Originally Posted by craft_media_hero
So concerning true cord injuries---
Are these injuries predictable before birth? Is the only option c-section?
Bandgeek said she didn't believe that doctors in a hospital would have been able to handle anything differently; that makes me wonder if worrying about this can even be productive. If nothing can be done, then it makes no sense to stress it, yk?
Based on my research and in talking to many parents about their birth stories, I do not believe much can be done, no. Oxygen deprivation causes damage quickly. Think about it....the higher the c-section rate goes and we're not seeing ANY improvement in outcomes.
Our case is quite odd. DD had severe oxygen deprivation but never had a single heart decel. She came out not breathing, but HR 130-140. Very odd. She had to be intubated and was not breathing completely on her own until she was 4 day sold.
This is how it usually happens (hospital birth scenario which is the majority of people I've talked to):
As labor progresses, the baby starts having small decels, then all the sudden crashes. HR below 80 or they lose it altogether. Mom goes in for emergency c-section. Baby is stillborn or close to it. Baby is resuscitated, intubated, and put in the NICU. Baby suffers brain damage. Some are lucky. Many are not. Some cannot be resuscitated and die. From the time of the first sign of oxygen deprivation to the time of the c-section, many babies have gone 10+ minutes with very little or no oxygen.
So this is what has happened...doctors are doing the c-sections when they see small decels and not waiting for the crash. You'd think this would help, but for some reason, we're not seeing better numbers. I think it's partly because of inductions. A lot of the time this happens with pitocin which causes harder contractions and compresses the cord too much. These are usually the people who end up suing and winning. So on one hand, we have doctors taking babies out before they have a crash, possibly saving a few in the process (the others would have never crashed and were sectioned unnecessarily...you just never know who will be who) but on the other hand you have doctors CAUSING some of the problems. I think that's why the fetal outcomes haven't improved. It's been a toss-up.
An ultrasound can't catch it since the cord and baby move around during labor. It can happen to any mom, even the ones who did everything perfect. It happens to small babies and big babies.
My best advice? Stay away from any intervention that could cause a problem...pitocin, breaking water artificially (especially if baby's head isn't engaged yet), meds and epidurals that keep you stuck in the bed, unable to change positions easily, ect. Then the rest is just up to fate. If you think you need to go in for a c-section, go in. Maybe it'll be alright, maybe baby has already been oxygen deprived a long time. Sometimes even with oxygen deprivation, the baby has very few lasting effects. I'm not sure how often this happens, but I'm sure it's rare. I've only met one child who had severe deprivation and ended up with only mild CP. Usually they are like my DD. Because once the deprivation happens, the brain swells. When it presses against the skull, it gets damaged. Why that little girl's brain only swelled a little, I don't know. Sometimes they put cooling caps on their head to keep the swelling down. I didn't even know it was an option with DD.
All of that was based mostly on my experience and in talking to other parents.
The *numbers* say 50% cannot be predicted or prevented, even with a c-section. That's not set in stone I think since they can't go back and redo it to see how it might have turned out if they'd just done this or that. I think in my case, nothing could have been done. We're not even sure it happened during labor. It's possible it happened up to 2 days before labor started based on the ultrasound of her brain swelling when she was born.
I can't find where I read it, but I think it was something like 1 in 6000 this happens to, but I can't remember if that was all of them, or just the severe ones. Sorry.
I definitely think that no one should forgo a homebirth out of fear of a cord injury. It happens, and it sucks, but it's not the end of the world. And it's just as likely to happen in the hospital. I don't know the exact statistics on that either, but we all know there's no statistically significant difference in the safety of homebirths and hospital births, so it just makes sense to me that you just have to do what feels right for you.
When people asked me when I was pregnant with DD and they found out I was having a homebirth "What if something goes wrong?" I would reply, "So I'll go to the hospital, big deal! It's only 10 minutes away." I never dreamed that things could go wrong so quickly. Not in a million years. But it does. I don't regret my homebirth at all. I did a fair bit of "what-iffing" after she was born, but I know a lot about how birth works and now I believe nothing would have helped. And it's sad that she's disabled and very sick. But she's a wonderful little girl that has taught me SO much. I wouldn't trade her for anything. Like I said, cord injuries suck, but they aren't the end of the world. We all want perfect, happy, healthy children, but that's not what we always get. Sometimes they have genetic disorders, sometimes they get cancer. Heck I know a little girl that had HIE when she was 18 months when she choked on a goldfish cracker. She could walk and talk and now she can't and is g-tube fed. You can't go through life trying to prevent every little thing. Obviously you stay on alert and keep an eye on your kids while they bathe and try and keep them from choking. But they have to eat, they have to bathe, and we have to birth them. And $hit happens.