I am warning you now that this post has some sad in it. A lot, probably. Please don’t read if you can’t deal with sad today. I don’t want to make you sad. Only read until the picture of Vivian and then close your browser tab or window. If you do choose to read this post in its entirety, there’s a happy waiting for you at the end of the post to take away your sad.
Hope you had a wonderful Christmas, Yule, Beltane, Hanukkah, Kwanzaa or whatever you celebrated at the end of December, if you celebrate anything. And that this year brings you wonderful things. We had a low-key couple of weeks and I had 12! days off in a row to spend at home with Ben and Vivian. This was mostly wonderful, if you don’t count being sick at the start of it.
We were supposed to go over to Ben’s brother’s house for lunch on Christmas Day, but Ben was sick with a gastro bug that I had the week before. I thought it was food poisoning. Still could have been? We don’t know. Luckily Vivian didn’t get it. She hasn’t had anything other than that cold a few months back *knocks on wood*.
Our Christmas was very low-key as a result- we didn’t decorate this year. We haven’t in a few, actually. For me it is just too hot to feel like Christmas! But I’m sure next year we will be more festive, as Vivian will be older. We still got her a holiday outfit (it’s not red and green! Pink and chocolate-brown instead, the only thing in her size I could find at the Warehouse on Christmas Eve). Obligatory holiday greetings from the munchkin:
We got some bittersweet news on the day before Christmas Eve. A few months back, I filed an ACC claim for the events surrounding Vivian’s birth. Our GP was on annual leave at the time, so a random locum doctor filed the paperwork for me and he was very pessimistic about our chances of it being accepted. He really knew nothing about us or the situation, though. He explained that with every labor and delivery, there is an element of risk and ACC calculates that risk based on what happened and the factors involved. He said it could take a very, very long time.
Our case officer called and said Vivian’s claim was accepted. Ben had just woken up from a nap and so didn’t hear her very clearly and she had to repeat what she said a few times for it to sink in. He called me to tell me while I was at work and said that the case officer told him that this basically means that a lot of what Vivian needs in relation to her birth injury will be covered by ACC.
This is pretty big news, and while we won’t know what we will need until we need it, we know that there are means for us getting it easier than we would be able to otherwise. This is a big thing. I really am happy about this, even if it doesn’t sound like I am, but there’s a reason for me not sounding like I am.
On another level, this means that Vivian’s care didn’t go the way it should have gone when we were admitted to hospital on the night she was born. We are still waiting for Christchurch Women’s Hospital to complete their review of what happened that night, but I received a letter in the mail yesterday that included the independent ACC review of Vivian’s notes. It clearly states that the registrar on duty that night should have expedited her birth sooner than she did, and that this could have changed the outcome of events.
It is hard knowing that Vivian will not have an easy road ahead of her because of a mistake made before she was even born, and it’s a part of Vivian’s birth story that Ben and I have already asked the hospital representative to explain to us, as we felt this is where things went wrong.
I labored at home for about 10 hours on the day she was born- I was planning a home water birth and we had a birthing pool set up in our living room. Everything was going well until my water broke and I noticed some meconium in it when I went to the bathroom.
My midwife examined me to see how far along I was and found I was only 5cm dilated, so we decided to transfer to hospital and get things sorted there, as that was not a good sign.
After I was admitted, I was hooked up to a monitor that kept track of Vivian’s heartbeat, and one for my contractions. Vivian’s heart rate looked OK, but my midwife was concerned that it wasn’t as responsive as it should have been, as it wasn’t accelerating and decelerating as well as it was when I was at home. The registrar decided to take some blood samples from Vivian’s scalp to measure some levels in her blood that would let her know how Vivian was doing.
This is where things started to go wrong. Vivian had passed meconium (stool) into her amniotic fluid and a lot of it. They said it was the most meconium they had ever seen. This alone, I think, should have been a red flag that she was in a lot of distress, but her heart rate was still not abnormal enough to make anyone panic. It wasn’t until an hour and a half later that this was acted upon, and the ACC report states that if the decision had been made to perform an emergency c-section then, there is a “significant chance that [Vivian’s] prognosis could have been improved.”
After the registrar took the samples, her heart rate improved a bit, and then the samples came back in a very contradictory fashion. One was “wildly abnormal” and one was normal. The doctor thought the wildly abnormal one may have been taken from an area in Vivian’s scalp that had been pressing on my cervix for some time, and so the blood there may not have been moving around much. In hindsight we now know this was very wrong.
The registrar called her boss, the OBGYN on that night, and got his advice on we should do next. It was determined that we should wait an hour and see how far I would progress in that time. After the hour was up, they would retest Vivian’s blood and start me on an IV drop of pitocin to induce me if I hadn’t progressed.
Vivian’s blood was retested at around 10:35pm and the decision was made to go ahead and start me on pitocin to progress my labor, while we were waiting for the results. My midwife decided to wait until 11pm on the hour to start the pitocin drip, and then while we were waiting, Vivian’s heart rate plummeted. They moved me on my side to see if it would come back up and it didn’t. The alarm call bell button was pressed.
Everything after that is a blur. A half a dozen people came into the delivery room. I remember an anesthetist coming in and explaining that they were deciding whether to give me a spinal block or to knock me out under general anesthesia. Then while he was explaining both to me and getting consent as people rushed around, moving me out of the room and getting me into theater. They decided to go the GA route and my midwife came with me into the operating room. Ben couldn’t come in.
I remember the gas mask being put on and the OBGYN smiling at me as I was complaining to my midwife about the mask poking into my eyes. About 2 minutes later, at 10:58pm, Vivian was born via emergency c-section. She was floppy and unresponsive with apgars of 0 at one minute, 2 at 5 minutes and 4 at 10 minutes. She obviously was not breathing and had to be resuscitated and was rushed into NICU.
I woke up groggy and out of it, to a very solemn Ben and midwife. I was still druggy and it would have been horrible for Ben to see me not even register the fact that Vivian wasn’t with him. It wasn’t until later that I found out that Ben had been told several different things ranging from “she’s going to be OK” and invited to go to NICU with Vivian and the neonatal specialists to “she’s not going to make it” and kicked as soon as he walked into NICU with our back up midwife.
It is hard feeling like I should have known better and questioned the doctor’s decision to wait another hour before more samples were taken when the initial two came back “wildly abnormal” and “normal”. Had I not been in labor, I probably would have pushed for a more definitive answer instead of two samples that contradicted each other.
I feel like the people who were supposed to protect Vivian failed her. I feel like we failed her.
It is hard to think that the doctor didn’t take the fact that I was passing “copious amounts” of thick meconium and combine that with the “wildly abnormal” results and decide to get me into theater right then.
But that cannot be changed for Vivian. I am still processing this. I think the ACC review and our claim being accepted will help me with this but it really has brought it all rushing back to the front of my mind again.
Hopefully it can be different for another baby in the future.
So yes, this is really good news for us, but also a bit sad, as we have relived exactly what happened in very strong detail since we got that letter and reviewed what happened again. And questioned everything again. And wondered what would have happened if different decisions had been made.
For now we’re still taking things one day at a time and enjoying every little thing as it comes. And celebrating every step of progress Vivian is making.
I am sorry for turning this into a sad post but it’s a bit hard to explain without going into detail.
Here’s the happy I promised you at the beginning of the post, and I hope it takes your sad away :) I sing to Vivian that I’ll take hers away whenever she cries in the middle of the night and it seems to help. Don’t worry, the video does not contain any of my horrible off-key singing.