QuestionI just delivered my first baby 3 weeks ago after having a wonderful pregnancy
with no complications. It was a vaginal delivery that included 2 hours of
pushing and the doctor using a vacuum to assist for the last 3 contractions.
To make our sad story short, our precious baby girl ended up only living for 2
days. At first, the doctors had no definite answers for us as to why her body
was failing, but now after some lab tests have come back, it is looking like it
was all due to a head bleed (subgaleal hemmorage), which was most likely
caused by the vacuum. My husband and I did not know much about the
vacuum before our daughter's delivery and the doctor did not tell us about
any risks before using it.
I wanted to ask you how you feel about vacuum assisted deliveries or what
your experience has been with them?
Also, we would like to try to get pregnant again someday...do you have any
advice as to when would be a good (healthy) time for that?
Finally, if I am able to get pregnant again, I know we will be terrified about
how the delivery will go, do you have any advice? Would we be better off
scheduling a c-section if possible?
Thanks for your help!
AnswerI am so very, very sorry for your loss. If you haven't already, I recommending seeking out a medical malpractice attorney immediately. It sounds like the vacuum was used improperly, and you were not given the benefit of informed consent. The doctor MUST inform you of all risks with any procedure before it is done- otherwise it is not informed consent (because the "inform" part isn't there). Even if you don't want to cause a fuss, I strongly recommend you consider a malpractice lawsuit simply so future parents won't have to go through what you are right now. Sadly, some medical practitioners will continue to make the same mistakes until there is a lawsuit involved.
One of the risks of vacuum extraction is hemorrhage- especially if the vacuum is used improperly. If an epidural is being used, this can cause further complications in regards to the vacuum. This is because when an epidural is used, a mother often births on her back and sadly, this is not at all the optimal birthing position for several reasons- one of which being that it does not allow for optimal widening of the pelvis. More pressure has to be put on the baby from the vacuum because the pelvis is not as wide as it can, or should, be. Labor goes a lot faster, and smoother, if the mother is in a position where the pelvis can widen all the way- such as sitting, squatting, or on the hands and knees. It is very hard to get in these positions when you are completely numb from the waist down (as is with an epidural). Spinal blocks, which simply numb one area of the pelvis but which allow movement of the legs, are much better if one does not wish to attempt homeopathic or natural pain relief.
I have known of vacuum extractions to go smoothly, but the mother was always informed of potential risks beforehand. While it is often used as a "last resort before cesarean" due to the risks, when used properly it can be an effective tool in delivery.
As for when to start trying for another baby, your body may be ready in three months or less but your emotions may not be ready. It is entirely up to you and your husband. You may want to give yourself up to a year to allow time to grieve, ease your anxiety, and clear up any legal issues. You may also want to consult with a counselor or religious/civic leader that you trust.
Where your next pregnancy/delivery is concerned, I recommend looking into options other than an elective cesarean. Cesarean sections carry just as much risk, if not more, than a vacuum extraction- this is why they are used as a "last resort". In addition, several studies have shown that chances of maternal death and/or hysterectomy rise sharply after each cesarean. "Elective" cesareans carry numerous risks and many doctors/hospitals will not do them anymore (even more insurance companies will not cover elective ones).
Some information about the risks involved with cesareans:
* "Cesarean Delivery Associated with Increased Risk of Maternal Death..."
http://www.acog.org/from_home/publications/press_releases/nr08-31-06-2.cfm
(American College of Obstetricians and Gynecologists)
* "Postpartum Maternal Mortality and Cesarean Delivery"
http://www.greenjournal.org/cgi/content/abstract/108/3/541
(Obstetrics & Gynecology 2006;108:541-548)
* "Women who opt for an elective cesarean have a threefold higher risk of mortality than those who choose vaginal delivery..."
http://www.medpagetoday.com/OBGYN/Pregnancy/dh/4022
(MedPage Today)
I also have more research I can give you regarding Cesareans, especially the higher risks involved with elective Cesareans, if you'd like.
You may want to look into other hospitals in the area, or look to see if there are birthing centers. Unlike hospitals, birthing centers have the advantage of being focused on births. However, birthing centers have the medical technology of hospitals. Some hospitals even sponsor, and or are affiliated, with birthing centers so the centers have all medical resources but in a much more birth-centered atmosphere. You may also want to consider other birthing options, such as a spinal block (as mentioned above), birthing in water, a TENS machine, hypnobirthing (essentially meditative birthing), or other options where you could get into a better birthing position next time. Many women aren't aware that there are options other than just an epidural- with modern technology and medicine, there are numerous, and just as effective/safe, pain relief options.
Please let me know if I can help you further or with anything else.
Best wishes (and my thoughts are with you)
Helen
