Pages

Monday, November 22, 2010

Birth story: cord prolapse at home

A reader recently sent me an incredible birth story, and I wanted to share it with you. After a few irregular contractons, she had a cord prolapse at home. She wrote to me:

"This was a planned homebirth...we had called the midwife as soon as my water broke to have her come out (my water had never broke previous to the pushing stage before). Then when I stood to get up, I saw the cord. Feel free to post and link back to me, I thought it was a story you might be interested in hearing. Amazingly, when I went in for my postpartum visit with the OB who did the c-section, the first thing he said to me was, 'You know, nothing would have been any different if you had planned a hospital birth. You still would have been at home when your water broke and the cord would still have prolapsed.' I was amazed at how positive he was and how willing he was to admit this was not a 'home birth' issue. I think Apollo's story is important for people to hear...being knowledgeable about that one issue (what to do in case of a cord prolapse) is what saved his life."

~~~~~



Friday night after we put the children to bed, Chuck and I sat down to watch a movie. As I sat idly rubbing my belly, I noticed the baby had once again turned transverse. I had a head bulging on one side and bottom bulging on the other. We looked at each other and sighed…

The movie ended and I headed to bed at 11:20. Sometime after midnight I woke up to a strong contraction…I had a few more, very strong but infrequent (12-20 minutes apart). I was uncomfortable so I kept making trips back and forth to the bathroom. At one point I finished up in the bathroom and was about to stand up when my water broke with a pop and a gush. The water just poured out of and wouldn’t stop. I called to Chuck (who had headed to bed only 10 minutes before) but he didn’t hear me. Once the flood slowed a bit I put a towel between my legs and waddled down the hall, gushing fluid the whole way. I flicked on our bedroom light and told Chuck my water broke. I headed back the toilet where the fluid continued to pour out.

We were immediately on high alert. If you read my previous birth stories, you know my water has never broken before I was fully dilated and ready to push…and in every case except Hezekiah, the water broke as the baby was emerging. Was I in for a long, long labor? Or were we going to deliver this baby in the next ten minutes by ourselves???

Chuck got the phone and called the (back-up) midwife and asked he to come out to the house and check me. He turned and headed down the hall and I stood up…I glanced down and saw a good 3 ½ inches of umbilical hanging out of me.

This was the single worst moment of my life. A prolapsed cord = death of the baby…the only way this can be prevented is with an immediate c-section…and I was alone in my bathroom.

Nightmare or not, I didn’t hesitate for one second. I grabbed the cord and stuffed it back when it belonged, then slid to lie down on the bathroom floor. I yelled down the hall to Chuck, “Chuck, the cord’s prolapsed, call 911 NOW.

He came back in and said he needed to call the midwife. “No, call 911.”

“I need to call the midwife first,” he said. He still had the phone in his hand- he had only made it down the hall a few steps when I realized the cord was prolapsed.

“Call the midwife, then 911.”

The conversation with the midwife was short. “The cord’s prolapsed.” “Call 911 and get to the hospital,” the midwife replied. As he called 911, I crab walked into the playroom, holding the cord in the whole time. I lay on the couch with a couple of pillows under me and soon realized I could not keep holding the cord in. Chuck needed to do it. With out a moment’s hesitation, up went his hand to keep the cord safe in my uterus. Soon I realized I couldn’t keep holding up my pelvic area so I slid down until my bottom was on the couch and my head on the floor. Chuck shoved another pillow under my bum.

It of course seemed to take forever for the ambulance to arrive but Chuck said it only took 10-12 minutes. Once we heard them on the property, we realized we had no way to unlock the door. No one else in the house was awake…after a moment of deliberation, Chuck let go, dashed across the room to unlock the door and ran back to me. Up went his hand again.

The paramedics were a bit shocked by the scene they fell upon…by this time I was hanging halfway off the couch--upside down, jammies around my ankles and Chuck was holding the cord in. “Can you see the head?” they asked. “NO! The baby’s not being born- the cord is prolapsed.” It took several explanations to get them to understand the situation. All the while I was trying to stay relaxed…so I wouldn’t bring on more contractions. Once Chuck could hang up the phone, he called a neighbor to stay with the kids. There we were--headed away in an ambulance in the middle of the night. Chuck had no wallet, no shoes (a paramedic grabbed a pair for him and our neighbor his cell phone). Off we went.

Once in the ambulance, Chuck called my mom to come out to the house with the kids and get everyone she knew to pray--the baby’s very life was on the line. The ride seemed to me to take forever (but by checking his cell phone record, we saw it took only 19 minutes to get from our road into the OR). As soon as we arrived they wheeled us straight through the front doors of the childbirth center at the hospital and through the lobby. I can only imagine what the visitors thought as they saw me rushed in on a gurney, Chuck’s hand inside me, and the paramedics running full speed.

The OB was waiting for us and ushered us into a room with an ultrasound machine. After it warmed up he put it on my stomach and said, “There’s a heartbeat--we’re doing surgery. Code Purple!” They of course had the room all set up and ready to go for us. In we went (I heard them yell, “Entering the room at 2:45!”) They of course had no time for an epidural. It took about five minutes to prep me and put me out. As they were prepping me, they noticed my jammies around my ankles and someone removed them. Meanwhile, Chuck was still holding the cord in place.

The doctor elected to do a “bikini cut.” Despite coming c-section, Apollo still refused to come out! In fact, he came out breech and had his feet caught up under my ribs. Chuck was able to remove his hand just as they maneuvered Apollo out and had a great view of his gender. They warned Chuck ahead that he needed to stay back as they worked on Apollo. He wasn’t crying, was floppy and of course had lungs and a tummy full of fluid. He had to be transported to the nursery because his lungs were “wet.” Chuck spent the first hours with Apollo, holding his hand, rubbing him and talking to him.

Chuck likes to tease me about how after finding out the baby was alive, I came out of the anesthesia hollering for pain medication because my stomach hurt so bad. I’ll admit it--I was yelling and insisting they give me something for the pain, which they did. I was wheeled back to a room and Chuck stayed with Apollo.

There is no doubt that Apollo surviving the prolapsed cord at home is a miracle. Thank God I knew what a prolapsed cord was and thank God Chuck had the courage to do what he did. I only had one contraction after my water broke--another miracle. Contractions would have moved Apollo down and pushed on the cord. It took only nineteen minutes to get from our house the operating room. It took 14 minutes from entering the operating room until Apollo’s birth. The doctors and nurses all told Chuck he saved Apollo’s life by holding his cord in and allowing him to breathe. A maternity nurse on duty said she has never heard of a baby surviving a prolapsed cord that started at home.

I have no regrets. I don’t regret the c-section, not seeing him for his first few hours or anything else about the experience. I am only grateful to have my beautiful baby alive and healthy.

Our son is a miracle, and my husband a hero.

39 comments:

  1. Beautiful story! We also had a prolapsed cord, but just as I was ready to push. We were in the hospital, but my OB just told me to push immediately and get the baby out *NOW*. Thank God, she was out in just a few pushes and is a perfectly healthy and happy two year old. :)

    ReplyDelete
  2. Well, I'm bawling over here. Congratulations to the fast-acting and courageous parents and their strong baby.

    ReplyDelete
  3. Wow. It is good for me to hear stories like this. I would never! wish this on anyone, but to hear that c-section was used for true good and there are no regrests. Amazing Story!!

    ReplyDelete
  4. wonderful!!! I only wish they bothered to teach those types of things to ALL women b/c it just so happens to this happened to an educate women. Thanks God she knew exactly what to do! Hopefully this story will inspire others to know more about their birth.

    Congratulations and Happy Birthday Apollo!

    ReplyDelete
  5. Stories like that make me grateful for modern medicine. Paramedics, a clean operating room, only 33 minutes from prolapse to birth, and safe anesthesia. It's a shame they aren't used more judiciously, like in this case where they saved a life, instead of being over used to point where they end up costing lives.

    ReplyDelete
  6. amazing story.
    i give all of my doula clients a handout on cord prolapse with very simple instructions (and illustrations) on exactly what to do if they are at home.
    it is indeed a very scary situation. i do personally know of cord prolapses that happened at home that have made it in time to the hospital to have a healthy baby, like this story.
    i'm sure alot of it is pure luck but i do also think that having knowledge (like this couple did) could make a HUGE difference.
    on a side note, i attended a homebirth of a home who we realized at 7cm was having a surprise breech. she chose to transport to the hospital (non-emergency) and when she arrived and went into the OR they discovered a prolapsed cord but baby still had strong heart rate. they were all shocked! the prolapsed cord have to have happened en route to hospital and it was not present at home.

    ReplyDelete
    Replies
    1. Hi there, MereMortal,
      Would you be willing to send your handout via email. I am a midwife and would love to have it as resource. (I was just thinking what would be the best way to explain it to patients)
      Thank you kindly,
      Karen
      email: karendnd@gmail.com

      Delete
  7. I personally know two women who had a cord prolapse in the course of a planned home birth. In both cases the midwife was already present and took immediate steps to keep the presenting part off the cord while the ambulance was called, and both babies were fine. Interestingly, both mothers (like the one in this story) were grand multips (had previously given birth 6 or more times).

    ReplyDelete
  8. Wonderful story! Sounds like you handled the situation really well, I can't imagine how terrifying that would be

    ReplyDelete
  9. What an amazing story! I'm so glad that things worked out and that the mother encountered competent and understanding medical personnel during and after the birth.

    @MereMortal - Is there any way you could provide a link to your cord prolapse handout? I think I should add it to the "just in case" things I'm trying to make sure my husband knows about childbirth.

    ReplyDelete
  10. Amazing story. As someone in my 8th month planning my 2nd homebirth of my 3rd child, I am of course in tears. It's so good to see things working as they should and a mom and dad that knew what they were dealing with and could manage the situation. Just a remarkable story.

    ReplyDelete
  11. I loved reading this - again. It still gives me the chills and brings {joyful} tears to my eyes.

    Apollo is beautiful!

    ReplyDelete
  12. Wonderful story. Thank you for sharing.

    ReplyDelete
  13. Great story! Cord prolapse is often but not always a very dangerous situation for the baby. A prolapsed cord that isn't noticed until the cord is trapped between the fetal skull and the bony pelvis is a pretty bad situation. In this case, your baby had turned tranverse. That meant there was no fetal part in your pelvis and the baby was literally in no danger as long as it remained transverse! You might say your baby saved it's own life!. Smart kid.
    Congratulations.

    ReplyDelete
  14. I love reading stories where everything goes right in a very scary and potentially deadly situation. And the power of prayer cannot be underestimated. This exact scenario could've happened to a mom planning a hospital birth, too. It sounds like all your preparation and experiences with home births made you and your husband very knowledgeable and competent to handle this situation quite well. I'm so happy for the great outcome for your baby! Congratulations on your little miracle in so many ways!

    ReplyDelete
  15. Amazing story, and also a very important PSA! The OP (and her OB) points out rightly that this kind of situation can happen to any woman no matter what kind of birth she plans. Thus it makes sense that ALL women & their partners should know what to do in case of cord prolapse, even though it's very rare. I'm so glad to have this information. I would have had no idea what to do.

    ReplyDelete
  16. Apollo is so lucky his mom knew what to do, and I'm so lucky to be reading this information before I give birth. Thank you.

    ReplyDelete
  17. My goodness!! I can't even imagine!! ANd I feel extra educated too. I am glad to have read this story as we are expecting baby #3 (planned homebirth) and it is definitely good to know. Thank you so much for sharing!

    ReplyDelete
  18. Thank you so much for sharing your story. It's powerful & important.

    ReplyDelete
  19. Thank you for sharing this story. A wonderful example of how education and faith and intuition can work together to save lives.

    I am so glad this baby is doing well.

    ReplyDelete
  20. I am joyous that mom and babe are well. And midwives used to know how to deal w/ prolapse cords. Babes can be pushed up and cords can be re-positioned. Was successful every time in the practice I worked with. Seems the more mainstreamed midwives become, the fewer skills they have, and further we slip down the slope.

    ReplyDelete
    Replies
    1. Would you be willing to share how this maneuver is performed? I think it is vital information for mothers who either do not have midwives present or where the midwife is taking too long to arrive.

      Delete
  21. what an inspiring story of knowledge and teamwork saving a life!

    ReplyDelete
  22. this nearly made me cry (we lost our fourth pregnancy to pprom followed by cord prolapse- I vividly remember that panic!). She's extremely lucky. Also kinda funny, my son (my fifth pregnancy and only living baby)was frank breech-same as the mom in the story- which is why we didn't even attempt a "normal" delivery for fear it would happen to him too.

    ReplyDelete
  23. @ Christie B. and anyone else who wants to know specifically how to handle cord prolapse. Note: you must stay in knee-chest position until delivery time, even while in the ambulance! http://www.ehow.com/how_4476192_handle-cord-prolapse.html

    ReplyDelete
    Replies
    1. Yes! My paramedic husband saved our son's life just this past Friday in our planned homebirth by telling me to get in the knee-chest position. The 911 paramedics couldn't get the stretcher up our stairs so I had to run down the stairs between contractions and jump on the stretcher and resume the knee-chest position en route to the hospital. For those unfamiliar with the term, knee-chest means on hands and knees, butt in the air and head down. Let gravity help keep baby's head off of the cord.

      Delete
  24. i cried reading this, i too had a traumatic birth, and i know how incredibly scary the situation is when youre unsure if youre baby will survive the birth! this truly was an inspirational story for me to read. what a miracle indeed, God bless you!

    ReplyDelete
  25. As a former L&D nurse, that story gives me shivers! I don't even have words! That was definitely undeniably a miracle!

    ReplyDelete
  26. Amazing story. Actually, I'd say that your desire to have a home birth was part of what saved his life - most mothers are not as educated about complications. Your quick action, and your husband's amazing support, are clearly part of what saved your son's life. Thank you for telling the story and congratulations on your beautiful baby!!

    ReplyDelete
  27. This may be THE most amazing birth story I've ever read, and I love birth stories! As a woman considering home birth, I really needed to know this. I haven't started deeply researching my choices yet (and am not pregnant yet), but can not believe this never came up during three previous pregnancies!

    How amazing that the parents knew what to do and DID it.

    ReplyDelete
  28. i had a prolasped cord with my third pregnancy and unfortunalty my baby didnt survived.i didnt no anything about prolasped cord before it happened to me i cant help thinking that maybe if i did the out come might of been different. stories like these are great as they give parents the information they need to keep they baby alive i tell all of my friends about prolasped cords and what to do if it happens.

    ReplyDelete
  29. If there is a complete cord prolapse into the vagina or below,it would be good to wrap it in warm saline instead of pushing the completely prolapsed cord back into the uterus.When the presenting part is the head,then there would be compresion on the cord and reduced blood supply to the baby.What ever the presenting part,the knee elbow position would be ideal at home and a lateral position with a pillow below the hip on the ambulance would be best.The most important factor is DO NOT PANIC,I know it is easily said than done.

    ReplyDelete
  30. As mentioned before, the issue with a prolapsed cord is not that it is dangling out but that the pressure of presenting part on the cord stops the flow of blood through the cord to the baby. Pushing up on the presenting part, wrapping the cord in warm saline soaked cloth, keeping the pelvis elevated and immediate transport to labor and delivery is the best anyone can do.
    You and your husband did a terrific job - and thank heavens the baby was transverse!
    This is a lesson that all expectant parents should be taught - not frightened with, just taught.

    ReplyDelete
  31. We had a prolapsed cord at home as well. I was rushed to the hospital by ambulance on my knees with my rear end in the air. The town we live in only has one hospital, and in the middle of the night the anesthesiologist is on call. There was no time to wait for the anesthesiologist, and they could not get an IV in me. So, they flipped me over, and told me, “We have to go now or the baby will die.” What could I say? I knew I had no IV, no painkiller, no anything. I said, “Go.” Five men held me down while the doctor cut. She made three slices. I had my eyes closed tight, but I remember thinking as she was cutting that she wasn’t using a scalpel. It felt like a jagged rock on fire cutting through my stomach. It was the worst pain I've felt in my entire life. After feeling them remove the baby, I aspirated, and passed out. The baby, our now healthy almost two year old daughter, was born not breathing and without a heartbeat. She was successfully resuscitated. I was in taken to ICU after the delivery, and after 2 days in ICU, I was allowed to finally meet her. I'm glad to read your story. There are not a lot out there.

    ReplyDelete
    Replies
    1. Wow, how terrifying. I'm so glad you and your daughter lived through the experience.

      Delete
    2. Thanks. I'd do it again in a heartbeat for her. Children are amazing!

      Delete
  32. Amazing story! I am sitting here with my baby boy who is 9 days old and was born emergency c section after my water broke at home and I arrived at the doctor 7 cm dilated and in active labor with a transverse baby at 41 weeks. I didn't know the risk of cord prolapse until I was rushed to the OR to get my baby out before a possible cord prolapse. I was very sad about not having a natural birth but so incredibly thankful that my baby arrived safely.

    ReplyDelete
    Replies
    1. I am so glad your baby arrived safely! I hope you heal quickly and enjoy the newborn stage...it ends all too quickly.

      Delete