Wednesday, January 18, 2012

Mother and baby would have died if VBAC was attempted elsewhere

Photo by Simon Finlay
This birth story was quite rightly reported as a good news story in last week's Norwich Evening News: 'Our little boy is just cool after 72 hour fight for life'

But there's also something very troubling about the story if you consider the fact that had this VBAC been attempted in a different hospital - one without the specialist life-saving equipment that was needed - both mother and baby would have died (according to the report).

Baby Adam's mother, Marie Jermy, is quoted as saying, “I wanted a natural delivery with Adam, as my other two kids were born by C section, and the hospital were very supportive.".

Yet despite being considered 'low risk' enough to attempt labor, Marie's experience emphasizes just how quickly problems can escalate during labor, leading to possible death or disability.

She says, “If they hadn’t done the tests on Adam when I was in labour, we would have both died... We owe them our lives, I just can’t thank them enough."

“The results came back as I was about to push, saying I would bleed to death if I tried it. It was that close... I was minutes away from dying.”

“I don’t think they’ve ever done a C section that fast before, their speed saved his life."

She continues, “It was going OK until last thirty minutes. Blood tests were all normal, wasn’t until in theatre that problems started.”

Marie's surgery reportedly took 17 minutes, breaking all previous records for the unit, and baby Adam needed to stay in a special unit for seven days.

Complications in labor

Dr. Mark Dyke, a consultant in paediatrics, explained, “The condition that we treated in this case is perinatal hypoxia-ischaemia, where the baby suffers a reduced blood and oxygen supply from the placenta via the umbilical cord often due to complications in labour.

“The result is a baby who may suffer severe shock, which can be fatal in some cases, and/or organ failure.

“Where infants survive the early problems the risk of brain damage in the longer term is high – that’s where the ‘cooling mat’ comes in. By reducing the body temperature (by 3-4 degrees C) for 72 hours we can reduce the risk of cerebral palsy or learning problems."

“We were the only unit in the East of England to be involved in the major trial in this country (ToBY Study) and have been offering this treatment for 4 years now. We cool 1-2 babies per month overall, many of whom come from other parts of the region specifically for this treatment.”

Informed choice

Please note that I don't write this blog in order to criticize anyone's decision to attempt VBAC, but rather it is to demonstrate that there are risks, just as there are risks with cesarean surgery, and I hope that all women are being advised of these risks before being encouraged to have a normal birth experience 'because that's best'.

Sometimes it isn't - only hindsight knows for sure - and that's why women need to be fully informed and allowed to make a choice.

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