scary birth stories

[llwr]

I believe that birth is normal and possible and not an emergency. So the stories about babies from normal, healthy pregnancies ending up in the NICU are bothering me.

I'm not pregnant and thus hearing everyone's stories; they're just happening.

This one in particular is upsetting to me and I'm feeling some sort of need to work through it:

Everything was normal and healthy and the labor was going well until the mom stalled at 9 cm. She had no epidural. She accepted pitocin. At some point between this and the birth the heartrate dropped very dramatically. There was absolutely no time, no warning. The got the baby out ASAP with the vacuum. The cord was around the neck several times. Baby had multiple apgars of 1 and was in the NICU for a couple of weeks. But no long term complications are ecpected.

I just can't seem to stop imagining how terrible it must be to almost succeed in an unmedicated birth and expect a healthy baby right up to the very end and then the baby is barely even alive. This was a full term pregnancy and a normal weight baby.

And then that's why home birth isn't safe.... And that's not the point I want to get stuck on, because I do believe in home birth. But when they say this baby would have died at home, I certainly can't disagree. And after thinking about it, I suppose I could say that if you were able to have your homebirth midwife in the hospital and she was allowed to do (or not do) everything she normally does, maybe the hospital would be safer. And yet you can't discount just being where the mother is most comfortable no matter where that is.

I know there are many different scenarios. Maybe without the pitocin, it would have been different, but as far as pitocin goes, being stalled at 9 sounds like a reasonable use of it.

I know that nuchal cords are common and rarely dangerous. Is this just a rare case where it was? Would the same thing be likely to happen without pitocin, just more slowly?

Maybe getting stuck at 9 was the body's way of not having this emergency, but you can't stay there forever. What is a safe thing to do if you get stuck at 9? Even if a nuchal cord was known, they're normally not a problem.

I don't have all the details, and even if I did, my DH and I perceived our children's births a bit differently, so I realize that how fast or how dramatically it happened could be a bit of opinion. But the bottom line is that this was healthy and normal and appears to be minimally managed followed by a true emergency and almost lifeless baby. I guess I know that this happens, but it really bothers me.

[phoebemommy]

How long was she stalled? Was she given a reasonable amount of time and space to get unstalled? Did she feel like pushing and was told not to? Was she free to move around? Was she being checked incessantly? Was there something in the room bothering her (bright lights, an anxious husband, a pushy nurse, the sight of medical equipment)?

These are just things that come to mind that could have helped stall labor. I think in a homebirth, you'd be free not to know how long you were at 9, or you'd have support getting through the stall naturally. Also, if everything's fine, and then she's given pitocin, and then suddenly, out of nowhere, everything goes bad, it seems logical to think maybe the pitocin caused the catastrophic reaction.

There's just really not enough information about the story to draw huge conclusions about the safety of birth or homebirth, in my opinion. A hospital person could make a big case for "thank God it was in the hospital"; a homebirth person could make the same case that the hospital caused it.

[CI Mama]

Originally Posted by phoebemommy

There's just really not enough information about the story to draw huge conclusions about the safety of birth or homebirth, in my opinion.

I'd like to offer the perspective that birth isn't 100% guaranteed "safe" under any circumstance.

Life isn't "safe."

It is scary to think that suddenly, out of nowhere, something terrible could happen. Not just in birth, but as you're walking down the street, driving your car, sleeping, whatever...

That's why we have religion, philosophy & art. It takes courage to live in the face of the truth that we all die someday, and there's really nothing we can do about it.

And that's why birthing babies is courageous work, no matter where it happens, no matter whether it goes without a hitch or takes a turn down a scary path. We can do a lot to mitigate our risks, but there just aren't 100% guarantees.

[onlyboys]

Originally Posted by llwr

Maybe getting stuck at 9 was the body's way of not having this emergency, but you can't stay there forever. What is a safe thing to do if you get stuck at 9? Even if a nuchal cord was known, they're normally not a problem.

There's always several perspectives to view births. I can tell you some frankly pretty frightening stories that were really not at all emergent. Perception makes a huge difference in whether or not a birth story is scary.

In the births that I have witnessed (hundreds) women who are experiencing a healthy, normal, unhindered birth do not get stuck at nine. They may have a "rest and be thankful" period, where contractions seem to peter out, or seem to not do much dilation, but the care provider honestly doesn't know what's happening inside the uterus.

Perhaps this baby needed to rotate, maybe his or her head needed to mold a bit before the cervix opened all the way. We don't know why she had a break in her dilation. All in all, arrest of dilation doesn't really matter at 9 cms. As you saw, babies can still come through a nine-cm cervix.

The doctor or midwife likely gave her pitocin not because something was WRONG, but because she was off the curve and they were uncomfortable. Progress is measured in dilation, but there's a lot more than that going on.

I don't have all the details, and even if I did, my DH and I perceived our children's births a bit differently, so I realize that how fast or how dramatically it happened could be a bit of opinion. But the bottom line is that this was healthy and normal and appears to be minimally managed followed by a true emergency and almost lifeless baby. I guess I know that this happens, but it really bothers me.

Giving pitocin is not "minimally managed." If the baby needed time for head molding or for rotation, those rough pitocin contractions might have distressed him or her unnecessarily.

I do know what you are saying... It can be scary to hear of what appears to be normal, healthy births going south. And, it does happen sometimes. Adding pitocin into the mix, however, can cause problems.

[curiouscanadian]

I feel like I have an interesting perspective on this because that's essentially what happened to me, minus the horrible dropping heart rate and terrifying ending. I stalled out at 10, and was given Pit. and ended up with a vacuum delivery. BUT I've come to believe it was at least in part because of the hospital environment.

How long was she stalled? Was she given a reasonable amount of time and space to get unstalled? Did she feel like pushing and was told not to? Was she free to move around? Was she being checked incessantly? Was there something in the room bothering her (bright lights, an anxious husband, a pushy nurse, the sight of medical equipment)?

For me at least, a lot of the above were factors. When after the birth I was trying to puzzle out the "why did I stall?", I came to realize that (except for the first couple times) I had been pushing because I felt like I "should", not because my body was telling me to. My brain got in the way of my instincts; honestly, all I wanted at the time was a nap!

I now believe that if I had been left to my own devices as I would've been at home with a midwife, I could've had a short nap and the contractions would've started up again once I was better rested and feeling able to carry on with the birth. At the time I stalled, there was no real reason to push the labour along, baby's heartrate was fine, my water hadn't even broken, it was just the expectation of myself and everyone around me that labour should keep progressing. It was a huge lightbulb moment for me when I read something that made me wonder why and I realized there wasn't any good answer!

Maybe getting stuck at 9 was the body's way of not having this emergency, but you can't stay there forever. What is a safe thing to do if you get stuck at 9? Even if a nuchal cord was known, they're normally not a problem.

No, you can't stay stuck at 9 forever, but my point is, who's to say you will be? Maybe you just need a little more time to work through some things (or baby to shift position) before labour carries on.

[*MamaJen*]

It's true that birth can be dangerous, just like life can be dangerous. Things like placental abruption can come out of nowhere, and can be fatal in a home or hospital birth. There are no guarantees in birth, just like there are no guarantees in life. You just have to accept a certain amount of risk in birth, just like you accept the risk that you could get hit by a bus or diagnosed with cancer.
But that said, I believe that for 1. a low risk mother, 2. attended by a qualified midwife, and 3. with procedures in place to enable a quick hospital transfer, I think that home birth is as safe or safer than hospital birth, and studies show that. In this particular birth story -- and I'm not a medical professional and I don't know all the details -- but I would strongly wonder if the pitocin contributed to the fetal distress. I think it's very common in hospital births to perform an intervention, have an iatrogenic complication, rush the baby off to the OR, and then say, phew, what a good thing it was that the baby was in the hospital where we could save it (from the complication we caused).
Also, there are a lot of things that may feel scary, but can capably be handled with minimal action. The baby can come out with low apgars, need a resuscitating breath, and be fine 10 minutes later. Babies have really high oxygen saturation levels to protect them from some distress during the birth.

[laohaire]

I DO believe there are some births where the baby could have died at home or lived at the hospital.

I also believe in the reverse, though.

I can't really comment on the story you told, though. It's possible the baby was saved by the hospital. It's possible the hospital caused this issue.

I don't know what "stalled" means in this case, how long it supposedly "stalled" for. Maybe it stalled maybe it didn't. I don't consider a stall to be inherently problematic (though of course it CAN indicate a problem).

It does seem very likely to me that the pitocin caused the baby to crash. But I don't know that for sure, of course.

Was the nuchal cord really a problem or did they just say that? Every nuchal cord birth I've heard of (and I've heard of quite a few, they are common after all) ends with "thank god we were at the hospital." My SIL, for example, had a nuchal cord and it's a running family joke that she tried to strangle herself at birth. However, as you've said, a nuchal cord is rarely a problem, and when it is, it's because either it's wrapped enough that the cord is too short and hinders descent, or because something got pinched.

It's possible we had a too-short-cord problem in the example you described, but we don't know that for sure.

I do know that those issues can be dealt with at home, though. Midwifes can clamp and cut a nuchal cord just like the doctor can, if they think there's an issue and they can't just unwrap it.

I hear what you're saying though, but we've got two conclusions and we don't know which it is. One conclusion is that medical management of this birth caused the problems, and that's certainly a possibility. The other conclusion is that some births are very problematic, and some of those can be helped by hospitals and some can't be helped by anyone.

When I chose to homebirth, I did so knowing that there are some situations where only being in a hospital would help. But I also knew that the hospital causes problems in many cases. It seems like the risks are roughly balanced. So I prefer home, where I can be in peace and not harrassed.

[CI Mama]

Originally Posted by *MamaJen*

But that said, I believe that for 1. a low risk mother, 2. attended by a qualified midwife, and 3. with procedures in place to enable a quick hospital transfer, I think that home birth is as safe or safer than hospital birth, and studies show that.

Yes, agreed.

I don't feel like there's enough information about this particular case to know what the real situation is.

It is scary to think that some women don't have a real choice about where to give birth. It is scary to think that some women don't have a support system that allows them to advocate for themselves at the times when it matters most. It is scary to contemplate the reality of medical mismanagement that is re-told as "rescue mission." And if you're the mom who experienced all this, it can be overwhelming to process all the "what ifs" that such a situation inevitably raises.

[mwherbs]

not enough info-even in what you do have it isn't enough
multiple apgars of 1 you mean apgar of 1 at one minute and an, apgar of 1 at 5 minutes, what was the 1 given for? heart rate ? an apgar of 1 if given for heart rate means that the heart rate is below 100 but above 0-- some places will do a 10 minute apgar and if that is below 2-3 it usually does not bode well even for long term outcomes of surviving infants--
did the camp and cut the cord right away? it could be that the cord was compressed during delivery and with the heart rate low and no tone or breathing efforts they clamped and cut the cord right away- this can compromise the resuscitation efforts in that the fluid resuscitation to be had via cord blood would not be there- hospitals are completely set up for someone at a remote table to work on the baby and there is no simple way for those people to be able to start working on an attached baby--it is a rare thing to happen to a full term baby with no other s or s of problems- in general 10% of all infants born will need some type of resuscitative efforts/ from physical stimulation to puffs of air- 1% of babies will need something more done like chest compressions and meds - so it is hard to say if it was just a rare unpredictable/no explaination experience of if they over did the pit or there are some other elements to the story we don't know and it could be that the people telling you the story have the facts wrong--

[laohaire]

That's true, premature clamping of the cord (which almost certainly happened) could have also negatively affected the outcome, though clearly it didn't cause the original issue. In fact, I would say it almost certainly had a negative affect - removing a distressed newborn's life support at birth is simply counterintuitive. But it's all done in the name of convenience - easier to move a baby to a table than care for it on mom's belly.

So many factors, so many unknowns. But this still COULD have been 100% iatrogenic (pit plus premature clamping). It might not have been, but if your point is that you feel you are hearing of all these babies that might have died at home, keep in mind that you really, truly don't know - they might have indeed been better off at home.

[Cheshire]

My second son's pregnancy was uneventful except for diet maintained gestational diabetes. No medication necessary. His birth was fine until the very end when his cord tore around the time I was reaching 10 cm (it was a velamentous insertion we didn't know about and possible vasa previa, which we and the docs pretty strongly suspect from the pathology findings). I pushed him out as fast as I could but it still took 8 minutes. He lost the majority of his blood in a few heartbeats.

If I had been at home he would have had no chance. Being in the hospital he had a small chance. But, he still died. It was a complete and total shock. Almost two years later it still is.

As others have said there are no guarantees in life, including birth.

What deciding on a home birth or a hospital birth you have to do your research but in the end you and your partner have to consider what choices you can live with in case something does go wrong because you are the ones that will live with it.

Some babies do die when birthed at home and some die when birthed at a hospital. The best thing to do when pregnant is to be your own advocate no matter who you choose or where you choose to have your baby.

[laohaire]

I'm so sorry, Cheshire. It's one thing to talk about the what-ifs, it's another to have it happen.

[jengacnm]

Great thread with thoughful responses. I can't really add much that hasn't been said already. I have lots of home birth stories that COULD have ended, "...and thank god we trasnferred to the hospital." But the problem got handled, a slow labor progressed to a great birth with a little patience and lots of support, or whatever. And we stayed home.

That magical line of what is a reasonable amount of time to wait before inntervening is between the mother/family and the midwife/care provider. How long is it ok to be stalled at 9 cms? For most hospitals it's 2 hours. For a mom who's had a three day prodromal labor, 24 hours to get from 5cms to 9, then stalls, her limit of how long she's willing to wait before going to the hospital is going to be different from the woman who went from 2 to 9 in 3 hours.

That's the great thing about home birth. If a woman ends up going to the hospital for an intervention, she can be reasonably assured that those interventions were very likely actually needed. If the pitocin caused the distress, well, what was the alternative? For her to be at 9 cms for 4 or 8 or 24 hours?

The point being that even the crunchiest of midwives and the mom with the most endurance is going to have a limit somewhere. When that limit is reached, thank god we live in this day and age rather than 100 years ago.

[MyFullHouse]

I've had a scary birth (2x nuchal cord w/ true knot) with a mw in the hospital. My midwifery team is now offering homebirths in addition to hospital births. I'd absolutely choose homebirth if I lived closer to potential transfer hospitals.

I'm more concerned about post-birth complications (even though I haven't had any) than I am delivery complications (even though I have had one!) so it isn't exactly the most rational thinking, and I own that.

[cappuccinosmom]

Life isn't "safe."

It is scary to think that suddenly, out of nowhere, something terrible could happen. Not just in birth, but as you're walking down the street, driving your car, sleeping, whatever...

Yep. Sometimes poop happens. It can happen at home. It can happen at the hospital. Almost everything we do comes with risk, because we live in an imperfect world and cannot create circumstances that are 100% perfect and risk free. We try. We can reduce risk. But we can't eliminate it.

So some people are going to have scary births. Sometimes it is the fault of caregivers. Other times it's just a poop-happens moment.

[mwherbs]

jengacnm ,I agree with you. I also wanted to comment on pit, it may have to do with dosage, it doesn't have to be an on-off ,all or nothing proposition we don't know amount or duration, I have seen all sorts of dosages used when we have transferred care. At home depending on the labor length, baby's position-is this baby at -2 or a +, is there an ear presenting or baby is op or do we have a canted pelvic inlet that mom needs to be flat on her back to get the baby low enough there may or may not be things we would try like having mom sleep or eat, drink or get in a tub or walk/dance, cry , sing, discuss some serious fears/concerns , mom by herself for a little bit maybe in the shower or the couple alone, or transfer for some pit and/or pain meds, oxygen for mom. What we know is that the numbers are pretty close as far as infant mortality somethings are better at home others are better managed at the hospital and some it may not matter where you are.

Cheshire, I don't even know what to say,what happened at your baby's birth is sad and humbling for me, I am sorry for your loss but also thank you for sharing with us your views.

[liz-hippymom]

my baby did die because of a homebirth. she was my fourth pregnancy, after 3 normal vag births (two at home). her pregnancy was perfect. i abrupted in the last hour of labor and she was born before we transfered. dead. she would have certainly been alive had we been at the hospital. every one of my close friends who know the whole story will never birth at home, not one of them (even thought they all had previous homebirths) because of how clear it was that she would have lived if we had been in a hospital.

[MegBoz]

Originally Posted by phoebemommy

Also, if everything's fine, and then she's given pitocin, and then suddenly, out of nowhere, everything goes bad, it seems logical to think maybe the pitocin caused the catastrophic reaction.

Exactly.
Actually I'm pretty sure there's lots of research that backs up a higher rate of fetal distress when pit is used. So this seems an extremely reasonable conclusion to me. The exact opposite conclusion you made, OP, that the baby would have died at home.

The fact alone that she was "stalled" tells me she absolutely MUST have had repeated VEs. So, yeah, sounds to me like it wasn't very much of a 'no-pressure' "hands-off" "just do your thing-so long as baby & mama are fine" sorta birth atmosphere.

Great post from CI Mama!

[Romana]

In some situations, yeah, you'd have been better off in a hospital and you or your baby might have lived where they died at home. That's just the way it is. Massive PPH requiring immediate surgery? Mom could easily die on the way to the hospital. Catastrophic placental abruption or uterine rupture? Baby could easily die due to transfer when said baby could have lived had birth happened in the hospital.

The deal is that there are tradeoffs, even if the overall mortality is about the same (which has not been satisfactorily proven with U.S. homebirths, in my opinion).

I don't for one second believe that having a perfectly handled, totally normal birth with a perfectly healthy, totally normal low-risk pregnancy = always a manageable outcome at homebirth. Sometimes being in the hospital IS the difference between life and death. But at what cost? And is the choice to birth at home anyway reasonable, or not? And quantifying the risks, exactly how bad is it, anyway? And in what ways can a particular woman minimize those risks?

At the end of the day, either choice is reasonable, but there are no guarantees, and there are unquestionably some rare (but real) situations where I'd much rather be in a hospital. If a woman isn't comfortable with that reality, she shouldn't be birthing at home, in my opinion. Ignoring the unique risks of home versus hospital birth doesn't help anyone - not moms, not babies, not midwives, and not doctors or hospitals, either.

[Magali]

Originally Posted by CI Mama

It is scary to think that some women don't have a real choice about where to give birth. It is scary to think that some women don't have a support system that allows them to advocate for themselves at the times when it matters most. It is scary to contemplate the reality of medical mismanagement that is re-told as "rescue mission."

Wow, you totally hit the nail on the head about what scares me about my upcoming birth.