Tuesday, May 13, 2008

Another UC death on MDC

Yet another unanticipated stillbirth at UC on MDC. The baby was known to be breech. In addition, the baby had not been moving much, but mother declined the ultrasound that was recommended by her midwife:
... I did have a mw appt on Thursday morning... and she thought she felt head up as did I. I declined the doppler and she was unsuccessful finding the heartbeat her stethoscope. This was the 2nd time though so didn't really think much of it. Then she asked about movement and I stopped in my tracks and said, "The baby hasn't moved much for a day or two" still didn't think much about it cuz that sometimes happens at the end of a pregnancy. I declined the U/S
One of the most horrific features of homebirth deaths is that other children in the family are often present to witness the birth of the dead baby, the frantic 911 call, and the transport to the hospital:
contractions started feeling pushy, but not great pushing... The baby was breech. No hard head to push against... Pushed hard as I could from 7-8. Pushing the head (with the arms both up against it) took three pushes. Albert caught up and put him on the floor. He did not move at all. He is blue. He really is BEAUTIFUL. I pick him up and rub his back. James (age 12) puts down the camera and calls 911. We flick Micah's feet. I blow in his mouth. I hear gurgling in the lungs. I get the fetoscope, I can not find the heartbeat. My neighbor (a volunteer EMT) comes over @ 8:06 AM (Micah born @ 8:00) and tries everything. a few minutes later the ambulance arrives... Neighbor stayed in ambulance with me and did chest compression on baby the entire way... When we get there they take Micah and wheel me into ER where they are inserting IV's and crap... While they are still hooking me up to stuff the NICU nurse comes in and says the were unable to get the baby to breathe. Seconds later my husband comes in with Micah. It was TERRIBLE. worse moment of my life. I held it together really well. I *knew* from the moment I saw him that he was gone. Albert took it harder @ this moment. I never want him to have to go through this ever! ...
Perhaps UC should take a new motto: Trust birth, have a dead baby.

The death of any baby is a tragedy of major proportions. The possibility that the death was preventable by routine obstetric care makes it an even greater tragedy. Did trusting birth prevent this baby from being breech? No. Did trusting birth mean that it is appropriate to ignore decreased fetal movement? No. Did trusting birth make refusing an ultrasound a good idea? No. Did trusting birth prevent this baby from suffocating to death inside the uterus? No. What did trusting birth accomplish? The same thing it always accomplishes: NOTHING!

It is not clear at this point what caused the baby's death and if the baby had anomalies, it might have died in spite of medical treatment. However, that is not a reason to decline appropriate medical care. This baby might have died of entirely preventable causes, or it may have died of causes that could have been treated in the hospital. At a minimum, appropriate medical care would have alerted both parents and providers that something was wrong, and might have spared the other children the horror of watching the birth of a sibling that, entirely unanticipated, was dead.

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