obstetrician said the opposite — don’t rule it out! I saw red. “How dare you,” I growled. I remember saying that he would never be so cavalier about a man’s body.
Every year, about 25,000 women who give birth — approximately 4 per cent — are so distressed that they meet the diagnostic criteria for post-traumatic stress disorder. That makes birth one of the biggest causes of PTSD in the UK according to the Birth Trauma Association charity – probably coming second only to sexual abuse and rape. Hundreds of thousands more women are traumatised. This is a major health crisis. And yet it is barely discussed.
“Birth trauma is a broad term, but generally it’s overwhelming distress that leads to a detrimental impact on well-being,” explains Susan Ayers, professor of maternal and child health at City University in London. Estimates “range massively”, she says, but having conducted research into birth trauma for almost 30 years, Ayers puts it at about a third. “If you ask women whether they thought they or their baby was going to die or be severely injured, then it’s around 19-20 [per cent] in the UK. But if people just ask women, ‘Was your birth traumatic?’ some of those estimates are up to 50 per cent.”
“I’M BEATRICE’S MUM,” EMILY SAID, introducing herself to a committee of MPs in March. “Beatrice died during labour at full term in May 2022.” Emily is one of a number of brave women who have shared their traumatic birth stories with the all-party parliamentary group (APPG) on birth trauma, during the first parliamentary inquiry into this issue.
“As soon as my labour started,” Emily explained, “I knew it wasn’t right, wasn’t normal.” The details are harrowing: a series of obvious but missed red flags and an attitude from medical professionals that can only be described as cruel. The midwife who shrugged her shoulders when Emily’s waters were meconium-stained; the consultant obstetrician who laughed at the “slimy” feel of that meconium while her hand was still inside Emily.
“The ultrasound scanning machine was brought in and showed that Beatrice’s heartbeat had stopped,” she explained. “At that point I begged, pleaded like I’ve never pleaded for anything in my life for a caesarean, and that consultant obstetrician refused. She said no. And she left.”
“It’s destroyed my life,” Emily says now. “I’m not the person I was before.”
This inquiry has been led by the APPG’s co-chairs, the Conservative MP Theo Clarke and Labour’s Rosie Duffield. They received more than 1,200 written submissions after asking women to share their experiences; that number doubles if you count the letters and emails they’ve been sent informally.
“The thing that’s really struck me is there seems to be a taboo around talking about the risk of childbirth,” Clarke tells me when I sit down with both women in Westminster. There shouldn’t be, she adds. “Something we’ve heard from a number of the mothers coming to speak to us is that there’s such a focus on the baby post-delivery, they almost forget there’s a second patient in the room, and that’s the mother.”
“I was constantly told by GPs that I had nothing wrong with me,” one mother, Sarah, told the MPs. She experienced a major tear that doctors and midwives failed to diagnose. “I was discharged two days later with [an] untreated tear, which very quickly led to enormous amounts of pain, incontinence, faecal incontinence and thinking I was going mad.”
“It’s very painful,” explained Jenny, who also experienced a serious tear that was left untreated, “but the long-term consequences of an unrepaired tear are that I had to give up my job. I’ve suffered PTSD, anxiety, depression. My activities are restricted. My life is impacted in that I have to meticulously plan my day around toilets.”
Another mother, Neera, lost three litres of blood and required more than ten hours of life-saving emergency surgery the day her daughter was born. The haemorrhage had not been picked up by staff. She said she is fortunate to have had the “means and support” to access mental healthcare over four and a half years of her five-year-old’s life. “I have personally spent over £6,000 and received more than 50 hours of mental health support,” she told parliament.
The women who have spoken to politicians as part of the inquiry had different medical experiences. But there were obvious similarities. Their concerns and their pain were dismissed. They were not treated with respect or, in some cases, like human beings. They felt helpless, angry and scared. “Nobody really cares about women,” says Kim Thomas, CEO of the Birth Trauma Association. “What we tend to find with most of these stories is there’s failure after failure after failure. Lots of things go physically wrong… and that continues afterwards in the postnatal period with really poor care.” Almost all women seeking out the charity say their experience was made much worse by the way they were treated during labour. “The number of stories we hear of women being shouted at by midwives or laughed at by midwives is quite extraordinary.”
Birth doesn’t have to be this way. And it isn’t for many women. But women, in England in particular, could — and should — be having better experiences than they are.
Let’s start with serious tears. The number one risk factor is being a first-time mum. There’s nothing much that can be done about that. But the next is having an instrumental vaginal delivery — and in particular one that uses forceps. “Data indicates that we use more forceps than other parts of Europe,” says Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG). While rates in several European countries hover at around 0 per cent, a 2023 study of assisted births in 13 high-income countries found England used forceps in a higher proportion of births — about 11 per cent — than any other.
There are cases where forceps must be used. When babies are premature, suction would cause too much damage to the head. But that’s doesn’t explain the discrepancy. “It’s education,” Thakar explains. “We should be trained to do both [forceps and ventouse], so that we provide the best care to women and use the right instrument for the right baby and the right mother.”
The risk of a severe tear when forceps are used is at least twice as high as with ventouse: 8-12 per cent compared with 4 per cent. Women should be told this. The recent parliamentary inquiry heard other suggestions that might explain why forceps use in England is so high. The consultant gynaecologist and obstetrician Dr Nitish Raut explained that when poor outcomes of childbirth become part of litigation, the question, “Why were forceps not applied earlier?” will be asked. Although they can cause injury to mothers, forceps are the most effective instrument for getting a baby out. If a doctor tries and fails to deliver a baby with the less invasive ventouse first, a record will be made at the hospital trust. It was suggested by others that this might also be pushing some doctors straight to forceps use even when they might not be necessary.
“Training is a really key part of everything here,” Posy Bidwell, deputy head of midwifery at South Warwickshire Foundation Trust, told MPs. “If we can train people, we can prevent these injuries happening. Many midwifery students wouldn’t know the impact that these injuries are having on women.”
Newly qualified midwives did not know enough about perineal damage, and yet they’re providing one-to-one care to women. Current training did not seem to see it as a priority: while several aspects of maternity care are mandatory each year, suturing and perineal protection are not.
Neither doctors nor midwives appear to be taught how to routinely examine women after they have given birth either. Where this was once part of mandatory medical training, doctors are no longer encouraged to do it, Raut explained.
England is short of as many as 2,500 midwives, the Royal College of Midwives (RCM) estimates, although people are wanting to train and join the profession. Donna Ockenden, who is reviewing maternity services at Nottingham and who previously did so at Shrewsbury and Telford Hospitals NHS Trust, cautions against being too optimistic, however. The focus needs to be on retention. “Two midwives don’t equal two midwives,” she told parliament, “of we are losing midwives with 20, 30, 35 years’ experience… and they’re then being replaced by a more junior workforce, who are not being supported in those early days of their career.”
In the past decade and a half, the UK has seen several NHS maternity scandals — in Morecambe Bay, Shrewsbury and Telford, and East Kent. In all these cases, some of the poor care provided to mothers and their babies was because of a push towards “normal” or “natural” birth and a desire to keep caesarean section rates low. The RCM ended its campaign for “normal births” in 2017, but its legacy persists. Some NHS trusts still talk about them today. A culture of cover-ups and a lack of care remains in others. Just last month, the Care Quality Commission found that staff at Great Western Hospital in Swindon had been downgrading third and fourth-degree tears, “which meant they were not investigated as thoroughly as they should” have been. The c-section target was only officially dropped in 2022. Does RCOG now accept that it was a mistake? “It’s difficult for me to say years later whether it was a mistake or not,” Thakar tells me. “I think there was a general trend at the time to put figures to caesarean section rates. But now we know that, we don’t do that.” It was now right that women were offered a choice; she insists she hasn’t seen an attitude against caesareans more recently.
Aside from any physical and psychological impact, traumatic births are costing the country billions. According to figures from NHS Resolution, the arm of the Department of Health and Social Care that handles litigation, 62 per cent of the total clinical negligence cost of harm in 2022-23 (£6.6 billion) related to maternity. Of the £2.6 billion spent on clinical negligence payments that year, £1.1 billion (41 per cent) related to maternity. (As the fact-checking service Full Fact explains, the cost of harm differs from the amount actually paid out in compensation: the former includes an estimate of claims expected in the future arising from incidents in that financial year.) The year before, maternity services accounted for 60 per cent of the total clinical negligence cost of harm (£13.6 billion). NHS England spends about £3 billion a year on maternity and neonatal services.
There is such a long way to go. The government is well behind on its long-term target of halving the rates of stillbirth and neonatal mortality by 2025; the death of mothers within 42 days of the end of pregnancy is at its highest rate in almost 20 years. And while only a handful of trusts have been subject to official investigations, there are signs that poor care is happening across the country. Only half of maternity units in England are rated good or outstanding; one in ten is inadequate. That is a damning indictment of the way so many women are cared for.
One crucial area of improvement does not cost money at all. It requires a shift in attitude to one where women are treated with respect, listened to and allowed to make informed decisions about their bodies and babies.
When I first heard of parliament’s inquiry into birth trauma, it was never my intention to share my experience. Doing so has been upsetting and uncomfortable. But as I sat listening to other women talk about how giving birth had affected them so profoundly, it felt dishonest to stay quiet. Difficult births are not something we should feel ashamed of — much as I know many women will have been, myself included.
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So it’s really been bothering me that Hunter’s reaction to Omega turning herself over to the Empire was almost nonexistent. Like, sure I get it could have just been writer’s choice to focus on the overall plot, but the same writers have gone out of their way to show how passionate Hunter is about keeping Omega safe and how much it effected him when she was captured at the end of season two. SO, I got an idea:
What if Omega surrendering during the invasion was always the plan?
Okay, hear me out. Omega has been very vocal about her desire to go back to Tantiss even before they’d actually escaped. Leaving the other prisoners behind never even crossed her mind. On the other hand, Crosshair has done everything he can to ignore anything remotely related to Tantiss except Omega. Hence why he won’t address the real reason behind his hand tremor.
Now consider: Omega is wracked with guilt/determination, finding it more difficult each day (especially as she sees the extent of Crosshair’s trauma) to sit back and do nothing while there are still so many clones stuck in that awful prison undergoing who knows what torture. So she goes to Hunter, resolved to do Something. Except, there’s nothing they can do until they get the base’s coordinates. Which Hunter and Wrecker already know is nearly impossible since they’ve been trying since Omega was kidnapped in s2.
THEN it becomes apparent that Crosshair isn’t telling them everything. They try to talk to him repeatedly, but nothing is working. He’s locked up tight. So someone (probably Omega) comes up with a plan.
If Omega, the only person Crosshair feels has never abandoned him as well as the one he’s the most protective of now, is taken back to Tantiss then Crosshair will have to reveal what he knows in order to rescue her.
It’s kinda mean and manipulative and very dangerous, but it’s the only feasible plan they’ve got. And as Omega says to Crosshair before she turns herself over: they need to focus on the bigger mission and they, as individuals, are only a small part of it. Omega clearly knows this and as bad as she may feel for forcing Crosshair to return, she knows they HAVE to save the imprisoned clones. It’s a matter of life and death.
And because Omega is Hunter’s weak spot (he will literally do anything for her since she’s basically his child— which makes his sudden lack of reaction even weirder) he agrees.
So Hunter approaches Cid, convincing her to tip off her Imperial informant either out of guilt or monetary incentive. Cid’s info leads CX-2 to Phee who leads him to Pabu. Then all they have to do is get Omega in a position where she seems to have no choice but surrender. It’s not hard to predict, the Empire’s done all this before.
THIS is why neither Hunter or Wrecker are losing it like everyone thought they would. It’s why they’re not blaming Crosshair or running themselves ragged or burning down the galaxy to find her. It’s why Omega is so calm even though she’s back to square one in Hemlock’s ‘care’. It’s why Crosshair seems to be the one most effected by her loss. The others knew what was going to happen; they were prepared. They trust Omega implicitly, knowing that she can keep herself safe until Crosshair leads them to Tantiss. In return, Omega trusts that they will find her. She trusts that Crosshair won’t leave her behind.
I know this is highly unlikely to become canon, but I think it would make all their seemingly uncharacteristic behavior actually very in character without the vague explanation: Writer’s Choice. Either way, that’s my headcanon and I’m sticking to it!
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