Difficult labour -- what went wrong?

Archived User

Difficult labour -- what went wrong?

A very good friend went through an ordeal four weeks ago. It was her first baby and the pregnancy was normal, but her doctor decided to induce 2 days after her expected due date. She immediately reacted to artificial homones (I understand it was cervical ripening gel) and had strong contractions every minute for three hours before the midwife checked and verified that she was indeed in labour. She discontinued with the synthetic hormones to prevent too strong contractions but labour stopped after a few hours.

At this stage they administered syntocinon intravenously and strong contractions came back. After 16 hours of labour her cervix was effaced and she dilated to 2 cm but then contractions again started getting weaker. The doctor performed amniotomy and contractions started again. I understand that she had synthetic hormones administered to her intravenously throughout. The doctor then recommended epidural at this stage to 'speed up the first stage' and allow her to 'conserve energy for the second stage'.

A few hours later she was fully dilatated and pushed, but the baby did not move down fast enough. The doctor tried with vacuum, then forceps delivery. When he pulled the head with forceps the baby's heart rate took a dive. The doctor said that the baby had the umbillical cord wrapped around the neck and that vaginal delivery was not possible any more. The midwife pushed the baby back and the doctor performed an emergency Caesarean.

My friend lost consciousness after delivery and developed high fever and convulsions. She was kept under observation and only hours later they discovered that she was bleeding heavily from what they later said were lacerations of both cervix and vagina, so they had to perform another operation to stop the bleeding. She saw her baby for the first time 12 hours after birth and could not hold her or breastfeed at all 36 hours after the operation.

The doctor blamed the midwife for causing lacerations by pushing the baby back, the midwife blaimed the doctor for causing injury during failed forceps delivery. They both told my friend that the baby could have died because the umbillical cord was wrapped twice around the neck and once around the shoulder.

Just to mention that this happened in Switzerland, in an expensive private hospital. I gave birth twice in the same hospital and managed to avoid most medical procedures thanks to thoroughly studying 'The Thinking Woman's Guide...' -- which put me in a strong negotiating position with hospital staff and doctors.

So what went wrong with my friend? I suspect that consenting to induction was the biggest initial mistake, but was the rest of this sad story really unavoidable? I would really appreciate getting your views.

Henci Goer

RE: Difficult labour -- what went wrong?
(in response to Archived User)

I am sorry to hear that your friend had such a difficult birth. It is difficult to say what part labor management played in all of this, but, certainly, she would have had a better chance of normal birth without complications if she had begun labor on her own and labored without extra stimulation and without an epidural so that she could push effectively. Many babies can be born with the cord wrapped around their necks and bodies, though not all, so it is possible your friend was destined for a cesarean under any circumstances. There is no way to tell. As for the lacerations to the vaginal canal, the most likely thing is that the obstetrician and the midwife are both right.

If your friend is fluent in English, there is a website for women who are suffering emotional difficulties after a traumatic  birth experience called Solace.

Note: "Syntocinon" is a brand name for oxytocin. In the U.S., the brand is "Pitocin," also called "Pit."

-- Henci

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