Oct 172012
 

“Your baby does have a small cut on his face, but it was very important that we got him out quickly.” – OB to mother on during a cesarean that was not in any way urgent.

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 October 17, 2012  Cesarean, newborn, OB  Add comments

  43 Responses to ““Your Baby Does Have A Small Cut On His Face…””

  1. “I feel guilt that I injured your baby due to my own carelessness, therefore I am going to lie and tell you that it was an emergency situation in order to make myself feel better.”

  2. Precisely the reason why i will not submit to another c-section unless the life of me and/or my baby is in imminent danger. AND they have to PROVE it to me!

  3. A “small” cut with an extremely sharp scalpel? unlikely. Its probably way worse then this doc is putting on. Plus they should have been more careful!

    • My daughter had a small cut after the non-urgent unplanned c-section. It was less than a centimeter long and less than a centimeter from her eye. I have asked a number of times for an explanation but I haven’t had a response at all and it was not recorded in the hospital records :/

    • I sliced into my own finger with a scalpel just a few days ago. It was a small cut and it you can’t even tell now. So yeah you can make a small cut even with a sharp sharp blade.

  4. I’ve heard an astonishingly high percentage of babies are lacerated during c-sections, but most OBs don’t report it because they don’t go looking for it.

    What the doctor said sounds nice and smooth, though. As if the doctor says it often. Especially because it doesn’t apply to this mother’s case, it sounds like a canned explanation, which makes me wonder how often this doctor is lacerating babies.

    • An ex-friend of mine had this happen to her first and it scared and scarred HER so badly that it took her 10 years to even attempt to get pregnant again.

      I feel bad mostly because I kept trying to warn her of what they would say and or do to get her into that OR and sure enough and very unfortunately everything I predicted came true. :( What I never saw coming was the slicing of the baby’s cheek. :’(

    • My brother has a scar from being cut during a cesarean. And I think it was simply failure to progress/descend. Not emergency. Its not hugely noticeable but he can point it out. He’s 40…

    • Years ago on the ICAN list there was a woman whose baby had a massive slice down most of his back. First time I’d ever heard of babies being cut during cesareans. I was horrified. I think it’s largely due to carelessness, as I’m sure they usually use fingers to open the uterus.

  5. I am a CNM and assist with cesarean sections. One thing I can tell you is that it is important for the surgery to be done quickly and efficiently to reduce complications, mainly for the mother. Remember, the mother is bleeding the entire time the surgery is being performed and so it is always important to get babies out quickly. You have no idea if the placenta was anterior and low – maybe the incision into the uterus went through the placenta and the urgency of delivering the baby was very real. Also, no matter how careful a surgeon is, there is an inherent risk to opening the uterus with a scalpel. There are many times when the uterus is very thin and one incision to start the process of entering the uterus results in going all the way through the muscle layers. Usually, surgeons carefully make small incisions to get to the final layer of muscle and then use their finger to enter the uterus, but when the uterus is very thin this may not happen. These cuts are usually very small, very clean – because they are made with a scalpel – and heal perfectly well.

    • Everything you said in this paragraph sounds accurate. I’ve had 3 c-sections (none elective) And I can tell you that I did bleed all over the place! It is important to get the job done as quickly as possible. This is major surgery. It would be nice if the doctor who is against VBAC or is induction happy would remember things like this. I disagree with you later comment about it being rare. One of my 3 had a nick on her thumb that was either made by a scapel or she chewed herself before birth (with no teeth) it was already scabbed over 12 hours after birth. This happens lots of times. Usually they are nothing more than a paper cut and leave no permanent damage, but they do happen. This mother deserved a more thoughtful explaination and an “I’m sorry.” Take some responsiblity for crying out loud! This is one of those informed consent issues that drives us up the wall. We can handle the truth, and I appreciate you reminding us that once the surgery has begun it is best to get done asap for the mother’s sake.

    • And that is a big part of what is wrong with the medical field– it doesn’t matter that you are physically hurting a person, it doesn’t matter that they very likely will have a permanent scar -no matter how faint— they will heal and get over it. I am sorry but no person should ever get cut my a scaple without pain management. Yes, it does happen– and some times there is no way around it but trying to minimize it by saying they ‘heal perfectly well’ is a slap in the face to all of those who have had it happen to them.

      Maybe I am a little bias because that little cut that healed beautifully took a friend’s baby’s pinky finger. Since it was so small it wasn’t able to be reattached.

    • That sounds reasonable to me. I don’t see a reason the dr could not just apologize though. The baby still had its face cut.

    • What you’ve said here is medically accurate. Let’s face it, doctors are human and humans make mistakes. I don’t know how I would feel if my baby was cut during delivery. What I do know is that this doctor should have apologized to the parents profusely. Instead, he just lied about it and shrugged it off.

      I’ve often wondered how many less lawsuits people in the medical field would have if they only offered sincere apologies. More often than not, people just want their concerns and anger acknowledged. I think a lot of doctors don’t do that because of that whole “God complex” thing.

  6. No, these cuts do not happen that often. And yes, doctors do look for things like this and try to prevent them. And pediatricians look for things like this. I have seen 2 cases where the babies have had a small cut from cesarean section in over 100 first assists.

    • That is still nearly 2%. That statistic is higher than the risk of uterine rupture with a VBAC or VBA2C if I remember correctly. Someone correct me if I am wrong, please. Sorry, I’m gonna be a slacker and not go look it up today.

      • Yeah, the statistic is higher, but the two events are in no way equivalent in terms of outcome! Small cut on the face is just a smidge less harm than uterine rupture, don’t you think?

        • But many doctors claim the risk of uterine rupture in a VBAC is so high that they won’t even permit it — and yet it’s minuscule compared to the percentage chance that a baby will be cut during a surgical delivery, something which “almost never happens.”

          Either two percent is a high risk or a small risk. Either .2% is a high risk or small risk. But .2% can’t be a very high risk while 2% is such a low risk that it almost never happens. :-)

          • I guess I did not make my point clearly enough. Risk assessment is not just a matter of .2 vs 2%. You also have to account for the actual outcome. What is the mortality rate of a baby who has a small facial lac vs a baby born after a uterine rupture? Are they equivalent? No, they are not. One is potentially hypoxic brain injury, death, maternal hemorrhage and hysterectomy. The other is a small, superficial laceration. It matters more to most people if a baby ends up a vegetable rather than gets a cut on his face.

          • I realize I was comparing apples to oranges, and I hear your point. It is valid. And in an ideal world it would be the parents making a fully informed decision, based on good information provided by their physician.

            Since my comparison didn’t sit well with you let me propose another. How about the comparable risk of rupture during VBAC that is induced vs. not induced? Or even the use of cytotec in non-scarred uterus. I would suppose then you would say that if the risk variation is 2% then these interventions should be used with an abundance of caution, right? I’m sorry if I’m not making much sense here, kinda worn out this week. Really, Jane nailed it on the head that either 2% is a high risk or it isn’t. If it is it is not up to the doc to minimize it or not even mention it in pre-op.

    • I’m on pubmed right now.

      http://www.ncbi.nlm.nih.gov/pubmed/9277641 –> 2% of babies had lacerations, but it was up at 6% when the baby was nonvertex.

      http://www.ncbi.nlm.nih.gov/pubmed/15547541 –> 3%

      http://www.ncbi.nlm.nih.gov/pubmed/19198643 –> cites it at 3% but was not itself a study of laceration prevalence

      When you consider that more than 30% of pregnancies in the US are now being delivered by cesarean section, and 3% of those babies are going to be cut during delivery, you can no longer say these cuts “do not happen that often.”

      I was able to find one study claiming lacerations were under-reported, but not the text so I didn’t link it.

    • My comment just got lost in moderationn purgatory because of the links, but if you go on pubmed, I found three studies that cited 2 or 3 percent laceration rate for babies born by c-sections. When you consider that 30% of deliveries are by c-section in the US (or higher) that’s not an injury that “does not happen that often.”

  7. My daughter is in 2nd grade and has been friends w/a little boy since Kindergarten. I’ve made friends w/his mom and heard his birth story. She asks baby’s Dad where baby is & he says oh he’s getting stitched up too…!!! They cut him! Yeesh.

  8. i was cut very near my eye when i was born via (nonemergent, failure to progress) c/s – 33 years later still can see the scar which is now over by my ear.

  9. I am a csection mama, and if my booger had any cuts, I didnt notice it. I would like to plan on a vbac for my next birth, but obviously the risk for a repeat is there.

    So not to in any way diminish the cuts that heal, Im wondering how many of those injuries are “serious”, as in, cutting the eye or cutting a pinky off, etc etc.

    • According to the second study I linked above,

      “Of these accidental lacerations, 94 were mild; 2 were moderate, and 1 was severe.”

      If that study is correct, then less than three percent of three percent of babies sustain moderate or severe lacerations.

  10. I would love the pink link.
    How small is “small?”

  11. Having done a c-section before (on a dog) I can personally attest to how thin the abdominal wall is stretched (thus putting other abdominal contents at risk of laceration) and how thin the uterine wall is stretched. Cutting only the abdominal wall or only the uterine wall is possible but still a tricky thing. Mistakes happen. Life happens and sometimes it isn’t a mistake. Cuts heal. And if they’re small they don’t need pain medication. Just good hygiene like any other cut. Just because it happens with a scalpel blade doesn’t make it some super special horrible cut. It’s a cut.

    And yes, 100% absolutely once a c-section starts it is crucial that baby get out as quickly as possible – emergent or not due to decreased bloodflow to the uterus and any potential effects on the baby of drugs that you’ve given mom.

  12. My son got a laceration on his forehead, but I didn’t have a c-section. He got it from AROM (which I didn’t know enough to decline then)! The doctor said it wasn’t possible, but considering there are no other sharp objects in my vajayjay, it had to have been from that. An he didn’t come out for about another 6 hours, so he was in there with ruptured membranes and an open cut for that long.

  13. Not a c/s, but my daughter has a permanent little cluster of broken veins on her cheek that I am certain resulted from her (also non-emergent) forceps delivery. The real tragedy is that while the medical model is “do whatever you must to mother to get baby out quickly and efficently,” the way these interventions also hurt babies is underreported or dismissed. Who exactly is being helped?

    • Me too. I have a scar on my face because of forceps/episiotomy. I also have nerve damage to my face. I can’t smile quite right. I am sure it was not reported.
      Now, my Mom did have a very long labor with me but I can’t help but wonder if things would have been different if she hadn’t been induced because she lost her mucous plug.

    • My sister was delivered with the aid of forceps and one side of her face was partially paralyzed because of it.

  14. One of my daughters had quite a few cuts on top of her head after the student ob broke my water. They blamed the cuts on my mom’s nails!!

    • Oy. Yeah, that makes total sense. Because your mom has less sensation in her fingertips, that she can see on the baby’s head, than a student OB has with a long plastic crochet hook being used in the dark inside a woman’s body. **eyeroll**

  15. I am amazed I don’t cut the baby every other c/s. I have done it 3 times in over 2000 c/s and each time have been devasted but they do always heal without a scar. I always sincerley apologize no excuses but if all you second Tuesdays want to show how to do it better please call

  16. Lacerations should be accepted at all during a c-section.

    There is a device specifically created to avoid this.

    http://www.csafe.us

  17. should not be accepted!!

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