There was a woman who had to be in ICU after a c-section. On her maternity floor she was eventually found unresponsive with a soaking wet abdominal dressing. She was given O2 by facemask and her hemoglobin level was around 4 (this is 1/3 normal). She was brought back to consciousness and emergently taken to the OR for exploration and a possible hysterectomy. No obvious bleeding was seen, but something like 4 liters of blood were sucked out of her abdominal cavity. It was probably a slow intra-abdominal bleed, following a path of least resistance out of the uterine incision instead of out her vagina. She was given something like 5 units of blood and 10,000 ml (!!!) of IV fluids in the OR. That's more than five 2 liter bottles in one sitting. I've never heard of that much being given in my life.
She spent the next day in the ICU in critical condition. Four units of blood the next day along with multiple blood products (platelets, plasma, etc) to recover her clotting ability. The way her labs were trending, she was entering a condition called DIC (disseminated intravascular coagulopathy) where her body uses up so many factors involved in clotting that she would start to bleed spontaneously from all sorts of places—mouth, nose, eyes, ears, skin, and certainly her uterine incision. DIC is freaking scary. I know I'm new, but I've never seen anyone survive full-blown DIC. She really owes her life to the ICU nurse who aggressively blasted liters of blood products in a handful of hours. The same nurse also demanded that the interventional radiologists (guys who can use x-rays and guidewires to go into your blood vessels and fix them) see her that day, because after all those blood products her hemoglobin was still low. After their evaluation they went in and embolized (closed off, probably by electrocautery) her uterine artery.
The next day she was doing much better. Still in pain, but able to get up to the chair.
This is her first child, and she expressed the wish to keep her fertility if possible. I'm not sure what her stopping up her uterine artery means in terms of that, but it doesn't sound good.
Why did she have a C-section? It was a scheduled section for breech presentation. I'm not an OB, but I can't help feeling that a breech vaginal birth might have been safer for her. However, standard protocol now is to section all breech babies. I'm not sure what the reason is, or what study led to deciding that, but I've heard from midwives and frustrated OBs who wish to perform breeches but are not allowed to. It seems like even if breeches are dangerous, there's two problems with doing them on every mother. The first is that people have the impression that c-sections are minor surgical operations. They're not. A section is a major abdominal surgery with multiple risks. The second is the risks of a breech birth are against the baby (e.g. cord compression by the descending head); the risks of a section are against the baby and mother. So sectioning all breech babies presumes consent by all mothers to place themselves at higher risk to eliminate a possible risk to their baby. I don't know that this is a fair decision, and I don't think most mothers are informed that this is the choice they are being compelled by the healthcare industry to make.
The Nursing Birth blog just posted reasons why you might die in childbirth in the modern developed world. Hemorrhage related to obstetric procedures, such as caesarean section, causes 13.4% of maternal deaths.
Update: Since this writing, Canada's society of obstetricians decided to reverse their position on c-sections being the standard treatment for breech births, and set an initiative to teach new obstetricians to attend vaginal deliveries of breech babies. Read more in Give Breech a Chance: Canada Reverses C-Section Policy. One hopes their American counterpart will follow suit.
Other posts on c-section complications:
Breech Babies (patient scheduled for a section, baby turned, sectioned anyway)
Obstetrics: causing a problem and then fixing it
Image credit: The Cesarean Art collection was created by an artist (who wishes to remain anonymous) after a traumatic c-section. You can read this interview for more info. Used with permission.
She spent the next day in the ICU in critical condition. Four units of blood the next day along with multiple blood products (platelets, plasma, etc) to recover her clotting ability. The way her labs were trending, she was entering a condition called DIC (disseminated intravascular coagulopathy) where her body uses up so many factors involved in clotting that she would start to bleed spontaneously from all sorts of places—mouth, nose, eyes, ears, skin, and certainly her uterine incision. DIC is freaking scary. I know I'm new, but I've never seen anyone survive full-blown DIC. She really owes her life to the ICU nurse who aggressively blasted liters of blood products in a handful of hours. The same nurse also demanded that the interventional radiologists (guys who can use x-rays and guidewires to go into your blood vessels and fix them) see her that day, because after all those blood products her hemoglobin was still low. After their evaluation they went in and embolized (closed off, probably by electrocautery) her uterine artery.
The next day she was doing much better. Still in pain, but able to get up to the chair.
This is her first child, and she expressed the wish to keep her fertility if possible. I'm not sure what her stopping up her uterine artery means in terms of that, but it doesn't sound good.
Why did she have a C-section? It was a scheduled section for breech presentation. I'm not an OB, but I can't help feeling that a breech vaginal birth might have been safer for her. However, standard protocol now is to section all breech babies. I'm not sure what the reason is, or what study led to deciding that, but I've heard from midwives and frustrated OBs who wish to perform breeches but are not allowed to. It seems like even if breeches are dangerous, there's two problems with doing them on every mother. The first is that people have the impression that c-sections are minor surgical operations. They're not. A section is a major abdominal surgery with multiple risks. The second is the risks of a breech birth are against the baby (e.g. cord compression by the descending head); the risks of a section are against the baby and mother. So sectioning all breech babies presumes consent by all mothers to place themselves at higher risk to eliminate a possible risk to their baby. I don't know that this is a fair decision, and I don't think most mothers are informed that this is the choice they are being compelled by the healthcare industry to make.
The Nursing Birth blog just posted reasons why you might die in childbirth in the modern developed world. Hemorrhage related to obstetric procedures, such as caesarean section, causes 13.4% of maternal deaths.
Update: Since this writing, Canada's society of obstetricians decided to reverse their position on c-sections being the standard treatment for breech births, and set an initiative to teach new obstetricians to attend vaginal deliveries of breech babies. Read more in Give Breech a Chance: Canada Reverses C-Section Policy. One hopes their American counterpart will follow suit.
Other posts on c-section complications:
Breech Babies (patient scheduled for a section, baby turned, sectioned anyway)
Obstetrics: causing a problem and then fixing it
Image credit: The Cesarean Art collection was created by an artist (who wishes to remain anonymous) after a traumatic c-section. You can read this interview for more info. Used with permission.
Hello! Thanks so much for the link. I have read a few of your posts and I really enjoy your blog so far :) Thanks for posting on such an important topic like Cesarean Section and its risks. Somehow I think if more ICU nurses (externs) like yourself talked about those experiences more women would start to realize how serious major abdominal surgery a C/S really is! Because apparently when I talk about it as an L&D nurse I am just being hippy dippy! Hahaha! Keep up the good work!
ReplyDelete~Melissa
www.nursingbirth.com
thank you for this. it's powerful evidence of the immediate need for maternity care reform in this country. i'm glad i found your blog, i'll keep reading!
ReplyDeleteThanks for sharing this story as scary as it is. I am glad that she survived. I also had a c/s for breech presentation. I think that women should have a choice whether to try a breech vaginal delivery or not. It's something you never hear of now-a-days but I guess that is because not many are trained to do it.
ReplyDeleteWow. Great blog. A whole lotta brilliant here.
ReplyDelete"this decision presumes... consent by the mother to place themselves at higher risk to eliminate one perceived risk to their baby."
Don't you think the martyr role is overwrought in the delivery room (and in clinic, too)? The truth is, most of us mothers would sacrifice our bodies for our babies in a snap. It doesn't seem like women are given accurate info with which to weigh their own risks.
I've never seen that Cesarean Art interview. Good to know.
Jill
the size of the baby is kind of irrelevant here. if she'd have had a vaginal breech, likely it would have been after a naturally starting labor, not a planned induction, in which case it would been days or weeks later, and the baby might have been bigger than 6 lb.
ReplyDeletenot that I think a bigger baby would be a problem in a breech birth.
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ReplyDeleteSorry, I clicked delete for some reason haha...
ReplyDeleteI had a cesarean for my breech daughter. We did a sucessful version, but they said something went wrong and I had to have an emergency cesarean just a few hours after she was vertex.
This is a great story, if that doesn't sound strange. I wish women were given the option to have a vaginal breech delivery. This whole thing about cesareans safer for mother are baby in a breech presentation is ridiculous. My old manager at work had 3 breech babies without a single tear.
Love the blog btw!
Kayce
http://kaycesdoulajourney.blogspot.com
Wow, what a story. I hope the woman is alright and that her bonding and breastfeeding relationships were not irreparably harmed.
ReplyDeleteYou wrote:
2. consent by the mother to place themselves at higher risk to eliminate one perceived risk to their baby. I don't know that this is a fair decision, and I don't think most mothers are informed that this is the choice they are being compelled by their healthcare providers to make.
Exactly - INFORMED consent is a huge issue in childbirth. Women have to go out of their way or above and beyond to make informed decisions about interventions, and then in the "heat of the moment," informed choice tends to go out the window anyway. This is probably why more women are seeking out of hospital births.
Women generally can NOT be equal partners in their own care in the obstetric care model.
About a year ago I gave birth to my 5th child in a hospital setting. Upon pushing we had a big suprise.. frank breech. My Dr. was mandated (likely by insurance policy or something) to call in the on call OB who was in my face with all sorts of forms and telling me I needed an emergency cesarean or my baby would die or most certainly risk brain damage, etc. I looked at her square and told her to get out of my face because I didn't want her negativity anywhere near me as I gave birth. One push later I gave birth to my nearly 10 pound baby girl, frank breech. Thankfully I had the support of my physician. The bad thing is, even supportive physicians aren't really trained or given the chance to become skilled in the art of breech birth. Mothers have to take responsibility for informing themselves if they walk into the lion's den to birth their cubs. Sad but true. I was scared as I garnered up my courage to give birth. I knew if something happened to my baby I was assuming responsibilty.. but deep down I knew that signing consent forms for a cesarean also held risk..many unforeseeable risks, .. presently and for my reproductive future, not to mention this baby and future babies. I wish more families realized this instead of granting blind trust to a trade union (aka ACOG et al)
ReplyDeletePrayers go out to this poor mom. I also endured a massive hemmorrage postpartum. I was thankful for medical skill for that event, but I also wondered if enduring a cesarean would have made it that much worse, more blood loss to deal with/compensate for, etc. in additon to all the other risks ((but for the grace of God, there go I...))
Just found your blog. Amazing. :)
ReplyDeleteThanks for sharing this story - and the reality that cesarean births are still major surgery with all the risks that go along with that.
Thank you for this story.
ReplyDeleteThanks for the great post!!!
ReplyDeleteI would just like to reiterate the ability of Chiropractors trained in prenatal techniques such as Webster to successfully turn breech babies a high percentage of the time. I only hope that more healthcare providers utilize this invaluable service.
ReplyDeleteDr. Ashley Waggoner, D.C.
This comment has been removed by a blog administrator.
ReplyDeleteAs an L&D nurse who birthed both of her babies at home I just want you know: you rock! Thank you for your post, I'll definitely be following your blog.
ReplyDeleteThanks to Barbara Herrera for pointing me to this post, and to your blog. Very powerful story. Thanks for being brave enough to share your experiences and your opinions.
ReplyDeleteGrr – after having lost my comments I will start again. Firstly a brilliant post from someone within telling it how it actually is. What women fail to understand is a caesarean section is MAJOR ABDOMINAL SURGERY. It needs to be spoken of in this term for women and their families, and medical professionals to really embrace the seriousness of it.
ReplyDeleteSecondly – there has been a case before the coroner in Australia http://www.smh.com.au/national/blood-loss-from-caesarean-was-mistreated-inquest-told-20090601-bszj.html of a woman who bleed to death in her bed after staff had been alerted to her bleeding (she’d already lost one litre of blood during surgery)
Thirdly – if you are interested in the politics of breech birth begin with the Term Breech Trial which changed the way breech birth was seen by medical professionals. After the release of this research paper the way breech was managed changed almost over night. It goes to show how BAD medical research informs future practise without any analysis or conversation. Women in a very short period of time have come to believe a breech babies can only come via surgery and are often bullied, and/or terrified into agreeing to the surgery. It takes an empowered and strong woman to say no. Most breech births occur now at home – where the skills to support a woman to birth a breech baby remain.
Fourthly – the wisdom of breech birth.
1. do not push until dilated completely. Women are often supported to resist the urge to push much longer with a breech baby to ensure this.
2. birth the baby upright – so the mother is working with gravity.
3. keep the room warm – a cool room will encourage the baby to breathe before the head is birthed.
4. hands off (ha! See any medical professional cope with this one!) again – touching the baby before it is born will encourage the baby to breathe.
Of the women who have birthed vaginally a vertex and a breech baby – they all agree a breech baby is far easier to birth and old wives tales say breech babies were designed to be born in a field – feet and bottom touch the earth first.
Women deserve informed choice and access to information which details or the true risks rather than just a list of the benefits. Keep up the brilliant writing. I will be back!
PS: I see all your babes were born at home with a midwife. You probably already knew all the info I've supplied here!
Nice to find your blog.
ReplyDeleteThanks for sharing!!! Women need to have options in childbirth and she probaly didn't even know the risks of cesarean...
ReplyDeleteCheck out ican-online.org/pregnancy/breech
Icanofjacksonms.blogspot.com
nursingbirth: it is interesting that most of the ICU nurses I work with understand that it is major surgery with significant risks; sometimes it's because they have to take care of these women, but if nothing else it's because they know from other abdominal surgery patients that surgery on your guts is never something to take lightly.
ReplyDeleteJill--Unnecesarean: I'm certain that in general most mothers would risk a c-section over placing their baby at risk (though I'm not sure the breech risk warrants it)...but I do think the martyr attitude is kind of inflicted on women. Ironically the same OBs and L&D nurses who push epidurals on patients because it's easier for the staff to deal with, are often the same people who think that women just have to accept and deal with tears, interventions, birth trauma (to baby and mother)...or post-c-section grief like that cesarean-art lady. It comes with the "we had to save your baby!" attitude.
And I hate to say it, but even if the risk of a breech delivery was that big (which I don't think it is), some moms might not opt to be cut open and instead place their baby at risk. I don't necessarily know if that's selfish, but that's beside my point, which is that a woman should be able to make that choice.
Jodi Cleghorn: Thanks for the info on breech births! Actually, I don't know a lot about the mechanics of breech vaginal deliveries, and both the technique and the legal ramifications are something I'm looking into. All I know is that every midwife we've had would be willing to do certain breech presentations (not all; I gather not all breeches are the same, and there is a huge difference in risk and ease-of-passage based on fetal lie and attitude), but that if we went to an obstetrician or CNM their hands would be tied. Even if I did know everything you wrote, your explanation can show other readers that it's doable.
labortrials: Ironically, our out-of-hospital prenatal care including much discussion about possible risks and courses of treatment (you know, if X happens, then we'll do Y) so we knew ahead of time. In a hospital obstetric setting, I don't think pregnant women get very much of this, if any at all. And they perhaps need it more, since there is a greater number of possible procedures and courses of treatment. I know the births I saw in the hospital involved treatments I hadn't even heard about in class (like manual dilation of the cervix with a Foley catheter), and were only briefly explained to the patient. And all the possible courses of action were known to the doctor and staff, but not the patient or her family. It's a shame.
ReplyDeleteKayce Pearson: External versions are pretty risky as well. I'm curious what happened in your case. We know someone in the area who had an external version and then a drop in fetal heartrate, but nothing was done for two days until the birth, and the baby had severe brain damage. Apparently the external version had abrupted the placenta and he should've been sectioned immediately. Of course I don't know if that happened in your case, but it may have been enough of a worry to lead to a section.
momyshaver: Kudos to you for frank-breeching that big girl out! You're right: when practitioners are tied to doing c-sections, either from a lack of skilled resources (i.e. getting an OB who knows who to do it), or hospital policies, apparently it all comes down to the woman to decide what is going to happen to her. It's awful you had to stand your ground like that in the heat of the moment, though.
red pomegrante: Wow, I'm really curious to hear your story, being an L&D nurse but birthing at home! Have you written about it anywhere? All the L&D nurses (well, most) that I worked with in clinical were interested in my home births, but none of them were home birthers themselves, and I'm pretty sure most of them, even though they have big problems with the L&D environment, wouldn't be "brave" enough to do it at home.
Everyone else: Thanks for the great comments! Wow!
Hi, Chris,
ReplyDeleteGreat blog. Just wanted to mention that I've heard of nurses getting in trouble for sharing detailed stories of patients. I hope you don't so you can keep on posting and sharing your perspective. It's very important.
Also wanted to mention that CranioSacral therapy in which practitioner is a aware of baby's ability to communicate is also good for helping baby to turn.
I hope you've checked out my film trailer for "The Other Side of the Glass" www.metacafe.com/watch/2881352/the_other_side_of_the_glass/ and my short on cord clamping "We Can Be Much Kinder" both on metacafe.
Thanks again.
I want to know about the art? It's great!
ReplyDeleteBTW I'm also a mom who had an emergency section for a last minute breech presentation The ob/gyn in the ER told me that she'd "try" to deliver vaginally but that the results could be "tragic." With that information, I was too afraid to "try." Second baby born vaginally- at home. 13 and 8 now.
I reviewed two books on breech birth on my blog a few months back. When/if you have the interest, you might enjoy reading them:
ReplyDeletehttp://rixarixa.blogspot.com/2008/11/books-on-breech-birth.html
ps--I'm currently researching nurse's perceptions about home birth (particularly L&D nurses). Do you know if anything has ever been published on this topic?
In Maryland one of our (at least) three cesarean related deaths in 2007 was due to a post-breech cesarean blood clot.
ReplyDeleteA few years earlier we also had a mom very nearly die like this mom due to an emergency cesarean done on a breech baby who was within moments of being born vaginally.
We had another death 11/08 and I don't know if it was breech related. I just know that she was a healthy, first time mother with no pregnancy complications. The baby was sectioned out then the mom got an amniotic fluid embolism and died on the OR table. AFEs are very rare and risk factors include induction and cesarean section.
-Barbara (1 1/2 years of daily pain post-cesarean)
OK so perhaps we decide to deliver this lady vaginally? Who is going to do it? None of my Obs would do it. Why? Because the Hanna study is enough evidence to see that 6 out of 1000 vaginally breech births will die. And here is the rub, you don't know before hand which ones. Just like they didn't know this lady would be one of the very, very few women who have a massive hemmorhage and thus a massive transfusion.
ReplyDeleteMy suggestion would be to get your a$$ into the medical library and look up a few things. Then you can make some decisons on what to do with each patient. Until then, you got nothing but ancedotal evidence. Which makes you sound a little like Jenny Mccarthy and her Autism thing....
"it's powerful evidence of the"
ReplyDeleteIt is not powerful evidence it is one persons view on one case. That does not make it powerful evidence it make it anecdotal. If you want to be taken seriously by your peers, learn how to read the studies and use statistics. Because that is how we decide how to treat patients.
Chanced upon this entry. You are quite correct about DIC being quite quite bad. Among veterinarians DIC also stands for Death Is Coming. Pretty sure the human medicos know that, too.
ReplyDeleteThought provoking - thank you. Here in the UK we have the ridiculous situation where the decision is made to section a breech when the buttocks are visible. In all the causes I have seen it has been a questionable decision as progress to second stage has been rapid indicating no disproportion.
ReplyDeleteWhen I read stories like this, I often wonder if true informed consent has been given. Was this woman given all the risks of CS, and all the risks of vaginal birth? Often, CS is made out to be the safer option for the baby, but we forget that the safest option for the baby is to have a live and healthy mum.
ReplyDeleteHi Chris,
ReplyDeleteA friend posted this link on Facebook, and I am so happy to have found your blog. I have a 15-year old son, who was a breech (bum-first) and who was delivered at home. I birthed on my hands and knees, as this was what my body wanted to do. I had gone into labour that morning on my way to the doctor (I had kept parallel appointments with both my doctor and my midwives, so that I could talk about the difference, from personal experience) and the doctor confirmed that I was in labour, but did not detect the breech presentation. After the doctor, I went to the appointment with the midwives, who also did not know he was breech. I am very glad that I had both, as I am certain that if I hadn't, then people would say that a DOCTOR would have known! In any case, I had a wonderful, med-free delivery, my son was 6.75 pounds, and I had no tears. It was one of the most amazing things, and a truly empowering experience. I recently watched a film called 'Orgasmic Birth' which is an amazing film. I would recommend it for anyone planning a birth. Another film that I am aware of (I've read everything on their web site but haven't seen the film) is called 'What Babies Want' and it looks very good as well. Lastly, thanks for your blog! You are a really good writer, and I have now read all of your posts!!
Andrea in Canada
Incredible post, horrifying story. Thank you-- I'll be following your b log from now on!
ReplyDeleteOMG!! That's horrible...but one more example of why I chose to birth my breech babe vaginally. Best decision I ever made.
ReplyDeleteAnother great post, Man Nurse! I'll be back.
ReplyDeletePinky, I think the reason many of us weren't worried about the Hanna study was because it was very poorly done. We DID look at the evidence before making an informed decision. As has been pointed out in numerous places, Hanna drew their study conclusions by including numerous vaginal infant deaths that had absolutely nothing to do with the baby being born breech. It's easy to overlook when only looking at the numbers. I also wasn't impressed with how few participants the study used.
It is deeply saddening to me that women unknowingly put not only their lives at risk, but also their future fertility, when they have a cesarean. I hope this poor woman is able to heal and find peace in the situation. There are too many woman out there who would love to have more children and yet are hindered by the fact that their uterus cannot handle another cut.
ReplyDeleteI'm shaking and sick to my stomach right now. As a mom sectioned twice for breech (and never told of the risks of surgery, other than a quick "sign this" as they were wheeling me to the OR), I'm disgusted at the treatment of cesareans as no big deal.
ReplyDeleteI went on to give birth to my 3rd child, also breech, vaginally and the recovery was amazingly different.
How did I come to that decision? Research. Yes, there were risks to a vaginal breech (though I argue that these are minimal when a competent care provider is in attendance), and there were risks to the VBAC, *but* what no one wants to tell you is that there are real risks to a cesarean, especially with each successive one.
As Andrew Kotaska and Henci Goer remind us, regardless of what anyone thinks about a woman's choice, she has the right to make it. Women need the information to make an informed choice.
Thank you so much for the work that you do!
Stay tuned for more information about the 2nd International Breech Conference in Ottawa...
Christie,
International Cesarean Awareness Network
and the Coalition for Breech Birth
Thanks for sharing this. I had a scheduled breech cesarean...though I kinda new better, as all my prenatal care was with a midwife at a birthing center. She was willing to attend but there was so much going on (i wont bore you with details) and the baby wasn't turning, after 4 weeks of trying. As some one else mentioned, there were not a whole lot of resources available online or books. I definitely want to buy these books for next time to have on hand. I would try a couple more things that i didn't try at the time (acupuncture, moxibustion, a vag breech birth). I tried Webster's technique, an ECV, handstands in the pool, cat/cow stretches, lights, music and parades at my crotch..lol..to "encourage" her to turn. C-sections suck when it's not a life or death thing. All the issues (emotional and physical) that I've had for the last 17 months have been brutal. In case anyone is having pain after their c/s, go to a pelvic pain specialist and see if you can get into Physical Therapy for pelvic floor rehab. It's helped me out a lot.
ReplyDeleteLouann Janel: I've been thinking about this a lot lately (getting in trouble for sharing patient stories). I don't think I'm violating HIPAA by talking about anonymous patients from a vaguely anonymous nursing perspective...but I'm wondering if I should maintain complete anonymity, and also obliterate any reference to time or place in particular stories. I'm also going to try to focus more on general issues than individual anecdotes about patients. Of course, none of that would really prevent a boss (or instructor) from getting angry at what's here. I'm mulling over it. I need some more resources or guidelines to read about it.
ReplyDeleteRixa: I don't know of any writing on the perception of home birth by L&D RNs...except, well, whatever I plan to write one of these days. I had a couple interesting conversations about it with the L&D staff on my OB rotation. By the way, I love your blog and I've been following it for a while, if I haven't mentioned that.
Anonymous in Maryland: Thanks for sharing. I think it's important that stories like these get out, hopefully without scaring people away from necessary or important c-sections, but at least letting people know what real risks are there.
pinky: There's certainly a place to discuss 'anecdotes' (single patient cases) in evidence-based care, especially considering that statistics is simply masses of anecdotes put into numbers. However, I didn't intend to frame this as an argument against sectioned breech deliveries, but as an anecdote about the after-effects of one section which was not convincingly necessary. And just to clarify, I'm willing to believe that sections are sometimes truly safer or even necessary for some breech presentations. Thank you for mentioning that study.
midwifemuse: That makes no sense. I don't think some practitioners realize what they're saying or doing, and I think it's because they have this view that delivery must be completely managed. Our last midwife said she would never touch certain face presentations and lies—unless the woman was actively delivering the baby like that, in which case there's obviously there's no problem!
My daughter was breech at 35 weeks and we tried everything to turn her, so finally at 36 1/2 weeks they scheduled our version. The doctor downplayed all the risks, and I didn't think enough to research it. I trusted him. My midwife said he was great, so I had no reason to worry.
ReplyDeleteThey did the version, and all the drugs they pumped into me made me very nauseous and out of it. They turned her around and everything looked good.
My labor started, but since I had the epidural, the contractions did nothing. They were about a minute apart, lasting 30-40 seconds. With every contraction, my daughter's heart would stop or decelerate. After about 4 hours of labor, they came in and said they were doing a cesarean.
During the version, they had torn half the placenta off and didn't even notice in the ultrasound they did after.
My daughter ended up being in a NICU for a week because she was earlier than they thought and couldn't breathe on her own.
It was an awful experience, and it has definitely made me question the birthing society of hospitals and informed consent.
Were you able to review this woman's chart? Certain fetal lies will not lend themselves to a vag delivery no matter what you do or do not do.
ReplyDeleteHave you taken statistics? Are you in a 2 year or 4 year nursing program. Statistics is a wee bit more than just amassing numbers of anectdotes. If you are going to be a nurse, it is very important that you read the research for yourself. Then you are able to discuss a viable plan. However, if your only arument is I saw this once and it didn't go well. Not going to be convincing. Also when you know the studies better than the Doctors do, you are in a good position to advocate for your patients.
I appreciate your post and sharing what you are experiencing in the hospital setting. My organization, The Natural Birth Project, is concerned with the same unsafe and often unnecessary practices. My belief is that doctors went into the medical profession to be of service and to heal. Sadly the culture of the hospitals is not always in alignment. I commend you for having your feet and mind on both sides to give us perspective. When training is such that doctors are actually trained in birthing babies rather than in surgery, we will begin to see a shift. How many OBGYN's have actually witnessed and participated in a live birth without intervention? Even more rare, actually attended a home birth to see what ACTUALLY happens and doesn't happen...when our hearts and minds open to the possibilities of entrusting women in their own personal process, a shift will occur, and I believe for the better. Thank you again.
ReplyDeleteWow!
ReplyDeleteIn our local area we have a situation where a mom in labor with her 10th child arrived at the hospital in full labor, 8-9 cm dialated, and baby was discovered to be breech. The resident on call immediately started prepping for a cesarean without even asking the mom. Someone--not sure if it was the mom or the dad, finally asked to discuss their options, and the resident told them their options were stitches or staples for the repair.
The dad was in shock at this response. He turned to their primary care provider--a certified nurse midwife--and asked if she could safely handle this situation as a vaginal birth. She replied that she could...and she proceeded to do just that. (I'm sure there were some very heated words between her and the resident between her telling the dad that a vaginal birth could be safe, and the actual vaginal birth.)
The father--in his "spare time" (yeah, 10 kids, one being a newborn, results in a lot of spare time!) wrote a letter to the hospital complaining about the bullying behavior of the resident, and praising the midwife up one side and down the other--I've seen the letter, it was very well written. Apparently one of the big issues was that since the mother had a history of hemmorhage with birth (which the midwife knew about, but the resident did not--and he didn't want to be bothered to learn about her medical history because "oh my gosh, we need to get this cesarean done NOW before the baby just drops right out of that woman!"), there was a concern that had she gotten a cesarean with its higher risk of hemmorhage, she likely would have ended up with a hysterectomy, which was not acceptable to them. I don't think the letter even touched on the maternal death issue.
The response it got? The midwife lost her priviledges at the hospital.
Jenn (sorry, I can't get the "name" box to work right!)
Thanks for sharing that. Wow!
ReplyDeleteThis commented edited by Man-Nurse at the request of the artist, who wishes to remain anonymous
ReplyDeleteHi there, I'm one of the editors of the book "Cesarean Voices" published by ICAN and I can tell you that the artist is B***** A******, an amazingly talented graphic artist and cesarean survivor living in California. This picture and many of her other stunning pieces form the visual counterpoint to the raw emotion of the words in the book. She is an amazing woman and I am happy to give credit to her where it's due. First time on your blog but I'll definitely be back.
Originally posted Tuesday, June 02, 2009
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ReplyDeleteInteresting story, very glad the lady survived. I went through very simelar and happily went on to have another baby by c section with no excess bleeding.
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ReplyDeleteHeya!
ReplyDelete1) I emailed the artist directly, and let her know to contact you. =)
2) Please get in touch with Robin Guy at the Coalition for Breech Birth. The SOGC just announced that breech no longer equals cesarean there. They have, you see, kept current with the world's research, including gorgeous info from Germany that proves that vaginal breech is perfectly safe; far safer than cesarean, for both mother and baby, and in over 400 births since they began tracking, they have not had to intervene or use instruments (forceps) even once.
3) The first Hannah paper got debunked by Dr. Marek Glazerman years and years ago. Quoting Hannah to justify cesarean for breech is disingenuous at worst, and demonstrating a lack of conversance with the literature at best.
Did you all hear about the change in policy in Canada to move towards delivering breech babies vaginally?
ReplyDeleteThanks for this story. Re. the Hanna breech trial, the late Phil Hall wrote a piece after investigating each of the reported deaths and as someone else said above, none of them were about the baby being breech. What exasperates me the most is that all breech presentations are treated as equally risky and requiring cesareans, when in fact, my understanding is that the major risk is that of a prolapsed cord with a footling breech presentation. When the baby presents bum first the risk isn't particularly high and vaginal delivery is as safe as any other delivery, provided the woman is upright and the caregiver is hands off. Thank you for posting this story--the comments are as informative as the post. Incidentally, in Canada doctors are coming to their own conclusions about the folly of not training doctors to do vaginal breech births and there is a movement to restore this skill so that women have a viable choice with providers who are competent in vaginal breech delivery. Hopefully, soon there will be a study demonstrating that this is do-able, and maybe by then the US will consider following suit.
ReplyDeleteI posted about the Canada SOGC decision to train obstetricians to attend breech births. I would like to see that information from Germany, however.
ReplyDeleteAlso, I eventually got in contact with the artist. Thanks!
Can anyone tell me the name of the c-section artist? I saw this art a few years ago & I have been looking for it ever since. joyjudithjech@gmail.com
ReplyDeleteI too had DIC post my c-section...well in my case c-section was necessary as I had twins both in breech position...I was in the ICU for 5 days...got 30 units of blood, had a hysterectomy, another surgery to remove both the tubes and one ovary...luckily the babies were pretty much full term and didn't need to saty in the NICU...i just consider myself blessed to have survived this..
ReplyDeleteThe same thing happened to me, i lost 6 litres of blood, i bled 15 minutes after being put in recovery, they worked on me for 2 hours while i was awake before having to reopen my wound as they couldnt stop the bleeding. I also had blood squeezed into me by the doctor, the fear on their face was frightening although i was extrememly calm. luckily i didnt have to have a hysterectomy. I had 4 consultants working on me, a registrar, and about 10 midwives. they couldnt tell my husband or parents if i was going to be OK they just said "they are doing everything they can". This happened 9 weeks ago and i am lucky to be alive. my whole body was swollen out to twice the size, my face was like a beach ball and my legs and arms and hands were also massively swollen. My epidural top up didnt work so i had to have another epidural and this was called a spinal, it paralysed me up to my neck, the whole labour / delivery was a mess. It took 5 years to conceive our son and is our first child and i have been told that there is a 10% chance this could happen again. I find out next week all the details as to why this could have happened and have all my questions answered. i have had 2 counselling sessions, but feel good and love my son to pieces. I just hope that i can get over this quickly (feel great now) and that it doesnt come back to haunt me later on. i am sorry to read that this has happened to other people, mums to be need to know how high risk this procedure really is.
ReplyDeleteHello! Just wanted to say thank you for posting this sad, but informative, story a few years ago. It's unfortunate that this story is quite relevant years later as cesarean rates still remain unnecessarily high. We work to transform this at Midwife International by training midwives to provide safe, natural maternity care around the world. For more information, please visit: http://midwifeinternational.org/midwife-training/.
ReplyDeleteThank you for all that you do!!
It is very scary for this unforseen incident to happen and hope she made a full recoveries. All people out there should cherish and love their mother more cause this is the potential risk they take to bring us out to the world.
ReplyDeletewhat if u r HIV positive? is it a must to get C-section?
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