Complications during VBAC and a terrible tragedy

The Mad Momma has posted Rashmi and Vivek's horrifying story of the birth and death of their second child. Attempting a vaginal birth after caeserean (VBAC), the delivery ran into complications resulting in the baby's death. It is an excruciatingly painful story, their grief amplified by what they say was the hospital's negligence and uncaring attitude.

I felt no urge whatsoever to push, yet was asked to do so. The stirrup on the delivery table kept breaking off – I was told that this is a recurring problem that “needed attention”. At 1.50 pm, the fetal heart rate dropped to 80 beats per minute. Dr. Prabha was called again. She checked the fetal heart rate on the CTG, explained that this was normal when the baby was passing through the birth canal, and asked me to hold my breath and push hard. I felt no sensation in my cervical area, but felt intense pain tearing my stomach apart. I felt like my baby had rolled into my stomach and could see its body pushing up against my ribcage. I was screaming, pointing at my stomach, and telling them that my stomach was hurting, and there was no urge to push. But she told me to “push, push harder”. I then heard Dr. Prabha saying “Get the OT ready”. She told my husband that she was going to attempt to deliver by forceps – if that was unsuccessful, she’d have to do a Caesarian.

The OT wasn’t on standby, wasn’t ready. I was numb with pain. They wanted me to get up and move to the operation table. I couldn’t move. They eventually slid something under my back and I pushed myself on to the OT table, as there was no transfer stretcher available. I complained of severe shoulder and chest pain. No one paid me any attention; everyone was busy preparing the OT, and the anesthetist was attempting to top up my epidural. The fetal heart rate was never monitored in the OT. Dr. Prabha unsuccessfully attempted a forceps delivery at 2.20 p.m., and then cut me open. I heard a deafening sucking sound, after which I must have passed out.

Later, I learnt that my uterus had ruptured along the scar of my previous Caeserian section. My baby was found floating in my abdomen. He had no heartbeat and he wasn’t breathing. He had been deprived of oxygen for a long time – 43 minutes. They “resuscitated” my son and put him on a ventilator.

When I opened my eyes I saw Dr. Latha leave, followed by Dr. Prabha. Dr. Shirley was suturing me while laughing and talking with another nurse. I felt reassured that my baby was okay, even though I had neither seen nor heard him.

After months of working with the hospital to find out exactly what when wrong, Rashmi and Vivek were met with stonewalling and assertions by the attending doctor that she would do the same thing over again in a similar case in the future. And that is exactly what Rashmi says she is looking to prevent.

Please do click the link above and read the entire post.

Wockhardt Bangalore, the hospital where Rashmi attempted to have her baby, is responding in the comments section to The Mad Momma's post. Girl on the Bridge linked to the post on her blog:

As someone who will be (hopefully) a mother soon, this story is my worst nightmare. Of course, my situation is not the same. This is my first child. What annoys me most is the hospital’s claim (Wockhardt has a long rebuttal in MM’s comments) that Rashmi chose Dr. Latha because she wanted a VBAC. This is conjecture and probably not useful to any lawyer fighting on facts but I know, I just KNOW that no matter how certain a woman is about how she wants her birth to be, no matter how much she is set on a certain type of experience she would not, would not put her child at risk.

I have said many times before on this blog that we need to be involved in the medical procedures that we go through, we need to ask questions, read on our own about the conditions and the procedures. Rashmi's story does not take away from any of that. If anything, it emphasizes the need to not only be aware of what's being done to us but also the need to be careful in choosing medical institutions and doctors.

Many times, in emergencies especially, we don't have a choice regarding what hospital we end up in or which doctor attends to us, but for the times we do, I wish there were some service that would rate the doctors on their competency and bedside manner and success in their field. I'm not saying that the tragedy that befell Rashmi and her family will never ever happen again, but it will arm people with the kind of information that I didn't have when I was getting ready to have my baby in Bangalore, the kind of information that parents-to-be come searching for to my blog (and I'm sure many others) on the backs of a google search.

I deeply admire Rashmi for what she is doing. She has lived through an experience so devastating that we would not wish it on our worst enemies and she is using her story to educate mothers-to-be. A story that, I'm sure, calls up her pain every time she recounts it, that reopens wounds that would heal faster if only they were allowed to stay closed. I do hope that her efforts result in a better experience with hospitals for anyone considering having a baby.

P.S. Thanks, Aaman, for alerting me to this story.