A woman 20 weeks pregnant feels she is going into labor. She'd already lost twins at 23 weeks and another baby at 20 weeks, so she has a pretty good idea of what she is talking about.
In the hospital, they explain she really needs to consider cerclage... where the cervix is sewn shut until the end of pregnancy. She agrees. She is 2cm dilated already.
During the stitching, her membranes are accidently ruptured.
She is now hospitalized, ass end up (Trendelenberg position) with monitors on as she waits another 20 weeks for her baby's birth. She doesn't move except slightly side to side. No bathroom privileges. No trips to Babies R Us for receiving blankets. No La Leche League meetings or childbirth classes. Just lying, ass end up in a hospital bed, waiting.
The hospital doesn't have an exquisite NICU, so through consultation, it was decided to wait until the woman was 24 weeks along and send her to the Big University Hospital (BUH) where they could take better care of the baby should he be born early.
During the weeks, a guess is made that the membranes have re-sealed, however her amniotic fluid volume remains terribly low... between 2 and 4. Normal would be 18.
The extremely difficult 4 weeks go by and the woman, via ambulance, ass end up, is shipped to the BUH.
At the BUH, the doctor admits her and says she doesn't need to remain ass end up anymore. That there is no research showing that Trendelenburg does anything for women trying to keep a baby inside... that there is pressure anyway, so she might as well get up and do something. She refuses. She asks to see another doc who says the same as the first. She asks for another. Same answer. She goes through this 6 times, including with perinatologists, who tell her it is fine to get up.
She doesn't believe so, but she guesses they must know what they are talking about.
The nurse gives her a sleeping pill for her agitation and sends the woman to the bathroom to pee before bed. It is the woman's first upright in over 4 weeks.
She climbs back into the bed and the nurse attaches the monitors back on and wishes the mom a good night.
About 30 minutes later, the nurse wanders in and says the baby must have moved because they haven't heard the baby in about 20 minutes.
She can't find the baby, so they bring in an ultrasound machine. The baby's heart has stopped.
A vaginal exam shows an occult cord prolapse through the 2.5 cm open cervix.
This happened here, to one of my midwife's clients, last week.
The mom that lost her baby is a lawyer.