Explanations for why a baby would be born with good color but not breathing. Outcome fine but...

[IdentityCrisisMama]

Hey, mamas & birth professionals

I gave birth 5 months ago to my beautiful baby girl.  In the end, the birth was fine and she is a healthy, beautiful baby but there was a moment just after she was born that was scary and I'd love to hear some opinions on what happened.  

From what I remember she was born after about 2 hours of pushing in the birth tub.  As she came out I was on my hands an knees and the midwives brought her up out of the water behind me (they didn't pass her through my arms they had planned).  I flipped on my back in a crab position with the cord still attached to see that she was a good color but not moving at all and not breathing.  She was a beautifully healthy looking limp and non-responsive baby.  It was an image I'll never forget.  The midwives sucked a bunch of mucus, gave her mouth to mouth (just once or twice I think) and oxygen.  In about 5 minutes she was breathing and crying like crazy and I knew she would be fine.  

Apparently my MW knew she would be fine all along.  At one point she looked deep in my eyes and told me she was going to be fine.  My have I never been happier to have had a strong, experienced midwife!   In the beautiful baby moon I just wasn't all that curious about what happened so I never talked much with my MW about it afterwards.  And now I'm curious...

My question I guess is does this kind of thing happen often?  Does anyone know what are likely causes of this?  I'm curious what the procedure would have been in the hospital (this was a homebirth).  Did having the cord attached mean the baby didn't need to breath right away?  But why wasn't she moving?  

Thanks so much.  

[HappyMonkey]

My second (now 4 weeks old) came out looking so still. White too since he was covered in vernix. It seemed forever before he breathed and moved... much longer than my first baby. Enough for me to worry a little. BUT his heart rate had been fine seconds before he came out, and without any intervention other than rubbing him he started to breath just fine.

The baby does get oxygen until the cord stops pulsing, so it's fine for the baby not to breath right away. My midwives also said they knew he was just fine.. it did look alarming though. It sounds like to me you were in a similar situation. And I wonder if it really was 5 minutes... or just felt like it?

[katelove]

Some babies are a bit "stunned" for want of a better word by the birth process. IME it often ( but not always) happens when they are born very quickly. It's possibly due to the changing pressure on their head or that some babies naturally take a little bit longer for their circulation to switch from foetal to neonatal.

As a hospital midwife I would have put the baby on your chest, covered her with a warm towel and wiped her face and head a bit. If that wasn't enough to get her going then I would have held an oxygen tube just near her nose until she was breathing well on her own and her tone was good.

[crunchy_mommy]

Something similar happened with DS when he was born, though it was handled quite differently since we were in the hospital. Before he was born, his heart rate was decelerating with each push, and they had me on oxygen and a pedi team on standby & ended up doing a vacuum extraction. I didn't actually see him but DH said he was normal color. He wasn't breathing & they quickly cut the cord (???!!) and the pedi dr. basically held him upside down & patted his back or something and that got him breathing but he required a lot of suctioning, he had a lot of mucous. He also was having trouble maintaining his body temp (duh... they took him away from me... I bet I could have warmed him up ) We had a rough hospital stay but ultimately he was fine & he's now 2.5 years old.

I still don't really understand why this happened. I don't know much about his birth because I was in a traumatic state (labor/birth process was really triggering for me, past abuse issues) but DH also says he was born sunny-side up but the cord wasn't wrapped around him or anything. Having him so still and quiet at birth was really traumatic for me as well, I thought he was dead and no one bothered to assure me otherwise. I don't know if this kind of thing happens often but it hasn't happened to anyone I know.

[starrlamia]

It really depends on the situation, I would speak to your midwife and ask if she can provide an explanation.

[Peony]

DS1 was born rather purple and not breathing right away. He was a UC and I knew he was fine. I just held him and stimulated him by rubbing his back. He started breathing and very slowly started pinking up some. 

[kathrineg]

The cord doesn't necessarily keep giving the baby oxygen, it depends on how long the placenta stays attached and there are no guarantees.

At my hospital birth a pediatric team took my son immediately, suctioned fluids out of him and rubbed him in a warmer. They gave him back to me for skin to skin a few minutes later, once it was obvious that he was okay. My placenta came out almost immediately after he did and wouldn't have provided any oxygen even if he had still been attached to it.

[starrlamia]

it is very obvious when the placenta becomes detached, so I wouldnt think there is a huge risk there.
 

Originally Posted by kathrineg 

The cord doesn't necessarily keep giving the baby oxygen, it depends on how long the placenta stays attached and there are no guarantees.
At my hospital birth a pediatric team took my son immediately, suctioned fluids out of him and rubbed him in a warmer. They gave him back to me for skin to skin a few minutes later, once it was obvious that he was okay. My placenta came out almost immediately after he did and wouldn't have provided any oxygen even if he had still been attached to it.

[IdentityCrisisMama]

Originally Posted by HappyMonkey 

The baby does get oxygen until the cord stops pulsing, so it's fine for the baby not to breath right away. My midwives also said they knew he was just fine.. it did look alarming though. It sounds like to me you were in a similar situation. And I wonder if it really was 5 minutes... or just felt like it?

Thanks - ours sounds like a similar situation.  Other than my MW chose to intervene much more than yours.  I wonder if baby really needed as much suctioning as she got...hum.  As far as the time goes, yes, I do think it was pretty close to 5 minutes.  It was long enough for me to get quite cold in the water - I remember suggesting we all get out of the pool, worried that the baby was cold.   

Originally Posted by katelove 

Some babies are a bit "stunned" for want of a better word by the birth process. IME it often ( but not always) happens when they are born very quickly.

One of the things that I am just remembering thanks to your post is that baby was very active in the birth canal.  It was the craziest feeling because she would move as I was pushing her down - woa!  In retrospect, I think that is one of the reasons I was worried about her when she came out -- because knew she had been alert just a bit before, yk?  

It wasn't a quick birth - a nice average length for a 2nd birth I think -- about 6 hours of active labor + about 4 or early labor.  Pretty typical, no?  

Originally Posted by crunchy_mommy 

I still don't really understand why this happened. I don't know much about his birth because I was in a traumatic state (labor/birth process was really triggering for me, past abuse issues) but DH also says he was born sunny-side up but the cord wasn't wrapped around him or anything. Having him so still and quiet at birth was really traumatic for me as well, I thought he was dead and no one bothered to assure me otherwise. I don't know if this kind of thing happens often but it hasn't happened to anyone I know.

HUGS, mama!!  It is such a powerful thing, ha?  I am so grateful for my MW and how she handled the situation because I can see how easily it could have felt much worse.  My baby was born in the caul and I've wondered if that could have had anything to do with it.  

Did your baby cry and cry after?  It was crazy that after her being so still I was totally fine with the crying.  I remember my MW and my other birth guests were kind of stressed by the crying and I was like, "It's the best sound in the world to me right now."  :-)   

Originally Posted by starrlamia 

It really depends on the situation, I would speak to your midwife and ask if she can provide an explanation.

Yes, that is the obvious solution.  I wonder if you thought I hadn't thought of that.  ;-)   My lovely MW is going through a tough time right now (think of the worst possible professional problem a CPM in the US can have and you're probably right on track for what sort of issue she's facing)  I'm sure she would be happy to go over this with me but I want to give her some space right now.  

Originally Posted by Peony 

DS1 was born rather purple and not breathing right away. He was a UC and I knew he was fine. I just held him and stimulated him by rubbing his back. He started breathing and very slowly started pinking up some. 

I wondered about this birth in terms of UC.  I'm totally not a UCer - my gut tells me that birth pain exists to bring the community around a laboring woman.  That said, I often wonder if I would have ever evolved in such a way that I started to consider UC.  This birth kind of reminded me that I'm OK with needing to count on a professional at birth.  OTOH, I never for a second considered wishing I was in the hospital - even in the darkest moment.  Certainly the act of holding the baby to your chest is far gentler than what my baby experienced with the MW.  Interesting to think about...

Originally Posted by kathrineg 

The cord doesn't necessarily keep giving the baby oxygen, it depends on how long the placenta stays attached and there are no guarantees.
At my hospital birth a pediatric team took my son immediately, suctioned fluids out of him and rubbed him in a warmer. They gave him back to me for skin to skin a few minutes later, once it was obvious that he was okay. My placenta came out almost immediately after he did and wouldn't have provided any oxygen even if he had still been attached to it.

My gut tells me that the MW knew the cord was giving blood - pulsing as was suggested earlier.  It would have SUCKED if I had passed the placenta right then - WAY more than I could have handled right at that moment.  What a bummer, mama!!  For me, I was happy to have been there so close.  Even if the cord wasn't providing anything I was happy to know it was connecting me and the baby still.  I think I would have been very upset if they had taken her.  I think that would have worried me so much.  OTOH, I can see how cutting the cord and taking her to the light and a good work table has its benefits.  Suctioning a baby in a birth pool, while she's still attached to mama is hard work for everyone!!   

[starrlamia]

identitycrisismama- a lot of people come on here asking for advice for situations without talking to their medical provider beforehand :P Unfortunately because no one was there and no one can see your medical records it is impossible to tell you why that happened to you.

[IdentityCrisisMama]

Quote:

Originally Posted by starrlamia 

identitycrisismama- a lot of people come on here asking for advice for situations without talking to their medical provider beforehand :P Unfortunately because no one was there and no one can see your medical records it is impossible to tell you why that happened to you.

Yea, sure.  Though I don't really think my MW knows what happened either.  I don't think there is any way to know for sure.  But I totally agree with you that my MW could offer a lot of closure.  OTOH, hearing other stories and experiences from other mamas and care providers IS super helpful and I knew it would be...which is why I posted here.  

As far as what a lot of other people do - I totally get why someone would post here before talking to their care provider.  I often do because it is really helpful to ask questions of your care provider when you already have some base knowledge.  I do a little basic research before asking nearly all questions to my midwives, then I do a little research after talking to them and a on and on.  I feel like that is a kind of common thread within the homebirth community, no?   I feel like this idea of "don't do research, don't ask friends first - just ask your care provider" is kind of the antithesis of the homebirth model.  I'm ranting though and I'm sure that isn't even what you meant and I know you are just trying to help remind me to rely on my midwife for help.  

ETA: sorry!!  I just realized this isn't posted in the HB forum so it is 100% unfair for me to expect a response in keeping with that model of care.   Still, I encourage any mama no matter where you birth to ask questions and do research before and after speaking with your provider.  I feel almost like it's a waste of time to speak with my midwife (or any medical care provider) before I've done some research.  Whenever I do I'm always having to say, "I'm going home to research this and I'll get back to you," which is such a waste of everyone's time.  

[katelove]

Originally Posted by IdentityCrisisMama 

One of the things that I am just remembering thanks to your post is that baby was very active in the birth canal.  It was the craziest feeling because she would move as I was pushing her down - woa!  In retrospect, I think that is one of the reasons I was worried about her when she came out -- because knew she had been alert just a bit before, yk?  

It wasn't a quick birth - a nice average length for a 2nd birth I think -- about 6 hours of active labor + about 4 or early labor.  Pretty typical, no?  

Sorry, I could have been clearer. I actually meant when a babe is pushed out really quickly at the last minute. Like when a mother has that explosive pushing urge and the baby doesn't really spend any time sitting on the perineum. Conversely, I have also seen it happen in the opposite circumstances, when the babe spends a long time in the crowned position.

[IdentityCrisisMama]

Originally Posted by katelove 

Sorry, I could have been clearer. I actually meant when a babe is pushed out really quickly at the last minute. Like when a mother has that explosive pushing urge and the baby doesn't really spend any time sitting on the perineum. Conversely, I have also seen it happen in the opposite circumstances, when the babe spends a long time in the crowned position.

Mine certainly could have been the latter - this baby was crowned for well over an hour (I pushed for 2 of the 6 hours of active labor!).  Interesting, thanks so much.   

[Just1More]

My babies are born rapidly.  The last baby was just one long push.  They all take a few minutes to adjust.  My third was a little scary to me.  She was very quiet, and purple, and didn't want to nurse.  They did give her a little "blow by" oxygen, and it helped her a bit.  Funny thing is STILL  super laid back though.  Some of how she acted after birth just turned out to be her personality!

[prothyraia]

Originally Posted by IdentityCrisisMama 

Thanks - ours sounds like a similar situation.  Other than my MW chose to intervene much more than yours.  I wonder if baby really needed as much suctioning as she got...hum.  As far as the time goes, yes, I do think it was pretty close to 5 minutes.  It was long enough for me to get quite cold in the water - I remember suggesting we all get out of the pool, worried that the baby was cold.   

It's always easy to go back and second-guess things.  My son was born very quickly and didn't breathe on his own right away.  He *wasn't* suctioned heavily, and probably would have benefited from it. Sometimes it's better to err on the side of doing more. 

I also appreciated having the resuscitation done with the cord still attached and being able to be somewhat involved in the process, and I'm very very grateful that he didn't need any more assistance than we were able to provide at home.

[Snugglebugmom]

Originally Posted by crunchy_mommy 

Something similar happened with DS when he was born, though it was handled quite differently since we were in the hospital. Before he was born, his heart rate was decelerating with each push, and they had me on oxygen and a pedi team on standby & ended up doing a vacuum extraction. I didn't actually see him but DH said he was normal color.

This happened with my oldest DD as well. As it turned out, the chord was wrapped around her shoulder, keeping her from descending properly. After 1 hour and 40 minutes of pushing, her decels were increasing alarmingly and she was yanked out in one contraction, head, body and all, and wasn't breathing, didn't have a heartbeat. Her first APGAR was 2, the only thing she had going for her was the fact that she was pink. They suctioned her, gave her oxygen, and after a few minutes she started breathing on her own, just as I had heard the nurse say into the intercom:"NICU team to room so-and-so, stat!"

I was hemorrhaging from an internal tear caused by the vacuum pump (which freaked out the OB, because she couldn't tell where all the blood was coming from and thought it was a uterine rupture), and was rather out of it, but I remember very clearly thinking:"NICU team? Stat? That's not good. That's not good at all."

She started breathing on her own just as they NICU team was about to intubate her. Traumatic, but everything turned out fine and she is now a happy, healthy 5 year old. 

[begoniamama]

this thread is old i see, but i was just searching for something along this exact line. my DS was born at home and during the whole labor and deep groaned through contractions and as i pushed him out, i was screaming as he was coming out. he was super floppy when the midwife caught him and was still floppy and not breathing for about a minute or so. finally he cried and turned pink, the midwife said he had a lot of fluid in his lungs. his apgar score was a 5 because of this. my MW mentioned something along the lines of him being in shock and that his entrance wasn't the most 'peaceful' because of this. it has always bugged me because i feel like it's my fault for screaming...or pushing him out too fast? i guess the fluid in his lungs was because he didn't get it all out coming through the birth canal. anyway, i have been harboring something about my birth as well, needing an explanation i guess.