Thanks so much for your encouragement before the BFP and the congratulations on the BFP. Your support means a lot to me and will continue to mean a lot to me. I can already tell I'm going to need it. How I'm feeling is the subject of a whole other post. Suffice it to say that there were tears when I told DH.
I have some catching up to do. I will start with trying to answer two questions posed by Artblog and Brenda on this post.
Artblog said: "I wonder if the fact that Moksha was overdue has anything to do with it? Did you ever ask about that."
and Brenda said: "Did your Dr's ever say it may have just been a kink in the cord? That is what they think happened to my angel. (well the start of things turning to shit). Not that the cord was around his neck or anything like that, but that it simply got a kink in it or he squashed it himself."
To answer Artblog's question, Moksha wasn't really considered overdue. I was only 4 days past my due date and since due dates aren't an exact science, I don't think he was overdue as such. Due dates should really be considered as due weeks.
However, it is true that the risk of stillbirth goes up from week 38 (even though the risk stays generally low, which doesn't help you one iota when it happens to you). I believe that is because the risk of a cord accident increases. I have a friend in the UK who was allowed to go 18 days past her due date before they induced her (at her request, it's not like they contacted her and said you need to be induced) and she gave birth, vaginally, to a 9lb13oz baby. Knowing what I know, I believe this was very lucky for her and her son and negligent of the National Health Service (NHS) in the UK.
Brenda, first of all I would like to say how very very sorry I am that Zak isn't with you. Your blog title sums it up completely. I wish he was here with you. I just read his birth story. What a fighter he was! and clearly he was a big little boy! I tried to leave a comment on your blog, but I don't have a Wordpress account which is why I'm leaving the message here.
To answer your question, there was an autopsy on the cord, and no kinks in the cord were reported. It was around his neck but very loosely like a scarf. The cord was on the short side; when I asked my OB about it she still didn't think that was the problem. He also died before I went into labour. My personal opinion on cord accidents, which is worth what is it worth, is that it seems that when there is clear evidence you can be sure, but when there is no clear evidence, it seems that the real cause could just as well be a cord accident as not.
What is the reason that they said this for Zak - was it the reason they thought as most likely for Zak's bleeding or did they find a kink in the cord? One thing I will say, Moksha had an autopsy on his body but not on his brain. So I don't know if they would have found evidence of bleeding in the brain.
Finally I don't speculate much any more about what exactly happened to Moksha as I don't know and no new evidence is going to come to light. In the course of the tests on me, it was discovered that I have heterozygous Factor V Leiden which makes it more likely for me to form blood clots. There is no conclusive evidence that a clot in the cord caused Moksha's death either although I tend to believe that more than any other theory. Now that they know I have FVL, it will be managed in the next, I mean in this pregnancy. I do believe as I said in the previous posts, that I could have* noticed the decreasing movement sooner and I could have prevented his death.
*see, Delphi, I'm trying to change my mindset, as I think you're on to something with the could have / should have. I'll start by just typing the words.
6 years ago
9 comments:
:)
I agree that I don't think you should be considered overdue... 4 days is within the range of having a cycle just a little longer than 28 days (which it sounds like you have been having lately).
But I can add to the 'overdue' bad stories... 17 days past my due date, and kate as 10 lbs 11 oz. I think the problem with the concept of over due is that doctors really can't tell when it is starting to be a problem. Sometimes it is clear, but not always.
Over here my OB gave me an induction date for the Saturday when my due date was on the Monday. The same day that Moksha was actually born. It is strange how the medical advice of "developed" countries can be so different. It was really really hot, and she said to me at my last appt that if I couldn't bear it anymore, I could be induced earlier, but since there was no effacement or dilation happening, she said that inducing might risk an emergency Caesarean. I said I was okay as long as I had an end date in sight, so she suggested the Saturday. Before terms like emergency Caesearean didn't really freak me out. Now I understand that the word emergency means emergency.
I’m glad you said you don't speculate much any more about what exactly happened. I’m hanging out for the day I can stop thinking about this, and that. What if I had done this, what if I had/hadn’t don't that. Drives me nuts.
We did have an autopsy done on Zak. And we did have his brain autopsied as well. But we didn't need that done to see the bleeding. That was VERY clear on the u/s.
I don't think they found any real evidence of 'a kink' in the cord. His oxygen had been compromised. His cord was around him (not his neck) and he was VERY breach so they said it was probably stuck in the position it was in as he was also stuck in the position he was in.
The Dr's did say they will never 100% know what caused his lack of oxygen but as everything that could be ruled out was ruled out I think they were left with this conclusion.
The bleeding they are not sure about. The autopsy gave them a time frame of 'around his birth or just after'. They said it was very unusual as at his age you don't see bleeding like this. They said it’s something you see in a baby that's around 23/24 weeks gestation. It was the bleeding that caused the seizures. (That's my understanding)
Here in Australia MOST Ob's wont let IVF babies go past 38 weeks. You get the odd Ob here and there who lets them go to their due date but NEVER over.
If I am lucky to ever get pg again I have been told I will be having steroids at 28 weeks and due to what’s happened and how big Zak was (we have big babies in my family. My Dad was 12 pound, brother 10 pound 7, and everyone else over 9 pound - they estimated Zak would have been 11 pound if he went to his due date) that I will be able to have a c section around 36-37 weeks.
I’m so sorry this has ended up so long.
Hugs
xxx
Good for you with the "could". It just really takes a long time.
The speculation about what happened is a horrible game to play, isn't it? I think that we process the information and either come to some conclusion on our own or accept that we will never know. Certainly, the medical professionals don't give us much information (except in clearly defined cases of abrubtions, etc.). When there is no clearly indicative evidence to tell us what went wrong, we are just left to our own devices, aren't we?
Like you say, it's odd how developed countries have such differing ideas on pregnancy and birth.
I had my antenatal care in Kent up to 33 weeks, then moved back to Oz to have my first baby at home. After the enormous amount of intervention I got here, I gained a new appreciation for the NHS system.
Of course my frame of reference has changed somewhat since then and somewhere in between the two seems the ideal. Also, having had 5 pregnancies, I have met enough doctors and nurses to know that your care comes down to luck of the draw sometimes.
I know I spent a lot of time agonizing over how I wanted my antenatal care to go with pregnancies 2 - 5. And when nature didn't step in a screw it all up for me, I got as close to what I wanted as possible. Good luck with negotiating your health system:) Is it a national service or private?
Yes, i have no real answers for Nicolas' death either -- my suspicion is cord compression but there is no evidence of anything, really. So at some point you have to stop speculating about it, since it doesn't do you any good -- i am glad you are at this point, or nearing it anyway. I still speculate sometimes but rarely.
I agree with the statistics etc. on going overdue or not. My dr. won't let me go to my due date, considering that Nicolas died (we induced Chloe at 39 wks, plan to induce (or section) the twins at 37)
I just checked in a few days late. May I offer a heartfelt congratulations on your BFP. I know you have a long emotional road ahead of you. I wish you the best.
Oh, I totally just posted a long comment and it disappeared. Dammit.
So yeah, clotting stuff...
Audrey didn't have evidence of a clot on her autopsy report, but I know several people who insisted that the slided and placenta be reviewed over and over only to have small clots found after the 2nd or 3rd review. I didn't know to insist on that for Audrey, so we don't know if there were clots for sure, but the other evidence points that way. I'm homozygous MTHFR and also Protien S deficient. I started to Lovenox a week or so ago. Will you go on it too?
Audrey also had a heart defect and there was some disagreement about that and the clotting issues. Ultimately I think it was a clot as do my RE and perinatologist. OB disagreed...
Anyway, speculation is tough. You want to know why because you feel like if you know you have a better chance of preventing it from happening again. It feels more powerful to know for sure, at least it does for me.
Try to take it easy. Welcome to the rollercoaster ride! Hop on, wanna sit next to me?
thevegasbaums@yahoo.com
I'm a faithful reader, but I've never commented before. Your story is so similar to mine, it's hard for me to read your raw grief, sometimes. I, too, had a text book pregnancy. Then my daughter just stopped moving two days before my scheduled c-section. (She was breech.) No cause was found on autopsy. She was perfect. But I was diagnosed with a blood clotting disorder after. My doctor surmised it could possibly be that the blood clotting caused poor blood flow to the placenta, which in turn caused some undetected cord compresssion. I am still convinced I could have saved her had I been paying enough attention. Anyway, I guess I'm writing to give you some encouragement. I had a live baby girl last year, I was on self-administered Lovenox shots. It was terrifying being pregnant again, at first I felt I was betraying my baby. Lots of mixed emotions. And despite the unbelievable anxiety (kick counts had me rushing to the hospital more than once) I had hope again ... and thankfully all turned out fine. I wish the same for you.
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