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Discussion Starter · #1 ·
This is a birth story from an aquaintance on another board. Could this whole scenario have been avoided?<br><br>
I posted last week that I was going in Wednesday night (8-27) to be induced........and so I did, but things did not go exactly as planned.<br><br>
There were several medical reasons the Dr. wanted to induce me this time, so Wednesday evening I headed in to the hospital to have them apply gel to my cervix to soften it. I had some contractions....nothing major....from the gel and dialated to 2 cm. The next morning they started the pit and broke my water. Usually I go VERY fast after my water breaks, but I was still at 2 cm an hour later and the contractions were getting more intense, still at 2 cm the next hour.....finally around 10 am the contractions were coming like I was in transition, but still at 2 cm. At about 10 minutes to 2 the Dr. checked me again and I had dialated to 4 and was going to put an internal monitor on because the baby's heartbeat was going down with each contraction and the external monitor would lose it quite frequently. Just as she was trying to feel the top of her head, she felt her face....she was coming down the birth canal face first! No wonder I wasn't dialating. The next thing she felt was the cord.....it was prolapsed and with each contraction her oxygen level was being cut off.<br><br>
The next part got a little crazy. The Dr. hit the nurse button on my bed and yelled she needed help in here NOW! and then yelled prolapsed cord. She then leaned up to my ear and gently told me we were going to need to do an emergency section. The whole time she was pushing the baby back up the birth canal. Immediately a nurse came in to relieve the Dr. and they both were pushing the baby back up. They covered the nurse on the bed with me with a sheet and started racing down to the OR. They had to move me across to the operating table with the nurse still holding the baby up off the cord, applied general anthesia to me and she was born in less that 5 minutes of them finding the prolapsed cord. It was like something out of a movie.<br><br>
So needless to say recovery has been a little slow on my end. Not only was I healing from the section, but I also had bruised ribs from the nurses pushing the baby out to the Dr., it hurt to breath for a couple days. I also had bruised shoulder blades and under my arms from being wrentched across to the operating table. As my Dr. told me.....they aren't as gentle with an emergency.....which was fine with me, just took me a little bit to get over that.<br><br>
My dh was talking to my dr. afterwards and mentioned that things got a little crazy that afternoon and she told him it doesn't get any more of an emergency than that. All I can say is I am so thankful I was induced, that the Dr. found the cord when she did and that I was not at home when that happened.....we would have probably lost her.
 

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I am by no means an expert, but I honestly think that things *might* have been totally different for her without the induction or the AROM.<br>
The last paragraph is particularly disturbing to me...sounds just like me after my c-section and I was in total denial, trying to hide the remorse I felt over the loss of the birth I wanted. Yeah, it truly was an emergency, but sure sounds like one of those stories where it was the interventions that led to the emergency in the first place. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/mecry.gif" style="border:0px solid;" title="crying">
 

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I'm confused. My understanding is that for a prolapsed cord, the pregnant woman gets on her knees, butt in the air, face down, so the baby goes back up a bit and the cord isn't compressed.<br><br>
At no point does she describe being told to do this. Isn't this the first thing you do?
 

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Discussion Starter · #4 ·
Well, she was in a hospital and not with a midwife so perhaps the Dr wasn't familar with other methods to help her.
 

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I have to admit that I did a birth this past week and the mother was two weeks over her due date. We did everything we could to get labor going - she was determined that if she didn't have her baby in two days, she was going to the hospital.<br><br>
One of the things we discussed was breaking her water. She was a good 3-4cm, her cervix was very soft and baby was low in the pelvis. After a day of trying various things, she wanted to break water.<br><br>
We broke water and it was clear. She started having contractions about eight hours later, with the help of some homeopathics.<br><br>
Labor progressed quickly (three hours), then she was pushing and I had only checked her an hour earlier at her request (8cm with a very molded head - or so I thought!). Meconium - fresh, from-the-butt meconium appeared. I felt again and baby was breech.<br><br>
Now, when I went in to break water, I felt a head. I know now that it was a tight bum. Baby was frank breech, with feet up by his head, so that's why we were getting feet over to the side. The head did not feel like a head. Baby was so low in her pelvis we were getting heart tones where we should have been getting it had the baby been head down. I never suspected baby was breech.<br><br>
In hindsight, I am sorry we broke water, however, I know it would have been the first thing to happen in the hospital when she went in the next day. When I break water, I keep my fingers in there to control the head coming down and also to feel for position and to check for cord. I didn't feel anything that would have clued me in that this baby was breech.<br><br>
(The outcome would have been the same because the mother did NOT want to do a breech birth at home, but if we had waited for labor to start or for the next day, we wouldn't have gotten the friendly docs at all!)<br><br>
So, while I think it's really sad that the baby in the post didn't get more time to get in a better position, I feel like AROM is a big risk. I don't do it without a firm discussion of all the risks involved. It usually takes hours to decide because I really want mom to feel that it's best, not just something we half-ass do.<br><br>
She asked for a cesarean section, and luckily, we had two of the friendliest docs in town come in to the hospital off call. They both are supportive of homebirth (and homebirths themselves) and they did the surgery (even after telling her she could have the baby vaginally!!). Still, I can't help but to wonder why I didn't see the breech coming (since breech babies and births has been a pet topic of mine since school). I feel like I wasn't supposed to see it - that for some reason, it happened. I also feel good that the mother initiated the process of intervention, instead of it being initiated from me. I was fine to wait - baby sounded great. I just knew she was serious about going to the hospital.<br><br>
All in all, she ended up with a hospital birth. Isn't that what we were trying to "prevent"?<br><br>
So, while some things can be felt before labor, sometimes there are good reasons why labor isn't kicking in and the number one reason is usually positioning. Baby needs time to get in a better position - usually the stronger BH contractions or the stop-start patterns at night that are so irritating are helping put baby in a better position.<br><br>
It's so much better to trust the wisdom of the body and the baby.<br><br>
I wonder, too, why this woman's butt wasn't in the air. That's the first thing - it would help get the baby off the cord better with the help of the nurse's hand. Did she have an epidural?<br><br>
Sorry about the long story/saga. Guess it really cemented for me what I do - and how to balance a mother's desires and how she wants her birth to be with mine.
 

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I would bet that if she had an i.v. they put Pitocin in it.<br>
I would also bet that the baby got really stressed because the length and strength of the contractions were unnaturally long and hard and/or the baby was not ready to be born yet.<br>
And yes, hands-knees, I've always heard, takes pressure off the cord. If she would have been at home, they would have kept the baby off the cord by getting her in the hands-knees position with the midwife's hand inserted, holding the baby's head up off the cord, until they could get her into the OR.
 
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