At about 7 am, the midwife came and we listened to his heartbeat again, and again it was perfect, before, during and after a contraction...So what happened?
An hour later my midwife checked my dilation again and I was 5-6 cm, we listened for the heartbeat on the doppler and we couldn't find it. We tried to stay calm and went straight to the hospital, hoping that they would confirm with ultrasound that he was fine and was just so low in the pelvis that we couldn't get his heartbeat on the doppler at that point, but sadly, they confirmed what we quietly feared. He didn't have a heartbeat. Sometime in that hour, he had passed away.
Umbilical Cord Torsion. It is very rare, and is when the umbilical cord twists in on itself and forms a kink. It essencially cut off all blood supply and oxygen to him immediately.
The MDC takeaway?
- There are situations where being down the hall from the OR means the difference between life and death.
- There are situations where intermittent monitoring will miss what continuous monitoring would pick up.
- Intermittent monitoring is not "as safe as" continuous. It increases your baby's risk of brain injury and death.
If memory serves, wasn't this baby postdates? If so, that is a significant take-away from this story, as both placentas and umbilical cords degenerate over time, and being post-dates is a risk factor for cord torsion.
ReplyDeleteThank you for starting this. The sense of perspective is badly needed.
ReplyDeleteA cord accident can happen any time in pregnancy or in birth. It is very sad, and I feel very bad for this family, but it is nobody's fault.
ReplyDeleteChoosing intermittent monitoring over continuous is a trade off. Yes, sometimes, rarely, continuous monitoring can save precious time, like in a situation like this, and might (not guaranteed) have saved this baby's life. Chances are, even with continuous monitoring, there would not have been enough time to have an emergency c-section in time to save this baby.
On the other hand, continuous monitoring does increase the risk of unnecessary c-section, and c-sections are not without risk to both mother and baby.
This mother made what she felt was the best choice for herself, her baby, and her family. It is shameful to push your agenda and attack their choice when they are grieving. How about a little compassion for what they're going through?
Intermittent monitoring that lets an hour lapse between checks? That's no one's fault?
ReplyDeleteMy only "agenda" is to shine a light on the number of deaths that MDC, CPMs, and birth-worshipping negligence are causing.
Don't think for a minute that I have no idea what this mother is going through. I know it all the way down to the denial of the homebirth community and defense of the negligent midwife.
"Sometimes babies die" isn't good enough anymore.
Thank you for starting this blog. I hope it saves some lives & shines a light on the very real dangers of homebirth.
ReplyDeleteBoth AWHONN and ACOG recommend intermittent fetal heart checks every 30 minutes while in active labor first stage for low risk women and ever 15 minutes for high risk women. Not 1 hour.
ReplyDeleteDoes this have anything at all to do with VBAC? Or is the title just a scare tactic about VBAC? I agree about the more frequent monitoring, but seriously, a VBAC labour and a cord accident are two completely different things.
ReplyDeleteBabycatcher, neither. It's just identifying which baby this was: #11, who happened to be a VBAC.
ReplyDeleteThere are a lot of deaths at MDC. I haven't kept up with this blog like I should, but if you spend some time there, you'll soon learn that there are so many, the details begin to blur in your mind.