The Delivery Gone Wrong

The Google Doodle for June 7 honored Dr. Virginia Apgar, whose work in obstetrics led to the development of the Apgar score.  The Apgar score is a quick assessment of how well a newborn managed the birthing process. Apgar scoring is done at one and five minutes after birth, assigns a score of zero, one or two for each of the following areas:  Appearance, Pulse, Grimace, Activity and Respiration.  This gives us APGAR….thus the name of the assessment. As each area is given a score of 0 to 2, and a healthy APGAR score would be 7, 8 or 9.  Rarely babies get a 10 because they have blue hands and feet as they get used to living outside of momma.  Babies with less than an APGAR score of 7 may indicate a baby needs medical attention.

Today’s Google Doodle was timely, as I wanted this next post to introduce you to what happened during Joseph’s birth in a little more detail. When Joseph was born, his APGAR scores at 1 and 5 minutes were 0.  That’s a big, fat ZERO.  Joseph was clinically dead when he was born. Let that sink in for a few seconds.   We can get into a discussion in the future about the quality of life versus the quantity of life, but the doctors were just trying to save the life of a baby.   The neonatologists did CPR on Joseph for almost 25 minutes before they were able to get a pulse and he took a breath on his own.  There were several things that led to this, a few which are called out in a report from the Virginia Board of Medicine, and of which the delivering OB was found negligent. 

To break down a few things I can explain:

1. Joseph had the umbilical cord wrapped around his neck.  Twice.  So every time I had a contraction, the cord pulled tight and restricted the flow of blood and oxygen to his body.
2. Joseph had what they call decreased beat to beat variability.
3. Joseph was so stressed during the labor process that he had what they call meconium...dark stained meconium to be specific. Joseph had stooled in utero and then was recirculating that into his poor little body.
4. I had pre-eclampsia during labor, had extremely high blood pressure (100+/190+) which was treated with magnesium sulfate that caused Joseph more stress.
5. The doctor order pitocin to induce labor, which was contra-indicted given all Joseph’s and my symptoms. As soon as the pitocin was administered, Joseph’s heart rate dropped drastically, and eventually stopped.  

I am linking a pdf of the Virginia Board of Medicine’s report issuing a REPRIMAND on the delivering doctor’s permanent record.  The reprimand has little to no significance in the grand scheme of things.  This is public record, and if you go to https://www.dhp.virginia.gov/medicine/ you can look up the reprimand on her license.  She still practices, she still delivers babies, she had no real consequences for the negligence the Board of Medicine identified her as guilty of committing.