She was suppose to go home with a beautiful baby girl. This was their first baby and they had waited anxiously for many months to meet her. Because of one those true blue obstetric emergencies though, she went home with empty arms.
It was a Monday morning and the labor ward was busy with 3 moms in labor. Two of the moms were at increased risk and she should have been low-risk. We don't routinely do continuous fetal monitoring on our low risk moms - we only have one monitor. It was noisy in the labor ward as the three moms all labored together in an 8-bed ward with their families plus several postpartum patients and their babies.
Somewhere around morning shift change though her water broke, the umbilical cord prolapsed and came down into the birth canal before the baby. For those that don't know obstetrics this means that with every contraction the baby's head compresses the umbilical cord cutting off the blood supply to the baby. As the labor progresses and the baby comes down the birth canal eventually the blood supply will be cut-off completely and the baby will die. Sometimes this happens in minutes and other times it can take longer depending on how much of the cord has dropped down. Once the problem happens though you have several emergency interventions that need to be done quickly, including doing a c-section usually, to save the life of the baby.
We did well for the most part, although there were complications including the fact that operating room team had to be called in and the fact that with two other high-risk moms in labor we were short-staffed. In the end we just couldn't move fast enough and we lost the baby. The other two moms and their babies both did well though and so did the other mom who came in completely dilated and pushing in the midst of all of this.
In recent weeks we have lost several moms and babies. Moms have gone home with empty arms and families have gone home with broken hearts. It has been hard. They died from the complications that are common killers of moms and babies around the world.
I have to admit I have struggled to figure out the best way I can be involved in our obstetric care here at the hospital. It is even harder knowing the level of care that exists in the U.S. with such well-trained teams, ready at a moments notice to use all sorts of equipment and medication to save the life of a mom or baby. Deaths happen in the U.S. though too, even with all of that. I want to improve our care here and I have so many dreams for what could be!
