An important question

[mamasmurf]

I managed to get hold of my medical notes and amongst all of the problems and omissions I have found so far, a question occurs to me. It is irrelevant in a legal sense but I still need to ask.
Nowadays, in modern hospital based midwifery and obstetrics, how long is it acceptable for a baby`s heart rate to be decelerating before it is considered an emergency and emergency measures should be taken?

[Alan]

Hi Bellie’s Mummy
Your question is not that easy to answer. It would depend on when the decelerations occurred. Some decelerations during labour are common and usually caused by head compression and are not of any major concern. For me to be able to answer your question fully I would need to see the GTG trace or perhaps read the notes.

[mamasmurf]

I am a healthcare professional and it`s the first time I looked at the trace when you said you would need to read it. The thing is i was absolutely shocked and astounded when I read the notes to find that the decelerations had gone on for three hours before I saw an OB by which time it was a full on emergency. The staff didnt tell me this was occurring and I gathered from the panic and the monitors at a rather late stage this was the case. It seems ridiculous now to think I was laying in bed with nothing happening, a delayed labour for many hours prior to this after the epidural was commenced.This is only a tiny part of which was a much more horrific and in my opinion blundered delivery. Don`t get me wrong, I feel i have been too forgiving for too long, It has taken a long time for me to work out what actually happened.
After looking at the trace i am nonetheless horrified it`s pretty much dire.I feel that the fact that my baby,although it was clearly documented on my record card, was not in a position conducive to spontaneous delivery may have been somewhat overlooked. Thanks Alan for your reply.

[Alan]

If I can be of any help in any way feel free to contact me. I would be more than happy to talk with you about your experience.
alan@yourmidwife.com.au
0429 709 008

[Mildez]

Bellie`s mummy I am with Alan in needing to see the trace before answering the question. Is there any way you can speak to an Obstetrician or Midwife with your notes to get some answers? Some times in can be very difficult to determine if a baby is distressed based on decelerations on the trace some types of decels are worse then others and variability of the heart rate beat to beat and how quick the baby's heart rate returns to normal after the decel all need to be considered before deciding what action if any needs to be taken. If the Decels aren't a big concern then often you (as a labouring woman) are left to continue labouring in order to give you the best chance to deliver vaginally. Some people do deliver vaginally where as other's then need to have a c/s.

If your baby wasn't in a position to be able to be born vaginally (like it read on your record card) then I would wonder why this wasn't discussed with you during this time (when bub was having the decels) to determine if position of the baby was causing his/her distress. I am sorry I can't really answer your question without seeing all the notes, details etc.