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Causation and Blame

Posted: Fri Jun 24, 2005 5:00 pm
by solson
I am not trying to inflame people, I am honestly curious about this and all of our arguments and anger over the injury.

Most would say that their OB's excessive traction caused this injury. They then have a c-section the next time around to prevent BPI from occuring again. But if the OB is truly at fault then why the c-sections? Why wouldnt we just find different OB's? It almost seems that by having the c-section we are attributing cause to our bodies rather than the doctors we blame.

In addition, all the prevention suggestions are purely biological.

So in reality are the OB's really to blame? And if so, why do we continue to c-section our subsequent births? If we all followed the biological suggestions of no epi, pitocin, stay off your back, etc. are we not confident that they would actually work?

I will add that I am having a c-section with this next baby. I have no idea if its really the right decision especially if its more doctor error as many argue.

Re: Causation and Blame

Posted: Fri Jun 24, 2005 5:15 pm
by Angela Butterfly
Sara,
If a baby is just too darn big.....The doctor needs to do a c-section.

Many doctor's do not recognize this. Also LARGE babies do a tremendous amount of damage to the mother. I know this first hand. Refering to my post on the c-section vs vaginal post.

My doctor delivered all 3 of my babies, and I believe with his MEDICAL training, he should have known better.....and I trusted him and his expertise. My 3rd baby was way too far overdue, considering all previous deliveries. The doctor should have known better.

I later learned the reason why he set up practice in another state, shortly after my child was born, was because so many others had sued him. I didn't sue....just focused on getting my little girl better....which was a hard road to climb in the early 1980's, with 3 young babes, and opening a business in 1986.

Re: Causation and Blame

Posted: Sat Jun 25, 2005 3:10 am
by UK Mum
Hi there

I can understand I think what you are trying to say but speaking from my own experiences I had a c/s for the following reasons

- I didn't want risk my baby going through the same experiences my girls endured. My 2nd daughter has life long learning disabilities aswell as initial physical injuries

- I had 2 prior Shoulder dystocias so statistically was at higher risk of a third. Shoulder dystocia itself even without injury to baby is a traumatic experience for many women and classed as a medical emergency. I was not prepared to put my midwife/consultant in the position of needing to use these manourveres to deliver my baby. Added to the fact my faith in medical professionals at that stage was an all time low.

- I had encountered 3 degree tears on 2 occasions this put me at risk of bowel incontience if I teared a 3rd time

- a scan had detected I was carrying a larger than average baby with a wide AC

- I had considered induction but as my 2nd baby was born at 39 weeks and weighed in at 9IB plus was aware for me that an induction at 38 weeks meant there was no guarenttee that this stage baby would be smaller.

Also I had researched induction at length and wasn't entirely happy about the issues with that either.

- I had been informed I had whats termed as a narrow pelvis (25% of us have them)and I now know whilst my pelvis was not to blame it did heighten my risk of having a longer labour

- I had found the births of my girls extremely traumatic and suffered PSTD as a result. I was unsure whether I was *emotionally* prepared to go ahead with a vaginal birth

- During consultation with medical staff they assessed my risk factors and stated given all the above it would be statistically safer in my particular circumstances to go ahead with an elected c/s.

- I did a fair amount of research into the pros and cons of c/s. Added input into what I wanted during the operation and aftercare via a birthplan so I felt involved,informed and in control.

I hope this helps a little. I should add here I do know other ladies who encountered shoulder dystocia and have gone on to have a vaginal birth, one lady I know of is planning a homebirth but in most cases these are ladies whose babies escaped injury first time around.

I had a vaginal birth 2nd time around but only because I wasn't informed of the risks nor the facts around my eldest daughters birth.

I live in the UK and you would be suprised how many women encounter shoulder dystocia during labour and are kept in the dark about what actually occured and are not told they had SD. I help out on a trauma board and often women come to us searching for answers why they found their birth so traumatic.Its often only when sharing their birth stories that those of us who are aware can actually give them some answers.

I hope this gives you some answers sorry it was so long

Jayne

Re: Causation and Blame

Posted: Sat Jun 25, 2005 1:37 pm
by admin
The key is that shoulder dystocia does tend to repeat itself, and not every OB will do the right maneuvers to free the baby uninjured. Babies also tend to get bigger with subsequent pregnancies. Not always, but often. It's just a risk to do another vaginal after a BPI and one I wasn't willing to take. There are moms on here with more than one BPI baby. I did not want that to happen.

Re: Causation and Blame

Posted: Sun Jun 26, 2005 11:33 am
by Tress
Sara,
Not all cases are the same, however, some c-sections are necessary and could have prevented injury.I agree with you and have definately vowed not to use the same OB.But I dont think a C-section is needed next time just because of the injury.
At 36 weeks my daughter was already at 7.9lbs and although my OB didn't seem to care, her PA did schedule a C-sec at 38 weeks due to the size.On my visit the day before scheduled event, the OB decided not to do it and said she thought I would dilate even though I had not to that point if she used pitocin.I had never used it and agreed with the dr.We all trust that they are the professionals and know what they are doing.Her own P.A. begged her not to do it this way.
My daughter was born 9lbs 4.6 oz, with a broken clavicle, Erb's Palsy, needed newborn recussitation and was cyatonic for hrs afterwards.I had a level 4 episiotomy and it wasn't until the dr used suction too many times that her clavicle snapped and she pried her out.I should have had a C-section, there were nurses on both sides of me pushing down on my abdomen while I was pushing to deliver and the dr was using suction and forceps.All this was covered up though even though I knew something was wrong.
Sorry to make this so long, but yes I think it can be prevented if the "professionals" take things into consideration more closely.I later found out this same obgyn has been reprimanded by the hospital for the same thing on numerous occasions.But unless they are sued, they dont have to put it on their public records.
Each parent has a right to their own personal options on how they birth their children.I hope things go well for you and your new little one,Tress

Re: Causation and Blame

Posted: Sun Jun 26, 2005 12:01 pm
by david'smom
Lets see 1st my son was a week early and was my 2sc child I had no epi i had no pitocin i was on my side the entire time i was in labor ,my stiches took longer than my sons delivery and were done in layers and if i ever have another child i would have a c section cause i could never do that again or have that much trust in an ob to decide for me ..sorry that i sound bitter but i am my son is 7 and it was the ob's fault

Re: Causation and Blame

Posted: Sun Jun 26, 2005 2:41 pm
by Chloesmom
I have thought about this at length. I will C section any future babies...for the reason that I will NEVER really know what happened and I absolutely refuse to take the chance of this happening again. In my own personal case I dont know if it was the dr. or me or a big baby or what...for sure. I believe it was the doctor and I believe I should have had a c section with Chloe BUT I dont know. And this has been hell. So I would rather go through the C section than have to deal with this again.

Re: Causation and Blame

Posted: Sun Jun 26, 2005 2:44 pm
by claudia
First off: If we are to just find new ob's, how do we know that this one hasn't injured many SD babies too? So, we almost all change ob's anyway.

One SD tends to lead to more SD--I had 2 head down SD babies and one full footling breech, who was also stuck. I dodged the bullet--only 1 injury, tho it was a doozy. The first child had a broken clavicle, but no one told me how that occurred, or why. So I didn't ask questions. "it will heal". Six years and three babies later...it was the same practice. They have my files, THEY SHOULD HAVE KNOWN BETTER.

I am done having kids, but if I were to get pregnant again, I would demand a c/s.

Also, our bodies do have a lot to do with what happens, but so does positioning and the use of pitocin. Things would have been so incredibly different if I had been able to get off my back (which I wanted so badly to do) and labor in a different position. Can I guarantee that there would not have been an injury, of course not. But at least we would have tried to use my body in a positive way instead of blaming it and me for not "doing it right".

My doctor did not do things properly that day. I would never take that chance again. Do c/s carry risks, yes, but I am pretty sure I would have SD again...

claudia

Re: Causation and Blame

Posted: Sun Jun 26, 2005 5:20 pm
by admin
I think it is human nature to blame the cause on the Doctor or Nurses, we all put our health and our babies health in someone we expect to fight for and take care of us . It is natural to be angry and to blame . Having a c - section is not manditory it is up to the individual to choose the Doctor and the method to deliver their next babies....it's one of those very difficult desicions that only the individual can make. I am the one who as to live with the decisions I make, as are the rest of us.

Good Luck,

Lenni

Re: Causation and Blame

Posted: Sun Jun 26, 2005 5:33 pm
by admin
Tress,

Even if the doctor is sued, I don't think it goes on their public record unless they LOSE the case. Settlements and won cases do not go on the public record most people search... that's why most doctors and hospitals prefer simply to settle; no-one wants to take the chance of losing and having it appear on their public record and ruining their reputation.