Posted by My OB said WHAT?!?.
Aug
2
Posted by My OB said WHAT?!?.
“Your Placenta Looks Weird…”
“Your placenta looks weird….I think you may have some collapsed fibroids on it.” -OB who had mistakenly pulled out the mother’s uterus with assertive cord traction resulting in complete uterine prolapse and hemorrhage.
There are 46 comments to this post.
Sarah Dorrance-Minch had this to say,
Aug 2, 2010 @ 5:14 pm (Quote)
And he rolls a “1″ on his ten sided die for perception…
Or maybe he just got his medical training from Mount Merry College, where the anatomy textbook is a colouring book, and grades are earned based on how neatly the students manage to colour in the lines of the drawings with their crayons.
What an idiot.
Oh, yeah. Cord traction usually isn’t a good idea even when it’s gentle – it’s risky. YANKING the cord is right out. It’s just not good. M’kaaaay?
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O_O I am completely shocked and horrified. The OB at my daughter’s birth managed my 3rd stage without my consent, and it angered me so much when I learned there were risks like this. I think this is one of those MOBSW posts that I won’t be able to stop thinking about. OP, please come tell us you’re alive and that sOB isn’t practicing anymore!
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The Deranged Housewife had this to say,
Aug 2, 2010 @ 6:16 pm (Quote)
Ho-leeee crap. WTH?! 
I’m sure that when the patient sues, the doctor will just say something lame like, “See, this is why we brand the uteruses of women now with the initials of our alma mater. So we know which organ is which.”
Dear God, I hope this woman – and her baby – are okay!
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Jane Reply:
August 2nd, 2010 at 6:48 pm (Quote)
In all seriousness, the doctor will get on the witness stand and say, “Standard of care is to actively manage the third stage of labor in order to prevent uterine inversion, but due to a hypertonic uterus, her placental blah blah blah blah lots of medical terms blah blah blah this woman’s body was flawed, it would ahve been much worse, it would have inverted anyhow, etc.”
And the doctor will convince a jury that the fact that her placenta didn’t “let go” when he yanked on the cord means that it would NEVER have come out anyhow and the mother would ahve bled to death had he not heroically inverted her uterus so he could manually compress it outside her body.
And thereafter, he’ll just keep doing it because he’s convinced it was a fluke. It happened DESPITE his excellent third-stage management, not because of it.
*sigh* Maybe I’m too cynical, but that’s the mindset, isn’t it? And what jury of non-medical types really wants to say a doctor who’s paid to manage labor and delivery doesn’t know how to manage labor and delivery?
Lawyer: How many times have you managed the third stage this way?
OB: Every time.
Lawyer: And this is the first time a uterus became inverted while you were managing the third stage of labor?
OB: Yes.
Yeah, I’m very cynical about malpractice suits. Sorry. I still hope the mom did it, though.
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CCindy Reply:
August 3rd, 2010 at 5:59 am (Quote)
But she should have a lawyer who can show beyond a shadow of a doubt that this common procedure is wrong! And the fact that not only did her invert her utuerus, but then he didn’t recognize it because his brain was in “I’m perfect and can do no wrong land” is just proof positive that he shouldn’t be practising.
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Jane Reply:
August 3rd, 2010 at 7:12 am (Quote)
I assume the doctor realized in the next second or two, and this was just the first thing that came out of the doctor’s mouth on seeing something unexpected.
The problem is that even if the mom has a great attorney, the jury would have to believe beyond reasonable doubt that the doctor had done something truly ignorant, and the doctor would say “It’s the standard of care–everyone does it” and suddenly there would be reasonable doubt. It’s sad.
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CCindy Reply:
August 3rd, 2010 at 10:56 am (Quote)
I still think the lawyer should be able to prove that is WAS the standard of care in 1962, but now everybody but this idiot knows better. Every OB should know that this is WRONG! They should all know to leave the cord the hell alone and not to cut an episiotomy unless they are going in with forceps or vacuum extractor. Natural child birth was all the rage 30 years ago. Very few of them were trained more than 30 yeas ago. Please, I can forgive them for watching the fetal monitor and being pitocin and epidural dependant. Those things are relatively new. But don’t pull the cord. That is old news. They should have all gotten the memo!
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Knitted in the Womb Reply:
August 3rd, 2010 at 12:07 pm (Quote)
Saddly, it still IS the standard of care. I actually see much more aggressive cord pulling in residents than in “seasoned” OB’s. What I see resulting from the aggressive cord pulling is “clots in the lower uterine segment” that the OB resident needs to manually remove–a VERY painful process.
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CCindy Reply:
August 5th, 2010 at 8:12 am (Quote)
Well if there are residents at your hospital then your hospital is training them to do this and YOU need to say something to the resident director. They don’t learn this shit in med school. Med school only gets them ready to take the basic MD exam. Pretty much ALL obsetric training is on the job during residency. Step up and DO something about it!
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Knitted in the Womb Reply:
August 5th, 2010 at 9:21 am (Quote)
If I step up and say something I risk getting myself, or possibly even all doulas banned from the hospital. Think I’m nuts? I had a client who resisted what her care provider wanted to do. I kept getting evil glares from the OB–even though I was NOT telling my client what to do at all. About a month later I learned that the practice that OB is no longer “allows” doulas to assist with their clients.
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CCindy Reply:
August 5th, 2010 at 1:41 pm (Quote)
Sorry, I didn’t realize you were a doula. I believe a nurse who was on staff and knew the Resident Director could effectively do something. But you probably cannot unless you go through someone else. Politics is an ugly thing.
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Jen Reply:
September 7th, 2010 at 9:21 pm (Quote)
A nurse runs just as much risk, if not more, if she or he says something. Complaining about someone with M.D. after their name is followed by a swift kick out the door in most places, and it makes it very hard to find work elsewhere. At least in most cases there is always another family wanting to hire the doula.
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Knitted in the Womb Reply:
August 5th, 2010 at 2:33 pm (Quote)
I would also point out that “active management” of third stage–which includes cord traction–IS considered to be “standard of care.” As late as a Cochrane review released last year (http://www.ncbi.nlm.nih.gov/pubmed/19588315), it was considered by the medical community to be the “best” treatment.
Now…having had a client have her cord broken off of her placenta by “gentle” cord traction, resulting in a manual removal of the placenta and a lot of clotting issues, coupled with the clotting issues I mentioned before, has made me question this. I’ve also been in the camp that wonders if the data that points to active management isn’t tainted by high percentages of women with induced/augmented labors and women who do not breastfeed immediately after the birth. I’ve also read research that indicates that Pitocin given after the birth–a part of “active management”–may interfere with breastfeeding. I have sought to educate my clients on all of this…and ultimately it is up to them if they will discuss with their care providers how 3rd stage will be handled.
Just last month a newer Cochrane review was released that admitted that active management might not be the best way to handle women who aren’t at risk for hemorrhage. http://www.ncbi.nlm.nih.gov/pubmed/20614458 But like the retraction many years ago of the ACOG policy recommending immediate cord clamping, or the repeated studies that suggest that deep suctioning for babies with light to moderate meconium staining is not beneficial…I have my doubts that this statement to decrease interventions will gain widespread acceptance.
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Katie Reply:
August 8th, 2010 at 9:32 am (Quote)
Knitted- as a midwifery student I was observing a resident manage the third stage and his traction was so aggressive I unthinkingly/instinctively pushed his hands off the patient while saying “STOP!” I am trained to do active management but there is a difference between truly gentle cord traction after seeing signs of separation and while guarding the uterus well, and yanking on the cord, and residents are yanking. Asked someone else if this was common and if so, were they seeing lots of retained placental fragments, and she said, yes, they just go in and do manual removals all the time.
I somehow escaped this run-in with no negative fallout. I felt more like a body guard than a midwife. Crazy.
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Knitted in the Womb Reply:
August 10th, 2010 at 10:30 am (Quote)
Really, of the OB’s that I see doing cord traction, I really don’t see any that wait for “signs of separation” that I can observe–those being movement of the umbillical cord by several inches or a gush of blood. I see them them just pulling on it from a moment or two after birth, and keeping constant traction on it. Some put gentle traction on, while others pull more “seriously.” It is the “serious” pullers that result in the “clots” (so they call them–I’d bet they are retained fragments).
It is partly because of this that I’ve become more aggressive with suggesting that clients try to get delayed cord clamping–the OB’s usually will not pull on the cord until after it is clamped. But unfortunately, many OB’s give lip service to allowing delayed clamping, but seem to come up with any reason they can to clamp.
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Alyson Miers had this to say,
Aug 2, 2010 @ 7:19 pm (Quote)
Wait, aren’t doctors supposed to make birthing safer? WHY are we supposed to birth in hospitals, again?
Jeeves, I’d rather have one of the insufferable teenagers I used to teach English attend my birth than a doctor like that one. I think they’d have a better grasp of the concept of “first do no harm.”
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Holy shhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh****
Are you kidding me?!
This isn’t ‘my OB said what?’ This is “MY OB DID WHAT?!!?!??!!!??”
My God, I hope the OP and baby is okay and that the OB is not in practice anymore.
No post has drawn out as much emotion in me as this one.
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Eeeeeeeeeeeeekkkkkkkk!
This one just makes my skin crawl.
Words are failing me here. I want to go on a rant about it but what I really want is the OP to come and let me know that she got away from this sOB with her life and organs intact.
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What I want to know is how did he not notice that this was a UTERUS with a PLACENTA attached to it? A uterus doesn’t just come out and detatch itself, this was inverted and still attached to the mother via her vagina… how do you miss that? How do you not realize that you’re not holding an organ that is separated from the mother?
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Jane Reply:
August 3rd, 2010 at 5:01 am (Quote)
It’s kind of dark out there under the twinkle lights.
This is a case of a doctor seeing what s/he expects to see. The doctor knew there should be a placenta there, and didn’t expect to see a uterus attached to it, and therefore the visual information wouldn’t have processed at first. S/He would be trying to make the visual information fit the preconceived notion, and that’s why the speculation about the “collapsed fibroids,” because nothing else made sense with what the doctor already believed.
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Mama Mirage had this to say,
Aug 3, 2010 @ 7:37 am (Quote)
Oh my word! This poor mama!
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This was mine. It was BRIGHT in there, early morning, I was a homebirth transfer, and I honestly feel I was being “punished” for daring to homebirth. That’s why she continued to pull on the cord while I was SCREAMING that it was still attached. I still shudder to think about it, more than 2 years later.
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Heather P Reply:
August 3rd, 2010 at 9:53 am (Quote)
I’m so sorry you were treated this way Mary. It sounds scary just hearing about it, being there must have been beyond scary.
And people wonder why women want to give birth at home.
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Kit Reply:
August 3rd, 2010 at 10:48 am (Quote)
How horrible.
I hope you’re okay? Please be okay.
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I wish I could have knocked her out. I was still traumatized from being knocked out, wheeled into the OR to have my uterus replaced, and missing out on the first 3 hours of my baby’s life. I was fairly numb the entire three days in the hospital and didn’t do a whole lot more than nod and cry.
I can’t really do anything. I got a copy of my medical records, and they are full of lies. I may know that they are lies, but it is the *official* record of what happened, kwim?
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Jena Reply:
August 3rd, 2010 at 2:48 pm (Quote)
I’m so sorry, Mary. I wish there was a good method of recourse for you.
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CCindy Reply:
August 4th, 2010 at 8:22 am (Quote)
You can still report the Dr. to the medical board. They may not do anything this time. But after a few complaint pile up it will eventually mean something. Be sure to report that there are lies in your records. That may be more damning than the actual inversion considering it is supposedly still standard of care to tug on the cord even though we all know that it shouldn’t be.
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Jane Reply:
August 5th, 2010 at 10:02 am (Quote)
Actually, I believe you can report them to the state licensing board for falsifying your medical records. Once you get that process going, you can also start a malpractice suit because if they can’t even write the records correctly, what are the odds they provided actual medical care?
I’m so sorry you went through that. **hugs**
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i had retained placenta and cervix had closed but midwife made me keep pushing to get placenta out after bout 20 mins doctor came in said why they were making me push when cervix had closed, was rushed to theatre for mannuel removal lost 2 litres of blood had to get blood transfusion baby was later admitted back into hospital with bad cough and not feeding he ended up having asymmetercial face and receding jaw then i was took in cause i was bleeding heavy for 6 wks ended up they left a bit of placenta in… do u think i could start a law suit against the hospital
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Add Your Comment.
Oh. My. Gossssssssssshhhhhhhhhhhhh! I cannot even BELIEVE some of the stuff that I read on this site, but they usually don’t cause such serious and unfixable medical issues! I hope the OP sued and this Dr lost his/her license!
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